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Andres R, Hernandez A, Fernandez A, Comin A, Nuño A, Aguirre E, Arevalo E, Millastre E, Alvarez I, Verdun J, Lao J, Murillo L, Galan N, Bueso P, Puertolas T, Hagen C, Inglada-Perez L, Anton A. P158 PONDx Aragon: First spanish prospective study evaluating the impact of the 21-gene test on real praxis for N1 patients after RxPONDER results. Breast 2023. [DOI: 10.1016/s0960-9776(23)00275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
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Guerrero-Zotano Á, Belli S, Zielinski C, Gil-Gil M, Fernandez-Serra A, Ruiz-Borrego M, Ciruelos Gil EM, Pascual J, Muñoz-Mateu M, Bermejo B, Margeli Vila M, Antón A, Murillo L, Nisenbaum B, Liu Y, Herranz J, Fernandez Garcia D, Caballero R, López-Guerrero JA, Bianco R, Formisano L, Turner N, Martín M. CCNE1 and PLK1 mediates resistance to palbociclib in HR+/HER2- metastatic breast cancer. Clin Cancer Res 2023; 29:1557-1568. [PMID: 36749874 PMCID: PMC10102847 DOI: 10.1158/1078-0432.ccr-22-2206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/10/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE In HR+/HER2- metastatic breast cancer (MBC) is imperative to identify patients who respond poorly to CDK4/6i and to discover therapeutic targets to reverse this resistance. Non-luminal breast cancer subtype and high levels of CCNE1 are candidate biomarkers in this setting but further validation is needed. EXPERIMENTAL DESIGN We performed mRNA gene expression profiling and correlation with progression-free-survival (PFS) on 455 tumor samples included in the phase III PEARL study, that assigned HR+/HER2- MBC patients to receive palbociclib+ET vs capecitabine. ER+/HER2- breast cancer cell lines were used to generate and characterize resistance to palbociclib+ET. RESULTS Non-luminal subtype was more prevalent in metastatic (14%) than in primary tumor samples (4%). Patients with non-luminal tumors had median PFS of 2.4months (m) with palbociclib+ET and 9.3m with capecitabine; HR:4.16, adjusted p-value<0.0001. Tumors with high CCNE1 expression (above median) had also worse median PFS with palbociclib+ET (6.2m) than with capecitabine (9.3m); HR:1.55, adjusted p-value=0.0036. In patients refractory to palbociclib+ET (PFS in the lower quartile) we found higher levels of Polo Like Kinase 1 (PLK1). In an independent data set (PALOMA3), tumors with high PLK1 show worse median PFS than those with low PLK1 expression under palbociclib+ET treatment. In ER+/HER2- cell line models we show that PLK1 inhibition reverses resistance to palbociclib+ET. CONCLUSIONS We confirm the association of non-luminal subtype and CCNE1 with resistance to CDK4/6i+ET in HR+ MBC. High levels of PLK1 mRNA identify patients with poor response to palbociclib, suggesting PLK1 could also play a role in the setting of resistance to CDK4/6i.
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Affiliation(s)
| | | | | | - Miguel Gil-Gil
- INSTITUT CATALÀ D'ONCOLOGIA Hospitalet de Llobregat, Hospitalet de Llobregat, Spain
| | | | | | | | - Javier Pascual
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Malaga, Spain, Malaga, Spain
| | - Montserrat Muñoz-Mateu
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | | | - Mireia Margeli Vila
- Catalan Institute of Oncology(ICO)-Badalona; B-ARGO (Badalona Applied Research group in Oncology) Research Group, Badalona, Spain
| | - Antonio Antón
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Yuan Liu
- Pfizer Oncology, La Jolla, CA, United States
| | | | | | | | | | | | | | - Nicholas Turner
- Breast Unit, The Royal Marsden NHS Foundation Trust, and Breast Cancer Now Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Miguel Martín
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón Instituto de Investigacion Sanitaria Gregorio Marañon, CIBERONC, Universidad Complutense, Madrid,, Madrid, Spain
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Martín M, Zielinski C, Ruiz-Borrego M, Carrasco E, Ciruelos EM, Muñoz M, Bermejo B, Margelí M, Csöszi T, Antón A, Turner N, Casas MI, Morales S, Alba E, Calvo L, de la Haba-Rodríguez J, Ramos M, Murillo L, Santaballa A, Alonso-Romero JL, Sánchez-Rovira P, Corsaro M, Huang X, Thallinger C, Kahan Z, Gil-Gil M. Overall survival with palbociclib plus endocrine therapy versus capecitabine in postmenopausal patients with hormone receptor-positive, HER2-negative metastatic breast cancer in the PEARL study. Eur J Cancer 2022; 168:12-24. [DOI: 10.1016/j.ejca.2022.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 11/03/2022]
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Kahan Z, Gil-Gil M, Ruiz-Borrego M, Carrasco E, Ciruelos E, Muñoz M, Bermejo B, Margeli M, Antón A, Casas M, Csöszi T, Murillo L, Morales S, Calvo L, Lang I, Alba E, de la Haba-Rodriguez J, Ramos M, López IÁ, Gal-Yam E, Garcia-Palomo A, Alvarez E, González-Santiago S, Rodríguez CA, Servitja S, Corsaro M, Rodrigálvarez G, Zielinski C, Martín M. Health-related quality of life with palbociclib plus endocrine therapy versus capecitabine in postmenopausal patients with hormone receptor-positive metastatic breast cancer: Patient-reported outcomes in the PEARL study. Eur J Cancer 2021; 156:70-82. [PMID: 34425406 DOI: 10.1016/j.ejca.2021.07.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The PEARL study showed that palbociclib plus endocrine therapy (palbociclib/ET) was not superior to capecitabine in improving progression-free survival in postmenopausal patients with metastatic breast cancer resistant to aromatase inhibitors, but was better tolerated. This analysis compared patient-reported outcomes. PATIENTS AND METHODS The PEARL quality of life (QoL) population comprised 537 patients, 268 randomised to palbociclib/ET (exemestane or fulvestrant) and 269 to capecitabine. Patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR23 and EQ-5D-3L questionnaires. Changes from the baseline and time to deterioration (TTD) were analysed using linear mixed-effect and stratified Cox regression models, respectively. RESULTS Questionnaire completion rate was high and similar between treatment arms. Significant differences were observed in the mean change in global health status (GHS)/QoL scores from the baseline to cycle 3 (2.9 for palbociclib/ET vs. -2.1 for capecitabine (95% confidence interval [CI], 1.4-8.6; P = 0.007). The median TTD in GHS/QoL was 8.3 months for palbociclib/ET versus 5.3 months for capecitabine (adjusted hazard ratio, 0.70; 95% CI, 0.55-0.89; P = 0.003). Similar improvements for palbociclib/ET were also seen for other scales as physical, role, cognitive, social functioning, fatigue, nausea/vomiting and appetite loss. No differences were observed between the treatment arms in change from the baseline in any item of the EQ-5D-L3 questionnaire as per the overall index score and visual analogue scale. CONCLUSION Patients receiving palbociclib/ET experienced a significant delay in deterioration of GHS/QoL and several functional and symptom scales compared with capecitabine, providing additional evidence that palbociclib/ET is better tolerated. TRIAL REGISTRATION NUMBER NCT02028507 (ClinTrials.gov). EUDRACT STUDY NUMBER 2013-003170-27.
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Affiliation(s)
- Zsuzsanna Kahan
- Department of Oncotherapy, University of Szeged, Szeged, Hungary.
| | - Miguel Gil-Gil
- Institut Catalá d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Manuel Ruiz-Borrego
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Eva Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Eva Ciruelos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; HM Hospitales Madrid, Spain; SOLTI Group on Breast Cancer Research, Spain
| | - Montserrat Muñoz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Institut Clinic de Malalties Hemato-Oncològiques-ICHMO, Barcelona, Spain
| | - Begoña Bermejo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria-INCLIVA Valencia, Spain; Centro de Investigacion Biomedica en Red de Oncologia, CIBERONC-ISCIII, Madrid, Spain
| | - Mireia Margeli
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Badalona Applied Research Group in Oncology (ARGO Group), Institut Catalá d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigacion Biomedica en Red de Oncologia, CIBERONC-ISCIII, Madrid, Spain; Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón-IISA, Zaragoza, Spain
| | | | - Tibor Csöszi
- Department of Oncology, Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelőintezet, Szolnok, Hungary
| | - Laura Murillo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico de Zaragoza Lozano Blesa, Zaragoza, Spain
| | - Serafín Morales
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Lourdes Calvo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Istvan Lang
- Istenhegyi Géndiagnosztika Private Health Center Oncology Clinic, Hungary
| | - Emilio Alba
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigacion Biomedica en Red de Oncologia, CIBERONC-ISCIII, Madrid, Spain; UGCI Medical Oncology, Hospitales Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - Juan de la Haba-Rodriguez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Instituto Maimonides de Investigacion Biomedica, Hospital Reina Sofia Hospital, Universidad de Córdoba, Córdoba, Spain
| | - Manuel Ramos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro Oncológico de Galicia, A Coruña, Spain
| | - Isabel Álvarez López
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario Donostia-Biodonostia, San Sebastián, Spain
| | - Einav Gal-Yam
- Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Andrés Garcia-Palomo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology. Hospital de León, León, Spain
| | - Elena Alvarez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Santiago González-Santiago
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Universitario San Pedro de Alcantara, Cáceres, Spain
| | - César A Rodríguez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital Clínico Universitario de Salamanca-IBSAL, Spain
| | - Sonia Servitja
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Hospital del Mar, Barcelona, Spain
| | | | | | - Christoph Zielinski
- Vienna Cancer Center, Medical University Vienna and Vienna Hospital Association, Vienna, Austria; CECOG Central European Cooperative Oncology Group, Vienna, Austria
| | - Miguel Martín
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigacion Biomedica en Red de Oncologia, CIBERONC-ISCIII, Madrid, Spain; Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain
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Pascual J, Gil-Gil M, Zielinski C, Hills M, Ruiz-Borrego M, Ciruelos EM, Garcia-Murillas I, Muñoz M, Bermejo B, Swift C, Vila MM, Antón Torres A, Nissenbaum B, Murillo L, Liu Y, Herranz J, Caballero R, Guerrero-Zotano A, Turner NC, Martin M. CCNE1 mRNA and cyclin E1 protein expression as predictive biomarkers for efficacy of palbociclib plus fulvestrant versus capecitabine in the phase III PEARL study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.1014] [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
1014 Background: The randomized PEARL trial found no superiority of palbociclib plus endocrine therapy over capecitabine in patients (pts) with metastatic HR-positive, HER2-negative breast cancer resistant to prior aromatase inhibitors (Martin M, Ann Oncol 2020). Gene expression analysis showed high CCNE1 mRNA ( CCNE1) conferring relative resistance to palbociclib in the PALOMA-3 trial (Turner N, JCO 2019), but further validation is needed. Cyclin E1 protein (cyclin E1) expression in this context has not been studied in randomized trials. We explored CCNE1 and cyclin E1 as predictive biomarkers in tumor samples from the PEARL study. Methods: Formalin-fixed paraffin-embeded tumor samples were retrieved from pts enrolled in PEARL cohort 2 (palbociclib (PAL) + fulvestrant (FUL) vs capecitabine (CAPE)). We measured CCNE1 using the HTG EdgeSeq Oncology Biomarker Panel (HTG Molecular Diagnostics). Cyclin E1 immunohistochemistry (IHC) staining was performed using specific mouse monoclonal antibody HE12 (Abcam) and scored as percentage of invasive nuclei stained (0-100%). CCNE1 and cyclin E1 correlations were explored using Pearson coefficients. Cox regression models were used for progression free-survival (PFS) analyses using expression levels split by median, to define high ( > median values) vs. low expression. Site of disease and prior chemotherapy were used as confounders in multivariate models. Results: Analyses were conducted in 219 pts (47% receiving PAL + FUL and 53% CAPE) with available tumors, with the analysed patients representative of the overall study. Most samples were from the archival primary (72%), obtained > 5 years before this analysisº (74%). CCNE1 and cyclin E1 were only moderately correlated (r = 0.5). Median CCNE1 was higher in metastatic vs primary (7.37 vs 6.94, p < 0.01), and in luminal B and non-luminal subtypes compared to luminal A (p < 0.001). In patients with high CCNE1 expression, median PFS on CAPE was 10.35 and PAL + FUL was 5.68 (HR = 1.63, 95% CI 1.02-2.59, p = 0.042). In patients with low CCNE1 expression, median PFS on CAPE was 9.43 and PAL + FUL was 8.97 (adjusted HR = 0.93, 95% CI 0.59-1.48, p = 0.762, interaction p = 0.072). Median cyclin E1 protein was higher in luminal B and non-luminal subtypes compared to luminal A (p < 0.01). Cyclin E1 protein expression was not predictive of treatment effect (high cyclin E1 expression CAPE vs PAL + FUL HR = 1.17, low cyclin E1 expression CAPE vs PAL + FUL HR = 1.21, interaction p = 0.977). Conclusions: High tumor CCNE1 mRNA expression identified patients with relative resistance to palbociclib plus fulvestrant, validating prior observations although without statistical significance for interaction. Assessment of Cyclin E1 protein expression did not show predictive value. Investigation treatments to enhance CDK4/6 inhibitor efficacy in tumors with high CCNE1 expression is warranted. Clinical trial information: NCT02028507 .
