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O'Sullivan D, Camila Cardenas M, Ricaurte L, Moreira R, Weaver AL, Hopson P, Absah I. Eosinophilic esophagitis: Does age matter? J Pediatr Gastroenterol Nutr 2024. [PMID: 38562024 DOI: 10.1002/jpn3.12201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Eosinophilic esophagitis (EoE) is often diagnosed in school-age children between 6- and 9-year-old. There is less known about those who are diagnosed with EoE that are younger than 6 years old. The objective of this study is to compare clinical presentation, comorbidities, and outcomes based on age at diagnosis of EoE. METHODS Single-center retrospective chart review of children (<18 years) diagnosed with EoE between 2005 and 2020. We recorded demographics, clinical presentation, family history, past medical history, treatment, and endoscopic findings. Children in this cohort were classified based on age into three age groups: <2 years, 2-<6 years, and 6-<18 years. RESULTS We identified 256 children with EoE, the mean age (SD) at the time of diagnosis was 9 (5.2) years and 184 (72%) were male. We had 164 (64%) patients with available follow-up esophagogastroduodenoscopies (EGD) data (495 EGDs in total) of those 99/164 (60%) reached mucosal remission. In the very young children (<2 years) vomiting was the most common presentation, while poor weight gain was seen more in the 2-<6-year group in comparison to the >6-years. Food impaction and abdominal pain were most likely to present in older children 6-18 years. Combination therapy, as opposed to a single therapy, induced remission at a higher frequency in the <6-year group in comparison to the 6-<18-year group (85% vs. 66%). CONCLUSION EoE should be considered in younger children presenting with feeding difficulty and poor weight gain. Combination therapy seems to be more effective in younger children with EoE, but further studies with bigger sample size are needed to study the efficacy of the different combination therapies.
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Affiliation(s)
- Donnchadh O'Sullivan
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Maria Camila Cardenas
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Luisa Ricaurte
- Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Roger Moreira
- Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Amy L Weaver
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Puanani Hopson
- Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Imad Absah
- Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
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Chamorro DF, Cardona AF, Rodríguez J, Ruiz-Patiño A, Arrieta O, Moreno-Pérez DA, Rojas L, Zatarain-Barrón ZL, Ardila DV, Viola L, Recondo G, Blaquier JB, Martín C, Raez L, Samtani S, Ordóñez-Reyes C, Garcia-Robledo JE, Corrales L, Sotelo C, Ricaurte L, Cuello M, Mejía S, Jaller E, Vargas C, Carranza H, Otero J, Archila P, Bermudez M, Gamez T, Russo A, Malapelle U, de Miguel Perez D, de Lima VCC, Freitas H, Saldahna E, Rolfo C, Rosell R. Genomic Landscape of Primary Resistance to Osimertinib Among Hispanic Patients with EGFR-Mutant Non-Small Cell Lung Cancer (NSCLC): Results of an Observational Longitudinal Cohort Study. Target Oncol 2023; 18:425-440. [PMID: 37017806 DOI: 10.1007/s11523-023-00955-9] [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] [Accepted: 02/19/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) mutations (EGFRm) represent one of the most common genomic alterations identified among patients with non-small cell lung cancer (NSCLC). Several targeted agents for patients with EGFRm have been proven safe and effective, including the third-generation tyrosine kinase inhibitor (TKI) osimertinib. Nonetheless, some patients will present with or develop EGFR-TKI resistance mechanisms. OBJECTIVE We characterized the genomic landscape of primary resistance to osimertinib among Hispanic patients with EGFR-mutant NSCLC. METHODS An observational longitudinal cohort study was conducted with two groups of patients, those with intrinsic resistance (cohort A) and those with long-term survival (cohort B). All patients were treated and followed between January 2018 and May 2022. All patients were assessed for Programmed Cell Death Ligand 1 (PD-L1) expression and Bcl-2-like protein 11 (BIM)/AXL mRNA expression before starting TKI. After 8 weeks of treatment, a liquid biopsy was performed to determine the presence of circulating free DNA (cfDNA), and next-generation sequencing (NGS) was used to identify mutations at the time of progression. In both cohorts, overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated. RESULTS We found a homogeneous distribution of EGFR-sensitizing mutations in both cohorts. For cohort A, exon 21 mutations were more common than exon 19 deletions (ex19dels) for cohort B (P = 0.0001). The reported ORR for osimertinib was 6.3% and 100% for cohorts A and B, respectively (P = 0.0001). PFS was significantly higher in cohort B (27.4 months vs. 3.1 months; P = 0.0001) and ex19del patients versus L858R (24.5 months, 95% confidence interval [CI] 18.2-NR), vs. 7.6 months, 95% CI 4.8-21.1; P = 0.001). OS was considerably lower for cohort A (20.1 months vs. 36.0 months; P = 0.0001) and was better for patients with ex19del, no brain metastasis, and low tumor mutation burden. At the time of progression, more mutations were found in cohort A, identifying off-target alterations more frequently, including TP53, RAS, and RB1. CONCLUSION EGFR-independent alterations are common among patients with primary resistance to osimertinib and significantly impact PFS and OS. Our results suggest that among Hispanic patients, other variables associated with intrinsic resistance include the number of commutations, high levels AXL mRNA, and low levels of BIM mRNA, T790M de novo, EGFR p.L858R presence, and a high tumoral mutational burden.
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Affiliation(s)
- Diego F Chamorro
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Andrés F Cardona
- Direction of Research, Science, and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Calle 168 # 14, 110221, Bogotá, Colombia.
- Thoracic Oncology Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia.
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Darwin A Moreno-Pérez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Zyanya Lucia Zatarain-Barrón
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Dora V Ardila
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana-FNC, Bogotá, Colombia
| | - Gonzalo Recondo
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clinicas (CEMIC), Buenos Aires, Argentina
| | - Juan B Blaquier
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clinicas (CEMIC), Buenos Aires, Argentina
| | - Claudio Martín
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Luis Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Florida Atlantic University (FAU), Miami, FL, USA
| | - Suraj Samtani
- Medical Oncology Department, Bradford Hill Institute, Santiago, Chile
| | - Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | | | - Luis Corrales
- Thoracic Oncology Unit, Centro de Investigación y Manejo del Cáncer-CIMCA, San José, Costa Rica
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | | | - Mauricio Cuello
- Medical Oncology Department, Hospital de Clínicas, Universidad de la Republica-UdeLAR, Montevideo, Uruguay
| | - Sergio Mejía
- Toracic Oncology Unit, Oncology Department, Cancer Institute, Clínica de las Américas, Medellín, Colombia
| | - Elvira Jaller
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Maritza Bermudez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gamez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Alessandro Russo
- Medical Oncology Department, Azienda Ospedaliera Papardo, Messina, Sicilia, Italy
| | - Umberto Malapelle
- Predictive Molecular Pathology Laboratory, Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Diego de Miguel Perez
- Thoracic Oncology Center, Tisch Cáncer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | | | - Helano Freitas
- Thoracic Oncology Unit, A.C. Camargo Cancer Center, Sao Paulo, Brazil
| | - Erick Saldahna
- Thoracic Oncology Unit, A.C. Camargo Cancer Center, Sao Paulo, Brazil
| | - Christian Rolfo
- Thoracic Oncology Center, Tisch Cáncer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Germans Trias i Pujol Research Institute (IGTP)/Dr. Rosell Oncology Institute (IOR) Quirón-Dexeus University Institute, Barcelona, Spain
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Cifuentes C, Lombana M, Vargas H, Laguado P, Ruiz-Patiño A, Rojas L, Navarro U, Vargas C, Ricaurte L, Arrieta O, Zatarain-Barron L, Zapata L, González G, Ortiz C, Bernal L, Restrepo JG, Viola L, Grosso F, Zapata R, Mantilla W, Carranza H, Bustillo I, Llinas N, Duarte R, Rodríguez J, Archila P, Ávila J, Bermúdez M, Gámez T, Sotelo C, Otero J, Forero E, Lema M, Limpias C, Ordóñez-Reyes C, Mejía S, Rolfo C, Rosell R, Cardona AF. Application of Comprehensive Genomic Profiling-Based Next-Generation Sequencing Assay to Improve Cancer Care in a Developing Country. Cancer Control 2023; 30:10732748231175256. [PMID: 37148308 PMCID: PMC10164853 DOI: 10.1177/10732748231175256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
PURPOSE Identifying actionable oncogenic mutations have changed the therapeutic landscape in different types of tumors. This study investigated the utility of comprehensive genomic profiling (CGP), a hybrid capture-based next-generation sequencing (NGS) assay, in clinical practice in a developing country. METHODS In this retrospective cohort study, CGP was performed on clinical samples from patients with different solid tumors recruited between December 2016 and November 2020, using hybrid capture-based genomic profiling, at the individual treating physicians' request in the clinical care for therapy decisions. Kaplan-Meier survival curves were estimated to characterize the time-to-event variables. RESULTS Patients median age was 61 years (range: 14-87 years), and 64.7% were female. The most common histological diagnosis was lung primary tumors, with 90 patients corresponding to 52.9% of the samples (95% CI 45.4-60.4%). Actionable mutations with FDA-approved medications for specific alterations correspondent to tumoral histology were identified in 58 cases (46.4%), whereas other alterations were detected in 47 different samples (37.6%). The median overall survival was 15.5 months (95% CI 11.7 months-NR). Patients who were subjected to genomic evaluation at diagnosis reached a median overall survival of 18.3 months (95% CI 14.9 months-NR) compared to 14.1 months (95% CI 11.1 months-NR) in patients who obtained genomic evaluation after tumor progression and during standard treatment (P = .7). CONCLUSION CGP of different types of tumors identifies clinically relevant genomic alterations that have benefited from targeted therapy and improve cancer care in a developing country to guide personalized treatment to beneficial outcomes of cancer patients.
