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Riveiro-Barciela M, Barreira-Díaz A, Salcedo MT, Callejo-Pérez A, Muñoz-Couselo E, Iranzo P, Ortiz-Velez C, Cedrés S, Díaz-Mejía N, Ruiz-Cobo JC, Morales R, Aguilar-Company J, Zamora E, Oliveira M, Sanz-Martínez MT, Viladomiu L, Martínez-Gallo M, Felip E, Buti M. An algorithm based on immunotherapy discontinuation and liver biopsy spares corticosteroids in two thirds of cases of severe checkpoint inhibitor-induced liver injury. Aliment Pharmacol Ther 2024; 59:865-876. [PMID: 38327102 DOI: 10.1111/apt.17898] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/21/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND There are few data on corticosteroids (CS)-sparing strategies for checkpoint inhibitor (ICI)-induced liver injury (ChILI). AIM We aimed to assess the performance of a 2-step algorithm for severe ChILI, based on ICI temporary discontinuation (step-1) and, if lack of biochemical improvement, CS based on the degree of necroinflammation at biopsy (step-2). METHODS Prospective study that included all subjects with grade 3/4 ChILI. Peripheral extended immunophenotyping was performed. Indication for CS: severe necroinflammation; mild or moderate necroinflammation with later biochemical worsening. RESULTS From 111 subjects with increased transaminases (January 2020 to August 2023), 44 were diagnosed with grade 3 (N = 35) or grade 4 (N = 9) ChILI. Main reason for exclusion was alternative diagnosis. Lung cancer (13) and melanoma (12) were the most common malignancies. ICI: 23(52.3%) anti-PD1, 8(18.2%) anti-PD-L1, 3(6.8%) anti-CTLA-4, 10(22.7%) combined ICI. Liver injury pattern: hepatocellular (23,52.3%) mixed (12,27.3%) and cholestatic (9,20.5%). 14(32%) presented bilirubin >1.2 mg/dL. Overall, 30(68.2%) patients did not require CS: 22(50.0%) due to ICI discontinuation (step-1) and 8/22 (36.4%) based on the degree of necroinflammation (step-2). Biopsy mainly impacted on grade 3 ChILI, sparing CS in 8 out of 15 (53.3%) non-improvement patients after ICI discontinuation. CD8+ HLA-DR expression (p = 0.028), central memory (p = 0.046) were lower in CS-free managed subjects, but effector-memory cells (p = 0.002) were higher. Time to transaminases normalisation was shorter in those CS-free managed (overall: p < 0.001, grade 3: p < 0.001). Considering our results, a strategy based on ICI discontinuation and biopsy for grade 3 ChILI is proposed. CONCLUSIONS An algorithm based on temporary immunotherapy discontinuation and biopsy allows CS avoidance in two thirds of cases of severe ChILI.
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Affiliation(s)
- Mar Riveiro-Barciela
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- CIBERehd, Instituto Carlos III, Barcelona, Spain
| | - Ana Barreira-Díaz
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - María-Teresa Salcedo
- Human Pathology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Ana Callejo-Pérez
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Eva Muñoz-Couselo
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Patricia Iranzo
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Carolina Ortiz-Velez
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Susana Cedrés
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Nely Díaz-Mejía
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Juan Carlos Ruiz-Cobo
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Rafael Morales
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Juan Aguilar-Company
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Ester Zamora
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Mafalda Oliveira
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - María-Teresa Sanz-Martínez
- Immunology Division, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Translational Immunology Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
- Department of Cell Biology, Physiology and Immunology, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Lluis Viladomiu
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mónica Martínez-Gallo
- Immunology Division, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Translational Immunology Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
- Department of Cell Biology, Physiology and Immunology, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Enriqueta Felip
- Oncology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - María Buti
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- CIBERehd, Instituto Carlos III, Barcelona, Spain
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Cedres S, Valdivia A, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Assaf-Pastrana JD, Felip E, Garrido P. Current State-of-the-Art Therapy for Malignant Pleural Mesothelioma and Future Options Centered on Immunotherapy. Cancers (Basel) 2023; 15:5787. [PMID: 38136333 PMCID: PMC10741743 DOI: 10.3390/cancers15245787] [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: 11/17/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is a locally aggressive disease related to asbestos exposure with a median survival for untreated patients of 4-8 months. The combination of chemotherapy based on platinum and antifolate is the standard treatment, and the addition of bevacizumab adds two months to median survival. Recently, in first-line treatment, immunotherapy combining nivolumab with ipilimumab has been shown to be superior to chemotherapy in the CheckMate-743 study in terms of overall survival (18.1 months), leading to its approval by the FDA and EMA. The positive results of this study represent a new standard of treatment for patients with MPM; however, not all patients will benefit from immunotherapy treatment. In an effort to improve the selection of patient candidates for immunotherapy for different tumors, biomarkers that have been associated with a greater possibility of response to treatment have been described. MPM is a type of tumor with low mutational load and neo-antigens, making it a relatively non-immunogenic tumor for T cells and possibly less susceptible to responding to immunotherapy. Different retrospective studies have shown that PD-L1 expression occurs in 20-40% of patients and is associated with a poor prognosis; however, the predictive value of PD-L1 in response to immunotherapy has not been confirmed. The purpose of this work is to review the state of the art of MPM treatment in the year 2023, focusing on the efficacy results of first-line or subsequent immunotherapy studies on patients with MPM and possible chemo-immunotherapy combination strategies. Additionally, potential biomarkers of response to immunotherapy will be reviewed, such as histology, PD-L1, lymphocyte populations, and TMB.
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Affiliation(s)
- Susana Cedres
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
| | - Augusto Valdivia
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
| | - Patricia Iranzo
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
| | - Ana Callejo
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
| | - Nuria Pardo
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
| | - Alejandro Navarro
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
| | - Alex Martinez-Marti
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
| | - Juan David Assaf-Pastrana
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
| | - Enriqueta Felip
- Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain; (A.V.); (P.I.); (A.C.); (N.P.); (A.N.); (A.M.-M.); (J.D.A.-P.); (E.F.)
- Thoracic Cancers Translational Genomics Unit, Medical Oncology Department, Vall d´Hebron Institute of Oncology (VHIO), Vall d´Hebron Hospital Universitari, 08035 Barcelona, Spain
| | - Pilar Garrido
- Medical Oncology Department, Ramón y Cajal University Hospital, 28034 Madrid, Spain;
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Aparicio I, Iranzo P, Reyes R, Bote H, Saigi M, Bringas M, Bosch-Barrera J, Corral J, Aparisi F, Ruffinelli JC, Jiménez B, Lage Y, López-Castro R, Majem M, Vázquez S, Artal Á, Rodríguez-Pérez Á, Lázaro-Quintela M, Torres JMS, Reguart N, Cucurull M, Gil-Bazo I, Camps C, Nadal E, Del Barrio A, Garrido P, Dómine M, Álvarez R, Muñoz AJ, Calles A. Brief report: High incidence of peridiagnosis thromboembolic events in patients with BRAF-mutant lung cancer. Thromb Res 2023; 232:133-137. [PMID: 37976733 DOI: 10.1016/j.thromres.2023.11.007] [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: 06/12/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION We aimed to determine if advanced BRAF-mutant NSCLC has a higher thromboembolic events (TEE) rate than the expected. METHODS Between 2008 and 2021, 182 patients with BRAF-mutant advanced NSCLC (BRAF V600E, n = 70; BRAF non-V600E, n = 112) were retrospectively identified from 18 centers in Spain. Patients received chemotherapy (n = 147), immunotherapy (n = 69), targeted therapy (n = 42), and immunotherapy + chemotherapy (n = 26). RESULTS Incidence rate of TEE was 26.4 % (95%CI: 19.9 %-32.9 %). A total of 72 TEE were documented among 48 patients, as 18 patients (37.5 %) developed more than one event. Median time to TEE onset was 2 months, 69 % of TEE occurred in the peridiagnostic period (+/- 90 days from cancer diagnosis), and in 16 pts. (33 %) TEE was the form of lung cancer presentation. Although most TEE were only venous (82 %; PE, n = 33; DVT, n = 16), arterial events were reported in 31 % and occurred earlier, or TEE presented in atypical locations (13.9 %). TEE were related to high hospitalization rate (59 %), recurrence (23 %), and mortality (10.4 %) despite appropriate anticoagulant/antiaggregant treatment. Median OS in patients without-TEE was 19.4 months (95%CI: 4.6-34.1), and significantly shorter in patients with arterial-TEE vs venous-TEE vs both of them: 9.9 months (95%CI: 0-23.5) vs 41.7 months (95%CI: 11.3-72.2 m) vs 2.7 months (95%CI: 2.1-3.3), p = 0.001. Neither clinical or molecular features (BRAF V600E/non-V600E), nor cancer treatment was associated to TEE occurrence. Khorana score underperformed to predict thrombosis at cancer diagnosis, as only 19.2 % of patients were classified as high-risk. CONCLUSIONS Thrombotic events represent a new clinical feature of BRAF-mutant lung cancer. Patients with almost a 30 % incidence of TEE should be offered systematic anticoagulation.
