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Martinez-Bueno A, Baulies S, Molina-Vila MA, Bertran-Alamillo J, Gonzalez Cao M, Gonzalez X, Viteri Ramirez S, Karachaliou N, Teixido C, Sanchez-Ronco M, Tresserra F, Cusido MT, Fabregas R, Rosell R. Association of non-disruptive P53 mutations with poor progression-free survival (PFS) in resected breast cancer treated with neoadjuvant chemotherapy. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Sonia Baulies
- University Hospital Quiron Dexeus, Gynecologic Department, Barcelona, Spain
| | | | | | - Maria Gonzalez Cao
- Instituto Oncológico Dr Rosell, Hospital Universitario Quirón Dexeus,, Barcelona, Spain
| | - Xavier Gonzalez
- Quirón-Dexeus University Hospital, Translational Research Unit, Dr Rosell Oncology Institute, Barcelona, Spain
| | - Santiago Viteri Ramirez
- Quirón-Dexeus University Institute, Translational Research Unit and Medical Oncology Service, Barcelona, Spain
| | - Niki Karachaliou
- Quirón Dexeus University Institute, Translational Research Unit, Barcelona, Spain
| | | | | | - Francesc Tresserra
- University Hospital Quiron Dexeus, Pathology Department, Barcelona, Spain
| | | | - Rafael Fabregas
- University Hospital Quiron Dexeus, Gynecologic Department, Barcelona, Spain
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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Romeo M, Karachaliou N, Chaib I, Queralt C, de Aguirre I, Gomez MC, Sanchez-Ronco M, Radua J, Ramirez JL, Rosell R. RAP80 mRNA expression impact on sporadic high-grade serous ovarian cancer survival. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Margarita Romeo
- Catalan Institute of Oncology, Medical Oncology Department, Badalona, Barcelona, Spain
| | - Niki Karachaliou
- Quirón Dexeus University Institute, Translational Research Unit, Barcelona, Spain
| | - Imane Chaib
- Catalan Institute of Oncology, Laboratory of Molecular Biology, Badalona, Barcelona, Spain
| | - Cristina Queralt
- Catalan Institute of Oncology, Laboratory of Molecular Biology, Badalona, Barcelona, Spain
| | - Itziar de Aguirre
- Catalan Institute of Oncology, Laboratory of Molecular Biology, Badalona, Barcelona, Spain
| | - Maria Carmen Gomez
- Hospital Germans Trias i Pujol, Pathology Department, Badalona, Barcelona, Spain
| | | | - Joaquim Radua
- Research Unit, FIDMAG Germanes Hospitalàries, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Barcelona, Spain
| | - Jose Luis Ramirez
- Catalan Institute of Oncology, Laboratory of Molecular Biology, Badalona, Barcelona, Spain
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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Jimeno J, Acosta G, Teixido C, Olbiol C, Karachaliou N, Molina M, Villacañas O, Sanchez-Ronco M, Bertran J, Gimenez-Capitan A, Monasterio J, Taron M, Rosell R, Albericio F. 478 Pharmacological disruption of the Astrocytic Elevated Gene-1 (AEG1) in anticancer intervention: PB0412_3 (PB03) as a first-in-class AEG1 interacting agent. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70604-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rosell R, Karachaliou N, Molina M, Codony J, Ramirez J, Chaib I, Garcia-Roman S, Morales-Espinosa D, Estrada R, Bertran J, Codony C, Gimenez-Capitan A, Gonzalez-Cao M, Sureda BM, Vergnenegre A, Moran T, Carcereny E, Teixido C, Villanueva A, Sanchez-Ronco M. Can we Do Better with Our Current Therapies for Nsclc? the Spanish Lung Cancer Group Approach. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu324.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Moran T, Wei J, Cobo M, Qian X, Domine M, Zou Z, Bover I, Wang L, Provencio M, Yu L, Chaib I, You C, Massuti B, Song Y, Vergnenegre A, Lu H, Lopez-Vivanco G, Hu W, Robinet G, Yan J, Insa A, Xu X, Majem M, Chen X, de Las Peñas R, Karachaliou N, Sala MA, Wu Q, Isla D, Zhou Y, Baize N, Zhang F, Garde J, Germonpre P, Rauh S, ALHusaini H, Sanchez-Ronco M, Drozdowskyj A, Sanchez JJ, Camps C, Liu B, Rosell R, Colinet B, De Grève J, Germonpré P, Chen H, Chen X, Du J, Gao Y, Hu J, Hu W, Kong W, Li L, Li R, Li X, Liu B, Liu J, Lu H, Qian X, Ren W, Song Y, Wang L, Wei J, Wen L, Wu Q, Xiao X, Xu X, Yan J, Yang J, Yang M, Yang Y, Yin J, You C, Yu L, Yue X, Zhang F, Zhang J, Zhou Y, Zhu L, Zou Z, Baize N, Bombaron P, Chouaid C, Dansin E, Fournel P, Fraboulet G, Gervais R, Hominal S, Kahlout S, Lecaer H, Lena H, LeTreut J, Locher C, Molinier O, Monnet I, Oliviero G, Robinet G, Schoot R, Thomas P, Vergnènegre A, Berchem G, Rauh S, Al Husaini H, Aparisi F, Arriola E, Ballesteros I, Barneto I, Bernabé R, Blasco A, Bosch-Barrera J, Bover I, Calvo de Juan V, Camps C, Carcereny E, Catot S, Cobo M, De Las Peñas R, Dómine M, Felip E, García-Campelo MR, García-Girón C, García-Gómez R, Garcia-Sevila R, Garde J, Gasco A, Gil J, González-Larriba JL, Hernando-Polo S, Jantus E, Insa A, Isla D, Jiménez B, Lianes P, López-López R, López-Martín A, López-Vivanco G, Macias JA, Majem M, Marti-Ciriquian JL, Massuti B, Montoyo R, Morales-Espinosa D, Morán T, Moreno MA, Pallares C, Parera M, Pérez-Carrión R, Porta R, Provencio M, Reguart N, Rosell R, Rosillo F, Sala MA, Sanchez JM, Sullivan I, Terrasa J, Trigo JM, Valdivia J, Viñolas N, Viteri S, Botia-Castillo M, Mate JL, Perez-Cano M, Ramirez JL, Sanchez-Rodriguez B, Taron M, Tierno-Garcia M, Mijangos E, Ocaña J, Pereira E, Shao J, Sun X, O'Brate R. Two biomarker-directed randomized trials in European and Chinese patients with nonsmall-cell lung cancer: the BRCA1-RAP80 Expression Customization (BREC) studies. Ann Oncol 2014; 25:2147-2155. [PMID: 25164908 DOI: 10.1093/annonc/mdu389] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In a Spanish Lung Cancer Group (SLCG) phase II trial, the combination of BRCA1 and receptor-associated protein 80 (RAP80) expression was significantly associated with outcome in Caucasian patients with nonsmall-cell lung cancer (NSCLC). The SLCG therefore undertook an industry-independent collaborative randomized phase III trial comparing nonselected cisplatin-based chemotherapy with therapy customized according to BRCA1/RAP80 expression. An analogous randomized phase II trial was carried out in China under the auspices of the SLCG to evaluate the effect of BRCA1/RAP80 expression in Asian patients. PATIENTS AND METHODS Eligibility criteria included stage IIIB-IV NSCLC and sufficient tumor specimen for molecular analysis. Randomization to the control or experimental arm was 1 : 1 in the SLCG trial and 1 : 3 in the Chinese trial. In both trials, patients in the control arm received docetaxel/cisplatin; in the experimental arm, patients with low RAP80 expression received gemcitabine/cisplatin, those with intermediate/high RAP80 expression and low/intermediate BRCA1 expression received docetaxel/cisplatin, and those with intermediate/high RAP80 expression and high BRCA1 expression received docetaxel alone. The primary end point was progression-free survival (PFS). RESULTS Two hundred and seventy-nine patients in the SLCG trial and 124 in the Chinese trial were assessable for PFS. PFS in the control and experimental arms in the SLCG trial was 5.49 and 4.38 months, respectively [log rank P = 0.07; hazard ratio (HR) 1.28; P = 0.03]. In the Chinese trial, PFS was 4.74 and 3.78 months, respectively (log rank P = 0.82; HR 0.95; P = 0.82). CONCLUSION Accrual was prematurely closed on the SLCG trial due to the absence of clinical benefit in the experimental over the control arm. However, the BREC studies provide proof of concept that an international, nonindustry, biomarker-directed trial is feasible. Thanks to the groundwork laid by these studies, we expect that ongoing further research on alternative biomarkers to elucidate DNA repair mechanisms will help define novel therapeutic approaches. TRIAL REGISTRATION NCT00617656/GECP-BREC and ChiCTR-TRC-12001860/BREC-CHINA.
