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García-Donas J, de Velasco G, Madurga R, Chamorro J, Rosero D, Etxaniz O, Pérez-Gracia JL, Pinto Á, Cacho D, Barba M, Borrega P, Lázaro M, Rodriguez L, Villalobos L, García L, Cuellar A, Solís-Hernández MP, González A, Pernaut C, Rodríguez-Moreno JF. Case-control study assessing the impact of COVID19 in advanced kidney cancer patients treated with antiangiogenics or immunotherapy: the COVID-REN study. Clin Transl Oncol 2024; 26:732-738. [PMID: 37556096 DOI: 10.1007/s12094-023-03295-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Cancer is a risk factor for developing severe COVID19. Additionally, SARS-CoV2 has a special tropism for renal cells and complications like thrombosis or cytokine storm could be enhanced by standard treatments in kidney cancer (i.e., antiangiogenics or immunotherapy). Thus, understanding the impact of COVID19 in patients with this tumor is key for their correct management. METHODS We designed a retrospective case-control study comparing the outcome of three groups of advanced kidney cancer patients on systemic treatment: cohort A (developed COVID19 while on antiangiogenics), cohort B (developed COVID19 while on immunotherapy) and cohort C (non-infected). Matching factors were age, gender, and treatment. RESULTS 95 patients were recruited in 16 centers in Spain from September 2020 to May 2021. Finally, 85 were deemed as eligible (23 cohort A, 21 cohort B, 41 cohort C). Patients with COVID required more dose interruptions (25 vs. six) and hospitalizations (10 vs. none) than those without COVID (both p = 0.001). No difference between cohorts A and B was observed regarding hospitalization or length of stay. No ICU admission was registered and one patient in cohort B died due to COVID19. Regarding cancer evolution, three patients in cohort A presented progressive disease after COVID19 compared to two in cohort B. One case in cohort B, initially deemed as stable disease, achieved a partial response after COVID19. CONCLUSIONS Kidney cancer patients who developed COVID19 while on systemic therapy required more treatment interruptions and hospitalizations than those non-infected. However, no significant impact on cancer outcome was observed. Also, no difference was seen between cases on antiangiogenics or immunotherapy.
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Affiliation(s)
| | | | - Rodrigo Madurga
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Diana Rosero
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | | | - Diego Cacho
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - María Barba
- HM Hospitales-Centro Integral Oncológico Clara Campal, Madrid, Spain
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Escobar Y, Ramchandani A, Salgado M, Castillo-Trujillo A, Martínez de Castro E, Diaz de Corcuera I, Vera R, Lacalle A, Torres I, Pérez Segura P, Hierro C, Soto de Prado D, Cotes A, Marín Zafra G, Marsé Fabregat R, Virizuela J, Villa JC, Borrega P, Jimenez-Fonseca P. What do patients and oncologists think about the evaluation and management of cancer-related anorexia-cachexia? The Quasar_SEOM study. Clin Transl Oncol 2023; 25:3479-3491. [PMID: 37289352 DOI: 10.1007/s12094-023-03212-7] [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: 02/08/2023] [Accepted: 04/29/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Cancer patients often suffer from malnutrition and early detection and raising awareness of nutritional issues is crucial in this population. METHODS The Spanish Oncology Society (SEOM) conducted the Quasar_SEOM study to investigate the current impact of the Anorexia-Cachexia Syndrome (ACS). The study employed questionnaires and the Delphi method to gather input from both cancer patients and oncologists on key issues related to early detection and treatment of ACS. A total of 134 patients and 34 medical oncologists were surveyed about their experiences with ACS. The Delphi methodology was used to evaluate oncologists' perspectives of ACS management, ultimately leading to a consensus on the most critical issues. RESULTS Despite widespread acknowledgement of malnutrition in cancer as a significant issue by 94% of oncologists, the study revealed deficiencies in knowledge and protocol implementation. A mere 65% of physicians reported being trained to identify and treat these patients, with 53% failing to address ACS in a timely manner, 30% not monitoring weight, and 59% not adhering to any clinical guidelines. The lack of experience was identified as the primary hindrance to the use of orexigens in 18% of cases. Furthermore, patients reported concerns and a perception of inadequate attention to malnutrition-related issues from their physicians. CONCLUSION The results of this study point to a gap in the care of this syndrome and a need to improve education and follow-up of cancer patients with anorexia-cachexia.
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Affiliation(s)
- Yolanda Escobar
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Avinash Ramchandani
- Medical Oncology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | | | - Alfredo Castillo-Trujillo
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Avenida de Roma s/n, Oviedo, Spain
| | - Eva Martínez de Castro
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIBAL, Santander, Spain
| | | | - Ruth Vera
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Irene Torres
- Medical Oncology Department, Hospital Clínico Universitario Lozano Bleza, Zaragoza, Spain
| | - Pedro Pérez Segura
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Cinta Hierro
- Medical Oncology Department, Instituto Catalán de Oncología (ICO), Badalona, Spain
| | - Diego Soto de Prado
- Medical Oncology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Almudena Cotes
- Medical Oncology Department, Hospital Universitario de Elda, Elda, Spain
| | - Gema Marín Zafra
- Medical Oncology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | | | - Juan Virizuela
- Medical Oncology Department, Hospital Universitario Virgen de La Macarena, Sevilla, Spain
| | - Jose Carlos Villa
- Medical Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Pablo Borrega
- Medical Oncology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Paula Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Avenida de Roma s/n, Oviedo, Spain.
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3
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Romero-Laorden N, Lorente D, de Velasco G, Lozano R, Herrera B, Puente J, López PP, Medina A, Almagro E, Gonzalez-Billalabeitia E, Villla-Guzman JC, González-Del-Alba A, Borrega P, Laínez N, Fernández-Freire A, Hernández A, Rodriguez-Vida A, Chirivella I, Fernandez-Parra E, López-Campos F, Isabel Pacheco M, Morales-Barrera R, Fernández O, Villatoro R, Luque R, Hernando S, Castellano DC, Castro E, Olmos D. Prospective Assessment of Bone Metabolism Biomarkers and Survival in Metastatic Castration-resistant Prostate Cancer Patients Treated with Radium-223: The PRORADIUM Study. Eur Urol Oncol 2023:S2588-9311(23)00207-9. [PMID: 37838555 DOI: 10.1016/j.euo.2023.09.015] [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: 07/15/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Radium-223 is an active therapy option for bone metastatic castration-resistant prostate cancer (mCRPC). The lack of adequate biomarkers for patient selection and response assessment are major drawbacks for its use. OBJECTIVE To assess the prognostic value of bone metabolism biomarkers (BMBs) in ra-223-treated mCRPC patients. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study of mCRPC patients treated with Ra-223 (PRORADIUM study: NCT02925702) was conducted. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The main objective of the study was to evaluate the association between high (≥median) baseline values in at least three bone formation (bone alkaline phosphatase [BAP] and C-terminal type-I collagen propeptide) and bone resorption (N-terminal telopeptide and pyridinoline) biomarkers, and survival. The independent prognostic value of each BMB was also assessed. The association with time to radiographic, clinical, and prostate-specific antigen (PSA) progression; time to skeletal-related events; and PSA response were secondary objectives. Multivariable (MV) Cox-regression models were evaluated. RESULTS AND LIMITATIONS A total of 169 patients were included. Of the patients, 70.4% received Ra-223 in second/third line; 144 (85.2%) were Eastern Cooperative Oncology Group 0-1, 126 (74.6%) were in pain, and 80 (47.5%) had more than ten bone metastases. Sixty-seven (39.6%) patients had elevation in at least three BMBs. The median overall survival was 12.1 mo (95% confidence interval [CI]: 10-14.7). No association was observed with other treatment-related secondary outcome parameters. Patients with high values in three or more BMBs had significantly worse survival (9.9 vs 15.2 mo; hazard ratio [HR]: 1.8 [95% CI: 1.3-2.5]; p < 0.001) in the univariate analysis, but not independent in the MV analysis (HR: 1.33; 95% CI: 0.89-2; p = 0.181). High baseline BAP was the only biomarker associated with survival in the MV model (HR: 1.89; 95% CI: 1.28-2.79; p = 0.001). Addition of BAP to the MV clinical model increased the area under the receiver operating characteristic curve 2-yr value from 0.667 to 0.755 (p = 0.003). CONCLUSIONS Biomarkers of bone formation, especially BAP, have prognostic value in mCRPC patients treated with radium-223. Its predictive value remains to be assessed, ideally in prospective, adequately powered, randomised clinical trials. PATIENT SUMMARY In this study, we evaluate the role of bone metabolism biomarkers to help improve the use of radium-223 as therapy for advanced prostate cancer. We found that bone alkaline phosphatase may be a suitable tool.
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Affiliation(s)
- Nuria Romero-Laorden
- Medical Oncology Department, Hospital Universitario La Princesa, Madrid, Spain; Cátedra UAM-Fundación Instituto Roche de Medicina Personalizada de Precisión, Madrid, Spain
| | - David Lorente
- Medical Oncology Department, Hospital Provincial de Castellón, Castellón de la Plana, Spain
| | - Guillermo de Velasco
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Biomarkers in Genito-Urinary Cancers Group, I+12 Biomedical Research Institute, Madrid, Spain
| | - Rebeca Lozano
- Medical Oncology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Bernardo Herrera
- Urology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Genitourinary Cancers Traslational Research Unit, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Javier Puente
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Pedro P López
- Genomics and Therapeutics in Prostate Cancer Group, I+12 Biomedical Research Institute, Madrid, Spain
| | - Ana Medina
- Fundación Centro Oncológico de Galicia, A Coruña, Spain
| | - Elena Almagro
- Hospital Universitario Quirón, Pozuelo de Alarcón, Spain
| | - Enrique Gonzalez-Billalabeitia
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Biomarkers in Genito-Urinary Cancers Group, I+12 Biomedical Research Institute, Madrid, Spain
| | | | | | | | - Nuria Laínez
- Department of Medical Oncology, Navarra University Hospital, Pamplona, Spain
| | | | - Amaia Hernández
- Medical Oncology Department, Gipuzkoa Cancer Unit, OSI Donostialdea - Onkologikoa Foundation, San Sebastián, Spain
| | - Alejo Rodriguez-Vida
- Medical Oncology Department, Hospital del Mar, CIBERONC, IMIM Research Institute, Barcelona, Spain
| | - Isabel Chirivella
- Medical Oncology Department, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | | | - Fernando López-Campos
- Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Rafael Morales-Barrera
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ovidio Fernández
- Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Raquel Luque
- Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
| | | | - Daniel C Castellano
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Biomarkers in Genito-Urinary Cancers Group, I+12 Biomedical Research Institute, Madrid, Spain
| | - Elena Castro
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Cancer Genetics Group, I+12 Biomedical Research Institute, Madrid, Spain
| | - David Olmos
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Genomics and Therapeutics in Prostate Cancer Group, I+12 Biomedical Research Institute, Madrid, Spain.