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Affiliation(s)
- Claudia Cifuentes
- Clinical Oncology Department, Hospital Universitario Mayor de Mederi, Bogotá, Colombia
| | - Milton Lombana
- Hematology and Oncology Department, Clínica de Occidente, Cali, Colombia
| | - Henry Vargas
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Paola Laguado
- Clinical Research Institute, Clínica del Country, Bogotá Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
- Clinical Oncology Department, Clínica del Country, Bogotá, Colombia
| | - Uriel Navarro
- Clinical Oncology Department, Clínica General del Norte, Barranquilla, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
- Clinical Oncology Department, Clínica del Country, Bogotá, Colombia
| | | | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), México City, México
| | | | - Leandro Zapata
- Oncology Department, San Vicente Fundación, Medellín, Colombia
| | - Guido González
- Centro Integral del Cáncer, Clínica de Occidente, Cali, Colombia
| | - Carlos Ortiz
- Clinical Oncology Department, Clínica del Country, Bogotá, Colombia
| | - Laura Bernal
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
- Clinical Oncology Department, Clínica Marly, Bogotá, Colombia
| | - Juan G Restrepo
- Oncology Department, Fundación Valle de Lili, Cali, Colombia
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Fabio Grosso
- Oncology Department, Medical Plus, Bogotá, Colombia
| | - Ricardo Zapata
- Oncology Department, Clínica Cardio-VID, Medellín, Colombia
| | - William Mantilla
- Hematology and Oncology Department, Fundación Cardio Infantil, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
- Clinical Oncology Department, Clínica del Country, Bogotá, Colombia
| | - Iván Bustillo
- Oncology Department, Clínica Porto Azul, Barranquilla, Colombia
| | - Néstor Llinas
- Oncology Department, Clínica Vida, Medellín, Colombia
| | - Ricardo Duarte
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jenny Ávila
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Maritza Bermúdez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gámez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Elkin Forero
- Clinical Oncology Department, Hospital Universitario Mayor de Mederi, Bogotá, Colombia
| | - Mauricio Lema
- Hematology and Oncology Department, Clínica Astorga, Medellín, Colombia
| | | | - Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Sergio Mejía
- Clinical Oncology Department, San Vicente Fundación, Medellín, Colombia
| | - Christian Rolfo
- Thoracic Oncology Center, Icahn School of Medicine at Mount Sinai Tisch Cáncer Center, Mount Sinai Hospital System, New York, NY, US
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
- Direction of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
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Mejia S, Rodríguez J, Ruiz-Patiño A, Archila P, Chamorro D, Arrieta O, Viola L, Ordoñez-Reyes C, Garcia-Robledo J, Sotelo C, Raez L, Samtani S, Recondo G, Martín C, Corrales L, Zatarain-Barrón L, Más L, Ricaurte L, Santoyo N, Cuello M, Jaller E, Vargas C, Carranza H, Otero J, Bermudez M, Gamez T, Cordeiro de Lima V, Malapelle U, Rolfo C, Rosell R, Cardona A. EP16.03-003 Systematic Population-based Identification of NTRK Fusion Genes Among Hispanic Patients with Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1063] [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: 11/29/2022]
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Chamorro D, Ruiz-Patiño A, Recondo G, Martín C, Raez L, Samtani S, Minata J, Blaquier J, Enrico D, Burotto M, Ordoñez-Reyes C, Garcia-Robledo J, Corrales L, Zatarain-Barrón L, Más L, Sotelo C, Ricaurte L, Santoyo N, Cuello M, Mejia S, Jaller E, Vargas C, Carranza H, Otero J, Rodríguez J, Archila P, Bermudez M, Gamez T, Cordeiro de Lima V, Freitas H, Russo A, Polo C, Malapelle U, de Miguel-Perez D, Rolfo C, Viola L, Rossell R, Arrieta O, Cardona A. EP16.03-002 Mechanisms of Resistance to First-line Osimertinib in Hispanic Patients with EGFR mutant Non-Small Cell Lung Cancer (FRESTON-CLICaP∫). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1062] [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: 11/26/2022]
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Vargas C, Sotelo C, Chamorro DF, Pino LE, Archila P, Sua LF, Sarmiento I, Rodríguez J, Ruíz Patiño A, Rojas L, Carranza H, Otero J, Ricaurte L, García-Robledo JE, Ordóñez-Reyes C, Corrales L, Martín C, Raez L, Rolfo C, Arrieta O, Zatarain-Barrón L, Mosquera-Paternina AF, Forero Martínez YJ, Cardona AF. Perspectiva oncológica de la medicina de precisión y su implementación en pacientes pediátricos y adultos con genes de fusión NTRK: una visión para Colombia. Medicina (B Aires) 2022. [DOI: 10.56050/01205498.1679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
La oncología de precisión, definida como la perfilación molecular de los tumores para identificar alteraciones modulables, se ha desarrollado rápidamente para integrarse en la práctica clínica. Las pruebas genómicas involucran diversas partes interesadas que trabajan coordinada y articuladamente para controlar la logística de las muestras de tejido tumoral y desarrollar las pruebas en laboratorios con altos parámetros de calidad, donde el análisis apropiado conduce a resultados reproducibles. Los médicos deben estar familiarizados con las variantes genómicas informadas y con la tecnología utilizada para determinarlas, incluidas las limitaciones de los informes y las metodologías actuales. La interpretación de los hallazgos genómicos se realiza de manera óptima gracias al aporte multidisciplinario, necesario para reducir la incertidumbre de las recomendaciones relacionadas con las variantes documentadas. Los genes 1/2/3 del receptor neurotrópico de la quinasa para la tropomiosina (NTRK) codifican las quinasas del receptor de tropomiosina (TRK) A/B/C, respectivamente. Los reordenamientos cromosómicos que causan fusiones del gen NTRK pueden dar como resultado la activación constitutiva de las proteínas TRK, que actúan como impulsores oncogénicos a través de la activación de diversas vías de crecimiento celular. Las fusiones del gen NTRK ocurren en ~0,3 % de los tumores sólidos, aunque su incidencia varía según el tipo de cáncer. Su prevalencia es >90 % en algunas neoplasias raras como el carcinoma secretor de mama y el carcinoma secretor análogo de la glándula salivar (MASC). Los inhibidores de TRK (larotrectinib, entrectinib y repotrectinib) son activos en los tumores positivos para la fusión de NTRK, y han permitido cambiar el curso natural de múltiples enfermedades. El artítuculo desarrolla una revisión integral sobre la perspectiva de la medicina de precisión y su implementación en pacientes pediátricos y adultos con genes de fusión NTRK en Colombia.
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Rojas L, Mayorga D, Ruiz-Patiño A, Rodríguez J, Cardona AF, Archila P, Avila J, Bravo M, Ricaurte L, Sotelo C, Arrieta O, Zatarain-Barrón ZL, Carranza H, Otero J, Vargas C, Barrón F, Corrales L, Martín C, Recondo G, Pino LE, Bermudez MA, Gamez T, Ordoñez-Reyes C, García-Robledo JE, de Lima VC, Freitas H, Santoyo N, Malapelle U, Russo A, Rolfo C, Rosell R. Human papillomavirus infection and lung adenocarcinoma: special benefit is observed in patients treated with immune checkpoint inhibitors. ESMO Open 2022; 7:100500. [PMID: 35753086 PMCID: PMC9434139 DOI: 10.1016/j.esmoop.2022.100500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/27/2022] [Accepted: 04/19/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Human papilloma virus (HPV) has been associated with the development and modulation of response in a series of neoplasms. In the case of lung adenocarcinoma, its role in etiology and pathogenesis is still controversial. Considering that this infection brings foreign epitopes, it could be of prognostic significance in patients with lung adenocarcinoma treated with immunotherapy. METHODS In a retrospective cohort study we evaluated the presence of HPV genomic material in lung adenocarcinoma primary lesions with the INNO-LiPA platform. Viral replication was also evaluated by detecting the presence of oncoprotein E6/E7 messenger RNA (mRNA) by quantitative RT-PCR. To confirm possible hypotheses regarding viral oncogenesis, vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 (HIF1) were evaluated with stromal fibrosis and immunoscore. RESULTS A total of 133 patients were included in the analysis, of whom 34 tested positive for HPV, reaching an estimated prevalence of 25.6% [95% confidence interval (CI) 18.2% to 32.9%]. E6/7 mRNA was identified in 28 out of the 34 previously positive cases (82.3%). In immune checkpoint inhibitor (ICI)-treated patients, the median overall survival reached 22.3 months [95% CI 19.4 months- not reached (NR)] for HPV-negative and was not reached in HPV-positive (HPV+) ones (95% CI 27.7-NR; P = 0.008). With regard to progression-free survival, HPV- patients reached a median of 9.2 months (95% CI 7.9-11.2 months) compared to 14.3 months (95% CI 13.8-16.4 months) when HPV was positive (P = 0.001). The overall response rate for HPV+ patients yielded 82.4% compared to 47.1% in negative ones. No differences regarding programmed death-ligand 1, VEGF, HIF1, stromal fibrosis, or immunoscore were identified. CONCLUSIONS In patients with HPV+ lung adenocarcinoma, a significant benefit in overall response and survival outcomes is observed.
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Affiliation(s)
- L Rojas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - D Mayorga
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - A Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - J Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - A F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia.
| | - P Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - J Avila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - M Bravo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - L Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Pathology Department, Mayo Clinic, Rochester, USA
| | - C Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - O Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Z L Zatarain-Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - H Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - J Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - C Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Oncology Department, Clinica Colsanitas, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - F Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - L Corrales
- Medical Oncology Department, Centro de Investigación y Manejo del Cáncer - CIMCA, San José, Costa Rica
| | - C Martín
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina
| | - G Recondo
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - L E Pino
- Clinical Oncology Department, Institute of Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - M A Bermudez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - T Gamez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - C Ordoñez-Reyes
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | | | - V C de Lima
- Medical Oncology Department, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil; Oncologia D'Or, São Paulo, Brazil
| | - H Freitas
- Medical Oncology Department, Thoracic Oncology Section, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - N Santoyo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - U Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - A Russo
- Medical Oncology Unit, A.O. Papardo, Messina, Italy
| | - C Rolfo
- Center for Thoracic Oncology, Tisch Cancer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, USA
| | - R Rosell
- Coyote Research Group, Pangaea Oncology, Laboratory of Molecular Biology, Quiron-Dexeus University Institute, Barcelona, Spain; Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain; Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
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8
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Cordeiro de Lima VC, Corassa M, Saldanha E, Freitas H, Arrieta O, Raez L, Samtani S, Ramos M, Rojas C, Burotto M, Chamorro DF, Recondo G, Ruiz-Patiño A, Más L, Zatarain-Barrón L, Mejía S, Nicolas Minata J, Martín C, Bautista Blaquier J, Motta Guerrero R, Aliaga-Macha C, Carracedo C, Ordóñez-Reyes C, Garcia-Robledo JE, Corrales L, Sotelo C, Ricaurte L, Santoyo N, Cuello M, Jaller E, Rodríguez J, Archila P, Bermudez M, Gamez T, Russo A, Viola L, Malapelle U, de Miguel Perez D, Rolfo C, Rosell R, Cardona AF. STK11 and KEAP1 mutations in non-small cell lung cancer patients: Descriptive analysis and prognostic value among Hispanics (STRIKE registry-CLICaP). Lung Cancer 2022; 170:114-121. [PMID: 35753125 DOI: 10.1016/j.lungcan.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mutations in STK11 (STK11Mut) and, frequently co-occurring, KEAP1 mutations (KEAP1Mut) are associated with poor survival in metastatic Non-small Cell Lung Cancer (mNSCLC) patients treated with immunotherapy. However, there are limited data regarding the prognostic or predictive significance of these genomic alterations among Hispanics. METHODS This retrospective study analyzed a cohort of Hispanic patients (N = 103) diagnosed with mNSCLC from the US and seven Latin American countries (LATAM) treated with immune checkpoint inhibitors (ICI) alone or in combination as first-line (Cohort A). All cases were treated in routine care between January 2016 and December 2021. The main objectives were to determine the association of mutations in STK11 or KEAP1 in these patients' tumors with overall (OS) and progression-free survival (PFS), presence of KRAS mutations, tumor mutational burden (TMB), and other relevant clinical variables. To compare outcomes with a STK11Wt/KEAP1Wt population, historical data from a cohort of Hispanic patients (N = 101) treated with first-line ICI was used, matching both groups by country of origin, gender, and Programed Death-ligand 1 (PD-L1) expression level (Cohort B). RESULTS Most tumors had mutations only in STK11 or KEAP1 (45.6%) without KRAS co-mutation or any other genomic alteration. Besides, 35%, 8.7%, 6.8%, and 3.9% were KRASMut + STK11Mut, KRASMut + STK11Mut + KEAP1Mut, STK11Mut + KEAP1Mut, and KRASMut + KEAP1Mut, respectively. Based on KRAS status, STK11 alterations were associated with significantly lower PD-L1 expression among those with KRASWt (p = 0.023), whereas KEAP1 mutations were predominantly associated with lower PD-L1 expression among KRASMut cases (p = 0.047). Tumors with KRASMut + KEAP1Mut had significantly higher median TMB when compared to other tumors (p = 0.040). For Cohort A, median PFS was 4.9 months (95%CI 4.3-5.4), slightly longer in those with KEAP1mut 6.1 months versus STK11Mut 4.7 months (p = 0.38). In the same cohort, PD-L1 expression and TMB did not influence PFS. OS was significantly longer among patients with tumors with PD-L1 ≥ 50% (30.9 months), and different from those with PD-L1 1-49% (22.0 months), and PD-L1 < 1% (12.0 months) (p = 0.0001). When we compared the cohorts A and B, OS was significantly shorter for patients carrying STK1 [STK11Mut 14.2 months versus STK11Wt 27.0 months (p = 0.0001)] or KEAP1 [KEAP1Mut 12.0 months versus KEAP1Wt 24.4 months (p = 0.005)] mutations. PD-L1 expression significantly affected OS independently of the presence of mutations in STK11, KEAP1, or KRAS. TMB-H favored better OS. CONCLUSIONS This is the first large Hispanic cohort to study the impact of STK11 and KEAP1 mutations in NSCLC patient treated with ICI. Our data suggest that mutations in the above-mentioned genes are associated with PD-L1 expression levels and poor OS.
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Affiliation(s)
| | - Marcelo Corassa
- Thoracic Oncology Unit, A.C.Camargo Cancer Center, Sao Paulo, Brazil
| | - Erick Saldanha
- Thoracic Oncology Unit, A.C.Camargo Cancer Center, Sao Paulo, Brazil
| | - Helano Freitas
- Thoracic Oncology Unit, A.C.Camargo Cancer Center, Sao Paulo, Brazil
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), México City, Mexico
| | - Luis Raez
- Thoracic Oncology Department, Memorial Cancer Institute, Memorial Health Care System, Miami, FL, USA
| | - Suraj Samtani
- Medical Oncology Department, Bradford Hill Clinical Research Center, Santiago, Chile
| | - Maritza Ramos
- Thoracic Oncology Unit, National Cancer Institute (INCan), México City, Mexico
| | - Carlos Rojas
- Medical Oncology Department, Bradford Hill Clinical Research Center, Santiago, Chile
| | - Mauricio Burotto
- Medical Oncology Department, Bradford Hill Clinical Research Center, Santiago, Chile
| | - Diego F Chamorro
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Gonzalo Recondo
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Luis Más
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - INEN, Lima, Peru
| | | | - Sergio Mejía
- Clinical Oncology Department, Instituto de Cancerologia - Clinica las Americas - AUNA, Colombia
| | - José Nicolas Minata
- Clinical Oncology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Claudio Martín
- Thoracic Oncology Unit, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Juan Bautista Blaquier
- Thoracic Oncology Unit, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | | | - Carlos Carracedo
- Clinical Oncology Department, Centro Oncológico Aliada, Lima, Peru
| | - Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Luis Corrales
- Thoracic Oncology Unit, Centro de Investigación y Manejo del Cáncer - CIMCA, San José, Costa Rica
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Nicolas Santoyo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Mauricio Cuello
- Medical Oncology Department, Hospital de Clínicas, Universidad de la Republica -UdeLAR, Montevideo, Uruguay
| | - Elvira Jaller
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Maritza Bermudez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Tatiana Gamez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Alessandro Russo
- Medical Oncology Department, Azienda Ospedaliera Papardo, Messina, Sicilia, Italy
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Umberto Malapelle
- Predictive Molecular Pathology Laboratory, Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Diego de Miguel Perez
- Center for Thoracic Oncology, The Tisch Cancer Institute Icahn School of Medicine, Mount Sinai, Mount Sinai Health System, One Gustave Levy Place, NY, USA
| | - Christian Rolfo
- Center for Thoracic Oncology, The Tisch Cancer Institute Icahn School of Medicine, Mount Sinai, Mount Sinai Health System, One Gustave Levy Place, NY, USA
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Germans Trias i Pujol Research Institute (IGTP)/Dr. Rosell Oncology Institute (IOR) Quirón-Dexeus University Institute, Barcelona, Spain
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia; Direction of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia.
