1
|
Martín-Cullell B, Virgili AC, Riera P, Fumagalli C, Mirallas O, Pelegrín FJ, Sánchez-Cabús S, Molina V, Szafranska J, Páez D. Histopathological, Clinical, And Molecular (HICAM) score for patients with colorectal liver metastases. Br J Surg 2024; 111:znae016. [PMID: 38488528 DOI: 10.1093/bjs/znae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/19/2023] [Accepted: 01/06/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Histopathological and molecular features have been proposed to hold prognostic information, but few have been validated. The aim of this retrospective study was to validate the Genetic And Morphological Evaluation ('GAME') score and assess the impact of histological characteristics on the prognosis in patients with colorectal liver metastases. METHODS Data were collected from 176 patients with metastatic colorectal cancer undergoing liver resection at Hospital de la Santa Creu i Sant Pau. Patients were classified into Genetic And Morphological Evaluation score groups and relapse-free survival and overall survival were calculated. Histopathological changes in colorectal liver metastases were documented and prognostic variables were selected to create a post-surgery score, called the Histopathological, Clinical, And Molecular ('HICAM') score. RESULTS Regarding the Genetic And Morphological Evaluation score, the high-risk group had a median relapse-free survival of 8.8 months, compared with 20.5 months for the low-risk group (P = 0.005), and the high-risk group had a median overall survival of 37.8 months, compared with 67.0 months for the low-risk group (P = 0.005). Histological examination of 144 liver samples showed that the desertic immune phenotype was associated with worse overall survival in the multivariable analysis (P = 0.020). The Histopathological, Clinical, And Molecular score variables were age at diagnosis, tumour burden score, carcinoembryonic antigen levels greater than or equal to 20 ng/ml, primary tumour resection, TNM stage at diagnosis, molecular status, histopathological growth patterns, and immune phenotypes of the liver. The high-risk group had a median relapse-free survival of 8.4 months, compared with 20.4 months for the low-risk group (P < 0.001), and a median overall survival of 30.4 months, compared with 105.0 months for the low-risk group (P < 0.001). CONCLUSION The Genetic And Morphological Evaluation score was validated as a preoperative prognostic tool to predict candidacy for liver resection. The Histopathological, Clinical, And Molecular score could be useful to assess adjuvant treatment after hepatic resection.
Collapse
Affiliation(s)
- Berta Martín-Cullell
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Translational Medical Oncology Laboratory, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Anna C Virgili
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Translational Medical Oncology Laboratory, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Pau Riera
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- U705, Instituto de Salud Carlos III, Center for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain
| | - Caterina Fumagalli
- Pathology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Francisco J Pelegrín
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Translational Medical Oncology Laboratory, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | | | - Víctor Molina
- Surgery Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Justyna Szafranska
- Pathology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - David Páez
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Translational Medical Oncology Laboratory, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
- U705, Instituto de Salud Carlos III, Center for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain
| |
Collapse
|
2
|
Hernando-Calvo A, Vila-Casadesús M, Bareche Y, Gonzalez-Medina A, Abbas-Aghababazadeh F, Lo Giacco D, Martin A, Saavedra O, Brana I, Vieito M, Fasani R, Stagg J, Mancuso F, Haibe-Kains B, Han M, Berche R, Pugh TJ, Mirallas O, Jimenez J, Gonzalez NS, Valverde C, Muñoz-Couselo E, Suarez C, Diez M, Élez E, Capdevila J, Oaknin A, Saura C, Macarulla T, Galceran JC, Felip E, Dienstmann R, Bedard PL, Nuciforo P, Seoane J, Tabernero J, Garralda E, Vivancos A. A pan-cancer clinical platform to predict immunotherapy outcomes and prioritize immuno-oncology combinations in early-phase trials. Med 2023; 4:710-727.e5. [PMID: 37572657 DOI: 10.1016/j.medj.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 06/01/2023] [Accepted: 07/14/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Immunotherapy is effective, but current biomarkers for patient selection have proven modest sensitivity. Here, we developed VIGex, an optimized gene signature based on the expression level of 12 genes involved in immune response with RNA sequencing. METHODS We implemented VIGex using the nCounter platform (Nanostring) on a large clinical cohort encompassing 909 tumor samples across 45 tumor types. VIGex was developed as a continuous variable, with cutoffs selected to detect three main categories (hot, intermediate-cold and cold) based on the different inflammatory status of the tumor microenvironment. FINDINGS Hot tumors had the highest VIGex scores and exhibited an increased abundance of tumor-infiltrating lymphocytes as compared with the intermediate-cold and cold. VIGex scores varied depending on tumor origin and anatomic site of metastases, with liver metastases showing an immunosuppressive tumor microenvironment. The predictive power of VIGex-Hot was observed in a cohort of 98 refractory solid tumor from patients treated in early-phase immunotherapy trials and its clinical performance was confirmed through an extensive metanalysis across 13 clinically annotated gene expression datasets from 877 patients treated with immunotherapy agents. Last, we generated a pan-cancer biomarker platform that integrates VIGex categories with the expression levels of immunotherapy targets under development in early-phase clinical trials. CONCLUSIONS Our results support the clinical utility of VIGex as a tool to aid clinicians for patient selection and personalized immunotherapy interventions. FUNDING BBVA Foundation; 202-2021 Division of Medical Oncology and Hematology Fellowship award; Princess Margaret Cancer Center.
Collapse
Affiliation(s)
- Alberto Hernando-Calvo
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain; Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G2C4, Canada; Departamento de Medicina, Universidad Autónoma de Barcelona (UAB), 08035 Barcelona, Spain
| | | | - Yacine Bareche
- Institut du Cancer de Montréal, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC H2X0A9, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, QC H3T1J4, Canada
| | | | | | | | - Agatha Martin
- Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Omar Saavedra
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Irene Brana
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Maria Vieito
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Roberta Fasani
- Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - John Stagg
- Institut du Cancer de Montréal, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC H2X0A9, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, QC H3T1J4, Canada
| | | | - Benjamin Haibe-Kains
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G2C4, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G1L7, Canada; Department of Computer Science, University of Toronto, Toronto, ON M5S2E4, Canada; Ontario Institute for Cancer Research, Toronto, ON M5G0A3, Canada; Vector Institute for Artificial Intelligence, Toronto, ON M5G1M1, Canada
| | - Ming Han
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G2C4, Canada
| | - Roger Berche
- Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Trevor J Pugh
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G2C4, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G1L7, Canada; Ontario Institute for Cancer Research, Toronto, ON M5G0A3, Canada
| | - Oriol Mirallas
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Jose Jimenez
- Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Nadia Saoudi Gonzalez
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Claudia Valverde
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Eva Muñoz-Couselo
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Cristina Suarez
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Marc Diez
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Elena Élez
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Jaume Capdevila
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Ana Oaknin
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Cristina Saura
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Teresa Macarulla
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Joan Carles Galceran
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Enriqueta Felip
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | | | - Philippe L Bedard
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G2C4, Canada
| | - Paolo Nuciforo
- Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Joan Seoane
- Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Josep Tabernero
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Elena Garralda
- Department of Medical Oncology, Vall D'Hebron University Hospital, 08035 Barcelona, Spain; Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - Ana Vivancos
- Vall d'Hebron Institute of Oncology, 08035 Barcelona, Spain.
| |
Collapse
|
3
|
Cuesta-Borràs E, Salvans C, Arqués O, Chicote I, Ramírez L, Cabellos L, Martínez-Quintanilla J, Mur-Espinosa A, García-Álvarez A, Hernando J, Tejedor JR, Mirallas O, Élez E, Fraga MF, Tabernero J, Nuciforo P, Capdevila J, Palmer HG, Puig I. DPPA3-HIF1α axis controls colorectal cancer chemoresistance by imposing a slow cell-cycle phenotype. Cell Rep 2023; 42:112927. [PMID: 37537841 DOI: 10.1016/j.celrep.2023.112927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 08/05/2023] Open
Abstract
Tumor relapse is linked to rapid chemoresistance and represents a bottleneck for cancer therapy success. Engagement of a reduced proliferation state is a non-mutational mechanism exploited by cancer cells to bypass therapy-induced cell death. Through combining functional pulse-chase experiments in engineered cells and transcriptomic analyses, we identify DPPA3 as a master regulator of slow-cycling and chemoresistant phenotype in colorectal cancer (CRC). We find a vicious DPPA3-HIF1α feedback loop that downregulates FOXM1 expression via DNA methylation, thereby delaying cell-cycle progression. Moreover, downregulation of HIF1α partially restores a chemosensitive proliferative phenotype in DPPA3-overexpressing cancer cells. In cohorts of CRC patient samples, DPPA3 overexpression acts as a predictive biomarker of chemotherapeutic resistance that subsequently requires reduction in its expression to allow metastatic outgrowth. Our work demonstrates that slow-cycling cancer cells exploit a DPPA3/HIF1α axis to support tumor persistence under therapeutic stress and provides insights on the molecular regulation of disease progression.
Collapse
Affiliation(s)
- Estefania Cuesta-Borràs
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Cándida Salvans
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Oriol Arqués
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Irene Chicote
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; CIBERONC, 08029 Madrid, Spain
| | - Lorena Ramírez
- Gastrointestinal and Endocrine Tumors Group, Medical Oncology Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Laia Cabellos
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | | | - Alex Mur-Espinosa
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Alejandro García-Álvarez
- Gastrointestinal and Endocrine Tumors Group, Medical Oncology Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Jorge Hernando
- Gastrointestinal and Endocrine Tumors Group, Medical Oncology Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Juan Ramón Tejedor
- Nanomaterials and Nanotechnology Research Center (CINN), Spanish National Research Council (CSIC), Health Research Institute of the Principality of Asturias (ISPA), Spanish Biomedical Research Network in Rare Diseases (CIBERER), Institute of Oncology of Asturias (IUOPA), University of Oviedo, 33011 Oviedo, Asturias, Spain
| | - Oriol Mirallas
- Gastrointestinal and Endocrine Tumors Group, Medical Oncology Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Elena Élez
- CIBERONC, 08029 Madrid, Spain; Gastrointestinal and Endocrine Tumors Group, Medical Oncology Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Mario F Fraga
- Nanomaterials and Nanotechnology Research Center (CINN), Spanish National Research Council (CSIC), Health Research Institute of the Principality of Asturias (ISPA), Spanish Biomedical Research Network in Rare Diseases (CIBERER), Institute of Oncology of Asturias (IUOPA), University of Oviedo, 33011 Oviedo, Asturias, Spain
| | - Josep Tabernero
- CIBERONC, 08029 Madrid, Spain; Gastrointestinal and Endocrine Tumors Group, Medical Oncology Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain; UVic-UCC, IOB-Quiron, 08023 Barcelona, Spain
| | - Paolo Nuciforo
- CIBERONC, 08029 Madrid, Spain; Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Jaume Capdevila
- Gastrointestinal and Endocrine Tumors Group, Medical Oncology Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain; IOB-Teknon, 08023 Barcelona, Spain
| | - Héctor G Palmer
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; CIBERONC, 08029 Madrid, Spain.
| | - Isabel Puig
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain; CIBERONC, 08029 Madrid, Spain.
| |
Collapse
|
4
|
Tagliamento M, Gennari A, Lambertini M, Salazar R, Harbeck N, Del Mastro L, Aguilar-Company J, Bower M, Sharkey R, Dalla Pria A, Plaja A, Jackson A, Handford J, Sita-Lumsden A, Martinez-Vila C, Matas M, Miguel Rodriguez A, Vincenzi B, Tonini G, Bertuzzi A, Brunet J, Pedrazzoli P, D'Avanzo F, Biello F, Sinclair A, Lee AJ, Rossi S, Rizzo G, Mirallas O, Pimentel I, Iglesias M, Sanchez de Torre A, Guida A, Berardi R, Zambelli A, Tondini C, Filetti M, Mazzoni F, Mukherjee U, Diamantis N, Parisi A, Aujayeb A, Prat A, Libertini M, Grisanti S, Rossi M, Zoratto F, Generali D, Saura C, Lyman GH, Kuderer NM, Pinato DJ, Cortellini A. Pandemic Phase-Adjusted Analysis of COVID-19 Outcomes Reveals Reduced Intrinsic Vulnerability and Substantial Vaccine Protection From Severe Acute Respiratory Syndrome Coronavirus 2 in Patients With Breast Cancer. J Clin Oncol 2023; 41:2800-2814. [PMID: 36720089 PMCID: PMC10414724 DOI: 10.1200/jco.22.01667] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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] [Received: 07/22/2022] [Revised: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Although representing the majority of newly diagnosed cancers, patients with breast cancer appear less vulnerable to COVID-19 mortality compared with other malignancies. In the absence of patients on active cancer therapy included in vaccination trials, a contemporary real-world evaluation of outcomes during the various pandemic phases, as well as of the impact of vaccination, is needed to better inform clinical practice. METHODS We compared COVID-19 morbidity and mortality among patients with breast cancer across prevaccination (February 27, 2020-November 30, 2020), Alpha-Delta (December 1, 2020-December 14, 2021), and Omicron (December 15, 2021-January 31, 2022) phases using OnCovid registry participants (ClinicalTrials.gov identifier: NCT04393974). Twenty-eight-day case fatality rate (CFR28) and COVID-19 severity were compared in unvaccinated versus double-dosed/boosted patients (vaccinated) with inverse probability of treatment weighting models adjusted for country of origin, age, number of comorbidities, tumor stage, and receipt of systemic anticancer therapy within 1 month of COVID-19 diagnosis. RESULTS By the data lock of February 4, 2022, the registry counted 613 eligible patients with breast cancer: 60.1% (n = 312) hormone receptor-positive, 25.2% (n = 131) human epidermal growth factor receptor 2-positive, and 14.6% (n = 76) triple-negative. The majority (61%; n = 374) had localized/locally advanced disease. Median age was 62 years (interquartile range, 51-74 years). A total of 193 patients (31.5%) presented ≥ 2 comorbidities and 69% (n = 330) were never smokers. In total, 392 (63.9%), 164 (26.8%), and 57 (9.3%) were diagnosed during the prevaccination, Alpha-Delta, and Omicron phases, respectively. Analysis of CFR28 demonstrates comparable estimates of mortality across the three pandemic phases (13.9%, 12.2%, 5.3%, respectively; P = .182). Nevertheless, a significant improvement in outcome measures of COVID-19 severity across the three pandemic time periods was observed. Importantly, when reported separately, unvaccinated patients from the Alpha-Delta and Omicron phases achieved comparable outcomes to those from the prevaccination phase. Of 566 patients eligible for the vaccination analysis, 72 (12.7%) were fully vaccinated and 494 (87.3%) were unvaccinated. We confirmed with inverse probability of treatment weighting multivariable analysis and following a clustered robust correction for participating center that vaccinated patients achieved improved CFR28 (odds ratio [OR], 0.19; 95% CI, 0.09 to 0.40), hospitalization (OR, 0.28; 95% CI, 0.11 to 0.69), COVID-19 complications (OR, 0.16; 95% CI, 0.06 to 0.45), and reduced requirement of COVID-19-specific therapy (OR, 0.24; 95% CI, 0.09 to 0.63) and oxygen therapy (OR, 0.24; 95% CI, 0.09 to 0.67) compared with unvaccinated controls. CONCLUSION Our findings highlight a consistent reduction of COVID-19 severity in patients with breast cancer during the Omicron outbreak in Europe. We also demonstrate that even in this population, a complete severe acute respiratory syndrome coronavirus 2 vaccination course is a strong determinant of improved morbidity and mortality from COVID-19.