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Carles J, Alonso-Gordoa T, Mellado B, Méndez-Vidal MJ, Vázquez S, González-Del-Alba A, Piulats JM, Borrega P, Gallardo E, Morales-Barrera R, Paredes P, Reig O, Garcías de España C, Collado R, Bonfill T, Suárez C, Sampayo-Cordero M, Malfettone A, Garde J. Radium-223 for patients with metastatic castration-resistant prostate cancer with asymptomatic bone metastases progressing on first-line abiraterone acetate or enzalutamide: A single-arm phase II trial. Eur J Cancer 2022; 173:317-326. [PMID: 35981452 DOI: 10.1016/j.ejca.2022.06.057] [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: 03/04/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The paper aims to evaluate the efficacy and safety of 223Ra in patients who progressed after first-line androgen deprivation therapy. PATIENTS AND METHODS EXCAAPE (NCT03002220) was a multicentre, single-arm, open-label, non-controlled phase IIa trial in 52 patients with metastatic castration-resistant prostate cancer and asymptomatic bone metastases who have progressed on abiraterone acetate or enzalutamide, up to six doses of 223Ra (55 kBq/kg of body weight per month). The primary end-point was radiographic progression-free survival (rPFS). Secondary end-points included rPFS based on androgen receptor splice variant 7 (AR-V7) expression in circulating tumour cells (CTCs), overall survival, and safety. RESULTS Median rPFS was 5.5 months (95% CI 5.3-5.5). Median rPFS of patients with AR-V7(-) CTCs was longer than that of patients with AR-V7(+) CTCs (5.5 versus 2.2 months, respectively; P = 0.056). Median overall survival was 14.8 months (95% CI 11.2-not reached) and was significantly greater for AR-V7(-) patients than for AR-V7(+) patients (14.8 months versus 3.5 months, respectively; P < 0.01). 223Ra was well tolerated; anaemia and thrombocytopenia were the most common grade 3/4 adverse events (5.8% and 11.5%, respectively). CONCLUSIONS 223Ra seems to be a reasonable treatment for patients with metastatic castration-resistant prostate cancer and asymptomatic bone metastases progressing on novel hormonal therapy and had an acceptable safety profile.
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Affiliation(s)
- Joan Carles
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Universitat Autónoma de Barcelona, Barcelona, Spain.
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Begoña Mellado
- Medical Oncology Department, Hospital Clínic Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors Lab, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - María J Méndez-Vidal
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain; Reina Sofía University Hospital (HURS), Córdoba, Spain
| | | | | | | | | | - Enrique Gallardo
- Parc Taulí University Hospital, Parc Taulí Institute of Research and Innovation I3PT, Barcelona, Spain
| | - Rafael Morales-Barrera
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Pilar Paredes
- Medical Oncology Department, Hospital Clínic Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors Lab, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Oscar Reig
- Medical Oncology Department, Hospital Clínic Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors Lab, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | | | - Cristina Suárez
- Universitat Autónoma de Barcelona, Barcelona, Spain; Parc Taulí University Hospital, Parc Taulí Institute of Research and Innovation I3PT, Barcelona, Spain
| | | | | | - Javier Garde
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
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Romero Laorden N, Lorente D, Lozano Mejorada R, Sanchez-Soler N, De Velasco G, Puente J, Borrega P, Gonzalez-Billalabeitia E, Castillo-Morales V, Hernández A, Fernandez-Freire A, Campos FL, Villatoro R, Fernandez Calvo O, Anido U, Lainez N, Luque R, Ros Martínez S, Castro E, Olmos D. 606P Role of serum biomarkers of bone metabolism in metastatic castration-resistance prostate cancer (mCRPC) patients (pts) treated with radium-223 (Ra223): PRORADIUM study final results. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Castro E, Lozano Mejorada R, Medina A, Giorgi U, Romero Laorden N, Conteduca V, De Velasco G, Alameda D, Sanz A, Puente J, Gonzalez del Alba A, Borrega P, Villa Guzmán J, Fernández-Parra E, Rodriguez-Vida A, Chirivella I, Vazquez F, Morales Barrera R, Lorente D, Olmos D. 590P PRORADIUM: Prospective analysis of the impact of germline mutations in homologous recombination (HR) genes on the response to radium-223 for metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1103] [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: 10/20/2022] Open
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Donas JG, de Velasco G, Alonso Gordoa T, Chamorro J, Rosero D, Etxaniz O, Perez-Gracia JL, Pinto A, Duran I, Cacho D, Barba M, Yagüe M, Borrega P, Lázaro M, Rodriguez L, Villalobos Leon MLL, Garcia Sanchez L, Cuellar MA, Rodriguez-Moreno JF. Retrospective study for the characterization of COVID-19 in renal cancer (COVID-REN) patients treated with antiangiogenics or immunotherapy and outcome comparison with non-infected cases. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.4577] [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
4577 Background: Cancer is recognized as a major risk factor for severe COVID19. However little is known about the impact of oncologic treatments in the evolution of the disease. On the other hand, the influence of SARS-CoV2 in cancer response remains to be established. We aim to determine both aspects in renal cancer patients receiving different therapeutic options. Methods: We designed a retrospective case-control study to compare the outcome of patients with advanced renal cancer who developed COVID19 under antiangiogenic treatment (cohort A [ChA]) vs immunotherapy (alone or in combination: cohort B [ChB]) vs matched controls (cohort C [ChC]). Controls were renal cancer patients who were not infected during the period of study. One control per case was selected regarding age, gender, kidney cancer histology and type of treatment. Results: From May 20 to Feb 21, 80 patients were recruited. We present the first 55 patients included (15 ChA, 16 ChB and 20 ChC, 4 patients were screening failure) from 13 centers in Spain. Median age was 62 (range 25 to 88) overall and 62 (range 44 to 88) in Ch A, 64,5 (range 42 to 83) in ChB and 61 (range 41 to 77) in ChC. 38 patients were male and 13 were female. Overall 45 cases were clear cell carcinoma (13 ChA, 14 ChB and 18 ChC), 4 papillary (1 ChA, 2 ChB and 1 ChC), 1 chromophobe (ChA) and 1 unclassified (ChC). Median number of prior lines of treatment was 2 (range 1 to 6) overall, (1 [range 1 to 4] in ChA, 2 [range 1 to 4] in ChB and 2 [range 1 to 6] in ChC). 25 patients required treatment interruptions (8 in ChA [32%], 14 in ChB [56%] and 3 [12%] in ChC). 9 patients were hospitalized (4 in Ch A, 5 in ChB and none in ChC) for a median of 10 days (range 4 to 16) overall (7 [range 4 to 14] in ChA and 12 [range 5 to 16] in ChB). No patient required ICU admission. Best tumor response was complete or partial (CR+PR) in 25 patients (5 [20%] in ChA, 9 [36%] in ChB and 11 [44%] in ChC). Clinical benefit (CR+PR+stable disease) was observed in 38 patients (11 [28,9%] in ChA, 10 [26,3%] in ChB and 17 [44,7%] in ChC). One patient in ChB died (due to COVID19). Updated results will be presented. Conclusions: Patients with renal cancer who developed COVID19 held treatment more frequently and presented lower clinical benefit rates than non infected cases. Patients receiving immunotherapy required more frequent dose interruptions and longer hospitalizations than cases on antiangiogenics. These results point to an impact of SARS-CoV2 in renal cancer outcome. Therapies administered to treat renal cancer, could play a role in the evolution of COVID19.
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Affiliation(s)
| | | | | | | | - Diana Rosero
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Olatz Etxaniz
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Alvaro Pinto
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | - Ignacio Duran
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Cantabria, Spain
| | - Diego Cacho
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - María Barba
- HM Sanchinarro Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain
| | - Monica Yagüe
- HM Hospitales-Centro Integral Oncológico Clara Campal, Madrid, Spain
| | | | | | | | | | | | - M. Andres Cuellar
- Medical Oncology. Institut Català d'Oncologia (ICO) L'Hospitalet del Llobregat, Barcelona, Spain
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Khalaf D, Aragón I, Annala M, Lozano R, Taavitsainen S, Lorente D, Finch D, Romero-Laorden N, Vergidis J, Cendón Y, Oja C, Pacheco M, Zulfiqar M, Gleave M, Wyatt A, Olmos D, Chi K, Castro E, Almagro E, Arranz J, Billalabeitia E, Borrega P, Castro E, Contreras J, Domenech M, Escribano R, Fernández-Parra E, Gallardo E, García-Carbonero I, García R, Garde J, González del Alba A, González B, Hernández A, Hernando S, Jiménez P, Laínez N, Lorente D, Luque R, Martínez E, Medina A, Méndez-Vidal M, Montesa A, Morales R, Olmos David, Pérez-Gracia J, Pérez-Valderrama B, Pinto Á, Piulats J, Puente J, Querol R, Rodríguez-Vida A, Romero-Laorden N, Sáez M, Vázquez S, Vélez E, Villa-Guzmán J, Villatoro R, Zambrana C. HSD3B1 (1245A>C) germline variant and clinical outcomes in metastatic castration-resistant prostate cancer patients treated with abiraterone and enzalutamide: results from two prospective studies. Ann Oncol 2020; 31:1186-1197. [DOI: 10.1016/j.annonc.2020.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/15/2020] [Accepted: 06/03/2020] [Indexed: 12/22/2022] Open
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9
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Romero-Laorden N, Lozano R, Llacer Perez C, Piulats Rodriguez JMM, Puente J, Lorente D, Medina A, Cattrini C, Vitrone F, Almagro E, Borrega P, Lainez N, Rivera L, Villatoro R, Hernandez A, Rodriguez-Vida A, López-Casas PP, Gallardo Diaz E, Castro E, Olmos D. Cabazitaxel versus enzalutamide/abiraterone in CARD eligible mCRPC patients with or without germline HRR defects. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.5554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5554 Background: The CARD trial proved that in mCPRC patients (pts), previously treated with docetaxel and an androgen-receptor signaling inhibitor (ARSi), cabazitaxel (CBZ) significantly improves progression-free (PFS) and Overall Survival (OS) compared with the alternative ARSi. Concurrently, the PROFOUND study showed the superiority of olaparib vs. ARSi in pts with similar prior treatment history and genetic alterations in Homologus Recombination DNA repair related genes (HRR). Methods: PROREPAIR-B (NCT03075735) is a prospective study which aimed to demonstrate the prognostic role of germline deleterious mutations in (g)HRR genes and the benefit of first (1L), second (2L) and subsequent therapy lines for mCRPC. Outcomes with 1-2L have been previously reported. Here we evaluated radiographic (r)-PFS, clinical (c)-PFS, and OS in PROREPAIR-B pts who meet CARD study eligibility criteria and who received CBZ and/or ARSi. Survival analysis were performed using Kaplan Meier method and Cox regression models. Results: 95 out of 419 mCRPC pts included in PROREPAIR-B meet CARD eligibility criteria and received CBZ (n=60) or ARSi (n=35) including 14 gHRR carriers, 8/6 treated with CBZ/ARSi, respectively. Visceral metastases were more frequent among pts treated with CBZ (p=0.01). ECOG 2, M1 at diagnosis, Abiraterone as 1st ARSi and prior radiographic PD (all p<0.05) were more frequent in our pts than in the CARD study. Overall, CBZ was superior to ARSi in terms of rPFS (median 6.0 vs. 3.7 months (m), p=0.03), cPFS (median 4.4 vs. 3.4 m, p=0.01) and PSA50 responses (39% vs. 17%, p=0.027). Differences in OS were not observed, although approximately 60% of patients in ARSi had crossed to CBZ at the time of the analyses. Results of subgroups analyses were similar to those reported by CARD. In this series, gHRR carriers had a significant worse prognosis (OS HR 1.9; rPFS HR 2.4; cPFS HR 2.6) than non-carriers. In gHRR carriers CBZ was not superior to ARSi in terms of rPFS (2.5 vs. 3.0 m, p=0.8), cPFS (2.5 vs. 2.4 m, p=0.8) and OS (4.5 vs. 3.7, p=0.8). Cox MVA models adjusted for unbalances and CARD grouping factors confirmed a significant interaction between treatment and gHRR status for rPFS and cPFS, suggesting that the benefit of CBZ was not observed in gHRR. Conclusions: Our results confirm the benefit of CBZ treatment over a second ARSi (either abiraterone or enzalutamide) in unselected mCRPC population. However, the outcomes in gHRR carriers are poor with either CBZ or ARSi supporting the need of novel therapies in this setting. Clinical trial information: NCT03075735 .