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9
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Cardona AF, Ruiz-Patiño A, Recondo G, Martín C, Raez L, Samtani S, Minata JN, Blaquier JB, Enrico D, Burotto M, Ordóñez-Reyes C, Chamorro DF, Garcia-Robledo JE, Corrales L, Zatarain-Barrón ZL, Más L, Sotelo C, Ricaurte L, Santoyo N, Cuello M, Mejía S, Jaller E, Vargas C, Carranza H, Otero J, Rodríguez J, Archila P, Bermudez M, Gamez T, de Lima VC, Freitas H, Russo A, Polo C, Malapelle U, Perez DDM, Rolfo C, Viola L, Rosell R, Arrieta O. Mechanisms of Resistance to first-line Osimertinib in Hispanic patients with EGFR mutant non-small cell lung cancer (FRESTON-CLICaP). Clin Lung Cancer 2022; 23:522-531. [DOI: 10.1016/j.cllc.2022.06.001] [Citation(s) in RCA: 1] [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: 03/25/2022] [Revised: 05/24/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
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10
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Burgos R, Cardona AF, Santoyo N, Ruiz-Patiño A, Cure-Casilimas J, Rojas L, Ricaurte L, Muñoz Á, Garcia-Robledo JE, Ordoñez C, Sotelo C, Rodríguez J, Zatarain-Barrón ZL, Pineda D, Arrieta O. Case Report: Differential Genomics and Evolution of a Meningeal Melanoma Treated With Ipilimumab and Nivolumab. Front Oncol 2022; 11:691017. [PMID: 35070950 PMCID: PMC8766339 DOI: 10.3389/fonc.2021.691017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Primary melanocytic tumors of the CNS are extremely rare conditions, encompassing different disease processes including meningeal melanoma and meningeal melanocytosis. Its incidence range between 3-5%, with approximately 0.005 cases per 100,000 people. Tumor biological behavior is commonly aggressive, with poor prognosis and very low survivability, and a high recurrence rate, even after disease remission with multimodal treatments. Specific genetic alterations involving gene transcription, alternative splicing, RNA translation, and cell proliferation are usually seen, affecting genes like BRAF, TERT, GNAQ, SF3B1, and EIF1AX. Here we present an interesting case of a 59-year-old male presenting with neurologic symptoms and a further confirmed diagnosis of primary meningeal melanoma. Multiple therapy lines were used, including radiosurgery, immunotherapy, and chemotherapy. The patient developed two relapses and an evolving genetic makeup that confirmed the disease’s clonal origin. We also provide a review of the literature on the genetic basis of primary melanocytic tumors of the CNS.
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Affiliation(s)
- Remberto Burgos
- Neurosurgery Department, Clínica del Country/Clínica Colsanitas, Bogotá, Colombia
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.,Direction of Research and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Nicolas Santoyo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Leonardo Rojas
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luisa Ricaurte
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.,Direction of Research and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Álvaro Muñoz
- Radiotherapy Department, Carlos Ardila Lulle Institute of Cancer (ICCAL), Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Camila Ordoñez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Zyanya Lucia Zatarain-Barrón
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Diego Pineda
- Thoracic Oncology Unit and Personalized Oncology Laboratory, National Cancer Institute (INCan), México City, Mexico
| | - Oscar Arrieta
- Radiology Department, Clinica del County/Resonancia Magnética de Colombia, Bogotá, Colombia
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11
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Ruiz-Patiño A, Rodríguez J, Cardona AF, Ávila J, Archila P, Carranza H, Vargas C, Otero J, Arrieta O, Zatarain-Barrón L, Sotelo C, Ordoñez C, García-Robledo JE, Rojas L, Bermúdez M, Gámez T, Mayorga D, Corrales L, Martín C, Recondo G, Mas L, Samtani S, Ricaurte L, Malapelle U, Russo A, Barrón F, Santoyo N, Rolfo C, Rosell R. p.G12C KRAS mutation prevalence in non-small cell lung cancer: Contribution from interregional variability and population substructures among Hispanics. Transl Oncol 2021; 15:101276. [PMID: 34823093 PMCID: PMC8626684 DOI: 10.1016/j.tranon.2021.101276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
The identification of the KRAS G12C mutation in non-small cell lung cancer is relevant with new molecules being introduced for treatment. The variation of mutation prevalence among different regions indicate that certain populations are more prone to develop KRAS G12C mutations among lung cancer than others. Using genomic markers traditionally employed for the identification of individuals we managed to construct a model that was predictive for KRAS G12C mutational incidence, further indicating that appearance of KRAS G12C follows population substructures.
Background The KRAS exon 2 p. G12C mutation in patients with lung adenocarcinoma has been increasing in relevance due to the development and effectiveness of new treatment medications. Studies around different populations indicate that regional variability between ethnic groups and ancestries could play an essential role in developing this molecular alteration within lung cancer. Methods In a prospective and retrospective cohort study on samples from lung adenocarcinoma from 1000 patients from different administrative regions in Colombia were tested for the KRAS p.G12C mutation. An analysis of STR populations markers was conducted to identify substructure contributions to mutation prevalence. Results Included were 979 patients with a national mean frequency for the KRAS exon 2 p.G12C mutation of 7.97% (95%CI 6.27–9.66%). Variation between regions was also identified with Antioquia reaching a positivity value of 12.7% (95%CI 9.1–16.3%) in contrast to other regions such as Bogota DC (Capital region) with 5.4% (2.7–8.2%) and Bolivar with 2.4% (95%CI 0–7.2%) (p-value = 0.00262). Furthermore, Short tandem repeat population substructures were found for eight markers that strongly yielded association with KRAS exon 2 p.G12C frequency reaching an adjusted R2 of 0.945 and a p-value of < 0.0001. Conclusions Widespread identification of KRAS exon 2 p.G12C mutations, especially in cases where NGS is not easily achieved is feasible at a population based level that can characterize regional and national patterns of mutation status. Furthermore, this type of mutation prevalence follows a population substructure pattern that can be easily determined by population and ancestral markers such as STR.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia.
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia.
| | - Jenny Ávila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), México, Mexico
| | | | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Camila Ordoñez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | | | - Leonardo Rojas
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia; Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Maritza Bermúdez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gámez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Diana Mayorga
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José Costa Rica, Costa Rica
| | - Claudio Martín
- Medical Oncology Group, Fleming Institute, Buenos Aires, Argentina
| | - Gonzalo Recondo
- Thoracic Oncology Section, Centro de Educación Médica e Investigaciones Clínicas - CEMIC, Buenos Aires, Argentina
| | - Luis Mas
- Thoracic Oncology Unit, Instituto de Enfermedades Neoplásicas, Lima, Perú
| | - Suraj Samtani
- Medical Oncology Service, Clinica Bradford Hill, Santiago, Chile
| | - Luisa Ricaurte
- Pathology Department, Mayo Clinic, Rochester, MN, United States
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Feliciano Barrón
- Thoracic Oncology Unit, National Cancer Institute (INCan), México, Mexico
| | - Nicolas Santoyo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Calle 116 No. 9 - 72, c. 718, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cáncer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, NY, United States
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
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- Colombian Group for Clinical and Translational Cancer Research - ONCOLGroup
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- Latin American Consortium for the Investigation of Lung Cancer - CLICaP
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12
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Cardona AF, Ordóñez-Reyes C, Ruiz-Patiño A, Garcia-Robledo JE, Barron LZ, Recondo G, Rojas L, Corrales L, Martín C, Barrón F, Sotelo C, Rodríguez J, Ricaurte L, Rolfo C, Ávila J, Mayorga D, Archila P, Otero J, Mas L, Bermudez M, Gamez T, Carranza H, Vargas C, Rosell R, Arrieta O. EGFR Inhibitors Plus Bevacizumab are Superior Than EGFR Inhibitors Alone as First-Line Setting in Advanced NSCLC With EGFR Mutations and BIM Deletion Polymorphisms (BIM-CLICaP). JCO Precis Oncol 2021; 5:839-848. [DOI: 10.1200/po.20.00404] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE BIM activation is essential for epidermal growth factor receptor ( EGFR)-tyrosine kinase inhibitor (TKI)–triggered apoptosis in EGFR-mutant non–small-cell lung cancer (NSCLC). A deletion in the intron two of the BIM gene results in generation of alternatively spliced isoforms that impairs their apoptotic response to TKIs, conferring the NSCLC cells intrinsic resistance to these medications. Patients with both alterations have poor clinical evolution. The current study aimed to investigate the clinical efficacy and tolerability of EGFR-TKIs plus bevacizumab (Bev) versus EGFR-TKIs alone as first-line treatment in advanced NSCLC patients with EGFR mutations and BIM deletions ( BIMdel). MATERIALS AND METHODS A retrospective analysis was conducted. BIMdel was detected using polymerase chain reaction analysis and direct sequencing of DNA. BIM protein expression was investigated by immunohistochemistry, and BIM mRNA levels by reverse transcriptase-polymerase chain reaction. Clinical characteristics, overall survival, progression-free survival (PFS), overall response rate (ORR), and treatment-related adverse events were compared between both groups. RESULTS Thirty-three patients were included; 15 received EGFR-TKIs, and 18 received EGFR-TKIs plus Bev. The median age was 63 years, with a majority of recruited female patients. All included individuals had an Eastern Cooperative Oncology Group performance score of 2 or less. The addition of Bev resulted in a significantly higher ORR (94.4% v 40%, P > .001). Median PFS was longer with the use of the combination therapy (11.12 v 7.87 months; P = .001). Median overall survival tended to be longer in the EGFR-TKIs plus Bev (30.9 v 25.4 months; P = .06) but failed to reach statistical significance. Response in terms of both partial and complete as well as overall favorably affected PFS. CONCLUSION EGFR-TKIs plus Bev conferred a significantly higher ORR and PFS in advanced NSCLC patients with EGFR mutation and BIMdel. Further prospective studies are needed to validate these findings.
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Affiliation(s)
- Andrés F. Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Camila Ordóñez-Reyes
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | | | | | - Gonzalo Recondo
- Thoracic Oncology Section, Centro de Educación Médica e Investigaciones Clínicas—CEMIC, Buenos Aires, Argentina
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
- Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luis Corrales
- Oncology Unit, Hospital San Juan de Dios/Centro de Investigación y Manejo del Cáncer (CIMCA), San José, Costa Rica
| | - Claudio Martín
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, México
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
- Pathology Department, Mayo Clinic, Rochester, MN
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jenny Ávila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Diana Mayorga
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Luis Mas
- Thoracic Oncology Department, Instituto Nacional de Enfermedades Neoplásicas—INEN, Lima, Perú
| | - Maritza Bermudez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gamez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Hernán Carranza
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad el Bosque, Bogotá, Colombia
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, México
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13
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Cardona AF, Jaramillo-Velásquez D, Ruiz-Patiño A, Polo C, Jiménez E, Hakim F, Gómez D, Ramón JF, Cifuentes H, Mejía JA, Salguero F, Ordoñez C, Muñoz Á, Bermúdez S, Useche N, Pineda D, Ricaurte L, Zatarain-Barrón ZL, Rodríguez J, Avila J, Rojas L, Jaller E, Sotelo C, Garcia-Robledo JE, Santoyo N, Rolfo C, Rosell R, Arrieta O. Efficacy of osimertinib plus bevacizumab in glioblastoma patients with simultaneous EGFR amplification and EGFRvIII mutation. J Neurooncol 2021; 154:353-364. [PMID: 34498213 DOI: 10.1007/s11060-021-03834-3] [Citation(s) in RCA: 2] [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: 07/08/2021] [Accepted: 08/19/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Amplification of EGFR and its active mutant EGFRvIII are common in glioblastoma (GB). While EGFR and EGFRvIII play critical roles in pathogenesis, targeted therapy with EGFR-tyrosine kinase inhibitors or antibodies has shown limited efficacy. To improve the likelihood of effectiveness, we targeted adult patients with recurrent GB enriched for simultaneous EGFR amplification and EGFRvIII mutation, with osimertinib/bevacizumab at doses described for non-small cell lung cancer. METHODS We retrospectively explored whether previously described EGFRvIII mutation in association with EGFR gene amplification could predict response to osimertinib/bevacizumab combination in a subset of 15 patients treated at recurrence. The resistance pattern in a subgroup of subjects is described using a commercial next-generation sequencing panel in liquid biopsy. RESULTS There were ten males (66.7%), and the median patient's age was 56 years (range 38-70 years). After their initial diagnosis, 12 patients underwent partial (26.7%) or total resection (53.3%). Subsequently, all cases received IMRT and concurrent and adjuvant temozolomide (TMZ; the median number of cycles 9, range 6-12). The median follow-up after recurrence was 17.1 months (95% CI 12.3-22.6). All patients received osimertinib/bevacizumab as a second-line intervention with a median progression-free survival (PFS) of 5.1 months (95% CI 2.8-7.3) and overall survival of 9.0 months (95% CI 3.9-14.0). The PFS6 was 46.7%, and the overall response rate was 13.3%. After exposure to the osimertinib/bevacizumab combination, the main secondary alterations were MET amplification, STAT3, IGF1R, PTEN, and PDGFR. CONCLUSIONS While the osimertinib/bevacizumab combination was marginally effective in most GB patients with simultaneous EGFR amplification plus EGFRvIII mutation, a subgroup experienced a long-lasting meaningful benefit. The findings of this brief cohort justify the continuation of the research in a clinical trial. The pattern of resistance after exposure to osimertinib/bevacizumab includes known mechanisms in the regulation of EGFR, findings that contribute to the understanding and targeting in a stepwise rational this pathway.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Brain Tumor Unit, Clínica del Country, Calle 116 No. 9 - 72, c. 318, Bogotá, Colombia. .,Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia. .,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia. .,Thoracic Oncology Unit, Clínica del Country, Bogotá, Colombia.
| | | | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carolina Polo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Enrique Jiménez
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Fernando Hakim
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diego Gómez
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | | | - Fernando Salguero
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Camila Ordoñez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Álvaro Muñoz
- Radio-Oncology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sonia Bermúdez
- Neuroradiology Section, Radiology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Nicolas Useche
- Neuroradiology Section, Radiology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diego Pineda
- Neuroradiology Section, Radiology Department, Clínica del Country, Bogotá, Colombia
| | | | | | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Jenny Avila
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Brain Tumor Unit, Clínica del Country, Calle 116 No. 9 - 72, c. 318, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia.,Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Elvira Jaller
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Nicolas Santoyo
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cáncer Center, Mount Sinai Hospital System & Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Oscar Arrieta
- Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
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14
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Angel MO, Colombo Bonadio R, Harada G, Waisberg F, Enrico D, Arrieta O, Corrales L, Martin C, Werutsky G, Barrios C, Ricaurte L, Cardona AF. Mentoring as an opportunity to improve research and cancer care in Latin America (AAZPIRE project). ESMO Open 2021; 5:e000988. [PMID: 33234553 PMCID: PMC7689104 DOI: 10.1136/esmoopen-2020-000988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/15/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 11/04/2022] Open
Abstract
Effective networking and mentoring are critical determinants of professional satisfaction and success in oncology. There are multiple benefits associated with established mentoring programs. However, these are scarce in Latin America (LATAM). The AAZPIRE project meeting was held to encourage the discussion of mentorship strategies in our region, to create new learning frameworks, and improve cancer care. A group of 30 young oncologists and investigators, together with seven members of LACOG and CLICaP experts of 8 LATAM countries, were reunited to share views and define opportunities, barriers, and possible solutions to implement mentorship programs in LATAM. For each of the mentioned topics, key points were obtained by consensus, and a literature review was conducted to support group conclusions. This article analyses mentoring in LATAM countries and its role on promoting leadership. It will address conceptual frameworks, limitations, and opportunities from the perspectives of both mentor and mentee. The creation of regional and international group stimulation programs and joint projects that impact health policies are attractive, starting points to implement mentorship scenarios.
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Affiliation(s)
- Martín Osvaldo Angel
- Genitourinary Oncology Unit, Instituto Alexander Fleming Instituto Privado de Oncología, Buenos Aires, Argentina.
| | - Renata Colombo Bonadio
- Oncology, Universidade de São Paulo Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, Sao Paulo, Brazil
| | | | - Federico Waisberg
- Oncology, Instituto Alexander Fleming Instituto Privado de Oncología, Buenos Aires, Argentina
| | - Diego Enrico
- Oncology, Instituto Alexander Fleming Instituto Privado de Oncología, Buenos Aires, Argentina
| | - Oscar Arrieta
- Thoraxic Oncology Unit, Instituto Nacional de Cancerología, Mexico, Mexico
| | - Luis Corrales
- Medical Oncology, Center for Research and Management of Cancer, San Jose, Costa Rica
| | - Claudio Martin
- Thoraxic Oncology Unit, Instituto Alexander Fleming Instituto Privado de Oncología, Buenos Aires, Argentina
| | | | | | - Luisa Ricaurte
- Pathology Department, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Andres F Cardona
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogota, Colombia.
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15
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Martín C, Enrico D, Mas L, Patane AK, Arrieta O, Soria T, Cardona AF, Ruiz‐Patiño A, Ruiz R, Rioja P, Lozano S, Zatarain‐Barrón ZL, Barrón F, Puparelli C, Tsou F, Corassa MP, Freitas HC, Cordeiro de Lima VC, Rojas L, Ordóñez‐Reyes C, Corrales L, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Archila P, Rosell R, Cuello M, Remon J. Characteristics and outcomes of thymomas in Latin America: Results from over 10 years of experience (CLICaP-LATimus). Thorac Cancer 2021; 12:1328-1335. [PMID: 33729676 PMCID: PMC8088938 DOI: 10.1111/1759-7714.13901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/06/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Thymomas are a group of rare neoplasms of the anterior mediastinum. The objective of this study was to describe the demographics, clinical characteristics and treatment approaches in Latin America. METHODS This was a retrospective multicenter cohort study including patients with histologically proven thymomas diagnosed between 1997 and 2018. Demographics, clinicopathological characteristics and therapeutic outcomes were collected locally and analyzed in a centralized manner. RESULTS A total of 135 patients were included. Median age at diagnosis was 53 years old (19-84), 53.3% (n = 72) of patients were female and 87.4% had an ECOG performance score ranging from 0-1. A total of 47 patients (34.8%) had metastatic disease at diagnosis. Concurrent myasthenia gravis occurred in 21.5% of patients. Surgery was performed in 74 patients (54.8%), comprising 27 (20%) tumorectomies and 47 (34.8%) thymectomies. According to the Masaoka-Koga system, overall survival (OS) at five-years was 73.4%, 63.8% and 51%, at stages I-II, III-IVA and IVB, respectively (p = 0.005). Furthermore, patients with low lactate dehydrogenase (LDH) (≤373 IU/L) at baseline and myasthenia gravis concurrence showed significantly better OS (p = 0.001 and p = 0.008, respectively). In multivariate analysis, high LDH levels (HR 2.8 [95% confidence interval [CI]: 1.1-7.8]; p = 0.036) at baseline and not performing a surgical resection (HR 4.1 [95% CI: 1.3-12.7]; p = 0.016) were significantly associated with increased risk of death. CONCLUSIONS Our data provides the largest insight into the clinical characteristics and outcomes of patients with thymomas in Latin America. Survival in patients with thymomas continues to be very favorable, especially when subjected to adequate local control.
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Affiliation(s)
- Claudio Martín
- Thoracic Oncology UnitAlexander Fleming Cancer InstituteBuenos AiresArgentina
| | - Diego Enrico
- Clinical Oncology DepartmentAlexander Fleming Cancer InstituteBuenos AiresArgentina
| | - Luis Mas
- Thoracic Oncology Unit, Oncology DepartmentInstituto Nacional de Enfermedades Neoplásicas – INENLimaPeru
| | | | - Oscar Arrieta
- Thoracic Oncology UnitInstituto Nacional de Cancerología‐ INCanMéxico CityMexico
| | - Tannia Soria
- Thoracic Oncology UnitHospital SOLCAQuitoEcuador
| | - Andrés F. Cardona
- Clinical and Traslational Oncology GroupClinica del CountryBogotáColombia
- Foundation for Clinical and Applied Cancer Research – FICMACBogotáColombia
- Molecular Oncology and Biology Systems Research Group (Fox‐G)Universidad el BosqueBogotáColombia
| | - Alejandro Ruiz‐Patiño
- Foundation for Clinical and Applied Cancer Research – FICMACBogotáColombia
- Molecular Oncology and Biology Systems Research Group (Fox‐G)Universidad el BosqueBogotáColombia
| | - Rossana Ruiz
- Thoracic Oncology Unit, Oncology DepartmentInstituto Nacional de Enfermedades Neoplásicas – INENLimaPeru
| | - Patricia Rioja
- Thoracic Oncology Unit, Oncology DepartmentInstituto Nacional de Enfermedades Neoplásicas – INENLimaPeru
| | - Sophia Lozano
- Thoracic Oncology Unit, Oncology DepartmentInstituto Nacional de Enfermedades Neoplásicas – INENLimaPeru
| | | | - Feliciano Barrón
- Thoracic Oncology UnitInstituto Nacional de Cancerología‐ INCanMéxico CityMexico
| | - Carmen Puparelli
- Thoracic Oncology UnitAlexander Fleming Cancer InstituteBuenos AiresArgentina
| | - Florencia Tsou
- Thoracic Oncology UnitAlexander Fleming Cancer InstituteBuenos AiresArgentina
| | | | - Helano C. Freitas
- Department of Medical OncologyA C Camargo Cancer CenterSão PauloBrazil
| | | | - Leonardo Rojas
- Clinical and Traslational Oncology GroupClinica del CountryBogotáColombia
- Molecular Oncology and Biology Systems Research Group (Fox‐G)Universidad el BosqueBogotáColombia
- Oncology DepartmentClínica ColsanitasBogotáColombia
| | | | - Luis Corrales
- Thoracic Oncology UnitHospital San Juan de Dios/Centro de Investigación y Manejo del Cáncer (CIMCA)San JoséCosta Rica
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research – FICMACBogotáColombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research – FICMACBogotáColombia
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research – FICMACBogotáColombia
| | - Jenny Ávila
- Foundation for Clinical and Applied Cancer Research – FICMACBogotáColombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research – FICMACBogotáColombia
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program at the Catalan Institute of OncologyHospital Germans Trias i PujolBarcelonaSpain
| | - Mauricio Cuello
- Medical Oncology Department, Hospital de ClínicasUniversidad de la Republica – UdeLARMontevideoUruguay
| | - Jordi Remon
- Department of Medical Oncology, Centro Integral Oncológico Clara Campal (HM‐CIOCC)Hospital HM Delfos, HM HospitalesBarcelonaSpain
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16
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Rodríguez J, Avila J, Rolfo C, Ruíz-Patiño A, Russo A, Ricaurte L, Ordóñez-Reyes C, Arrieta O, Zatarain-Barrón ZL, Recondo G, Cardona AF. When Tissue is an Issue the Liquid Biopsy is Nonissue: A Review. Oncol Ther 2021; 9:89-110. [PMID: 33689160 PMCID: PMC8140006 DOI: 10.1007/s40487-021-00144-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/11/2021] [Indexed: 02/07/2023] Open
Abstract
Precision medicine has impacted the field of medical oncology by introducing personalized therapies, improving all measurable outcomes. This field, in turn, has expanded to obtaining and analyzing a vast and ever-increasing amount of genomic information. One technique currently applied is the liquid biopsy, which consists of detecting and isolating DNA and exosomes in cancer patients. Newly developed techniques have made it possible to use the liquid biopsy in a wide range of settings. However, challenges regarding the validation of its clinical utility exist because of a lack of standardization across different techniques and tumor types, confounder genomic information, lack of appropriate clinical trial designs, and a non-measured, and therefore not estimated, economic impact on population health. Nowadays, liquid biopsy is not routinely used, but ongoing research is increasing its popularity, and a new era in oncology is developing. Therefore, it is essential to have an in-depth understanding of the liquid biopsy technique. In this review, we summarize the leading techniques and liquid biopsy applications in cancer.
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Affiliation(s)
- July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogota, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad El Bosque, Bogota, Colombia
| | - Jenny Avila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogota, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad El Bosque, Bogota, Colombia
| | - Christian Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alejandro Ruíz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogota, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad El Bosque, Bogota, Colombia
| | - Alessandro Russo
- Medical Oncology Unit A.O. Papardo and Department of Human Pathology, University of Messina, Messina, Italy
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogota, Colombia
- Pathology Department, Mayo Clinic, Rochester, MN, USA
| | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | | | - Gonzalo Recondo
- Thoracic Oncology Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogota, Colombia.