Collapse
Affiliation(s)
- Marco Tagliamento
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
- Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Barcelona, Spain
| | - Nadia Harbeck
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Lucia Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
- Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Andrea Plaja
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology-Badalona, Badalona, Spain
| | | | - Jasmine Handford
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | | | | | | | - Bruno Vincenzi
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Giuseppe Tonini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Francesca D'Avanzo
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alasdair Sinclair
- Cancer Division, University College London Hospitals, London, United Kingdom
| | - Alvin J.X. Lee
- Cancer Division, University College London Hospitals, London, United Kingdom
| | - Sabrina Rossi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Isabel Pimentel
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Annalisa Guida
- Department of Oncology, Azienda Ospedaliera Santa Maria, Terni, Italy
| | - Rossana Berardi
- Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy
| | | | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, United Kingdom
| | | | - Alessandro Parisi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Michela Libertini
- Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | | | - Maura Rossi
- Oncology Unit, Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo,” Alessandria, Italy
| | | | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Cremona, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Cristina Saura
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Gary H. Lyman
- Public Health Sciences Division and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA
- Divisions of Public Health Science and Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA
| | | | - David J. Pinato
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Alessio Cortellini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| |
Collapse
|
5
|
Hernando-Calvo A, Mirallas O, Marmolejo D, Saavedra O, Vieito M, Assaf Pastrana JD, Aguilar S, Bescós C, Lorente J, Giralt J, Benavente S, Temprana-Salvador J, Alberola M, Dienstmann R, Garralda E, Felip E, Villacampa G, Brana I. Nutritional status associates with immunotherapy clinical outcomes in recurrent or metastatic head and neck squamous cell carcinoma patients. Oral Oncol 2023; 140:106364. [PMID: 36989964 DOI: 10.1016/j.oraloncology.2023.106364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/04/2023] [Accepted: 03/05/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Beyond programmed death-ligand 1 (PD-L1) assessed by the combined positive score (CPS) and tumor mutational burden (TMB), no other biomarkers are approved for immunotherapy interventions. Here, we investigated whether additional clinical and pathological variables may impact on immunotherapy outcomes in recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients. METHODS R/M HNSCC patients treated with immunotherapy were reviewed. Analyzed variables at baseline included: clinicopathological, laboratory, and variables reflecting the host nutritional status such as the prognostic nutritional index (PNI) and albumin. The primary endpoint was progression free survival (PFS). The secondary endpoints were overall survival (OS) and objective response rate (ORR). Univariable and multivariable Cox models were fitted and random forest algorithm was used to estimate the importance of each prognostic variable. RESULTS A total of 100 patients were treated with immunotherapy; 50% with single agent and 50% with experimental immunotherapy combinations. In the multivariable analysis, both ECOG performance status (HR: 1.73; 95%CI 1.07-2.82; p = 0.03) and PNI levels (10-point increments, HR: 0.66; 0.46-0.95; p = 0.03) were significantly associated with PFS. However, the derived neutrophil to lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) were not significantly associated with PFS (p-values > 0.15). In the OS analysis, albumin and PNI were the only statistically significant factors in the multivariable model (p < 0.001). CONCLUSIONS In our cohort, PNI and ECOG performance status were most strongly associated with PFS in R/M HNSCC patients treated with immunotherapy. These results suggest that parameters informative of nutritional status should be considered before immunotherapy.
Collapse
|
6
|
Cortellini A, Tabernero J, Mukherjee U, Salazar R, Sureda A, Maluquer C, Ferrante D, Bower M, Sharkey R, Mirallas O, Plaja A, Cucurull M, Mesia R, Dalla Pria A, Newsom-Davis T, Van Hemelrijck M, Sita-Lumsden A, Apthorp E, Vincenzi B, Di Fazio GR, Tonini G, Pantano F, Bertuzzi A, Rossi S, Brunet J, Lambertini M, Pedrazzoli P, Biello F, D'Avanzo F, Lee AJX, Shawe-Taylor M, Rogers L, Murphy C, Cooper L, Andaleeb R, Khalique S, Bawany S, Ahmed S, Carmona-García MC, Fort-Culillas R, Liñan R, Zoratto F, Rizzo G, Perachino M, Doonga K, Gaidano G, Bruna R, Patriarca A, Martinez-Vila C, Pérez Criado I, Giusti R, Mazzoni F, Antonuzzo L, Santoro A, Parisi A, Queirolo P, Aujayeb A, Rimassa L, Diamantis N, Bertulli R, Fulgenzi CAM, D'Alessio A, Ruiz-Camps I, Saoudi-Gonzalez N, Garcia Illescas D, Medina I, Fox L, Gennari A, Aguilar-Company J, Pinato DJ. SARS-CoV-2 omicron (B.1.1.529)-related COVID-19 sequelae in vaccinated and unvaccinated patients with cancer: results from the OnCovid registry. Lancet Oncol 2023; 24:335-346. [PMID: 36898391 PMCID: PMC9991062 DOI: 10.1016/s1470-2045(23)00056-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND COVID-19 sequelae can affect about 15% of patients with cancer who survive the acute phase of SARS-CoV-2 infection and can substantially impair their survival and continuity of oncological care. We aimed to investigate whether previous immunisation affects long-term sequelae in the context of evolving variants of concern of SARS-CoV-2. METHODS OnCovid is an active registry that includes patients aged 18 years or older from 37 institutions across Belgium, France, Germany, Italy, Spain, and the UK with a laboratory-confirmed diagnosis of COVID-19 and a history of solid or haematological malignancy, either active or in remission, followed up from COVID-19 diagnosis until death. We evaluated the prevalence of COVID-19 sequelae in patients who survived COVID-19 and underwent a formal clinical reassessment, categorising infection according to the date of diagnosis as the omicron (B.1.1.529) phase from Dec 15, 2021, to Jan 31, 2022; the alpha (B.1.1.7)-delta (B.1.617.2) phase from Dec 1, 2020, to Dec 14, 2021; and the pre-vaccination phase from Feb 27 to Nov 30, 2020. The prevalence of overall COVID-19 sequelae was compared according to SARS-CoV-2 immunisation status and in relation to post-COVID-19 survival and resumption of systemic anticancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974. FINDINGS At the follow-up update on June 20, 2022, 1909 eligible patients, evaluated after a median of 39 days (IQR 24-68) from COVID-19 diagnosis, were included (964 [50·7%] of 1902 patients with sex data were female and 938 [49·3%] were male). Overall, 317 (16·6%; 95% CI 14·8-18·5) of 1909 patients had at least one sequela from COVID-19 at the first oncological reassessment. The prevalence of COVID-19 sequelae was highest in the pre-vaccination phase (191 [19·1%; 95% CI 16·4-22·0] of 1000 patients). The prevalence was similar in the alpha-delta phase (110 [16·8%; 13·8-20·3] of 653 patients, p=0·24), but significantly lower in the omicron phase (16 [6·2%; 3·5-10·2] of 256 patients, p<0·0001). In the alpha-delta phase, 84 (18·3%; 95% CI 14·6-22·7) of 458 unvaccinated patients and three (9·4%; 1·9-27·3) of 32 unvaccinated patients in the omicron phase had sequelae. Patients who received a booster and those who received two vaccine doses had a significantly lower prevalence of overall COVID-19 sequelae than unvaccinated or partially vaccinated patients (ten [7·4%; 95% CI 3·5-13·5] of 136 boosted patients, 18 [9·8%; 5·8-15·5] of 183 patients who had two vaccine doses vs 277 [18·5%; 16·5-20·9] of 1489 unvaccinated patients, p=0·0001), respiratory sequelae (six [4·4%; 1·6-9·6], 11 [6·0%; 3·0-10·7] vs 148 [9·9%; 8·4-11·6], p=0·030), and prolonged fatigue (three [2·2%; 0·1-6·4], ten [5·4%; 2·6-10·0] vs 115 [7·7%; 6·3-9·3], p=0·037). INTERPRETATION Unvaccinated patients with cancer remain highly vulnerable to COVID-19 sequelae irrespective of viral strain. This study confirms the role of previous SARS-CoV-2 immunisation as an effective measure to protect patients from COVID-19 sequelae, disruption of therapy, and ensuing mortality. FUNDING UK National Institute for Health and Care Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.
Collapse
Affiliation(s)
- Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, London, UK; Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy.
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | - Ramon Salazar
- Catalan Institute of Oncology (ICO), University of Barcelona, Bellvitge Biomedical Research Institute (IDIBELL), CIBERONC, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Clara Maluquer
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Daniela Ferrante
- Unit of Medical Statistics, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Andrea Plaja
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Marc Cucurull
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Ricard Mesia
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Mieke Van Hemelrijck
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK; Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | | | - Bruno Vincenzi
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Giuseppina Rita Di Fazio
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Giuseppe Tonini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Francesco Pantano
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Sabrina Rossi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Matteo Lambertini
- Medical Oncology Department, UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Francesca D'Avanzo
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | | | - Lucy Rogers
- Cancer Division, University College London Hospitals, London, UK
| | - Cian Murphy
- Cancer Division, University College London Hospitals, London, UK
| | - Lee Cooper
- Cancer Division, University College London Hospitals, London, UK
| | - Ramis Andaleeb
- Cancer Division, University College London Hospitals, London, UK
| | - Saira Khalique
- Cancer Division, University College London Hospitals, London, UK
| | - Samira Bawany
- Cancer Division, University College London Hospitals, London, UK
| | - Sarah Ahmed
- Cancer Division, University College London Hospitals, London, UK
| | - M Carmen Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Roser Fort-Culillas
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Raquel Liñan
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | | | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marta Perachino
- Medical Oncology Department, UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
| | - Kris Doonga
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Riccardo Bruna
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | | | | | | | | | | | - Armando Santoro
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alessandro Parisi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Queirolo
- Melanoma and Sarcoma Medical Treatment Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Rossella Bertulli
- Medical Oncology 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia A M Fulgenzi
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Antonio D'Alessio
- Department of Surgery and Cancer, Imperial College London, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Isabel Ruiz-Camps
- Department of Infectious Diseases, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - David Garcia Illescas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Irene Medina
- Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Laura Fox
- Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain; Department of Infectious Diseases, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - David J Pinato
- Department of Surgery and Cancer, Imperial College London, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| |
Collapse
|
7
|
Jimenez-Fonseca P, Foy V, Raby S, Carmona-Bayonas A, Macía-Rivas L, Arrazubi V, Cacho Lavin D, Hernandez San Gil R, Custodio A, Cano JM, Fernández Montes A, Mirallas O, Macias Declara I, Vidal Tocino R, Visa L, Limón ML, Pimentel P, Martínez Lago N, Sauri T, Martín Richard M, Mangas M, Gil Raga M, Calvo A, Reguera P, Granja M, Martín Carnicero A, Hernández Pérez C, Cerdá P, Gomez Gonzalez L, Garcia Navalon F, Pacheco Barcia V, Gutierrez Abad D, Ruiz Martín M, Weaver J, Mansoor W, Gallego J. The AGAMENON-SEOM model for prediction of survival in patients with advanced HER2-positive oesophagogastric adenocarcinoma receiving first-line trastuzumab-based therapy. Ther Adv Med Oncol 2023; 15:17588359231157641. [PMID: 36895850 PMCID: PMC9989382 DOI: 10.1177/17588359231157641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/30/2023] [Indexed: 03/06/2023] Open
Abstract
Background Trastuzumab and chemotherapy is the standard first-line treatment in human epidermal growth factor receptor 2 (HER2)-positive advanced gastro-oesophageal cancer. The objective was to develop a predictive model for overall survival (OS) and progression-free survival (PFS) in patients treated with trastuzumab. Methods Patients with HER2-positive advanced gastro-oesophageal adenocarcinoma (AGA) from the Spanish Society of Medical Oncology (SEOM)-AGAMENON registry and treated first line with trastuzumab and chemotherapy between 2008 and 2021 were included. The model was externally validated in an independent series (The Christie NHS Foundation Trust, Manchester, UK). Results In all, 737 patients were recruited (AGAMENON-SEOM, n = 654; Manchester, n = 83). Median PFS and OS in the training cohort were 7.76 [95% confidence interval (CI), 7.13-8.25] and 14.0 months (95% CI, 13.0-14.9), respectively. Six covariates were significantly associated with OS: neutrophil-to-lymphocyte ratio, Eastern Cooperative Oncology Group performance status, Lauren subtype, HER2 expression, histological grade and tumour burden. The AGAMENON-HER2 model demonstrated adequate calibration and fair discriminatory ability with a c-index for corrected PFS/OS of 0.606 (95% CI, 0.578-0.636) and 0.623 (95% CI, 0.594-0.655), respectively. In the validation cohort, the model is well calibrated, with a c-index of 0.650 and 0.683 for PFS and OS, respectively. Conclusion The AGAMENON-HER2 prognostic tool stratifies HER2-positive AGA patients receiving trastuzumab and chemotherapy according to their estimated survival endpoints.