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Affiliation(s)
| | - Rebeca Lozano
- Spanish National Cancer Research Centre, Prostate Cancer Clinical Research Unit, Madrid, Spain
| | | | | | - Javier Puente
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - David Lorente
- Hospital Provincial De Castellón, Castellón De La Plana, Spain
| | - Ana Medina
- Centro Oncologico de Galicia, A Coruña, Spain
| | | | | | - Elena Almagro
- Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | - Nuria Lainez
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Leticia Rivera
- Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Rosa Villatoro
- Hospital Costa del Sol, Oncology Department, Marbella, Spain
| | | | | | - Pedro P. López-Casas
- Spanish National Cancer Research Centre, Prostate Cancer Clinical Research Unit, Madrid, Spain
| | | | - Elena Castro
- Hospitales Virgen de la Victoria y Regional de Málaga, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - David Olmos
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Center, Madrid, Spain
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Ayala de Miguel P, Enguix-Riego MV, Cacicedo J, Delgado BD, Pérez M, Praena-Fernández JM, Quintana Cortés L, Borrega P, Rivin del Campo E, Lopez Guerra J. Prognostic value of the TGFß1 rs4803455 single nucleotide polymorphism and its association with prophylactic cranial irradiation in small cell lung cancer. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e21038] [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
e21038 Background: Small cell lung cancer (SCLC) is one of the greatest therapeutic challenges of oncology. Potential associations between single-nucleotide polymorphisms (SNP) in Heat shock protein beta- 1 (HSPB1) and Transforming growth factor (TGFß1) and survival have been investigated. Methods: A prospective multicenter study of 94 SCLC patients treated between 2013 and 2016 was conducted. Several variables clinical, tumour-related, therapeutic, and genetic (9 SNPs of TGFß1 gene and 5 of HSPB1 gene) variables were analyzed. Results: The cohort included 77 men and 17 women with a median age of 61 years. Eighty percent presented with limited stage at diagnosis and received thoracic radiation with a median dose of 45 Gy (BID in 42%). Forty-seven percent received concomitant platinum-based chemotherapy and 57% received prophylactic cranial irradiation (PCI). Overall survival (OS) was 34% at 2 years and 16% at 3 years. In multivariate analysis PCI and the TGFß1 SNP rs4803455 showed a statistically significant association with OS and local control. Patients with the CA genotype of the TGFß1 SNP rs4803455 showed worse OS (HR 2.53; IC 1.22-5.21; p = 0.012) and higher local recurrence (HR 2.26; IC 1.01-5.08;p = 0.048). A combined analysis showed that those patients receiving PCI and carrying the rs4803455:CA genotype had a statistically significant lower OS (p < 0.001) and disease-free survival (p < 0.001) than patients receiving PCI and carrying the rs4803455:AA genotype. Conclusions: Genetic analysis showed that the CA genotype of TGFß1 SNP rs4803455 was associated with worse prognosis in SCLC patients and could be considered as a potential biomarker for OS.
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Affiliation(s)
- Pablo Ayala de Miguel
- Department of Clinical Oncology, University Hospital San Pedro de Alcántara, Caceres, Spain
| | - María Valle Enguix-Riego
- Department of Biomedicine (IBIS/HUVR/CSIC/University of Seville), Seville, Spain, Sevilla, Spain
| | - Jon Cacicedo
- Hospital Universitario de Cruces, Barakaldo, Spain
| | - Blas David Delgado
- Department of Radiation Oncology, University Hospital Virgen del Rocío, Seville, Spain
| | - Marco Pérez
- Department of Biomedicine (IBIS/HUVR/CSIC/University of Seville), Seville, Spain, Seville, Spain
| | | | | | | | | | - Jose Lopez Guerra
- Department of Radiation Oncology, University Hospital Virgen del Rocío, Seville, Spain
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11
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Lozano R, Castro E, Piulats JM, Medina A, Guzman JCV, Garcia Carbonero I, Villatoro R, Arranz JA, Perez-Gracia JL, Garde J, Gonzalez del Alba A, Montesa A, Luque R, Borrega P, Vázquez S, Martinez E, Gonzalez Gragera B, Romero-Laorden N, Olmos D, Lorente D. Impact of treatment sequence in metastatic castration-resistant prostate cancer (mCRPC) on outcome in a prospective cohort study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
264 Background: Abiraterone (Abi), enzalutamide (Enza) and docetaxel (Doc) are all valid first-line (1L) mCRPC treatment options. Evidence suggests a degree of cross-resistance between agents, which may impact the efficacy of subsequent lines of therapy. Evidence on the optimal treatment sequence is lacking. Methods: We evaluated the outcome of patients (pts) treated with 1L Doc, Abi or Enza in the prospective PROREPAIR-B cohort study. We assessed the impact of 1L treatment option (Doc vs Abi/Enza) on overall survival (OS), progression-free survival (PFS) to 1L-therapy (PCWG2) and PFS2 (time from initiation of 1L-therapy to progression on second-line [2L] therapy). Uni- (UV) and multivariable (MV) cox-regression models were used. MV model covariates included age (≥75 years), local therapy, Gleason Score, metastases at diagnosis, visceral metastases, ALP (≥ULN), LDH (≥ULN), haemoglobin (≤LNL), albumin (≤LNL) and ECOG PS. Results: 406 pts received 1L-Doce (N=188) or Abi/Enza (N=218). Pts receiving Doc were younger (p=0.002), had higher rates of visceral metastases (17.6 vs 8.7%; p=0.008), ALP (52.1% vs 40.4%; p=0.018), LDH (48.1% vs 31.2%; p<0.001) and lower Hb (7.4 vs 2.8%; p=0.029) and albumin (11.3 vs 4.6%). PFS was higher in pts receiving 1L-Abi/Enza (10.8 vs 8.3 months; HR:0.5; p<0.001). Pts receiving 1L Abi/Enza had higher rates of radiographic progression (88.4 vs 80%; p=0.032). 123/188 pts treated with 1L-Doc received 2L-Abi/Enza: 30 received other 2L and 35 had not started 2L. 111/216 pts treated with 1L-Abi/Enza received 2L-Doc, 26 were started on other 2L and 79 had not initiated 2L. A significant difference between pts treated with initial Abi/Enza vs Doc was observed in PFS2 (20.6 vs 16.6m; HR:0.78; p=0.006) but not OS (31.3 vs 29.9 m; HR:1.05; p=0.725). Choice of first-line agent was not associated with OS in the MV model. Conclusions: Despite longer PFS to 1L and PFS2 in pts treated with initial Abi/Enza, no differences in OS were observed between treatment sequences starting with Doc vs Abi/Enza. Pts treated with 1L-Doc had worse baseline prognostic features. Molecular stratification may enable biomarker-driven patient selection to optimize benefit in pts. (NCT03075735).
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Affiliation(s)
- Rebeca Lozano
- Spanish National Cancer Research Centre, Madrid, Spain
| | - Elena Castro
- Spanish National Cancer Research Centre, Madrid, Spain
| | | | - Ana Medina
- Centro Oncologico de Galicia, La Coruna, Spain
| | | | | | | | | | | | | | - Aranzazu Gonzalez del Alba
- Medical Oncology Department, Hospital Universitario Puerta de Hierro Majadahonda, Palma De Mallorca, Spain
| | - A. Montesa
- CNIO-IBIMA Genitorurinary Cancer Clinical Research Unit, Hospitales Universitarios Virgen de la Victoria and Regional de Málaga, Malaga, Spain
| | - Raquel Luque
- Medical Oncology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | | | | | | | | | - David Olmos
- CNIO-IBIMA Genitourinary Cancer Research Unit, Malaga, Spain
| | - David Lorente
- MEdical Oncology Department, Hospital Provincial de Castellón, Castellón De La Plana, Spain
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12
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Castro E, Romero-Laorden N, Del Pozo A, Lozano R, Medina A, Puente J, Piulats JM, Lorente D, Saez MI, Morales-Barrera R, Gonzalez-Billalabeitia E, Cendón Y, García-Carbonero I, Borrega P, Mendez Vidal MJ, Montesa A, Nombela P, Fernández-Parra E, Gonzalez Del Alba A, Villa-Guzmán JC, Ibáñez K, Rodriguez-Vida A, Magraner-Pardo L, Perez-Valderrama B, Vallespín E, Gallardo E, Vazquez S, Pritchard CC, Lapunzina P, Olmos D. PROREPAIR-B: A Prospective Cohort Study of the Impact of Germline DNA Repair Mutations on the Outcomes of Patients With Metastatic Castration-Resistant Prostate Cancer. J Clin Oncol 2019; 37:490-503. [PMID: 30625039 DOI: 10.1200/jco.18.00358] [Citation(s) in RCA: 224] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Germline mutations in DNA damage repair (DDR) genes are identified in a significant proportion of patients with metastatic prostate cancer, but the clinical implications of these genes remain unclear. This prospective multicenter cohort study evaluated the prevalence and effect of germline DDR (gDDR) mutations on metastatic castration-resistance prostate cancer (mCRPC) outcomes. PATIENTS AND METHODS Unselected patients were enrolled at diagnosis of mCRPC and were screened for gDDR mutations in 107 genes. The primary aim was to assess the impact of ATM/BRCA1/BRCA2/ PALB2 germline mutations on cause-specific survival (CSS) from diagnosis of mCRPC. Secondary aims included the association of gDDR subgroups with response outcomes for mCRPC treatments. Combined progression-free survival from the first systemic therapy (PFS) until progression on the second systemic therapy (PFS2) was also explored. RESULTS We identified 68 carriers (16.2%) of 419 eligible patients, including 14 with BRCA2, eight with ATM, four with BRCA1, and none with PALB2 mutations. The study did not reach its primary end point, because the difference in CSS between ATM/BRCA1/BRCA2/PALB2 carriers and noncarriers was not statistically significant (23.3 v 33.2 months; P = .264). CSS was halved in germline BRCA2 (g BRCA2) carriers (17.4 v 33.2 months; P = .027), and g BRCA2 mutations were identified as an independent prognostic factor for CCS (hazard ratio [HR], 2.11; P = .033). Significant interactions between g BRCA2 status and treatment type (androgen signaling inhibitor v taxane therapy) were observed (CSS adjusted P = .014; PFS2 adjusted P = .005). CSS (24.0 v 17.0 months) and PFS2 (18.9 v 8.6 months) were greater in g BRCA2 carriers treated in first line with abiraterone or enzalutamide compared with taxanes. Clinical outcomes did not differ by treatment type in noncarriers. CONCLUSION g BRCA2 mutations have a deleterious impact on mCRPC outcomes that may be affected by the first line of treatment used. Determination of g BRCA2 status may be of assistance for the selection of the initial treatment in mCRPC. Nonetheless, confirmatory studies are required before these results can support a change in clinical practice.