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Affiliation(s)
- Javier Pascual
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, United Kingdom
| | - Miguel Gil-Gil
- Instituto Catalán de Oncología, Hospital Duran i Reynalds, IDIBELL. GEICAM Breast Cancer Group, Barcelona, Spain
| | - Christoph Zielinski
- Vienna Cancer Center, Medical University Vienna and Vienna Hospital Association. Central European Cooperative Oncology Group (CECOG), Vienna, Austria
| | - Margaret Hills
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Manuel Ruiz-Borrego
- Hospital Universitario Virgen del Rocio, GEICAM Breast Cancer Group, Seville, Spain
| | | | | | - Montserrat Muñoz
- Hospital Clínic Barcelona. GEICAM Breast Cancer Group, Barcelona, Spain
| | - Begoña Bermejo
- Hospital Clinico Universitario Valencia. Biomedical Research Institute INCLIVA. CIBERONC ISCIII. GEICAM, Breast Cancer Group, Valencia, Spain
| | - Claire Swift
- Ralph Lauren Centre for Breast Cancer Research, Royal Marsden, London, United Kingdom
| | - Mireia Margeli Vila
- Instituto Catalán de Oncología, Hospital Germans Trias i Pujol. GEICAM Breast Cancer Group, Badalona, Spain
| | - Antonio Antón Torres
- Hospital Universitario Miguel Servet. Geicam Breast Cancer Group, Zaragoza, Spain
| | | | - Laura Murillo
- Hospital General Universitario San Jorge, GEICAM Breast Cancer Group, Huesca, Spain
| | | | | | | | | | | | - Miguel Martin
- Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Universidad Complutense de Madrid. GEICAM Breast Cancer Group, Madrid, Spain
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Hidalgo-Gómez G, Palacio-Garcia C, Gallur L, Blanco A, Tazón-Vega B, Saumell S, Martínez N, Murillo L, Murciano T, Velasco P, Bosch F, Diaz-Heredia C, Ortega M. Is acute lymphoblastic leukemia with mature B-cell phenotype and KMT2A rearrangements a new entity? A systematic review and meta-analysis. Leuk Lymphoma 2021; 62:2202-2210. [PMID: 33827367 DOI: 10.1080/10428194.2021.1907375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The association between mature B-cell phenotype and KMT2A rearrangements in acute lymphoblastic leukemia is a very rare finding. It identifies a group of patients with similar clinical and biological characteristics that clearly differs from the entity B-cell lymphoblastic leukemia/lymphoma with t(v;11q23)/KMT2A-rearranged, which typically presents an immature pro B-cell phenotype. We describe the clinical-biological characteristics and disease outcome of three pediatric ALL patients with these features treated at our institution, and review 28 cases described in the literature. Most cases occur in children under 2 years-old, presenting a mature B-cell phenotype that uniformly expresses cytoplasmic and surface IgM with lambda light chain restriction, with heterogeneous co-expression of immaturity antigens. Patients do not have MYC rearrangements and all show KMT2A abnormalities, with 76% presenting t(9;11)(p21;q23)/MLLT3-KMT2A. These patients have an unfavorable clinical outcome and a 48% relapse rate. In-depth knowledge of this disease entity is needed to improve outcome.
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Affiliation(s)
- Gloria Hidalgo-Gómez
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Carlos Palacio-Garcia
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Laura Gallur
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Adoración Blanco
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Bárbara Tazón-Vega
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Silvia Saumell
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Noemí Martínez
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Laura Murillo
- Pediatric Oncology and Hematology Service, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Thais Murciano
- Pediatric Oncology and Hematology Service, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Pablo Velasco
- Pediatric Oncology and Hematology Service, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Francesc Bosch
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Cristina Diaz-Heredia
- Pediatric Oncology and Hematology Service, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Margarita Ortega
- Hematology Service, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Martin M, Zielinski C, Ruiz-Borrego M, Carrasco E, Turner N, Ciruelos EM, Muñoz M, Bermejo B, Margeli M, Anton A, Kahan Z, Csöszi T, Casas MI, Murillo L, Morales S, Alba E, Gal-Yam E, Guerrero-Zotano A, Calvo L, de la Haba-Rodriguez J, Ramos M, Alvarez I, Garcia-Palomo A, Huang Bartlett C, Koehler M, Caballero R, Corsaro M, Huang X, Garcia-Sáenz JA, Chacón JI, Swift C, Thallinger C, Gil-Gil M. Palbociclib in combination with endocrine therapy versus capecitabine in hormonal receptor-positive, human epidermal growth factor 2-negative, aromatase inhibitor-resistant metastatic breast cancer: a phase III randomised controlled trial-PEARL. Ann Oncol 2020; 32:488-499. [PMID: 33385521 DOI: 10.1016/j.annonc.2020.12.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [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: 09/01/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Palbociclib plus endocrine therapy (ET) is the standard treatment of hormone receptor-positive and human epidermal growth factor receptor 2-negative, metastatic breast cancer (MBC). However, its efficacy has not been compared with that of chemotherapy in a phase III trial. PATIENTS AND METHODS PEARL is a multicentre, phase III randomised study in which patients with aromatase inhibitor (AI)-resistant MBC were included in two consecutive cohorts. In cohort 1, patients were randomised 1 : 1 to palbociclib plus exemestane or capecitabine. On discovering new evidence about estrogen receptor-1 (ESR1) mutations inducing resistance to AIs, the trial was amended to include cohort 2, in which patients were randomised 1 : 1 between palbociclib plus fulvestrant and capecitabine. The stratification criteria were disease site, prior sensitivity to ET, prior chemotherapy for MBC, and country of origin. Co-primary endpoints were progression-free survival (PFS) in cohort 2 and in wild-type ESR1 patients (cohort 1 + cohort 2). ESR1 hotspot mutations were analysed in baseline circulating tumour DNA. RESULTS From March 2014 to July 2018, 296 and 305 patients were included in cohort 1 and cohort 2, respectively. Palbociclib plus ET was not superior to capecitabine in both cohort 2 [median PFS: 7.5 versus 10.0 months; adjusted hazard ratio (aHR): 1.13; 95% confidence interval (CI): 0.85-1.50] and wild-type ESR1 patients (median PFS: 8.0 versus 10.6 months; aHR: 1.11; 95% CI: 0.87-1.41). The most frequent grade 3-4 toxicities with palbociclib plus exemestane, palbociclib plus fulvestrant and capecitabine, respectively, were neutropenia (57.4%, 55.7% and 5.5%), hand/foot syndrome (0%, 0% and 23.5%), and diarrhoea (1.3%, 1.3% and 7.6%). Palbociclib plus ET offered better quality of life (aHR for time to deterioration of global health status: 0.67; 95% CI: 0.53-0.85). CONCLUSIONS There was no statistical superiority of palbociclib plus ET over capecitabine with respect to PFS in MBC patients resistant to AIs. Palbociclib plus ET showed a better safety profile and improved quality of life.
