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Cámara-Checa A, Rubio-Alarcón M, Dago M, Crespo-García T, Rapún J, Marín M, Tamargo J, Gómez R, Caballero R, Delpón E. Reply to Benndorff and DiFrancesco: Reliable human HCN4 single-channel recordings using the cell-attached configuration in expression systems. Proc Natl Acad Sci U S A 2024; 121:e2402992121. [PMID: 38588416 PMCID: PMC11032473 DOI: 10.1073/pnas.2402992121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Affiliation(s)
- Anabel Cámara-Checa
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Marcos Rubio-Alarcón
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - María Dago
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Teresa Crespo-García
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Josu Rapún
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Juan Tamargo
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
| | - Ricardo Gómez
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Ricardo Caballero
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
| | - Eva Delpón
- Cardiac Cellular Electrophysiology Group at the Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid28029, Spain
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Fraile A, Cebrián J, Thuissard-Vasallo I, Pérez-Martín S, Casado R, Gil-Fournier B, Alonso-Martín J, Tamargo J, Caballero R, Delpón E, Cosío FG. Coexistent HCN4 and GATA5 rare variants and Atrial Fibrillation in a large Spanish Family. Can J Cardiol 2024:S0828-282X(24)00189-2. [PMID: 38432398 DOI: 10.1016/j.cjca.2024.02.024] [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: 09/26/2023] [Revised: 02/02/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Familial association of atrial fibrillation (AF) can involve single gene variants related to known arrhythmogenic mechanisms; however, genome-wide association studies often disclose complex genetic variants in familial and non-familial AF, making it difficult to relate to known pathogenetic mechanisms. METHODS The finding of 4 siblings with AF led to studying 47 members of a family. Long-term Holter monitoring (298 hours average) ruled out silent AFWhole-exome sequencing was performed and variants shared by the index cases were filtered and prioritized according to current recommendations. HCN4 currents (IHCN4) were recorded in Chinese hamster ovary cells expressing human p.P1163H and/or native Hcn4 channels using the patch-clamp technique and topologically associated domain analysis of GATA5 variant carriers were performed. RESULTS The clinical study diagnosed 2 more AF cases. Five family members carried the heterozygous p.P1163H, HCN4 variant, 14 the intronic 20,61040536,G,A GATA5 rare variant, and 9 carried both variants (HCN4+GATA5). Five of the 6 AF cases (onset age ranging 33-70 years) carried both variants and one the GATA5 variant alone. Multivariate analysis showed that the presence of HCN4+GATA5 variants significantly and independently increased AF risk [OR=32.740 (1.812-591.408)] and not age, hypertension or overweight. Functional testing showed that IHcn4 generated by heterozygous p.P1163H were normal. Topologically associating domain analysis suggested that GATA5 could affect the expression of many genes, including those encoding microRNA-1. CONCLUSION The coincidence of two rare gene variants was independently associated with AF, but functional studies do not allow the postulation of the arrhythmogenic mechanism(s) involved.
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Affiliation(s)
- Alfonso Fraile
- Cardiology Department. Hospital Universitario de Getafe. Carretera de Toledo, Km. 12,500. 28905-Getafe, Spain.
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Israel Thuissard-Vasallo
- Department of Biomedical and Health Sciences. Universidad Europea de Madrid. 28670-Madrid, Spain
| | - Sara Pérez-Martín
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Raquel Casado
- Cardiology Department. Hospital Universitario de Getafe. Carretera de Toledo, Km. 12,500. 28905-Getafe, Spain
| | - Belen Gil-Fournier
- Cardiology Department. Hospital Universitario de Getafe. Carretera de Toledo, Km. 12,500. 28905-Getafe, Spain
| | - Joaquín Alonso-Martín
- Cardiology Department. Hospital Universitario de Getafe. Carretera de Toledo, Km. 12,500. 28905-Getafe, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain.
| | - Eva Delpón
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Francisco G Cosío
- Department of Biomedical and Health Sciences. Universidad Europea de Madrid. 28670-Madrid, Spain
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Tamargo J, Villacastín J, Caballero R, Delpón E. Drug-induced atrial fibrillation. A narrative review of a forgotten adverse effect. Pharmacol Res 2024; 200:107077. [PMID: 38244650 DOI: 10.1016/j.phrs.2024.107077] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/22/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with an increased morbidity and mortality. There is clinical evidence that an increasing number of cardiovascular and non-cardiovascular drugs, mainly anticancer drugs, can induce AF either in patients with or without pre-existing cardiac disorders, but drug-induced AF (DIAF) has not received the attention that it might deserve. In many cases DIAF is asymptomatic and paroxysmal and patients recover sinus rhythm spontaneously, but sometimes, DIAF persists, and it is necessary to perform a cardioversion. Furthermore, DIAF is not mentioned in clinical guidelines on the treatment of AF. The risk of DIAF increases in elderly and in patients treated with polypharmacy and with risk factors and comorbidities that commonly coexist with AF. This is the case of cancer patients. Under these circumstances ascribing causality of DIAF to a given drug often represents a clinical challenge. We review the incidence, the pathophysiological mechanisms, risk factors, clinical relevance, and treatment of DIAF. Because of the limited information presently available, further research is needed to obtain a deeper insight into DIAF. Meanwhile, it is important that clinicians are aware of the problem that DIAF represents, recognize which drugs may cause DIAF, and consider the possibility that a drug may be responsible for a new-onset AF episode.
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Affiliation(s)
- Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
| | - Julián Villacastín
- Hospital Clínico San Carlos, CardioRed1, Universidad Complutense de Madrid, CIBERCV, 28040 Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain.
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
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Figueredo J, Lopez LF, Leguizamon BF, Samudio M, Pederzani M, Apelt FF, Añazco P, Caballero R, Bianco H. Clinical evolution and mortality of critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir in an adult intensive care unit of Paraguay. BMC Infect Dis 2024; 24:37. [PMID: 38166777 PMCID: PMC10762832 DOI: 10.1186/s12879-023-08917-2] [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: 08/07/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The health crisis due to Covid-19 led to the search for therapeutics that could improve the evolution of the disease. Remdesivir, an antiviral that interferes with viral replication, was one of the first to be used for the treatment of this pathology. OBJECTIVE To determine clinical course and mortality of patients with severe SARS-CoV-2 pneumonia treated with remdesivir, in comparison of those who didn't receive the medication. PATIENTS AND METHODS Retrospective cohort study, with medical records review of COVID-19 patients, between August 2020 and August 2021. The subjects were divided into two groups, those who received remdesivir before or after admission to intensive care and those who didn't. The primary outcome variable was mortality in intensive care. RESULTS Of 214 subjects included, 109 (50,9%) received remdesivir. The median of days for the drug administration was 8 (2-20), IQR: 3. The bivariate analysis prove that the use of remdesivir was related with lower risk of develop Acute Respiratory Distress Syndrome (ARDS) (p = 0,019; OR: 0,521) and lower requirement of mechanical ventilation (p = 0,006; OR:0,450). Additionally, patients treated with remdesivir develop less kidney injury (p = 0,009; OR: 0,441). There was a total of 82 deaths, 29 (26,6%) in the remdesivir group and 53 (50,5%) in the control group [p < 0,001; OR: 0,356 (0,201-0,630)]. All the risk factors associated with mortality in the bivariate analysis were entered into the multivariate analysis by logistic regression, the use of remdesivir remained associated as an independent protective factor to mortality (p = 0.034; OR: 0.429). CONCLUSION Critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir had a lower risk of death and need for mechanical ventilation and develop less ARDS as compared to the control group. No differences were found in the presentation of adverse effects.