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Affiliation(s)
- Inmaculada Aparicio
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Patricia Iranzo
- Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Roxana Reyes
- Medical Oncology Department, Thoracic Oncology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Helena Bote
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain;-H12O-CNIO Lung Cancer Clinical Research Unit, Health Research Institute Hospital Universitario 12 de Octubre (i+12), Madrid, Spain
| | - María Saigi
- Medical Oncology Department, Hospital Germans Trías i Pujol, Institut Català d'Oncologia-ICO, Badalona, Barcelona, Spain
| | - Marianela Bringas
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Joaquim Bosch-Barrera
- Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, 17007 Girona, Spain. Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), 17190, Salt, Spain
| | - Jesús Corral
- Clínica Universidad de Navarra, Department of Oncology, Pamplona, Spain
| | - Francisco Aparisi
- Medical Oncology Department, Hospital General Universitario de Valencia, Department of Medicine, Universitat de València, TRIAL Mixed Unit, Centro Investigación Príncipe Felipe-Fundación Investigación Hospital General Universitario de Valencia. CIBERONC, Valencia, Spain
| | - Jose C Ruffinelli
- Medical Oncology Department, Centre Sanitari i Universitari de Bellvitge, Institut Català d'Oncologia (-ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Yolanda Lage
- Medical Oncology Department; Ramón y Cajal University Hospital, Madrid, Spain
| | | | - Margarita Majem
- Department of Medical Oncology; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sergio Vázquez
- Medical Oncology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Ángel Artal
- Medical Oncology Service, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Ángel Rodríguez-Pérez
- Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Noemí Reguart
- Medical Oncology Department, Thoracic Oncology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Hospital Germans Trías i Pujol, Institut Català d'Oncologia-ICO, Badalona, Barcelona, Spain
| | - Ignacio Gil-Bazo
- Clínica Universidad de Navarra, Department of Oncology, Pamplona, Spain; Instituto Valenciano de Oncología, Department of Oncology, Valencia, Spain
| | - Carlos Camps
- Medical Oncology Department, Hospital General Universitario de Valencia, Department of Medicine, Universitat de València, TRIAL Mixed Unit, Centro Investigación Príncipe Felipe-Fundación Investigación Hospital General Universitario de Valencia. CIBERONC, Valencia, Spain
| | - Ernest Nadal
- Medical Oncology Department, Centre Sanitari i Universitari de Bellvitge, Institut Català d'Oncologia (-ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Pilar Garrido
- Medical Oncology Department; Ramón y Cajal University Hospital, Madrid, Spain
| | - Manuel Dómine
- Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Rosa Álvarez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Andrés J Muñoz
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Antonio Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
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Iranzo P, Callejo A, Arbej J, Menao S, Isla D, Andrés R. [Risk factors for cancer-related cognitive impairment in breast and colorectal cancer patients who undergo chemotherapy]. An Sist Sanit Navar 2023; 46:e1040. [PMID: 37594060 PMCID: PMC10498134 DOI: 10.23938/assn.1040] [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: 11/05/2022] [Revised: 03/28/2023] [Accepted: 06/08/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Our study aims to evaluate the impact of different factors on cancer-related cognitive impairment in patients who undergo chemotherapy. METHODOLOGY Prospective longitudinal single-centre study that included patients with breast and colon carcinoma who underwent chemotherapy as part of their treatment. Clinical and genetic characteristics of the patients (single nucleotide polymorphisms, SNPs) were collected. Patients' neurocognitive status was assessed using eleven validated tests at three time points: before chemotherapy (M0 - baseline), between one and four weeks after completing chemotherapy (M1), and between 24-30 weeks after completing chemotherapy (M2). RESULTS Sixty-two patients were included in this study; 82% were female, median age was 56 years (range 30-74), and 64.5% had been diagnosed with breast cancer. Overall, better cognitive results at M0 were associated with age < 55 years, higher educational level, absence of comorbidities, and the CC variant rs471692 (TOP2A). Significant decline was found between M0 to M1 in the Rey Auditory Verbal Learning Test and the Letter and Number test, with evidence of recovery in M2 compared to M0 regarding the following test: Visual Memory, Functioning Assessment Short Test (FAST), Digit Symbol Substitution and Cube. In the multivariate analysis, being =55 years of age, adjuvant chemotherapy, presence of comorbidities, tobacco and alcohol use, and GT variant rs1800795 were associated with cognitive decline between M0 and M1. CONCLUSION Being =55 years of age, female, presence of comorbidities and basic education level are related to a higher risk of cognitive impairment after chemotherapy.
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Affiliation(s)
| | | | - Julio Arbej
- Servicio de Psiquiatría. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España..
| | - Sebastian Menao
- Servicio de Bioquímica. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España..
| | - Dolores Isla
- Servicio de Bioquímica. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España..
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Cedres S, Serna G, Gonzalez-Medina A, Valdivia A, Assaf-Pastrana JD, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Priano I, Fasani R, Guardia X, Gonzalo J, Carbonell C, Frigola J, Amat R, Navarro V, Dienstmann R, Vivancos A, Nuciforo P, Felip E. Expression of TILs and Patterns of Gene Expression from Paired Samples of Malignant Pleural Mesothelioma (MPM) Patients. Cancers (Basel) 2023; 15:3611. [PMID: 37509274 PMCID: PMC10377125 DOI: 10.3390/cancers15143611] [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: 03/15/2023] [Revised: 05/31/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
MPM is an aggressive disease with an immunosuppressive tumor microenvironment, and interest in exploring immunotherapy in this disease has been increasing. In the first line of treatment, the combination of nivolumab and ipilimumab demonstrated an improvement in survival over chemotherapy. The presence of TILs has been recognized as a marker of antitumor immune response to chemotherapy in solid tumors. The aim of our study is to identify the effect of treatment on immune cells and the immune gene profile in MPM. We investigated the changes in expression of TILs in 10 human MPM paired tumor tissues using immunohistochemistry and gene expression analysis from paired untreated and treated samples. In this small series, we demonstrated that during the evolution of disease without any treatment there was an increase in the inflammatory component in tumor samples. After systemic treatment there was a decrease in the number of TILs. We observed that after systemic treatment or disease progression immune gene signatures were suppressed. Our integrated analysis of paired samples with immune profile and genomic changes on MPM suggested that during the evolution of the disease the immune system tends to switch, turning off with treatment.
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Affiliation(s)
- Susana Cedres
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Garazi Serna
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | | | - Augusto Valdivia
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Juan David Assaf-Pastrana
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Patricia Iranzo
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Ana Callejo
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Nuria Pardo
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Alejandro Navarro
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Alex Martinez-Marti
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Ilaria Priano
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Roberta Fasani
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Xavier Guardia
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Javier Gonzalo
- Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Caterina Carbonell
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Joan Frigola
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Ramon Amat
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Victor Navarro
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Lab, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Enriqueta Felip
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
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Carbonell C, Frigola J, Pardo N, Callejo A, Iranzo P, Valdivia A, Priano I, Cedrés S, Martinez-Marti A, Navarro A, Lenza L, Soleda M, Gonzalo-Ruiz J, Vivancos A, Sansó M, Carcereny E, Morán T, Amat R, Felip E. Dynamic changes in circulating tumor DNA assessed by shallow whole-genome sequencing associate with clinical efficacy of checkpoint inhibitors in NSCLC. Mol Oncol 2023; 17:779-791. [PMID: 36852704 PMCID: PMC10158763 DOI: 10.1002/1878-0261.13409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 03/01/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis are the main therapeutic option for patients with advanced non-small cell lung cancer (NSCLC) without a druggable oncogenic alteration. Nevertheless, only a portion of patients benefit from this type of treatment. Here, we assessed the value of shallow whole-genome sequencing (sWGS) on plasma samples to monitor ICI benefit. We applied sWGS on cell-free DNA (cfDNA) extracted from plasma samples of 45 patients with metastatic NSCLC treated with ICIs. Over 150 samples were obtained before ICI treatment initiation and at several time points throughout treatment. From sWGS data, we computed the tumor fraction (TFx) and somatic copy number alteration (SCNA) burden and associated them with ICI benefit and clinical features. TFx at baseline correlated with metastatic lesions at the bone and the liver, and high TFx (≥ 10%) associated with ICI benefit. Moreover, its assessment in on-treatment samples was able to better predict clinical efficacy, regardless of the TFx levels at baseline. Finally, for a subset of patients for whom SCNA burden could be computed, increased burden correlated with diminished benefit following ICI treatment. Thus, our data indicate that the analysis of cfDNA by sWGS enables the monitoring of two potential biomarkers-TFx and SCNA burden-of ICI benefit in a cost-effective manner, facilitating multiple serial-sample analyses. Larger cohorts will be needed to establish its clinical potential.
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Affiliation(s)
- Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Ana Callejo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Patricia Iranzo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Augusto Valdivia
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Ilaria Priano
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Susana Cedrés
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Alex Martinez-Marti
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Alejandro Navarro
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Laura Lenza
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Mireia Soleda
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Javier Gonzalo-Ruiz
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Laboratory, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Miriam Sansó
- Balearic Islands Health Research Institute (IdISBa), Palma de Mallorca, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Barcelona, Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
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7
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Morgado-Carrasco D, Ibaceta J, Iranzo P, Bosch-Amate X, Mascaró-Galy JM. [Translated article] Excellent Long-term Clinical Response to Rivaroxaban in Livedoid Vasculopathy: A Retrospective Study. Actas Dermosifiliogr 2023; 114:T183-T185. [PMID: 36495940 DOI: 10.1016/j.ad.2022.03.029] [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] [Received: 11/14/2021] [Accepted: 03/10/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J Ibaceta
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - P Iranzo
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - X Bosch-Amate
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J M Mascaró-Galy
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.
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8
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Morgado-Carrasco D, Ibaceta J, Iranzo P, Bosch-Amate X, Mascaró-Galy JM. Excellent Long-term Clinical Response to Rivaroxaban in Livedoid Vasculopathy: A Retrospective Study. Actas Dermosifiliogr 2023; 114:183-185. [PMID: 36115384 DOI: 10.1016/j.ad.2022.03.022] [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] [Received: 11/14/2021] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 02/06/2023] Open
Affiliation(s)
- D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - J Ibaceta
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - P Iranzo
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - X Bosch-Amate
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - J M Mascaró-Galy
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España.