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Affiliation(s)
- Elena Castro
- 1 Prostate Cancer Clinical Unit, Spanish National Cancer Research Center, Madrid, Spain.,2 Hospital Universitario Quiron, Madrid, Spain
| | - Nuria Romero-Laorden
- 1 Prostate Cancer Clinical Unit, Spanish National Cancer Research Center, Madrid, Spain.,3 Hospital Universitario La Princesa, Madrid, Spain
| | - Angela Del Pozo
- 4 Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, and CIBERER Instituto de Salud Carlos III, Madrid, Spain
| | - Rebeca Lozano
- 1 Prostate Cancer Clinical Unit, Spanish National Cancer Research Center, Madrid, Spain.,5 CNIO_IBIMA Genitourinary Cancer Research Unit, Institute of Biomedical Research in Málaga, Málaga Spain
| | - Ana Medina
- 6 Centro Oncológico de Galicia, Coruña, Spain
| | - Javier Puente
- 7 Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Josep Maria Piulats
- 8 Institut Català d'Oncologia, Bellvitge Biomedical Research Institute, Barcelona, Spain
| | | | - Maria Isabel Saez
- 5 CNIO_IBIMA Genitourinary Cancer Research Unit, Institute of Biomedical Research in Málaga, Málaga Spain.,10 Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga, Spain
| | - Rafael Morales-Barrera
- 11 Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Ylenia Cendón
- 1 Prostate Cancer Clinical Unit, Spanish National Cancer Research Center, Madrid, Spain.,13 Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | - Alvaro Montesa
- 5 CNIO_IBIMA Genitourinary Cancer Research Unit, Institute of Biomedical Research in Málaga, Málaga Spain.,10 Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga, Spain
| | - Paz Nombela
- 1 Prostate Cancer Clinical Unit, Spanish National Cancer Research Center, Madrid, Spain
| | | | | | | | - Kristina Ibáñez
- 4 Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, and CIBERER Instituto de Salud Carlos III, Madrid, Spain
| | | | - Lorena Magraner-Pardo
- 1 Prostate Cancer Clinical Unit, Spanish National Cancer Research Center, Madrid, Spain
| | | | - Elena Vallespín
- 4 Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, and CIBERER Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Gallardo
- 22 Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | | | | | - Pablo Lapunzina
- 4 Institute of Medical and Molecular Genetics, Hospital Universitario La Paz, and CIBERER Instituto de Salud Carlos III, Madrid, Spain
| | - David Olmos
- 1 Prostate Cancer Clinical Unit, Spanish National Cancer Research Center, Madrid, Spain.,5 CNIO_IBIMA Genitourinary Cancer Research Unit, Institute of Biomedical Research in Málaga, Málaga Spain
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13
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Angelergues A, Efstathiou E, Gyftaki R, Wysocki PJ, Lainez N, Gonzalez I, Castellano DE, Ozguroglu M, Carbonero IG, Flechon A, Borrega P, Guillot A, Balea BC, Le Moulec S, Esteban E, Munarriz J, Rubio G, Birtle AJ, Delanoy N, Bellmunt J, Oudard S. Results of the FLAC European Database of Metastatic Castration-Resistant Prostate Cancer Patients Treated With Docetaxel, Cabazitaxel, and Androgen Receptor–Targeted Agents. Clin Genitourin Cancer 2018; 16:e777-e784. [DOI: 10.1016/j.clgc.2018.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/14/2018] [Accepted: 02/18/2018] [Indexed: 10/18/2022]
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14
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Romero-Laorden N, Castro E, Medina A, Lorente D, González-Billalabeitia E, Méndez-Vidal MJ, Gonzalez del Alba A, Lozano R, Borrega P, Fernandez Parra E, Sáez MI, Garcia Carbonero I, Rodriguez Vida A, Morales Barrera R, del Pozo A, Pritchard C, Lapunzina P, Piulats Rodriguez JM, Puente J, Olmos D. Impact of treatment sequence on the outcomes of metastatic castration resistant prostate cancer patients (mCRPC) with germline BRCA2 mutations: A subanalysis of the PROREPAIR-B study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Elena Castro
- Spanish National Cancer Research Centre, Madrid, Spain
| | - Ana Medina
- Medical Oncology Department, Centro Oncologico de Galicia, A Coruña, Spain
| | - David Lorente
- Servicio Oncologia Medica Hospital Universitario La Fe, Valencia, Spain
| | | | | | | | - Rebeca Lozano
- Spanish National Research Cancer Centre, Madrid, Spain
| | | | | | - M Isabel Sáez
- CRIS Cancer Foundation Prostate Cancer Research Group, Institute of Biomedical Research in Malaga/ CNIO-IBIMA Genitourinary Cancer Research Unit, H Universitarios Virgen de la Victoria y Regional de Málaga, Malaga, Spain
| | | | | | | | - Angela del Pozo
- Medical Genetics and Molecular Institute, La Paz, Madrid, Spain
| | | | - Pablo Lapunzina
- Medical Genetics and Molecular Institute, La Paz, Madrid, Spain
| | | | - Javier Puente
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - David Olmos
- Spanish National Cancer Research Centre, Madrid, Spain
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15
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Ayala P, Cacicedo J, Delgado D, Nieto-Guerrero J, Herrero D, Praena J, Quintana L, Borrega P, Ortiz M, López-Guerra J. EP-2306: Prognostic value of PCI and single nucleotide polymorphism rs4803455 of TGFß1 gene in SCLC. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32615-x] [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: 10/14/2022]
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16
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Puente J, Romero-Laorden N, Vallespin Garcia E, Piulats JM, Saez MI, Fernandez Parra E, Perez Valderrama B, Borrega P, Cendon Y, Ibáñez K, Lainez N, Heras L, Velez E, Almagro E, Zambrana F, García Domínguez R, Contreras JA, Lapunzina P, Olmos D, Castro E. Outcomes of metastatic castration resistant prostate cancer (mCRPC) patients with DNA repair germline mutations (gDDR) following first taxane-based treatment. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.247] [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
247 Background: Germline DDR have been identified in up to 12% of mCRPC patients. Initial results from various retrospective series have reported discordant impact in clinical outcomes associated to these gDDR following conventional treatments. PROREPAIR-B (Castro et al ESMO 2017) is the first prospective study to address this question. In this planned sub-analysis, we report mCRPC treatment outcomes associated to taxanes. Methods: PROREPAIR-B (NCT03075735) is a prospective multicentre observational cohort study. Patients diagnosed with mCRPC, with unknown mutational status at study entry and who were going to start a first-line treatment for mCRPC were eligible. For this sub-analysis patients who received docetaxel or cabazitaxel as first-taxane were selected. The endpoints of this sub-analysis included to assess the impact of BRCA1, BRCA2, ATM and PALB2 and other gDDR on cause-specific survival (CSS), progression free survival (PFS), time to PSA progression (bPFS) and response to the first administered taxane as 1st or 2nd line therapy. Results: 326 (12 BRCA2, 8 ATM and 1 BRCA1 mutation carrier [gMUT]) out of 419 patients were eligible for this analysis. Diagnostic characteristic included Stage IV 51%, G8-10 60%. At the time of taxane initiation median PSA was 30.1 ng/mL, 84%, 48% and 11% of patients had bone, nodal and visceral metastases. CSS from first-taxane were not significantly different between gMUT and non-carriers (NC) (16.9 vs 23.2 m, p > 0.05). However, in BRCA2 carriers was significantly shorter than in NC (13.1 vs 23.3 m, p = 0.026). Despite a trend to higher PSA response rates in gMUT compared to NC (n = 288, 63% vs 42%, p = 0.07, BRCA2 55%, p > 0.05), PFS were not significantly different between both groups (7.2 vs 7.8 m, p > 0.05), with a trend to shorter survival in BRCA2 carriers (4.5 vs 7.4 m, P = 0.11). Conclusions: These results suggest that DDR mutation carriers respond to taxanes with similar time to progression compared to NC, with the exception of BRCA2 carriers, who despite to the initial response to taxanes, presented worse survival outcomes. This highlights the need for close monitoring and novel therapies in this population. Clinical trial information: NCT03075735.