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Affiliation(s)
- M Martin
- Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Medicine Department, Universidad Complutense, Madrid, Spain; Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain.
| | - C Zielinski
- Medical Oncology, Central European Cancer Center, Wiener Privatklinik Hospital, Vienna, Austria; CECOG Central European Cooperative Oncology Group, Vienna, Austria
| | - M Ruiz-Borrego
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - E Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - N Turner
- Institute of Cancer Research and Royal Marsden, London, UK
| | - E M Ciruelos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain; Medical Oncology, HM Hospitales Madrid, Madrid, Spain; SOLTI Group on Breast Cancer Research, Barcelona, Spain
| | - M Muñoz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clinic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors (IDIBAPS), Barcelona, Spain
| | - B Bermejo
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Biomedical Research Institute INCLIVA, Valencia, Spain
| | - M Margeli
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; B-ARGO Group, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - A Anton
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Z Kahan
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - T Csöszi
- Department of Oncology, Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelőintezet, Szolnok, Hungary
| | - M I Casas
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - L Murillo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico de Zaragoza Lozano Blesa, Zaragoza, Spain
| | - S Morales
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - E Alba
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; UGCI Medical Oncology, Hospitales Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - E Gal-Yam
- Department of Oncology, Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
| | - A Guerrero-Zotano
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Instituto Valenciano de Oncología, Valencia, Spain
| | - L Calvo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Complejo Hospitalario A Coruña, Coruña, Spain
| | - J de la Haba-Rodriguez
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Reina Sofia, Córdoba; Instituto Maimonides de Investigación Biomédica (IMIBIC); Universidad de Córdoba, Córdoba, Spain
| | - M Ramos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro Oncológico de Galicia, A Coruña, Coruña, Spain
| | - I Alvarez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Donostia-Biodonostia, San Sebastián, Spain
| | - A Garcia-Palomo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital de León, León, Spain
| | | | - M Koehler
- Pfizer, USA; Repare Therapeutics, Cambridge, USA
| | - R Caballero
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | | | - J A Garcia-Sáenz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - J I Chacón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Virgen de la Salud, Toledo, Spain
| | - C Swift
- Ralph Lauren Centre for Breast Cancer Research, Royal Marsden, London, UK
| | - C Thallinger
- CECOG Central European Cooperative Oncology Group, Vienna, Austria; Department of Oncology, Medical University of Vienna, Department of Oncology, Vienna, Austria
| | - M Gil-Gil
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Institut Català d'Oncologia (ICO) & IDIBELL, L'Hospitalet, Barcelona, Spain
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8
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Ory P, Hamani V, Bodet PE, Murillo L, Graber M. The variegated scallop, Mimachlamys varia, undergoes alterations in several of its metabolic pathways under short-term zinc exposure. Comp Biochem Physiol Part D Genomics Proteomics 2020; 37:100779. [PMID: 33360397 DOI: 10.1016/j.cbd.2020.100779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/19/2020] [Accepted: 11/20/2020] [Indexed: 01/25/2023]
Abstract
The variegated scallop (Mimachlamys varia) is a filter feeder bivalve encountered in marine regions of the Atlantic coast. In particular, it is present in the La Rochelle marina (France), where it is used for the biomonitoring of marine pollution, due to its ability to strongly bioaccumulate pollutants. In this semi-closed environment, contamination generated by port activities leads to an accumulation of both organic and metal pollutants. Zinc is one of these pollutants, present at a dose of up to 150 μg.L-1. This study investigated the effects of 48 h zinc exposure upon the metabolic profiles of Mimachlamys varia using UHPLC/QToF (ultra-high performance liquid chromatography-quadrupole time-of-flight) tandem mass spectrometry metabolomics. After acclimation in mesocosms recreating in situ conditions, both controls and exposed with Zn2+ (150 μg.L-1) bivalves were dissected to recover the gills after 48 h and stored at -80 °C before metabolites extraction. UHPLC/QToF tandem mass spectrometry was performed to study metabolite composition of samples. Statistical analysis of results using multivariate techniques showed a good classification between control and exposed groups. Eleven identified metabolites were found to be down-modulated in exposed scallops. These variations could reflect potential zinc effects on several of the biological processes, such as energy metabolism, osmoregulation and defense against oxidative stress. Among the eleven metabolites highlighted, four were reported for the first time in an aquatic organism exposed to Zn. This study demonstrates once again the diversity of interactions between bivalves and metals and the complexity of the physiological response of marine bivalves to pollutants.
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Affiliation(s)
- P Ory
- Littoral Environnement et Sociétés (LIENSs), UMR 7266, CNRS-Université de La Rochelle, 2 rue Olympe de Gouges, F-17042 La Rochelle Cedex 01, France
| | - V Hamani
- Littoral Environnement et Sociétés (LIENSs), UMR 7266, CNRS-Université de La Rochelle, 2 rue Olympe de Gouges, F-17042 La Rochelle Cedex 01, France
| | - P-E Bodet
- Littoral Environnement et Sociétés (LIENSs), UMR 7266, CNRS-Université de La Rochelle, 2 rue Olympe de Gouges, F-17042 La Rochelle Cedex 01, France
| | - L Murillo
- Littoral Environnement et Sociétés (LIENSs), UMR 7266, CNRS-Université de La Rochelle, 2 rue Olympe de Gouges, F-17042 La Rochelle Cedex 01, France
| | - M Graber
- Littoral Environnement et Sociétés (LIENSs), UMR 7266, CNRS-Université de La Rochelle, 2 rue Olympe de Gouges, F-17042 La Rochelle Cedex 01, France.
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9
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Adamo B, Bellet M, Paré L, Pascual T, Vidal M, Pérez Fidalgo JA, Blanch S, Martinez N, Murillo L, Gómez-Pardo P, López-González A, Amillano K, Canes J, Galván P, González-Farré B, González X, Villagrasa P, Ciruelos E, Prat A. Oral metronomic vinorelbine combined with endocrine therapy in hormone receptor-positive HER2-negative breast cancer: SOLTI-1501 VENTANA window of opportunity trial. Breast Cancer Res 2019; 21:108. [PMID: 31533777 PMCID: PMC6751874 DOI: 10.1186/s13058-019-1195-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022] Open
Abstract
Background The biological effect of oral metronomic vinorelbine (mVNB) alone or in combination with endocrine therapy in patients with hormone receptor-positive (HR+)/HER2-negative breast cancer has been scarcely addressed. Methods Postmenopausal women with untreated stage I–III HR+/HER2-negative breast cancer were randomized (1:1:1) to receive 3 weeks of letrozole (LTZ) 2.5 mg/day, oral mVNB 50 mg 3 days/week, or the combination. The primary objective was to evaluate, within PAM50 Luminal A/B disease, if the anti-proliferative effect of LTZ+mVNB was superior to monotherapy. An anti-proliferative effect was defined as the mean relative decrease of the PAM50 11-gene proliferation score in combination arm vs. both monotherapy arms. Secondary objectives included the evaluation of a comprehensive panel of breast cancer-related genes and safety. An unplanned analysis of stromal tumor-infiltrating lymphocytes (sTILs) was also performed. PAM50 analyses were performed using the nCounter®-based Breast Cancer 360™ gene panel, which includes 752 genes and 32 signatures. Results Sixty-one patients were randomized, and 54 paired samples (89%) were analyzed. The main patient characteristics were mean age of 67, mean tumor size of 1.7 cm, mean Ki67 of 14.3%, stage I (55.7%), and grades 1–2 (90%). Most baseline samples were PAM50 Luminal A (74.1%) or B (22.2%). The anti-proliferative effect of 3 weeks of LTZ+mVNB (− 73.2%) was superior to both monotherapy arms combined (− 49.9%; p = 0.001) and mVNB (− 19.1%; p < 0.001). The anti-proliferative effect of LTZ+mVNB (− 73.2%) was numerically higher compared to LTZ (− 65.7%) but did not reach statistical significance (p = 0.328). LTZ+mVNB induced high expression of immune-related genes and gene signatures, including CD8 T cell signature and PDL1 gene and low expression of ER-regulated genes (e.g., progesterone receptor) and cell cycle-related and DNA repair genes. In tumors with ≤ 10% sTILs at baseline, a statistically significant increase in sTILs was observed following LTZ (paired analysis p = 0.049) and LTZ+mVNB (p = 0.012). Grade 3 adverse events occurred in 3.4% of the cases. Conclusions Short-term mVNB is well-tolerated and presents anti-proliferative activity alone and in combination with LTZ. The high expression of immune-related biological processes and sTILs observed with the combination opens the possibility of studying this combination with immunotherapy. Further investigation comparing these biological results with other metronomic schedules or drug combinations is warranted. Trial registration NCT02802748, registered 16 June 2016. Supplementary information Supplementary information accompanies this paper at 10.1186/s13058-019-1195-z.
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Affiliation(s)
- Barbara Adamo
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain
| | - Meritxell Bellet
- Vall d'Hebrón University Hospital/Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.,SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Laia Paré
- Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain.,SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Tomás Pascual
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain.,SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Maria Vidal
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain
| | | | - Salvador Blanch
- Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Laura Murillo
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Patricia Gómez-Pardo
- Vall d'Hebrón University Hospital/Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Jordi Canes
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Patricia Galván
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | | | - Eva Ciruelos
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain. .,Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain. .,SOLTI Breast Cancer Research Group, Barcelona, Spain.
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10
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Murillo L, Dapena JL, Velasco P, de Heredia CD. Use of inotuzumab-ozogamicin in a child with Down syndrome and refractory B-cell precursor acute lymphoblastic leukemia. Pediatr Blood Cancer 2019; 66:e27562. [PMID: 30485640 DOI: 10.1002/pbc.27562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/28/2018] [Accepted: 11/05/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Laura Murillo
- Servicio de Oncología y Hematología Pediátricas, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - José Luis Dapena
- Servicio de Oncología y Hematología Pediátricas, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Pablo Velasco
- Servicio de Oncología y Hematología Pediátricas, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Cristina Díaz de Heredia
- Servicio de Oncología y Hematología Pediátricas, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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11
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Mayordomo JI, Andres R, Isla MD, Murillo L, Cajal R, Yubero A, Blasco C, Lasierra P, Palomera L, Fuertes MA, Güemes A, Sousa R, Garcia-Prats MD, Escudero P, Saenz A, Godino J, Marco I, Saez B, Visus C, Asin L, Valdivia G, Larrad L, Tres A. Results of a Pilot Trial of Immunotherapy with Dendritic Cells Pulsed with Autologous Tumor Lysates in Patients with Advanced Cancer. Tumori 2018; 93:26-30. [PMID: 17455868 DOI: 10.1177/030089160709300106] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 11/15/2022]
Abstract
Aims and background The purpose of the study was to test the immunological and clinical effects of infusions of dendritic cells pulsed with autologous tumor lysate in patients with advanced cancer. Patients and methods Peripheral blood mononuclear cells from 15 patients with metastatic cancer (melanoma in 10, lung cancer in 2, renal cell carcinoma in 1, sarcoma in 1, breast cancer in 1) were harvested by leukapheresis after mobilization with GM-CSF (5 μg/kg/day s.c. for 4 days). Mononuclear cells were separated and cultured in GM-CSF (1000 U/ml) and interleukin-4 (1000 U/ml) for 7 days. Phenotype was assessed by 2-color flow cytometry and immunocytochemistry. On day 6, dendritic cells were pulsed with 1 g of fresh autologous tumor lysate for 24 h and infused intravenously. Interleukin-2 (6 million IU), interferon a (4 million IU) and GM-CSF (400 μg) were injected s.c. daily for 10 days beginning on the day of dendritic cell infusion. Treatment was repeated every 21 days for 3 courses. Results The morphology, immunocytochemistry and phenotype of cultured cells was consistent with dendritic cells: intense positivity for HLA-DR and CD86, with negativity for markers of other lineages, including CD3, CD4, CD8 and CD14. More than 5 × 107 dendritic cells were injected in all patients. Nine patients developed >5 mm delayed type cutaneous hypersensitivity reactions to tumor lysate ± GM-CSF after the first immunization (larger than GM-CSF in all cases). Median delayed type cutaneous hypersensitivity to lysate + GM-CSF was 3 cm after the third immunization. One melanoma patient with skin, liver, lung and bone metastases had a partial response lasting 8 months (followed by progression in the brain). Seven patients had stable disease for >3 months, and 7 had progression. Conclusions Infusion of tumor lysate-pulsed dendritic cells induces a strong cell-mediated antitumor immune reaction in patients with advanced cancer and has some clinical activity.