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9
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Cedres S, Cruellas M, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Carbonell C, Frigola J, Amat R, Gonzalo J, Navarro V, Dienstmann R, Balmaña J, Felip E. EP07.01-023 Family History of Cancer in a Series of Malignant Pleural Mesothelioma (MPM) Patients (P). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.555] [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: 11/27/2022]
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10
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Cedres S, Romero L, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Molina G, Garcia-Illescas D, Sanchez L, Rosado J, Carbonell C, Frigola J, Amat R, Gonzalo J, Navarro V, Dienstmann R, Felip E. EP07.01-022 Analysis of Second Surgery for Recurrence in Malignant Pleural Mesothelioma (MPM) Patients (P). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.554] [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]
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11
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Nadal E, Cantero A, Ortega A, Dómine M, Barba A, Blasco A, García J, Mosquera J, Vázquez S, Rodríguez D, López-Castro R, Juan-Vidal O, Sánchez A, Paz-Ares L, Hernández A, Iranzo P, Diz P, Provencio M, Simó M, Navarro V, Bruna J. EP08.01-029 NIVIPI-BRAIN, A Phase II Study of Nivolumab plus Ipilimumab Combined with Chemotherapy for Patients with NSCLC and Synchronous Brain Metastases. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Cedres Perez S, Serna G, Assaf Pastrana JD, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Cabrera Galvez C, Gonzalez-Medina A, Fasani R, Guardia X, Gonzalo J, Carbonell C, Frigola J, Amat R, Vivancos A, Nuciforo P, Felip E. T-cell infiltration in matched samples from malignant pleural mesothelioma (MPM) during evolution of disease. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e20595] [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
e20595 Background: MPM is an aggressive cancer associated with asbestos exposure. Chemotherapy has been a mainstay of therapy and recently immunotherapy has been associated with survival improvements. Chemotherapy and immunotherapy influence the tumor microenvironment and some reports have shown increased of TIL after chemotherapy in MPM. The purpose of this study was to determine dynamic changes in the tumor immune environment during mesothelioma evolution and after systemic therapies in paired samples. Methods: We examined 20 matched formalin-fixed paraffin embedded tissue samples from 10 patients (p) with MPM taken at diagnosis and at disease progression (follow-up), including untreated and treated with chemotherapy or immunotherapy. Tissue densities (number of cells/mm2) of key immune effector cells such as total lymphocytes (CD3), cytotoxic T cells (CD8), regulatory T cells (FOXP3) and monocytes/macrophages (CD163) were quantified by image analysis using multiplexed immunohistochemistry (IHC). PD-L1 expression in both tumor cells and immune cells was analysed by singleplex IHC and quantified using the CPS score. Results: Median age was 62 years (range 53-84), 7 p were male and all p presented epithelioid histology. Three matched samples belong to patients that did not receive any systemic treatment between biopsies and the other 7 pair of samples belong to patients treated with chemotherapy +/- immunotherapy. The median interval between paired biopsies was 12 m (3-33 m). Median overall survival was 27.8 months (1 m-NR). Median densities of T cells and macrophages in diagnostic and matched follow-up samples were: CD3+:982 vs 712; CD8+:422 vs 334, FOXP3+: 22 vs 25 and CD163+: 2086 vs 1706. Median PD-L1 CPS was 2.5 and 4 in diagnostic and follow-up samples, respectively. In p receiving treatment between sample pairs, the median densities in diagnostic and follow-up matched samples were: CD3+:979 vs 407; CD8+:467 vs 225, FOXP3+: 25 vs 15, CD163+: 1583 vs 1508, and PD-L1: 2 and 1. In p without any systemic treatment between sample pairs, the median densities were CD3+:1645 vs 2397; CD8+:376 vs 1605, FOXP3+: 19 vs 121, CD163+: 2102 vs 2377, and PD-L1: 3 vs 25. Conclusions: In our small series with paired samples from MPM p, we observed immune cells infiltration changes during MPM evolution with a trend towards a decrease after systemic therapy. Further investigation in tumor microenvironment in MPM to define the most appropriate time for immunotherapy is needed.
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Affiliation(s)
- Susana Cedres Perez
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Garazi Serna
- Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Juan David Assaf Pastrana
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandro Navarro
- Vall d'Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Alex Martinez-Marti
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Roberta Fasani
- Molecular Oncology Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Xavier Guardia
- Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Gonzalo
- Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Vall d’Hebron University Hospital and Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
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13
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Iranzo P, Callejo A, Assaf JD, Molina G, Lopez DE, Garcia-Illescas D, Pardo N, Navarro A, Martinez-Marti A, Cedres S, Carbonell C, Frigola J, Amat R, Felip E. Overview of Checkpoint Inhibitors Mechanism of Action: Role of Immune-Related Adverse Events and Their Treatment on Progression of Underlying Cancer. Front Med (Lausanne) 2022; 9:875974. [PMID: 35707528 PMCID: PMC9189307 DOI: 10.3389/fmed.2022.875974] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/02/2022] [Indexed: 12/02/2022] Open
Abstract
In recent years, immunotherapy-based regimens have been included into the treatment's algorithm of several cancer types. Programmed death-1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4) interact with their ligands found on the surface of antigen presenting cells (APC) or tumor cells (PD-L1/2 and CD80/86). Through these interactions, stimulatory or inhibitory signals are established. Immune checkpoint inhibitors (ICIs), block these interactions, and when administered not only as monotherapy but also as part of combination regimens, have shown to improve survival results in multiple advanced cancers leading to an increasing number of patients treated with ICI and, as a consequence, a rise in the number of patients developing immune-related adverse events (irAEs). Presence of irAEs has been associated with greater benefit from treatment, especially when blocking PD-L1. Recent data suggests that treatment benefit persists after discontinuation of ICIs due to a treatment related adverse event, regardless of the grade. Patients experiencing grade 3-4 irAEs are at risk of toxicity recurrence after reintroducing immunotherapy and therefore, the decision to resume the treatment is challenging. In these cases, a multidisciplinary approach is always needed and several factors should be considered. Management of severe toxicities may require systemic corticosteroids which can impact on T-cell function. Due to their immunosuppressive properties, it is necessary to deeper determine how corticosteroids influence responses. In terms of overall survival (OS), the use of steroids as therapy for irAEs seems not to reduce OS and several studies have reported durable responses in patients experiencing autoimmune toxicities treated with corticosteroids.
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Affiliation(s)
- Patricia Iranzo
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Ana Callejo
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Juan David Assaf
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Gaspar Molina
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Daniel Esteban Lopez
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - David Garcia-Illescas
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Nuria Pardo
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Alejandro Navarro
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Alex Martinez-Marti
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Susana Cedres
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
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14
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Frigola J, Carbonell C, Iranzo P, Pardo N, Callejo A, Cedres S, Martinez-Marti A, Navarro A, Soleda M, Jimenez J, Hernandez-Losa J, Vivancos A, Felip E, Amat R. High levels of chromosomal aberrations negatively associate with benefit to checkpoint inhibition in NSCLC. J Immunother Cancer 2022; 10:jitc-2021-004197. [PMID: 35477861 PMCID: PMC9047699 DOI: 10.1136/jitc-2021-004197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) targeting the programmed cell death 1/programmed death-ligand 1 axis have transformed the management of advanced non-small cell lung cancer (NSCLC). However, many patients do not benefit from this type of treatment, and thus several molecular biomarkers of benefit have been explored. The value of somatic copy number alterations (SCNAs) burden remains elusive. PATIENTS AND METHODS We assembled a cohort of 109 patients with NSCLC treated with ICIs and available tumor samples. We performed shallow whole-genome sequencing on 89 patients to determine genome-wide SCNAs and targeted gene expression analysis on 63 patients to study immune infiltration. We analyzed SCNAs burden in different ways (ie, the fraction of the genome altered or number of events) and studied their association with ICIs benefit based on survival analysis. We correlated SCNAs burden and immune infiltration on 35 patients of our cohort and on patients with lung adenocarcinoma from The Cancer Genome Atlas (TCGA). RESULTS High SCNAs burden, computed in diverse ways, is negatively associated with ICIs progression-free survival (PFS), with the fraction of the genome altered (FGA) by arm and chromosome events showing the strongest association with PFS (p=0.002) (n=77). Nevertheless, we found differences in SCNAs across some clinicopathological features (sample site origin). A multivariate analysis adjusted for relevant characteristics showed that the FGA of arm and chromosome alterations was strongly associated with PFS (HR=2.21, p=3.3 x 10-5). Finally, we confirmed that SCNAs burden negatively correlates with tumor immune infiltration (n=35), although this correlation was not found for the males studied. Similar results were observed in the TCGA cohort. CONCLUSIONS SCNAs burden is a potential biomarker of benefit to ICIs in patients with NSCLC, although there appear to be some nuances worth consideration. Further studies will be needed to establish its role as a biomarker of benefit to ICIs.
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Affiliation(s)
- Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Nuria Pardo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ana Callejo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Susana Cedres
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Alex Martinez-Marti
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Alejandro Navarro
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mireia Soleda
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Jose Jimenez
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Ana Vivancos
- Cancer Genomics Laboratory, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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15
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Mirallas O, Bosch-Schips M, Pardo N, Aubanell A, Salcedo-Allende MT, Callejo A, Iranzo P, Tabernero J, Felip E. Hepatic Rupture as the Initial Presentation of an EGFR-Mutated Lung Adenocarcinoma: A Case Report. Front Oncol 2022; 12:837630. [PMID: 35433405 PMCID: PMC9005950 DOI: 10.3389/fonc.2022.837630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Hepatic rupture is a rare complication of solid tumor malignancies, notably in lung adenocarcinomas, and carries an extremely poor overall prognosis. Epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma predict benefit with tyrosine kinase inhibitors (TKIs). This case report describes a female patient who presented with a metastatic hepatic rupture and was subsequently diagnosed with EGFR-mutated lung adenocarcinoma. The tumor had an impressive response to TKI inhibitor treatment, reversing her extremely poor, short-term prognosis. We believe this unique case sheds light on the treatment management of hepatic ruptures and supports the high response rate seen with TKIs in EGFR-mutated lung cancers, regardless of the patient’s performance status.