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Affiliation(s)
- Javier Puente
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | | | | | - M Isabel Saez
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | | | | | - Ylenia Cendon
- Spanish National Cancer Research Centre, Madrid, Spain
| | | | - Nuria Lainez
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Lucia Heras
- Consorci Sanitari Integral – Hospital General de l´Hospitalet, Hospitalet De Llobregat, Spain
| | | | - Elena Almagro
- Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | | | | | - Pablo Lapunzina
- Instituto de Genética Médica y Molecular, La Paz University Hospital, Madrid, Spain
| | - David Olmos
- Spanish National Cancer Research Centre, Madrid, Spain
| | - Elena Castro
- Spanish National Cancer Research Centre, Madrid, Spain
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Maximiano C, Puertas Alvarez JL, Maroto Rey JP, Pinto A, Miranda Pallares MJ, Suarez C, Climent MA, Garcia Carbonero I, Guzman JCV, Borrega P, De Velasco G, Fernandez Parra E, Crespo G, García Domínguez R, Gallardo Diaz E, Meana Garcia A, Garcia Marrero R, Gonzalez Larriba JL, Perez Ramirez S, Arranz Arija JA. SPAZO2 (SOGUG): Outcomes of patients treated with pazopanib as first line in mRC according to gender in real world. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.623] [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
623 Background: Treatment of mRC is not affected by gender, studying possible differences in a real-world study, could increase the knowledge of toxicity and possible prognostic factors. Methods: SPAZO2 (NCT03091465) was a retrospective real-world study to analyze the effectiveness of 1st-line pazopanib and subsequent therapies in mRC. Data from 530 pt treated outside CT were collected in 50 spanish centers, and externally monitored. Ineligibility criteria: ECOG > 1, pure nonclear-cell, Hgb < 9 g/dl, renal failure, severe cardiovascular disease, chronic liver disease, or recent neoplasia Results: 530 pt were included, 67.2% men (M), mean age was 66.2 years (26-92). There were no significant differences (M vs W) in the age > 75 (24.7 vs 24.1%), clear cell carcinoma (77.2 vs 79.9%), nephrectomy (72.5 vs 68.4%), IMDC (favourable: 15.2 vs 12.1%, intermediate: 59.3 vs 64.4%, poor: 25.6 vs 23.6%), metastases (lymph nodes: 46.1 vs 43.1%, lung: 69,7 vs 67,2 %, liver: 16 vs 20.1%, bone: 27 vs 24.1%, skin/soft tissues: 1.1 vs 3,4% and CNS: 4,8% vs 6.3%). Discontinuation due to toxicity or comorbidities was 12.4 vs 9.8%. There were no differences in the second lines received (57.9 vs 56.9%), neither response, PFS and OS (table). Median follow up was 39 mo. The gender has no prognostic value when adjusted for the prognostic groups of IMDC (HR of PFS 0.96, CI 95% 0.78-1.2, HR of OS: 0.92, CI 95% 0.72-1.14). Only diarrhea and elevation of uric acid were higher in the men group. Conclusions: Pazopanib was safe and effective in both groups with similar outcome. Women had less diarrhea and less increased uric acid. There were not differences in OS or PFS. In IMDC subgroup analysis, there is a trend towards a better evolution or PFS in the poor prognosis women subgroup. Clinical trial information: NCT03091465. [Table: see text]
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Affiliation(s)
| | | | | | | | | | - Cristina Suarez
- Vall d’Hebron Institute of Oncology, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
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Marcos EC, Romero Laorden N, Rodriguez JP, del Pozo A, Sáez M, Colmenero AM, Puente J, Silla-Castro J, Mejorada RL, Garcia-Carbonero I, Rivera L, Vidal MM, Barrera RM, Parra EF, Flórez YC, Borrega P, Del Alba Baamonde MG, Pritchard C, Lapunzina P, Hidalgo DO. PROREPAIR-B: A prospective cohort study of DNA repair defects in metastatic castration resistant prostate cancer (mCRPC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx440.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Carles Galceran J, Bonfill Abella T, Borrega P, Collado R, Garde J, Gonzalez del Alba Baamonde M, Grande Pulido E, Mellado B, Mendez Vidal M, Piulats Rodriguez J, Morales Barrera R, Gallardo Diaz E, Paredes P, Suarez Rodriguez C, Reig O, Vazquez Estevez S. A phase II clinical trial of radium-223 activity in patients (pts) with metastatic castration-resistant prostate cancer (mcrpc) with asymptomatic progression while on abiraterone acetate or enzalutamide besides AR-V7 mutational status (EXCAAPE). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.056] [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: 11/12/2022] Open
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Harshman L, Logue J, Sternberg C, Sundar S, Schrijvers D, Schostak M, Sylvester J, George S, Tucci M, Mantz C, Borrega P, Ziem P, Concepcion R, Miller K, Sartor O, Kalinovsky J, De Sanctis Y, Tombal B. First interim results of the radium-223 (Ra-223) REASSURE observational study: Analysis of patient (Pt) characteristics and safety by use of abiraterone and/or enzalutamide (Abi/Enza). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Medina A, Montesa A, Romero Laorden N, Gonzalez-Billalabeitia E, Rodriguez-Vida A, Grau G, Garcés T, Morales Barrera R, Vazquez Mazon F, Villatoro R, Gonzalez Del Alba Baamonde M, López F, Hernando Polo S, Domenech M, de Velasco G, Borrega P, Querol R, Velez E, Castro Marcos E, Olmos Hidalgo D. PROSENZA: Prospective multi-centre study of prognostic factors in castration resistant prostate cancer (CRPC) patients treated with enzalutamide (ENZ). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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González-Maeso I, Lainez N, Castellano D, Garcia Carbonero I, Borrega P, Campos Balea B, Garcia Marrero R, Esteban E, Rodriguez Vida A, Munarriz J, Garcia-Bueno JM, Villalobos ML, Viciana R, Rubio G, Perez-Valderrama B, Garcia Sanchez J, Pelaez Lorenzo B, Cumplido Buron JD, Martin A, Bellmunt J. Predictors for survival with cabazitaxel (CBZ) in metastatic, castration-resistant prostate cancer (mCRPC): Long term follow-up of the Spanish registry. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.e602] [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
e602 Background: The clinical experience with CBZ in mCRPC patients (pts) has enriched notably since its approval for clinical use, but there is still a lack of well-defined prognostic/predictive factors to better characterize the profile of pts that could achieve the best therapeutic benefit. Analysis of the final expanded cohort and mature long-term follow-up are presented. Methods: Medical records from mCRPC pts progressing during or after docetaxel and treated with CBZ at 21 centres in Spain were reviewed retrospectively. Baseline characteristics, overall survival (OS), radiographic progression-free survival (rPFS), and toxicity were collected. Univariate and multivariate analysis of a variety of factors predicting OS were conducted. Results: 187 consecutive pts (median age 69) with intermediate-poor prognostic baseline characteristics (Table 1) received a median of 6 cycles (range 2-59) of CBZ. Median OS from first CBZ cycle was 15.3 [CI: 11.7; 18.0] months (mo) and median clinical and/or rPFS was 7.9 mo [CI: 6.8; 10.3]. Gleason score (GS) < 8 (vs ≥ 8), time under first-line androgen deprivation therapy (ADT) ( > 16.1 (median) vs < 16.1 mo) and the number of chemotherapy lines before CBZ did not significantly influence OS. Median follow-up was 9.5 mo. Febrile neutropenia occurred in 4 pts and 1 pt had neutropenic infection. Main nonhematologic grade ≥ 3 toxicities were asthenia (2.7%) and diarrhea (1.6%). Alopecia, nails disorders and peripheral neuropathy were uncommon. Conclusions: CBZ administered in the daily clinical practice is associated with consistent OS, similar to that observed in pivotal clinical trials. GS, median time under first-line ADT and number of chemotherapy lines before CBZ did not influence clinical benefit. CBZ has an acceptable safety profile. Funding: Sanofi [Table: see text]
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Affiliation(s)
| | - Nuria Lainez
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | | | | | | | | | - Emilio Esteban
- Hospital Universitario Central de Asturias, Oviedo, Spain
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Delanoy N, Angelergues A, Efstathiou E, Gyftaki R, Wysocki PJ, Lainez N, Gonzalez I, Castellano DE, Ozguroglu M, Garcia Carbonero I, Flechon A, Borrega P, Guillot A, Campos Balea B, Le Moulec S, Esteban E, Munarriz J, Barker C, Birtle AJ, Oudard S. Sequencing in metastatic castration-resistant prostate cancer (mCRPC): Updated results of the FLAC International Database. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
267 Background: Optimal sequencing of new androgen-receptor targeted agents (ART) abiraterone and enzalutamide with docetaxel (DOC) and cabazitaxel (CABA) is unknown. In this large retrospective cohort of mCRPC patients (pts) treated with CABA after docetaxel (DOC), we evaluated the impact of 3 different sequences: DOC → CABA (group 1, n = 267) Or DOC → ART → CABA (group 2, n = 183) Or DOC → CABA → ART (group 3, n = 124). Methods: Records of 574 consecutive mCRPC patients were retrospectively collected in 44 centres in 6 European countries (France, Spain, UK, Greece, Poland, Turkey) from August 2012 to July 2016. Disease history and clinical characteristics at initiation of DOC therapy and outcomes were collected. Factors influencing OS were evaluated using multivariate stepwise logistic regression. Results: At DOC initiation, median age was 67 years, 83% of pts were ECOG 0-1, 45.1% had pain and 10.8% had visceral metastases. Median number of DOC cycles was 7 (6 in group 2, 7 in groups 1 and 3). Median number of CABA cycles was 6 (6 in groups 1 and 2, 7 in group 3). Median duration of ART treatment was 5.9 and 4.4 mths in groups 2 and 3, retrospectively. Median OS from first DOC cycle were 30.1, 37.1 and 40.1 mths in groups 1, 2 and 3, respectively. Factors influencing OS are summarized in the table below. Conclusions: Results of this retrospective cohort suggest that patients receiving DOC → CAB → ART show the greatest OS. High baseline PSA, short response to first-ADT and clinical progression of pts are major prognostic factors of OS at DOC initiation. The window of opportunity for chemotherapy should not be missed. [Table: see text]
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Affiliation(s)
- Nicolas Delanoy
- Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France
| | - Antoine Angelergues
- Department of Medical Oncology, Hopital Europeen Georges Pompidou, Paris, France
| | - Eleni Efstathiou
- Alexandra General Hospital of Athens, University of Athens, Athens, Greece
| | - Revekka Gyftaki
- Oncology Department, Department of Clinical Therapeutics, Alexandra General Hospital of Athens, Athens, Greece
| | | | - Nuria Lainez
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Iria Gonzalez
- University Hospital del Mar - IMIM, Barcelona, Spain
| | | | | | | | | | | | - Aline Guillot
- Institut de Cancerologie Lucien Neurwith, Saint-Etienne, France
| | | | | | - Emilio Esteban
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Claire Barker
- Rosemere Cancer Center, Royal Preston Hospital, Preston, United Kingdom
| | - Alison J. Birtle
- Rosemere Cancer Centre, Royal Preston Hospital, Preston, United Kingdom
| | - Stephane Oudard
- Department of Medical Oncology, Hopital Europeen Georges Pompidou, Paris, France
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Rivera F, Polo Marques E, Aranda E, Fernandez-Martos C, La Casta Munoa A, Guillen C, Lopez R, Gil S, Lema L, Aparicio J, Martinez Villacampa M, Pisa A, Borrega P, Lopez-Vivanco G, Garcia Alfonso P. Aflibercept (Z) in combination with FOLFIRI for second-line treatment of patients (pts) with metastatic colorectal cancer (mCRC): Safety and quality of life (QoL) data from the Spanish subgroup of the Aflibercept Safety and Quality-of-Life Program (ASQoP). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.751] [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