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Affiliation(s)
- T Moran
- Catalan Institute of Oncology, Medical Oncology Service, Hospital Germans Trias i Pujol, Badalona, Spain
| | - J Wei
- The Comprehensive Cancer Centre, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - M Cobo
- Medical Oncology Service, Hospital Carlos Haya, Malaga
| | - X Qian
- The Comprehensive Cancer Centre, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - M Domine
- Medical Oncology Service, Fundacion Jimenez Diaz, Madrid
| | - Z Zou
- The Comprehensive Cancer Centre, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - I Bover
- Medical Oncology Service, Hospital Son Llatzer, Palma de Mallorca
| | - L Wang
- The Comprehensive Cancer Centre, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - M Provencio
- Medical Oncology Service, Hospital Puerta de Hierro, Madrid, Spain
| | - L Yu
- The Comprehensive Cancer Centre, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - I Chaib
- Catalan Institute of Oncology, Medical Oncology Service, Hospital Germans Trias i Pujol, Badalona, Spain
| | - C You
- Department of Oncology, Suqian General Hospital, Suqian, China
| | - B Massuti
- Medical Oncology Service, Hospital General de Alicante, Alicante, Spain
| | - Y Song
- Department of Pneumology, Jinling Hospital, Nanjing, China
| | - A Vergnenegre
- Service de Pathologie Respiratoire et d'Allergologie, CHU Limoges, Limoges, France
| | - H Lu
- Department of Pneumology, Taizhou General Hospital, Taizhou, China
| | | | - W Hu
- The Comprehensive Cancer Centre, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - G Robinet
- Service Pneumologie, CHU Brest, Brest, France
| | - J Yan
- The Comprehensive Cancer Centre, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - A Insa
- Medical Oncology Service, Hospital Clinico de Valencia, Valencia, Spain
| | - X Xu
- Department of Pneumology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - M Majem
- Medical Oncology Service, Hospital Sant Pau, Barcelona, Spain
| | - X Chen
- Department of Oncology, Huaian General Hospital, Huaian, China
| | - R de Las Peñas
- Medical Oncology Service, Hospital Provincial de Castellon, Castellon, Spain
| | - N Karachaliou
- Translational Research Unit, Dr Rosell Oncology Institute, Quiron-Dexeus University Hospital, Barcelona
| | - M A Sala
- Medical Oncology Service, Hospital de Basurto, Bilbao, Spain
| | - Q Wu
- Department of Oncology, Yixin General Hospital, Yixin, China
| | - D Isla
- Medical Oncology Service, Hospital Lozano Blesa, Zaragoza, Spain
| | - Y Zhou
- Department of Oncology, Yixin General Hospital, Yixin, China
| | - N Baize
- Department de Pneumologie, CHU Angers, Angers, France
| | - F Zhang
- Department of Oncology, Maanshan General Hospital, Maanshan, China
| | - J Garde
- Medical Oncology Service, Hospital Arnau de Vilanova, Valencia, Spain
| | - P Germonpre
- Department of Pulmonary Medicine, Antwerp University Hospital, Edegem, Belgium
| | - S Rauh
- Department of Internal Medicine and Oncology, Centre Hospitalier Emile Mayrisch, Luxembourg, Luxembourg
| | - H ALHusaini
- Oncology Center, King Faisal Cancer Center, Riyadh, Saudi Arabia
| | - M Sanchez-Ronco
- Department of Health and Medicosocial Sciences, University of Alcala, Madrid
| | | | - J J Sanchez
- Department of Preventive Medicine, Autonomous University of Madrid, Madrid
| | - C Camps
- Medical Oncology Service, Hospital General de Valencia, Valencia
| | - B Liu
- The Comprehensive Cancer Centre, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - R Rosell
- Catalan Institute of Oncology, Cancer Biology and Precision Medicine Program, Hospital Germans Trias i Pujol, Badalona; MORe Foundation, Barcelona, Spain; Cancer Therapeutic Innovation Group, New York,USA.
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Campelo RG, Felip E, Massuti B, Majem M, Carcereny Costa E, Palmero R, Molina-Vila MA, Martinez P, Marti-Ciriquian JL, Alonso-Jaudenes Curbera G, Pallares C, Cardenal F, Gonzalez-Arenas MC, Mayo-de las Casas C, Sanchez-Ronco M, Rosell R. Phase IB study to evaluate efficacy and tolerability of olaparib (AZD2281) plus gefitinib in patients (P) with epidermal growth factor receptor (EGFR) mutation positive advanced non-small cell lung cancer (NSCLC) (NCT=1513174/GECP-GOAL). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.8079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | - Enric Carcereny Costa
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Ramon Palmero
- Catalan Institute of Oncology, Section of Medical Oncology, L'Hospitalet de Llobregat, Spain
| | | | - Pablo Martinez
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | | | | | - Felipe Cardenal
- Catalan Institute of Oncology, Section of Medical Oncology, Barcelona, Spain
| | | | | | | | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Pangaea Biotech, Cancer Therapeutics Innovation Group, USP Institut Universitari Dexeus, Barcelona, Spain
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Margeli M, Quiroga V, Castella E, Tapia G, Sola M, Sanchez-Ronco M, Radua J, Buges C, Espasa L, Capdevila L, Luna MA, Ballester R, Arce J, Mariscal A, Vizcaya S, Vila L, Indacochea A, Barnadas A, Rosell R, Cirauqui B. HIP1 expression and response to chemotherapy in breast cancer. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mireia Margeli
- Institut Català d'Oncologia - Hospital Germans Trias i Pujol, Badalona, Spain
| | - Vanesa Quiroga
- Institut Català d'Oncologia - Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Gustavo Tapia
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Montserrat Sola
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Joaquim Radua
- Research Unit, FIDMAG Germanes Hospitalàries, Barcelona, Spain. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Barcelona, Spain
| | - Cristina Buges
- Institut Català d'Oncologia - Hospital Germans Trias i Pujol, Badalona, Spain
| | - Laia Espasa
- Institut Català d'Oncologia Badalona- HU Germans Trias i Pujol, Badalona, Spain
| | | | | | - Rosa Ballester
- ICO Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Javier Arce
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Sara Vizcaya
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Laia Vila
- Institut Català d'Oncologia Badalona- HU Germans Trias i Pujol, Badalona, Spain
| | - Alberto Indacochea
- Institut Català d'Oncologia Badalona- HU Germans Trias i Pujol, Badalona, Spain
| | | | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Pangaea Biotech, Cancer Therapeutics Innovation Group, USP Institut Universitari Dexeus, Barcelona, Spain
| | - Beatriz Cirauqui
- Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Spain
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Moran T, Cobo M, Domine M, Sanchez-Ronco M, Bover I, Provencio M, Massuti B, Vergnenegre A, Lopez-Vivanco G, Robinet G, Insa A, Majem M, De Las Penas R, Sala MÁ, Isla D, Baize N, Garde J, Chaib I, Camps C, Rosell R. Interim analysis of the Spanish Lung Cancer Group (SLCG) BRCA1-RAP80 Expression Customization (BREC) randomized phase III trial of customized therapy in advanced non-small cell lung cancer (NSCLC) patients (p) (NCT00617656/GECP-BREC). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.18_suppl.lba8002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA8002 Background: Findings from the SLCG phase II customized chemotherapy trial (NCT00883480) showed that RAP80, a component of the BRCA1 complex, influenced outcome both in p with low BRCA1 expression treated with cisplatin (cis)/gemcitabine (gem) and in p with intermediate/high BRCA1 levels treated with cis/docetaxel (doc) or with doc alone. Together with the French Lung Cancer Group, the SLCG has performed a prospective, randomized phase III trial comparing noncustomized cis/doc with customized therapy in metastatic NSCLC p. A parallel phase II study (ChiCTR-TRC-12001860) is being carried out in China under the auspices of the SLCG. Methods: Since 6 March 2008, 391 p with wild-type EGFR have been randomized 1:1 to the control or experimental arm. p in the control arm receive cis/doc; p in the experimental arm receive treatment according to their BRCA1 and RAP80 levels: p with low RAP80, regardless of BRCA1 levels, cis/gem; p with intermediate/high RAP80 and low/intermediate BRCA1, cis/doc; p with intermediate/high RAP80 and high BRCA1, doc alone. The primary endpoint is progression-free survival (PFS). Results: At the planned interim analysis (cut-off, 15 October 2012; N=279), PFS was 5.49 months (m) in the control and 4.38 m in the experimental arm (P=0.07). Overall survival (OS) was 12.66 m in the control and 8.52 m in the experimental arm (P=0.006). Response rate (RR) was 37.3% in the control and 27% in the experimental arm (P=0.07). In the multivariate analysis including PS, treatment arm, BRCA1, RAP80, histology, smoking status, and metastatic site, only extrathoracic metastases were associated with an increased risk of progression (HR, 1.78; P=0.02). Conclusions: Based on the negative results for PFS at the interim analysis, accrual has been closed on this study. Negative results may be due to the poor predictive capacity of RAP80 and the inclusion of doc alone as a treatment in the experimental arm. In addition, doc/cis may not be the ideal combination for the control arm. Clinical trial information: NCT00617656.