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12
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de Rojas T, Bautista F, Flores M, Igual L, Rubio R, Bardón E, Navarro L, Murillo L, Hladun R, Cañete A, Garcia-Ariza M, Garrido C, Fernández-Teijeiro A, Quiroga E, Calvo C, Llort A, de Prada I, Madero L, Cruz O, Moreno L. Management and outcome of children and adolescents with non-medulloblastoma CNS embryonal tumors in Spain: room for improvement in standards of care. J Neurooncol 2017; 137:205-213. [PMID: 29248974 DOI: 10.1007/s11060-017-2713-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 04/21/2017] [Accepted: 12/11/2017] [Indexed: 02/07/2023]
Abstract
Non-medulloblastoma CNS embryonal tumors (former PNET/Pineoblastomas) are aggressive malignancies with poor outcome that have been historically treated with medulloblastoma protocols. The purpose of this study is to present a tumor-specific, real-world data cohort of patients with CNS-PNET/PB to analyze quality indicators that can be implemented to improve the outcome of these patients. Patients 0-21 years with CNS-PNET treated in eight large institutions were included. Baseline characteristics, treatment and outcome [progression-free and overall survival (PFS and OS respectively)] were analyzed. From 2005 to 2014, 43 patients fulfilled entry criteria. Median age at diagnosis was 3.6 years (range 0.0-14.7). Histology was pineoblastoma (9%), ependymoblastoma (5%), ETANTR (7%) and PNET (77%). Median duration of the main symptom was 2 weeks (range 0-12). At diagnosis, 28% presented with metastatic disease. Seventeen different protocols were used on frontline treatment; 44% had gross total resection, 42% craniospinal radiotherapy, 86% chemotherapy, and 33% autologous hematopoietic stem cell transplantation (aHSCT). Median follow-up for survivors was 3.5 years (range 1.7-9.3). 3-year PFS was 31.9% (95% CI 17-47%) and OS 35.1% (95% CI 20-50%). Age, extent of resection and radiotherapy were prognostic of PFS and OS in univariate analysis (p < 0.05). Our series shows a dismal outcome for CNS-PNET, especially when compared to patients included in clinical trials. Establishing a common national strategy, implementing referral circuits and collaboration networks, and incorporating new molecular knowledge into routine clinical practice are accessible measures that can improve the outcome of these patients.
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Affiliation(s)
- Teresa de Rojas
- Pediatric Oncology Department, Hospital Niño Jesús, Av. Menéndez Pelayo, 65, 28009, Madrid, Spain
| | - Francisco Bautista
- Pediatric Oncology Department, Hospital Niño Jesús, Av. Menéndez Pelayo, 65, 28009, Madrid, Spain
| | - Miguel Flores
- Pediatric Oncology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Lucía Igual
- Pediatric Oncology Department, Hospital La Fe, Valencia, Spain
| | - Raquel Rubio
- Pediatric Oncology Department, Hospital Cruces, Bilbao, Spain
| | - Eduardo Bardón
- Pediatric Oncology Department, Hospital Gregorio Marañón, Madrid, Spain
| | - Lucía Navarro
- Pediatric Oncology Department, Hospital Virgen del Rocío, Sevilla, Spain
| | - Laura Murillo
- Pediatric Oncology Department, Hospital Miguel Servet, Zaragoza, Spain
| | - Raquel Hladun
- Pediatric Oncology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Adela Cañete
- Pediatric Oncology Department, Hospital La Fe, Valencia, Spain
| | | | - Carmen Garrido
- Pediatric Oncology Department, Hospital Gregorio Marañón, Madrid, Spain
| | | | - Eduardo Quiroga
- Pediatric Oncology Department, Hospital Virgen del Rocío, Sevilla, Spain
| | - Carlota Calvo
- Pediatric Oncology Department, Hospital Miguel Servet, Zaragoza, Spain
| | - Anna Llort
- Pediatric Oncology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | | | - Luis Madero
- Pediatric Oncology Department, Hospital Niño Jesús, Av. Menéndez Pelayo, 65, 28009, Madrid, Spain.,Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
| | - Ofelia Cruz
- Pediatric Oncology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Lucas Moreno
- Pediatric Oncology Department, Hospital Niño Jesús, Av. Menéndez Pelayo, 65, 28009, Madrid, Spain. .,Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.
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13
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Adamo B, Perez Fidalgo J, Ciruelos E, Vidal M, Blanch S, Lopez A, Gomez Pardo P, Murillo L, Amillano K, Martínez Jañez N, Gonzalez X, Canes J, Prat A. VENTANA (SOLTI-1501): Antiproliferative effect of the addition of oral metronomic vinorelbine to endocrine therapy in luminal/HER2-negative early breast cancer: A window of opportunity trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.063] [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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14
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Adamo B, Vidal M, Gomez Pardo P, Zaragoza K, Ciruelos E, Virizuela JA, Blanch Tormo S, Pérez-Fidalgo JA, Murillo L, Lopez-Gonzalez A, Amillano Parraga K, Martinez Jañez N, Gonzàlez Farré X, Prat A. Abstract OT1-01-04: VENTANA (SOLTI-1501): Oral metronomic vinorelbine combined with endocrine therapy in luminal/HER2-negative early breast cancer: A window of opportunity trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-01-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
The CDK4/6 inhibitor palbociclib, in combination with endocrine therapy (ET), has been approved for patients (pts) with HR+/HER2- metastatic breast cancer (BC), suggesting that inhibition of the cell cycle in combination with ET is a strategy to keep exploring. In this context, vinorelbine (VNB) inhibits chromosome segregation during mitosis and blocks cells at G2/M. Interestingly, several metronomic schedules of VNB are being used in the clinical setting, a strategy that might not only affect cell-cycle but also aims to target tumor angiogenesis.
VENTANA is a “window-of-opportunity” trial designed to explore whether, similarly to CDK4/6 and mTOR inhibitors, oral metronomic VNB in combination with endocrine therapy induces a superior anti-proliferative effect than ET alone, as suggested by preclinical and clinical studies. We believe that a biological synergy of the combined treatment could open the door to include this treatment strategy in pts with BC as an alternative to CDK4/6 inhibitors.
METHODS
VENTANA is a phase 0 multicenter, three-arm, randomized clinical trial of oral metronomic VNB and letrozole (LET) versus either treatment alone in postmenopausal women with newly diagnosed, untreated HR+ and HER2-, stage I-III operable BC. Other eligibility criteria include primary tumor size ≥1 cm (cT1-3) and N0-1, ECOG PS 0-1 and evaluable diagnostic tumor sample. Pts are randomized (1:1:1) to receive LET 2.5mg daily, oral VNB 50mg 3 days a week, or LET 2.5mg daily and oral VNB 50mg 3 times a week. After 3 weeks of treatment, pts will undergo surgery, and both pre-treatment and post-treatment surgical samples will be analyzed for gene expression. Primary objective is to test if oral metronomic VNB and LET induce a superior anti-proliferative effect than either drug alone in pts with early BC defined as Luminal by PAM50. This will be evaluated by the expression of 11 proliferative genes contained in the PAM50 subtype predictor (BIRC5, CCNB1, CDC20, CDCA1, CEP55, KNTC2, MKI67, PTTG1, RRM2, TYMS and UBE2C) as surrogate signature biomarker of its anticancer activity.
VENTANA is a proof-of-concept study to describe the change in the expression of a proliferation-related gene signature in all 3 treatment arms. Changes in the proliferation signature will be determined by following formula: Mean suppression of proliferation signature score = 100 − [geometric mean (post treatment proliferation score / pre-treatment proliferation score · 100)]. By evaluating other BC-related gene signatures (560 genes), the antiangiogenic and immunogenic potential of the treatment arms will also be compared and genes regulated in a treatment-specific manner identified. All analyses will be performed within the different PAM50-defined subtypes (Luminal, Luminal A or Luminal B).
As the primary endpoint is continuous and there are no previous data to make assumptions about the degree of suppression of these genes, the sample size has not been determined by statistical calculations. A sample size of 20 pts per arm is considered appropriate to support our hypothesis. The targeted accrual of 60 pts will be enrolled in 10 sites across Spain (EudraCT Number 2015-004714-24).
Citation Format: Adamo B, Vidal M, Gomez Pardo P, Zaragoza K, Ciruelos E, Virizuela JA, Blanch Tormo S, Pérez-Fidalgo JA, Murillo L, Lopez-Gonzalez A, Amillano Parraga K, Martinez Jañez N, Gonzàlez Farré X, Prat A. VENTANA (SOLTI-1501): Oral metronomic vinorelbine combined with endocrine therapy in luminal/HER2-negative early breast cancer: A window of opportunity trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-01-04.
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Affiliation(s)
- B Adamo
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - M Vidal
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - P Gomez Pardo
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - K Zaragoza
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - E Ciruelos
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - JA Virizuela
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - S Blanch Tormo
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - JA Pérez-Fidalgo
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - L Murillo
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - A Lopez-Gonzalez
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - K Amillano Parraga
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - N Martinez Jañez
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - X Gonzàlez Farré
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - A Prat
- Hospital Clínic de Barcelona, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Universitari Vall d'Hebron, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Quirón Sagrado Corazón, Sevilla, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Hospital de León, León, Spain; Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari General de Catalunya, Sant Cugat del Vallés, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain
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15
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Garcia J, Tahiliani J, Johnson NM, Aguilar S, Beltran D, Daly A, Decker E, Haverfield E, Herrera B, Murillo L, Nykamp K, Topper S. Clinical Genetic Testing for the Cardiomyopathies and Arrhythmias: A Systematic Framework for Establishing Clinical Validity and Addressing Genotypic and Phenotypic Heterogeneity. Front Cardiovasc Med 2016; 3:20. [PMID: 27446933 PMCID: PMC4921949 DOI: 10.3389/fcvm.2016.00020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 06/06/2016] [Indexed: 12/19/2022] Open
Abstract
Advances in DNA sequencing have made large, diagnostic gene panels affordable and efficient. Broad adoption of such panels has begun to deliver on the promises of personalized medicine, but has also brought new challenges such as the presence of unexpected results, or results of uncertain clinical significance. Genetic analysis of inherited cardiac conditions is particularly challenging due to the extensive genetic heterogeneity underlying cardiac phenotypes, and the overlapping, variable, and incompletely penetrant nature of their clinical presentations. The design of effective diagnostic tests and the effective use of the results depend on a clear understanding of the relationship between each gene and each considered condition. To address these issues, we developed simple, systematic approaches to three fundamental challenges: (1) evaluating the strength of the evidence suggesting that a particular condition is caused by pathogenic variants in a particular gene, (2) evaluating whether unusual genotype/phenotype observations represent a plausible expansion of clinical phenotype associated with a gene, and (3) establishing a molecular diagnostic strategy to capture overlapping clinical presentations. These approaches focus on the systematic evaluation of the pathogenicity of variants identified in clinically affected individuals, and the natural history of disease in those individuals. Here, we applied these approaches to the evaluation of more than 100 genes reported to be associated with inherited cardiomyopathies and arrhythmias including hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia or cardiomyopathy, long QT syndrome, short QT syndrome, Brugada, and catecholaminergic polymorphic ventricular tachycardia, and to a set of related syndromes such as Noonan Syndrome and Fabry disease. These approaches provide a framework for delivering meaningful and accurate genetic test results to individuals with hereditary cardiac conditions.