Collapse
Affiliation(s)
- Paula Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Victoria Foy
- Department of Medical Oncology, Christie Hospital, Manchester, UK
| | - Sophie Raby
- Department of Medical Oncology, Christie Hospital, Manchester, UK
| | - Alberto Carmona-Bayonas
- Medical Oncology Department, Hospital Universitario Morales Meseguer, Calle Marqués de los Vélez, s/n, Murcia 30007, Spain
| | - Lola Macía-Rivas
- Pharmacy Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Virginia Arrazubi
- Medical Oncology Department, Complejo Hospitalario de Navarra, IdiSNA (Navarra Institute for Health Research), Pamplona, Spain
| | - Diego Cacho Lavin
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | - Ana Custodio
- Medical Oncology Department, Hospital Universitario La Paz, CIBERONC CB16/12/00398, Madrid, Spain
| | - Juana María Cano
- Medical Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | - Oriol Mirallas
- Medical Oncology Department, Hospital Universitario Vall d'Hebron, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Rosario Vidal Tocino
- Medical Oncology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Laura Visa
- Medical Oncology Department, Hospital Universitario El Mar, Barcelona, Spain
| | - María Luisa Limón
- Medical Oncology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Paola Pimentel
- Medical Oncology Department, Hospital General Universitario Santa Lucía, Cartagena, Spain
| | - Nieves Martínez Lago
- Medical Oncology Department, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Tamara Sauri
- Medical Oncology Department, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | | | - Monserrat Mangas
- Medical Oncology Department, Hospital Galdakao-Usansolo, Usansolo, Spain
| | - Mireia Gil Raga
- Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain
| | - Aitana Calvo
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Pablo Reguera
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Mónica Granja
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | - Carolina Hernández Pérez
- Medical Oncology Department, Hospital Universitario Nuestra Señora de the Candelaria, Santa Cruz de Tenerife, Spain
| | - Paula Cerdá
- Medical Oncology Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain
| | - Lucía Gomez Gonzalez
- Medical Oncology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | | | | | - David Gutierrez Abad
- Medical Oncology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Maribel Ruiz Martín
- Medical Oncology Department, Hospital Universitario Rio Carrión de Zamora, Zamora, Spain
| | - Jamie Weaver
- Department of Medical Oncology, Christie Hospital/University of Manchester, Manchester, UK
| | - Wasat Mansoor
- Department of Medical Oncology, Christie Hospital/University of Manchester, Manchester, UK
| | - Javier Gallego
- Medical Oncology Department, Hospital General Universitario of Elche, Elche, Spain
| |
Collapse
|
8
|
Grau-Bejar JF, Garcia-Duran C, Garcia-Illescas D, Mirallas O, Oaknin A. Advances in immunotherapy for cervical cancer. Ther Adv Med Oncol 2023; 15:17588359231163836. [PMID: 37007635 PMCID: PMC10052578 DOI: 10.1177/17588359231163836] [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] [Received: 11/20/2022] [Accepted: 02/22/2023] [Indexed: 03/30/2023] Open
Abstract
Cervical cancer still represents a major public health problem, being the fourth most common cancer in incidence and mortality in women worldwide. These figures are unacceptable since cervical cancer, an human papillomavirus-related malignancy, is a largely preventable disease by means of well-established screening and vaccination programs. Patients with recurrent, persistent, or metastatic disease unsuitable for curative therapeutic approaches represent a dismal prognosis population. Until recently, these patients were only candidates for cisplatin-based chemotherapy plus bevacizumab. However, the introduction of immune checkpoint inhibitors has revolutionized the treatment landscape of this disease achieving historical overall survival improvements in both the post-platinum and frontline settings. Interestingly, the clinical development of immunotherapy in cervical cancer is currently advancing to earlier stages of the disease, as the locally advanced setting, whose standard of care has not changed in the last decades with still modest outcomes. As more innovative immunotherapy approaches are in clinical early development in advanced cervical cancer, promising efficacy data are emerging that may shape the future of this disease. This review summarizes the main treatment advances carried out in the field of immunotherapy throughout the past years.
Collapse
Affiliation(s)
- Juan Francisco Grau-Bejar
- Gynaecologic Cancer Programme Vall d’Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Carmen Garcia-Duran
- Gynaecologic Cancer Programme Vall d’Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - David Garcia-Illescas
- Gynaecologic Cancer Programme Vall d’Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Oriol Mirallas
- Gynaecologic Cancer Programme Vall d’Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | |
Collapse
|
9
|
Saavedra Santa Gadea O, Vila Casadesus M, Mirallas O, Calvo A, Ros Montana F, Baraibar Argota I, Suarez Rodriguez C, Oberoi A, Morales Barrera R, Iranzo Gomez P, Alonso G, Brana I, Cabrera Navarro A, Hernández-Illán E, Vieito Villar M, Elez Fernandez M, Gonzalez Rodriguez M, Felip E, Garralda E, Vivancos A. 126P The HLA I composite score and VHIO immune gene-expression signature (VIGex) as selection tools to explore the tumor microenvironment (TME) in patients (pts) treated with immunotherapy (IT). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
10
|
Mirallas O, López Valbuena D, Yaringaño J, Martin Cullell B, Illescas D, Aguilar Izquierdo S, Martínez-Sáez E, Pedrola A, Vivancos A, Saoudi Gonzalez N, Ros Montana F, Gonzalez Rodriguez M, Dienstmann R, Mateo J, Tabernero J, Garralda E, Carles Galceran J, Vieito Villar M. 290P Potential enrichment strategies for next-generation sequencing (NGS) in primary brain cancers (pBCs) in a clinical series according to ESMO scale for clinical actionability of molecular targets (ESCAT). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
11
|
Mirallas O, Marmolejo Castaneda D, Illescas D, Gómez-Puerto D, Berché R, Calvo A, Vieito Villar M, Lorini L, Navarro V, Assaf Pastrana J, Saavedra O, Alonso G, Aguilar Izquierdo S, Bescós C, Lorente J, Giralt J, Dienstmann R, Garralda E, Felip E, Brana I. 686P Next generation sequencing (NGS) helps predict response to immunotherapy (IO) in recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients (pts). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.810] [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: 11/30/2022] Open
|
12
|
Pinato DJ, Ferrante D, Aguilar-Company J, Bower M, Salazar R, Mirallas O, Sureda A, Bertuzzi A, Brunet J, Lambertini M, Maluquer C, Pedrazzoli P, Biello F, Lee AJX, Sng CCT, Liñan R, Rossi S, Carmona-García MC, Sharkey R, Eremiev S, Rizzo G, Bain HD, Yu T, Cruz CA, Perachino M, Saoudi-Gonzalez N, Fort-Culillas R, Doonga K, Fox L, Roldán E, Zoratto F, Gaidano G, Ruiz-Camps I, Bruna R, Patriarca A, Shawe-Taylor M, Fusco V, Martinez-Vila C, Berardi R, Filetti M, Mazzoni F, Santoro A, Delfanti S, Parisi A, Queirolo P, Aujayeb A, Rimassa L, Prat A, Tabernero J, Gennari A, Cortellini A. Vaccination against SARS-CoV-2 protects from morbidity, mortality and sequelae from COVID19 in patients with cancer. Eur J Cancer 2022; 171:64-74. [PMID: 35704976 PMCID: PMC9124924 DOI: 10.1016/j.ejca.2022.04.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although SARS-CoV-2 vaccines immunogenicity in patients with cancer has been investigated, whether they can significantly improve the severity of COVID-19 in this specific population is undefined. METHODS Capitalizing on OnCovid (NCT04393974) registry data we reported COVID-19 mortality and proxies of COVID-19 morbidity, including post-COVID-19 outcomes, according to the vaccination status of the included patients. RESULTS 2090 eligible patients diagnosed with COVID-19 between 02/2020 and 11/2021 were included, of whom 1930 (92.3%) unvaccinated, 91 (4.4%) fully vaccinated and 69 (3.3%) partially vaccinated. With the exception of a higher prevalence of patients from the UK (p = 0.0003) and receiving systemic anticancer therapy at COVID-19 diagnosis (p = 0.0082) among fully vaccinated patients, no demographics/oncological features were associated with vaccination status. The 14-days case fatality rate (CFR) (5.5% vs 20.7%, p = 0.0004) and the 28-days CFR (13.2% vs 27.4%, p = 0.0028) demonstrated a significant improvement for fully vaccinated patients in comparison with unvaccinated patients. The receipt of prior full vaccination was also associated with reduced symptomatic COVID-19 (79.1% vs 88.5%, p = 0.0070), need of COVID-19 oriented therapy (34.9% vs 63.2%, p < 0.0001), complications from COVID-19 (28.6% vs 39.4%, p = 0.0379), hospitalizations due to COVID-19 (42.2% vs 52.5%, p = 0.0007) and oxygen therapy requirement (35.7% vs 52%, p = 0.0036). Following Inverse Probability Treatment Weighting (IPTW) procedure no statistically significant difference according to the vaccination status was confirmed; however, all COVID-19 related outcomes were concordantly in favour of full vaccination. Among the 1228 (58.8%) patients who underwent a formal reassessment at participating centres after COVID-19 resolution, fully vaccinated patients experienced less sequelae than unvaccinated patients (6.7% vs 17.2%, p = 0.0320). CONCLUSIONS This analysis provides initial evidence in support of the beneficial effect of SARS-CoV-2 vaccines against morbidity and mortality from COVID-19 in patients with cancer.
Collapse
Affiliation(s)
- David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | - Juan Aguilar-Company
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain; Infectious Diseases, Vall D'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain
| | - Oriol Mirallas
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Matteo Lambertini
- Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Clara Maluquer
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia Italy
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | | | - Raquel Liñan
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Sabrina Rossi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - M Carmen Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Simeon Eremiev
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Hamish Dc Bain
- Cancer Division, University College London Hospitals, London, UK
| | - Tamara Yu
- Cancer Division, University College London Hospitals, London, UK
| | - Claudia A Cruz
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Marta Perachino
- Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Roser Fort-Culillas
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Kris Doonga
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Laura Fox
- Department of Hematology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Elisa Roldán
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore Della Carità Hospital, Novara, Italy
| | - Isabel Ruiz-Camps
- Infectious Diseases, Vall D'Hebron University Hospital, Barcelona, Spain
| | - Riccardo Bruna
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore Della Carità Hospital, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore Della Carità Hospital, Novara, Italy
| | | | - Vittorio Fusco
- Oncology Unit and Centro Documentazione Osteonecrosi, Azienda Ospedaliera "SS Antonio e Biagio e Cesare Arrigo", Alessandria, Italy
| | | | - Rossana Berardi
- Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy
| | | | | | - Armando Santoro
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy
| | - Sara Delfanti
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandro Parisi
- Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Queirolo
- Melanoma and Sarcoma Medical Treatment Unit, IEO - Istituto Europeo di Oncologia, Milan, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology, Vall D'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alessio Cortellini
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK.