751 Background: In the VELOUR trial, adding Z to FOLFIRI improves OS, PFS and RR in mCRC pts progressing after oxaliplatin ±biologic agents. The ASQoP trial (NCT01571284) was designed to gather safety and QoL data from mCRC in real-life setting. We report data collected by the Spanish investigators. Methods: ASQoP is single-arm, open-label trial evaluating safety and QoL of Z in mCRC pts as 2nd line. Eligible pts received Z (4mg/kg) q2wks on day 1/cycle, followed by FOLFIRI (dosing was at physician’s discretion) until disease progression, unacceptable toxicity, death, or investigator/pt decision. The EQ-5D was used for utility index (UI) measure and the EORTC QLQ-C30 as generic cancer instrument. QoL population consisted of pts completing the questionnaire at baseline and ≥1 assessment post-baseline and received ≥1 part of 1 dose of study treatment. Results: The safety population comprised 77 pts with ≥1 completed cycle of treatment. Grade (G)3/4 AEs were reported in 72.7% of pts (vs 83.5% in VELOUR), being G3 most commonly reported. There was no G4 hypertension, stomatitis, or proteinuria. G4 Diarrhea was found in 1.3% of pts. Mean baseline UI was 0.7 (95% CI, 0.63-0.78) in 51 pts, and remained relatively stable at cycles 3 (n=39) and 7 (n=24), with a mean (±SD) change from baseline of 0.03 (±0.26) and -0.06 (±0.35), respectively. Mean baseline global health status score was 63.1 (95% CI, 55.8-70.4) in 54 pts, and remained stable up to cycle 9 with a mean (±SD) change from baseline of 4.17 (±38). Conclusions: Thisanalysis has identified no new safety signals and suggests an acceptable toxicity profile with a relatively stable UI and QoL in Spanish mCRC pts in the real-life setting. [Table: see text]
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Affiliation(s)
- Fernando Rivera
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | | | | | | | | | - Carmen Guillen
- Medical Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
| | - Rafael Lopez
- Hospital Clinico Universitario de Santiago de Compostela, Santiago De Compostela, Spain
| | - Silvia Gil
- H. Universitario Carlos Haya, Malaga, Spain
| | - Laura Lema
- Hospital 12 de Octubre Avda de Cordoba, Madrid, Spain
| | - Jorge Aparicio
- Hospital Universitario y Politecnico de La Fe, Valencia, Spain
| | | | - Aleydis Pisa
- Institut Oncologic del Valles, Corporacio Sanitària Parc Tauli, Consorci Sanitari de Terrassa, Sabadell, Spain
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Muñoz-Langa J, Borrega P, García-Bueno J, Purificación Martínez del Prado P, Campos J, Quindos M, López Castro R, Valentí Moreno V, Jiménez Orozco E, Lazaro M. Risk model for clinically relevant neutropenic event among patients with non hematological tumors receiving chemotherapy regimens not classified as high-risk for febrile neutropenia: results from a multicenter prospective cohort study (NEURISK). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Sánchez LM, Antón FM, Perón YI, De Mingorance JI, Borrega P, González ME, Martínez N, González AL, Olier C, García AB, Chacón I, Ciruelos E, García-Sáenz J, Paz-Ares L. Single arm, multicentre, non-randomized open-label trial to evaluate the safety of eribulin in third line chemotherapy in patients with HER2-negative metastatic or locally advanced breast cancer previously treated with anthracyclines and taxanes: Onsite study (ONCOSUR 2012-02). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Seguí-Palmer MA, Martinez Janez N, Blanco E, Batista JN, Munoz M, Rodriguez CA, Fernandez I, Jerez Y, Garau I, Amillano K, Garcia C, Perello A, Santaballa A, Borrega P, Salvador J, Garcia A, Ruiz M, Pellin L, Andres R. Time to definitive deterioration in patients with metastatic breast cancer subjected to second-line monochemotherapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e12504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Montserrat Munoz
- H. Clínic de Barcelona y Genómica Traslacional y Terapias Dirigidas en Tumores Sólidos, Barcelona, Spain
| | | | | | - Yolanda Jerez
- Hospital Universitario Gregorio Marañon, Madrid, Spain
| | | | - Kepa Amillano
- Hospital Universitari de Sant Joan de Reus, Tarragona, Spain
| | - Carlos Garcia
- Complejo Asistencial de Burgos, Hospital General Yagüe, Burgos, Spain
| | | | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | - Andres Garcia
- Complejo Asistencial de León, Hospital de León, Leon, Spain
| | - Manuel Ruiz
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Raquel Andres
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
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Puente J, Gonzalez del Alba A, Sala N, Méndez-Vidal MJ, Pinto A, Rodriguez Sanchez A, Cuevas Sanz JM, Guma J, Borrega P, Molins C, García Domínguez R, Basterrechea L, López Jiménez A, Gonzalez-Billalabeitia E, Crespo G, Domenech M, Cabrera Suárez MÁ, Luque R, Ruiz P, Vazquez-Estevez S. Novel agents’ sequencing following first-line docetaxel in mCRPC patients: CAPRO study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.2_suppl.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
229 Background: Novel agents, such as abiraterone (A), cabazitaxel (CZ), and enzalutamide are currently available for the treatment of docetaxel (D)-treated metastatic castration resistant prostate cancer (mCRPC). The sequencing approach following D progression is still unknown. We now explore which factors are driving sequencing decisions in routine clinical practice in Spain. Methods: A prospective multicenter national observational descriptive study collecting data of 2nd line (L) treatments in mCRPC patients to analyze responses and progression to 1stL D. Results: 149 patients have been recruited from July 2013 to January 2015. Median age was 72 (48-89). Median D cycles was 6 (1-24), and median dose: 75 mg/m2 (30-75). 24 patients (16%) required dose reduction. The reasons for D ending were treatment completion (40%, n = 60), toxicity (15.3%, n = 23), progression (radiological, biochemical, clinical; 42%, n = 63), or others (2.7%, n = 4). 67% (n = 100) of the patients received A, 25% (n = 44) CZ, and 8% (n = 5) other treatments as 2ndL. From those who completed or progressed to D (n = 123), 2ndL initiation was mainly determined by two progression criteria (2C; biological and radiological), followed by one progression criteria (1C). This was independent of the 2ndL treatment chosen, and it was observed in similar ratios in both A (2C: 50%, n = 39; 1C: 37.2%, n = 29) and CZ (2C: 62.5%, n = 25; 1C: 27.5%, n = 11). Nevertheless, A was predominantly given when patients progressed after D ending, whereas CZ was mostly given when progressing during D (Table 1). Conclusions: A is the 2ndL treatment of choice in routine clinical practice in Spain, independent of the type and time of progression. CZ is preferentially used in patients progressing during D treatment. [Table: see text]
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Affiliation(s)
- Javier Puente
- Hospital Clinico Universitario San Carlos, Madrid, Spain
| | | | - Nuria Sala
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Josep Trueta, Girona, Spain
| | | | | | | | | | - Josep Guma
- Hospital Universitari Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | | | | | | | | | | | | | | | | | - Miguel Ángel Cabrera Suárez
- Hospital Universitario Nuestra Señora Candelaria, Medical Oncology Department, Santa Cruz De Tenerife, Spain
| | - Raquel Luque
- Medical Oncology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pedro Ruiz
- Janssen-Cilag Medical Oncology Department, Madrid, Spain
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Arija JA, Pérez-Valderrama B, González-Larriba J, Rodríguez Sánchez A, Chirivella I, Pinto A, Marrero RG, Rubio G, García JJ, Borrega P, Quintela ML, Castellano D, Rodríguez CS, García JM, Lambea-Sorrosal J, Gajate P, Fita MJ, Puertas J, Domínguez RG, Guzmán JV. 2638 Effectiveness of 2nd-line and subsequent therapies after pazopanib (Paz) in patients (pt) with metastatic renal cell carcinoma (mRCC): Final results of the SPAZO study (SOGUG). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31455-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gironés R, Alonso J, Arcusa A, Sánchez A, Barretina P, Borrega P, Cueva J, Alarcón J, Esteban M, Fuentes J, Garcia A, Garrigos L, Guerra E, Herrero A, Lainez N, Maximiano C, Martínez P, González-Martín A. 2774 ROSE study: A retrospective evaluation of clinical management of advanced ovarian cancer (AOC) in Spain by the Spanish Group for Research in Ovarian Cancer (GEICO). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31540-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Perez-Valderrama B, Arija JA, Vidal MM, Carbonero IG, Rodríguez CS, Gallego PJ, López-Brea M, Marrero RG, García JM, Gajate P, Santander C, Palau CM, Parra EF, Torras OR, Basterrechea L, Estévez SV, Borrega P, Sánchez AR, Pinto A, Castellano D. 2602 Pazopanib (Pz) as first line for metastatic renal carcinoma (mRC): Updated validation of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model (IMRCC). The SPAZO study (SOGUG). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31420-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Manso L, Moreno F, Delgado Mingorance JI, Echarri MJ, Lopez-Gonzalez A, Izarzugaza Y, Borrega P, Martínez N, Olier C, Ballesteros Garcia AI, Chacon JI, Ciruelos E, Pascual T, Paz-Ares L. Circulating tumor cells (CTCs) in patients with HER2-negative recurrent or metastatic breast cancer treated with eribulin as third-line therapy: ONSITE trial (OncoSur Analysis of the Treatment in Third Line of ABC with Eribulin). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e22042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Luis Manso
- Medical Oncology Department. Hospital 12 de Octubre, Madrid, Spain
| | | | | | | | | | - Yann Izarzugaza
- Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Clara Olier
- H Universitario Fundación Alcorcón, Alcarcon, Spain
| | | | | | - Eva Ciruelos
- Hospital Universitario 12 De Octubre, Madrid, Spain
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Perez-Valderrama B, Arranz Arija JA, Borrega P, Rodriguez Sanchez A, Pinto A, Castellano DE, Juan Fita MJ, Rubio G, Maximiano Alonso C, Chirivella I, Villa Guzman JC, Puertas JL, García Domínguez R, León Mateos L, Luque R, Lázaro Quintela M, Lambea- Sorrosal JJ, Gonzalez del Alba A, De Mendizabal EV, Gonzalez-Larriba JL. Validation of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model (IMRCC), in patients (pt) treated with pazopanib (Pz) as first line for metastatic renal carcinoma (mRC): First results of the SOGUG SPAZO study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e15597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Luis León Mateos
- Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Raquel Luque
- Medical Oncology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Manso L, Moreno F, Delgado J, Echarri M, López A, Izarzugaza Y, Borrega P, Martínez N, Olier C, Cortes-Funes H. High reduction of circulating tumor cells (CTCs) in patients with HER2-negative recurrent or metastatic breast cancer treated with eribulin as third-line therapy: ONSITE trial (OncoSur Analysis of the Treatment in Third Line of ABC with Eribulin). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv115.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Grávalos C, Salvador J, Albanell J, Barnadas A, Borrega P, García-Mata J, Garrido P, González-Flores E, Isla D, Lomas M, Rodríguez-Lescure Á, Cruz JJ, Alba E. Functions and workload of medical oncologists in Spain. Clin Transl Oncol 2013; 14:423-9. [PMID: 22634530 DOI: 10.1007/s12094-012-0819-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The functions and workload of medical oncologists are becoming increasingly relevant as cancer is a priority health issue in our country. Taking into account the specific characteristics and complexity of caring for cancer patients, the time of physicians attached to Medical Oncology could be distributed as follows: 70% for consultation (including participation in tumour committees and multidisciplinary units), 15% for research and 15% for training, teaching and clinical sessions. The time distribution for Heads of Services or Heads of Units is different, since it must also include their clinical management tasks, team coordination, and relations with other services and institutions. The average time, calculated in minutes, spent on each activity per patient is as follows: first visit and "second visit or results visit" 60-90 min; successive visits at the day hospital 15 min; successive visits of patients for follow-up or checkups 20 min; visits with family members 15-20 min; telephone or e-mail consultations 5-10 min; hospitalisation 20 min; and interconsultation 30-60 min. Also, participation in multidisciplinary committees takes up 60-120 min of an oncologist's time each week. When new technologies such as electronic medical records, e-mail and other software are used, these times increase with a correction factor that is still to be defined and which could vary according to the centre. Finally, the ratio recommended by SEOM is one medical oncologist for every 83 new patients a year.