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Affiliation(s)
- John Garcia
- Invitae Corporation , San Francisco, CA , USA
| | | | | | | | | | - Amy Daly
- Invitae Corporation , San Francisco, CA , USA
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16
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de Rojas T, Bautista FJ, Flores M, Fioravantti V, Igual L, Rubio R, Bardón E, Navarro L, Murillo L, Hladun R, Cañete A, García M, Garrido C, Fernández-Teijeiro A, Quiroga E, Calvo C, Llort A, Madero L, Cruz O, Moreno L. PNR-16DIAGNOSIS, MANAGEMENT AND OUTCOME OF CHILDREN WITH CENTRAL NERVOUS SYSTEM (CNS) PRIMITIVE NEUROECTODERMAL TUMORS (PNET) IN SPAIN: A STUDY FROM THE SPANISH NATIONAL PEDIATRIC ONCOLOGY & HEMATOLOGY SOCIETY (SEHOP). Neuro Oncol 2016. [DOI: 10.1093/neuonc/now067.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Rodrigo A, Callejo A, Lastra R, Fernandez A, Iranzo P, Cancela MAV, Quilez E, Yubero-Esteban A, Galan N, Lambea J, Murillo L, Andres R, Escudero P, Pujol E, Saenz A, Saez B, Isla D. Expression and correlation of HLA-G and sHLA-G as prognostic factors in renal cell carcinoma. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e16066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Alberto Rodrigo
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Ana Callejo
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Rodrigo Lastra
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Alexia Fernandez
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Patricia Iranzo
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | | | - Elisa Quilez
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | | | - Nieves Galan
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Julio Lambea
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Laura Murillo
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Raquel Andres
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Pilar Escudero
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Eduardo Pujol
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Alberto Saenz
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Berta Saez
- Department of Immunology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Dolores Isla
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
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18
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Llombart-Cussac A, Ramos M, Dalmau E, García-Saenz JA, González-Farré X, Murillo L, Calvo L, Morales S, Carañana V, González A, Fernández-Morales LA, Moreno F, Casas MI, Angulo MDM, Cámara MC, Garcia-Mace AI, Carrasco E, Jara-Sánchez C. Incidence of chemotherapy-induced nausea and vomiting associated with docetaxel and cyclophosphamide in early breast cancer patients and aprepitant efficacy as salvage therapy. Results from the Spanish Breast Cancer Group/2009-02 study. Eur J Cancer 2016; 58:122-9. [PMID: 26994459 DOI: 10.1016/j.ejca.2016.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 09/15/2015] [Revised: 11/30/2015] [Accepted: 01/17/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Docetaxel-cyclophosphamide (TC) has become a common regimen in moderate-high-risk early breast cancer (EBC), but the incidence of chemotherapy-induced nausea and vomiting (CINV) with this regimen is not well established. This trial investigates the effect of guideline-consistent prophylaxis on CINV related to TC regimen and explores the efficacy of aprepitant among resistant patients. PATIENTS AND METHODS This prospective multicentre study enrolled 212 chemotherapy-naïve EBC patients receiving T-75 mg/m(2) and C-600 mg/m(2). Antiemetic therapy on the first cycle consisted of dexamethasone for 3 d plus 5-hydroxytryptamine (5-HT3) antagonists on day 1, according to Multinational Association of Supportive Care in Cancer guidelines. The primary end-point was complete response (CR) (no emesis and no need of rescue treatment within the initial 120 h). Patients failing CR on cycle 1 entered in a single-arm study exploring the efficacy of aprepitant on the second cycle. Patients' diaries and Functional Living Index-Emesis (FLIE) questionnaires were collected in cycles 1 and 2. RESULTS Among the 185 evaluable patients on cycle 1, 161 (87%, 95% confidence interval [CI]: 82.2-91.8) achieved a CR. Twenty-three patients received aprepitant on cycle 2, and 12 reached a CR (52.2%, 95% CI: 31.8-72.6). The absence of CR had a very substantial impact on quality of life on cycles 1 (FLIE before and after: 23.8-38.1, p = 0.0124) and 2 (18.3-42.9, p = 0.0059). CONCLUSIONS Guideline-consistent antiemetic prophylaxis for the TC regimen is associated with a low incidence of CINV. Aprepitant is effective as secondary prevention of CINV and should be considered as rescue therapy in patients treated with moderate emetogenic chemotherapy.
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Affiliation(s)
| | | | - Elsa Dalmau
- Corporació Sanitarià Parc Tauli, Sabadell, Barcelona, Spain
| | | | | | - Laura Murillo
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Lourdes Calvo
- Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | | | | | | | | | - M Isabel Casas
- GEICAM (Spanish Breast Cancer Research Group), San Sebastián de los Reyes, Madrid, Spain
| | - M Del Mar Angulo
- GEICAM (Spanish Breast Cancer Research Group), San Sebastián de los Reyes, Madrid, Spain
| | - M Carmen Cámara
- GEICAM (Spanish Breast Cancer Research Group), San Sebastián de los Reyes, Madrid, Spain
| | - Ana I Garcia-Mace
- GEICAM (Spanish Breast Cancer Research Group), San Sebastián de los Reyes, Madrid, Spain
| | - Eva Carrasco
- GEICAM (Spanish Breast Cancer Research Group), San Sebastián de los Reyes, Madrid, Spain
| | - Carlos Jara-Sánchez
- Hospital Universitario Fundación Alcorcón-Universidad Rey Juan Carlos, Madrid, Spain
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19
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Walsh EM, Shalaby A, Murillo L, Webber M, Kerin M, Glynn S, Callaghy G, Ingoldsby H, Keane M. Abstract 1708: Identification of triple negative breast cancer (TNBC) subtypes by an immunohistochemistry (IHC) panel with impact on clinical outcomes. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-1708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
TNBC comprises 10-20% of breast cancers. Lehmann et al. identified 6 TNBC subtypes by gene expression profiling: BL1, BL2, IM, M, MSL & LAR. Despite the diversity of TNBC, standard of care is combination chemotherapy as in non TNBCs. Identification of chemosensitive TNBC subtypes is necessary. Chemoresistant TNBCs need alternative targets to improve treatment strategies.
Aims
1. To validate an IHC biomarker panel to define molecular subtypes of TNBC
2. To correlate molecular subtypes with prognosis to identify appropriate therapy
3. To improve diagnostic tools to individualize therapy based on TNBC subtypes
Methods
A TMA was constructed of 197 TNBCs diagnosed from 1999 - 2014. An 8-protein IHC panel was developed to identify TNBC subtypes on FFPE tissue. The panel includes markers for key pathways to discriminate between 6 subtypes: AR, Bcl2, c-myc, TIE1, PDGFC, MMP2, Il2R, MSH2. To date, AR & Bcl2 have been stained and assessed, together with p53 & Ki67. 10% was used as the cut off for positivity. Clinical data were obtained from hospital records and incorporated in the database.
Results
On initial observation, AR+ tumors had an older age at diagnosis than AR- (60 v 56), lower rates of family history (36 v 87%) and longer DFS (31 v 21 months).
Bcl2+ tumors had a younger age at diagnosis than Bcl2- (55 v 59), lower recurrence rates (25 v 31%) and longer DFS (33 v 15 months).
High Ki67 tumors had a younger age at diagnosis than low Ki67 (56 v 65), higher rates of family history (30 v 14%), lower recurrence rates (16 v 25%) and longer DFS (30 v 2 months).
By the time of presentation, the entire panel of 8 proteins will be analyzed. The clinicopathological association of specific TNBC subtypes and the impact of TNBC subtype on chemotherapy response will be statistically assessed. Analysis will include response, duration, DFS and OS.
This study will ultimately correlate TNBC molecular subtypes with prognosis to aid clinical decision making, individualize therapies and improve patient outcomes.
n = 197AR +AR -Bcl2 +Bcl2 -Ki67 >10%Ki67 <10%P53 +P53 -n141429963160149164%7%72%50%32%30%7%46%32%Median Age6056555956655755Range37-7729-9029-8431-9229-8235-9029-9030-88Family Historyn51232916182313%36%87%29%25%30%14%3%20%BRCA Mutation06331134BRCA 1-3121122BRCA 2-321--12NACT010544364PR-8324144SD-111-11-POD-111-11-Recurrencen3 (of 12)38 (of 138)25 (of 98)18 (of 58)9 (of 58)3 (of 12)22 (of 88)18 (of 62)%25%28%25%31%16%25%25%29%Median DFS312133153022731Range30-342-549-542-384-542-22-549-52Median OS3537373628363438Range5-890-1342-1341-1331-1379-1261-1340-137
Citation Format: Elaine M. Walsh, Aliaa Shalaby, Laura Murillo, Mark Webber, Michael Kerin, Sharon Glynn, Grace Callaghy, Helen Ingoldsby, Maccon Keane. Identification of triple negative breast cancer (TNBC) subtypes by an immunohistochemistry (IHC) panel with impact on clinical outcomes. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1708. doi:10.1158/1538-7445.AM2015-1708
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Affiliation(s)
| | | | | | | | | | - Sharon Glynn
- 4Prostate Cancer Institute and Apoptosis Research Centre, Galway, Ireland
| | | | | | - Maccon Keane
- 1Department of Medical Oncology, Galway, Ireland
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20
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Martín M, Beslija S, Carrasco E, Kahan Z, Escudero MJ, Lang I, Bermejo B, Inbar M, Chacón JI, Jinga D, García-Saenz JÁ, de la Haba J, Morales S, Gil M, Murillo L, Antón A, Ruiz-Borrego M, Zielinski C, Steger G, Nisenbaum B. Abstract OT1-1-05: Phase III study of palbociclib in combination with exemestane vs. capecitabine, in hormonal receptor (HR) positive/HER2 negative metastatic breast cancer (MBC) patients with resistance to non-steroidal aromatase inhibitors (NSAI): PEARL study (GEICAM/2013-02_CECOG/BC.1.3.006). Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-ot1-1-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Endocrine therapy (ET) is the cornerstone treatment for HR–positive, HER2-negative breast cancer (BC) patients. AIs have become the treatment of choice in postmenopausal patients. The high response rates with ET in these patients are partially undermined by the resistance developed by most of them over time. On early disease recurrence/progression to AIs, the treatment options include other AI, estrogen-receptor antagonists or chemotherapy (being capecitabine one of the best options). Preclinical data suggest that ER+/HER2- BC are dependent on cyclin-dependent kinases 4/6 (CDK4/6) function; the inhibition of this target may be effective in delaying/reverting endocrine resistance. Palbociclib is an oral novel CDK4/6 inhibitor that seems to be synergistic with ET in preclinical and clinical studies.