| |
Collapse
|
13
|
Pinato DJ, Aguilar-Company J, Ferrante D, Hanbury G, Bower M, Salazar R, Mirallas O, Sureda A, Plaja A, Cucurull M, Mesia R, Townsend S, Jackson A, Dalla Pria A, Newsom-Davis T, Handford J, Sita-Lumsden A, Apthorp E, Vincenzi B, Bertuzzi A, Brunet J, Lambertini M, Maluquer C, Pedrazzoli P, Biello F, Sinclair A, Bawany S, Khalique S, Rossi S, Rogers L, Murphy C, Belessiotis K, Carmona-García MC, Sharkey R, García-Illescas D, Rizzo G, Perachino M, Saoudi-Gonzalez N, Doonga K, Fox L, Roldán E, Gaidano G, Ruiz-Camps I, Bruna R, Patriarca A, Martinez-Vila C, Cantini L, Zambelli A, Giusti R, Mazzoni F, Caliman E, Santoro A, Grosso F, Parisi A, Queirolo P, Aujayeb A, Rimassa L, Prat A, Tucci M, Libertini M, Grisanti S, Mukherjee U, Diamantis N, Fusco V, Generali D, Provenzano S, Gennari A, Tabernero J, Cortellini A, Evans JS, Swallow J, Chung C, Patel M, Dettorre G, Ottaviani D, Chowdhury A, Merry E, Chopra N, Lee AJX, Sng CCT, Yu T, Shawe-Taylor M, Bain HDC, Wong YNS, Galazi M, Benafif S, Dileo P, Earnshaw I, Patel G, Wu A, Soosaipillai G, Cooper L, Andaleeb R, Dolly S, Apthorp E, Srikandarajah K, Jones E, Van Hemelrijck M, Moss C, Russell B, Chester J, Loizidou A, Piccart M, Cruz CA, Reyes R, Segui E, Marco-Hernández J, Viladot M, Eremiev S, Fort-Culillas R, Garcia I, Liñan R, Roqué Lloveras A, Harbeck N, Wuerstlein R, Henze F, Mahner S, Felip E, Pous A, D'Avanzo F, Scotti L, Krengli M, Marrari A, Delfanti S, Maconi A, Betti M, Tonini G, Di Fazio GR, Tondini C, Chiudinelli L, Franchi M, Libertini M, Bertulli R, Baggi A, Tovazzi V, Ficorella C, Porzio G, Saponara M, Filetti M, Zoratto F, Paoloni F, Berardi R, Guida A, Bracarda S, Iglesias M, Sanchez de Torre A, Tagliamento M, Colomba E, Pommeret F. Outcomes of the SARS-CoV-2 omicron (B.1.1.529) variant outbreak among vaccinated and unvaccinated patients with cancer in Europe: results from the retrospective, multicentre, OnCovid registry study. Lancet Oncol 2022; 23:865-875. [PMID: 35660139 PMCID: PMC9162476 DOI: 10.1016/s1470-2045(22)00273-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND The omicron (B.1.1.529) variant of SARS-CoV-2 is highly transmissible and escapes vaccine-induced immunity. We aimed to describe outcomes due to COVID-19 during the omicron outbreak compared with the prevaccination period and alpha (B.1.1.7) and delta (B.1.617.2) waves in patients with cancer in Europe. METHODS In this retrospective analysis of the multicentre OnCovid Registry study, we recruited patients aged 18 years or older with laboratory-confirmed diagnosis of SARS-CoV-2, who had a history of solid or haematological malignancy that was either active or in remission. Patient were recruited from 37 oncology centres from UK, Italy, Spain, France, Belgium, and Germany. Participants were followed up from COVID-19 diagnosis until death or loss to follow-up, while being treated as per standard of care. For this analysis, we excluded data from centres that did not actively enter new data after March 1, 2021 (in France, Germany, and Belgium). We compared measures of COVID-19 morbidity, which were complications from COVID-19, hospitalisation due to COVID-19, and requirement of supplemental oxygen and COVID-19-specific therapies, and COVID-19 mortality across three time periods designated as the prevaccination (Feb 27 to Nov 30, 2020), alpha-delta (Dec 1, 2020, to Dec 14, 2021), and omicron (Dec 15, 2021, to Jan 31, 2022) phases. We assessed all-cause case-fatality rates at 14 days and 28 days after diagnosis of COVID-19 overall and in unvaccinated and fully vaccinated patients and in those who received a booster dose, after adjusting for country of origin, sex, age, comorbidities, tumour type, stage, and status, and receipt of systemic anti-cancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974, and is ongoing. FINDINGS As of Feb 4, 2022 (database lock), the registry included 3820 patients who had been diagnosed with COVID-19 between Feb 27, 2020, and Jan 31, 2022. 3473 patients were eligible for inclusion (1640 [47·4%] were women and 1822 [52·6%] were men, with a median age of 68 years [IQR 57-77]). 2033 (58·5%) of 3473 were diagnosed during the prevaccination phase, 1075 (31·0%) during the alpha-delta phase, and 365 (10·5%) during the omicron phase. Among patients diagnosed during the omicron phase, 113 (33·3%) of 339 were fully vaccinated and 165 (48·7%) were boosted, whereas among those diagnosed during the alpha-delta phase, 152 (16·6%) of 915 were fully vaccinated and 21 (2·3%) were boosted. Compared with patients diagnosed during the prevaccination period, those who were diagnosed during the omicron phase had lower case-fatality rates at 14 days (adjusted odds ratio [OR] 0·32 [95% CI 0·19-0·61) and 28 days (0·34 [0·16-0·79]), complications due to COVID-19 (0·26 [0·17-0·46]), and hospitalisation due to COVID-19 (0·17 [0·09-0·32]), and had less requirements for COVID-19-specific therapy (0·22 [0·15-0·34]) and oxygen therapy (0·24 [0·14-0·43]) than did those diagnosed during the alpha-delta phase. Unvaccinated patients diagnosed during the omicron phase had similar crude case-fatality rates at 14 days (ten [25%] of 40 patients vs 114 [17%] of 656) and at 28 days (11 [27%] of 40 vs 184 [28%] of 656) and similar rates of hospitalisation due to COVID-19 (18 [43%] of 42 vs 266 [41%] of 652) and complications from COVID-19 (13 [31%] of 42 vs 237 [36%] of 659) as those diagnosed during the alpha-delta phase. INTERPRETATION Despite time-dependent improvements in outcomes reported in the omicron phase compared with the earlier phases of the pandemic, patients with cancer remain highly susceptible to SARS-CoV-2 if they are not vaccinated against SARS-CoV-2. Our findings support universal vaccination of patients with cancer as a protective measure against morbidity and mortality from COVID-19. FUNDING National Institute for Health and Care Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.
Collapse
|
14
|
Mirallas O, Lopez Valbuena D, Vega-Cano KS, Gómez-Puerto D, Martin Cullell B, Recuero-Borau J, Salva-Torres C, Andurell L, Navarro Garces V, Bueno-Salazar S, Aguilar-Company J, Roca M, Alonso A, Gómez Pardo P, Peñuelas A, Dienstmann R, Serradell S, Servitja S, Paez D, Tabernero J. Machine learning model to predict mortality after discharge in hospitalized oncologic patients (pts) under active systemic therapy in the advanced setting: A multicenter cross-validation study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.12121] [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
12121 Background: Prognostic factors for oncologic pts after surgery or curative systemic treatment have been described, including ECOG performance status, tumor staging and malnutrition. However, there is no solid evidence on which combination of variables best predicts mortality after hospitalization of metastatic cancer pts under active systemic treatment. Methods: Prospective multicentric study of pts hospitalized between 2020 and 2022 at the Oncology wards of Vall d’Hebron, Sant Pau and Mar Hospitals [PLANTOLOGY database] in Barcelona, Spain. Clinical factors such as ECOG, comorbidities, tumor characteristics, and laboratory results were collected at admission. Mental status (depression and anxiety) and QOL were assessed through the HADS and EORTC-QLQ30 questionnaires, respectively. Nutritional assessment was performed using the chair and hand grip tests. All variables were analyzed in uni- and multivariable regressions including a machine learning LASSO model to assess predictive discriminators of 30-day mortality after discharge. Missing data was imputed using Multivariate Imputation by Chained Equations. A bootstrap with 1000 iterations was used to validate the model and c-index. Results: Among 1,663 pts, 932 had advanced disease and were under oncologic treatment during the 6 months previous to urgent admission, our target population for model development and validation. Median age was 64 years, 51% had an ECOG > 1, median Charlson comorbidity index was 8 and 34% were under treatment in a clinical trial. The most frequent tumor types were lung (25%), colorectal (14%) and breast (12%) cancer. The most relevant factors associated with higher mortality at 30-day after discharge in LASSO model were high Charlson index, low neutrophil count, high LDH, poor ECOG status and progressive disease at admission (all p-values p < 0.05). The c-index corrected after bootstrap validation was 0.75. After adding the nutritional assessment, mental health status and QoL (subset of 606 with complete data), the predictive power of the model increased to a c-index corrected after bootstrap validation of 0.81. Our final prognostic model called the PRognostic Oncologic Plantology score (PROP) obtained a sensitivity of 0.75 and a specificity of 0.80 with an overall accuracy of 0.80. Only 10% of “low” PROP score pts (72% of the population) died within 30 days of discharge, as compared to 58% of early mortality in “high” PROP score pts. Conclusions: Our model, including clinical and analytical factors, predicts with accuracy the 30-day mortality of oncologic pts after discharge which is significantly improved with the addition of nutritional assessment and standardized questionnaires of QoL and mental status. The PROP score calculator will be built to help physicians adjust medical interventions for hospitalized cancer pts.
Collapse
Affiliation(s)
- Oriol Mirallas
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Diego Gómez-Puerto
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | | | - Laura Andurell
- Vall d'Hebron University Hospital Campus, Barcelona, Spain
| | | | | | - Juan Aguilar-Company
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | - Maria Roca
- Vall d'Hebron University Hospital Campus, Barcelona, Spain
| | - Ada Alonso
- Vall d'Hebron University Hospital Campus, Barcelona, Spain
| | - Patricia Gómez Pardo
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Angeles Peñuelas
- Vall d´Hebron University Hospital / Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | | | - David Paez
- Department of Medical Oncology. Santa Creu i Sant Pau University Hospital, Barcelona, Spain
| | | |
Collapse
|
15
|
Mirallas O, López-Valbuena D, García-Illescas D, Fabregat-Franco C, Verdaguer H, Tabernero J, Macarulla T. Advances in the systemic treatment of therapeutic approaches in biliary tract cancer. ESMO Open 2022; 7:100503. [PMID: 35696747 PMCID: PMC9198382 DOI: 10.1016/j.esmoop.2022.100503] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/19/2022] [Accepted: 04/22/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Biliary tract cancers (BTCs) are a rare and heterogenous group with an increasing incidence and high mortality rate. The estimated new cases and deaths of BTC worldwide are increasing, but the incidence and mortality rates in South East Asia are the highest worldwide, representing a real public health problem in these regions. BTC has a poor prognosis with a median overall survival <12 months. Thus, an urgent unmet clinical need for BTC patients exists and must be addressed. RESULTS The backbone treatment of these malignancies is chemotherapy in first- and second-line setting, but in the last decade a rich molecular landscape has been discovered, expanding conceivable treatment options. Some druggable molecular aberrations can be treated with new targeted therapies and have already demonstrated efficacy in patients with BTC, improving clinical outcomes, such as the FGFR2 or IDH1 inhibitors. Many other molecular alterations are being discovered and the treatment of BTC will change in the near future from our current clinical practice. CONCLUSIONS In this review we discuss the epidemiology, molecular characteristics, present treatment approaches, review the recent therapeutic advances, and explore future directions for patients with BTC. Due to the rich molecular landscape of BTC, molecular profiling should be carried out early. Ongoing research will bring new targeted treatments and immunotherapy in the near future.
Collapse
Affiliation(s)
- O Mirallas
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
| | - D López-Valbuena
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - D García-Illescas
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - C Fabregat-Franco
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - H Verdaguer
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J Tabernero
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - T Macarulla
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| |
Collapse
|
16
|
Mirallas O, Bosch-Schips M, Pardo N, Aubanell A, Salcedo-Allende MT, Callejo A, Iranzo P, Tabernero J, Felip E. Hepatic Rupture as the Initial Presentation of an EGFR-Mutated Lung Adenocarcinoma: A Case Report. Front Oncol 2022; 12:837630. [PMID: 35433405 PMCID: PMC9005950 DOI: 10.3389/fonc.2022.837630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Hepatic rupture is a rare complication of solid tumor malignancies, notably in lung adenocarcinomas, and carries an extremely poor overall prognosis. Epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma predict benefit with tyrosine kinase inhibitors (TKIs). This case report describes a female patient who presented with a metastatic hepatic rupture and was subsequently diagnosed with EGFR-mutated lung adenocarcinoma. The tumor had an impressive response to TKI inhibitor treatment, reversing her extremely poor, short-term prognosis. We believe this unique case sheds light on the treatment management of hepatic ruptures and supports the high response rate seen with TKIs in EGFR-mutated lung cancers, regardless of the patient’s performance status.
Collapse
Affiliation(s)
- Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Marc Bosch-Schips
- Hematology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anton Aubanell
- Radiology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | | | - Ana Callejo
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| |
Collapse
|
17
|
Baraibar I, Mirallas O, Saoudi N, Ros J, Salvà F, Tabernero J, Élez E. Combined Treatment with Immunotherapy-Based Strategies for MSS Metastatic Colorectal Cancer. Cancers (Basel) 2021; 13:6311. [PMID: 34944931 PMCID: PMC8699573 DOI: 10.3390/cancers13246311] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 12/24/2022] Open
Abstract
In recent years, deepening knowledge of the complex interactions between the immune system and cancer cells has led to the advent of effective immunotherapies that have revolutionized the therapeutic paradigm of several cancer types. However, colorectal cancer (CRC) is one of the tumor types in which immunotherapy has proven less effective. While there is solid clinical evidence for the therapeutic role of immune checkpoint inhibitors in mismatch repair-deficient (dMMR) and in highly microsatellite instable (MSI-H) metastatic CRC (mCRC), blockade of CTLA-4 or PD-L1/PD-1 as monotherapy has not conferred any major clinical benefit to patients with MMR-proficient (pMMR) or microsatellite stable (MSS) mCRC, reflecting 95% of the CRC population. There thus remains a high unmet medical need for the development of novel immunotherapy approaches for the vast majority of patients with pMMR or MSS/MSI-low (MSI-L) mCRC. Defining the molecular mechanisms for immunogenicity in mCRC and mediating immune resistance in MSS mCRC is needed to develop predictive biomarkers and effective therapeutic combination strategies. Here we review available clinical data from combinatorial therapeutic approaches using immunotherapy-based strategies for MSS mCRC.
Collapse
Affiliation(s)
- Iosune Baraibar
- Department of Medical Oncology, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain; (O.M.); (N.S.); (J.R.); (F.S.); (J.T.); (E.É.)
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Oriol Mirallas
- Department of Medical Oncology, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain; (O.M.); (N.S.); (J.R.); (F.S.); (J.T.); (E.É.)
| | - Nadia Saoudi
- Department of Medical Oncology, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain; (O.M.); (N.S.); (J.R.); (F.S.); (J.T.); (E.É.)