- Molecular Oncology and Biology Systems Research Group (Fox-G/ONCOLGroup), Universidad El Bosque, Bogota, Colombia.
- Clinical and Traslational Oncology Group, Clinica del Country, Bogota, Colombia.
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17
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Cardona AF, Ruiz-Patiño A, Zatarain-Barron ZL, Ariza S, Ricaurte L, Rolfo C, Arrieta O. Refractory Bullous Pemphigoid in a Patient with Metastatic Lung Adenocarcinoma Treated with Pembrolizumab. Case Rep Oncol 2021; 14:386-390. [PMID: 33776733 PMCID: PMC7983585 DOI: 10.1159/000514144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 12/25/2022] Open
Abstract
We present the case of a 73-year-old male patient with a history of tobacco use who presented with a central nervous system mass that was confirmed to be a lung adenocarcinoma metastasis. High PD-L1 expression as well as negativity to other targetable drivers led to initiation of pembrolizumab monotherapy and ablative stereotactic radiation therapy on oligo-residual disease, achieving a complete response after 2 years of therapy. Following discontinuation of systemic treatment, the patient developed widespread desquamative plaques. A skin biopsy revealed subepidermal blistering and eosinophilic infiltration in conjunction with C3 and IgG depositions on the basement membrane, detected by immunofluorescence. A diagnosis of bullous pemphigoid was obtained, and systemic corticosteroids were administered with lesion progression. Infliximab was also administered without meaningful clinical improvement. Metronomic cyclophosphamide achieved a complete resolution of skin lesions and up to this day the patient continues with tumor control and is free of dermatological findings. In conclusion, bullous pemphigoid is a very rare dermatological adverse effect related with pembrolizumab treatment. Only two cases, including this one, have been reported, especially with this medication for the treatment of non-small cell lung cancer. With more reported cases, management strategies can be optimized even in the steroid refractory setting.
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Affiliation(s)
- Andrés F Cardona
- Oncology Department, Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Oncology Department, Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | | | - Santiago Ariza
- Dermatology Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luisa Ricaurte
- Pathology Department, Mayo Clinic, Rochester, Minnesota, USA
| | - Christian Rolfo
- Thoracic Oncology Unit, Marlene and Stewart Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland, USA
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
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18
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Cardona AF, Ruiz-Patiño A, Arrieta O, Ricaurte L, Zatarain-Barrón ZL, Rodriguez J, Avila J, Rojas L, Recondo G, Barron F, Archila P, Sotelo C, Bravo M, Zamudio N, Corrales L, Martín C, Rolfo C, Viola L, Carranza H, Vargas C, Otero J, Bermudez M, Gamez T, Pino LE, Rosell R. Genotyping Squamous Cell Lung Carcinoma in Colombia (Geno1.1-CLICaP). Front Oncol 2021; 10:588932. [PMID: 33384957 PMCID: PMC7771515 DOI: 10.3389/fonc.2020.588932] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/10/2020] [Indexed: 11/29/2022] Open
Abstract
Background Lung cancer is a public health problem, and squamous cell carcinoma (SCC) is the second most prevalent subtype of this neoplasm. Compared to other subtypes, including adenocarcinoma, SCC is less well understood in terms of molecular pathogenesis, limiting therapeutic options among targeted agents approved for other disease subgroups. In this study, we sought to characterize the SCC genomic profile using a validated Next Generation Sequencing (NGS) platform. Methods The comprehensive NGS assay (TruSight Tumor 170) was used in order to target the full coding regions of 170 cancer-related genes on SCC samples. PD-L1 expression in tumor cells (TCs) was assessed using clone 22C3 (Dako). Clinical outcomes were correlated with molecular profile, including progression free survival (PFS), overall response rate (ORR), and overall survival (OS). Results A total of 26 samples were included, median age was 67 years (r, 33–83) and 53.8% were men. Tobacco consumption was identified in all subjects (mean 34-year package). For first-line treatment 80.8% of patients received cisplatin or carboplatin plus gemcitabine. In terms of molecular profile, we identified a high prevalence of inactivating mutations in TP53 (61.5%), PIK3CA (34.6%), MLL2 (34.6%), KEAP1 (38.4%), and NOTCH1 (26.9%). PD-L1 expression ranged from negative, 1, 2–49, and ≥50% in 23.1, 38.5, 26.9, and 11.5%, respectively. Interestingly, the genetic alterations did not have an effect in PFS, OS or ORR in this study. However, PDL1 expression was higher among those who had mutations in TP53 (p = 0.037) and greater expression of PDL1 was related to PIK3CA alterations (p = 0.05). Conclusions The genomic profile of SCC encompasses important genes including TP53, PIK3CA and KEAP1. TP53 mutations could be associated with PDL1 expression, generating hypothesis regarding specific treatment options.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Luisa Ricaurte
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | | | - July Rodriguez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jenny Avila
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia.,Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Gonzalo Recondo
- Thoracic Oncology Section, Centro de Educación Médica e Investigaciones Clínicas - CEMIC, Buenos Aires, Argentina
| | - Feliciano Barron
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Pilar Archila
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Carolina Sotelo
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Melissa Bravo
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Nataly Zamudio
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José Costa Rica, Costa Rica
| | - Claudio Martín
- Medical Oncology Group, Fleming Institute, Buenos Aires, Argentina
| | - Christian Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Hernán Carranza
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jorge Otero
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Maritza Bermudez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gamez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Luis Eduardo Pino
- Department of Medical Oncology, Fundación Santa Fé de Bogotá, Bogotá, Colombia
| | - Rafael Rosell
- Department of Medical Oncology, Catalan Institute of Oncology, Barcelona, Spain
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19
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Ruiz-Patiño A, Barrón F, Cardona AF, Corrales L, Mas L, Martín C, Zatarain-Barrón ZL, Recondo G, Ricaurte L, Rojas L, Archila P, Rodríguez J, Sotelo C, Viola L, Vargas C, Carranza H, Otero J, Pino LE, Rolfo C, Rosell R, Arrieta O. Antibiotics impair immune checkpoint inhibitor effectiveness in Hispanic patients with non-small cell lung cancer (AB-CLICaP). Thorac Cancer 2020; 11:2552-2560. [PMID: 32705787 PMCID: PMC7471049 DOI: 10.1111/1759-7714.13573] [Citation(s) in RCA: 11] [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: 05/28/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022] Open
Abstract
Background The intestinal microbiota is an important factor in modulating immune‐mediated tumor cell destruction. Alterations in the microbiome composition have been linked to reduced efficacy of immune checkpoint inhibitor (ICI) therapies. Therefore, antibiotic treatment (ATB), which modifies the diversity of the gut bacteria populations, could lead to a reduced efficacy of ICI treatments. Methods This was a retrospective cohort study. Patients with advanced non‐small cell lung cancer (NSCLC) treated with anti‐programmed cell death ligand‐1 (PD‐L1) alone, or in combination in three different countries in Latin America were included. After identification, patients were placed into three groups: Non‐ATB exposed (no‐ATB), exposed within 30 days of the first dose of ICI (pre‐ICI ATB) and patients receiving ATB concomitantly with ICI (ICI‐ATB). Progression‐free survival (PFS), overall survival (OS) and response rates to treatment with ICI were assessed. Results A total of 140 patients were included, of which 32 patients (23%) received ATB treatment. The most common ATB types were fluoroquinolones and B‐lactams. No differences in survival according to antibiotic type were identified. Median OS in patients not exposed to ATB was 40.6 months (95% CI: 32–67.7), compared with 20.3 months (95% CI: 12.1‐non‐reached [NR]) for patients with pre‐ICI ATB treatment and 24.7 months (95% CI: 13‐NR) for patients treated with ATB concomitantly with ICI. There were no significant differences in terms of PFS, or response rates across all treatment groups. Conclusions Antibiotic treatment was associated with reduced OS in Hispanic patients with NSCLC treated with ICIs.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Luis Corrales
- Medical Oncology Department, Hospital San Juan de Dios, San José, Costa Rica.,Thoracic Oncology Department, Centro de Investigación y Manejo del Cáncer - CIMCA, San José, Costa Rica
| | - Luis Mas
- Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - IneN, Lima, Peru
| | - Claudio Martín
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | | | - Gonzalo Recondo
- Medical Oncology Department, Center for Medical Education and Clinical Research (CEMIC), Buenos Aires, Argentina
| | - Luisa Ricaurte
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana- FNC, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Luis E Pino
- Oncology Department, Institute of Oncology - ICAL, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Christian Rolfo
- Thoracic Oncology Unit, Marlene and Stewart Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland, USA
| | - Rafael Rosell
- Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, Mexico
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20
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Ruiz-Patiño A, Cardona AF, Arrieta O, Rolfo C, Gómez HL, Raez LE, Lopes G, Zatarain-Barrón ZL, Ricaurte L, Zamudio-Molano N, Rangel V, Oviedo J, Solano MP, Rojas L, Corrales L, Martín C, Mas L, Cuello M, Barrón F, Otero J, Carranza H, Vargas C, Rosell R. Scientific publications in cancer: in Latin America, strong scientific networks increase productivity (the TENJIN study). J Clin Epidemiol 2020; 126:1-8. [PMID: 32540384 DOI: 10.1016/j.jclinepi.2020.05.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 04/22/2020] [Accepted: 05/11/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The objectives of this study are to evaluate the relationship between authorship networking, socioeconomic factors, and scientific productivity across Latin America. METHODS In a bibliometric analysis of cancer-related Latin-American publications, the relationship between authorship network indicators, sociodemographic factors, and number of peer-reviewed indexed publications per country was explored. A systematic review of the literature for cancer publications between 2000 and 2018 using the Scopus database limited to Latin-American authors was used for the construction of coauthorship and publication networks and their respective metrics. Sociodemographic variables including percentage of invested gross domestic product in research, population, and cancer incidence were also estimated. Multiple linear regression models were constructed to determine the relationship between productivity and the aforementioned variables. RESULTS A total of 8,528 articles across nine countries were included. Brazil was the most productive nation with 41.8% of identified references followed by Mexico (16.6%) and Argentina (12.9%). Latin America experienced a 9% growth in number of publications across the studied time frame. After analyzing networking and sociodemographic variables, number of authors in a collaboration network and percentage of invested gross domestic product were associated with high productivity yielding a multiple regression model with an R2 value of 0.983. CONCLUSIONS This study indicates that extensive authorship networking and a high investment in research strongly predict cancer-related productivity.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Andrés Felipe Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia.