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Affiliation(s)
- Oriol Mirallas
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Marc Bosch-Schips
- Hematology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anton Aubanell
- Radiology Department, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | | | - Ana Callejo
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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16
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Marinello A, Duruisseaux M, Zrafi W, Dall'Olio F, Massa G, Iranzo P, Tabbò F, Guisier F, Lindsay C, Fallet V, Audigier-Valette C, Mezquita L, Calles A, Mountzios G, Tagliamento M, Raimbourg J, Terrisse S, Planchard D, Besse B, Aldea M. 34P RET-MAP: An international multi-center study on clinicopathologic features and treatment response in patients with NSCLC and RET fusions. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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17
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Cedres S, Assaf JD, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Marmolejo D, Rezqallah A, Carbonell C, Frigola J, Amat R, Pedrola A, Dienstmann R, Felip E. Efficacy of chemotherapy for malignant pleural mesothelioma according to histology in a real-world cohort. Sci Rep 2021; 11:21357. [PMID: 34725384 PMCID: PMC8560806 DOI: 10.1038/s41598-021-00831-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/18/2021] [Indexed: 11/09/2022] Open
Abstract
CheckMate 743 trial demonstrated survival benefit of immunotherapy in first line in MPM with some differences in the efficacy of chemotherapy according to histology. The objective of this study is to characterize the impact of chemotherapy according to histology in patients diagnosed with MPM at our institution. Clinical records of all MPM patients diagnosed at Vall d'Hebron University Hospital between November 2002 and April 2020 were reviewed. Associations between clinical variables and outcomes were assessed with Cox regression models. Survival data were calculated by the Kaplan-Meier method. 189 patients were included with 76% of tumors classified as epithelioid subtype. First line chemotherapy was offered to 85% of patients. Median survival in overall population was 21.3 months (95% CI 17.2-24.3). We found that patients with epithelioid tumors had better overall survival (OS) and progression free survival (PFS). Median OS of epithelioid patients treated with first line chemotherapy was 26.7 months versus 15.0 months in non-epithelioid patients (HR 2.25 CI 95% 1.4-3.4; p < 0.001). Median PFS for patients with epithelioid tumors treated with chemotherapy was 4.8 months versus 3.6 months in non-epithelioid (HR 1.5 CI 95% 1.0-2.3; p = 0.03). The improvement of outcomes in patients with epithelioid histology was detected in patients treated with cisplatin or carboplatin. Histology was not a predictive factor for the platinum agent sensitivity (p of interaction PFS = 0.09, p of interaction OS = 0.65). In our series, patients with non-epithelioid tumors presented worse prognosis. Although epithelioid tumors exposed to cisplatin had higher PFS, histology was not a clear predictor of chemotherapy efficacy.
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Affiliation(s)
- Susana Cedres
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
| | - Juan-David Assaf
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandro Navarro
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alex Martinez-Marti
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - David Marmolejo
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandra Rezqallah
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Pedrola
- Oncology Data Science (ODysSey Group), Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science (ODysSey Group), Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Enriqueta Felip
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.,Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Martinez-Marti A, Felip E, Mancuso FM, Caratú G, Matito J, Nuciforo P, Sansano I, Diaz-Mejia N, Cedrés S, Callejo A, Iranzo P, Pardo N, Miquel JM, Navarro A, Vivancos A, Sansó M. Genetic evolution to tyrosine kinase inhibitory therapy in patients with EGFR-mutated non-small-cell lung cancer. Br J Cancer 2021; 125:1561-1569. [PMID: 34599295 DOI: 10.1038/s41416-021-01558-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/31/2021] [Accepted: 09/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tumour heterogeneity impacts the efficacy of metastatic cancer treatment even if actionable mutations are identified. Clinicians need to understand if assessing one lesion provides reliable information to drive a therapeutic decision in non-small-cell lung cancer (NSCLC) patients. METHODS We analysed inter-tumour heterogeneity from five autopsied individuals with NSCLC-harbouring mutations in the epidermal growth factor receptor (EGFR), treated with EGFR tyrosine kinase inhibitors (TKIs). Through a comprehensive next-generation sequencing (NGS) oncopanel, and an EGFR panel for digital droplet PCR (ddPCR), we compared metastases within individuals, longitudinal biopsies from the same lesions and, whenever possible, the primary naive tumour. RESULTS Analysis of 22 necropsies from five patients revealed homogeneity in pathogenic mutations and TKI-resistance mechanisms within each patient in four of them. In-depth analysis by whole-exome sequencing from patient 1 confirmed homogeneity in clonal mutations, but heterogeneity in passenger subclonal alterations. Different resistance mechanisms were detected depending on the patient and line of treatment. Three patients treated with a c-MET inhibitor in combination with TKI lost MET amplification upon progression. CONCLUSION At a given point and under selective TKI pressure, a single metastasis biopsy in disseminated tumours from EGFR-mutated NSCLC patients could provide a reasonable assessment of actionable alterations useful for therapeutic decisions.
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Affiliation(s)
- Alex Martinez-Marti
- Department of Medical Oncology, Vall d'Hebron University Hospital (VHUH), Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.,Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Enriqueta Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital (VHUH), Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.,University of Vic (UVIC) Central University of Catalonia (UCC), Barcelona, Spain
| | | | | | | | | | | | - Nely Diaz-Mejia
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Susana Cedrés
- Department of Medical Oncology, Vall d'Hebron University Hospital (VHUH), Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Department of Medical Oncology, Vall d'Hebron University Hospital (VHUH), Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Department of Medical Oncology, Vall d'Hebron University Hospital (VHUH), Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Department of Medical Oncology, Vall d'Hebron University Hospital (VHUH), Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Alejandro Navarro
- Department of Medical Oncology, Vall d'Hebron University Hospital (VHUH), Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Miriam Sansó
- Cancer Genomics Group, VHIO, Barcelona, Spain. .,Balearic Islands Health Research Institute (IdISBa), Palma de Mallorca, Spain. .,Genomics for Precision Oncology Group, Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain.
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19
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Callejo A, Frigola J, Iranzo P, Carbonell C, Diaz N, Marmolejo D, Assaf JD, Cedrés S, Martinez-Marti A, Navarro A, Pardo N, Amat R, Felip E. Interrelations between Patients' Clinicopathological Characteristics and Their Association with Response to Immunotherapy in a Real-World Cohort of NSCLC Patients. Cancers (Basel) 2021; 13:3249. [PMID: 34209601 PMCID: PMC8268100 DOI: 10.3390/cancers13133249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 12/11/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have transformed non-small cell lung cancer (NSCLC) treatment. Unfortunately, only some patients benefit from these therapies. Thus, certain clinicopathological characteristics of the patients have been proposed as biomarkers of ICIs response. We assembled a retrospective cohort of 262 NSCLC patients treated with ICIs, compiled relevant clinicopathological characteristics, and studied their associations with treatment outcome using Cox proportional-hazards survival models. Additionally, we investigated the interrelations between clinicopathological features and devised a method to create a compendium associated with ICIs response by selecting those that provide non-redundant information. In multivariate analyses, ECOG performance status (hazard ratio (HR) 1.37 (95% CI 1.11 to 1.68), p < 0.005), LDH (HR 1.24 (95% CI 1.03 to 1.48), p = 0.02)) and PD-L1 negativity were associated with decreased PFS (HR 1.92 (95% CI 1.03 to 3.58), p < 0.04), whereas presentation of immune-related adverse events (irAEs) (HR 0.35 (95% CI 0.22 to 0.55, p < 0.005) or females (HR 0.52 (95% CI 0.33 to 0.80, p < 0.005) had longer progression-free survival. Additionally, numerous clinicopathological indicators were found to be interrelated. Thus, we searched for features that provide non-redundant information, and found the combination of LDH levels, irAEs, and gender to have a better association with ICIs treatment response (cross-validated c-index = 0.66). We concluded that several clinicopathological features showed prognostic value in our real-world cohort. However, some are interrelated, and compendiums of features should therefore consider these interactions. Joint assessment of LDH, irAEs, and gender may be a good prognostic compendium.
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Affiliation(s)
- Ana Callejo
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), C/Nazaret 115-117, 08035 Barcelona, Spain; (J.F.); (C.C.)
| | - Patricia Iranzo
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), C/Nazaret 115-117, 08035 Barcelona, Spain; (J.F.); (C.C.)
| | - Nely Diaz
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - David Marmolejo
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Juan David Assaf
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Susana Cedrés
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Alex Martinez-Marti
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Alejandro Navarro
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Nuria Pardo
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), C/Nazaret 115-117, 08035 Barcelona, Spain; (J.F.); (C.C.)
| | - Enriqueta Felip
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
- Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), C/Nazaret 115-117, 08035 Barcelona, Spain; (J.F.); (C.C.)