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Affiliation(s)
- Teresa Moran
- Institut Catala d´Oncologia, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Manuel Cobo
- Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Manuel Domine
- Oncology Department and Translational Oncology Division. Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
| | | | - Isabel Bover
- Son Llatzer University Hospital, Mallorca, Spain
| | | | | | | | | | | | - Amelia Insa
- Hospital Clinico Universitario de Valencia, Valencia, Spain
| | | | | | | | | | | | | | - Imane Chaib
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Carlos Camps
- Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Pangaea Biotech, Cancer Therapeutics Innovation Group, USP Institut Universitari Dexeus, Barcelona, Spain
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Lopez-Vivanco G, Marti T, Kotov IN, Chaib I, Ponce-Aix S, García Campelo R, Sanchez JM, Artal A, Bover I, Taron M, Sanchez-Ronco M, Rolfo CD, Massuti B, Stahel RA, Rosell R. Components of homologous recombination and translesion synthesis (TLS) in pemetrexed/cisplatin-treated non-small-cell lung cancer (NSCLC) patients (p). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.11028] [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
11028 Background: REV3, the catalytic subunit of the TLS polymerase ξ, can continue replication past DNA adducts. Depletion of REV3 sensitizes A549 lung cancer cells to cisplatin. REV3 expression is part of a gene signature that predicted pemetrexed sensitivity in 17 NSCLC cell lines. Homologous recombination and TLS pathways have non-redundant functions in response to cisplatin. We hypothesized that low REV3 mRNA expression – alone or in combination with low expression levels of genes involved in homologous recombination – could correlate with better outcome to cisplatin/pemetrexed in NSCLC. Methods: REV3, BRCA1, RAP80, TS and AEG1 mRNA was examined by quantitative RT-PCR and categorized by terciles. Expression of each gene was correlated with outcome in 47 cisplatin/pemetrexed-treated NSCLC p. Results: 63.8% male; 47% smokers; 80.9% ECOG PS 1; 80.8% adenocarcinoma. Overall response rate was 51%, with no differences according to expression levels of any of the genes. Progression-free survival (PFS) for p with low, intermediate and high BRCA1 levels was 13.4, 5.5 and 3.9 months (m), respectively (P=0.005). Similar differences in PFS were observed according to TS (P=0.003) and AEG1 (P<0.001) expression. Hazard ratio (HR) for PFS for p with high BRCA1 levels was 4 (P=0.002). Overall survival (OS) for p with low, intermediate and high BRCA1 levels was 29.7, 7.4 and 6.3 m, respectively (P=0.05). Similar differences in OS were observed according to TS (P=0.005) and AEG1 (P=0.001) expression.HR for OS for p with high BRCA1 levels was 3.6 (P=0.004). There were no differences in PFS or OS according to REV3 or RAP80 levels. However, the joint effect of BRCA1 and REV3 was significant for predictive modeling. PFS for p with low, intermediate and high levels of both genes was 14.9, 7.2 and 2.8 m, respectively (P=0.001). OS for p with low, intermediate and high levels of both genes was 29.7, 7.8 and 6.3 m, respectively (P=0.04). Conclusions: Low BRCA1 expression predicts longer PFS and OS in pemetrexed/cisplatin-treated NSCLC p. Low TS and AEG1 levels have similar predictive value. Analysis of these genes could be useful for customizing pemetrexed/platinum chemotherapy.
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Affiliation(s)
| | | | | | - Imane Chaib
- Catalan Institute of Oncology, Laboratory of Molecular Biology, Badalona, Barcelona, Spain
| | | | | | | | - Angel Artal
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Isabel Bover
- Son Llatzer University Hospital, Mallorca, Spain
| | - Miquel Taron
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | | | | | | | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Pangaea Biotech, Cancer Therapeutics Innovation Group, USP Institut Universitari Dexeus, Barcelona, Spain
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Moran T, Cobo M, Domine M, Sanchez-Ronco M, Bover I, Provencio M, Massuti B, Vergnenegre A, Lopez-Vivanco G, Robinet G, Insa A, Majem M, De Las Penas R, Sala MÁ, Isla D, Baize N, Garde J, Chaib I, Camps C, Rosell R. Interim analysis of The Spanish Lung Cancer Group (SLCG) BRCA1-RAP80 Expression Customization (BREC) randomized phase III trial of customized therapy in advanced non-small-cell lung cancer (NSCLC) patients (p) (NCT00617656/GECP-BREC). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.lba8002] [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
LBA8002 The full, final text of this abstract will be available at abstract.asco.org at 7:30 AM (EDT) on Monday, June 3, 2013, and in the Annual Meeting Proceedings online supplement to the June 20, 2013, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.
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Affiliation(s)
- Teresa Moran
- Institut Catala d´Oncologia, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Manuel Cobo
- Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Manuel Domine
- Oncology Department and Translational Oncology Division. Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
| | | | - Isabel Bover
- Son Llatzer University Hospital, Mallorca, Spain
| | | | | | | | | | | | - Amelia Insa
- Hospital Clinico Universitario de Valencia, Valencia, Spain
| | | | | | | | | | | | | | - Imane Chaib
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Carlos Camps
- Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Pangaea Biotech, Cancer Therapeutics Innovation Group, USP Institut Universitari Dexeus, Barcelona, Spain
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García Campelo R, Felip E, Massuti B, Majem M, Carcereny E, Cardenal F, Molina-Vila MA, Martinez Marti A, Marti-Ciriquian JL, Alonso-Jaudenes Curbera G, Pallares C, Palmero R, Gonzalez-Arenas MC, Mayo-de las Casas C, Sanchez-Ronco M, Rosell R. Phase IB study of olaparib (AZD2281) plus gefitinib in EGFR-mutant patients (p) with advanced non-small-cell lung cancer (NSCLC) (NCT01513174/GECP-GOAL). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.2581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2581 Background: Progression-free survival (PFS) and response to EGFR tyrosine kinase inhibitors (TKIs) vary in p with NSCLC driven by EGFR mutations. In our experience, high BRCA1 mRNA expression was associated with shorter PFS in EGFR-mutant p treated with erlotinib. We hypothesized that since olaparib downregulates BRCA1 expression, the addition of olaparib to gefitinib could improve PFS in these p. Methods: This is a Phase IB dose escalation study to identify the maximum tolerated dose (MTD), dose limiting toxicity (DLT), pharmacokinetics, and clinical activity of orally administered olaparib in combination with gefitinib in EGFR-mutant advanced NSCLC p. In a standard 3+3 design, p were treated with gefitinib 250mg once daily plus olaparib tablets at escalating doses ranging from 100mg BID to 250mg TDS during a 28-day cycle. Results: 18 p have been included across four dose levels of olaparib: 100mg BID (3), 200mg BID (6), 200mg TDS (3) and 250mg TDS (6). Median age, 69; male, 4; PS 0, 17; EGFR TKI treatment-naïve, 10. Toxicities: anemia (66.6%), leucopenia (33.3%), nausea (33.3%), diarrhea (33.3%), asthenia (27.7%), rash (22.2%) vomiting (11%), decreased appetite (16%), and hyperlipasemia (5.5%). Most toxicities were G1-2; G3 drug-related events included leucopenia (1) and anemia (3). No DLT at dose levels 1, 2, and 3; 1 DLT at dose level 4 (G3 anemia and repeated blood transfusion within 4-6 weeks). Few dose reductions or interruptions were needed. 1 p died due to pulmonary embolism unrelated to treatment. Partial responses (PR) were observed in 7 p (41.1%), all EGFR TKI-naïve; stable disease (SD) in 7 (41.1%), most previously treated; progressive disease (PD) in 3 (17.6%), all previously treated. Durable PR and SD were observed in EGFR TKI-naïve and previously treated p. 8 patients are still on treatment. Enrollment to dose level 4 will be completed in February 2013. Conclusions: This phase IB trial of gefitinib plus olaparib, has confirmed the activity and tolerability of the combination. The final recommended dose of olaparib is expected to be between 200 and 250 mg TDS. A phase II randomized trial in treatment-naïve EGFR-mutant advanced NSCLC will be opened in 2013. Clinical trial information: NCT0151317.
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Affiliation(s)
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | - Enric Carcereny
- Medical Oncology, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Felipe Cardenal
- Catalan Institute of Oncology, Section of Medical Oncology, Barcelona, Spain
| | | | - Alex Martinez Marti
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | | | - Ramon Palmero
- Catalan Institute of Oncology, Section of Medical Oncology, L'Hospitalet de Llobregat, Spain
| | | | | | | | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Pangaea Biotech, Cancer Therapeutics Innovation Group, USP Institut Universitari Dexeus, Barcelona, Spain
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Rosell R, Carcereny E, Gervais R, Vergnenegre A, Massuti B, Felip E, Palmero R, Garcia-Gomez R, Pallares C, Sanchez JM, Porta R, Cobo M, Garrido P, Longo F, Moran T, Insa A, De Marinis F, Corre R, Bover I, Illiano A, Dansin E, de Castro J, Milella M, Reguart N, Altavilla G, Jimenez U, Provencio M, Moreno MA, Terrasa J, Muñoz-Langa J, Valdivia J, Isla D, Domine M, Molinier O, Mazieres J, Baize N, Garcia-Campelo R, Robinet G, Rodriguez-Abreu D, Lopez-Vivanco G, Gebbia V, Ferrera-Delgado L, Bombaron P, Bernabe R, Bearz A, Artal A, Cortesi E, Rolfo C, Sanchez-Ronco M, Drozdowskyj A, Queralt C, de Aguirre I, Ramirez JL, Sanchez JJ, Molina MA, Taron M, Paz-Ares L. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol 2012. [DOI: 78495111110.1016/s1470-2045(11)70393-x' target='_blank'>'"<>78495111110.1016/s1470-2045(11)70393-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [78495111110.1016/s1470-2045(11)70393-x','', 'Maria Sanchez-Ronco')">Reference Citation Analysis] [78495111110.1016/s1470-2045(11)70393-x', 12)">What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