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Affiliation(s)
- Jessica Figueredo
- Adult Intensive Care Department, Facultad de Ciencias Médicas, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Lorena Fontclara Lopez
- Adult Intensive Care Department, Facultad de Ciencias Médicas, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Belinda Figueredo Leguizamon
- Adult Intensive Care Department, Facultad de Ciencias Médicas, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay.
| | - Margarita Samudio
- Critical Medicine and Intensive Care, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Marcelo Pederzani
- Adult Intensive Care Department, Facultad de Ciencias Médicas, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Federico Fretes Apelt
- Adult Intensive Care Department, Facultad de Ciencias Médicas, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Patricia Añazco
- Adult Intensive Care Department, Facultad de Ciencias Médicas, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Ricardo Caballero
- Adult Intensive Care Department, Facultad de Ciencias Médicas, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Hugo Bianco
- Adult Intensive Care Department, Facultad de Ciencias Médicas, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
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Cámara-Checa A, Perin F, Rubio-Alarcón M, Dago M, Crespo-García T, Rapún J, Marín M, Cebrián J, Gómez R, Bermúdez-Jiménez F, Monserrat L, Tamargo J, Caballero R, Jiménez-Jáimez J, Delpón E. A gain-of-function HCN4 mutant in the HCN domain is responsible for inappropriate sinus tachycardia in a Spanish family. Proc Natl Acad Sci U S A 2023; 120:e2305135120. [PMID: 38032931 DOI: 10.1073/pnas.2305135120] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
In a family with inappropriate sinus tachycardia (IST), we identified a mutation (p.V240M) of the hyperpolarization-activated cyclic nucleotide-gated type 4 (HCN4) channel, which contributes to the pacemaker current (If) in human sinoatrial node cells. Here, we clinically study fifteen family members and functionally analyze the p.V240M variant. Macroscopic (IHCN4) and single-channel currents were recorded using patch-clamp in cells expressing human native (WT) and/or p.V240M HCN4 channels. All p.V240M mutation carriers exhibited IST that was accompanied by cardiomyopathy in adults. IHCN4 generated by p.V240M channels either alone or in combination with WT was significantly greater than that generated by WT channels alone. The variant, which lies in the N-terminal HCN domain, increased the single-channel conductance and opening frequency and probability of HCN4 channels. Conversely, it did not modify the channel sensitivity for cAMP and ivabradine or the level of expression at the membrane. Treatment with ivabradine based on functional data reversed the IST and the cardiomyopathy of the carriers. In computer simulations, the p.V240M gain-of-function variant increases If and beating rate and thus explains the IST of the carriers. The results demonstrate the importance of the unique HCN domain in HCN4, which stabilizes the channels in the closed state.
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Affiliation(s)
- Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Francesca Perin
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Josu Rapún
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Ricardo Gómez
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Francisco Bermúdez-Jiménez
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
- Centro Nacional de Investigaciones Cardiovasculares, Madrid 28029, Spain
| | - Lorenzo Monserrat
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
- Health in Code Sociedad Limitada, A Coruña 15008, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Juan Jiménez-Jáimez
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
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González-Santiago S, Gil-Gil M, Carrasco E, Martínez-Jáñez N, Adamo B, Antolín S, Alonso J, Vethencourt A, Martínez-Vila C, Galve E, Rojo F, Caballero R, Casas M, Cortazar E, McCulloch L, Vedovato JC, Martín M. P006 Randomized Phase II trial evaluating three anti-diarrhoeal prophylaxis strategies in patients with HER2+/HR+ early breast cancer treated with extended adjuvant neratinib (DIANER GEICAM/2018-06). Breast 2023. [DOI: 10.1016/s0960-9776(23)00125-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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Tamargo J, Caballero R, Mosquera ED. Sex and gender differences in the treatment of arterial hypertension. Expert Rev Clin Pharmacol 2023; 16:329-347. [PMID: 36891888 DOI: 10.1080/17512433.2023.2189585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
INTRODUCTION Arterial hypertension represents the leading modifiable risk factor for all-cause death and early development of cardiovascular disease in women. Current clinical guidelines for the treatment of hypertension noted that women respond to antihypertensive drugs similarly to men and, therefore, treatment recommendations remain the same for both sexes. However, clinical evidence suggests the existence of sex- and gender-related differences (SGRD) in the prevalence, pathophysiology, pharmacodynamics (efficacy and safety) and pharmacokinetics of antihypertensive drugs. AREAS COVERED This review summarizes SGRD in the prevalence of hypertension, hypertension-mediated organ damage and blood pressure control, prescription patterns, and pharmacokinetics/ pharmacodynamics and doses of antihypertensive drugs. EXPERT OPINION There is limited information on SGRD in antihypertensive drug efficacy because of the underrepresentation of women in randomized clinical trials and, more important, because few trials reported results stratified by sex or performed sex-specific analyses. However, there are SGRD in hypertension-mediated organ damage, drug pharmacokinetics and, particularly, in drug safety. Prospective trials specifically designed to better understand the basis for SGRD in the pathophysiology of hypertension and in the efficacy and safety of antihypertensive drugs are needed to achieve a more personalized treatment of hypertension and hypertension-mediated organ damage in women.
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Affiliation(s)
- Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
| | - Eva Delpón Mosquera
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
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Caballero R, Martínez MÁ, Peña E. Coronary artery properties in atherosclerosis: A deep learning predictive model. Front Physiol 2023; 14:1162436. [PMID: 37089419 PMCID: PMC10113490 DOI: 10.3389/fphys.2023.1162436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
In this work an Artificial Neural Network (ANN) was developed to help in the diagnosis of plaque vulnerability by predicting the Young modulus of the core (E core ) and the plaque (E plaque ) of atherosclerotic coronary arteries. A representative in silico database was constructed to train the ANN using Finite Element simulations covering the ranges of mechanical properties present in the bibliography. A statistical analysis to pre-process the data and determine the most influential variables was performed to select the inputs of the ANN. The ANN was based on Multilayer Perceptron architecture and trained using the developed database, resulting in a Mean Squared Error (MSE) in the loss function under 10-7, enabling accurate predictions on the test dataset for E core and E plaque . Finally, the ANN was applied to estimate the mechanical properties of 10,000 realistic plaques, resulting in relative errors lower than 3%.
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Affiliation(s)
- Ricardo Caballero
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Miguel Ángel Martínez
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Estefanía Peña
- Aragón Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicina (CIBER-BBN), Madrid, Spain
- *Correspondence: Estefanía Peña,
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Figueredo B, Samudio M, Fontclara L, Fretes F, Ávila S, Gómez F, Pederzani M, Caballero R, Galeano N, Bianco H. IL6 dosage in critical patients with COVID-19 and its relationship with mortality in the Adult Intensive Care Department of the Hospital de Clínicas. Paraguay. Rev parag reumatol 2022. [DOI: 10.18004/rpr/2022.08.02.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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de la Cruz-Merino L, Gion M, Cruz J, Alonso-Romero JL, Quiroga V, Moreno F, Andrés R, Santisteban M, Ramos M, Holgado E, Cortés J, López-Miranda E, Cortés A, Henao F, Palazón-Carrión N, Rodriguez LM, Ceballos I, Soto A, Puertes A, Casas M, Benito S, Chiesa M, Bezares S, Caballero R, Jiménez-Cortegana C, Sánchez-Margalet V, Rojo F. Pembrolizumab in combination with gemcitabine for patients with HER2-negative advanced breast cancer: GEICAM/2015-04 (PANGEA-Breast) study. BMC Cancer 2022; 22:1258. [PMID: 36463104 PMCID: PMC9719636 DOI: 10.1186/s12885-022-10363-3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND We evaluated a new chemoimmunotherapy combination based on the anti-PD1 monoclonal antibody pembrolizumab and the pyrimidine antimetabolite gemcitabine in HER2- advanced breast cancer (ABC) patients previously treated in the advanced setting, in order to explore a potential synergism that could eventually obtain long term benefit in these patients. METHODS HER2-negative ABC patients received 21-day cycles of pembrolizumab 200 mg (day 1) and gemcitabine (days 1 and 8). A run-in-phase (6 + 6 design) was planned with two dose levels (DL) of gemcitabine (1,250 mg/m2 [DL0]; 1,000 mg/m2 [DL1]) to determine the recommended phase II dose (RP2D). The primary objective was objective response rate (ORR). Tumor infiltrating lymphocytes (TILs) density and PD-L1 expression in tumors and myeloid-derived suppressor cells (MDSCs) levels in peripheral blood were analyzed. RESULTS Fourteen patients were treated with DL0, resulting in RP2D. Thirty-six patients were evaluated during the first stage of Simon's design. Recruitment was stopped as statistical assumptions were not met. The median age was 52; 21 (58%) patients had triple-negative disease, 28 (78%) visceral involvement, and 27 (75%) ≥ 2 metastatic locations. Progression disease was observed in 29 patients. ORR was 15% (95% CI, 5-32). Eight patients were treated ≥ 6 months before progression. Fourteen patients reported grade ≥ 3 treatment-related adverse events. Due to the small sample size, we did not find any clear association between immune tumor biomarkers and treatment efficacy that could identify a subgroup with higher probability of response or better survival. However, patients that experienced a clinical benefit showed decreased MDSCs levels in peripheral blood along the treatment. CONCLUSION Pembrolizumab 200 mg and gemcitabine 1,250 mg/m2 were considered as RP2D. The objective of ORR was not met; however, 22% patients were on treatment for ≥ 6 months. ABC patients that could benefit of chemoimmunotherapy strategies must be carefully selected by robust and validated biomarkers. In our heavily pretreated population, TILs, PD-L1 expression and MDSCs levels could not identify a subgroup of patients for whom the combination of gemcitabine and pembrolizumab would induce long term benefit. TRIAL REGISTRATION ClinicalTrials.gov and EudraCT (NCT03025880 and 2016-001,779-54, respectively). Registration dates: 20/01/2017 and 18/11/2016, respectively.