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Morgado-Carrasco D, Giavedoni P, Mascaró J, Iranzo P. Ultrasound Features of Facial and Extrafacial Granuloma Facial. A Caso Series. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2021.02.002] [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] Open
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Morgado-Carrasco D, Giavedoni P, Mascaró J, Iranzo P. Características ecográficas del granuloma facial y extrafacial. Una serie de casos. Actas Dermo-Sifiliográficas 2021. [DOI: 10.1016/j.ad.2019.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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22
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Riquelme-Mc Loughlin C, Iranzo P. Subcutaneous rituximab for autoimmune bullous diseases. Br J Dermatol 2021; 185:870-871. [PMID: 34009646 DOI: 10.1111/bjd.20493] [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] [Received: 02/25/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- C Riquelme-Mc Loughlin
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - P Iranzo
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
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Cedres Perez S, Assaf Pastrana JD, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Marmolejo Castañeda DH, Lostes J, Gonzalo J, Frigola J, Carbonell C, Amat R, Pedrola A, Dienstmann R, Felip E. Analysis of chemotherapy efficacy according to histology in malignant pleural mesothelioma (MPM) patients (p). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e20563] [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
e20563 Background: MPM is a highly aggressive pleural tumor associated with asbestos exposure and with limited survival despite systemic therapy. Histology is a prognostic factor and recently CheckMate 743 trial demonstrated survival benefit of immunotherapy in first line with some differences in the efficacy of chemotherapy according to histology. However, randomized trials who led to the approval of antifolate in mesothelioma did not include analysis of outcomes by histology. The objective of this study is to characterize the impact of chemotherapy according to histology in p with MPM at our institution. Methods: We review 189 MPM p diagnosed at Vall d´Hebron University Hospital between November 2002 and April 2020. Associations between clinical variables and outcome were assessed with Cox regression models and survival data were calculated by the Kaplan-Meier method. Results: Patient’s characteristics: median age 68 years (y) (45-88 y), males: 70%, performance status (PS)1: 69%, asbestos exposure: 75%, epithelioid subtype: 76%. First line chemotherapy was offered to 85% of p (66% cisplatin-pemetrexed and 27% carboplatin-pemetrexed). Median overall survival (OS) in overall population was 21.3 m (95%CI17.2-24.3). Epithelioid histology, PS 0, neutrophil-lymphocyte ratio <5 and treatment with cisplatin vs carboplatin were associated with significant improvements in OS (p<0.001). When we analyzed the survival of patients who received first line chemotherapy according to histology, we found that patients with epithelioid tumors had better PFS and OS. Median PFS for p with epithelioid tumors treated with chemotherapy in first line was 4.8 m versus 3.6 months non-epithelioid (HR1.5 CI95% 1.1-2.3; p=0.03). OS of epithelioid p treated with first line chemotherapy was 26.7 m versus 15.0 m non-epithelioid patients (HR2.25 CI95% 1.4-3.4; p<0.001). We analyzed if the differences in survival according to histology were due to type of systemic treatment received (Table). Conclusions: In our series, p with non-epithelioid tumors presented worse prognosis. We confirmed histology is a prognostic factor with better OS for p with epithelioid tumors. Moreover, we demonstrated better efficacy of chemotherapy in epithelioid tumors, although histology is not a predictive factor for the platinum agent sensitivity (p of interaction PFS=0.09, p of interaction OS= 0.65).[Table: see text]
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Affiliation(s)
- Susana Cedres Perez
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Juan David Assaf Pastrana
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandro Navarro
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alex Martinez-Marti
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Julia Lostes
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Gonzalo
- Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Pedrola
- Oncology Data Science Group, Vall D’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Enriqueta Felip
- Lung Cancer Unit, Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Iranzo P, Callejo A, Marmolejo D, Assaf J, Pardo N, Navarro A, Martinez-Marti A, Cedres S, Mejia ND, Carbonell C, Amat R, Frigola J, Felip E. 127P Real-world evidence and clinical characteristics in patients (pts) with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI). J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01969-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cedres S, Assaf J, Iranzo P, Callejo A, Pardo N, Navaro A, Martinez-Marti A, Bote H, Marmolejo D, Lostes J, Monton V, Gonzalo J, Pedrola A, Felip E. 198P Analysis of efficacy of immunotherapy according to histology in malignant pleural mesothelioma (MPM) patients. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)02040-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Frigola J, Navarro A, Carbonell C, Callejo A, Iranzo P, Cedrés S, Martinez‐Marti A, Pardo N, Saoudi‐Gonzalez N, Martinez D, Jimenez J, Sansano I, Mancuso FM, Nuciforo P, Montuenga LM, Sánchez‐Cespedes M, Prat A, Vivancos A, Felip E, Amat R. Molecular profiling of long-term responders to immune checkpoint inhibitors in advanced non-small cell lung cancer. Mol Oncol 2021; 15:887-900. [PMID: 33342055 PMCID: PMC8024716 DOI: 10.1002/1878-0261.12891] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 12/12/2022] Open
Abstract
Immunotherapy has transformed advanced non-small cell lung cancer (NSCLC) treatment strategies and has led to unprecedented long-lasting responses in some patients. However, the molecular determinants driving these long-term responses remain elusive. To address this issue, we performed an integrative analysis of genomic and transcriptomic features of long-term immune checkpoint inhibitors (ICIs)-associated responders. We assembled a cohort of 47 patients with NSCLC receiving ICIs that was enriched in long-term responders [>18 months of progression-free survival (PFS)]. We performed whole-exome sequencing from tumor samples, estimated the tumor mutational burden (TMB), and inferred the somatic copy number alterations (SCNAs). We also obtained gene transcription data for a subset of patients using Nanostring, which we used to assess the tumor immune infiltration status and PD-L1 expression. Our results indicate that there is an association between TMB and benefit to ICIs, which is driven by those patients with long-term response. Additionally, high SCNAs burden is associated with poor response and negatively correlates with the presence of several immune cell types (B cells, natural killers, regulatory T cells or effector CD8 T cells). Also, CD274 (PD-L1) expression is increased in patients with benefit, mainly in those with long-term response. In our cohort, combined assessment of TMB and SCNAs burden enabled identification of long-term responders (considering PFS and overall survival). Notably, the association between TMB, SCNAs burden, and PD-L1 expression with the outcomes of ICIs treatment was validated in two public datasets of ICI-treated patients with NSCLC. Thus, our data indicate that TMB is associated with long-term benefit following ICIs treatment in NSCLC and that TMB, SCNAs burden, and PD-L1 are complementary determinants of response to ICIs.
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Affiliation(s)
- Joan Frigola
- Thoracic Cancers Translational Genomics UnitHebron Institute of Oncology (VHIO)Vall dBarcelonaSpain
| | - Alejandro Navarro
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics UnitHebron Institute of Oncology (VHIO)Vall dBarcelonaSpain
| | - Ana Callejo
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Patricia Iranzo
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Susana Cedrés
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Alex Martinez‐Marti
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Nuria Pardo
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Nadia Saoudi‐Gonzalez
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Debora Martinez
- Department of Medical OncologyHospital ClinicBarcelonaSpain
- Translational Genomics and Targeted Therapies in Solid TumorsIDIBAPSBarcelonaSpain
| | - Jose Jimenez
- Molecular Oncology GroupVall d'Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Irene Sansano
- Pathology UnitVall d’Hebron University HospitalBarcelonaSpain
| | - Francesco M. Mancuso
- Cancer Genomics LaboratoryVall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Paolo Nuciforo
- Molecular Oncology GroupVall d'Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Luis M. Montuenga
- Program in Solid TumorsCenter for Applied Medical Research (CIMA)PamplonaSpain
- Department of Pathology, Anatomy and PhysiologySchool of MedicineUniversity of NavarraPamplonaSpain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC)MadridSpain
- Navarra Health Research Institute (IDISNA)PamplonaSpain
| | - Montse Sánchez‐Cespedes
- Cancer Genetics GroupJosep Carreras Leukaemia Research Institute (IJC)Campus ICO‐Germans Trias i PujolBadalona, BarcelonaSpain
| | - Aleix Prat
- Department of Medical OncologyHospital ClinicBarcelonaSpain
- Translational Genomics and Targeted Therapies in Solid TumorsIDIBAPSBarcelonaSpain
| | - Ana Vivancos
- Cancer Genomics LaboratoryVall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Enriqueta Felip
- Thoracic Cancers Translational Genomics UnitHebron Institute of Oncology (VHIO)Vall dBarcelonaSpain
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics UnitHebron Institute of Oncology (VHIO)Vall dBarcelonaSpain
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Cedres S, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Valdivia A, Filipi-Arriaga F, Monton V, Gonzalo J, Pedrola A, Recasens S, Madrenas R, Feliu B, Roman B, Dienstmann R, Felip E. P24.06 Real World use of Cisplatin and Carboplatin Based Therapy in Patients with Malignant Pleural Mesothelioma (MPM). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.615] [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: 11/24/2022]
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Rodríguez-Garijo N, Bielsa I, Mascaró JM, Quer A, Idoate MA, Paricio JJ, Iranzo P, España A. Reactive granulomatous dermatitis as a histological pattern including manifestations of interstitial granulomatous dermatitis and palisaded neutrophilic and granulomatous dermatitis: a study of 52 patients. J Eur Acad Dermatol Venereol 2020; 35:988-994. [PMID: 33098595 DOI: 10.1111/jdv.17010] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/15/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Confusion exists regarding interstitial granulomatous dermatitis (IGD) and palisaded neutrophilic and granulomatous dermatitis (PNGD). OBJECTIVE To determine whether IGD and PNGD are two different entities, or whether they must be considered as two subtypes of the same reactive pattern, and thus whether the unification of the nomenclature is necessary. METHODS Observational retrospective multicentre study of patients with IGD and PNGD evaluated between 1999 and 2019 and review of their clinical and histological features. RESULTS We identified 52 patients (38 women and 14 men). Clinical and histological findings of IGD were observed in 88.4% of cases. The most common cutaneous lesions were plaques/macules (IGD) or annular plaques and papules/nodules (PNGD), located mostly on the limbs and trunk. The rope sign was developed in two patients with IGD that associated autoimmune disorders. Similar associated comorbidities (75%) were found in both entities, mainly autoimmune diseases (53.8%). In IGD, the infiltrate was predominantly lympho-histiocytic. Neutrophilic infiltrates, karyorrhexis and skin lesions with limited clinical course were mainly associated with PNGD biopsies. In biopsies with a limited recurrent course, a predominant lymphocytic inflammatory infiltrate was found. Collagen degeneration was present in 75.9% of cases. The floating sign was observed only in IGD type patients (63%). Overlapping histological findings were found in one fourth of cases, especially between IGD and interstitial granuloma annulare. Interface dermatitis, apparently unrelated to drug intake, was observed in 4 cases of IGD. CONCLUSION We support the term reactive granulomatous dermatitis to unify both the clinical and histological findings of IGD and PNGD, and the overlapping between IGD and interstitial granuloma annulare. According to this, a spectrum of histological changes will be found depending on the clinical course of the skin lesions.