78495111110.1016/s1470-2045(11)70393-x" />
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Rosell R, Carcereny E, Gervais R, Vergnenegre A, Massuti B, Felip E, Palmero R, Garcia-Gomez R, Pallares C, Sanchez JM, Porta R, Cobo M, Garrido P, Longo F, Moran T, Insa A, De Marinis F, Corre R, Bover I, Illiano A, Dansin E, de Castro J, Milella M, Reguart N, Altavilla G, Jimenez U, Provencio M, Moreno MA, Terrasa J, Muñoz-Langa J, Valdivia J, Isla D, Domine M, Molinier O, Mazieres J, Baize N, Garcia-Campelo R, Robinet G, Rodriguez-Abreu D, Lopez-Vivanco G, Gebbia V, Ferrera-Delgado L, Bombaron P, Bernabe R, Bearz A, Artal A, Cortesi E, Rolfo C, Sanchez-Ronco M, Drozdowskyj A, Queralt C, de Aguirre I, Ramirez JL, Sanchez JJ, Molina MA, Taron M, Paz-Ares L. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol 2012; 13:239-46. [PMID: 22285168 DOI: 10.1016/s1470-2045(11)70393-x] [Citation(s) in RCA: 4169] [Impact Index Per Article: 347.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Erlotinib has been shown to improve progression-free survival compared with chemotherapy when given as first-line treatment for Asian patients with non-small-cell lung cancer (NSCLC) with activating EGFR mutations. We aimed to assess the safety and efficacy of erlotinib compared with standard chemotherapy for first-line treatment of European patients with advanced EGFR-mutation positive NSCLC. METHODS We undertook the open-label, randomised phase 3 EURTAC trial at 42 hospitals in France, Italy, and Spain. Eligible participants were adults (> 18 years) with NSCLC and EGFR mutations (exon 19 deletion or L858R mutation in exon 21) with no history of chemotherapy for metastatic disease (neoadjuvant or adjuvant chemotherapy ending ≥ 6 months before study entry was allowed). We randomly allocated participants (1:1) according to a computer-generated allocation schedule to receive oral erlotinib 150 mg per day or 3 week cycles of standard intravenous chemotherapy of cisplatin 75 mg/m(2) on day 1 plus docetaxel (75 mg/m(2) on day 1) or gemcitabine (1250 mg/m(2) on days 1 and 8). Carboplatin (AUC 6 with docetaxel 75 mg/m(2) or AUC 5 with gemcitabine 1000 mg/m(2)) was allowed in patients unable to have cisplatin. Patients were stratified by EGFR mutation type and Eastern Cooperative Oncology Group performance status (0 vs 1 vs 2). The primary endpoint was progression-free survival (PFS) in the intention-to-treat population. We assessed safety in all patients who received study drug (≥ 1 dose). This study is registered with ClinicalTrials.gov, number NCT00446225. FINDINGS Between Feb 15, 2007, and Jan 4, 2011, 174 patients with EGFR mutations were enrolled. One patient received treatment before randomisation and was thus withdrawn from the study; of the remaining patients, 86 were randomly assigned to receive erlotinib and 87 to receive standard chemotherapy. The preplanned interim analysis showed that the study met its primary endpoint; enrolment was halted, and full evaluation of the results was recommended. At data cutoff (Jan 26, 2011), median PFS was 9·7 months (95% CI 8·4-12·3) in the erlotinib group, compared with 5·2 months (4·5-5·8) in the standard chemotherapy group (hazard ratio 0·37, 95% CI 0·25-0·54; p < 0·0001). Main grade 3 or 4 toxicities were rash (11 [13%] of 84 patients given erlotinib vs none of 82 patients in the chemotherapy group), neutropenia (none vs 18 [22%]), anaemia (one [1%] vs three [4%]), and increased amino-transferase concentrations (two [2%] vs 0). Five (6%) patients on erlotinib had treatment-related severe adverse events compared with 16 patients (20%) on chemotherapy. One patient in the erlotinib group and two in the standard chemotherapy group died from treatment-related causes. INTERPRETATION Our findings strengthen the rationale for routine baseline tissue-based assessment of EGFR mutations in patients with NSCLC and for treatment of mutation-positive patients with EGFR tyrosine-kinase inhibitors. FUNDING Spanish Lung Cancer Group, Roche Farma, Hoffmann-La Roche, and Red Temática de Investigacion Cooperativa en Cancer.
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Santarpia M, Magri I, Sanchez-Ronco M, Costa C, Molina-Vila MA, Gimenez-Capitan A, Bertran-Alamillo J, Mayo C, Benlloch S, Viteri S, Gasco A, Mederos N, Carcereny E, Taron M, Rosell R. mRNA expression levels and genetic status of genes involved in the EGFR and NF-κB pathways in metastatic non-small-cell lung cancer patients. J Transl Med 2011; 9:163. [PMID: 21951562 PMCID: PMC3203857 DOI: 10.1186/1479-5876-9-163] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 09/27/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Metastatic non-small-cell lung cancer (NSCLC) has a dismal prognosis. EGFR is overexpressed or mutated in a large proportion of cases. Downstream components of the EGFR pathway and crosstalk with the NF-κB pathway have not been examined at the clinical level. We explored the prognostic significance of the mRNA expression of nine genes in the EGFR and NF-κB pathways and of BRCA1 and RAP80 in patients in whom EGFR and K-ras gene status had previously been determined. In addition, NFKBIA and DUSP22 gene status was also determined. METHODS mRNA expression of the eleven genes was determined by QPCR in 60 metastatic NSCLC patients and in nine lung cancer cell lines. Exon 3 of NFKBIA and exon 6 of DUSP22 were analyzed by direct sequencing. Results were correlated with outcome to platinum-based chemotherapy in patients with wild-type EGFR and to erlotinib in those with EGFR mutations. RESULTS BRCA1 mRNA expression was correlated with EZH2, AEG-1, Musashi-2, CYLD and TRAF6 expression. In patients with low levels of both BRCA1 and AEG-1, PFS was 13.02 months, compared to 5.4 months in those with high levels of both genes and 7.7 months for those with other combinations (P=0.025). The multivariate analysis for PFS confirmed the prognostic role of high BRCA1/AEG-1 expression (HR, 3.1; P=0.01). Neither NFKBIA nor DUSP22 mutations were found in any of the tumour samples or cell lines. CONCLUSIONS The present study provides a better understanding of the behaviour of metastatic NSCLC and identifies the combination of BRCA1 and AEG-1 expression as a potential prognostic model.
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Affiliation(s)
- Mariacarmela Santarpia
- Pangaea Biotech, USP Dexeus University Institute, Sabino Arana 5- 19, Barcelona, 08028, Spain
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Santarpia M, Sanchez-Ronco M, Magri I, Viteri S, Costa C, Gasco A, Gonzalez Cao M, Mederos N, Salazar F, Bertran-Alamillo J, Gimenez Capitan A, Altavilla G, Benlloch S, Yeste Z, Aldeguer E, Taron M, Rosell R. The nuclear factor kB (NFkB) and Notch signaling pathways and BRCA1 mRNA expression in stage IV non-small cell lung cancer (NSCLC) patients (p). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Magri I, Santarpia M, Sanchez-Ronco M, Viteri S, Costa C, Gasco A, Mederos N, Gonzalez Cao M, Salazar F, Bertran-Alamillo J, Gimenez Capitan A, Molina MA, Yeste Z, Aldeguer E, Moran T, Altavilla G, Benlloch S, Taron M, Rosell R. Differential expression of BRCA1 and genes involved in the nuclear factor kappa B (NFκB) and notch signalling pathways in non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) patients (p). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e21025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rosell R, Molina MA, Costa C, Simonetti S, Gimenez-Capitan A, Bertran-Alamillo J, Mayo C, Moran T, Mendez P, Cardenal F, Isla D, Provencio M, Cobo M, Insa A, Garcia-Campelo R, Reguart N, Majem M, Viteri S, Carcereny E, Porta R, Massuti B, Queralt C, de Aguirre I, Sanchez JM, Sanchez-Ronco M, Mate JL, Ariza A, Benlloch S, Sanchez JJ, Bivona TG, Sawyers CL, Taron M. Pretreatment EGFR T790M mutation and BRCA1 mRNA expression in erlotinib-treated advanced non-small-cell lung cancer patients with EGFR mutations. Clin Cancer Res 2011; 17:1160-8. [PMID: 21233402 DOI: 10.1158/1078-0432.ccr-10-2158] [Citation(s) in RCA: 257] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Advanced non-small-cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) mutations (deletion in exon 19 or L858R) show an impressive progression-free survival of 14 months when treated with erlotinib. However, the presence of EGFR mutations can only imperfectly predict outcome. We hypothesized that progression-free survival could be influenced both by the pretreatment EGFR T790M mutation and by components of DNA repair pathways. EXPERIMENTAL DESIGN We assessed the T790M mutation in pretreatment diagnostic specimens from 129 erlotinib-treated advanced NSCLC patients with EGFR mutations. The expression of eight genes and two proteins involved in DNA repair and four receptor tyrosine kinases was also examined. RESULTS The EGFR T790M mutation was observed in 45 of 129 patients (35%). Progression-free survival was 12 months in patients with and 18 months in patients without the T790M mutation (P = 0.05). Progression-free survival was 27 months in patients with low BRCA1 mRNA levels, 18 months in those with intermediate levels, and 10 months in those with high levels (P = 0.02). In the multivariate analysis, the presence of the T790M mutation (HR, 4.35; P = 0.001), intermediate BRCA1 levels (HR, 8.19; P < 0.0001), and high BRCA1 levels (HR, 8.46; P < 0.0001) emerged as markers of shorter progression-free survival. CONCLUSIONS Low BRCA1 levels neutralized the negative effect of the T790M mutation and were associated with longer progression-free survival to erlotinib. We advocate baseline assessment of the T790M mutation and BRCA1 expression to predict outcome and provide alternative individualized treatment to patients based on T790M mutations and BRCA1 expression.
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Affiliation(s)
- Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain.