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Affiliation(s)
- L. de la Cruz-Merino
- grid.411375.50000 0004 1768 164XDepartment of Medical Oncology, Medicine Department, Virgen Macarena University Hospital, University of Seville, Dr. Fedriani St, No. 3, Seville, 41009 Spain ,grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - M. Gion
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411347.40000 0000 9248 5770Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J. Cruz
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - JL. Alonso-Romero
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411372.20000 0001 0534 3000Department of Medical Oncology, Hospital Clínico Universitario Virgen de La Arrixaca-IMIB, Murcia, Spain
| | - V. Quiroga
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.418701.b0000 0001 2097 8389Department of Medical Oncology, Badalona Applied Research Group in Oncology (B-ARGO Group), Catalan Institute of Oncology, Badalona, Spain
| | - F. Moreno
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411068.a0000 0001 0671 5785Department of Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - R. Andrés
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411050.10000 0004 1767 4212Department of Medical Oncology, Hospital Clínico Universitario Lozano Blesa, Saragossa, Spain
| | - M. Santisteban
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411730.00000 0001 2191 685XDepartment of Medical Oncology, Clínica Universidad de Navarra, Navarra, Spain ,grid.508840.10000 0004 7662 6114IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M. Ramos
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.418394.3Department of Medical Oncology, Centro Oncológico de Galicia, A Coruña, Spain
| | - E. Holgado
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.414808.10000 0004 1772 3571Department of Medical Oncology, Hospital La Luz, Quironsalud, Madrid, Spain
| | - J. Cortés
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,International Breast Cancer Center (IBCC), Quiron Group, Barcelona and Madrid, Spain ,grid.411083.f0000 0001 0675 8654Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain ,grid.119375.80000000121738416Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - E. López-Miranda
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411347.40000 0000 9248 5770Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A. Cortés
- grid.411347.40000 0000 9248 5770Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - F. Henao
- grid.411375.50000 0004 1768 164XDepartment of Medical Oncology, Medicine Department, Virgen Macarena University Hospital, University of Seville, Dr. Fedriani St, No. 3, Seville, 41009 Spain ,grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - N. Palazón-Carrión
- grid.411375.50000 0004 1768 164XDepartment of Medical Oncology, Medicine Department, Virgen Macarena University Hospital, University of Seville, Dr. Fedriani St, No. 3, Seville, 41009 Spain ,grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - L. M. Rodriguez
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - I. Ceballos
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - A. Soto
- grid.411372.20000 0001 0534 3000Department of Medical Oncology, Hospital Clínico Universitario Virgen de La Arrixaca-IMIB, Murcia, Spain
| | - A. Puertes
- grid.411372.20000 0001 0534 3000Department of Medical Oncology, Hospital Clínico Universitario Virgen de La Arrixaca-IMIB, Murcia, Spain
| | - M. Casas
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - S. Benito
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - M. Chiesa
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - S. Bezares
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - R. Caballero
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - C. Jiménez-Cortegana
- grid.411375.50000 0004 1768 164XMedical Biochemistry and Molecular Biology and Immunology Department, Virgen Macarena University Hospital, University of Seville, Seville, Spain
| | - V. Sánchez-Margalet
- grid.411375.50000 0004 1768 164XMedical Biochemistry and Molecular Biology and Immunology Department, Virgen Macarena University Hospital, University of Seville, Seville, Spain
| | - F. Rojo
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.419651.e0000 0000 9538 1950Pathology Department, IIS-Fundación Jiménez Díaz, Madrid, Spain ,CIBERONC-ISCIII, Madrid, Spain
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11
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Dago M, Crespo-García T, Cámara-Checa A, Rapún J, Rubio-Alarcón M, Marín M, Tamargo J, Caballero R, Delpón E. Empagliflozin and Dapagliflozin Increase Na + and Inward Rectifier K + Current Densities in Human Cardiomyocytes Derived from Induced Pluripotent Stem Cells (hiPSC-CMs). Cells 2022; 11:3707. [PMID: 36496967 PMCID: PMC9738206 DOI: 10.3390/cells11233707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022] Open
Abstract
Dapagliflozin (dapa) and empagliflozin (empa) are sodium-glucose cotransporter-2 inhibitors (SGLT2is) that reduce morbidity and mortality in heart failure (HF) patients. Sodium and inward rectifier K+ currents (INa and IK1), carried by Nav1.5 and Kir2.1 channels, respectively, are responsible for cardiac excitability, conduction velocity, and refractoriness. In HF patients, Nav1.5 and Kir2.1 expression are reduced, enhancing risk of arrhythmia. Incubation with dapa or empa (24-h,1 µM) significantly increased INa and IK1 densities recorded in human-induced pluripotent stem cell-cardiomyocytes (hiPSC-CMs) using patch-clamp techniques. Dapa and empa, respectively, shifted to more hyperpolarized potentials the INa activation and inactivation curves. Identical effects were observed in Chinese hamster ovary (CHO) cells that were incubated with dapa or empa and transiently expressed human Nav1.5 channels. Conversely, empa but not dapa significantly increased human Kir2.1 currents in CHO cells. Dapa and empa effects on INa and IK1 were also apparent in Ca-calmodulin kinase II-silenced CHO cells. Cariporide, a Na+/H+ exchanger type 1 (NHE1) inhibitor, did not increase INa or IK1 in hiPSC-CMs. Dapa and empa at therapeutic concentrations increased INa and IK1 in healthy human cardiomyocytes. These SGLT2is could represent a new class of drugs with a novel and long-pursued antiarrhythmic mechanism of action.
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Affiliation(s)
- María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Josu Rapún
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
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12
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Crespo-García T, Rubio-Alarcón M, Cámara-Checa A, Dago M, Rapún J, Nieto-Marín P, Marín M, Cebrián J, Tamargo J, Delpón E, Caballero R. A Cantú syndrome mutation produces dual effects on KATP channels by disrupting ankyrin B regulation. J Gen Physiol 2022; 155:213613. [PMID: 36287534 PMCID: PMC9614705 DOI: 10.1085/jgp.202112995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/09/2022] [Accepted: 10/04/2022] [Indexed: 02/01/2023] Open
Abstract
ATP-sensitive potassium (KATP) channels composed of Kir6.x and sulfonylurea receptor (SURs) subunits couple cellular metabolism to electrical activity. Cantú syndrome (CS) is a rare disease caused by mutations in the genes encoding Kir6.1 (KCNJ8) and SUR2A (ABCC9) that produce KATP channel hyperactivity due to a reduced channel block by physiological ATP concentrations. We functionally characterized the p.S1054Y SUR2A mutation identified in two CS carriers, who exhibited a mild phenotype although the mutation was predicted as highly pathogenic. We recorded macroscopic and single-channel currents in CHO and HEK-293 cells and measured the membrane expression of the channel subunits by biotinylation assays in HEK-293 cells. The mutation increased basal whole-cell current density and at the single-channel level, it augmented opening frequency, slope conductance, and open probability (Po), and promoted the appearance of multiple conductance levels. p.S1054Y also reduced Kir6.2 and SUR2A expression specifically at the membrane. Overexpression of ankyrin B (AnkB) prevented these gain- and loss-of-function effects, as well as the p.S1054Y-induced reduction of ATP inhibition of currents measured in inside-out macropatches. Yeast two-hybrid assays suggested that SUR2A WT and AnkB interact, while p.S1054Y interaction with AnkB is decreased. The p.E322K Kir6.2 mutation, which prevents AnkB binding to Kir6.2, produced similar biophysical alterations than p.S1054Y. Our results are the first demonstration of a CS mutation whose functional consequences involve the disruption of AnkB effects on KATP channels providing a novel mechanism by which CS mutations can reduce ATP block. Furthermore, they may help explain the mild phenotype associated with this mutation.