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Affiliation(s)
- N Rodríguez-Garijo
- Department of Dermatology, School of Medicine, University Clinic of Navarra, University of Navarra, Pamplona, Spain
| | - I Bielsa
- Department of Dermatology, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - J M Mascaró
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Quer
- Department of Pathology, Hospital Germans Trias i Pujol University, Universitat Autònoma de Barcelona, Badalona, Spain
| | - M A Idoate
- Department of Pathology, School of Medicine, University Clinic of Navarra, University of Navarra, Pamplona, Spain
| | - J J Paricio
- Department of Pathology, School of Medicine, University Clinic of Navarra, University of Navarra, Pamplona, Spain
| | - P Iranzo
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A España
- Department of Dermatology, School of Medicine, University Clinic of Navarra, University of Navarra, Pamplona, Spain
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Corral-Magaña O, Morgado-Carrasco D, Fustà-Novell X, Iranzo P. Penfigoide de mucosas: cuando la mucosa oral puede ser la clave para el diagnóstico de una estenosis esofágica de origen desconocido. Actas Dermo-Sifiliográficas 2020; 111:792-794. [DOI: 10.1016/j.ad.2019.04.011] [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] [Received: 11/18/2018] [Revised: 03/05/2019] [Accepted: 04/20/2019] [Indexed: 11/25/2022] Open
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Cedres S, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Saoudi Gonzalez N, Valdivia A, Monton V, Gonzalo J, Pedrola A, Dienstmann R, Felip E. 1910P Outcomes of systemic therapy after first line therapy in patients (p) with malignant pleural mesothelioma (MPM). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1453] [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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Saoudi Gonzalez N, Navarro A, Villacampa Javierre G, Garcia-Alvarez A, Assaf Pastrana J, Iranzo P, Callejo A, Lostes Bardaji M, Pardo N, Cedres S, Martinez-Marti A, Dienstmann R, Felip E. 1807P Real world data on 442 patients (p) with small cell lung cancer (SCLC) treated in the last ten years at Vall d’Hebron Hospital. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Garcia-Alvarez A, Saoudi N, Villacampa Javierre G, Assaf Pastrana J, Iranzo P, Callejo A, Pardo N, Cedres S, Martinez-Marti A, Dienstmann R, Felip E, Navarro A. 1798P Carboplatin-paclitaxel (CP) chemotheraphy as salvage treatment for small cell lung cancer (SCLC): A real-world evidence analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1559] [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: 11/27/2022] Open
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Riquelme-Mc Loughlin C, Iranzo P, Mascaró JM. Apremilast in benign chronic pemphigus (Hailey-Hailey disease). Clin Exp Dermatol 2020; 45:737-739. [PMID: 32198945 DOI: 10.1111/ced.14225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 11/28/2022]
Affiliation(s)
- C Riquelme-Mc Loughlin
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - P Iranzo
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J M Mascaró
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
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Callejo A, Carbonell C, Iranzo P, Pardo Aranda N, Navarro A, Martinez-Marti A, Cedres Perez S, Gutierrez R, Recasens S, Madrenas R, Sanchez L, Saoudi N, Assaf JD, Masnou M, Frigola J, Amat R, Felip E. Genomic alterations profiling by liquid biopsy and their association to immune checkpoints inhibitors (ICI) response in a cohort of non-small cell lung cancer (NSCLC) patients. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e21524] [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
e21524 Background: In metastatic NSCLC, identification of biomarkers of response to immune checkpoint inhibitors (ICI) is still an unmet need. Liquid biopsy, including the detection of circulating tumor DNA (ctDNA) in patients’ bloodstream, is an emerging tool for detecting and monitoring genetic alterations. Mutations in specific genes as KRAS or STK11, in combination with PDL1, have been suggested as potential biomarkers to select responders to ICI. Methods: Digital NGS of ctDNA was analyzed by Guardant360 in samples from 89 patients with advanced NSCLC treated with ICI between 2017 to 2019. Plasma samples after progression to ICI were obteined from 40 patients and we focus in this subgroup to explore mutations of genes commonly alterated in lung cancer and correlate them with clinical outcomes. Results: Forty patients were included in the analysis with a median age of 64.5 years and 62.5% were diagnosed with adenocarcinoma. Fourteen patients were treated with single agent ICI as first line, 19 patients as second line and 7 in third line. A median of 4 mutations per patient were detected (range 0-13). Mutations (mut) in TP53 were found in 85% of the patients, KRAS in 34%, STK11 in 22% and both genes KRAS and STK11 were alterated in 12.5% of the patients. Globally, median PFS (mPFS) of the patients treated with ICI was 7.5 months. mPFS in patients harboring KRAS mutations was 4.9 m ( vs 10.1 m in patients without KRASmut, logrank test p-value = 0.031) and 4.1 m in those patients with STK11 mutations (vs 9.5 m in patients without STK11mut, logrank test p-value = 0.034). Additionally, mutations in both genes were also associated to statistically significant shorter mPFS 3.9 m vs 9.5 m (logrank test p-value < 0.01). Conclusions: Our results support the idea that tumor alterations identified by liquid biopsy panels can potentially contribute as biomarkers of response to ICI in NSCLC. When analyzing the mutational panorama after ICI treatment, we find that those patients exhibiting KRAS and/or STK11 mutations in their ctDNA have a shorter PFS.
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Affiliation(s)
- Ana Callejo
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo Aranda
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Alex Martinez-Marti
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Susana Cedres Perez
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Raquel Gutierrez
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, Barcelona, Spain
| | - Sergi Recasens
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | - Raquel Madrenas
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, Barcelona, Spain
| | - Laura Sanchez
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, Barcelona, Spain
| | - Nadia Saoudi
- Medical Oncology Department, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Juan David Assaf
- Medical Oncology Department, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Mar Masnou
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, Barcelona, Spain
| | - Joan Frigola
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Iranzo P, Callejo A, Pedrola A, Pardo Aranda N, Navarro A, Martinez-Marti A, Cedres Perez S, Ros J, Assaf JD, Saoudi N, Carbonell C, Amat R, Frigola J, Jimenez J, Dienstmann R, Palmer HG, Vivancos A, Felip E. Immune checkpoint inhibitors (ICI) response in metastatic non-small cell lung cancer (NSCLC) patients with WNT pathway mutations (APC/CTNNB1). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e15137] [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
e15137 Background: APC and CTNNB1 mutations (mut) lead to an aberrant activation of the WNT pathway which has been linked to lack of benefit of immunotherapy in patients (pts) with lung cancer. Our aim is to describe the pts’ characteristics of a NSCLC cohort with APC or CTNNB1 mut and their association with outcomes (Overall survival [OS] and Progression-Free-Survival [PFS]) when treated with ICI. Methods: We selected NSCLC pts with mut in APC or CTNNB1 by targeted NGS (tissue), whole exome sequencing (tissue) or Guardant 360(plasma) between January 2014 and October 2019. Functionality of mut and β-catenin protein expression by immunohistochemistry (IHC) were correlated with outcome. Results: We identified a total of 37 patients with 44 mutually-exclusive mutations in APC (31) or CTNNB1 (6), 25 adenocarcinomas (68%). Of APC mut cohort, 16 had pathogenic mut (52%) and 15 of unknown significance (48%). All 6 CTN NB1 mut were known pathogenic. Median OS (mOS) in metastatic setting was 21.6 months (m) (CI95% 14.9-NR), without differences between APC and CTNNB1 groups (HR 1.5, p = 0.4) or when stratified by mut functionality (HR 1.1, p = 0.8). Globally, 21 pts received treatment with ICI (57%, 19 APC, 2 CTNNB1), median PFS (mPFS) was 5.43m (1.8-21.7), with trend for shorter mPFS in CTNNB1 mut (mPFS 1.7m) vs. APC mut (mPFS 6.6m, HR 1.5, p = 0.1). Among patients treated with ICI, 8 (38%) had coexisting driver targetable alterations ( EGFR, ERBB2 or MET) and 13 (62%) other functional mut were found ( TP53, KRAS, STK11, BRCA2, ATM). mPFS was 3.9m (1.8-NR) in the subgroup with driver mut vs. 6.6m (1.4-NR) for remaining pts (HR 1.36, p = 0.5). In 15 pts β-catenin IHC was performed, being positive in 7 cases (47%), 4 of them received ICI with a mPFS 12.1m. Conclusions: In our experience, benefit with ICI is not influenced by the presence of APC mut, and small numbers of CTNNB1 cohort limit conclusive statements. Additional studies are required to assess WNT pathway activation on top of genomics and correlate with the ICI efficacy.
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Affiliation(s)
- Patricia Iranzo
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Pedrola
- Oncology Data Science Group, Vall D’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo Aranda
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandro Navarro
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alex Martinez-Marti
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Susana Cedres Perez
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Ros
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Juan David Assaf
- Medical Oncology Department, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Nadia Saoudi
- Medical Oncology Department, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Jose Jimenez
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Hector G. Palmer
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Lab and Molecular Pathology Lab, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Cedrés S, Ponce-Aix S, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Gómez-Abecia S, Zucchiatti AC, Sansano I, Enguita AB, Miquel JM, Viaplana C, Dienstmann R, Paz-Ares L, Felip E. Analysis of mismatch repair (MMR) proteins expression in a series of malignant pleural mesothelioma (MPM) patients. Clin Transl Oncol 2020; 22:1390-1398. [PMID: 31916017 DOI: 10.1007/s12094-019-02275-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/16/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Promising results have been reported with immune checkpoint inhibitors (ICI) in a small proportion of MPM patients. MMR deficiency (dMMR) has been well described in several malignancies and was approved as a biomarker for anti-PD-1 inhibitors. Next generation sequencing (NGS) data demonstrated that 2% of MPM harbor microsatellite instability. The aim of this study is to characterize MMR by immunohistochemistry (IHC) in a series of MPM including a subset of patients treated with immunotherapy. METHODS Tumors of 159 MPM p diagnosed between 2002 and 2017 were reviewed. Formalin-fixed, paraffin-embedded tissue was stained for MLH1, MSH2, MSH6 and PMS2 and tumors were classified as dMMR (MMR protein expression negative) and MMR intact (all MMR proteins positively expressed). We retrospectively collected clinical outcomes under standard chemotherapy and experimental immunotherapy in the entire cohort. RESULTS MMR protein expression was analyzed in 158 samples with enough tissue and was positive in all of the cases. Twenty two patients received ICI with anti-CTLA4 or anti-PD-1 blockade in clinical trials, 58% had a response or stable disease for more than 6 m, with median progression-free survival (PFS) of 5.7 m (2.1-26.1 m). The median overall survival (mOS) in all population was 15 months (m) (13.5-18.8 m). In a multivariable model factors associated to improved mOS were PS 0, neutrophil-lymphocyte ratio (NLR) < 5 and epithelioid histology (p < 0.001). CONCLUSIONS In our series we were unable to identify any MPM patient with dMMR by IHC. Further studies are needed to elucidate potential predictive biomarkers of ICI benefit in MPM.