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Salazar F, Molina MA, Sanchez-Ronco M, Moran T, Ramirez JL, Sanchez JM, Stahel R, Garrido P, Cobo M, Isla D, Bertran-Alamillo J, Massuti B, Cardenal F, Manegold C, Lianes P, Trigo JM, Sanchez JJ, Taron M, Rosell R. First-line therapy and methylation status of CHFR in serum influence outcome to chemotherapy versus EGFR tyrosine kinase inhibitors as second-line therapy in stage IV non-small-cell lung cancer patients. Lung Cancer 2010; 72:84-91. [PMID: 20705357 DOI: 10.1016/j.lungcan.2010.07.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 07/11/2010] [Indexed: 12/12/2022]
Abstract
The potential differential effect of first-line treatment and molecular mechanisms on survival to second-line chemotherapy or EGFR tyrosine kinase inhibitors (TKIs) in non-small-cell lung cancer (NSCLC) has not been fully investigated. In particular, CHFR is frequently methylated in NSCLC and may influence outcome. We analyzed the outcome of second-line chemotherapy or EGFR TKIs in 179 of 366 patients who had been treated in an ERCC1 mRNA-based customized cisplatin trial and correlated the results with CHFR methylation status. CHFR methylation in circulating DNA was examined by methylation-specific assay. A panel of seven human EGFR wild-type NSCLC cell lines was characterized for their sensitivity to sequential treatment with cisplatin and erlotinib, and the results were correlated with CHFR. Patients who had received first-line docetaxel/cisplatin attained an overall survival of 19.2 months when treated with second-line EGFR TKIs, in comparison with 10.7 months when treated with second-line chemotherapy (P = 0.0002). However, for patients who had received first-line docetaxel/gemcitabine, overall survival was 14.8 months with EGFR TKIs and 10.8 months with chemotherapy (P = 0.29). For patients with unmethylated CHFR overall survival to EGFR TKIs was 21.4 months, and 11.2 months for those with treated with chemotherapy (P = 0.0001). In the only lung tumor cell line not expressing CHFR, pretreatment with cisplatin was antagonistic to erlotinib, while it was synergistic in the other six lines. Second-line EGFR TKIs improved survival in patients receiving first-line cisplatin-based treatment. Unmethylated CHFR predicts increased survival to EGFR TKIs.
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Carcereny E, Ramirez JL, Sanchez-Ronco M, Isla D, Cobo M, Moran T, de Aguirre I, Okamoto T, Wei J, Provencio M, Lopez-Vivanco G, Camps C, Domine M, Alberola V, Sanchez JM, Massuti B, Mendez P, Taron M, Rosell R. Blood-based CHRNA3 single nucleotide polymorphism and outcome in advanced non-small-cell lung cancer patients. Lung Cancer 2009; 68:491-7. [PMID: 19733931 DOI: 10.1016/j.lungcan.2009.08.004] [Citation(s) in RCA: 5] [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] [Received: 06/10/2009] [Revised: 07/29/2009] [Accepted: 08/06/2009] [Indexed: 12/30/2022]
Abstract
Nicotine acetylcholine receptors (nAChRs) are associated with resistance to gemcitabine, cisplatin and paclitaxel in non-small-cell lung cancer (NSCLC) cell lines. Three single nucleotide polymorphisms (SNPs) of CHRNA3, CHRNA5 and LOC123688 increase lung cancer risk. These SNPs may have influenced outcome in patients treated in our phase III trial. Stage IV NSCLC patients were treated with customized chemotherapy based on ERCC1 (excision repair cross-complementing 1) mRNA expression. Patients in the control arm received docetaxel/cisplatin; patients in the genotypic arm with low levels of ERCC1 received docetaxel/cisplatin; patients in the genotypic arm with high levels of ERCC1 received docetaxel/gemcitabine. DNA was extracted from lymphocytes, and CHRNA3 (rs1051730), CHRNA5 (rs16969968) and LOC123688 (rs8034191) SNPs were genotyped with the Taqman allele discrimination assay. A significant interaction was found for CHRNA3 and PS (P=0.02). In patients with PS 0, CT patients had a better response than both CC (P=0.01) and TT (P=0.02) patients, and patients in the low genotypic group also had a better response (P=0.01). When the CHRNA3 genotype was added in the multivariate analysis for progression-free survival, an improvement was observed in the low genotypic group in PS 0 patients (P=0.02). PS 0 patients in the low genotypic group with the CT genotype attained an 84% response rate, 12.1-month progression-free survival, and 19-month median survival. CHRNA3 (rs1051730) genotyping can improve customized chemotherapy based on tumor assessment of ERCC1 mRNA in stage IV NSCLC with PS 0.
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Rosell R, Ramirez JL, Sanchez-Ronco M, Isla D, Moran T, Cobo M, Massuti B, Taron M, Carbone D, De Aguirre I. Blood-based CHRNA3 single nucleotide polymorphisms (SNPs) and outcome in advanced non-small cell lung cancer (NSCLC) patients (p). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8033] [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
8033 Background: Nicotonic acetylcholine receptors (nAChRs) are associated with resistance to gemcitabine (gem), cisplatin (cis) and paclitaxel in NSCLC cell lines. Three SNPs of CHRNA3, CHRNA5 and LOC123688 increase lung cancer risk. These SNPs may have influenced outcome in p treated in our phase III trial (Cobo et al. J Clin Oncol 2007;25:2747–54). Methods: Stage IV NSCLC p were treated with customized chemotherapy based on ERCC1 mRNA expression. p in the control arm received docetaxel (doc)/cis; p in the genotypic arm with low ERCC1 levels (low genotypic group [LG]) received doc/cis; p in the genotypic arm with high ERCC1 levels (high genotypic group [HG]) received doc/gem. DNA was extracted from lymphocytes, and CHRNA3 (rs1051730), CHRNA5 (rs16969968) and LOC123688 (rs8034191) SNPs were genotyped with the Taqman allele discrimination assay. Results: A significant interaction was found for CHRNA3 and PS (P = 0.02). In p with PS 0, CT p had a better response than both CC (P = 0.01) and TT (P = 0.02) p, and LG p also had a better response (P = 0.01). When the CHRNA3 genotype was added in the multivariate analysis for progression-free survival (PFS), an improvement was observed in the LG in PS 0 p (P = 0.02). PS 0 p in the LG with the CT genotype attained an 84% response, 12.1-month PFS, and 19-month median survival (MS) ( Table ). Conclusions: CHRNA3 genotyping can improve customized chemotherapy based on tumor ERCC1 mRNA in stage IV NSCLC p with PS 0. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- R. Rosell
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - J. L. Ramirez
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - M. Sanchez-Ronco
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - D. Isla
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - T. Moran
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - M. Cobo
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - B. Massuti
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - M. Taron
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - D. Carbone
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
| | - I. De Aguirre
- ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; University of Alcala de Henares, Madrid, Spain; Hospital Lozano Blesa, Zaragoza, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Hospital General de Alicante, Alicante, Spain; Vanderbilt University Cancer Center, Nashville, TN
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Santarpia M, Altavilla G, Margeli M, Cirauqui B, Mesiti M, Cavallari V, Ramirez JL, Sanchez-Ronco M, Santarpia L, Taron M, Rosell R. PIK3CA mutations and BRCA1 expression in breast cancer: potential biomarkers for chemoresistance. Cancer Invest 2009; 26:1044-51. [PMID: 18798071 DOI: 10.1080/07357900802112701] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Mutations in PIK3CA and alterations of BRCA1 expression are common in breast cancer and have been correlated with altered sensitivity to taxanes in human cancer cell lines and with outcome of patients. We assessed mutations in the three hotspots of PIK3CA (E542K, E545K and H1047R) and intratumoral BRCA1 mRNA expression by quantitative RT-PCR in 61 breast cancer patients. Mutations of PIK3CA were found in 17 (27.9%) and did not correlate with BRCA1 transcript levels. Correlation with clinical and pathological features identified a significant association of mutations with older patients (P = 0.03). Higher BRCA1 mRNA expression was significantly correlated with advanced disease (P = 0.01) and ERBB2 overexpression (P = 0.02). These findings may help to identify a subgroup of patients who will likely benefit from chemotherapy regimens containing microtubule-disrupting agents.
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Benlloch S, Galbis-Caravajal J, Alenda C, Peiró F, Sanchez-Ronco M, Rodríguez-Paniagua J, Baschwitz B, Rojas E, Massutí B. Expression of molecular markers in mediastinal nodes from resected stage I non-small-cell lung cancer (NSCLC): prognostic impact and potential role as markers of occult micrometastases. Ann Oncol 2009; 20:91-7. [DOI: 10.1093/annonc/mdn538] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Boukovinas I, Papadaki C, Mendez P, Taron M, Mavroudis D, Koutsopoulos A, Sanchez-Ronco M, Sanchez JJ, Trypaki M, Staphopoulos E, Georgoulias V, Rosell R, Souglakos J. Tumor BRCA1, RRM1 and RRM2 mRNA expression levels and clinical response to first-line gemcitabine plus docetaxel in non-small-cell lung cancer patients. PLoS One 2008; 3:e3695. [PMID: 19002265 PMCID: PMC2579656 DOI: 10.1371/journal.pone.0003695] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Accepted: 10/21/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Overexpression of RRM1 and RRM2 has been associated with gemcitabine resistance. BRCA1 overexpression increases sensitivity to paclitaxel and docetaxel. We have retrospectively examined the effect of RRM1, RRM2 and BRCA1 expression on outcome to gemcitabine plus docetaxel in advanced non-small-cell lung cancer (NSCLC) patients. METHODOLOGY AND PRINCIPAL FINDINGS Tumor samples were collected from 102 chemotherapy-naïve advanced NSCLC patients treated with gemcitabine plus docetaxel as part of a randomized trial. RRM1, RRM2 and BRCA1 mRNA levels were assessed by quantitative PCR and correlated with response, time to progression and survival. As BRCA1 levels increased, the probability of response increased (Odds Ratio [OR], 1.09: p = 0.01) and the risk of progression decreased (hazard ratio [HR], 0.99; p = 0.36). As RRM1 and RRM2 levels increased, the probability of response decreased (RRM1: OR, 0.97; p = 0.82; RRM2: OR, 0.94; p<0.0001) and the risk of progression increased (RRM1: HR, 1.02; p = 0.001; RRM2: HR, 1.005; p = 0.01). An interaction observed between BRCA1 and RRM1 allowed patients to be classified in three risk groups according to combinations of gene expression levels, with times to progression of 10.13, 4.17 and 2.30 months (p = 0.001). Low BRCA1 expression was the only factor significantly associated with longer time to progression in 31 patients receiving cisplatin-based second-line therapy. CONCLUSIONS The mRNA expression of BRCA1, RRM1 and RRM2 is potentially a useful tool for selecting NSCLC patients for individualized chemotherapy and warrants further investigation in prospective studies.