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Affiliation(s)
- Cristina Grávalos
- Servicio de Oncología Médica, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n - km 5,400, ES-28041 Madrid, Spain.
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Salvador J, Grávalos C, Albanell J, Barnadas A, Borrega P, García-Mata J, Garrido P, Gonzalez-Flores E, Isla D, Lomas M, Rodríguez-Lescure A, Cruz JJ, Alba E. Pilot study on workload estimate in breast cancer, lung cancer and colorectal cancer in a Medical Oncology Service at Valme hospital. Clin Transl Oncol 2012; 14:820-6. [PMID: 22855162 DOI: 10.1007/s12094-012-0873-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 01/18/2012] [Indexed: 11/26/2022]
Abstract
New advances in the diagnosis and treatment of cancer and the increased incidence and prevalence of this disease have led to an increase in the number and duration of visits in Medical Oncology in the last few years. Based on the functions of a medical oncologist and the time recommended for each work activity established by the Spanish Society of Medical Oncology (SEOM), we carried out a pilot study on the three most frequent neoplasias in our country [breast cancer (BC), lung cancer (LC) and colorectal cancer (CRC)], in order to determine the real time each patient requires from a physician and thus establish a recommendation on the number of medical oncologists necessary. Using the actual itinerary of the first 20 patients of 2009 in each of the three neoplasias seen at the Medical Oncology Service of the Virgen de Valme University Hospital, we measured the number of visits, the antineoplastic treatments received, the number of hospital admissions and average length of stay. During the years following the study, these data were estimated based on the natural history of each neoplasia. During the first year, the average time spent by the medical oncologist was 235, 390 and 265 min on each outpatient with BC, LC and CRC, respectively. In hospitalisation, the average oncologist/patient minutes were 40, 360 and 118 for BC, LC and CRC, respectively. Finally, the time spent on each visit or day of hospitalisation was that recommended by the SEOM, achieving an ultimate ratio of 1 oncologist for every 83 first visits.
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Affiliation(s)
- Javier Salvador
- Servicio de Oncología Médica, Avda. Cádiz s/nº, 41014, Sevilla, Spain.
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Gámez-Pozo A, Anton-Aparicio L, Bayona C, Borrega P, Cornide M, Garcia R, de Portugal T, Ramos M, Perez-Carrion R, Espinosa E. 7160 POSTER MicroRNA Profiling in Peripheral Blood Predicts Major Response to Sunitinib in Metastatic Renal Cell Carcinoma. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72075-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gámez-Pozo A, Antón Aparicio LM, Bayona C, Borrega P, Gallegos I, García Domínguez R, de Portugal T, Ramos M, Perez Carrion RM, Sánchez-Navarro I, Benguría A, Dopazo A, Madero R, Fresno-Vara JA, Bolos MV, Espinosa E. The role of microRNA profiling in peripheral blood in predicting early progression to sunitinib in renal cell carcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Feliu J, Borrega P, León A, López-Gómez L, López M, Castro J, Belda-Iniesta C, Barriuso J, Martínez V, González-Barón M. Phase II study of a fixed dose-rate infusion of gemcitabine associated with erlotinib in advanced pancreatic cancer. Cancer Chemother Pharmacol 2010; 67:215-21. [PMID: 20927525 DOI: 10.1007/s00280-010-1472-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 09/13/2010] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate the feasibility, toxicity and efficacy of the combination regimen consisting of gemcitabine-FDR infusion plus erlotinib, in ACP patients. METHODS Forty-two patients with histologically confirmed, locally advanced or metastatic pancreatic cancer were included in this phase II trial. Main objectives were to assess the efficacy and safety of this regimen. Therapeutic regimen consisted of gemcitabine 1,200 mg/m(2) in 120-min infusion on days 1, 8 and 15, plus erlotinib 100 mg orally once daily. Cycles were repeated every 28 days. RESULTS A total of 160 courses of gemcitabine-FDR erlotinib were administered (median 3.8 courses per patient). The most common grade 3-4 AEs were neutropenia (21%), thrombocytopenia (10%), skin rash (10%) and asthenia (10%). Complete response was achieved in one patient (2%) and 11 (26%) achieved a partial response. Stable disease and progression disease were observed in 11 patients (26%) and 19 (45%), respectively. Median time to progression was 5 months (95%CI: 3.9-5.8 months) and median overall survival was 8 months (95% CI: 5.1-10.8). One-year survival rate was 35%. CONCLUSIONS A regimen consisting of gemcitabine-FDR infusion plus erlotinib is active and well tolerated in APC patients. However, the results do not justify the conduct of a Phase III trial.
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Affiliation(s)
- J Feliu
- Medical Oncology Department, Hospital Universitario La Paz, IDIPAZ, Pº de Castellana 261, 28046 Madrid, Spain.
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Gonzalez-Santiago S, Zárate R, Haba-Rodríguez J, Gómez A, Bandrés E, Moreno S, Borrega P, García-Foncillas J, Aranda E. CYP2D6*4 polymorphism as blood predictive biomarker of breast cancer relapse in patients receiving adjuvant tamoxifen. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.590] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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
590 Background: Polymorphisms in cytochrome P450 2D6 gene affect the plasma concentration of tamoxifen active metabolites (endoxifen). Some drugs are known to be CYP2D6 inhibitors. We aim to determine the relationship between CYP2D6*4 polymorphisms, concomitant CYP2D6 inhibitors use and clinical outcomes of breast cancer patients receiving adjuvant tamoxifen (TAM). Patients and Methods: CYP2D6*4 (1934 G>A+1) genotype was determinated from DNA of blood samples using PCR-RFLP technique and Taqman Allelic Discrimination Assay in a series of 84 breast cancer patients receiving adjuvant TAM. CYP2D6 inhibitors were recorded. Chi-square test and logistic regression models were used to determinate association between genotype, use of concomitant CYP2D6 inhibitors and disease relapse rate. Results: In our 84 patients series mean age was 51.5y. (33–71). 14.8% were stage I, 58.0% stage II and 27.2% stage III. 61.4% were nodes positive and 98.7% tumors had positive hormonal receptors. We observed disease recurrence in 36.9% of cases. The mean following-up was 5.5 y. Genotype frequency was: wt/wt (57.1%), wt/*4 (40.5%) and *4/*4 (2.4%). 50% (18 of 36) of patients with the wt/*4 + *4/*4 genotypes had disease relapse compared with 27% (13 of 48) with wt/wt genotype (P= 0.041). Only 6 patients received concomitants CYP2D6 inhibitors, mainly antidepressants, all of them with the wt/*4 genotype. 50% presented disease relapse. Clinical pathological variables were evaluated and significant relation was found between stage and disease relapse by univariate analysis (P= 0.001). We investigated whether CYP2D6*4 genotype and stage to diagnosis could influence in disease relapse. For these analyses we use as reference group the genotype wt/wt. We observed that combined genotype wt/*4 + *4/*4 was more strongly associated with disease recurrence than wt/wt genotype (adjusted hazard ratio [HR], 2.82, 95% confidence interval [CI] 1.0- 7.9) P= 0.049. Conclusions: Breast cancer patients with the CYP2D6 *4/*4 or wt/*4 genotype could have lower benefit of TAM adjuvant treatment and tend to have a higher risk of disease relapse. Pre-treatment CYP2D6 genotype determination from blood sample could predicts TAM clinical outcomes and help to oncologist in treatment decision. No significant financial relationships to disclose.
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Affiliation(s)
- S. Gonzalez-Santiago
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
| | - R. Zárate
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
| | - J. Haba-Rodríguez
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
| | - A. Gómez
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
| | - E. Bandrés
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
| | - S. Moreno
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
| | - P. Borrega
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
| | - J. García-Foncillas
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
| | - E. Aranda
- Hospital San Pedro de Alcántara, Caceres, Spain; Navarra University Clinic, Pamplona, Spain; Reina Sofia University Hospital, Córdoba, Spain
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Lorenzo A, Madroñal C, Sanz JJ, Centelles M, Ruiz López M, Casas A, Pérez VG, González de la Puente C, García López MJ, Borrega P. Phase II study of dose-dense docetaxel (T) and epirubicin (E) as neoadjuvant treatment for locally advanced breast cancer (LABC). An ONCOPAZ Cooperative Group study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Lorenzo
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - C. Madroñal
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - J. J. Sanz
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - M. Centelles
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - M. Ruiz López
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - A. Casas
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - V. G. Pérez
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - C. González de la Puente
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - M. J. García López
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
| | - P. Borrega
- Hosp de Puerto Real, Cádiz, Spain; Inst de Oncología Corachan, Barcelona, Spain; Hosp San Jorge, Huesca, Spain; Hosp Sagrat Cor, Barcelona, Spain; Hosp Punta Europa, Algeciras, Spain; Hosp Virgen del Rocío, Sevilla, Spain; Hosp Virgen de la Arritxaca, Murcia, Spain; Hosp Nuestra Señora de Alarcos, Ciudad Real, Spain; Hosp San Pedro de Alcántara, Huesca, Spain
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Arranz Arija JA, González Beca R, Velasco A, Borrega P, Siso I, Abad G, Pachon V, Iglesias L. Feasibility phase II study of pegylated liposomal doxorubicin (PLD) and weekly paclitaxel-carboplatin (wTC), as first line therapy for patients with advanced ovarian carcinoma suboptimally debulked. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. A. Arranz Arija
- Hosp Gregorio Maranon, Madrid, Spain; Hosp de la Princesa, Madrid, Spain; H San Pedro de Alcántara, Caceres, Spain
| | - R. González Beca
- Hosp Gregorio Maranon, Madrid, Spain; Hosp de la Princesa, Madrid, Spain; H San Pedro de Alcántara, Caceres, Spain
| | - A. Velasco
- Hosp Gregorio Maranon, Madrid, Spain; Hosp de la Princesa, Madrid, Spain; H San Pedro de Alcántara, Caceres, Spain
| | - P. Borrega
- Hosp Gregorio Maranon, Madrid, Spain; Hosp de la Princesa, Madrid, Spain; H San Pedro de Alcántara, Caceres, Spain
| | - I. Siso
- Hosp Gregorio Maranon, Madrid, Spain; Hosp de la Princesa, Madrid, Spain; H San Pedro de Alcántara, Caceres, Spain
| | - G. Abad
- Hosp Gregorio Maranon, Madrid, Spain; Hosp de la Princesa, Madrid, Spain; H San Pedro de Alcántara, Caceres, Spain
| | - V. Pachon
- Hosp Gregorio Maranon, Madrid, Spain; Hosp de la Princesa, Madrid, Spain; H San Pedro de Alcántara, Caceres, Spain
| | - L. Iglesias
- Hosp Gregorio Maranon, Madrid, Spain; Hosp de la Princesa, Madrid, Spain; H San Pedro de Alcántara, Caceres, Spain
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Espinosa E, Morales S, Borrega P, Casas A, Madroñal C, Machengs I, Illarramendi JA, Lizón J, Moreno JA, Belón J, Janáriz J, de la Puente M, Checa T, Mel JR, González Barón M. Docetaxel and high-dose epirubicin as neoadjuvant chemotherapy in locally advanced breast cancer. Cancer Chemother Pharmacol 2004; 54:546-52. [PMID: 15316749 DOI: 10.1007/s00280-004-0830-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2003] [Accepted: 03/29/2004] [Indexed: 11/29/2022]
Abstract
PURPOSE Epirubicin and docetaxel are two of the most active drugs against breast carcinoma. As the achievement of a pathological complete response (pCR) is important for survival of patients with locally advanced disease, we used both drugs as neoadjuvant chemotherapy. PATIENTS AND METHODS Women with locally advanced or inflammatory breast cancer received epirubicin 120 mg/m2 followed by docetaxel 75 mg/m2, both on day 1, every 21 days for four cycles. Lenograstim was administered for 10 days in all cycles. RESULTS Of 51 patients included, 50 received a total of 188 cycles, with a median of 4 per patient. The median age was 47 years, tumour stage was IIIA in 14 patients and IIIB in 36. Oestrogen receptors were positive in 65% of tumours. There were 10 clinical complete responses (20%) and 29 partial responses (58%). Surgery consisted of mastectomy in 40 patients and tumorectomy in 6. After surgery, 9 pCR were recorded (18%). One patient progressed and died soon after the end of chemotherapy. After a median follow-up of 22 months, the median disease-free survival was 33.7 months. Grade 3/4 neutropenia was observed in 32% of patients, anaemia in 6%, and thrombocytopenia in 4%. Five patients had febrile neutropenia. There were no toxic deaths or grade 4 nonhaematological toxicities. CONCLUSIONS Docetaxel plus high-dose epirubicin showed promising activity in patients with locally advanced and inflammatory breast cancer, at the cost of moderate toxicity.