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Affiliation(s)
- S Cedrés
- Medical Oncology Department, Vall d´Hebron University Hospital and Institute of Oncology, Barcelona, Spain.
- Servicio de Oncología, Hospital Vall D´Hebron, Paseo Vall d´Hebron 119-129, 08035, Barcelona, Spain.
| | - S Ponce-Aix
- CIBERONC, Madrid, Spain
- Medical Oncology Department, University Hospital Doce de Octubre, Madrid, Spain
| | - P Iranzo
- Medical Oncology Department, Vall d´Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - A Callejo
- Medical Oncology Department, Vall d´Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - N Pardo
- Medical Oncology Department, Vall d´Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - A Navarro
- Medical Oncology Department, Vall d´Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - A Martinez-Marti
- Medical Oncology Department, Vall d´Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | | | - A C Zucchiatti
- Pathology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - I Sansano
- Pathological Anatomy Department, University Hospital Doce de Octubre, Madrid, Spain
| | - A B Enguita
- Pathological Anatomy Department, University Hospital Doce de Octubre, Madrid, Spain
| | - J M Miquel
- Vall d´Hebron Institute of Oncology, Barcelona, Spain
| | - C Viaplana
- Oncology Data Science (ODysSey) Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - R Dienstmann
- Medical Oncology Department, Vall d´Hebron University Hospital and Institute of Oncology, Barcelona, Spain
- Oncology Data Science (ODysSey) Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - L Paz-Ares
- CIBERONC, Madrid, Spain
- H12O-CNIO Lung Cancer Clinical Research Unit, Biomedical Research Foundation I+12, Madrid, Spain
- H12O-CNIO Lung Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Medical School, Complutense University, Madrid, Spain
| | - E Felip
- Medical Oncology Department, Vall d´Hebron University Hospital and Institute of Oncology, Barcelona, Spain
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Rodrigo A, Vega S, Ojeda Cabrera J, Sanchez-Gracia O, Callejo A, Fernandez A, Iranzo P, Cruellas Lapena M, Quilez Bielsa E, Velazquez-Campoy A, Abian O, Isla D. Thermal liquid biopsy as a valuable tool in lung cancer screening programs. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz257.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ros Montana F, Iranzo P, Pedrola A, Callejo A, Pardo N, Amat R, Carbonell C, Martinez A, Navarro A, Cedres S, Dienstmann R, Palmer H, Vivancos A, Felip E. WNT pathway mutations (APC/CTNNB1) and immune checkpoint inhibitors (ICI) response in metastatic non-small cell lung cancer (NSCLC) patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Cedres S, Hernando-Calvo A, Iranzo P, Callejo A, Aranda NP, Navarro A, Martinez-Marti A, Assaf J, Miquel J, Rodriguez G, Monton V, Pedrola A, Viaplana C, Carbonell C, Sanso M, Dienstmann R, Amat R, Vivancos A, Felip E. P1.16-05 Incidence and Outcome of Multiple Primary Cancers (MPC) in a Series of Lung Cancer (LC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cedres S, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Rodriguez G, Monton V, Gonzalo J, Miquel J, Pedrola A, Dienstmann R, Felip E. Real-world use of systemic therapy in elderly patients with malignant pleural mesothelioma (MPM). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266.012] [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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Riera-Monroig J, Iranzo P, Ishii N, Hashimoto T, Mascaró JM. Persistence of antienvoplakin and antiperiplakin antibodies in a patient with paraneoplastic pemphigus 20 years after remission. Br J Dermatol 2019; 182:797-798. [PMID: 31529517 DOI: 10.1111/bjd.18534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- J Riera-Monroig
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - P Iranzo
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - N Ishii
- Department of Dermatology, Kurume University School of Medicine and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - T Hashimoto
- Department of Dermatology, Kurume University School of Medicine and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan.,Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - J M Mascaró
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
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Morgado-Carrasco D, Fustà-Novell X, Iranzo P. FR-Ciclosporin as a First-Line Treatment in Epidermal Necrolysis. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2018.01.005] [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] Open
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Morgado-sCarrasco D, Fustà-Novell X, Iranzo P. FR-Ciclosporina como tratamiento de primera línea en las necrólisis epidérmicas. Actas Dermo-Sifiliográficas 2019; 110:601-603. [DOI: 10.1016/j.ad.2018.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/09/2018] [Accepted: 01/14/2018] [Indexed: 11/25/2022] Open
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Affiliation(s)
- I García-Díez
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - A España
- Deparment of Dermatology, School of Medicine, University Clinic of Navarra, Pamplona, Spain
| | - P Iranzo
- Department of Dermatology, Hospital Clinic de Barcelona, Barcelona, Spain
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Zugazagoitia J, Ramos I, Trigo JM, Palka M, Gómez-Rueda A, Jantus-Lewintre E, Camps C, Isla D, Iranzo P, Ponce-Aix S, García-Campelo R, Provencio M, Franco F, Bernabé R, Juan-Vidal O, Felip E, de Castro J, Sanchez-Torres JM, Faul I, Lanman RB, Garrido P, Paz-Ares L. Clinical utility of plasma-based digital next-generation sequencing in patients with advance-stage lung adenocarcinomas with insufficient tumor samples for tissue genotyping. Ann Oncol 2019; 30:290-296. [PMID: 30535340 DOI: 10.1093/annonc/mdy512] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [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] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Approximately 30% of tumor biopsies from patients with advanced-stage lung adenocarcinomas yield insufficient tissue for successful molecular subtyping. We have analyzed the clinical utility of next-generation sequencing (NGS) of cell-free circulating tumor DNA (ctDNA) in patients with inadequate tumor samples for tissue genotyping. PATIENTS AND METHODS We conducted the study in a multi-institutional prospective cohort of clinically unselected patients with advanced-stage lung adenocarcinomas with insufficient tissue for EGFR, ALK or ROS1 genotyping across 12 Spanish institutions (n = 93). ctDNA NGS was carried out by Guardant Health (Guardant360, Redwood City, CA), using a hybrid-capture-based 73-gene panel. Variants were deemed actionable if they were part of the OncoKB precision oncology knowledge database and classified in four levels of actionability based on their clinical or preclinical evidence for drug response. RESULTS Eighty-three out of 93 patients (89%) had detectable levels of ctDNA. Potentially actionable level 1-4 genomic alterations were detected in 53 cases (57%), of which 13 (14%) had level 1-2A alterations (Food and Drug Administration-approved and standard-care biomarkers according to lung cancer guidelines). Frequencies of each genomic alteration in ctDNA were consistent with those observed in unselected pulmonary adenocarcinomas. The majority of the patients (62%), particularly those with actionable alterations (87%), had more than one pathogenic variant in ctDNA. The median turnaround time to genomic results was 13 days. Twelve patients (13%) received genotype-matched therapies based on ctDNA results, deriving the expected clinical benefit. Patients with co-occurring pathogenic alterations had a significantly shorter median overall survival as compared with patients without co-occurring pathogenic alteration (multivariate hazard ratio = 5.35, P = 0.01). CONCLUSION Digital NGS of ctDNA in lung cancers with insufficient tumor samples for tissue sequencing detects actionable variants that frequently co-occur with other potentially clinically relevant genomic alterations, allowing timely initiation of genotype-matched therapies.
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Affiliation(s)
- J Zugazagoitia
- Medical Oncology Department, Hospital Universitario 12 de Octubre and i+12 Research Institute, Madrid, Spain; Lung Cancer Group, Clinical Research Program, Spanish National Cancer Research Center (CNIO), Madrid, Spain; CIBERONC, Madrid, Spain
| | - I Ramos
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - J M Trigo
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - M Palka
- Medical Oncology Department, IRYCIS Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A Gómez-Rueda
- Medical Oncology Department, IRYCIS Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - E Jantus-Lewintre
- CIBERONC, Madrid, Spain; Molecular Oncology Laboratory, Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain; Biotechnology Department, Universitat Politècnica de València, Valencia, Spain
| | - C Camps
- CIBERONC, Madrid, Spain; Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain; Medicine Department, Universidad de Valencia, Valencia, Spain
| | - D Isla
- Medical Oncology Department, Hospital Universitario Lozano Blesa, Zaragoza, Spain
| | - P Iranzo
- Medical Oncology Department, Hospital Universitario Lozano Blesa, Zaragoza, Spain
| | - S Ponce-Aix
- Medical Oncology Department, Hospital Universitario 12 de Octubre and i+12 Research Institute, Madrid, Spain; Lung Cancer Group, Clinical Research Program, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - R García-Campelo
- Medical Oncology Department, Hospital Universitario Da Coruña, A Coruña, Spain
| | - M Provencio
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - F Franco
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - R Bernabé
- Medical Oncology Department, Hospital Universitario Vírgen del Rocío, Sevilla, Spain
| | - O Juan-Vidal
- Medical Oncology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - E Felip
- Medical Oncology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - J de Castro
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - J M Sanchez-Torres
- Medical Oncology Department, Hospital Universitario La Princesa, Madrid, Spain
| | - I Faul
- Medical Affairs, Guardant Health, Barcelona, Spain
| | - R B Lanman
- Medical Affairs, Guardant Health, Redwood City, USA
| | - P Garrido
- CIBERONC, Madrid, Spain; Medical Oncology Department, IRYCIS Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - L Paz-Ares
- Medical Oncology Department, Hospital Universitario 12 de Octubre and i+12 Research Institute, Madrid, Spain; Lung Cancer Group, Clinical Research Program, Spanish National Cancer Research Center (CNIO), Madrid, Spain; CIBERONC, Madrid, Spain; Complutense University, Madrid, Spain.