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Affiliation(s)
| | - Chara Papadaki
- Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Greece
| | - Pedro Mendez
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Ctra Canyet, Badalona, Barcelona, Spain
| | - Miquel Taron
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Ctra Canyet, Badalona, Barcelona, Spain
- Pangaea Biotech, USP Dexeus University, C/Sabino Arana 5, Barcelona, Spain
| | - Dimitris Mavroudis
- Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Greece
- Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece
| | | | | | | | - Maria Trypaki
- Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Greece
| | | | - Vassilis Georgoulias
- Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Greece
- Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece
| | - Rafael Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Ctra Canyet, Badalona, Barcelona, Spain
- Pangaea Biotech, USP Dexeus University, C/Sabino Arana 5, Barcelona, Spain
- * E-mail: (RR); (JS)
| | - John Souglakos
- Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Greece
- Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece
- * E-mail: (RR); (JS)
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Garrido P, González-Larriba JL, Insa A, Provencio M, Torres A, Isla D, Sanchez JM, Cardenal F, Domine M, Barcelo JR, Tarrazona V, Varela A, Aguilo R, Astudillo J, Muguruza I, Artal A, Hernando-Trancho F, Massuti B, Sanchez-Ronco M, Rosell R. Long-Term Survival Associated With Complete Resection After Induction Chemotherapy in Stage IIIA (N2) and IIIB (T4N0-1) Non–Small-Cell Lung Cancer Patients: The Spanish Lung Cancer Group Trial 9901. J Clin Oncol 2007; 25:4736-42. [DOI: 10.1200/jco.2007.12.0014] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposeTo assess the activity of induction chemotherapy followed by surgery in stage IIIA and selected stage IIIB non–small-cell lung cancer patients.Patients and MethodsMediastinoscopy proof of either positive N2 (IIIA) or T4N0-1 (IIIB) disease was required. Induction therapy was three cycles of cisplatin/gemcitabine/docetaxel, followed by surgery.ResultsFrom December 1999 to March 2003, 136 patients were entered onto the study; the clinical response rate in 129 assessable patients was 56%. The overall complete resection rate was 68.9% of patients eligible for surgery (72% of stage IIIA patients and 66% of stage IIIB patients) and 48% of all assessable patients. Eight (12.9%) of 62 completely resected patients had a pathologic complete response. Seven patients (7.8%) died during the postoperative period. The median overall survival time was 15.9 months, 3-year survival rate was 36.8%, and 5-year survival rate was 21.1%, with no significant differences in survival between stage IIIA and stage IIIB patients. Median survival time was 48.5 months for 62 completely resected patients, 12.9 months for 13 incompletely resected patients, and 16.8 months for 15 nonresected patients (P = .005). Three- and 5-year survival rates were 60.1% and 41.4% for completely resected patients, 23.1% and 11.5% for incompletely resected patients, and 31.1% and 0% for nonresected patients, respectively. In the multivariate analysis, complete resection (hazard ratio [HR] = 0.35; P < .0001), clinical response (HR = 0.32; P < .0001), and age younger than 60 years (HR = 0.64; P = .027) were the most powerful prognostic factors.ConclusionInduction chemotherapy followed by surgery is effective in stage IIIA and in selected stage IIIB patients attaining complete resection.
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Affiliation(s)
- Pilar Garrido
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - José Luis González-Larriba
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Amelia Insa
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Mariano Provencio
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Antonio Torres
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Dolores Isla
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - José Miguel Sanchez
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Felipe Cardenal
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Manuel Domine
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Jose Ramon Barcelo
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Vicente Tarrazona
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Andres Varela
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Rafael Aguilo
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Julio Astudillo
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Ignacio Muguruza
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Angel Artal
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Florentino Hernando-Trancho
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Bartomeu Massuti
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Maria Sanchez-Ronco
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
| | - Rafael Rosell
- From the Hospital Ramon y Cajal; Hospital San Carlos; Clinica Puerta de Hierro; Fundacion Jimenez Diaz; Autonomous University of Madrid, Madrid; Hospital Clinico, Valencia; Hospital Clinico; Hospital Miguel Servet, Zaragoza; Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Badalona; Hospital Duran i Reynals, Catalan Institute of Oncology, Bellvitge; Hospital Cruces, Bilbao; and Hospital General, Alicante, Spain
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Taron M, Cobo M, Isla L, Massuti B, Montes A, Sanchez J, Botia M, Domine M, Sanchez-Ronco M, Rosell R. 6528 POSTER Role of ERCC1, XRCC3, Aurora A and TGFBR1 gene single nucleotide polymorphisms (SNP) and CHFR and 14-3-3s methylation in a customized cisplatin (cis) trial based on ERCC1 mRNA levels in stage IV non-small-cell lung cancer (NSCLC) patients (pts). EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71356-3] [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: 10/22/2022] Open
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Santarpia C, Garrido P, Gonzalez-Larriba J, Azagra P, Cardenal F, Ramirez J, De Aguirre I, Sanchez-Ronco M, Taron M, Rosell R. 6531 POSTER XPD 312 single nucleotide polymorphism (SNP) predicts survival in stage IIIA–B non-small-cell lung cancer (NSCLC) patients (pts) < 59 years (y) treated with chemotherapy followed by surgery. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71359-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Cobo M, Isla D, Massuti B, Montes A, Sanchez JM, Provencio M, Viñolas N, Paz-Ares L, Lopez-Vivanco G, Muñoz MA, Felip E, Alberola V, Camps C, Domine M, Sanchez JJ, Sanchez-Ronco M, Danenberg K, Taron M, Gandara D, Rosell R. Customizing Cisplatin Based on Quantitative Excision Repair Cross-Complementing 1 mRNA Expression: A Phase III Trial in Non–Small-Cell Lung Cancer. J Clin Oncol 2007; 25:2747-54. [PMID: 17602080 DOI: 10.1200/jco.2006.09.7915] [Citation(s) in RCA: 385] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Purpose Although current treatment options for metastatic non–small-cell lung cancer (NSCLC) rely on cisplatin-based chemotherapy, individualized approaches to therapy may improve response or reduce unnecessary toxicity. Excision repair cross-complementing 1 (ERCC1) has been associated with cisplatin resistance. We hypothesized that assigning cisplatin based on pretreatment ERCC1 mRNA levels would improve response. Patients and Methods From August 2001 to October 2005, 444 stage IV NSCLC patients were enrolled. RNA was isolated from pretreatment biopsies, and quantitative real-time reverse transcriptase PCR assays were performed to determine ERCC1 mRNA expression. Patients were randomly assigned in a 1:2 ratio to either the control or genotypic arm before ERCC1 assessment. Patients in the control arm received docetaxel plus cisplatin. In the genotypic arm, patients with low ERCC1 levels received docetaxel plus cisplatin, and those with high levels received docetaxel plus gemcitabine. The primary end point was the overall objective response rate. Results Of 444 patients enrolled, 78 (17.6%) went off study before receiving one cycle of chemotherapy, mainly due to insufficient tumor tissue for ERCC1 mRNA assessment. Of the remaining 346 patients assessable for response, objective response was attained by 53 patients (39.3%) in the control arm and 107 patients (50.7%) in the genotypic arm (P = .02). Conclusion Assessment of ERCC1 mRNA expression in patient tumor tissue is feasible in the clinical setting and predicts response to docetaxel and cisplatin. Additional studies are warranted to optimize methodologies for ERCC1 analysis in small tumor samples and to refine a multibiomarker profile predictive of patient outcome.