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología - INCaN, México City, Mexico
| | - Christian Rolfo
- Thoracic Medical Oncology and Early Clinical Trials Unit, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC), Baltimore, MD, USA
| | - Henry L Gómez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - INEN, Lima, Peru
| | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute (MCI), Florida International University (FIU), Miami, FL, USA
| | - Gilberto Lopes
- Global Oncology Department, University of Miami, Sylvester Comprehensive Cancer Center and Miller School of Medicine, Miami, FL, USA
| | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Pathology Department, Mayo Clinic, Rochester, MN, USA
| | | | - Valentina Rangel
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Juan Oviedo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Maria Paula Solano
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Leonardo Rojas
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia; Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luis Corrales
- Clinical Oncology Department, Centro de Investigaciones y Manejo del Cáncer, San José, Costa Rica
| | - Claudio Martín
- Thoracic Oncology Unit, Instituto Fleming, Buenos Aires, Argentina
| | - Luis Mas
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - INEN, Lima, Peru
| | - Mauricio Cuello
- Medical Oncology Department, Hospital de Clínica, Universidad de la Republica - UdeLAR, Montevideo, Uruguay
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología - INCaN, México City, Mexico
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia; Clinical and Traslational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program Catalan Institute of Oncology; Germans Trias i Pujol Health Sciences Institute and Hospital Badalona, Barcelona, Spain
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21
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Ruiz-Patiño A, Arrieta O, Pino LE, Rolfo C, Ricaurte L, Recondo G, Zatarain-Barron ZL, Corrales L, Martín C, Barrón F, Vargas C, Carranza H, Otero J, Rodriguez J, Sotelo C, Viola L, Russo A, Rosell R, Cardona AF. Mortality and Advanced Support Requirement for Patients With Cancer With COVID-19: A Mathematical Dynamic Model for Latin America. JCO Glob Oncol 2020; 6:752-760. [PMID: 32469610 PMCID: PMC7268899 DOI: 10.1200/go.20.00156] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE In the midst of a global pandemic, evidence suggests that similar to other severe respiratory viral infections, patients with cancer are at higher risk of becoming infected by COVID-19 and have a poorer prognosis. METHODS We have modeled the mortality and the intensive care unit (ICU) requirement for the care of patients with cancer infected with COVID-19 in Latin America. A dynamic multistate Markov model was constructed. Transition probabilities were estimated on the basis of published reports for cumulative probability of complications. Basic reproductive number (R0) values were modeled with R using the EpiEstim package. Estimations of days of ICU requirement and absolute mortality were calculated by imputing number of cumulative cases in the Markov model. RESULTS Estimated median time of ICU requirement was 12.7 days, median time to mortality was 16.3 days after infection, and median time to severe event was 8.1 days. Peak ICU occupancy for patients with cancer was calculated at 16 days after infection. Deterministic sensitivity analysis revealed an interval for mortality between 18.5% and 30.4%. With the actual incidence tendency, Latin America would be expected to lose approximately 111,725 patients with cancer to SARS-CoV-2 (range, 87,116-143,154 patients) by the 60th day since the start of the outbreak. Losses calculated vary between < 1% to 17.6% of all patients with cancer in the region. CONCLUSION Cancer-related cases and deaths attributable to SARS-CoV-2 will put a great strain on health care systems in Latin America. Early implementation of interventions on the basis of data given by disease modeling could mitigate both infections and deaths among patients with cancer.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Luis E. Pino
- Oncology Department, Institute of Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Christian Rolfo
- Marlene and Stewart Comprehensive Cancer Center, Experimental Therapeutics Program, School of Medicine, University of Maryland, Baltimore, MD
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
| | - Gonzalo Recondo
- Center for Medical Education and Clinical Research, Buenos Aires, Argentina
| | | | - Luis Corrales
- Department of Oncology, Centro de Investigación y Manejo del Cáncer, San José, Costa Rica
| | - Claudio Martín
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - July Rodriguez
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neurmológica Colombiana, Bogotá, Colombia
| | - Alessandro Russo
- Marlene and Stewart Comprehensive Cancer Center, Experimental Therapeutics Program, School of Medicine, University of Maryland, Baltimore, MD
- Medical Oncology Unit, Azienda Ospedaliera Papardo, Messina, Italy
| | - Rafael Rosell
- Coyote Research Group, Pangaea Oncology, Laboratory of Molecular Biology, Quiron-Dexeus University Institute, Barcelona, Spain
- Institut d’Investigació en Ciències Germans Trias i Pujol, and Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Andrés F. Cardona
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group, Universidad el Bosque, Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
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22
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Cardona AF, Ruiz-Patiño A, Ricaurte L, Zatarain-Barrón ZL, Barrón F, Arrieta O. Chronic and Severe Non-Lichenoid Oral Ulcers Induced by Nivolumab - Diagnostic and Therapeutic Challenge: A Case Report. Case Rep Oncol 2020; 13:314-320. [PMID: 32308598 PMCID: PMC7154263 DOI: 10.1159/000505968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 12/17/2022] Open
Abstract
Due to the widespread use of immune checkpoint inhibitors and the growing research efforts in this area, immune-mediated toxicity is well recognized. Nonetheless, few severe cases of oral or upper gastrointestinal tract mucosal involvement have been documented. Early recognition and prompt treatment are key to the adequate management of these patients. We present a male 93-year-old patient with an advanced head and neck tumor treated with nivolumab who developed severe oral ulcers. After discontinuation of nivolumab, he received initial steroid treatment without any significant improvement. Histopathologic analysis of the lesions revealed a pattern similar to graft versus host disease. Extrapolating the results of colchicine mouth washing in patients with active oral ulcers and Behçet's disease, this strategy was implemented with concomitant metronomic cyclophosphamide, achieving complete ulcer resolution. Metagenomic oral bacterial sequencing during instauration of the lesions and highest extension revealed a significant decrease in microbiomic diversity and expansion of Haemophilus parainfluenzae similar to patients with active Behçet's disease. In conclusion, oral ulcers associated with immune checkpoint inhibitors correspond to a difficult-to-treat entity that could physiopathologically be related to both graft versus host disease and Behçet's disease.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Feliciano Barrón
- Thoracic Oncology Unit, National Cancer Institute (INCan), Mexico City, Mexico
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), Mexico City, Mexico
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23
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Bravo-Linares D, Acevedo-Melo AM, Ruiz-Patiño A, Ricaurte L, Lucio-Arias D, Cardona AF. Scientific Productivity and Cancer-Related Mortality: A Case Study of a Positive Association in Colombia. J Glob Oncol 2020; 5:1-10. [PMID: 31433711 PMCID: PMC6733203 DOI: 10.1200/jgo.19.00164] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Cancer morbidity represents an increasing public health issue; this worldwide phenomenon also is true for emerging upper-middle-income countries, such as Colombia. The main purpose of this study was to uncover the relationship between scientific productivity and cancer-related mortality in our setting. METHODS We conducted a temporal-trend ecologic study by means of bibliometric analysis from records of publications from SCOPUS database with Colombian institutional affiliations between 2000 and 2015. Productivity and overall mortality were estimated and compared using econometric modeling to identify potential correlations. Additional exploratory analyses per six most frequent cancer sites were performed. RESULTS Of 2,645 publication records retrieved, 1,464 (55.3%) met selection criteria to be classified as Colombian scientific production (interobserver agreement, 92.96%; κ = 0.859; 95% CI, 0.800 to 0.918). Overall, 79.6% of the records corresponded to original or in-press articles; furthermore, almost half (49.7%) embodied descriptive study designs. Selected records reported a median of five authors and three different affiliations per publication; 66% had been cited at least once up to September 2017. The most-studied cancer-specific locations were cervix (16.1%), breast (11.5%), and stomach (9.8%), but nonspecific locations had the largest combined participation (23.4%). An increasing trend in scientific productivity was correlated to decreasing trend in overall cancer mortality, which was reported as an inverse proportional relationship in the linear regression modeling (r = -0.958; P < .001). Graphic analyses per cancer-specific sites revealed heterogeneous behaviors of this relationship. CONCLUSION Colombian cancer-specific scientific productivity demonstrated a steady growth as opposed to a decreasing mortality trend in the recent years. The research output is predominantly descriptive with relatively low interinstitutional partnership and low impact in the international scientific community.
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Affiliation(s)
| | | | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | | | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Clínica del Country, Bogotá, Colombia.,Universidad El Bosque, Bogotá, Colombia
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Issa N, Lopez CL, Denic A, Taler SJ, Larson JJ, Kremers WK, Ricaurte L, Merzkani MA, Alexander MP, Chakkera HA, Stegall MD, Augustine JJ, Rule AD. Kidney Structural Features from Living Donors Predict Graft Failure in the Recipient. J Am Soc Nephrol 2020; 31:415-423. [PMID: 31974271 DOI: 10.1681/asn.2019090964] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 09/24/2019] [Accepted: 11/27/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Nephrosclerosis, nephron size, and nephron number vary among kidneys transplanted from living donors. However, whether these structural features predict kidney transplant recipient outcomes is unclear. METHODS Our study used computed tomography (CT) and implantation biopsy to investigate donated kidney features as predictors of death-censored graft failure at three transplant centers participating in the Aging Kidney Anatomy study. We used global glomerulosclerosis, interstitial fibrosis/tubular atrophy, artery luminal stenosis, and arteriolar hyalinosis to measure nephrosclerosis; mean glomerular volume, cortex volume per glomerulus, and mean cross-sectional tubular area to measure nephron size; and calculations from CT cortical volume and glomerular density on biopsy to assess nephron number. We also determined the death-censored risk of graft failure with each structural feature after adjusting for the predictive clinical characteristics of donor and recipient. RESULTS The analysis involved 2293 donor-recipient pairs. Mean recipient follow-up was 6.3 years, during which 287 death-censored graft failures and 424 deaths occurred. Factors that predicted death-censored graft failure independent of both donor and recipient clinical characteristics included interstitial fibrosis/tubular atrophy, larger cortical nephron size (but not nephron number), and smaller medullary volume. In a subset with 12 biopsy section slides, arteriolar hyalinosis also predicted death-censored graft failure. CONCLUSIONS Subclinical nephrosclerosis, larger cortical nephron size, and smaller medullary volume in healthy donors modestly predict death-censored graft failure in the recipient, independent of donor or recipient clinical characteristics. These findings provide insights into a graft's "intrinsic quality" at the time of donation, and further support the use of intraoperative biopsies to identify kidney grafts that are at higher risk for failure.
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Affiliation(s)
- Naim Issa
- Division of Nephrology and Hypertension.,William J von Liebig Center for Transplantation and Clinical Regeneration
| | | | | | - Sandra J Taler
- Division of Nephrology and Hypertension.,William J von Liebig Center for Transplantation and Clinical Regeneration
| | | | - Walter K Kremers
- William J von Liebig Center for Transplantation and Clinical Regeneration.,Division of Biomedical Statistics and Informatics, and
| | | | | | | | - Harini A Chakkera
- Division of Nephrology, Mayo Clinic Arizona, Scottsdale, Arizona; and
| | - Mark D Stegall
- William J von Liebig Center for Transplantation and Clinical Regeneration
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Cardona AF, Arrieta O, Ruiz-Patiño A, Sotelo C, Zamudio-Molano N, Zatarain-Barrón ZL, Ricaurte L, Raez L, Álvarez MPP, Barrón F, Rojas L, Rolfo C, Karachaliou N, Molina-Vila MA, Rosell R. Precision medicine and its implementation in patients with NTRK fusion genes: perspective from developing countries. Ther Adv Respir Dis 2020; 14:1753466620938553. [PMID: 32643553 PMCID: PMC7350048 DOI: 10.1177/1753466620938553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022] Open
Abstract
Precision oncology is the field that places emphasis on the diagnosis and treatment of tumors that harbor specific genomic alterations susceptible to inhibition or modulation. Although most alterations are only present in a minority of patients, a substantial effect on survival can be observed in this subgroup. Mass genome sequencing has led to the identification of a specific driver in the translocations of the tropomyosin receptor kinase family (NTRK) in a subset of rare tumors both in children and in adults, and to the development and investigation of Larotrectinib. This medication was granted approval by the US Food and Drug Administration for NTRK-positive tumors, regardless of histology or age group, as such, larotrectinib was the first in its kind to be approved under the premise that molecular pattern is more important than histology in terms of therapeutic approach. It yielded significant results in disease control with good tolerability across a wide range of diseases including rare pediatric tumors, salivary gland tumors, gliomas, soft-tissue sarcomas, and thyroid carcinomas. In addition, and by taking different approaches in clinical trial design and conducting allocation based on biomarkers, the effects of target therapies can be isolated and quantified. Moreover, and considering developing nations and resource-limited settings, precision oncology could offer a tool to reduce cancer-related disability and hospital costs. In addition, developing nations also present patients with rare tumors that lack a chance of treatment, outside of clinical trials. This, in turn, offers the possibility for international collaboration, and contributes to employment, education, and health service provisions. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Andrés F. Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Calle 116 No. 9-72, c. 318, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCaN), México city, México
| | - Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | | | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
- Pathology Department, Mayo Clinic, Rochester, Minnesota, Estados Unidos
| | - Luis Raez
- Thoracic Oncology Program, Memorial Cancer Institute (MCI), Florida International University (FIU), Miami, Florida
| | | | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCaN), México city, México
| | - Leonardo Rojas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
- Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Christian Rolfo
- Thoracic Medical Oncology and Early Clinical Trials Unit, University of Maryland, Baltimore, MD, USA
| | | | - Miguel Angel Molina-Vila
- Pangaea Oncology, Laboratory of Molecular Biology, Quirón-Dexeus University Institute, Barcelona, Catalunya, Spain
| | - Rafael Rosell
- Germans Trias i Pujol Research Institute and Hospital (IGTP), Badalona, Catalunya, Spain
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26
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Ruiz-Patiño A, Arrieta O, Cardona AF, Martín C, Raez LE, Zatarain-Barrón ZL, Barrón F, Ricaurte L, Bravo-Garzón MA, Mas L, Corrales L, Rojas L, Lupinacci L, Perazzo F, Bas C, Carranza O, Puparelli C, Rizzo M, Ruiz R, Rolfo C, Archila P, Rodríguez J, Sotelo C, Vargas C, Carranza H, Otero J, Pino LE, Ortíz C, Laguado P, Rosell R. Immunotherapy at any line of treatment improves survival in patients with advanced metastatic non-small cell lung cancer (NSCLC) compared with chemotherapy (Quijote-CLICaP). Thorac Cancer 2019; 11:353-361. [PMID: 31828967 PMCID: PMC6996989 DOI: 10.1111/1759-7714.13272] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background To compare survival outcomes of patients with advanced or metastatic non‐small cell lung cancer (NSCLC) who received immunotherapy as first‐, second‐ or beyond line, versus matched patients receiving standard chemotherapy with special characterization of hyperprogressors. Methods A retrospective cohort study of 296 patients with unresectable/metastatic NSCLC treated with either, first‐, second‐, third‐ or fourth‐line of immunotherapy was conducted. A matched comparison with a historical cohort of first‐line chemotherapy and a random forest tree analysis to characterize hyperprogressors was conducted. Results Median age was 64 years (range 34–90), 40.2% of patients were female. A total of 91.2% of patients had an Eastern Cooperative Oncology Group (ECOG) performance score ≤ 1. Immunotherapy as first‐line was given to 39 patients (13.7%), second‐line to 140 (48.8%), and as third‐line and beyond to 108 (37.6%). Median overall survival was 12.7 months (95% CI 9.67–14 months) and progression‐free survival (PFS) of 4.27 months (95% CI 3.97–5.0). Factors associated with increased survival included treatment with immunotherapy as first‐line (P < 0.001), type of response (P < 0.001) and PD‐L1 status (P = 0.0039). Compared with the historical cohort, immunotherapy proved to be superior in terms of OS (P = 0.05) but not PFS (P = 0.2). A total of 44 hyperprogressors were documented (19.8%, [95% CI 14.5–25.1%]). Leukocyte count over 5.300 cells/dL was present in both hyperprogressors and long‐term responders. Conclusions Patients who receive immune‐checkpoint inhibitors as part of their treatment for NSCLC have better overall survival (OS) compared with matched patients treated with standard chemotherapy, regardless of the line of treatment.