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Affiliation(s)
- Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Josu Rapún
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Paloma Nieto-Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain,Correspondence to Eva Delpón:
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, Madrid, Spain,Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Madrid, Spain
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13
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Caballero R, Dago M, Camara-Checa A, Crespo-Garcia T, Rubio-Alarcon M, Rapun J, Marin M, Tamargo J, Delpon E. Empagliflozin and dapagliflozin increase Na current in human cardiomyocytes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2885] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Empagliflozin (EMPA) and dapagliflozin (DAPA) are sodium-glucose cotransporter 2 inhibitors (SGLT2i) used for the treatment of type 2 Diabetes Mellitus (T2DM). Both drugs reduce morbidity and mortality in heart failure (HF) patients with reduced or preserved ejection fraction, even in the absence of T2DM. Moreover, these drugs decrease ventricular arrhythmias and sudden cardiac death in HF patients. The sodium current (INa), carried by Nav1.5 channels, is responsible for cardiac action potential (AP) depolarization and determines excitability and conduction velocity. In HF patients, the expression of Nav1.5 channels is reduced, leading to a decrease of ventricular excitability that enhances the arrhythmic risk.
Purpose
We aimed to determine the effects of EMPA and DAPA on human cardiac INa and AP characteristics.
Methods
Peak INa and ventricular-like APs were recorded in cardiomyocytes derived from human induced pluripotent stem cells (hiPSC-CM) using patch-clamp techniques. INa was also recorded in CHO cells transiently transfected with human Nav1.5+Navβ1 channels. In all cases, EMPA or DAPA (1 μM) were added to culture media and incubated for 24-h.
Results
APs recorded in hiPSC-CMs exhibited automatic activity and incubation with EMPA or DAPA did not modify spontaneous beating frequency (0.39±0.04 Hz; P>0.05, n≥16). In cells driven at 1 Hz, none of the drugs modified resting membrane potential (−76.7±1.4 mV; P>0.05, n≥11), but significantly increased AP amplitude from 98.6±3.6 to 105±2.2 (DAPA) and 107±2.3 mV (EMPA) (P<0.05). Interestingly, only EMPA lengthened AP duration measured at 20%, 50%, and 90% (from 605.6±31.3 to 760.5±59.0 ms, P<0.05) of repolarization. In hiPSC-CMs EMPA increased maximum INa density by 64% (from −156.0±28.0 to −256.4±28.1 pA/pF, P<0.05, n≥7) and shifted the midpoint (Vh) of the inactivation curve to more hyperpolarized potentials (from −97.3±4.5 to −108.6±4.4 mV, P<0.05, n≥7). In turn, DAPA increased maximum INa density by 24% (to −193.8±26.6 pA/pF) and shifted the Vh of the activation curve to more negative potentials (from −47.2±1.6 mV to −55.5±2.8 mV, P<0.05), an effect that would increase the INa at negative potentials coinciding with channel opening. None of the drugs modified the time course of current activation or inactivation. In CHO cells, EMPA and DAPA effects on INa were identical to those observed on hiPSC-CM. These results suggest that both SGLT2i increase INa by enhancing Nav1.5 expression into the cell membrane, by a direct gating effect on the channel, or by a combination of both.
Conclusions
In human cardiomyocytes, EMPA and DAPA increase INa and the AP amplitude. Moreover, EMPA, but not DAPA, prolonged AP duration. We propose that EMPA and DAPA exhibit a unique mechanism that increases cardiac excitability and conduction velocity and could contribute to the prevention of arrhythmic events in HF patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministerio de Ciencia e innovaciόnInstituto de de Salud Carlos III
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Affiliation(s)
- R Caballero
- Complutense University of Madrid , Madrid , Spain
| | - M Dago
- Complutense University of Madrid , Madrid , Spain
| | | | | | | | - J Rapun
- Complutense University of Madrid , Madrid , Spain
| | - M Marin
- Complutense University of Madrid , Madrid , Spain
| | - J Tamargo
- Complutense University of Madrid , Madrid , Spain
| | - E Delpon
- Complutense University of Madrid , Madrid , Spain
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Tamargo J, Tamargo M, Caballero R. Hypertrophic cardiomyopathy: an up-to-date snapshot of the clinical drug development pipeline. Expert Opin Investig Drugs 2022; 31:1027-1052. [PMID: 36062808 DOI: 10.1080/13543784.2022.2113374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Hypertrophic cardiomyopathy (HCM) is a complex cardiac disease with highly variable phenotypic expression and clinical course most often caused by sarcomeric gene mutations resulting in left ventricular hypertrophy, fibrosis, hypercontractility, and diastolic dysfunction. For almost 60 years, HCM has remained an orphan disease and still lacks a disease-specific treatment. AREAS COVERED This review summarizes recent preclinical and clinical trials with repurposed drugs and new emerging pharmacological and gene-based therapies for the treatment of HCM. EXPERT OPINION The off-label drugs routinely used alleviate symptoms but do not target the core pathophysiology of HCM or prevent or revert the phenotype. Recent advances in the genetics and pathophysiology of HCM led to the development of cardiac myosin adenosine triphosphatase inhibitors specifically directed to counteract the hypercontractility associated with HCM-causing mutations. Mavacamten, the first drug specifically developed for HCM successfully tested in a phase 3 trial, represents the major advance for the treatment of HCM. This opens new horizons for the development of novel drugs targeting HCM molecular substrates which hopefully modify the natural history of the disease. The role of current drugs in development and genetic-based approaches for the treatment of HCM are also discussed.
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Affiliation(s)
- Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
| | - María Tamargo
- Department of Cardiology, Hospital Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Doctor Esquerdo, 46, 28007 Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
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15
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Crespo-García T, Cámara-Checa A, Dago M, Rubio-Alarcón M, Rapún J, Tamargo J, Delpón E, Caballero R. Regulation of cardiac ion channels by transcription factors: Looking for new opportunities of druggable targets for the treatment of arrhythmias. Biochem Pharmacol 2022; 204:115206. [PMID: 35963339 DOI: 10.1016/j.bcp.2022.115206] [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: 06/27/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
Cardiac electrical activity is governed by different ion channels that generate action potentials. Acquired or inherited abnormalities in the expression and/or function of ion channels usually result in electrophysiological changes that can cause cardiac arrhythmias. Transcription factors (TFs) control gene transcription by binding to specific DNA sequences adjacent to target genes. Linkage analysis, candidate-gene screening within families, and genome-wide association studies have linked rare and common genetic variants in the genes encoding TFs with genetically-determined cardiac arrhythmias. Besides its critical role in cardiac development, recent data demonstrated that they control cardiac electrical activity through the direct regulation of the expression and function of cardiac ion channels in adult hearts. This narrative review summarizes some studies showing functional data on regulation of the main human atrial and ventricular Na+, Ca2+, and K+ channels by cardiac TFs such as Pitx2c, Tbx20, Tbx5, Zfhx3, among others. The results have improved our understanding of the mechanisms regulating cardiac electrical activity and may open new avenues for therapeutic interventions in cardiac acquired or inherited arrhythmias through the identification of TFs as potential drug targets. Even though TFs have for a long time been considered as 'undruggable' targets, advances in structural biology have led to the identification of unique pockets in TFs amenable to be targeted with small-molecule drugs or peptides that are emerging as novel therapeutic drugs.
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Affiliation(s)
- T Crespo-García
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain
| | - A Cámara-Checa
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain
| | - M Dago
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain
| | - M Rubio-Alarcón
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain
| | - J Rapún
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain
| | - J Tamargo
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain
| | - E Delpón
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain.
| | - R Caballero
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain
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- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, 28040 Madrid, Spain
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Figueredo B, Fontclara L, Figueredo J, Cabral J, Pederzani M, Fretes F, Caballero R, Galeano N, Bianco H, Ferreira F. Frequency and mortality of patients with rheumatologic disease affected by Covid-19 in the Adult Intensive Care Department of the Hospital de Clínicas. Rev parag reumatol 2022. [DOI: 10.18004/rpr/2022.08.01.27] [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: 10/17/2022] Open
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Tamargo J, Caballero R, Delpón E. Cancer Chemotherapy-Induced Sinus Bradycardia: A Narrative Review of a Forgotten Adverse Effect of Cardiotoxicity. Drug Saf 2022; 45:101-126. [PMID: 35025085 DOI: 10.1007/s40264-021-01132-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 12/20/2022]
Abstract
Cardiotoxicity is a common adverse effect of anticancer drugs (ACDs), including the so-called targeted drugs, and increases morbidity and mortality in patients with cancer. Attention has focused mainly on ACD-induced heart failure, myocardial ischemia, hypertension, thromboembolism, QT prolongation, and tachyarrhythmias. Yet, although an increasing number of ACDs can produce sinus bradycardia (SB), this proarrhythmic effect remains an underappreciated complication, probably because of its low incidence and severity since most patients are asymptomatic. However, SB merits our interest because its incidence increases with the aging of the population and cancer is an age-related disease and because SB represents a risk factor for QT prolongation. Indeed, several ACDs that produce SB also prolong the QT interval. We reviewed published reports on ACD-induced SB from January 1971 to November 2020 using the PubMed and EMBASE databases. Published reports from clinical trials, case reports, and recent reviews were considered. This review describes the associations between ACDs and SB, their clinical relevance, risk factors, and possible mechanisms of onset and treatment.