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Javier Ros
- Department of Medical Oncology, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain; (O.M.); (N.S.); (J.R.); (F.S.); (J.T.); (E.É.)
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Francesc Salvà
- Department of Medical Oncology, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain; (O.M.); (N.S.); (J.R.); (F.S.); (J.T.); (E.É.)
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Josep Tabernero
- Department of Medical Oncology, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain; (O.M.); (N.S.); (J.R.); (F.S.); (J.T.); (E.É.)
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Elena Élez
- Department of Medical Oncology, Vall d’Hebron University Hospital, Passeig de la Vall d’Hebron, 119, 08035 Barcelona, Spain; (O.M.); (N.S.); (J.R.); (F.S.); (J.T.); (E.É.)
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| |
Collapse
|
18
|
Mirallas O, López-Valbuena D, Javierre GV, Vega K, Gómez-Puerto D, Salva-Torres C, Rezqallah A, Molina G, Aguilar-Company J, Roca M, Andurell L, Palmas F, Fernandez ME, Alonso A, Gomez-Pardo P, Serradell S, Tabernero J, Felip E, Peñuelas A, Carles J. 1724P Prognostic parameters at admission as predictors of hospital length of stay (HLOS) and overall survival (OS) in hospitalized oncologic patients (pts) of a tertiary hospital. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
19
|
Mirallas O, López-Valbuena D, García-Illescas D, Martin Cullell B, Rodriguez N, Gantxegi A, Marmolejo Castaneda D, Valdivia A, Rezqallah Aron M, Villacampa Javierre G, Gómez-Puerto D, Vega K, Molina G, Salva-Torres C, Jofre M, Alsina M, Castro S, Tabernero J, Diez M, Macarulla Mercade T. 1431P Descriptive analysis and prognostic factors of microsatellite instability (MSI) gastric cancer patients (pts) compared to microsatellite stable (MSS) pts in a tertiary hospital. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
20
|
Cortellini A, Roldán E, Garcia MC, Berardi R, Sánchez A, Martinez C, Parisi A, Jones E, Bertulli R, Rizzo G, Guida A, Chung C, Bower M, Betti M, Vincenzi B, Mirallas O, Biello F, Queirolo P, Gennari A, Pinato D. 1560O Prevalence and impact of COVID-19 sequelae on treatment pathways and survival of cancer patients who recovered from SARS-CoV-2 infection. Ann Oncol 2021. [PMCID: PMC8454394 DOI: 10.1016/j.annonc.2021.08.1553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
21
|
Dettorre GM, Dolly S, Loizidou A, Chester J, Jackson A, Mukherjee U, Zambelli A, Aguilar-Company J, Bower M, Sng CC, Salazar R, Bertuzzi A, Brunet J, Mesia R, Sita-Lumsden A, Seguí E, Biello F, Generali D, Grisanti S, Seeva P, Rizzo G, Libertini M, Maconi A, Moss C, Tabernero J, Russell B, Harbeck N, Vincenzi B, Bertulli R, Ottaviani D, Liñan R, Marrari A, Carmona-García MC, Chopra N, Tondini C, Mirallas O, Tovazzi V, Fotia V, Cruz CA, Saoudi-Gonzalez N, Felip E, Roqué A, Lee AJ, Newsom-Davis T, Patriarca A, Rimassa L, Santoro A, Gennari A, Diamantis N, Pinato DJ. Abstract 701: The acute phase response identifies cancer patients with adverse outcomes from SARS-CoV-2 infection as quantified by the OnCovid Inflammatory Score. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Systemic inflammation is a pathogenic mechanism shared by infection and cancer. Mortality from Covid-19 is strongly linked to systemic cytokine excess. We investigated systemic inflammation as a driver of Covid-19 severity in patients with Covid-19 and cancer.
Methods. Between 27/02 and 23/06/2020, OnCovid retrospectively accrued 1,318 consecutive European cancer patients with Covid-19. Patients with myeloma, leukemia, or insufficient data were excluded. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and prognostic index (PI) were evaluated for their prognostic potential, with the NLR, PLR, and PNI risk stratifications dichotomized around median values, and the pre-established risk categorizations from literature utilized for the mGPS and PI.
Results. 1,071 eligible patients were randomly assorted into a training set (TS, n=529) and validation set (VS, n=542) matched for age (67.9±13.3 TS, 68.5±13.5 VS), presence of >1 comorbidity (52.1% TS, 49.8% VS), development of >1 Covid-19 complication (27% TS, 25.9% VS), and active malignancy at Covid-19 diagnosis (66.7% TS, 61.6% VS). Among all 1,071 patients, deceased patients tended to categorize into poor risk groups for the NLR, PNI, mGPS, and PI (P<0.0001). Recovered patients fully normalised NLR, PNI, and mGPS to pre-Covid-19 diagnosis levels (P<0.01). In the TS, higher mortality rates were associated with NLR>6 (44.6% vs 28%, P<0.0001), PNI<40 (46.6% vs 20.9%, P<0.0001), mGPS (50.6% for mGPS2 vs 30.4% and 11.4% for mGPS1 and 0, P<0.0001), and PI (50% for PI2 vs 40% for PI1 and 9.1% for PI0, P<0.0001). Findings were confirmed in the VS (P<0.001 for all comparisons). Patients in poor risk categories had shorter median overall survival [OS] (NLR>6 30 days 95%CI 1-63, PNI<40 23 days 95%CI 10-35, mGPS2 20 days 95%CI 8-32, PI2 23 days 95%CI 1-56) compared to patients in good risk categories, for whom median OS was not reached (P<0.001 for all comparisons). The PLR was not associated with survival. Analyses of survival in the VS confirmed the NLR (P<0.0001), PNI (P<0.0001), PI (P<0.01), and mGPS (P<0.001) as predictors of survival. In a multivariable Cox regression model including all inflammatory indices, the PNI was the only independent predictor in both TS and VS analysis (TS hazard ratio [HR] 1.97, 95%CI 1.19-3.26, P=0.008; VS HR 2.48, 95%CI 1.47-4.20, P=0.001). Estimates were adjusted for sex, age, comorbid burden, active malignancy, and receipt of anti-cancer therapy within 4 weeks of Covid-19 diagnosis.
Conclusion. Systemic inflammation drives mortality from Covid-19. Hypoalbuminemia and lymphocytopenia as measured by the PNI are the most accurate predictors of outcome and enable repurposing of the PNI as the OnCovid Inflammatory Score (OIS) as a readily available biomarker of severity.
Citation Format: Gino M. Dettorre, Saoirse Dolly, Angela Loizidou, John Chester, Amanda Jackson, Uma Mukherjee, Alberto Zambelli, Juan Aguilar-Company, Mark Bower, Christopher C. Sng, Ramon Salazar, Alexia Bertuzzi, Joan Brunet, Ricard Mesia, Ailsa Sita-Lumsden, Elia Seguí, Federica Biello, Daniele Generali, Salvatore Grisanti, Pavetha Seeva, Gianpiero Rizzo, Michela Libertini, Antonio Maconi, Charlotte Moss, Josep Tabernero, Beth Russell, Nadia Harbeck, Bruno Vincenzi, Rossella Bertulli, Diego Ottaviani, Raquel Liñan, Andrea Marrari, M. Carmen Carmona-García, Neha Chopra, Carlo Tondini, Oriol Mirallas, Valeria Tovazzi, Vittoria Fotia, Claudia Andrea Cruz, Nadia Saoudi-Gonzalez, Eudald Felip, Ariadna Roqué, Alvin J. Lee, Thomas Newsom-Davis, Andrea Patriarca, Lorenza Rimassa, Armando Santoro, Alessandra Gennari, Nikolaos Diamantis, David J. Pinato. The acute phase response identifies cancer patients with adverse outcomes from SARS-CoV-2 infection as quantified by the OnCovid Inflammatory Score [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 701.
Collapse
Affiliation(s)
| | | | | | - John Chester
- 4Cardiff University School of Medicine, Cardiff, United Kingdom
| | | | | | | | - Juan Aguilar-Company
- 8Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Mark Bower
- 9Chelsea and Westminster Hospital, London, United Kingdom
| | | | - Ramon Salazar
- 11ICO L'Hospitalet, Oncobell Program (IDIBELL), and CIBERONC, L'Hospitalet de Llobregat, Spain
| | - Alexia Bertuzzi
- 12Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Joan Brunet
- 13Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Ricard Mesia
- 14Catalan Institute of Oncology, Badalona, Spain
| | - Ailsa Sita-Lumsden
- 15Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | - Elia Seguí
- 16Hospital Clínic de Barcelona, Barcelona, Spain
| | - Federica Biello
- 17University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | | | | | - Pavetha Seeva
- 15Guy's and St Thomas' NHS Foundation Trust (GSTT), London, United Kingdom
| | | | | | - Antonio Maconi
- 22Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Charlotte Moss
- 23School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Josep Tabernero
- 24Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, and UVic-UCC, Barcelona, Spain
| | - Beth Russell
- 23School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Nadia Harbeck
- 25Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Bruno Vincenzi
- 26Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Diego Ottaviani
- 10University College London Hospitals, London, United Kingdom
| | - Raquel Liñan
- 13Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Andrea Marrari
- 12Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | | | - Neha Chopra
- 10University College London Hospitals, London, United Kingdom
| | | | - Oriol Mirallas
- 8Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | | | - Nadia Saoudi-Gonzalez
- 8Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Eudald Felip
- 14Catalan Institute of Oncology, Badalona, Spain
| | - Ariadna Roqué
- 13Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Alvin J. Lee
- 10University College London Hospitals, London, United Kingdom
| | | | - Andrea Patriarca
- 17University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Lorenza Rimassa
- 28Humanitas Clinical and Research Center-IRCCS and Humanitas University, Rozzano and Pieve Emanuele, Milan, Italy
| | - Armando Santoro
- 28Humanitas Clinical and Research Center-IRCCS and Humanitas University, Rozzano and Pieve Emanuele, Milan, Italy
| | - Alessandra Gennari
- 17University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | | | | |
Collapse
|
22
|
Pinato DJ, Scotti L, Gennari A, Colomba-Blameble E, Dolly S, Loizidou A, Chester J, Mukherjee U, Zambelli A, Aguilar-Company J, Bower M, Galazi M, Salazar R, Bertuzzi A, Brunet J, Mesia R, Sita-Lumsden A, Colomba J, Pommeret F, Seguí E, Biello F, Generali D, Grisanti S, Rizzo G, Libertini M, Moss C, Evans JS, Russell B, Wuerstlein R, Vincenzi B, Bertulli R, Ottaviani D, Liñan R, Marrari A, Carmona-García MC, Sng CCT, Tondini C, Mirallas O, Tovazzi V, Fotia V, Cruz CA, Saoudi-Gonzalez N, Felip E, R Lloveras A, Lee AJX, Newsom-Davis T, Sharkey R, Chung C, García-Illescas D, Reyes R, Sophia Wong YN, Ferrante D, Marco-Hernández J, Ruiz-Camps I, Gaidano G, Patriarca A, Sureda A, Martinez-Vila C, Sanchez de Torre A, Rimassa L, Chiudinelli L, Franchi M, Krengli M, Santoro A, Prat A, Tabernero J, V Hemelrijck M, Diamantis N, Cortellini A. Determinants of enhanced vulnerability to coronavirus disease 2019 in UK patients with cancer: a European study. Eur J Cancer 2021; 150:190-202. [PMID: 33932726 PMCID: PMC8023206 DOI: 10.1016/j.ejca.2021.03.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite high contagiousness and rapid spread, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to heterogeneous outcomes across affected nations. Within Europe (EU), the United Kingdom (UK) is the most severely affected country, with a death toll in excess of 100,000 as of January 2021. We aimed to compare the national impact of coronavirus disease 2019 (COVID-19) on the risk of death in UK patients with cancer versus those in continental EU. METHODS We performed a retrospective analysis of the OnCovid study database, a European registry of patients with cancer consecutively diagnosed with COVID-19 in 27 centres from 27th February to 10th September 2020. We analysed case fatality rates and risk of death at 30 days and 6 months stratified by region of origin (UK versus EU). We compared patient characteristics at baseline including oncological and COVID-19-specific therapy across UK and EU cohorts and evaluated the association of these factors with the risk of adverse outcomes in multivariable Cox regression models. FINDINGS Compared with EU (n = 924), UK patients (n = 468) were characterised by higher case fatality rates (40.38% versus 26.5%, p < 0.0001) and higher risk of death at 30 days (hazard ratio [HR], 1.64 [95% confidence interval {CI}, 1.36-1.99]) and 6 months after COVID-19 diagnosis (47.64% versus 33.33%; p < 0.0001; HR, 1.59 [95% CI, 1.33-1.88]). UK patients were more often men, were of older age and have more comorbidities than EU counterparts (p < 0.01). Receipt of anticancer therapy was lower in UK than in EU patients (p < 0.001). Despite equal proportions of complicated COVID-19, rates of intensive care admission and use of mechanical ventilation, UK patients with cancer were less likely to receive anti-COVID-19 therapies including corticosteroids, antivirals and interleukin-6 antagonists (p < 0.0001). Multivariable analyses adjusted for imbalanced prognostic factors confirmed the UK cohort to be characterised by worse risk of death at 30 days and 6 months, independent of the patient's age, gender, tumour stage and status; number of comorbidities; COVID-19 severity and receipt of anticancer and anti-COVID-19 therapy. Rates of permanent cessation of anticancer therapy after COVID-19 were similar in the UK and EU cohorts. INTERPRETATION UK patients with cancer have been more severely impacted by the unfolding of the COVID-19 pandemic despite societal risk mitigation factors and rapid deferral of anticancer therapy. The increased frailty of UK patients with cancer highlights high-risk groups that should be prioritised for anti-SARS-CoV-2 vaccination. Continued evaluation of long-term outcomes is warranted.