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Santarpia M, Garrido P, Gonzalez-Larriba J, Azagra P, Cardenal F, Ramirez J, de Aguirre I, Sanchez-Ronco M, Taron M, Rosell R. XPD 312 single nucleotide polymorphism (SNP) in stage IIIA-B non-small cell lung cancer (NSCLC) patients (p) <59 years (y) treated with chemotherapy followed by surgery. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7652] [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
7652 Background: SNPs in DNA repair genes may affect response to cytotoxic therapy. We investigated SNPs in XPD codons 751 and 312 and in RRM1 −37 in 109 stage IIIA (N2) and IIIB NSCLC p treated with neoadjuvant chemotherapy and correlated results with event- free (EFS) and median (MS) survival. Methods: p eligible for surgery received cisplatin day (d) 1, gemcitabine d 1,8, docetaxel d 1,8,15, every 3 weeks for 3 cycles, followed by thoracotomy. DNA was extracted from baseline peripheral lymphocytes and genotyping was performed by Taqman. Results: Median age, 60 y (range 31–77); 92 males (84%); 45 squamous cell (41%). 4 p (3.9%) attained complete response; 55 (53.9%) partial response. 75 p underwent surgery (62 complete, 13 incomplete resection); remaining 34 p were unresectable. Median follow-up was 15.7 months (m) (range, 0.5–74). MS for p still alive is 49.8 m (range, 6.7–74). MS: 48 m with complete resection, 13 m with incomplete resection, 17 m for unresected p. In the univariate analysis of survival, age <59 y (P=0.03), resection (P<0.001) and XPD312 AspAsp (P=0.05) emerged as predictive markers of longer survival. For all 109 p, those with XPD312 AspAsp had longer EFS and MS than p with Asn variants ( Table ). In addition, for 51 p <59 y, EFS was longer for 24 p with XPD312 AspAsp (36.4 m) than for 27 p with Asn variants (9.8 m) (P=0.009); MS in this group of younger p was 45.4 m for AspAsp vs 15.8 m for Asn (P=0.04). No other significant correlation between SNPs and survival was observed ( Table ). Conclusions: Interaction between SNPs, age and risk of lung cancer has previously been described. XPD312 AspAsp in p <59 y predicts longer survival in stage IIIA (N2) and IIIB NSCLC treated with neoadjuvant chemotherapy. No significant financial relationships to disclose. [Table: see text]
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Affiliation(s)
- M. Santarpia
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - P. Garrido
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. Gonzalez-Larriba
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - P. Azagra
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - F. Cardenal
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. Ramirez
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - I. de Aguirre
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Sanchez-Ronco
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Taron
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. Rosell
- University of Messina, Messina, Italy; Hospital Ramon y Cajal, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico de Valencia, Valencia, Spain; ICO Hospital Duran i Reynals, Barcelona, Spain; ICO Hospital Germans Trias i Pujol, Badalona, Spain; Autonomous University of Madrid, Madrid, Spain
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Taron M, Cobo M, Isla D, Massuti B, Montes A, Sanchez J, Botia M, Domine M, Sanchez-Ronco M, Rosell R. Role of ERCC1, XRCC3, Aurora A and TGFBR1 single-nucleotide polymorphisms (SNP) and CHFR and 14–3-3σ methylation in a customized cisplatin (cis) trial based on ERCC1 mRNA levels in stage IV non-small cell lung cancer (NSCLC) patients (pts). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7687] [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
7687 Background: The primary aim of this trial was response. In both the control arm and in the genotypic arm with low tumor ERCC1 mRNA levels, pts received docetaxel (doc)/cis; in the genotypic arm with high tumor ERCC1 mRNA levels, pts received doc/gemcitabine. Response was significantly higher in the genotypic arms. We examined 324 pts for genetic markers that could influence response, including ERCC1 118 C/T, ERCC1 C8092A, XRCC3 241 (Thr to Met), Aurora A 91 T>A, Aurora A 169G>A, a SNP within intron 7 of the TGFBR1 gene (Int7G24A), and an in-frame germline deletion (TGFBR1*6A). Methylation of 14–3-3s and CHFR were also analyzed. Methods: DNA from peripheral lymphocytes was used for genotyping (Taqman assay) and methylation-specific PCR was used for 14–3- 3s and CHFR in pretreatment serum DNA. Results: There were no differences in clinical characteristics among the different SNP types, except that pts with Aurora A 91 AA had higher tumor ERCC1 mRNA levels (P=0.005). No relationship was found between ERCC1 SNPs and tumor ERCC1 mRNA levels. A strong correlation was found between the Int7G24A and XRCC3 241 SNPs (P=0.03). The Int7G24A GA type had a higher odds ratio (OR) of response (OR 2.32) than the AA type (OR 3.15) (P=0.02). XRCC3 241 MetMet had a lower probability of response (OR 0.23) (P=0.04). No other differences in response were observed according to any of the other SNPs or methylation. In the multivariate model, the best response was observed in pts with performance status (PS) 0, low ERCC1 levels, and XRCC3 241 SNP ( Table ). Conclusions: Further research is warranted to define the role of theTGFBR1 Int7G24A gene in customized treatments. No significant financial relationships to disclose. [Table: see text]
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Affiliation(s)
- M. Taron
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Cobo
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - D. Isla
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - B. Massuti
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - A. Montes
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. Sanchez
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Botia
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Domine
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Sanchez-Ronco
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. Rosell
- Institut Catala D’Oncologia, Badalona Barcelona, Spain; Hospital Carlos Haya, Malaga, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital General de Alicante, Alicante, Spain; ICO, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain; Fundacion Hospital Alcorcon, Madrid, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
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Ramírez JL, Salazar MF, Gupta J, Sánchez JM, Taron M, Sanchez-Ronco M, Alberola V, De las Peñas R. Methylation patterns and chemosensitivity in NSCLC. Adv Exp Med Biol 2007; 587:195-209. [PMID: 17163167 DOI: 10.1007/978-1-4020-5133-3_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Survival in advanced non-small-cell lung cancer (NSCLC) patients treated with platinum-based chemotherapy is rather variable. Methylation-dependent transcriptional silencing of 14-3-3sigma, a major G2/M checkpoint control gene, could be a predictor of longer survival. A sensitive methylation-specific polymerase chain reaction assay was used to evaluate 14-3-3sigma methylation status in pretreatment serum DNA obtained from 115 cisplatin-plus-gemcitabine-treated advanced NSCLC patients. 14-3-3sigma methylation was observed in all histologic types in 39 patients (34%). After a median follow-up of 9.8 months, median survival was significantly longer in the methylation-positive group (15.1 vs 9.8 months; P = 0.004). Median time to progression was 8 months in the methylation-positive group, and 6.3 months in the methylation-negative group (P = 0.027 by the log-rank test). A multivariate Cox regression model identified only 14-3-3sigma methylation status and ECOG performance status (PS) as independent prognostic factors for survival. In an exploratory analysis, median survival for 22 methylation-positive responders has not been reached, while it was 11.3 months for 29 methylation-negative responders (P = 0.001). Methylation of 14-3-3sigma is a new independent prognostic factor for survival in NSCLC patients receiving platinum-based chemotherapy. It can be reliably and conveniently detected in the serum, thus obviating the need for tumor tissue analysis.
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Affiliation(s)
- José Luis Ramírez
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
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Ramirez JL, Rosell R, Taron M, Sanchez-Ronco M, Alberola V, de Las Peñas R, Sanchez JM, Moran T, Camps C, Massuti B, Sanchez JJ, Salazar F, Catot S. 14-3-3sigma methylation in pretreatment serum circulating DNA of cisplatin-plus-gemcitabine-treated advanced non-small-cell lung cancer patients predicts survival: The Spanish Lung Cancer Group. J Clin Oncol 2006; 23:9105-12. [PMID: 16361617 DOI: 10.1200/jco.2005.02.2905] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Survival in patients with advanced non-small-cell lung cancer (NSCLC) who are treated with platinum-based chemotherapy is rather variable. Methylation-dependent transcriptional silencing of 14-3-3sigma, a major G2-M checkpoint control gene, could be a predictor of longer survival. PATIENTS AND METHODS A sensitive methylation-specific polymerase chain reaction assay was used to evaluate 14-3-3sigma methylation status in pretreatment serum DNA obtained from 115 cisplatin-plus-gemcitabine-treated advanced NSCLC patients. RESULTS 14-3-3sigma methylation was observed in all histologic types of 39 patients (34%). After a median follow-up of 9.8 months, median survival was significantly longer in the methylation-positive group (15.1 v 9.8 months; P = .004). Median time to progression was 8 months in the methylation-positive group and 6.3 months in the methylation-negative group (log-rank test, P = .027). A multivariate Cox regression model identified only 14-3-3sigma methylation status and Eastern Cooperative Oncology Group performance status as independent prognostic factors for survival. In an exploratory analysis, median survival for 22 methylation-positive responders has not been reached, whereas survival was 11.3 months for 29 methylation-negative responders (P = .001). CONCLUSION Methylation of 14-3-3sigma is a new independent prognostic factor for survival in NSCLC patients receiving platinum-based chemotherapy. It can be reliably and conveniently detected in the serum, thus obviating the need for tumor tissue analysis.
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Affiliation(s)
- José Luis Ramirez
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
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de las Peñas R, Sanchez-Ronco M, Alberola V, Taron M, Camps C, Garcia-Carbonero R, Massuti B, Queralt C, Botia M, Garcia-Gomez R, Isla D, Cobo M, Santarpia M, Cecere F, Mendez P, Sanchez JJ, Rosell R. Polymorphisms in DNA repair genes modulate survival in cisplatin/gemcitabine-treated non-small-cell lung cancer patients. Ann Oncol 2006; 17:668-75. [PMID: 16407418 DOI: 10.1093/annonc/mdj135] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Impaired DNA repair capacity may favorably affect survival in cisplatin/gemcitabine-treated non-small-cell lung cancer (NSCLC) patients. We investigated the association of survival with genetic polymorphisms in X-ray repair cross-complementing group 1 and group 3 (XRCC3), xeroderma pigmentosum group D (XPD), excision repair cross-complementing group 1, ligase IV, ribonucleotide reductase, TP53, cyclooxygenase-2, interleukin-6, peroxisome proliferator-activated receptor gamma, epidermal growth factor, methylene-tetra-hydrofolate reductase and methionine synthase. PATIENTS AND METHODS One hundred and thirty-five stage IV or IIIB (with malignant pleural effusion) NSCLC patients treated with cisplatin/gemcitabine from different hospitals of the Spanish Lung Cancer Group were genotyped for 14 different polymorphisms in 13 genes. Polymorphisms were detected by the TaqMan method, using genomic DNA extracted from baseline blood samples. RESULTS Median survival was significantly increased in patients harboring XRCC3 241 MetMet: 16 months versus 10 months for patients with ThrMet and 14 months for those with ThrThr (P = 0.01). The risk of death ratio was significantly lower for MetMet than for ThrMet patients (hazard ratio, 0.43; P = 0.01). In the multivariate Cox model, XRCC3 241 remained an independent prognostic factor (hazard ratio: XRCC3 241 MetMet, 0.44; P = 0.01), and XPD 751 and XRCC1 399 also emerged as significant prognostic factors (hazard ratios: XPD 751 LysGln, 0.46, P = 0.03; XRCC1 399 ArgGln, 0.61, P = 0.04). No other association was observed between genotype and survival. CONCLUSION XRCC3 241 MetMet is an independent determinant of favorable survival in NSCLC patients treated with cisplatin/gemcitabine. A simple molecular assay to determine the XRCC3 241 genotype can be useful for customizing chemotherapy.