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Affiliation(s)
- Juan Tamargo
- Department of Pharmacology, School of Medicine, Universidad Complutense, Institute of Health Gregorio Marañón, CIBERCV, 28040, Madrid, Spain.
| | - Ricardo Caballero
- Department of Pharmacology, School of Medicine, Universidad Complutense, Institute of Health Gregorio Marañón, CIBERCV, 28040, Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology, School of Medicine, Universidad Complutense, Institute of Health Gregorio Marañón, CIBERCV, 28040, Madrid, Spain
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Rubio-Alarcón M, Cámara-Checa A, Dago M, Crespo-García T, Nieto-Marín P, Marín M, Merino JL, Toquero J, Salguero-Bodes R, Tamargo J, Cebrián J, Delpón E, Caballero R. Zfhx3 Transcription Factor Represses the Expression of SCN5A Gene and Decreases Sodium Current Density (I Na). Int J Mol Sci 2021; 22:ijms222313031. [PMID: 34884836 PMCID: PMC8657907 DOI: 10.3390/ijms222313031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/02/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 02/02/2023] Open
Abstract
The ZFHX3 and SCN5A genes encode the zinc finger homeobox 3 (Zfhx3) transcription factor (TF) and the human cardiac Na+ channel (Nav1.5), respectively. The effects of Zfhx3 on the expression of the Nav1.5 channel, and in cardiac excitability, are currently unknown. Additionally, we identified three Zfhx3 variants in probands diagnosed with familial atrial fibrillation (p.M1260T) and Brugada Syndrome (p.V949I and p.Q2564R). Here, we analyzed the effects of native (WT) and mutated Zfhx3 on Na+ current (INa) recorded in HL-1 cardiomyocytes. ZFHX3 mRNA can be detected in human atrial and ventricular samples. In HL-1 cardiomyocytes, transfection of Zfhx3 strongly reduced peak INa density, while the silencing of endogenous expression augmented it (from −65.9 ± 8.9 to −104.6 ± 10.8 pA/pF; n ≥ 8, p < 0.05). Zfhx3 significantly reduced the transcriptional activity of human SCN5A, PITX2, TBX5, and NKX25 minimal promoters. Consequently, the mRNA and/or protein expression levels of Nav1.5 and Tbx5 were diminished (n ≥ 6, p < 0.05). Zfhx3 also increased the expression of Nedd4-2 ubiquitin-protein ligase, enhancing Nav1.5 proteasomal degradation. p.V949I, p.M1260T, and p.Q2564R Zfhx3 produced similar effects on INa density and time- and voltage-dependent properties in WT. WT Zfhx3 inhibits INa as a result of a direct repressor effect on the SCN5A promoter, the modulation of Tbx5 increasing on the INa, and the increased expression of Nedd4-2. We propose that this TF participates in the control of cardiac excitability in human adult cardiac tissue.
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Affiliation(s)
- Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
- Correspondence: (M.D.); (J.C.)
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Paloma Nieto-Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - María Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - José Luis Merino
- Department of Cardiology, Hospital Universitario La Paz, Instituto de Investigación Sanitaria la Paz, CIBERCV, 28046 Madrid, Spain;
| | - Jorge Toquero
- Department of Cardiology, Hospital Universitario Puerta de Hierro, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, CIBERCV, Majadahonda, 28222 Madrid, Spain;
| | - Rafael Salguero-Bodes
- Department of Cardiology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre, CIBERCV, 28041 Madrid, Spain;
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
- Correspondence: (M.D.); (J.C.)
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
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Tamargo J, Caballero R, Delpón E. Sex-related differences in the pharmacological treatment of heart failure. Pharmacol Ther 2021; 229:107891. [PMID: 33992681 DOI: 10.1016/j.pharmthera.2021.107891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/23/2021] [Accepted: 05/03/2021] [Indexed: 12/21/2022]
Abstract
Heart failure (HF) represents a leading cause of morbidity and mortality. However, HF trials highlighted many differences between men and women with HF. Thus, women represent approximately a quarter of people with HF with reduced ejection fraction (HFrEF), while they account for over half of those with HF with preserved EF (HFpEF). There are also sex-related differences (SRDs) in the pharmacokinetics, pharmacodynamics and safety profile of some guideline-recommended drugs for the treatment of HF. As compared with men, women with HFrEF are less often treated with guideline-recommended HF drugs, experience more frequent and severe adverse reactions when these drugs are prescribed at the same doses in both sexes, and recent evidence suggests that women might need lower doses than men, bringing into question which are the optimal doses of HF drugs in women and men separately. However, information on SRDs in drug efficacy and safety in patients with HFrEF is very limited due to the underrepresentation of women and the lack of sex-specific evaluations of drug efficacy and safety in HF clinical trials. As a consequence, current clinical guidelines do not provide sex-specific recommendations, even when significant differences exist, at least, in drug safety. The aim of this article is to review the SRDs in the pharmacokinetics, efficacy and safety of guideline-recommended HF drugs and to identify emerging areas of research to improve our understanding of the SRDs, because a better understanding of these differences is the first step to achieve a personalized treatment of HF in women and men.
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Affiliation(s)
- Juan Tamargo
- Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain.
| | - Ricardo Caballero
- Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, 28040 Madrid, Spain
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Tamargo J, Caballero R, Delpón E. The pharmacotherapeutic management of hyperkalemia in patients with cardiovascular disease. Expert Opin Pharmacother 2021; 22:1319-1341. [PMID: 33620275 DOI: 10.1080/14656566.2021.1891223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Patients with cardiovascular diseases (CVD) are at increased risk of hyperkalemia, particularly when treated with renin-angiotensin-aldosterone inhibitors (RAASIs). Because the occurrence or fear of hyperkalemia, RAASIs are frequently down-titrated or discontinued in patients with CVD, with consequent worse outcomes than patients who remain on maximum doses.Areas covered: This article reviews potassium homeostasis, epidemiology, risk factors, and outcomes of hyperkalemia, and efficacy and safety of the drugs used for acute and chronic treatment of hyperkalemia. A literature search was carried out using the PubMed and guidelines for the management of hyperkalemia.Expert opinion: The emergency treatment of hyperkalemia is not supported by high-quality evidence and clinical trials did not report drug effects on clinical outcomes. Two potassium binders, patiromer and sodium zirconium cyclosilicate, represent a new approach in the treatment of chronic hyperkalemia as they may allow the titration and maintenance of guidelines-recommended doses of RAASIs in patients with CVD who otherwise would not tolerate them due to the risk of hyperkalemia.Further studies are needed to evaluate the safety and efficacy of drug therapy and support the development of guidelines for acute and chronic hyperkalemia.