Collapse
Affiliation(s)
- David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
| | - Lorenza Scotti
- Unit of Cancer Epidemiology, Department of Translational Medicine, CPO-Piemonte, University of Piemonte Orientale, Novara, Italy
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Emeline Colomba-Blameble
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Saoirse Dolly
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Angela Loizidou
- Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - John Chester
- Medical Oncology, School of Medicine, Cardiff University, Cardiff, UK; Medical Oncology, Velindre Cancer Centre, Cardiff, UK
| | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | | | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain; Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Myria Galazi
- Cancer Division, University College London Hospitals, London, UK
| | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Ricard Mesia
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Johann Colomba
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Fanny Pommeret
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Elia Seguí
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | | | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michela Libertini
- Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Charlotte Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Joanne S Evans
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Rachel Wuerstlein
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Bruno Vincenzi
- Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Rossella Bertulli
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Diego Ottaviani
- Cancer Division, University College London Hospitals, London, UK
| | - Raquel Liñan
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Andrea Marrari
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - M C Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | | | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Claudia A Cruz
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Eudald Felip
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ariadna R Lloveras
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Chris Chung
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - David García-Illescas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Roxana Reyes
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | | | - Daniela Ferrante
- Unit of Cancer Epidemiology, Department of Translational Medicine, CPO-Piemonte, University of Piemonte Orientale, Novara, Italy
| | | | - Isabel Ruiz-Camps
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Lorenza Rimassa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | | | | | - Marco Krengli
- Division of Radiotherapy, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore Della Carita, Novara, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Aleix Prat
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Mieke V Hemelrijck
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK; Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | - Alessio Cortellini
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy.
| |
Collapse
|
23
|
Mirallas O, Saoudi N, Gómez-Puerto D, Riveiro-Barciela M, Merino X, Auger C, Landolfi S, Blanco L, Garcia-Burillo A, Molero X, Salcedo-Allende MT, Capdevila J. Acquired hepatocerebral degeneration in a metastatic neuroendocrine tumor long-term survivor — an update on neuroendocrine neoplasm’s treatment: A case report. World J Hepatol 2021; 13:611-619. [PMID: 34131474 PMCID: PMC8173341 DOI: 10.4254/wjh.v13.i5.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/04/2021] [Accepted: 04/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Metastatic small bowel low-grade neuroendocrine tumors (NETs) have a good prognosis. Surgery is the only curative treatment; however, this may induce advanced liver disease, particularly in long-term survivor patients. Acquired hepatocerebral degeneration or Parkinsonism in cirrhosis is characterized by rapidly progressive extrapyramidal symptoms in patients with advanced liver disease.
CASE SUMMARY A 70-year-old man presented to the emergency department with diminished consciousness and disorientation, and was diagnosed with hepatic encephalopathy. The patient was diagnosed in 1993 with a metastatic small bowel NET, for which he twice underwent hepatic surgery, with metastatic resection in 1993 and a right hepatectomy in 2002 to remove two hepatic metastases. In 2003, the patient started first-line chemotherapy and in 2004 started the first of three consecutive biological treatments, followed by radio-molecular therapy, achieving stable disease for 14 years. Disease progression was identified and he underwent an endoscopic retrograde cholangiopancreatography. However, in 2019 advanced liver disease was identified. We diagnosed the development of acquired hepatocerebral degeneration, an unusual long-term side effect after multiple hepatic procedures.
CONCLUSION The importance of regular and ongoing surveillance in long-term NET survivors who undergo hepatic procedures should be integrated into the therapeutic management plan, as some of these negative outcomes could be prevented.
Collapse
Affiliation(s)
- Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall Hebron Institute of Oncology, Barcelona 08035, Catalunya, Spain
| | - Nadia Saoudi
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall Hebron Institute of Oncology, Barcelona 08035, Catalunya, Spain
| | - Diego Gómez-Puerto
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall Hebron Institute of Oncology, Barcelona 08035, Catalunya, Spain
| | - Mar Riveiro-Barciela
- Liver Unit, Department of Internal Medicine, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona 08035, Catalunya, Spain
| | - Xavier Merino
- Radiodiagnostic Department, Vall d’Hebron University Hospital, Barcelona 08035, Catalunya, Spain
| | - Cristina Auger
- Radiodiagnostic Department, Vall d’Hebron University Hospital, Barcelona 08035, Catalunya, Spain
| | - Stefania Landolfi
- Pathology Department, Vall d'Hebron University Hospital, Barcelona 08035, Catalunya, Spain
| | - Laia Blanco
- Hepatobiliopancreatic Surgery and Transplantation Department, Vall d'Hebron University Hospital, Barcelona 08034, Catalunya, Spain
| | - Amparo Garcia-Burillo
- Nuclear Medicine Department, Vall d'Hebron University Hospital, Barcelona 08035, Catalunya, Spain
| | - Xavier Molero
- Hepatobiliopancreatic Surgery and Transplantation Department, Vall d'Hebron University Hospital, Barcelona 08034, Catalunya, Spain
| | | | - Jaume Capdevila
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall Hebron Institute of Oncology, Barcelona 08035, Catalunya, Spain
| |
Collapse
|
24
|
Dettorre GM, Dolly S, Loizidou A, Chester J, Jackson A, Mukherjee U, Zambelli A, Aguilar-Company J, Bower M, Sng CCT, Salazar R, Bertuzzi A, Brunet J, Mesia R, Sita-Lumsden A, Seguí E, Biello F, Generali D, Grisanti S, Seeva P, Rizzo G, Libertini M, Maconi A, Moss C, Russell B, Tabernero J, Harbeck N, Vincenzi B, Bertulli R, Ottaviani D, Marrari A, Carmona-García MC, Chopra N, Tondini C, Mirallas O, Tovazzi V, Fotia V, Cruz CA, Saoudi-Gonzalez N, Felip E, Scotti L, Lee AJX, Newsom-Davis T, Patriarca A, Rimassa L, Santoro A, Gennari A, Van Hemelrijck M, Diamantis N, Pinato DJ. Abstract S01-03: The acute phase response identifies cancer patients with adverse outcomes from SARS-CoV-2 infection as quantified by the OnCovid Inflammatory Score. Clin Cancer Res 2021. [DOI: 10.1158/1557-3265.covid-19-21-s01-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
We sought to determine parameters of the acute phase response, a feature of innate immunity activated by infectious noxae and cancer, deranged by Covid-19 and establish oncological indices’ prognostic potential for patients with concomitant cancer and Covid-19. Between 27/02 and 23/06/2020, OnCovid retrospectively accrued 1,318 consecutive referrals of patients with cancer and Covid-19 aged 18 from the U.K., Spain, Italy, Belgium, and Germany. Patients with myeloma, leukemia, or insufficient data were excluded. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and prognostic index (PI) were evaluated for their prognostic potential, with the NLR, PLR, and PNI risk stratifications dichotomized around median values and the pre-established risk categorizations from literature utilized for the mGPS and PI. 1,071 eligible patients were randomly assorted into a training set (TS, n=529) and validation set (VS, n=542) matched for age (67.9±13.3 TS, 68.5±13.5 VS), presence of 1 comorbidity (52.1% TS, 49.8% VS), development of 1 Covid-19 complication (27% TS, 25.9% VS), and active malignancy at Covid-19 diagnosis (66.7% TS, 61.6% VS). Among all 1,071 patients, deceased patients tended to categorize into poor risk groups for the NLR, PNI, mGPS, and PI (P<0.0001) with a return to pre-Covid-19 diagnosis NLR, PNI, and mGPS categorizations following recovery (P<0.01). In the TS, higher mortality rates were associated with NLR>6 (44.6% vs 28%, P<0.0001), PNI<40 (46.6% vs 20.9%, P<0.0001), mGPS (50.6% for mGPS2 vs 30.4% and 11.4% for mGPS1 and 0, P<0.0001), and PI (50% for PI2 vs 40% for PI1 and 9.1% for PI0, P<0.0001). Findings were confirmed in the VS (P<0.001 for all comparisons). Patients in poor risk categories had shorter median overall survival [OS], (NLR>6 30 days 95%CI 1-63, PNI<40 23 days 95%CI 10-35, mGPS2 20 days 95%CI 8-32, PI2 23 days 95%CI 1-56) compared to patients in good risk categories, for whom median OS was not reached (P<0.001 for all comparisons). The PLR was not associated with survival. Analyses of survival in the VS confirmed the NLR (P<0.0001), PNI (P<0.0001), PI (P<0.01), and mGPS (P<0.001) as predictors of survival. In a multivariable Cox regression model including all inflammatory indices and pre-established prognostic factors for severe Covid-19 including sex, age, comorbid burden, malignancy status, and receipt of anti-cancer therapy at Covid-19 diagnosis, the PNI was the only factor to emerge with a significant hazard ratio [HR] in both TS and VS analysis (TS HR 1.97, 95%CI 1.19-3.26, P=0.008; VS HR 2.48, 95%CI 1.47-4.20, P=0.001). We conclude that systemic inflammation drives mortality from Covid-19 through hypoalbuminemia and lymphocytopenia as measured by the PNI and propose the PNI as the OnCovid Inflammatory Score (OIS) in this context.
Citation Format: Gino M. Dettorre, Saoirse Dolly, Angela Loizidou, John Chester, Amanda Jackson, Uma Mukherjee, Alberto Zambelli, Juan Aguilar-Company, Mark Bower, Christopher C. T. Sng, Ramon Salazar, Alexia Bertuzzi, Joan Brunet, Ricard Mesia, Ailsa Sita-Lumsden, Elia Seguí, Federica Biello, Daniele Generali, Salvatore Grisanti, Pavetha Seeva, Gianpiero Rizzo, Michela Libertini, Antonio Maconi, Charlotte Moss, Beth Russell, Josep Tabernero, Nadia Harbeck, Bruno Vincenzi, Rossella Bertulli, Diego Ottaviani, Andrea Marrari, M. Carmen Carmona-García, Neha Chopra, Carlo Tondini, Oriol Mirallas, Valeria Tovazzi, Vittoria Fotia, Claudia A. Cruz, Nadia Saoudi-Gonzalez, Eudald Felip, Lorenza Scotti, Alvin J. X. Lee, Thomas Newsom-Davis, Andrea Patriarca, Lorenza Rimassa, Armando Santoro, Alessandra Gennari, Mieke Van Hemelrijck, Nikolaos Diamantis, David J. Pinato. The acute phase response identifies cancer patients with adverse outcomes from SARS-CoV-2 infection as quantified by the OnCovid Inflammatory Score [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S01-03.
Collapse
Affiliation(s)
| | - Saoirse Dolly
- 2Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom,
| | | | - John Chester
- 4Cardiff University School of Medicine and Velindre Cancer Centre, Cardiff, United Kingdom,
| | | | | | | | - Juan Aguilar-Company
- 8Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain,
| | - Mark Bower
- 9Chelsea and Westminster Hospital, London, United Kingdom,
| | | | - Ramon Salazar
- 11ICO L’Hospitalet, Oncobell Program (IDIBELL), CIBERONC, L'Hospitalet de Llobregat, Spain,
| | - Alexia Bertuzzi
- 12Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Milan, Italy,
| | - Joan Brunet
- 13Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain,
| | - Ricard Mesia
- 14Catalan Institute of Oncology, Badalona, Spain,
| | | | | | - Federica Biello
- 16University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy,
| | - Daniele Generali
- 17ASST Cremona and University of Trieste, Cremona and Trieste, Italy,
| | | | - Pavetha Seeva
- 2Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom,
| | | | | | - Antonio Maconi
- 21Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy,
| | | | - Beth Russell
- 22King's College London, London, United Kingdom,
| | - Josep Tabernero
- 23Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain,
| | - Nadia Harbeck
- 24Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany,
| | - Bruno Vincenzi
- 25Policlinico Universitario Campus Bio-Medico, Rome, Italy,
| | | | - Diego Ottaviani
- 10University College London Hospitals, London, United Kingdom,
| | - Andrea Marrari
- 12Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Milan, Italy,
| | | | - Neha Chopra
- 10University College London Hospitals, London, United Kingdom,
| | | | - Oriol Mirallas
- 8Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain,
| | | | | | | | - Nadia Saoudi-Gonzalez
- 8Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain,
| | - Eudald Felip
- 14Catalan Institute of Oncology, Badalona, Spain,
| | - Lorenza Scotti
- 27CPO-Piemonte, University of Eastern Piedmont, Novara, Italy,
| | - Alvin J. X. Lee
- 10University College London Hospitals, London, United Kingdom,
| | | | - Andrea Patriarca
- 28University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy,
| | - Lorenza Rimassa
- 29Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS and Humanitas University, Milan, Italy,
| | - Armando Santoro
- 29Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS and Humanitas University, Milan, Italy,
| | - Alessandra Gennari
- 16University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy,
| | - Mieke Van Hemelrijck
- 30Guy's and St Thomas' NHS Foundation Trust and King's College London, London, United Kingdom
| | | | | |
Collapse
|
25
|
Dettorre GM, Dolly S, Loizidou A, Chester J, Jackson A, Mukherjee U, Zambelli A, Aguilar-Company J, Bower M, Sng CCT, Salazar R, Bertuzzi A, Brunet J, Mesia R, Sita-Lumsden A, Seguí E, Biello F, Generali D, Grisanti S, Seeva P, Rizzo G, Libertini M, Maconi A, Moss C, Russell B, Harbeck N, Vincenzi B, Bertulli R, Ottaviani D, Liñan R, Marrari A, Carmona-García MC, Chopra N, Tondini CA, Mirallas O, Tovazzi V, Fotia V, Cruz CA, Saoudi-Gonzalez N, Felip E, Roqué A, Lee AJX, Newsom-Davis T, García-Illescas D, Reyes R, Wong YNS, Ferrante D, Scotti L, Marco-Hernández J, Ruiz-Camps I, Patriarca A, Rimassa L, Chiudinelli L, Franchi M, Santoro A, Prat A, Gennari A, Van Hemelrijck M, Tabernero J, Diamantis N, Pinato DJ. Systemic pro-inflammatory response identifies patients with cancer with adverse outcomes from SARS-CoV-2 infection: the OnCovid Inflammatory Score. J Immunother Cancer 2021; 9:e002277. [PMID: 33753569 PMCID: PMC7985977 DOI: 10.1136/jitc-2020-002277] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patients with cancer are particularly susceptible to SARS-CoV-2 infection. The systemic inflammatory response is a pathogenic mechanism shared by cancer progression and COVID-19. We investigated systemic inflammation as a driver of severity and mortality from COVID-19, evaluating the prognostic role of commonly used inflammatory indices in SARS-CoV-2-infected patients with cancer accrued to the OnCovid study. METHODS In a multicenter cohort of SARS-CoV-2-infected patients with cancer in Europe, we evaluated dynamic changes in neutrophil:lymphocyte ratio (NLR); platelet:lymphocyte ratio (PLR); Prognostic Nutritional Index (PNI), renamed the OnCovid Inflammatory Score (OIS); modified Glasgow Prognostic Score (mGPS); and Prognostic Index (PI) in relation to oncological and COVID-19 infection features, testing their prognostic potential in independent training (n=529) and validation (n=542) sets. RESULTS We evaluated 1071 eligible patients, of which 625 (58.3%) were men, and 420 were patients with malignancy in advanced stage (39.2%), most commonly genitourinary (n=216, 20.2%). 844 (78.8%) had ≥1 comorbidity and 754 (70.4%) had ≥1 COVID-19 complication. NLR, OIS, and mGPS worsened at COVID-19 diagnosis compared with pre-COVID-19 measurement (p<0.01), recovering in survivors to pre-COVID-19 levels. Patients in poorer risk categories for each index except the PLR exhibited higher mortality rates (p<0.001) and shorter median overall survival in the training and validation sets (p<0.01). Multivariable analyses revealed the OIS to be most independently predictive of survival (validation set HR 2.48, 95% CI 1.47 to 4.20, p=0.001; adjusted concordance index score 0.611). CONCLUSIONS Systemic inflammation is a validated prognostic domain in SARS-CoV-2-infected patients with cancer and can be used as a bedside predictor of adverse outcome. Lymphocytopenia and hypoalbuminemia as computed by the OIS are independently predictive of severe COVID-19, supporting their use for risk stratification. Reversal of the COVID-19-induced proinflammatory state is a putative therapeutic strategy in patients with cancer.