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Affiliation(s)
- Alejandro Ruiz-Patiño
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, Mexico
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Claudio Martín
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute/Florida International University, Miami, Florida, USA
| | | | - Feliciano Barrón
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, Mexico
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | | | - Luis Mas
- Oncology Department, Instituto Nacional de Enfermedades Neoplásicas - IneN, Lima, Peru
| | - Luis Corrales
- Medical Oncology Department, Hospital San Juan de Dios, San José, Costa Rica
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia.,Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Lorena Lupinacci
- Thoracic Oncology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Carlos Bas
- Oncology Department, Hospital Alemán, Buenos Aires, Argentina
| | - Omar Carranza
- Oncology Department, Hospital Privado de la Comunidad de Mar del Plata, Mar del Plata, Argentina
| | - Carmen Puparelli
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | - Manglio Rizzo
- Oncology Department, Hospital Austral de Buenos Aires, Buenos Aires, Argentina
| | - Rossana Ruiz
- Hematology and Oncology Department, Hospital Militar Central, Bogotá, Colombia
| | - Christian Rolfo
- Thoracic Oncology Unit, Marlene and Stewart Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - July Rodríguez
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Carolina Sotelo
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia
| | - Carlos Vargas
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Hernán Carranza
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Jorge Otero
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (FOX-G), Universidad el Bosque, Bogotá, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Luis E Pino
- Oncology Department, Institute of Oncology - ICAL, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Carlos Ortíz
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Paola Laguado
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Rafael Rosell
- Coyote Research Group, Pangaea Oncology, Laboratory of Molecular Biology, Quiron-Dexeus University Institute, Barcelona, Spain.,Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
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Cardona A, Arrieta O, Ruiz-Patiño A, Barron LZ, Corrales-Rodriguez L, Martín C, Barrón F, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Archila P, Otero J, Freitas H, De Lima VC, Mas L, Carranza H, Vargas C, Rosell R. PD2.06 EGFR Inhibitors + Bevacizumab Demonstrated Superior Efficacy Compared with EGFR Inhibitors Alone as First-line Treatment in Advanced NSCLC Patients with EGFR Mutations and BIM Deletion Polymorphisms. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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28
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Cardona A, Arrieta O, Ruiz-Patiño A, Barron LZ, Corrales-Rodriguez L, Martín C, Barrón F, Sotelo C, Rodríguez J, Ricaurte L, Freitas H, De Lima VC, Mas L, Ávila J, Mayorga D, Archila P, Otero J, Carranza H, Vargas C, Rosell R. PD2.03 Exploration of Factors Relating to Immune Response in Patients Treated with Immune Checkpoint Inhibitors for Non-small Cell Lung Cancer (NSCLC). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cardona A, Arrieta O, Ruiz-Patiño A, Barron LZ, Corrales-Rodriguez L, Martín C, Barrón F, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Archila P, Freitas H, De Lima VC, Mas L, Otero J, Carranza H, Vargas C, Rosell R. P2.22 Immunotherapy-related Thrombosis: Considerations and Associated Factors in Non-small Cell Lung Cancer (NSCLC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mas L, Patane A, Arrieta O, Soria T, Cardona A, Martín C, Ruiz-Patiño A, Ruiz R, Rioja P, Lozano S, Barron LZ, Barrón F, Corassa M, Freitas H, De Lima VC, Corrales-Rodriguez L, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. P1.12 Real World Characterization and Treatment Patterns of Patients with Thymic Carcinoma: Lessons from a Latin American Collaborative Study (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cardona A, Ruiz-Patiño A, Arrieta O, Martín C, Raez L, Barron LZ, Barrón F, Ricaurte L, Bravo-Garzón M, Mas L, Corrales-Rodriguez L, Rojas L, Lupinacci L, Perazzo F, Bas C, Carranza O, Pupareli C, Rizzo M, Mendoza RR, Rolfo C, Archila P, Rodríguez J, Sotelo C, Vargas C, Carranza H, Otero J, Pino L, Ortíz C, Laguado P, Rosell R. P2.25 Immunotherapy at Any Line of Treatment Improves Survival in Hispanic Patients with Advanced Metastatic Non-Small Cell Lung Cancer (NSCLC) Compared with Chemotherapy (Quijote-CLICaP). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cardona A, Ruiz-Patiño A, Ricaurte L, Rojas L, Barrón ZZ, Barrón F, Arrieta O. EP1.04-47 Chronic and Severe Non-Lichenoid Oral Ulcers Induced by Nivolumab: Diagnostic and Therapeutic Challenge. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cardona A, Arrieta O, Ruiz-Patiño A, Barrón ZZ, Rojas L, Corrales L, Martin C, Barrón F, Sotelo C, Rodriguez J, Ricaurte L, Ávila J, Mayorga D, Archila P, Otero J, Freitas H, De Lima VC, Mas L, Carranza H, Vargas C, Rosell R. P1.14-61 EGFR Inhibitors Plus Bevacizumab Are Superior Compared to EGFR Inhibitor Monotherapy in Advanced EGFR+ NSCLC Patients with BIM Deletions. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mas L, Patané A, Arrieta O, Soria T, Cardona A, Martin C, Ruiz-Patiño A, Rojas L, Ruiz R, Rioja P, Lozano S, Barrón ZZ, Corassa M, Freitas H, De Lima VC, Corrales L, Sotelo C, Rodriguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. EP1.15-28 Survival of Thymoma Is Extensive in Latin-American Patients: Results from Over 10 Years of Experience (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Cardona A, Ruiz-Patiño A, Arrieta O, Martin C, Raez L, Barrón ZZ, Barrón F, Ricaurte L, Bravo-Garzón M, Mas L, Corrales L, Rojas L, Lupinacci L, Perazzo F, Bas C, Carranza O, Puparelli C, Rizzo M, Ruiz R, Rolfo C, Archila P, Rodriguez J, Sotelo C, Vargas C, Carranza H, Otero J, Pino L, Ortiz C, Laguado P, Rosell R. EP1.04-46 Immunotherapy at Any Line Improves Survival in Hispanic Patients with Advanced Metastatic NSCLC Compared to Chemotherapy (Quijote-CLICaP). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Denic A, Ricaurte L, Lopez CL, Narasimhan R, Lerman LO, Lieske JC, Thompson RH, Kremers WK, Rule AD. Glomerular Volume and Glomerulosclerosis at Different Depths within the Human Kidney. J Am Soc Nephrol 2019; 30:1471-1480. [PMID: 31278193 DOI: 10.1681/asn.2019020183] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/21/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Age, CKD risk factors, and kidney function are associated with larger glomerular volume and a higher percentage of globally sclerotic glomeruli. Knowledge of how these associations may differ by cortical depth is limited. METHODS To investigate glomerular volume and glomerulosclerosis across different depths of cortex, we studied wedge sections of the renal parenchyma from 812 patients who underwent a radical nephrectomy (for a tumor), separately characterizing glomeruli in the superficial (subcapsular), middle, and deep (juxtamedullary) regions. We compared the association of mean nonsclerotic glomerular volume and of glomerulosclerosis (measured as the percentage of globally sclerotic glomeruli) with age, obesity, diabetes, smoking, kidney function, and structural pathology in the superficial, middle, and deep regions. RESULTS The superficial, middle, and deep regions showed significant differences in glomerular volume (0.0025, 0.0031, and 0.0028 µm3, respectively) and in glomerulosclerosis (18%, 7%, and 11%, respectively). There was a marked increase in glomerulosclerosis with age in the superficial region, but larger glomerular volume was not associated with age at any cortical depth. Glomerulosclerosis associated more strongly with arteriosclerosis and ischemic-appearing glomeruli in the superficial region. Hypertension, lower eGFR, and interstitial fibrosis associated with glomerulosclerosis and glomerular volume to a similar extent at any depth. Diabetes and proteinuria more strongly associated with glomerulosclerosis in the deep and middle regions, respectively, but neither associated with glomerular volume differently by depth. Obesity associated more strongly with glomerular volume in the superficial cortex. CONCLUSIONS Most clinical characteristic show similar associations with glomerulosclerosis and glomerulomegaly at different cortical depths. Exceptions include age-related glomerulosclerosis, which appears to be an ischemic process and is more predominant in the superficial region.
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Affiliation(s)
| | | | | | | | | | - John C Lieske
- Division of Nephrology and Hypertension.,Department of Laboratory Medicine and Pathology
| | | | | | - Andrew D Rule
- Division of Nephrology and Hypertension, .,Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
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Sotelo-Rodríguez DC, Ruíz-Patiño A, Ricaurte L, Arrieta O, Zatarain-Barrón ZL, Cardona AF. Challenges and shifting paradigms in clinical trials in oncology: the case for immunological and targeted therapies. Ecancermedicalscience 2019; 13:936. [PMID: 31552109 PMCID: PMC6695130 DOI: 10.3332/ecancer.2019.936] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Indexed: 11/20/2022] Open
Abstract
The advent of immunotherapy has undoubtedly changed the current standard for cancer treatment. Immunotherapy offers the possibility of achieving excellent results—a new alternative for patients with advanced-stage or relapsed disease. Nowadays, the progress made in tumour biology has led to multiple advances in clinical and translational cancer research. Many oncogenic pathways responsible for tumour growth and metastases have been described and, consequently, multiple new cancer therapeutic agents have been developed and are under current investigation. Due to this rapid increase in knowledge and pharmaceutical development, traditional clinical trials designs have encountered major limitations. The pharmacological differences (in toxicity profiles and effectiveness patterns) between immunotherapy and chemotherapy have caused traditional clinical trials to evolve in order to meet this emerging need. This review focuses on the different options pertaining to clinical trial design that have arisen in the field of immuno-oncology, as well as the challenges of accurately interpreting traditional survival analyses within this novel area of cancer medicine.
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Affiliation(s)
| | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá 100110, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), México City 14080, Mexico
| | - Zyanya Lucia Zatarain-Barrón
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), México City 14080, Mexico
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogotá 100110, Colombia.,Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá 100110, Colombia
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Cardona AF, Ruiz-Patiño A, Zatarain-Barrón ZL, Hakim F, Jiménez E, Mejía JA, Ramón JF, Useche N, Bermúdez S, Pineda D, Cifuentes H, Rojas L, Ricaurte L, Pino LE, Balaña C, Arrieta O. Systemic management of malignant meningiomas: A comparative survival and molecular marker analysis between Octreotide in combination with Everolimus and Sunitinib. PLoS One 2019; 14:e0217340. [PMID: 31220093 PMCID: PMC6586269 DOI: 10.1371/journal.pone.0217340] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/10/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose To compare the effectiveness of octreotide/everolimus vs. sunitinib for the systemic treatment of recurrent aggressive meningiomas. Methods 31 patients with recurrent or refractory WHO II or WHO III meningiomas were examined in two reference centers in Colombia. Patients who had systemic treatment (sunitinib, everolimus/octreotide) and a complete follow-up were included. Overall survival (OS), progression-free survival (PFS) and toxicities were evaluated. Additionally, tissue samples were examined for PDGFRβ and VEGFR2, their expression was correlated with outcomes. Results Twenty-two patients (72%) were female with a median age of 55 years (SD±15.3). The most prevalent histology was anaplastic meningioma in 20 patients (65%) with 48% of patients suffering from three previous relapses before the start of systemic treatment. A total of 14 patients received combination therapy with octreotide/everolimus, 11 received sunitinib and the remaining 6 received other second-line agents. Median OS was 37.3 months (95%CI 28.5–42.1) and the PFS during the treatment with everolimus/octreotide (EO) and sunitinib (Su) was 12.1 months (95%CI 9.2–21.1) and 9.1 months (95%CI 6.8–16.8); p = 0.43), respectively. The OS of the group treated with the EO→Su→Bev sequence (1st/2nd/3rd line) was 6.5 months longer than the Su→EO→Bev sequence (36.0 vs. 29.5 months) (p = 0.0001). When analyzing molecular markers, the positive PDGFRβ and negative VEGFR2 expression were associated with longer survival both in OS and PFS. Conclusion Sunitinib and octreotide/everolimus have similar efficacy and safety in the systemic management of refractory meningioma. VEGFR2 and PDGFRβ expression are associated with better outcomes.