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Affiliation(s)
- E Espinosa
- Oncopaz Cooperative Group, Madrid, Spain.
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Borrega P, Lorenzo A, Madroñal C, Sanz JJ, Ruiz M, Centelles M, Casas A, González de La Puente C, Perez V, González-Barón M. Dose-dense neoadjuvant treatment with biweekly docetaxel (T) plus epirubicin (E) for locally advanced breast cancer (LABC). An ONCOPAZ Cooperative Group Study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. Borrega
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - A. Lorenzo
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - C. Madroñal
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - J. J. Sanz
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - M. Ruiz
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - M. Centelles
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - A. Casas
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - C. González de La Puente
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - V. Perez
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
| | - M. González-Barón
- Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital de Puerto Real, Cádiz, Spain; Instituto de Oncología Corachan, Barcelona, Spain; Hospital San Jorge, Huesca, Spain; Hospital Punta Europa, Algeciras, Spain; Hospital Sagrat Cor, Barcelona, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Nuestra Señora de Valme, Sevilla, Spain; Hospital Univ Virgen de la Arritxaca, Murcia, Spain; Hospital La Paz, Madrid, Spain
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Borrega P, Velasco A, Bolaños M, del Mar Perez M, Mel JR, Reina JJ, Rodríguez-Jaraiz MA, Chaves M, González-Barón M. Phase II trial of vinorelbine and estramustine in the treatment of metastatic hormone-resistant prostate cancer. Urol Oncol 2004; 22:32-5. [PMID: 14969801 DOI: 10.1016/s1078-1439(03)00102-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2003] [Revised: 05/19/2003] [Accepted: 06/16/2003] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to investigate the efficacy and safety of combination chemotherapy using estramustine and vinorelbine in chemotherapy-naïve patients with hormone-resistant prostate cancer (HRPC). The patients (n = 54) received oral estramustine 840 mg/day on Days 1 to 14 and IV vinorelbine 25 mg/m(2) on Days 1 and 8 of every 3 wk cycle. The median number of cycles per patient was 9 (range, 1 to 27). Fifty-three patients were evaluable for toxicity and survival and 52 for prostate specific antigen (PSA) response. Median age was 68 (range, 46-80). PSA sustained decrease >50% was seen in 52% of patients (95% CI: 38-66%). A complete response was seen in 3 and a partial response in 12 of 25 patients with measurable disease, for an overall objective response of 60% (95% CI: 41-79%). Improvement in performance status was observed in 30 out of 43 evaluable for clinical benefit response. The median duration of response was 7 mo and median time to progression was 6 mo. The median survival time was 15 mo. The most common adverse event was mild gastrointestinal toxicity. In general, toxicity G3-4 was low: granulocytopenia Grade 3-4 (8%), thrombocytopenia Grade 3 (6%), and anemia Grade 3 (13%). Other Grade 3 toxicities included deep vein thrombosis (4%), hepatic (2%), cardiac ischemia (2%), fatigue (6%), and sensory neuropathy (2%). There were 2 treatment-related deaths (4%). We conclude that vinorelbine and estramustine as used in this trial is an efficacious and well-tolerated therapeutic regimen in the management of HRPC.
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Reina JJ, Aparicio J, Salvador J, Pica JMP, Rueda A, Lorenzo A, de la Puente CG, Borrega P, Moreno-Nogueira JA. A multicenter phase II study of irinotecan (CPT-11) alternated with 5-fluorouracil and leucovorin as first-line treatment of patients with metastatic colorectal cancer. Cancer Chemother Pharmacol 2003; 52:339-45. [PMID: 12851783 DOI: 10.1007/s00280-003-0601-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2002] [Accepted: 02/12/2003] [Indexed: 11/26/2022]
Abstract
PURPOSE In this multicenter phase II study the efficacy and safety of the alternating schedule of irinotecan (CPT-11) with bolus 5-fluorouracil (5-FU) and leucovorin (LV) were assessed as first-line chemotherapy in patients with metastatic colorectal cancer (CRC). PATIENTS AND METHODS Enrolled in the study were 43 patients with advanced CRC. They received CPT-11 350 mg/m2 i.v. on day 1, alternating with LV 20 mg/m2 i.v. and 5-FU 425 mg/m2 i.v. daily for five consecutive days, on days 22-26 (Mayo Clinic regimen). One cycle consisted of 6 weeks. RESULTS A total of 179 cycles were administered with a median of four per patient (range one to nine). Efficacy was analyzed on an intention-to-treat basis. The overall objective response rate was 30% (95% CI 16-44), with four complete responses and nine partial responses, whereas 20 patients (4%) showed stable disease. The median time to disease progression was 9.0 months and median survival was 18.5 months. Grade 3/4 diarrhea was mainly related to CPT-11 rather than to 5-FU (9.3% vs 4.7% of patients), whereas grade 3/4 neutropenia was higher during 5-FU administration (16.3% vs 7.0% of patients). CONCLUSIONS The alternating schedule of CPT-11 with 5 days bolus of 5-FU and low-dose LV showed a clinical benefit in terms of tumor growth control as first-line treatment of patients with metastatic CRC. The overall safety data confirmed this alternating combination as a well-tolerated treatment.
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Feliu J, Mel R, Borrega P, López Gómez L, Escudero P, Dorta J, Castro J, Vázquez-Estévez SE, Bolaños M, Espinosa E, González Barón M. Phase II study of a fixed dose-rate infusion of gemcitabine associated with uracil/tegafur in advanced carcinoma of the pancreas. Ann Oncol 2002; 13:1756-62. [PMID: 12419748 DOI: 10.1093/annonc/mdf286] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The objectives of this study were to evaluate the efficacy and toxicity of a fixed dose-rate infusion of gemcitabine associated with uracil/tegafur (UFT) in patients with advanced adenocarcinoma of the pancreas. PATIENTS AND METHODS Forty-three chemotherapy-naïve patients with adenocarcinoma of the pancreas were included in this phase II study. All of whom had a Karnofsky performance status >or=50 and bi-dimensionally measurable disease (either advanced non-resectable or metastatic); median age 59 years (range 39-77); male:female ratio 29:14. Eight patients (19%) had locally advanced disease and 35 (81%) distant metastases. Treatment consisted of gemcitabine 1200 mg/m(2) given as a 120-min infusion weekly for 3 consecutive weeks, plus oral UFT 400 mg/m(2)/day (in 2-3 doses per day) on days 1-21, cycles were given every 28 days. Measurements of efficacy included response rate, clinical benefit response, time to disease progression and overall survival. RESULTS A total of 192 cycles of chemotherapy were delivered with a median of four per patient. There were two complete responses (5%) and 12 partial responses (28%), producing an overall response rate of 33% [95% confidence interval (CI) 16% to 49%]. Thirteen patients (30%) had stable disease, whereas 16 (37%) had a progression. The median time to progression was 6 months and the median overall survival was 11 months. Twenty-five patients (64%, 95% CI 47% to 78%) experienced a clinical benefit response. Grade 3-4 WHO toxicities were: neutropenia in nine patients (21%); thrombocytopenia in four (9%); anaemia in five (12%); diarrhoea in four (9%); and asthenia in one (2%). CONCLUSIONS A fixed dose-rate infusion of gemcitabine associated with UFT was well tolerated and showed promising activity in patients with locally advanced or metastatic carcinoma of the pancreas. This is an appropriate palliative treatment in this setting.
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Affiliation(s)
- J Feliu
- Services of Medical Oncology of the following hospitals, La Paz, Madrid, Spain.
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Arranz Arija J, Gonzalez-Beca R, Velasco A, Perez M, Borrega P, Bolaoos M, Bernal A, Cruz J, Alija V, Martinez-Prado P. Weekly paclitaxel and carboplatin followed by topotecan (TC-TP), as first-line therapy for patients with advanced epithelial ovarian cancer (AOC) suboptimally debulked. Updated preliminary results. Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)81458-1] [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: 10/26/2022]
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Salvador J, Bernabe R, Bolaños M, Borrega P, Valladares M, Cobo M, Reina J, Gomez-Reina M, Gallurt P, Moreno-Nogueira J. A phase II study of biweekly irinotecan (CPT-11) and 5-fluorouracil (5-FU) as first line treatment in advanced or metastatic colorectal cancer (CRC). Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)81582-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fernandez-Aceñero MJ, Galindo M, Bengoechea O, Borrega P, Reina JJ, Carapeto R. Primary malignant lymphoma of the kidney: case report and literature review. Gen Diagn Pathol 1998; 143:317-20. [PMID: 9653914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We report on a 65-year-old white woman who was hospitalized because of symptoms of an acute adrenocortical insufficiency. A CT scan revealed the presence of a large mass in the left kidney that infiltrated the adrenal gland. Fine needle aspiration cytology of the mass under imaging control failed to achieve a correct diagnosis, and nephrectomy was undertaken with a preoperative diagnosis of renal cell carcinoma. However, the frozen section reveals a neoplasm of large lymphoid cells with a diffuse growth pattern. Immunohistochemistry confirms the B-cell nature of the neoplasm (CD20+). The final diagnosis was non-Hodgkin B-cell high grade centroblastic lymphoma (KIEL classification). Postoperative studies failed to show lymph node or bone marrow infiltration by neoplastic cells. We found reports on only 60 malignant lymphomas, considered to be primary to the kidney. They usually affect middle-aged people, can be diagnosed with imaging techniques, and seem to show a better prognosis than other types of lymphoma.
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