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Affiliation(s)
- Juan Tamargo
- Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto De Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto De Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto De Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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21
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Nieto-Marín P, Tinaquero D, Utrilla RG, Cebrián J, González-Guerra A, Crespo-García T, Cámara-Checa A, Rubio-Alarcón M, Dago M, Alfayate S, Filgueiras D, Peinado R, López-Sendón JL, Jalife J, Tamargo J, Bernal JA, Caballero R, Delpón E. Tbx5 variants disrupt Nav1.5 function differently in patients diagnosed with Brugada or Long QT Syndrome. Cardiovasc Res 2021; 118:1046-1060. [PMID: 33576403 DOI: 10.1093/cvr/cvab045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/22/2020] [Accepted: 02/04/2021] [Indexed: 12/14/2022] Open
Abstract
AIMS The transcription factor Tbx5 controls cardiogenesis and drives Scn5a expression in mice. We have identified two variants in TBX5 encoding p.D111Y and p.F206L Tbx5, respectively, in two unrelated patients with structurally normal hearts diagnosed with Long QT (LQTS) and Brugada (BrS) Syndrome. Here we characterized the consequences of each variant to unravel the underlying disease mechanisms. METHODS AND RESULTS We combined clinical analysis with in vivo and in vitro electrophysiological and molecular techniques in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), HL-1 cells, and cardiomyocytes from mice trans-expressing human wildtype (WT) or mutant proteins. Tbx5 increased transcription of SCN5A encoding cardiac Nav1.5 channels, while repressing CAMK2D and SPTBN4 genes encoding Ca-calmodulin kinase IIδ (CaMKIIδ) and βIV-spectrin, respectively. These effects significantly increased Na current (INa) in hiPSC-CMs and in cardiomyocytes from mice trans-expressing Tbx5. Consequently, action potential (AP) amplitudes increased and QRS interval narrowed in the mouse electrocardiogram. p.F206L Tbx5 bound to the SCN5A promoter failed to transactivate it, thus precluding the pro-transcriptional effect of WT Tbx5. Therefore, p.F206L markedly decreased INa in hiPSC-CM, HL-1 cells, and mouse cardiomyocytes. The INa decrease in p.F206L trans-expressing mice translated into QRS widening and increased flecainide sensitivity. p.D111Y Tbx5 increased SCN5A expression but failed to repress CAMK2D and SPTBN4. The increased CaMKIIδ and βIV-spectrin significantly augmented the late component of INa (INaL) which, in turn, significantly prolonged AP duration in both hiPSC-CMs and mouse cardiomyocytes. Ranolazine, a selective INaL inhibitor, eliminated the QT and QTc intervals prolongation seen in p.D111Y trans-expressing mice. CONCLUSIONS In addition to peak INa, Tbx5 critically regulates INaL and the duration of repolarization in human cardiomyocytes. Our original results suggest that TBX5 variants associate with and modulate the intensity of the electrical phenotype in LQTS and BrS patients.
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Affiliation(s)
- Paloma Nieto-Marín
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - David Tinaquero
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Raquel G Utrilla
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | | | - Teresa Crespo-García
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - María Dago
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Silvia Alfayate
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - David Filgueiras
- Fundación Centro Nacional de Investigaciones Cardiovasculares. 28029-Madrid, Spain
| | - Rafael Peinado
- Department of Cardiology. Hospital Universitario La Paz. Instituto de Investigación Sanitaria la Paz. 28046-Madrid Spain
| | - José Luis López-Sendón
- Department of Cardiology. Hospital Universitario La Paz. Instituto de Investigación Sanitaria la Paz. 28046-Madrid Spain
| | - José Jalife
- Fundación Centro Nacional de Investigaciones Cardiovasculares. 28029-Madrid, Spain.,Departments of Internal Medicine and Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Juan Tamargo
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Juan Antonio Bernal
- Fundación Centro Nacional de Investigaciones Cardiovasculares. 28029-Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid. Instituto de Investigación Gregorio Marañón. CIBERCV. 28040-Madrid, Spain
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22
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Martin M, Zielinski C, Ruiz-Borrego M, Carrasco E, Turner N, Ciruelos EM, Muñoz M, Bermejo B, Margeli M, Anton A, Kahan Z, Csöszi T, Casas MI, Murillo L, Morales S, Alba E, Gal-Yam E, Guerrero-Zotano A, Calvo L, de la Haba-Rodriguez J, Ramos M, Alvarez I, Garcia-Palomo A, Huang Bartlett C, Koehler M, Caballero R, Corsaro M, Huang X, Garcia-Sáenz JA, Chacón JI, Swift C, Thallinger C, Gil-Gil M. Palbociclib in combination with endocrine therapy versus capecitabine in hormonal receptor-positive, human epidermal growth factor 2-negative, aromatase inhibitor-resistant metastatic breast cancer: a phase III randomised controlled trial-PEARL. Ann Oncol 2020; 32:488-499. [PMID: 33385521 DOI: 10.1016/j.annonc.2020.12.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [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: 09/01/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Palbociclib plus endocrine therapy (ET) is the standard treatment of hormone receptor-positive and human epidermal growth factor receptor 2-negative, metastatic breast cancer (MBC). However, its efficacy has not been compared with that of chemotherapy in a phase III trial. PATIENTS AND METHODS PEARL is a multicentre, phase III randomised study in which patients with aromatase inhibitor (AI)-resistant MBC were included in two consecutive cohorts. In cohort 1, patients were randomised 1 : 1 to palbociclib plus exemestane or capecitabine. On discovering new evidence about estrogen receptor-1 (ESR1) mutations inducing resistance to AIs, the trial was amended to include cohort 2, in which patients were randomised 1 : 1 between palbociclib plus fulvestrant and capecitabine. The stratification criteria were disease site, prior sensitivity to ET, prior chemotherapy for MBC, and country of origin. Co-primary endpoints were progression-free survival (PFS) in cohort 2 and in wild-type ESR1 patients (cohort 1 + cohort 2). ESR1 hotspot mutations were analysed in baseline circulating tumour DNA. RESULTS From March 2014 to July 2018, 296 and 305 patients were included in cohort 1 and cohort 2, respectively. Palbociclib plus ET was not superior to capecitabine in both cohort 2 [median PFS: 7.5 versus 10.0 months; adjusted hazard ratio (aHR): 1.13; 95% confidence interval (CI): 0.85-1.50] and wild-type ESR1 patients (median PFS: 8.0 versus 10.6 months; aHR: 1.11; 95% CI: 0.87-1.41). The most frequent grade 3-4 toxicities with palbociclib plus exemestane, palbociclib plus fulvestrant and capecitabine, respectively, were neutropenia (57.4%, 55.7% and 5.5%), hand/foot syndrome (0%, 0% and 23.5%), and diarrhoea (1.3%, 1.3% and 7.6%). Palbociclib plus ET offered better quality of life (aHR for time to deterioration of global health status: 0.67; 95% CI: 0.53-0.85). CONCLUSIONS There was no statistical superiority of palbociclib plus ET over capecitabine with respect to PFS in MBC patients resistant to AIs. Palbociclib plus ET showed a better safety profile and improved quality of life.
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Affiliation(s)
- M Martin
- Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Medicine Department, Universidad Complutense, Madrid, Spain; Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain.