Trial Design: This is an international (6 countries) randomized phase III study. Patients are randomized 1:1 to exemestane (25 mg daily) plus palbociclib (125 mg daily x3 weeks every 4 weeks) vs. capecitabine (1,250 mg/m2 twice daily x2 weeks every 3 weeks). Postmenopausal patients with HR+/HER2- MBC are eligible if resistant to previous NSAI (letrozole or anastrozole) defined as: recurrence while on or within 12 months after the end of adjuvant treatment or progression while on or within 1 month after the end of treatment for MBC. Previous chemotherapy is permitted either in the (neo)adjuvant setting and/or as first line for MBC. Patients must have measurable disease according to RECIST 1.1 or lytic bone lesions in the absence of measurable disease. The primary objective is Progression-Free Survival (PFS); secondary objectives are overall survival, response rate, clinical benefit rate, response duration, safety, quality of life and biomarker’s defined changes. The study will recruit 348 patients to detect a difference of 2.75 months in the median PFS (from 6 to 8.75 months; hazard ratio= 0.686), with a power of 80% and a 5% two sided significance level. The study started recruitment in March 2014 and 14 patients have been included so far (ClinTrials.gov reference NCT02028507).
Citation Format: Miguel Martín, Semir Beslija, Eva Carrasco, Zsuzanna Kahan, Ma José Escudero, Istvan Lang, Begoña Bermejo, Moshe Inbar, José Ignacio Chacón, Dan Jinga, José Ángel García-Saenz, Juan de la Haba, Serafín Morales, Miguel Gil, Laura Murillo, Antonio Antón, Manuel Ruiz-Borrego, Christoph Zielinski, Günther Steger, Bella Nisenbaum. Phase III study of palbociclib in combination with exemestane vs. capecitabine, in hormonal receptor (HR) positive/HER2 negative metastatic breast cancer (MBC) patients with resistance to non-steroidal aromatase inhibitors (NSAI): PEARL study (GEICAM/2013-02_CECOG/BC.1.3.006) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr OT1-1-05.
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Affiliation(s)
- Miguel Martín
- 3Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid
| | | | | | | | | | | | | | | | | | - Dan Jinga
- 10Emergency University Hospital Bucharest
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21
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Carañana V, Ramos M, Damau E, García-Saenz JA, González X, Murillo L, Calvo L, Morales S, González-Farré A, Fernández-Morales LA, Carrasco E, Casas MI, Angulo M, Cámara MC, García AI, Llombart A, Jara C. Abstract P3-15-02: A prospective, open label, non-comparative trial to determine the incidence of chemotherapy-induced nausea and vomiting associated with the docetaxel-cyclophosphamide regimen in early breast cancer patients. Results from the GEICAM 2009-02 study. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-15-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Docetaxel-Cyclophosphamide (TC) has become a common chemotherapy regimen for moderate-high risk Early Breast Cancer (EBC) patients. The incidence of chemotherapy induced nausea and vomiting (CINV) with TC together with an adequate standard anti-emetic therapy with 5-HT3 antagonist and corticosteroids are unknown. This study investigates the incidence of emesis control (complete response), defined as no vomiting (any grade of NCI CTCAE version 4.0) and no use of rescue treatment within 120 hours after the first cycle of TC. Secondary objective evaluates the efficacy of Aprepitant in non-responding patients.
Methods: EBC patients with no prior moderate-high risk CINV were included. Patients received Docetaxel 75 mg/m2 plus Cyclophosphamide 600 mg/m2 IV every three weeks. Antiemetic treatment consisted of oral Dexamethasone (D) 8 mg (at night) on day 0; oral D 8 mg x 3 (in the morning, 1 hour before chemotherapy and at night) plus 5-HT3 antagonists on day 1; and oral D 8 mg x 2 (in the morning and at night) on days 2 and 3. Non-responding patients (vomiting or need of rescue therapy in the first cycle) were offered participation in the efficacy phase (Aprepitant 125mg day 1 and 80 mg days 2 and 3 added to the standard antiemetic therapy in cycle 2). In addition to the standard NCI-CTCAE adverse event collection, a patient´s diary (from day 1 to 6) and the FLIE (Functional Living Index-Emesis questionnaire) were used. Assuming a 25% (+/- 6%) of patients resistant to standard antiemetic therapy, 212 patients were estimated.
Results: From May-11 to March-13, 212 EBC patients were included. Median age was 57 years (range 34-82), 29.3% were premenopausal. Twenty-seven patients were excluded from the main analysis because of major protocol violations (25) or consent withdrawal (2). Twenty-four patients (13%; IC95%: 8.2 – 17.8) did not respond to standard antiemetics and entered the efficacy phase with Aprepitant. From these 24 patients, 14 (56%; IC95%: 36.5 – 75.5) achieved a complete response on cycle 2. No adverse events related to Aprepitant were observed.
Conclusions: Proper use of standard antiemetic therapy for early breast cancer patients treated with TC provides a high control rate (87%). Among no responding patients, about half of them were rescued with Aprepitant. Identification of the non-responding patients could lead to a better antiemetic control with Aprepitant from the first cycle.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-15-02.
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Affiliation(s)
- V Carañana
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - M Ramos
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - E Damau
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - JA García-Saenz
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - X González
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - L Murillo
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - L Calvo
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - S Morales
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - A González-Farré
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - LA Fernández-Morales
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - E Carrasco
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - MI Casas
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - MdM Angulo
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - MC Cámara
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - AI García
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - A Llombart
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
| | - C Jara
- Hospital Arnau de Vilanova, Valencia, Spain; Centro Oncológico de Galicia, A Coruña, Spain; Corporació Sanitaria Par Tauli, Sabadell, Barcelona, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Hospital Arnau de Vilanova, Lleida, Spain; GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain; Fundación Hospital Alrcorcón, Alcorcón, Madrid
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Arauz A, Merlos-Benítez M, Roa L, Hernández-Curiel B, Cantú C, Murillo L, Roldán J, Vargas-Barrón J, Barinagarrementeria F. Infarto cerebral criptogénico en pacientes jóvenes. Pronóstico y recurrencia a largo plazo. Neurologia 2011; 26:279-84. [DOI: 10.1016/j.nrl.2010.10.010] [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] [Received: 07/10/2010] [Revised: 09/30/2010] [Accepted: 10/12/2010] [Indexed: 10/18/2022] Open
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Rafnar T, Sulem P, Besenbacher S, Gudbjartsson DF, Zanon C, Gudmundsson J, Stacey SN, Kostic JP, Thorgeirsson TE, Thorleifsson G, Bjarnason H, Skuladottir H, Gudbjartsson T, Isaksson HJ, Isla D, Murillo L, García-Prats MD, Panadero A, Aben KKH, Vermeulen SH, van der Heijden HFM, Feser WJ, Miller YE, Bunn PA, Kong A, Wolf HJ, Franklin WA, Mayordomo JI, Kiemeney LA, Jonsson S, Thorsteinsdottir U, Stefansson K. Genome-wide significant association between a sequence variant at 15q15.2 and lung cancer risk. Cancer Res 2011; 71:1356-61. [PMID: 21303977 DOI: 10.1158/0008-5472.can-10-2852] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Genome-wide association studies (GWAS) have identified 3 genomic regions, at 15q24-25.1, 5p15.33, and 6p21.33, which associate with the risk of lung cancer. Large meta-analyses of GWA data have failed to find additional associations of genome-wide significance. In this study, we sought to confirm 7 variants with suggestive association to lung cancer (P < 10(-5)) in a recently published meta-analysis. In a GWA dataset of 1,447 lung cancer cases and 36,256 controls in Iceland, 3 correlated variants on 15q15.2 (rs504417, rs11853991, and rs748404) showed a significant association with lung cancer, whereas rs4254535 on 2p14, rs1530057 on 3p24.1, rs6438347 on 3q13.31, and rs1926203 on 10q23.31 did not. The most significant variant, rs748404, was genotyped in an additional 1,299 lung cancer cases and 4,102 controls from the Netherlands, Spain, and the United States and the results combined with published GWAS data. In this analysis, the T allele of rs748404 reached genome-wide significance (OR = 1.15, P = 1.1 × 10(-9)). Another variant at the same locus, rs12050604, showed association with lung cancer (OR = 1.09, 3.6 × 10(-6)) and remained significant after adjustment for rs748404 and vice versa. rs748404 is located 140 kb centromeric of the TP53BP1 gene that has been implicated in lung cancer risk. Two fully correlated, nonsynonymous coding variants in TP53BP1, rs2602141 (Q1136K) and rs560191 (E353D) showed association with lung cancer in our sample set; however, this association did not remain significant after adjustment for rs748404. Our data show that 1 or more lung cancer risk variants of genome-wide significance and distinct from the coding variants in TP53BP1 are located at 15q15.2.
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Affiliation(s)
- Thorunn Rafnar
- deCODE genetics, Department of Medical Oncology, Landspitali-University Hospital, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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24
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Santocanale A, Natoni A, Murillo L, Catherwood M, Montagnoli A, Samali A, O'Dwyer M. 505 Dual Cdc7/Cdk9 kinase inhibitor, PHA-767491, targets both quiescent and proliferating CLL cells. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72212-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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25
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Lorenzo A, Modolell A, Valero P, Murillo L, García-Bueno JM, Yubero A, Machengs I. Docetaxel and carboplatin followed by sequential capecitabine as first line treatment in patients with locally advanced or metastatic breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-2155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #2155
Background: Anthracyclines and docetaxel (D) are the most active agents in metastatic breast cancer (BC). New regimens are being assesed to improve chemotherapy efficacy. D and carboplatin (C) has shown to be an active treatment in metastatic BC. Capecitabine (X) and D is also an active combination, despite the fact the toxicity profile needs to be improved. Sequential administration of D and X could lead to an improved toxicity profile compared with concomitant administration. We designed this study to evaluate activity and toxicity profile of treatment with D and C followed by sequential X in patients with locally advanced or metastatic BC.
 Methods: Patients with locally advanced or metastatic BC, at least one measurable lesion, age ≥ 18 years, ECOG PS ≤ 2, and adequate bone marrow and hepatic functions, were included in the study. Prior chemotherapy or radiotherapy for advanced disease was not allowed. Patients received 6 cycles of D 75 mg/m2 iv D1 and C AUC5 iv D1, every 21 days followed by 12 cycles of X 2000 mg/m2/day o.r. D1-14 in a 21 days course.