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Affiliation(s)
- Andrés F. Cardona
- Brain Tumor Section, Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research–FICMAC, Bogotá, Colombia
- Molecular Oncology and Biology Systems Group (G-FOX), Universidad El Bosque, Bogotá, Colombia
- * E-mail: ,
| | | | | | - Fernando Hakim
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
| | - Enrique Jiménez
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
| | - Juan Armando Mejía
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
| | - Juan Fernando Ramón
- Neurosurgery Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
| | - Nicolás Useche
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
- Neuroradiology Section, Radiology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sonia Bermúdez
- Neuroscience Department, Universidad El Bosque, Bogotá, Colombia
- Neuroradiology Section, Radiology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diego Pineda
- Brain Tumor Section, Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Neuroradiology Section, Clínica del Country, Bogotá, Colombia
| | | | - Leonardo Rojas
- Brain Tumor Section, Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research–FICMAC, Bogotá, Colombia
- Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research–FICMAC, Bogotá, Colombia
| | - Luis Eduardo Pino
- Clinical Oncology Group, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Carmen Balaña
- Neuro-Oncology Section, Oncology Department, Hospital Germans Trias I Pujol, Catalan Institute of Oncology–ICO, Barcelona, Spain
| | - Oscar Arrieta
- Laboratory of Experimental Oncology, Instituto Nacional de Cancerología (INCaN), México City, México
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Cardona AF, Ricaurte L, Zatarain-Barrón ZL, Arrieta O. Squamous cell lung cancer: genomic evolution and personalized therapy. ACTA ACUST UNITED AC 2019; 61:329-338. [DOI: 10.21149/10115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 04/30/2019] [Indexed: 11/06/2022]
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Cardona Zorrilla AF, Ruiz-Patiño A, Arrieta O, Martin C, Raez LE, Zatarain Barrón ZL, Barron FB, Ricaurte L, Bravo M, Mas L, Rojas L, Lupinacci L, Perazzo F, Puparelli C, Rizzo MM, Rolfo CD, Rodriguez J, Sotelo Rodríguez DC, Carranza H, Rosell R. Effect of immunotherapy at any line of treatment on survival in Hispanic patients with advanced metastatic non-small cell lung cancer (NSCLC) compared with chemotherapy (Quijote-CLICaP). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e20637] [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
e20637 Background: To compare survival outcomes of patients with advanced or metastatic NSCLC who received immunotherapy at first, second or beyond versus matched patients receiving standard chemotherapy. Methods: A retrospective multicenter international cohort study of 296 patients with unresectable/ metastatic NSCLC treated with immunotherapy either as first, second, third or fourth line was conducted. A matched comparison with a historical cohort of first line chemotherapy was conducted. Results: Median age was 64 years (Range 34-90) and 40.2% were female patients. 91.2% of patients had an ECOG performance score ≤ 1. Immunotherapy as first line was given to 39 patients (13.7%), second line to 140 (48.8%), and as third line and beyond to 108 (37.6%). Median overall survival was 12.7 months (95% CI 9.67-14 months) and progression-free survival was 4.27 months (95% CI 3.97-5.0). Factors associated with increased survival included treatment as first-line (p < 0.001), type of response (p < 0.001) and PD-L1 status (p = 0.0039). Compared to the historical cohort, immunotherapy proved to be superior in terms of OS (p = 0.05) but not PFS (p = 0.2). Conclusions: Patients who receive immune checkpoint inhibitors as part of their treatment for NSCLC have better OS compared with matched patients treated with standard chemotherapy, regardless treatment line.
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Affiliation(s)
| | - Alejandro Ruiz-Patiño
- Fundación para la Investigación Clínica y Molecular Aplicada del Cáncer - FICMAC, Bogotá, Colombia
| | - Oscar Arrieta
- Instituto Nacional de Cancerologia-INCAN, Mexico City, Mexico
| | | | - Luis E. Raez
- Memorial Cancer Institute, Florida International University, Miami, FL
| | | | | | - Luisa Ricaurte
- Fundación Para La Investigación Clínica y Molecular Aplicada del Cáncer FICMAC, Bogotá, Colombia
| | - Maria Bravo
- Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Luis Mas
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Leonardo Rojas
- Institute of Oncology, Clínica del Country, Bogota, Colombia
| | | | | | - Carmen Puparelli
- Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
| | | | | | - July Rodriguez
- Foundation for Clinical and Applied Cancer Research-FICMAC, Bogota, Colombia
| | | | - Hernan Carranza
- Clinical and Traslational Oncology Group, Clinica del Country, Bogota, Colombia
| | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain and Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain and Institute of Oncology Rosell (IOR), University Hospital Sagrat Cor, Badalona, Barcelona, Spain
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Cardona AF, Rojas L, Zatarain-Barrón ZL, Ruiz-Patiño A, Ricaurte L, Corrales L, Martín C, Freitas H, Cordeiro de Lima VC, Rodriguez J, Avila J, Bravo M, Archila P, Carranza H, Vargas C, Otero J, Barrón F, Karachaliou N, Rosell R, Arrieta O. Multigene Mutation Profiling and Clinical Characteristics of Small-Cell Lung Cancer in Never-Smokers vs. Heavy Smokers (Geno1.3-CLICaP). Front Oncol 2019; 9:254. [PMID: 31058075 PMCID: PMC6481272 DOI: 10.3389/fonc.2019.00254] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/20/2019] [Indexed: 12/14/2022] Open
Abstract
Objectives: Lung cancer is a heterogeneous disease. Presentation and prognosis are known to vary according to several factors, such as genetic and demographic characteristics. Small-cell lung cancer incidence is increasing in never-smokers. However, the disease phenotype in this population is different compared with patients who have a smoking history. Material and Methods: To further investigate the clinical and genetic characteristics of this patient subgroup, a cohort of small cell lung cancer patients was divided into smokers (n = 10) and never/ever-smokers (n = 10). A somatic mutation profile was obtained using a comprehensive NGS assay. Clinical outcomes were compared using the Kaplan-Meier method and Cox proportional models. Results: Median age was 63 years (46–81), 40% were men, and 90% had extended disease. Smoker patients had significantly more cerebral metastases (p = 0.04) and were older (p = 0.03) compared to their non-smoker counterparts. For never/ever smokers, the main genetic mutations were TP53 (80%), RB1 (40%), CYLD (30%), and EGFR (30%). Smoker patients had more RB1 (80%, p = 0.04), CDKN2A (30%, p = 0.05), and CEBPA (30%, p = 0.05) mutations. Response rates to first-line therapy with etoposide plus cisplatin/carboplatin were 50% in smokers and 90% in never/ever smokers (p = 0.141). Median overall survival was significantly longer in never smokers compared with smokers (29.1 months [23.5–34.6] vs. 17.3 months [4.8–29.7]; p = 0.0054). Never/ever smoking history (HR 0.543, 95% CI 0.41–0.80), limited-stage disease (HR 0.56, 95% CI 0.40–0.91) and response to first-line platinum-based chemotherapy (HR 0.63, 95% CI 0.60–0.92) were independently associated with good prognosis. Conclusion: Our data supports that never/ever smoker patients with small-cell lung cancer have better prognosis compared to their smoker counterparts. Further, patients with never/ever smoking history who present with small-cell lung cancer have a different mutation profile compared with smokers, including a high frequency of EGFR, MET, and SMAD4 mutations. Further studies are required to assess whether the differential mutation profile is a consequence of a diverse pathological mechanism for disease onset.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | | | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Luis Corrales
- Department of Oncology, Hospital San Juan de Dios, San José, Costa Rica
| | - Claudio Martín
- Medical Oncology Group, Fleming Institute, Buenos Aires, Argentina
| | - Helano Freitas
- Department of Oncology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | | | - July Rodriguez
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Jenny Avila
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Melissa Bravo
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Pilar Archila
- Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia
| | - Hernán Carranza
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Jorge Otero
- Clinical and Translational Oncology Group, Clinica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Feliciano Barrón
- Thoracic Oncology Unit, National Cancer Institute (INCan), Mexico City, Mexico
| | - Niki Karachaliou
- Instituto Oncológico Dr. Rosell (IOR), Quirón-Dexeus University Institute, Barcelona, Spain.,Instituto Oncológico Dr. Rosell (IOR), Sagrat Cor Hospital, Barcelona, Spain
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Oscar Arrieta
- Thoracic Oncology Unit, National Cancer Institute (INCan), Mexico City, Mexico
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Cardona AF, Rojas L, Wills B, Ruiz-Patiño A, Abril L, Hakim F, Jiménez E, Useche N, Bermúdez S, Mejía JA, Ramón JF, Carranza H, Vargas C, Otero J, Archila P, Rodríguez J, Rodríguez J, Behaine J, González D, Jacobo J, Cifuentes H, Feo O, Penagos P, Pineda D, Ricaurte L, Pino LE, Vargas C, Marquez JC, Mantilla MI, Ortiz LD, Balaña C, Rosell R, Zatarain-Barrón ZL, Arrieta O. A comprehensive analysis of factors related to carmustine/bevacizumab response in recurrent glioblastoma. Clin Transl Oncol 2019; 21:1364-1373. [DOI: 10.1007/s12094-019-02066-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 02/15/2019] [Indexed: 11/30/2022]
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Cardona A, Arrieta O, Rojas L, Zatarain-Barrón Z, Ricaurte L, Ruiz-Patiño A, Martin C, Carranza H, Vargas C, Otero J, Corrales L. P3.01-11 Depression and Inflammation in Patients with EGFR-Mutated Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1571] [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: 10/28/2022]
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Ruiz-Patiño A, Castro C, Ricaurte L, Cardona A, Rojas L, Zatarain-Barrón Z, Wills B, Reguart N, Carranza H, Vargas C, Otero J, Corrales L, Martín C, Archila P, Rodríguez J, Avila J, Bravo M, Pino L, Rosell R, Arrieta O. P02 EGFR Amplification and Sensitizing Mutations Correlates with Survival from Erlotinib in Lung Adenocarcinoma Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.07.041] [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: 10/28/2022]
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Cardona AF, Zatarain-Barrón ZL, Rubio C, Martínez S, Ruiz-Patiño A, Ricaurte L, Serna A, Barrios R, Garzón JC, Navarrete C, Balaguera A, Corrales L, Rojas L, Arrieta O. Probable hereditary familial overlap syndrome with multiple synchronous lung tumors. Lung Cancer 2018; 124:279-282. [PMID: 30268473 DOI: 10.1016/j.lungcan.2018.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 11/28/2022]
Abstract
Here we report a case of a young, never-smoker Hispanic woman with a hereditary familial overlap syndrome (Li-Fraumeni plus CDH1). The patient developed multiple synchronous primary lung adenocarcinomas related to Intra-Alveolar Tumor Spread (STAS) several years after the diagnosis of a locally advanced lower limb osteosarcoma. Comprehensive genomic profiling by next generation sequencing (NGS) was performed on 90 cancer-related genes over each lung lesion (including two nodules of acinar adenocarcinoma, one lepidic spread tumor and in the STAS area). Likewise, the broad genomic analysis was performed on archival tissue from the previous bone tumor. Lung tumors were found to harbor PIK3CA (invasive lesions) and a rare in-frame insertion of nucleotides in exon 19 of EGFR (lepidic tumor). STAS area showed KRAS and BRAF mutations in two different segments, and osteosarcoma tested positive for well known PIK3CA, KRAS and CDH1 alterations. This unique case raises practical questions as to the challenges of molecular testing and highlights the potential association of germline TP53 and CDH1 mutations with concurrent somatic alterations that elucidate the basis of tumor heterogeneity.
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Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Thoracic Oncology Unit, Institute of Oncology, Clínica del Country, Bogotá, Colombia; Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Bogotá, Colombia.
| | - Zyanya Lucia Zatarain-Barrón
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), México City, Mexico
| | - Cladelis Rubio
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Stella Martínez
- Thoracic Surgery Department, Clínica Colsanitas, Bogotá, Colombia
| | | | - Luisa Ricaurte
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Adriana Serna
- Thoracic Surgery Department, Clínica Colsanitas, Bogotá, Colombia
| | - Rodolfo Barrios
- Thoracic Surgery Department, Clínica Colsanitas, Bogotá, Colombia
| | - Juan Carlos Garzón
- Thoracic Surgery Department, Clínica Colsanitas, Bogotá, Colombia; Thoracic Surgery Department, Fundación Cardio Infantil, Bogotá, Colombia
| | | | | | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José de Costa Rica, Costa Rica
| | - Leonardo Rojas
- Clinical Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan), México City, Mexico
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Osorio J, Medina R, Patiño N, Ricaurte L, Moreno L, Lozano E. Significance of Cytomegalovirus Prophylaxis Strategies and Development of Cancer in Kidney Transplant Recipients. Transplant Proc 2011; 43:3380-2. [DOI: 10.1016/j.transproceed.2011.09.090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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