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Taron M, Ichinose Y, Rosell R, Mok T, Massuti B, Zamora L, Mate JL, Manegold C, Ono M, Queralt C, Jahan T, Sanchez JJ, Sanchez-Ronco M, Hsue V, Jablons D, Sanchez JM, Moran T. Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor are associated with improved survival in gefitinib-treated chemorefractory lung adenocarcinomas. Clin Cancer Res 2005; 11:5878-85. [PMID: 16115929 DOI: 10.1158/1078-0432.ccr-04-2618] [Citation(s) in RCA: 265] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) confer a strong sensitivity to gefitinib, a selective tyrosine kinase inhibitor of EGFR. EXPERIMENTAL DESIGN We examined EGFR mutations at exons 18, 19, and 21 in tumor tissue from 68 gefitinib-treated, chemorefractory, advanced non-small cell lung cancer patients from the United States, Europe, and Asia and in a highly gefitinib-sensitive non-small cell lung cancer cell line and correlated their presence with response and survival. In addition, in a subgroup of 28 patients for whom the remaining tumor tissue was available, we examined the relationship among EGFR mutations, CA repeats in intron 1 of EGFR, EGFR and caveolin-1 mRNA levels, and increased EGFR gene copy numbers. RESULTS Seventeen patients had EGFR mutations, all of which were in lung adenocarcinomas. Radiographic response was observed in 16 of 17 (94.1%) patients harboring EGFR mutations, in contrast with 6 of 51 (12.6%) with wild-type EGFR (P < 0.0001). Probability of response increased significantly in never smokers, patients receiving a greater number of prior chemotherapy regimens, Asians, and younger patients. Median survival was not reached for patients with EGFR mutations and was 9.9 months for those with wild-type EGFR (P = 0.001). EGFR mutations tended to be associated with increased numbers of CA repeats and increased EGFR gene copy numbers but not with EGFR and caveolin-1 mRNA overexpression (P = not significant). CONCLUSIONS The presence of EGFR mutations is a major determinant of gefitinib response, and targeting EGFR should be considered in preference to chemotherapy as first-line treatment in lung adenocarcinomas that have demonstrable EGFR mutations.
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Affiliation(s)
- Miguel Taron
- Catalan Institute of Oncology, Pathology Department, Hospital Germans Trias i Pujol, Badalona, Spain
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Rosell R, Felip E, Taron M, Majo J, Mendez P, Sanchez-Ronco M, Queralt C, Sanchez JJ, Maestre J. Gene expression as a predictive marker of outcome in stage IIB-IIIA-IIIB non-small cell lung cancer after induction gemcitabine-based chemotherapy followed by resectional surgery. Clin Cancer Res 2004; 10:4215s-4219s. [PMID: 15217961 DOI: 10.1158/1078-0432.ccr-040006] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The first suggestions of a relationship between gene mRNA expression and differential sensitivity to gemcitabine/cisplatin are now emerging. ERCC1, RRM1, and XPD are involved in the nucleotide excision repair pathways, and tumor up-regulation of these genes leads to chemotherapy failure. In the present study, we have examined the potential correlation and predictive value of ERCC1, RRM1, and XPD mRNA expression in resected specimens from 67 stage IIB, IIIA, and IIIB non-small cell lung cancer patients treated with neoadjuvant gemcitabine/platinum followed by surgery. EXPERIMENTAL DESIGN ERCC1, RRM1, and XPD expression was quantified using real-time quantitative reverse transcription-PCR. RESULTS A good correlation was found between mRNA expression levels of the three genes. For RRM1 levels, patients in the bottom quartile had a decreased risk of death compared with those in the top quartile (risk ratio = 0.30; P = 0.033). Median survival for the 17 patients in the bottom quartile was 52 months, whereas for the 15 in the top quartile, it was 26 months (P = 0.018). When the characteristics of these 17 patients were compared with all of the other 50 patients, no differences in initial staging were observed. However, the 17 patients in the bottom quartile had better outcomes, including more radiographic responses (65% versus 54%; P = 0.24), complete resections (94% versus 72%; P = 0.03), lobectomies (71% versus 34%; P = 0.004), and pathological complete responses (29% versus 0%; P = 0.00001). CONCLUSIONS Patients with RRM1 levels in the bottom quartile benefited significantly from gemcitabine/cisplatin neoadjuvant chemotherapy, leading us to conclude that RRM1 mRNA levels should be additionally validated to proceed with tailored chemotherapy.
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Affiliation(s)
- Rafael Rosell
- Institut Catala d'Oncologia, Medical Oncology Service, Hospital Germans Trias i Pujol, Barcelona, Spain.
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35
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Isla D, Sarries C, Rosell R, Alonso G, Domine M, Taron M, Lopez-Vivanco G, Camps C, Botia M, Nuñez L, Sanchez-Ronco M, Sanchez JJ, Lopez-Brea M, Barneto I, Paredes A, Medina B, Artal A, Lianes P. Single nucleotide polymorphisms and outcome in docetaxel-cisplatin-treated advanced non-small-cell lung cancer. Ann Oncol 2004; 15:1194-203. [PMID: 15277258 DOI: 10.1093/annonc/mdh319] [Citation(s) in RCA: 237] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Platinum-based doublets are the standard chemotherapy for advanced non-small-cell lung cancer (NSCLC). Excision-repair cross-complementing 1 (ERCC1), xeroderma pigmentosum group D (XPD) and ribonucleotide reductase subunit M1 (RRM1) are essential to the repair of cisplatin DNA adducts. Multidrug resistance 1 (MDR1) has been related to antimicrotubule resistance. We assessed whether single nucleotide polymorphisms (SNPs) in ERCC1, XPD, RRM1 and MDR1, and ERCC1 mRNA expression, predicted survival in docetaxel-cisplatin-treated stage IV NSCLC patients. PATIENTS AND METHODS Using the TaqMan 5' nuclease assay, we examined ERCC1 118, XPD 751 and 312, RRM1 -37C/A, and MDR1 C3435T SNPs in peripheral blood lymphocytes (PBLs) obtained from 62 docetaxel-cisplatin-treated advanced NSCLC patients. ERCC1 expression was measured in RNA isolated from PBLs using real-time reverse transcriptase PCR. RESULTS Overall median survival was 10.26 months. Median survival was 9.67 months for 34 patients with ERCC1 118 C/T, 9.74 months for 17 patients with T/T, and not reached for 11 patients with C/C (P=0.04). Similar significant differences in time to progression were observed according to ERCC1 118 genotype (P=0.03). No other significant differences were observed. CONCLUSIONS Patients homozygous for the ERCC1 118 C allele demonstrated a significantly better survival. ERCC1 SNP assessment could be an important component of tailored chemotherapy trials.
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Affiliation(s)
- D Isla
- Hospital Clinico Lozano Blesa, Zaragoza, Spain
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Alberola V, Ramirez JL, De Aguirre I, Rosell R, de las Penas R, Camps C, Cobo M, Taron M, Sanchez-Ronco M, Marti JL. Methylene-tetrahydrofolate reductase (MTHFR) single nucleotide polymorphism (SNP) in gemcitabine (gem)/cisplatin (cis)-treated non-small-cell lung cancer (NSCLC) patients (p). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V. Alberola
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - J. L. Ramirez
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - I. De Aguirre
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - R. Rosell
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - R. de las Penas
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - C. Camps
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - M. Cobo
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - M. Taron
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - M. Sanchez-Ronco
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - J. L. Marti
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
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Sarries C, Alberola V, De Las Penas R, Camps C, Massuti B, Garcia-Gomez R, Insa A, Sanchez-Ronco M, Taron M, Rosell R. Combined DNA repair gene single nucleotide polymorphisms (SNPs) in gemcitabine (gem)/cisplatin (cis)-treated non-small-cell lung cancer (NSCLC) patients (p). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C. Sarries
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - V. Alberola
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. De Las Penas
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - C. Camps
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - B. Massuti
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. Garcia-Gomez
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - A. Insa
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Sanchez-Ronco
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Taron
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. Rosell
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
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Alberola V, Sarries C, Rosell R, Taron M, de las Peñas R, Camps C, Massuti B, Insa A, Garcia-Gomez R, Isla D, Artal A, Muñoz MA, Cobo M, Bover I, Gonzalez-Larria JL, Terrasa J, Almenar D, Barcelo R, Diz P, Sanchez-Ronco M, Sanchez JJ. Effect of the Methylenetetrahydrofolate Reductase C677T Polymorphism on Patients with Cisplatin/Gemcitabine–Treated Stage IV Non–Small-Cell Lung Cancer. Clin Lung Cancer 2004; 5:360-5. [PMID: 15217535 DOI: 10.3816/clc.2004.n.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Single nucleotide polymorphisms (SNPs) in the metabolic pathways of S-adenosylmethionine have been related to global hypomethylation and a lower number of hypermethylated CpG islands of tumor suppressor genes. Hypermethylation of checkpoint and DNA repair genes has been shown to be indicative of chemosensitivity. In the present study, we have examined the SNP of methylenetetrahydrofolate reductase (MTHFR) C677T, which affects DNA methylation patterns and is linked to elevated plasma homocysteine levels in 208 patients with gemcitabine/cisplatin-treated stage IV non-small-cell lung cancer (NSCLC). No differences in response rate were observed according to the MTHFR genotype. However, time to progression was 7.4 months for 68 patients with CC genotype, 5.5 months for 108 patients with heterozygous CT genotype, and 5.2 months for 28 patients with TT genotype. These findings can lead us to distinguish different outcome patterns among patients with stage IV NSCLC whose similar clinical prognostic factors would otherwise indicate similar outcomes. Carriers of the MTHFR 677T allele could benefit from supplementation with folic acid and vitamin B12. The Spanish Lung Cancer Group has undertaken a phase III randomized trial to elucidate this concept.
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Affiliation(s)
- Vicente Alberola
- Medical Oncology Service, Hospital Arnau de Vilanova, Valencia, Spain
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