 Results: twenty patients have been analyzed. Median age was 55 years old (range 36-73), ECOG PS 0-1 94.4%; 90.0% of patients had infiltrating ductal carcinoma and 57.9% of patients had stage I-II at diagnosis. Main sites of metastatic disease were bone (35.0%), liver (25.0%) and lung (25.0%). Conservative surgery was performed in 35% of patients and mastectomy in 40%. Previous radiotherapy and chemotherapy was administered in 50.0% and 70.0% of patients, respectively. A total of 108 cycles of D and C (median 6, range 2-6) and 71 cycles of X (median 6, range 2-10) were administered. Median relative dose intensity was 96% for D and C and 95% for X. Over 17 evaluable patients for efficacy, 2 achieved complete response and 4 partial response; the ORR was 35.3% (95% CI:12.6-58.1). During D and C treatment, grade III/IV toxicities per patient were neutropenia (25.0%), leucopenia (10.0%), mucositis (5.0%), oedema (5.0%), febrile neutropenia (5.0%) and thrombophlebitis (5.0%). Most common grade II toxicities were nausea (20.0%), vomiting (15.0%) and asthenia (20.0%). During X treatment, grade III/IV toxicities per patient were neutropenia (7.1%) and hand-foot syndrome (7.1%). Main grade II toxicity was hand-foot syndrome (14.3%). Two patients finished treatment after 2 and 6 cycles of X due to diarrhea, oedema and anorexia, and hand-foot syndrome.
 Conclusion: In this preliminary analysis, D and C followed by sequential X seems to be an active and well-tolerated regimen as first line treatment in patients with locally advanced or metastatic BC.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2155.
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Affiliation(s)
- A Lorenzo
- 1 Servicio Oncología Médica, H. Universitario de Puerto Real, Cádiz, Spain
| | - A Modolell
- 2 Instituto de Oncología Corachán, Barcelona, Spain
| | - P Valero
- 3 Servicio Oncología Médica, Clínica Infanta Luisa, Sevilla, Spain
| | - L Murillo
- 4 Servicio Oncología Médica, H. Reina Sofía de Tudela, Navarra, Spain
| | - JM García-Bueno
- 5 Servicio Oncología Médica, Policlínica Miramar, Palma de Mallorca, Spain
| | - A Yubero
- 6 Servicio Oncología Médica, H. Obispo Polanco, Teruel, Spain
| | - I Machengs
- 7 Servicio Oncología Médica, H. Sagrat Cor, Barcelona, Spain
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Visús C, Andres R, Mayordomo JI, Martinez-Lorenzo MJ, Murillo L, Sáez-Gutiérrez B, Diestre C, Marcos I, Astier P, Godino J, Carapeto-Marquez de Prado FJ, Larrad L, Tres A. Prognostic role of circulating melanoma cells detected by reverse transcriptase-polymerase chain reaction for tyrosinase mRNA in patients with melanoma. Melanoma Res 2007; 17:83-9. [PMID: 17496783 DOI: 10.1097/cmr.0b013e3280a60878] [Citation(s) in RCA: 37] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A need for factors predictive of prognosis is present in patients who are diagnosed with malignant melanoma. The detection of circulating melanoma cells by reverse transcriptase-polymerase chain reaction for tyrosinase mRNA is a possible negative prognostic factor. The aim of this study was to assess the prognostic value of reverse transcriptase-PCR for tyrosinase mRNA in peripheral blood samples. From January 2000 to February 2003, duplicate blood samples were drawn from 114 melanoma patients following surgery and informed consent, and were tested with reverse transcriptase-PCR, for tyrosinase mRNA. Outer primers for the first PCR were R1 (sense): TTGGCAGATTGTCTGTAGCC and R2 (antisense): AGGCATTGTGCATGCTGCT. For the second round of PCR, nested primers were R3 (sense): GTCTTTATGCAATGGAACGC and R4 (antisense): GCTATCCCAGTAAGTGGACT. Threshold for detection of the technique was determined by adding serially diluted MelJuSo cells to healthy volunteer blood samples. Overall, 91 (79.1%) patients tested negative for tyrosinase mRNA and 24 (20.9%) tested positive. The number of patients who tested positive by stage was 3/38 (7.9%) for stage I, 3/22 (13.6%) for stage II, 5/30 (16.7%) for stage III and 13/24 (54.2%) for stage IV (P< 0.0001). 11/90 (12.2%) patients with no evidence of disease (stage I, II and III) tested positive and 13/24 (54.2%) patients with clinically confirmed distant metastases (stage IV) tested positive (P<0.00001). With median follow-up of 372 days or to death (range: 0-1303 days), median progression-free survival has not been reached for tyrosinase-negative patients and was 265 days for tyrosinase-positive patients (P<0.00001, log-rank test=21.07). Median overall survival was 344 days for tyrosinase-positive patients and has not been reached for tyrosinase-negative patients (P=0.0001, log-rank test=21.38). Stage, Breslow thickness and result of RT-PCR were significant prognostic factors for disease-free survival in a multivariate analysis, and stage was the only significant prognostic factor for overall survival. In conclusion, detection of circulating melanoma cells by reverse transcriptase-PCR for tyrosinase mRNA is a significant adverse prognostic factor for disease-free survival in patients with malignant melanoma.
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Affiliation(s)
- Carmen Visús
- Division of Medical Oncology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
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Modolell A, Mayordomo MD JI, Garcia-Bueno JM, Machengs I, Alvarez I, Centelles M, Palombo H, Burillo M, Yubero A, Murillo L, Andrés R. Multicenter phase II study of liposomal doxorubicin (M) and docetaxel (T) as neoadjuvant treatment in patients with stage II - III breast cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10662 Background: T and M is a very active chemotherapy regimen for breast cancer. M has been shown to be as effective as doxorubicin at same doses while reducing the cardiotoxicity and causing less myelosuppression. This study was designed to evaluate clinical and pathological response rate (RR) and toxicity after induction chemotherapy in patient with breast cancer. Methods: Patients with histological confirmation of breast cancer (stage II-III and inflammatory), age > 18 years, left ventricular eject fraction > 45% and adequate bone marrow, renal and hepatic function were included in the study. Prior systemic therapy or radiotherapy and surgery for breast cancer were not allowed. Treatment: T (75 mg/m2) iv and M (75 mg/m2) iv, every 21 days during 4 cycles, followed by surgery. Results: To date 59 patients have been enrolled; 50 were included in this interim analysis, with a median age of 52 years old (28–76), ECOG PS 0, 88.0%; ECOG PS 1, 12.0%; breast location: right, 52.0%; peri-postmenopausal status, 44.9%. Positive hormonal receptor status was 63.3%. Histology was ductal carcinoma in 84.0%. Patients received a total of 188 cycles (median 4, range 2–4). Median relative dose intensity was 99% for T and for M. Efficacy: Nine patients were non-evaluable (7 on treatment, 1 consent withdrawal and 1 lost of follow-up). Of 41 evaluable patients, 5 achieved complete response (CR) (12.2%), 26 partial response (PR)(63.4%), 9 stable disease (SD) (22.0%) and 1 progressive disease (PD) (2.4%), resulting in a clinical response rate (RR) of 75.6% (95% CI: 62.5–88.7%). Surgery was performed in 40 patients: six (15.0%) of them had pathological (p) CR, 25 (62.5%) pPR, 9 (22.5%) pSD resulting in a pathological RR of 77.5% (95% CI: 64.6–90.4%). Median of time to progression and overall survival has not been achieved yet. Hematological toxicities grades III/IV per patient were neutropenia (14%), thrombocytopenia (4%), leukopenia (2%), anemia (2%) and febrile neutropenia (12%). Non-hematological grade III/IV toxicities per patient were asthenia (6%), nausea / vomiting (4%) and infection (4%). Conclusions: T and M every 21 days during 4 cycles as induction chemotherapy in stage II and III breast cancer is an active and well tolerated treatment. No significant financial relationships to disclose.
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Affiliation(s)
- A. Modolell
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - J. I. Mayordomo MD
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - J. M. Garcia-Bueno
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - I. Machengs
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - I. Alvarez
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - M. Centelles
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - H. Palombo
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - M. Burillo
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - A. Yubero
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - L. Murillo
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
| | - R. Andrés
- Instituto Oncologico Corachan, Barcelona, Spain; Hospital Clinico Universitario, Zaragoza, Spain; Policlinica Miramar, Palma de Mallorca, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Clinica del Remedio, Barcelona, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital Reina Sofia, Tudela, Spain
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Mayordomo JI, Madroñal C, Garcia-Lopez MJ, Burillo MA, Perez V, Janariz J, Murillo L, Andres R, Lara R, Lambea J, Alvarez Javier Sanz I. Safety analysis of docetaxel (T) and doxorubicin (A) followed by sequential capecitabine (X) as adjuvant chemotherapy of patients with node-positive operable breast cancer (BC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. I. Mayordomo
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - C. Madroñal
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - M. J. Garcia-Lopez
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - M. A. Burillo
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - V. Perez
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - J. Janariz
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - L. Murillo
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - R. Andres
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - R. Lara
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - J. Lambea
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
| | - I. Alvarez Javier Sanz
- Hosp Clinico Univ, Zaragoza, Spain; Inst de Oncologia Corachan, Barcelona, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp Gen San Jorge, Huesca, Spain; Hosp de la Arritxaca, Murcia, Spain; Hosp de la Cruz Roja, Hospitalet (Barcelona), Spain; Hosp de Tudela, Tudela (Navarra), Spain
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Lara R, Mayordomo JI, Modolell A, Burillo M, Sanz J, Murillo L, Janariz J, Perez V, Andres R, Tres A. Feasibility of adjuvant chemotherapy with doxorubicin plus docetaxel followed by sequential capecitabine in patients with node positive breast cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Lara
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - J. I. Mayordomo
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - A. Modolell
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - M. Burillo
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - J. Sanz
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - L. Murillo
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - J. Janariz
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - V. Perez
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - R. Andres
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
| | - A. Tres
- Hospital Clinico Universitario, Zaragoza, Spain; Instituto de Oncologia Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital de Tudela, Tudela, Spain; Hospital de la Cruz Roja, Hospitalet (Barcelona), Spain; Hospital de la Arritxaca, Murcia, Spain
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Murillo L, Crusius JBA, van Bodegraven AA, Alizadeh BZ, Peña AS. CARD15 gene and the classification of Crohn's disease. Immunogenetics 2002; 54:59-61. [PMID: 11976792 DOI: 10.1007/s00251-002-0440-1] [Citation(s) in RCA: 64] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2001] [Revised: 01/21/2002] [Indexed: 12/11/2022]
Abstract
An insertion mutation at nucleotide 3020 (3020insC) in the CARD15 gene, originally reported as NOD2, has been strongly associated with Crohn's disease. The CARD15 G2722C missense mutation was also shown to be associated with this disease. We studied 130 Dutch Crohn's disease patients, with a median follow up of 9.2 years, in relation to the Vienna classification, and 152 ethnically matched healthy controls. We confirm reports that the CARD15 3020insC mutation increases the susceptibility to Crohn's disease, but we do not confirm this relationship for CARD15 G2722C. Our findings suggest that these mutations are not a marker of a particular form of Crohn's disease according to the Vienna classification. Whether the CARD153020insC and CARD15 G2722C mutations are responsible for a different etiopathogenic mechanism in a subgroup of patients remains to be studied.