Collapse
Affiliation(s)
- Gino M Dettorre
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - Saoirse Dolly
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Angela Loizidou
- Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - John Chester
- Medical Oncology, School of Medicine, Cardiff University, Cardiff, UK
- Medical Oncology, Velindre Cancer Centre, Cardiff, UK
| | | | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | | | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | | | - Ramon Salazar
- Department of Medical Oncology, ICO L'Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Spain
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Ricard Mesia
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Elia Seguí
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Daniele Generali
- Multidisciplinary Breast Pathology and Translational Research Unit, ASST Cremona, Cremona, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Pavetha Seeva
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michela Libertini
- Medical Oncology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Antonio Maconi
- Infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Charlotte Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Nadia Harbeck
- Department of Gynecology and Obstetrics, Breast Center and Gynecological Cancer Center and CCC Munich, University Hospital Munich, Munich, Germany
| | - Bruno Vincenzi
- Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Rossella Bertulli
- Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Diego Ottaviani
- Cancer Division, University College London Hospitals, London, UK
| | - Raquel Liñan
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Andrea Marrari
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - M Carmen Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Neha Chopra
- Cancer Division, University College London Hospitals, London, UK
| | | | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | | | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Eudald Felip
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona, Spain
| | - Ariadna Roqué
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | - Tom Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - David García-Illescas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | - Roxana Reyes
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | | | - Daniela Ferrante
- Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte, University of Eastern Piedmont, Novara, Italy
| | - Lorenza Scotti
- Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte, University of Eastern Piedmont, Novara, Italy
| | | | - Isabel Ruiz-Camps
- Infectious Diseases, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Lorenza Rimassa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy
| | | | | | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090 Pieve Emanuele, Milan, Italy
| | - Aleix Prat
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| | - Mieke Van Hemelrijck
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | | | - David J Pinato
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Maggiore della Carità Hospital, Novara, Italy
| |
Collapse
|
26
|
Mirallas O, Filippi-Arriaga F, Hernandez Hernandez I, Aubanell A, Chaachou A, Garcia-Alvarez A, Hernando J, Martínez-Saez E, Biagetti B, Capdevila J. Aggressive Pituitary Macroadenoma Treated With Capecitabine and Temozolomide Chemotherapy Combination in a Patient With Nelson's Syndrome: A Case Report. Front Endocrinol (Lausanne) 2021; 12:731631. [PMID: 34858324 PMCID: PMC8632214 DOI: 10.3389/fendo.2021.731631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/12/2021] [Indexed: 01/16/2023] Open
Abstract
Nelson's syndrome is considered a severe side effect that can occur after a total bilateral adrenalectomy in patients with Cushing's disease. It usually presents with clinical manifestations of an enlarging pituitary tumor including visual and cranial nerve alterations, and if not treated, can cause death through local brain compression or invasion. The first therapeutic option is surgery but in extreme cases of inaccessible or resistant aggressive pituitary tumors; the off-label use of chemotherapy with capecitabine and temozolomide can be considered. However, the use of this treatment is controversial due to adverse events, lack of complete response, and inability to predict results. We present the case of a 48-year-old man diagnosed with Nelson's syndrome with prolonged partial response and significant clinical benefit to treatment with capecitabine and temozolomide.
Collapse
Affiliation(s)
- Oriol Mirallas
- Medical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
- *Correspondence: Oriol Mirallas,
| | | | | | - Anton Aubanell
- Radiology Department, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Anas Chaachou
- Pathology Department, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Alejandro Garcia-Alvarez
- Medical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Jorge Hernando
- Medical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Betina Biagetti
- Endocrinology & Nutrition Service, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Jaume Capdevila
- Medical Oncology Department, Gastrointestinal and Endocrine Tumor Unit, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| |
Collapse
|
27
|
Gomez-Puerto D, Mirallas O, Vidal-González J, Vargas V. Hepatocellular carcinoma with tumor thrombus extends to the right atrium and portal vein: A case report. World J Hepatol 2020; 12:1128-1135. [PMID: 33312435 PMCID: PMC7701967 DOI: 10.4254/wjh.v12.i11.1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/23/2020] [Accepted: 09/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the most important primary malignant liver disease. A large proportion of patients with advanced HCC have macrovascular invasion. HCC tends to infiltrate vascular structures, particularly the portal vein and its branches, and more rarely, the hepatic veins. The intravascular tumor thrombus can affect the inferior vena cava (IVC) or even the right atrium (RA), the latter having a poor prognosis.
CASE SUMMARY HCC is one of the most aggressive malignant tumors. Tumor thrombus (TT) formation in advanced HCC stages is common and usually involves the hepatic or portal veins. Herein, we report a 69-year-old woman who presented with dyspnea to the emergency department. A ventilation/perfusion lung scan was performed, ruling out pulmonary embolism. Hepatopulmonary syndrome and portopulmonary hypertension were discarded with contrasted echocardiography, but a mass in the RA was detected and confirmed by cardiac magnetic resonance imaging. Abdominal computed tomography showed a liver mass with a dynamic enhancement pattern compatible with HCC and an intraluminal IVC mass extending from the hepatic vein into the RA. HCC with TT expansion to IVC and RA is rare and indicates poor prognosis.
CONCLUSION HCC with TT expansion to IVC and RA is rare and indicates poor prognosis. There is no consensus about anticoagulation or other interventions in these patients.
Collapse
Affiliation(s)
- Diego Gomez-Puerto
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona 08035, Spain
| | - Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona 08035, Spain
| | | | - Victor Vargas
- Liver Unit, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, CIBERehd, Barcelona, Spain
| |
Collapse
|
28
|
Carballar R, Martínez-Láinez JM, Samper B, Bru S, Bállega E, Mirallas O, Ricco N, Clotet J, Jiménez J. CDK-mediated Yku80 Phosphorylation Regulates the Balance Between Non-homologous End Joining (NHEJ) and Homologous Directed Recombination (HDR). J Mol Biol 2020; 432:166715. [PMID: 33217428 DOI: 10.1016/j.jmb.2020.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 11/04/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
There are two major pathways for repairing DNA double-strand breaks (DSBs): homologous directed recombination (HDR) and non-homologous end-joining (NHEJ). While NHEJ functions throughout the cell cycle, HDR is only possible during S/G2 phases, suggesting that there are cell cycle-specific mechanisms regulating the balance between the two repair systems. The regulation exerted by CDKs on HDR has been extensively demonstrated, and here we present evidence that the CDK Pho85, in association with the G1 cyclin Pcl1, phosphorylates Yku80 on Ser 623 to regulate NHEJ activity. Cells bearing a non-phosphorylatable version of Yku80 show increased NHEJ and reduced HDR activity. Accordingly, yku80S623A cells present diminished viability upon treatment with the DSB-producer bleomycin, specifically in the G2 phase of the cell cycle. Interestingly, the mutation of the equivalent residue in human Ku80 increases sensitivity to bleomycin in several cancer cell lines, suggesting that this mechanism is conserved in humans. Altogether, our results reveal a new mechanism whereby G1-CDKs mediate the choice between HDR and NHEJ repair pathways, putting the error prone NHEJ on a leash and enabling error free HDR in G2 when homologous sequences are available.
Collapse
Affiliation(s)
- Reyes Carballar
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Joan M Martínez-Láinez
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Bàrbara Samper
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Samuel Bru
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Elisabet Bállega
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Oriol Mirallas
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Natalia Ricco
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Josep Clotet
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Javier Jiménez
- Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
| |
Collapse
|
29
|
Seguí E, García de Herreros M, Auclin E, Mirallas O, Casadevall D, Rodriguez M, Epaillard N, Tagliamento M, Pilotto S, López-Castro R, Mielgo X, Urbano C, Pesántez D, Saoudi N, Bluthgen M, Masfarré L, Minatta J, Cruz C, Mezquita L, Prat A. 1681P First results of the COCO study: COVID-19 outcomes in patients with cancer. Ann Oncol 2020. [PMCID: PMC7506441 DOI: 10.1016/j.annonc.2020.08.1745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
30
|
Mirallas O, López Valbuena D, Rezqallah Aron M, Molina G, Vega S, Gómez-Puerto D, Villacampa Javierre G, Andurell L, Palmas F, Burgos R, Rodriguez K, Moreno I, Delgado Heredia M, Roca M, Dienstmann R, Alonso A, Serradell S, Carles J. 1858P Role of depression and quality of life (QOL) status as predictors of hospital length of stay (HLOS) and overall survival (OS) in hospitalized oncologic patients (pts). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
31
|
Mirallas O, Rezqallah Arón MA, Saoudi Gonzalez N, Escrivá-de-Romaní S. Paraneoplastic cerebellar degeneration diagnosed by anti-Yo determination in a young woman with early breast cancer. BMJ Case Rep 2020; 13:13/8/e233863. [PMID: 32843422 DOI: 10.1136/bcr-2019-233863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A 44-year-old woman diagnosed with a HER2 positive early breast cancer, receiving neoadjuvant treatment with paclitaxel and targeted agents, trastuzumab together with pertuzumab, presented to the emergency room with gait instability and upper right limb weakness. The neurological examination was compatible with cerebellar alteration showing right dissymmetry of the finger-nose and heel-knee manoeuvre. A head CT and a brain MRI were performed and negative. The electromyography showed alterations of the pyramidal pathway and somatosensory pathway. In order to determine the cause of the cerebellar affection, a lumbar puncture was performed. The cerebrospinal fluid analysis was non-specific, but the antineuronal anti-Yo antibody was positive, being diagnosed of a paraneoplastic cerebellar degeneration (PCD). A positron emission tomography CT ruled out metastatic disease. The patient completed four cycles of antiHER2 blockade and weekly paclitaxel, achieving a complete pathological response. One year later, she maintains a complete remission but the PCD still prevails.