| | - C Zielinski
- Medical Oncology, Central European Cancer Center, Wiener Privatklinik Hospital, Vienna, Austria; CECOG Central European Cooperative Oncology Group, Vienna, Austria
| | - M Ruiz-Borrego
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - E Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - N Turner
- Institute of Cancer Research and Royal Marsden, London, UK
| | - E M Ciruelos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain; Medical Oncology, HM Hospitales Madrid, Madrid, Spain; SOLTI Group on Breast Cancer Research, Barcelona, Spain
| | - M Muñoz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clinic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors (IDIBAPS), Barcelona, Spain
| | - B Bermejo
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Biomedical Research Institute INCLIVA, Valencia, Spain
| | - M Margeli
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; B-ARGO Group, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - A Anton
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Z Kahan
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - T Csöszi
- Department of Oncology, Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelőintezet, Szolnok, Hungary
| | - M I Casas
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - L Murillo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico de Zaragoza Lozano Blesa, Zaragoza, Spain
| | - S Morales
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - E Alba
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; UGCI Medical Oncology, Hospitales Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - E Gal-Yam
- Department of Oncology, Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
| | - A Guerrero-Zotano
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Instituto Valenciano de Oncología, Valencia, Spain
| | - L Calvo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Complejo Hospitalario A Coruña, Coruña, Spain
| | - J de la Haba-Rodriguez
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Reina Sofia, Córdoba; Instituto Maimonides de Investigación Biomédica (IMIBIC); Universidad de Córdoba, Córdoba, Spain
| | - M Ramos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro Oncológico de Galicia, A Coruña, Coruña, Spain
| | - I Alvarez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Donostia-Biodonostia, San Sebastián, Spain
| | - A Garcia-Palomo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital de León, León, Spain
| | | | - M Koehler
- Pfizer, USA; Repare Therapeutics, Cambridge, USA
| | - R Caballero
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | | | - J A Garcia-Sáenz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - J I Chacón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Virgen de la Salud, Toledo, Spain
| | - C Swift
- Ralph Lauren Centre for Breast Cancer Research, Royal Marsden, London, UK
| | - C Thallinger
- CECOG Central European Cooperative Oncology Group, Vienna, Austria; Department of Oncology, Medical University of Vienna, Department of Oncology, Vienna, Austria
| | - M Gil-Gil
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Institut Català d'Oncologia (ICO) & IDIBELL, L'Hospitalet, Barcelona, Spain
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Quintanar C, Caballero R, Ugalde M, Ramos M, Chavira E, Cruz-Manjarrez H, Espinosa F. Charge transfer and hydrogen adsorption in the Pd/Ag bimetallic nano system: an experimental and theoretical DFT cluster approach. Mol Phys 2020. [DOI: 10.1080/00268976.2020.1820090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Quintanar
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, México México
| | - R. Caballero
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, México México
| | - M. Ugalde
- Banco de México, Evaluación de Insumos, Irrigación México
| | - M. Ramos
- Universidad Nacional Autónoma de México, Instituto de Investigaciones en Materiales, México México
| | - E. Chavira
- Universidad Nacional Autónoma de México, Instituto de Investigaciones en Materiales, México México
| | - H. Cruz-Manjarrez
- Universidad Nacional Autónoma de México, Instituto de Física, México México
| | - F. Espinosa
- Centro de Investigación en Materiales Avanzados, Física de Materiales, Chihuahua México
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Alonso-Fernández-Gatta M, Gallego-Delgado M, Caballero R, Villacorta E, Díaz-Peláez E, García-BerrocaL B, Crespo-García T, Plata-Izquierdo B, Marcos-Vadillo E, García-Cuenllas L, Barreiro-Pérez M, Isidoro-García M, Tamargo-Menéndez J, Delpón E, Sánchez PL. A rare HCN4 variant with combined sinus bradycardia, left atrial dilatation, and hypertrabeculation/left ventricular noncompaction phenotype. ACTA ACUST UNITED AC 2020; 74:781-789. [PMID: 33008772 DOI: 10.1016/j.rec.2020.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/24/2020] [Indexed: 01/20/2023]
Abstract
INTRODUCTION AND OBJECTIVES HCN4 variants have been reported to cause combined sick sinus syndrome (SSS) and left ventricular noncompaction (LVNC) cardiomyopathy. This relationship has been proven in few cases and no previous patients have associated left atrial dilatation (LAD). Our objective was to study a familial disorder characterized by SSS, LAD, and hypertrabeculation/LVNC and to identify the underlying genetic and electrophysiological characteristics. METHODS A family with SSS and LVNC underwent a clinical, genetic, and electrophysiological assessment. They were studied via electrocardiography, Holter recording, echocardiography, and exercise stress tests; cardiac magnetic resonance imaging was additionally performed in affected individuals. Genetic testing was undertaken with targeted next-generation sequencing, as well as a functional study of the candidate variant in Chinese hamster ovary cells. RESULTS Twelve members of the family had sinus bradycardia, associated with complete criteria of LVNC in 4 members and hypertrabeculation in 6 others, as well as LAD in 9 members. A HCN4 c.1123C>T;(p.R375C) variant was present in heterozygosis in all affected patients and absent in unaffected individuals. Electrophysiological analyses showed that the amplitude and densities of the HCN4 currents (IHCN4) generated by mutant p.R375C HCN4 channels were significantly lower than those generated by wild-type channels. CONCLUSIONS The combined phenotype of SSS, LAD, and LVNC is associated with the heritable HCN4 c.1123C>T;(p.R375C) variant. HCN4 variants should be included in the genetic diagnosis of LVNC cardiomyopathy and of patients with familial forms of SSS, as well as of individuals with sinus bradycardia and LAD.
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Affiliation(s)
- Marta Alonso-Fernández-Gatta
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - María Gallego-Delgado
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain
| | - Ricardo Caballero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Eduardo Villacorta
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain.
| | - Elena Díaz-Peláez
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain
| | - Belén García-BerrocaL
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain; Unidad de Genética, Servicio de Bioquímica, Complejo Asistencial Universitario de Salamanca. Universidad de Salamanca, Salamanca, Spain
| | - Teresa Crespo-García
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Beatriz Plata-Izquierdo
- Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain; Servicio de Pediatría, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Elena Marcos-Vadillo
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain; Unidad de Genética, Servicio de Bioquímica, Complejo Asistencial Universitario de Salamanca. Universidad de Salamanca, Salamanca, Spain
| | - Luisa García-Cuenllas
- Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain; Servicio de Pediatría, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Manuel Barreiro-Pérez
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - María Isidoro-García
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain; Unidad de Genética, Servicio de Bioquímica, Complejo Asistencial Universitario de Salamanca. Universidad de Salamanca, Salamanca, Spain
| | - Juan Tamargo-Menéndez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Eva Delpón
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Pedro L Sánchez
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Centro de Referencia Nacional de Cardiopatías Familiares (CSUR), Salamanca, Spain
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Tinaquero D, Crespo-García T, Utrilla RG, Nieto-Marín P, González-Guerra A, Rubio-Alarcón M, Cámara-Checa A, Dago M, Matamoros M, Pérez-Hernández M, Tamargo M, Cebrián J, Jalife J, Tamargo J, Bernal JA, Caballero R, Delpón E. The p.P888L SAP97 polymorphism increases the transient outward current (I to,f) and abbreviates the action potential duration and the QT interval. Sci Rep 2020; 10:10707. [PMID: 32612162 PMCID: PMC7329876 DOI: 10.1038/s41598-020-67109-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/01/2020] [Indexed: 11/09/2022] Open
Abstract
Synapse-Associated Protein 97 (SAP97) is an anchoring protein that in cardiomyocytes targets to the membrane and regulates Na+ and K+ channels. Here we compared the electrophysiological effects of native (WT) and p.P888L SAP97, a common polymorphism. Currents were recorded in cardiomyocytes from mice trans-expressing human WT or p.P888L SAP97 and in Chinese hamster ovary (CHO)-transfected cells. The duration of the action potentials and the QT interval were significantly shorter in p.P888L-SAP97 than in WT-SAP97 mice. Compared to WT, p.P888L SAP97 significantly increased the charge of the Ca-independent transient outward (Ito,f) current in cardiomyocytes and the charge crossing Kv4.3 channels in CHO cells by slowing Kv4.3 inactivation kinetics. Silencing or inhibiting Ca/calmodulin kinase II (CaMKII) abolished the p.P888L-induced Kv4.3 charge increase, which was also precluded in channels (p.S550A Kv4.3) in which the CaMKII-phosphorylation is prevented. Computational protein-protein docking predicted that p.P888L SAP97 is more likely to form a complex with CaMKII than WT. The Na+ current and the current generated by Kv1.5 channels increased similarly in WT-SAP97 and p.P888L-SAP97 cardiomyocytes, while the inward rectifier current increased in WT-SAP97 but not in p.P888L-SAP97 cardiomyocytes. The p.P888L SAP97 polymorphism increases the Ito,f, a CaMKII-dependent effect that may increase the risk of arrhythmias.
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Affiliation(s)
- David Tinaquero
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - Raquel G Utrilla
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - Paloma Nieto-Marín
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | | | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - María Dago
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - Marcos Matamoros
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - Marta Pérez-Hernández
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - María Tamargo
- Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | - José Jalife
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Department of Internal Medicine/Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Juan Tamargo
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
| | | | - Ricardo Caballero
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain.