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Affiliation(s)
- Laura Murillo
- Department of Gastroenterology and Laboratory of Immunogenetics, Vrije Universiteit Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Martí JL, Bueso P, Mayordomo JI, Isla MD, Saenz A, Escudero P, Murillo L, Filipovich E, Andres R, Tres A. Combination chemotherapy with docetaxel plus vinorelbine in metastatic breast cancer patients with prior exposure to anthracyclines. Ann Oncol 2001; 12:1061-5. [PMID: 11583186 DOI: 10.1023/a:1011691307995] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [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: 11/12/2022] Open
Abstract
PURPOSE To evaluate the anti-tumor activity and tolerance of docetaxel plus vinorelbine in metastatic breast cancer (MBC) patients previously treated with anthracyclines. PATIENTS AND METHODS Fifty patients with MBC were treated with docetaxel 75 mg/m2 (subsequently reduced to 60 mg/m2) plus vinorelbine 30 mg/m2 (subsequently reduced to 24 mg/m2). both on day 1, every 3 weeks, for a maximum of six cycles. All patients had previously received anthracyclines as adjuvant treatment (< 12 months disease-free interval) or first-line therapy for MBC. Thirty-seven patients had received at least one prior regimen for MBC. Twenty-five patients had prior high-dose chemotherapy with stem-cell rescue. Thirty patients had multiple metastatic sites. Liver and lung disease were the predominant metastatic site in 31 patients. RESULTS Forty-nine patients were assessable for response. Nineteen patients achieved a partial response and four a complete response (overall response rate, 46%; 95% confidence interval (95% CI): 32%-60%). Fourteen patients (28%) had stable disease on treatment. Median Kaplan-Meier estimated progression-free and duration of response times are 21 and 29 weeks. Median survival time is 47 weeks. Hematological dose-limiting toxicity, prompted a 20% dose reduction for both drugs after the first thirteen patients were treated. Neutropenia > or = grade 3 occurred in nineteen (34%) patients, neutropenic fever in 15 (7) courses, and mucositis > or = grade 3 in 6 (3%) courses. CONCLUSIONS The combination of docetaxel plus vinorelbine on day 1 every 3 weeks is feasible and active in MBC patients with prior anthracycline exposure. This regimen is safe, well-tolerated and convenient for the patients.
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Affiliation(s)
- J L Martí
- Division of Medical Oncology, Hospital Clinico Universitario, Zaragoza, Spain
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Murillo-Fuentes L, Artillo R, Carreras O, Murillo L. Effects of maternal chronic alcohol administration in the rat: lactation performance and pup's growth. Eur J Nutr 2001; 40:147-54. [PMID: 11905955 DOI: 10.1007/s003940170002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A fostering/crossfostering analysis of the effects of maternal ethanol exposure on lactation performance and offspring growth was performed. Wistar rats were kept under one of the three experimental nutritional treatments: alcohol-treated (EG), pair-fed-treated (PFG) (as a nutritional control of alcohol-associated malnutrition), and control or normal diet (CG). Rats from the EG group were accustomed to increased amounts of ethanol (5% during the first week to 20% in the fourth week). The 20% ethanol level was maintained throughout three additional weeks and during gestational and lactational period. Daily food intake, fluid consumption, body weight and gestational parameters were studied in control (CG), pair-fed (PFG) and ethanol dams (EG). At birth, half the litters were fostered to other dams of the same treatment (GLG) and half were cross-fostered to dams of the opposite treatment (GG, LG). No cross-fostering analyses were performed on the pair-fed group. Offspring body weight was controlled throughout lactation. Liver, kidney and spleen weights as well as milk consumption were also studied at the end of lactation period. In dams, a significant reduction of body weight was described throughout the suckling period. No ethanol detrimental effects were observed on body weight at birth, but in spite of a normal birth weight, alcohol during lactation was responsible for a growth deficit. Milk consumption was significantly reduced in offspring exposed to ethanol during gestation and/or lactation. Curiously, prenatal alcohol exposure affects adversely the suckling behaviour in pups at the time of weaning. In our study, alcohol treatment and malnutrition affects liver and spleen weights. However, malnutrition decreases spleen weights more than alcohol treatment. In the case of the kidney weights the alcohol decreases kidney weight more than malnutrition. Collectively, the data from the present study show similar effects following pre/postnatal and postnatal alcohol exposure. The findings suggest that chronic alcohol administration during gestation and/or lactation adversely affects pup growth at weaning as indicated by its effect on milk consumption, pup and organ weight.
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Affiliation(s)
- L Murillo-Fuentes
- Departamento de Fisiología y Biología Animal, Facultad de Farmacia, Universidad de Sevilla, Spain
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Delgado M, Razola P, Abós MD, Martí JL, Murillo L, García F, Prats E, Banzo J. [Can 67Ga citrate predict the efficacy of chemotherapy early in Hodgkin's lymphoma?]. Rev Esp Med Nucl 2001; 20:40-1. [PMID: 11181330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- M Delgado
- Servicios de Medicina Nuclear. Hospital Clínico Universitario "Lozano Blesa". Zaragoza.
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Dockrell HM, Brahmbhatt S, Robertson BD, Britton S, Fruth U, Gebre N, Hunegnaw M, Hussain R, Manandhar R, Murillo L, Pessolani MC, Roche P, Salgado JL, Sampaio E, Shahid F, Thole JE, Young DB. A postgenomic approach to identification of Mycobacterium leprae-specific peptides as T-cell reagents. Infect Immun 2000; 68:5846-55. [PMID: 10992494 PMCID: PMC101546 DOI: 10.1128/iai.68.10.5846-5855.2000] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [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: 11/20/2022] Open
Abstract
To identify Mycobacterium leprae-specific human T-cell epitopes, which could be used to distinguish exposure to M. leprae from exposure to Mycobacterium tuberculosis or to environmental mycobacteria or from immune responses following Mycobacterium bovis BCG vaccination, 15-mer synthetic peptides were synthesized based on data from the M. leprae genome, each peptide containing three or more predicted HLA-DR binding motifs. Eighty-one peptides from 33 genes were tested for their ability to induce T-cell responses, using peripheral blood mononuclear cells (PBMC) from tuberculoid leprosy patients (n = 59) and healthy leprosy contacts (n = 53) from Brazil, Ethiopia, Nepal, and Pakistan and 20 United Kingdom blood bank donors. Gamma interferon (IFN-gamma) secretion proved more sensitive for detection of PBMC responses to peptides than did lymphocyte proliferation. Many of the peptides giving the strongest responses in leprosy donors compared to subjects from the United Kingdom, where leprosy is not endemic, have identical, or almost identical, sequences in M. leprae and M. tuberculosis and would not be suitable as diagnostic tools. Most of the peptides recognized by United Kingdom donors showed promiscuous recognition by subjects expressing differing HLA-DR types. The majority of the novel T-cell epitopes identified came from proteins not previously recognized as immune targets, many of which are cytosolic enzymes. Fifteen of the tested peptides had > or =5 of 15 amino acid mismatches between the equivalent M. leprae and M. tuberculosis sequences; of these, eight gave specificities of > or =90% (percentage of United Kingdom donors who were nonresponders for IFN-gamma secretion), with sensitivities (percentage of responders) ranging from 19 to 47% for tuberculoid leprosy patients and 21 to 64% for healthy leprosy contacts. A pool of such peptides, formulated as a skin test reagent, could be used to monitor exposure to leprosy or as an aid to early diagnosis.
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Affiliation(s)
- H M Dockrell
- Immunology Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom.
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Amador R, Moreno A, Valero V, Murillo L, Mora AL, Rojas M, Rocha C, Salcedo M, Guzman F, Espejo F. The first field trials of the chemically synthesized malaria vaccine SPf66: safety, immunogenicity and protectivity. Vaccine 1992; 10:179-84. [PMID: 1557934 DOI: 10.1016/0264-410x(92)90009-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.8] [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: 12/27/2022]
Abstract
This paper reports the results of the first field study performed to assess the safety, immunogenicity and protectivity of the synthetic malaria vaccine SPf66 directed against the asexual blood stages of Plasmodium falciparum. Clinical and laboratory tests were performed on all volunteers prior to and after each immunization, demonstrating that no detectable alteration was induced by the immunization process. The vaccines were grouped as high, intermediate or low responders according to their antibody titres directed against the SPf66 molecule. Two of the 185 (1.08%) SPf66-vaccinated and nine of the 214 (4.20%) placebo-vaccinated volunteers developed P. falciparum malaria. The efficacy of the vaccine was calculated as 82.3% against P. falciparum and 60.6% against Plasmodium vivax.
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Affiliation(s)
- R Amador
- Instituto de Inmunología, Hospital San Juan de Dios, Bogotá, Colombia
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Kelly JW, Sagebiel RW, Calderon W, Murillo L, Dakin RL, Blois MS. The frequency of local recurrence and microsatellites as a guide to reexcision margins for cutaneous malignant melanoma. Ann Surg 1984; 200:759-63. [PMID: 6508406 PMCID: PMC1250595 DOI: 10.1097/00000658-198412000-00015] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A retrospective study was undertaken of local, regional, and distant recurrences in 346 patients with primary melanomas of tumor thickness less than 1.0 mm that were excised with margins of normal skin varying between 0.1 cm and 5.0 cm or more. Prospective histopathologic examination of 284 melanomas for the presence of microsatellites was also performed and their effect upon the frequency of local recurrence was studied. Margins of excision did not influence the frequency of local, regional, or distant metastases. Four recurrences of in situ superficial spreading melanoma occurred, however, when very narrow margins of excision (0.5 cm or less) were employed. Microsatellites were uncommon with tumors less than 3.0 mm in thickness (2.8% of all tumors of less than 3.0 mm in thickness, taken together), but relatively frequent in association with thicker tumors (37%). Melanomas with microsatellites were associated with a greater frequency of local clinical metastasis than those without (14% vs. 3%). Removal of more than 1.0 cm of normal skin around a melanoma of less than 1.0 mm in thickness does not further reduce rates of recurrence of any type. The use of margins of 0.5 cm or less for melanomas with a radial growth phase does appear to result in an increased frequency of local recurrence of the primary melanoma with an epidermal in situ component. These recurrences can be prevented by the removal of 1.0 cm of normal skin around such a melanoma. Microsatellites constitute a risk factor for local recurrence, but are a relatively uncommon phenomenon at tumor thickness less than 3.0 mm.
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Zacarias J, Murillo L, Valdivieso L, Brinck P, Velasco M. [Study of Australia antigen in 148 children with viral hepatitis]. Rev Chil Pediatr 1974; 45:440-1. [PMID: 4376252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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