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46
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Paumard‐Hernández B, Calvete O, Inglada Pérez L, Tejero H, Al‐Shahrour F, Pita G, Barroso A, Carlos Triviño J, Urioste M, Valverde C, González Billalabeitia E, Quiroga V, Francisco Rodríguez Moreno J, Fernández Aramburo A, López C, Maroto P, Sastre J, José Juan Fita M, Duran I, Lorenzo‐Lorenzo I, Iranzo P, García del Muro X, Ros S, Zambrana F, María Autran A, Benítez J. Whole exome sequencing identifies
PLEC
,
EXO5
and
DNAH7
as novel susceptibility genes in testicular cancer. Int J Cancer 2018; 143:1954-1962. [DOI: 10.1002/ijc.31604] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 12/27/2022]
Affiliation(s)
| | - Oriol Calvete
- Human Genetics Group, Spanish National Cancer Research Center (CNIO)Madrid Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER)Madrid Spain
| | - Lucia Inglada Pérez
- Center for Biomedical Network Research on Rare Diseases (CIBERER)Madrid Spain
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Program, Spanish National Cancer Centre (CNIO)Madrid Spain
| | - Héctor Tejero
- Bioinformatics Unit, Spanish National Cancer Research Center (CNIO)Madrid Spain
| | - Fátima Al‐Shahrour
- Bioinformatics Unit, Spanish National Cancer Research Center (CNIO)Madrid Spain
| | - Guillermo Pita
- Human Genotyping‐CEGEN Unit, Human Cancer Genetic Program, Spanish National Cancer Research Centre (CNIO)Madrid Spain
| | - Alicia Barroso
- Human Genetics Group, Spanish National Cancer Research Center (CNIO)Madrid Spain
| | - Juan Carlos Triviño
- Bioinformatic Unit, Sistemas Genómicos, Valencia Spain, Spanish National Cancer Research Centre (CNIO)Madrid Spain
| | - Miguel Urioste
- Center for Biomedical Network Research on Rare Diseases (CIBERER)Madrid Spain
- Familial Cancer Clinical Unit, Spanish National Cancer Research Center (CNIO)Madrid Spain
| | - Claudia Valverde
- Department of Medical OncologyVall d'Hebron Institute of Oncology, Vall d'Hebron University HospitalBarcelona Spain
- Spanish Germ Cell Group (SGCCG)
| | - Enrique González Billalabeitia
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology‐Haematology DepartmentHospital Universitario Morales MeseguerMurcia Spain
| | - Vanesa Quiroga
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology DepartmentHospital Universitari Germans Trias i Pujol, Institut Català d'Oncologia‐BadalonaBarcelona Spain
| | | | - Antonio Fernández Aramburo
- Spanish Germ Cell Group (SGCCG)
- Department of OncologyComplejo Hospitalario Universitario AlbaceteAlbacete Spain
| | - Cristina López
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology DepartmentInstituto de Investigación Sanitaria Gregorio MarañónMadrid Spain
| | - Pablo Maroto
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology and Biochemistry DepartmentsHospital de la Santa Creu i Sant PauBarcelona Spain
| | - Javier Sastre
- Spanish Germ Cell Group (SGCCG)
- Department of Medical OncologyHospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC)Madrid Spain
| | - María José Juan Fita
- Spanish Germ Cell Group (SGCCG)
- Medical OncologyFundación Instituto Valenciano de OncologíaValencia Spain
| | - Ignacio Duran
- Spanish Germ Cell Group (SGCCG)
- Department of Medical OncologyInstituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de SevillaSevilla Spain
| | | | - Patricia Iranzo
- Spanish Germ Cell Group (SGCCG)
- Department of Medical OncologyHospital Clinico Universitario Lozano BlesaZaragoza Spain
| | - Xavier García del Muro
- Spanish Germ Cell Group (SGCCG)
- Sarcoma Multidisciplinary Unit and Medical Oncology DepartmentInstitut Català d'Oncologia Hospitalet, IDIBELLBarcelona Spain
| | - Silverio Ros
- Department of Clinical OncologyHospital Universitario Virgen ArrixacaMurcia Spain
| | - Francisco Zambrana
- Spanish Germ Cell Group (SGCCG)
- Medical Oncology DepartmentHospital Universitario Infanta Sofía, San Sebastián De Los Reyes Spain
| | - Ana María Autran
- Spanish Germ Cell Group (SGCCG)
- Medical Urology departmentFundación Jiménez DíazMadrid Spain
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Center (CNIO)Madrid Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER)Madrid Spain
- Human Genotyping‐CEGEN Unit, Human Cancer Genetic Program, Spanish National Cancer Research Centre (CNIO)Madrid Spain
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47
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Morgado-Carrasco D, Riquelme-Mc Loughlin C, Fustà-Novell X, Iranzo P. Doxycycline, a Well-Tolerated, Economic, and Effective Alternative for the First-Line Treatment of Bullous Pemphigoid. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.05.009] [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: 10/16/2022] Open
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48
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Rodrigo A, Abian O, Velázquez-Campoy A, Callejo A, Vega-Sánchez S, Fernandez A, Sánchez-Gracia O, Iranzo P, Cruellas M, Quilez E, Isla D. Liquid thermal biopsy as a new non-invasive method of diagnosis for lung cancer patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Alberto Rodrigo
- Department of Medical Oncology, Hospital Arnau de Vilanova, Lleida, Spain
| | | | | | - Ana Callejo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Alexia Fernandez
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | | | - Patricia Iranzo
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Mara Cruellas
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | - Elisa Quilez
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza, Spain
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49
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Prost-Squarcioni C, Caux F, Schmidt E, Jonkman MF, Vassileva S, Kim SC, Iranzo P, Daneshpazhooh M, Terra J, Bauer J, Fairley J, Hall R, Hertl M, Lehman JS, Marinovic B, Patsatsi A, Zillikens D, Werth V, Woodley DT, Murrell DF. International Bullous Diseases Group: consensus on diagnostic criteria for epidermolysis bullosa acquisita. Br J Dermatol 2018; 179:30-41. [PMID: 29165796 DOI: 10.1111/bjd.16138] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Epidermolysis bullosa acquisita (EBA) is a complex autoimmune bullous disease disease with variable clinical presentations and multiple possible diagnostic tests, making an international consensus on the diagnosis of EBA essential. OBJECTIVES To obtain an international consensus on the clinical and diagnostic criteria for EBA. METHODS The International Bullous Diseases Group (IBDG) met three times to discuss the clinical and diagnostic criteria for EBA. For the final voting exercise, 22 experts from 14 different countries voted on 50 different items. When > 30% disagreed with a proposal, a discussion was held and re-voting carried out. RESULTS In total, 48 of 50 proposals achieved consensus after discussion. This included nine diagnostic criteria, which are summarized in a flow chart. The IBDG was unable to determine one procedure that would be applicable worldwide. A limitation of the study is that differential diagnosis of bullous systemic lupus erythematosus has not been addressed. CONCLUSIONS This first international consensus conference established generally agreed-upon clinical and laboratory criteria defining the clinical classification of and diagnostic testing for EBA. Holding these voting exercises in person with the possibility of discussion prior to voting has advantages in reaching consensus over Delphi exercises with remote voting.
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Affiliation(s)
- C Prost-Squarcioni
- Department of Dermatology and Referral Center for Autoimmune Bullous Diseases, APHP, Avicenne Hospital, Bobigny, France.,Department of Histology, UFR Léonard de Vinci, University Paris 13, Bobigny, France.,Department of Pathology, APHP, Avicenne Hospital, Bobigny, France
| | - F Caux
- Department of Dermatology and Referral Center for Autoimmune Bullous Diseases, APHP, Avicenne Hospital, Bobigny, France
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - M F Jonkman
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - S Vassileva
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - S C Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
| | - P Iranzo
- Department of Dermatology, Hospital Clinic de Barcelona, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - M Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - J Terra
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - J Bauer
- Division of Molecular Dermatology, Department of Dermatology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - J Fairley
- Department of Dermatology, University of Iowa and Department of Veterans Affairs Medical Center, Iowa City, IA, U.S.A
| | - R Hall
- Department of Dermatology, Duke Medical Center, Durham, NC, U.S.A
| | - M Hertl
- Department of Dermatology, University Hospital, Marburg, Germany
| | - J S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, MN, U.S.A
| | - B Marinovic
- Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - A Patsatsi
- Second University Dermatology Department, Aristotle University School of Medicine, Papageorgiou General Hospital, Thessaloniki, Greece
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | | | - V Werth
- Department of Dermatology, University of Pennsylvania and Philadelphia Department of Veterans Affairs Medical Center, Philadelphia, PA, U.S.A
| | - D T Woodley
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, U.S.A
| | - D F Murrell
- Department of Dermatology at St George Hospital, University of New South Wales, Sydney, Australia
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50
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Morgado-Carrasco D, Giavedoni P, Fustà-Novell X, Iranzo P. Rituximab: Revolutionizing the Treatment of Pemphigus. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2017.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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