Collapse
Affiliation(s)
- Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - María Alejandra Rezqallah Arón
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Nadia Saoudi Gonzalez
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| | - Santiago Escrivá-de-Romaní
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Catalunya, Spain
| |
Collapse
|
32
|
Pinato DJ, Zambelli A, Aguilar-Company J, Bower M, Sng C, Salazar R, Bertuzzi A, Brunet J, Mesia R, Segui E, Biello F, Generali D, Grisanti S, Rizzo G, Libertini M, Maconi A, Harbeck N, Vincenzi B, Bertulli R, Ottaviani D, Carbo A, Bruna R, Benafif S, Marrari A, Wuerstlein R, Carmona-Garcia MC, Chopra N, Tondini C, Mirallas O, Tovazzi V, Betti M, Provenzano S, Fotia V, Cruz CA, Dalla Pria A, D'Avanzo F, Evans JS, Saoudi-Gonzalez N, Felip E, Galazi M, Garcia-Fructuoso I, Lee AJX, Newsom-Davis T, Patriarca A, Garcia-Illescas D, Reyes R, Dileo P, Sharkey R, Wong YNS, Ferrante D, Marco-Hernandez J, Sureda A, Maluquer C, Ruiz-Camps I, Gaidano G, Rimassa L, Chiudinelli L, Izuzquiza M, Cabirta A, Franchi M, Santoro A, Prat A, Tabernero J, Gennari A. Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients. Cancer Discov 2020; 10:CD-20-0773. [PMID: 32737082 PMCID: PMC7668225 DOI: 10.1158/2159-8290.cd-20-0773] [Citation(s) in RCA: 134] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/22/2020] [Accepted: 07/28/2020] [Indexed: 02/06/2023]
Abstract
The SARS-Cov-2 pandemic significantly impacted on oncology practice across the globe. There is uncertainty as to the contribution of patients' demographics and oncological features on severity and mortality from Covid-19 and little guidance as to the role of anti-cancer and anti-Covid-19 therapy in this population. In a multi-center study of 890 cancer patients with confirmed Covid-19 we demonstrated a worsening gradient of mortality from breast cancer to haematological malignancies and showed that male gender, older age, and number of co-morbidities identifies a subset of patients with significantly worse mortality rates from Covid-19. Provision of chemotherapy, targeted therapy and immunotherapy did not worsen mortality. Exposure to antimalarials was associated with improved mortality rates independent of baseline prognostic factors. This study highlights the clinical utility of demographic factors for individualized risk-stratification of patients and support further research into emerging anti-Covid-19 therapeutics in SARS-Cov-2 infected cancer patients.
Collapse
Affiliation(s)
| | | | | | - Mark Bower
- National Centre for HIV Malignancy, Chelsea and Westminster Hospital, UK
| | - Christopher Sng
- Cancer Division, University College London Hospitals NHS Foundation Trust
| | - Ramon Salazar
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Traslational Research Laboratory, ICO-Bellvitge Biomedical Research Institute (IDIBELL)-CIBERONC, L'Hospitalet de Llobregat
| | | | - Joan Brunet
- Medical Oncology, Catalan Institute of Oncology Hospital Josep Trueta
| | - Ricard Mesia
- Institut Catala d'Oncologia - L'Hospitalet, Universitat de Barcelona, IDIBELL
| | | | | | - Daniele Generali
- US Terapia Molecolare e Farmacogenomica, Az Istituti Ospitalieri di Cremona
| | | | | | | | - Antonio Maconi
- Research Education Innovation Infrastrucure, Ospedale Antonio e Biagio e Cesare Arrigo, Alessandria
| | | | | | - Rossella Bertulli
- Medical Oncology Unit 2 - Adult mesenchymal tumour and rare cancer network, Cancer Medicine department, Istituto Nazionale dei Tumori
| | | | - Anna Carbo
- Medical Oncology, Catalan Institute of Oncology, Girona
| | - Riccardo Bruna
- Department of Translational Medicine, Universita del Piemonte Orientale
| | | | | | | | - M Carmen Carmona-Garcia
- Medical Oncology Service, Hospital Universitari de Girona Doctor Josep Trueta- Catalan Insitute of Oncology
| | | | | | - Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona
| | | | - Marta Betti
- Infrastruttura Ricerca Formazione Innovazione, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo
| | - Salvatore Provenzano
- Medical Oncology Unit 2 - Adult mesenchymal tumour and rare cancer network, Cancer Medicine Department, Istituto Nazionale dei Tumori
| | | | | | | | | | | | | | - Eudald Felip
- Medical Oncology Department, Institut Catala d'Oncologia-Badalona, B-ARGO group- IGTP
| | | | | | | | | | - Andrea Patriarca
- Department of Translational Medicine, Universita del Piemonte Orientale
| | | | | | | | | | | | - Daniela Ferrante
- Department of Translational Medicine, Department of Translational Medicine, Unit of Medical Statistics, University of Eastern Piedmont and Cancer Epidemiology, CPO Piemonte, Novara
| | | | - Anna Sureda
- Hospital Duran i Reynals, Institut Catala d'Oncología (ICO)
| | | | | | - Gianluca Gaidano
- Hematology, Division of Hematology, Amedeo Avogadro Univeristy of Eastern Piedmont
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS; Department of Biomedical Sciences, Humanitas University
| | - Lorenzo Chiudinelli
- Dipartimento di Ingegneria Industriale e dell'Informazione, University of Pavia
| | | | - Alba Cabirta
- Hematology, Vall d'Hebron University Hospital, Barcelona
| | - Michela Franchi
- FROM Research Foundation, Ospedale Papa Giovanni XXIII, Bergamo
| | | | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic de Barcelona
| | - Josep Tabernero
- Medical Oncology Department, Vall d'Hebron University Hospital
| | | |
Collapse
|
33
|
Mirallas O, Marmolejo D, Valdivia A, Vieito M. Grade I meningioma with disseminated bone disease: a rare clinical phenomenon. BMJ Case Rep 2020; 13:13/4/e233708. [PMID: 32265210 DOI: 10.1136/bcr-2019-233708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Meningioma, the second most common primary tumour of the central nervous system, is classified into three different grades based on their characteristics. Each tumour grade includes different molecular subtype, growth potential, and thus, different prognosis. Grade I meningioma is the most common subtype with a benign course, in which systemic dissemination rarely occurs. We present the case of a 48-year-old male patient with a history of grade I meningioma who was referred 3 years after the initial diagnosis to our centre due to pelvic pain. Computed tomography (CT) images showed new pelvic bone lesions whose histopathological report was compatible with a grade I meningioma. Neither hormonal therapy concomitant with octreotide nor hydroxiurea treatments were effective. Very little is known about this entity's prevalence and treatment when disseminated disease occurs. Thus, we think it is important to increase the positive and negative clinical experiences in this setting.
Collapse
Affiliation(s)
- Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - David Marmolejo
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Augusto Valdivia
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Maria Vieito
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| |
Collapse
|
34
|
Hernando-Calvo A, Mirallas O, Marmolejo D, Felip E, Javierre GV, Garralda E, Gutierrez R, Feliu B, Martínez S, Dienstmann R, Braña I. Clinical biomarkers as predictors of immunotherapy (IT) benefit in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients (pt). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz449.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
35
|
Hernando-Calvo A, Mirallas O, Marmolejo D, Felip E, Garralda E, Javierre GV, Feliu B, Martínez S, Gutierrez R, Dienstmann R, Braña I. Efficacy of Cetuximab Based Chemotherapy after Immunotherapy Treatments (IT) in Recurrent/Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC) Patients (pts). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz450.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
36
|
Alsina Maqueda M, Ruiz F, Landolfi S, Viaplana C, Miquel J, Jimenez J, Diez M, Gullo I, Mirallas O, Tabernero J, Carneiro F, Nuciforo P, Vivancos A, Dienstmann R. Molecular subtypes of metastatic (met) gastric cancer (GC) (MoTriGastric): New biomarkers closer to the clinics. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.149] [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
|
37
|
Martin-Cullell B, Fumagalli C, Teres R, Melo PG, Garcia AS, Manrique ACV, Mirallas O, Cabús SS, Molina V, Szafranska J, Bravo DPL. Validation of GAME score risk groups in resected colorectal cancer liver metastases and the prognostic relevance of KRAS, NRAS and BRAF mutation analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.043] [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
|
38
|
Mirallas O, Rial N, Martín-Cullell B, Recio-Iglesias J. A rare case of long-term paraesthesia diagnosed as a paraneoplastic syndrome by anti-SOX1 antibody determination. BMJ Case Rep 2019; 12:12/7/e228916. [PMID: 31315840 DOI: 10.1136/bcr-2018-228916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Paraneoplastic syndromes (PS) are a rare presentation of cancer, most commonly associated with small cell lung cancer (SCLC), breast cancer and haematologic malignancies. The diagnosis of PS is challenging because it could affect multiple organ systems and it may present before the tumour is visible by imaging. We report a malignant tumour diagnosed in a male patient who referred long-term paraesthesia and proximal muscle strength loss. After ruling out common causes of polyneuropathy, the anti-SOX1 antibody gave light to the diagnosis. A pulmonary opacity in the upper right lobe was observed in the chest X-ray and a pulmonary tumour was later confirmed by CT scan. The biopsy of the cervical lymphadenopathy determined an SCLC, which caused a PS called Lambert-Eaton myasthenic syndrome (LEMS). Our case raises awareness of a rare PS presentation, which can be diagnosed by specific antibodies, allowing early diagnosis and treatment of lung cancer.
Collapse
Affiliation(s)
- Oriol Mirallas
- Internal Medicine Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Nuria Rial
- Internal Medicine Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Berta Martín-Cullell
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | |
Collapse
|
39
|
Mirallas O, Ballega E, Samper-Martín B, García-Márquez S, Carballar R, Ricco N, Jiménez J, Clotet J. Intertwined control of the cell cycle and nucleocytoplasmic transport by the cyclin-dependent kinase Pho85 and RanGTPase Gsp1 in Saccharomyces cerevisiae. Microbiol Res 2017; 206:168-176. [PMID: 29146254 DOI: 10.1016/j.micres.2017.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/09/2017] [Accepted: 10/17/2017] [Indexed: 10/18/2022]
Abstract
Deciphering the molecular mechanisms that connect cell cycle progression and nucleocytoplasmic transport is of particular interest: this intertwined relationship, once understood, may provide useful insight on the diseases resulting from the malfunction of these processes. In the present study we report on findings that indicate a biochemical connection between the cell cycle regulator CDK Pho85 and Ran-GTPase Gsp1, an essential nucleocytoplasmic transport component. When Gsp1 cannot be phosphorylated by Pho85, the cell cycle progression is impaired. Accordingly, a nonphosphorylatable version of Gsp1 abnormally localizes to the nucleus, which impairs the nuclear transport of molecules, including key components of cell cycle progression. Furthermore, our results suggest that the physical interaction of Gsp1 and the Kap95 karyopherin, essential to the release of nuclear cargoes, is altered. Altogether, the present findings point to the involvement of a biochemical mechanism in the interlocked regulation of the cell cycle and nuclear transport.
Collapse
Affiliation(s)
- Oriol Mirallas
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Elisabet Ballega
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Bàrbara Samper-Martín
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sergio García-Márquez
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Reyes Carballar
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Natalia Ricco
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Javier Jiménez
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Josep Clotet
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
| |
Collapse
|
40
|
Abstract
INTRODUCTION Postpartum telogen effluvium (PPTE) is a commonly described entity, but few studies deal with the real incidence and pathogenesis of this claimed common disease. OBJECTIVE To analyze the objective data published and to define the real incidence of the so-called PPTE. METHOD A retrospective review of the published data was conducted. RESULTS No statistically significant data were found in any of the papers reviewed, which could support the conclusion that the amount of hair shedding between pregnant and postpartum women is different. CONCLUSION PPTE is not a well-defined entity, and the exact incidence is unknown. From our literature review, we could state that the frequency of PPTE is so low and undefined that we dare say that PPTE does not exist.
Collapse
Affiliation(s)
- Oriol Mirallas
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Ramon Grimalt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| |
Collapse
|
41
|
Negga R, Stuart JA, Machen ML, Salva J, Lizek AJ, Richardson SJ, Osborne AS, Mirallas O, McVey KA, Fitsanakis VA. Exposure to glyphosate- and/or Mn/Zn-ethylene-bis-dithiocarbamate-containing pesticides leads to degeneration of γ-aminobutyric acid and dopamine neurons in Caenorhabditis elegans. Neurotox Res 2012; 21:281-90. [PMID: 21922334 PMCID: PMC3288661 DOI: 10.1007/s12640-011-9274-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 08/18/2011] [Accepted: 08/31/2011] [Indexed: 12/14/2022]
Abstract
Previous studies demonstrate a positive correlation between pesticide usage and Parkinson's disease (PD), which preferentially targets dopaminergic (DAergic) neurons. In order to examine the potential relationship between two common pesticides and specific neurodegeneration, we chronically (24 h) or acutely (30 min) exposed two Caenorhabditis elegans (C. elegans) strains to varying concentrations (LC(25), LC(50) or LC(75)) of TouchDown(®) (TD) as percent active ingredient (glyphosate), or Mancozeb(®) (MZ) as percent active ingredient (manganese/zinc ethylene-bis-dithiocarbamate). Furthermore, to more precisely model environmental exposure, worms were also exposed to TD for 30 min, followed by 30-min incubation with varying MZ concentrations. Previous data from out lab suggested general neuronal degeneration using the worm strain NW1229 (pan-neuronal//green fluorescent protein (GFP) construct). To determine whether distinct neuronal groups were preferentially affected, we specifically used EG1285 (GABAergic neurons//GFP construct) and BZ555 (DAergic neurons//GFP construct) worms to verify GABAergic and DAergic neurodegeneration, respectively. Results indicated a statistically significant decrease, when compared to controls (CN), in number of green pixels associated with GABAergic neurons in both chronic (*P < 0.05) and acute (*P < 0.05) treatment paradigms. Analysis of the BZ555 worms indicated a statistically significant decrease (*P < 0.05) in number of green pixels associated with DAergic neurons in both treatment paradigms (chronic and acute) when compared to CN. Taken together, our data suggest that exposure to TD and/or MZ promotes neurodegeneration in both GABAergic and DAergic neurons in the model organism C. elegans.
Collapse
Affiliation(s)
- Rekek Negga
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - J Andrew Stuart
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - Morgan L Machen
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - Joel Salva
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - Amanda J Lizek
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - S Jayne Richardson
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - Amanda S Osborne
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - Oriol Mirallas
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - Kenneth A McVey
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| | - Vanessa A Fitsanakis
- King College, Department of Biology, 1350 King College Road, Bristol, TN 37620 USA
| |
Collapse
|