| | - Eva Delpón
- Department of Pharmacology and Toxicology. School of Medicine. Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón. CIBERCV, Madrid, Spain
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Caraballo R, Silva S, Beltran L, Calvo A, Caballero R. Childhood-only epilepsy with generalized tonic-clonic seizures: A well-defined epileptic syndrome. Epilepsy Res 2019; 153:28-33. [DOI: 10.1016/j.eplepsyres.2019.03.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 03/21/2019] [Accepted: 03/26/2019] [Indexed: 11/26/2022]
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López-Alcorocho JM, Aboli L, Rodríguez-Iñigo E, Guillén-Vicente I, Guillén-Vicente M, Caballero R, Casqueiro M, Fernández-Jaen TF, Abelow S, Guillen-García P. Clinical outcome and subchondral bone edema presence at two-year follow-up after high density autologous chondrocyte implantation treatment in the knee. Rev Esp Cir Ortop Traumatol (Engl Ed) 2019; 63:253-260. [PMID: 31147299 DOI: 10.1016/j.recot.2019.03.004] [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: 10/18/2018] [Revised: 02/01/2019] [Accepted: 03/10/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Recently, a new approach of autologous chondrocyte implantation technique (using as biomaterial a collagen type i/iii membrane) based on increasing cell density called HD-ACI (High Density Autologous Chondrocyte Implantation) has been described. The objective of this paper was to study the clinical outcome and incidence of subchondral bone oedema in patients with cartilage lesions in the knee treated with HD-ACI at 1-2 years of follow-up. METHODS This is a retrospective study performed with forty patients with chondral injuries grade iii-iv. All patients were treated with HD-ACI with a cellular dose of 5×106 chondrocytes /cm2 of lesion. The subjective perception of improvement of symptoms and functionality was measured with the IKDC score (International Knee Documentation Committee). The presence of bone oedema was assessed at 6, 12 and 24 months of follow-up by magnetic resonance imaging. RESULTS IKDC values showed a significant improvement at 12 and 24 months (P<.001). The mean difference of IKDC between the baseline visit and 12 months was 26.3 points, and 31.6 points at 24 months. Twenty-seven point five percent of the patients presented subchondral bone oedema at 2 years of follow-up. CONCLUSIONS HD-ACI is an effective and safe treatment that improves pain, clinical perception and functionality of the joint. No correlation was found between the presence of bone oedema and the patients' clinical outcome.
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Affiliation(s)
- J M López-Alcorocho
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España.
| | - L Aboli
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
| | - E Rodríguez-Iñigo
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
| | - I Guillén-Vicente
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
| | - M Guillén-Vicente
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
| | - R Caballero
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
| | - M Casqueiro
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
| | - T F Fernández-Jaen
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
| | - S Abelow
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
| | - P Guillen-García
- Unidad de Investigación y Departamento de Traumatología, Cínica CEMTRO, Madrid, España
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Abstract
INTRODUCTION Hypertensive disorders of pregnancy (HDP) represent a major cause of maternal, fetal and neonatal morbidity and mortality and identifies women at risk for cardiovascular and other chronic diseases later in life. When antihypertensive drugs are used during pregnancy, their benefit and harm to both mother and fetus should be evaluated. AREAS COVERED This review summarizes the pharmacological characteristics of the recommended antihypertensive drugs and their impact on mother and fetus when administered during pregnancy and/or post-partum. Drugs were identified using MEDLINE and the main international Guidelines for the management of HDP. EXPERT OPINION Although there is a consensus that severe hypertension should be treated, treatment of mild hypertension without end-organ damage (140-159/90-109 mmHg) remains controversial and there is no agreement on when to initiate therapy, blood pressure targets or recommended drugs in the absence of robust evidence for the superiority of one drug over others. Furthermore, the long-term outcomes of in-utero antihypertensive exposure remain uncertain. Therefore, evidence-based data regarding the treatment of HDP is lacking and well designed randomized clinical trials are needed to resolve all these controversial issues related to the management of HDP.
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Affiliation(s)
- Juan Tamargo
- a Department of Pharmacology and Toxicology, School of Medicine , Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV , Madrid , Spain
| | - Ricardo Caballero
- a Department of Pharmacology and Toxicology, School of Medicine , Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV , Madrid , Spain
| | - Eva Delpón
- a Department of Pharmacology and Toxicology, School of Medicine , Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV , Madrid , Spain
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Nieto-Marín P, Jiménez-Jáimez J, Tinaquero D, Alfayate S, Utrilla RG, Rodríguez Vázquez del Rey MDM, Perin F, Sarquella-Brugada G, Monserrat L, Brugada J, Tercedor L, Tamargo J, Delpón E, Caballero R. La expresividad variable del síndrome de QT largo de una familia española se explica por la heterocigosis digénica en SCN5A y CACNA1C. Rev Esp Cardiol (Engl Ed) 2019. [DOI: 10.1016/j.recesp.2018.03.009] [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: 01/25/2023]
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Alba E, Rueda OM, Lluch A, Albanell J, Chin SF, Chacón JI, Calvo L, De la Haba-Rodriguez J, Bermejo B, Ribelles N, Sánchez-Rovira P, Plazaola A, Barnadas A, Cirauqul B, Ramos M, Arcusa A, Carrasco E, Herranz J, Chiesa M, Caballero R, Santonja A, Rojo F, Caldas C. Abstract P5-12-03: Genome copy number entropy as predictor of response for neoadjuvant therapy in early breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-12-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Copy Number Alterations (CNAs) represent changes in the copy number of genomic segments of somatic cells due to chromosomal instability. CNAs include gene amplifications or deletions and can be involved in tumorigenesis. We analyzed CNAs data in pre- and post-treatment (ttm) tumors from patients (pts) with early breast cancer (BC) in the neoadjuvant trials GEICAM/2006-03 and GEICAM/2006-14, with the aim to identify CNAs in particular genomic regions (genetic entropy) associated with treatment response.
Methods
GEICAM/2006-03 (NCT00432172) HER2-negative pts were selectively treated according to clinical subtypes: triple negative (TN) pts were treated with standard anthracycline/taxane -based chemotherapy (AT-CT) +/- carboplatin, while luminal patients were randomized to AT-CT vs. hormonotherapy; GEICAM/2006-14 (NCT00841828) HER2+ pts received AT-CT plus anti-HER2 therapy.Shallow-whole genome Illumina sequencing DNA data from 204 paraffin-embedded tumors (100 pre- and 104 post-ttm) were segmented to obtain CNAs and recurrent altered genomic regions were defined. We used Wilcoxon test to analyze the frequency of altered regions and logistic regression analyses to explore their association with tumor response, in terms of pathological complete response (pCR) in breast and axilla. Validation of altered genes associated with therapy response was performed in the microarray gene expression-based Hatzis dataset (GSE25066) from pts receiving neoadjuvant AT-CT (1).
Results
A total of 672 regions covering the whole genome were identified upon analysis of CNAs data. Regions were categorized according to their alteration status as amplified, normal and lost. Comparative analysis of alterations revealed 11 regions significantly different (p<0.05) in pre- vs post-ttm tumors. Logistic regression analysis showed that in pre-ttm tumors specific alterations of 8 regions localized in 3 different genomic loci (11q12, 16q22 and 21q22) were significantly associated with pCR (p<0.05). Independent analyses of CNAs data with “CGH regions” and “GISTIC2.0” tools confirmed the special relevance of 2 of these 8 regions (#653 and #654), amplified in the locus 21q22.12. This locus contains 20 genes whose expression was tested in Hatzis dataset (1) (GSE25066): the analysis showed that overexpression of 5 of these 20 genes (CHAF1B, CBR1, CBR3, RCAN1 and SLC5A3) turned out to be significantly higher in the cohort of pts who reached pCR, in agreement with our findings. Some of these genes have already been described as proliferation markers (CHAF1B) or involved in treatment response (CBR1) in BC. Other genes related to BC in this genomic region are the transcription factor RUNX1 and the Lysine Methyltransferase SETD4.
Conclusions
According to our results, neoadjuvant therapy can modulate genomic aberrations landscape in BC. Our data suggest that amplification of specific genes in the genomic locus (21q22.12) is involved in the neoadjuvant therapy response in early BC.
(1): Hatzis et al., JAMA 2011, 305(18) 1873-81
Citation Format: Alba E, Rueda OM, Lluch A, Albanell J, Chin S-F, Chacón JI, Calvo L, De la Haba-Rodriguez J, Bermejo B, Ribelles N, Sánchez-Rovira P, Plazaola A, Barnadas A, Cirauqul B, Ramos M, Arcusa A, Carrasco E, Herranz J, Chiesa M, Caballero R, Santonja A, Rojo F, Caldas C. Genome copy number entropy as predictor of response for neoadjuvant therapy in early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-12-03.
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Affiliation(s)
- E Alba
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - OM Rueda
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - A Lluch
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - J Albanell
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - S-F Chin
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - JI Chacón
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - L Calvo
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - J De la Haba-Rodriguez
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - B Bermejo
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - N Ribelles
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - P Sánchez-Rovira
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - A Plazaola
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - A Barnadas
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - B Cirauqul
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - M Ramos
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - A Arcusa
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - E Carrasco
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - J Herranz
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - M Chiesa
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - R Caballero
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - A Santonja
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - F Rojo
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
| | - C Caldas
- Instituto de Investigación Biomédica de Málaga (IBIMA) - Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC, Madrid, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain; Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, United Kingdom; Hospital Clínico Universitario de Valencia. Biomedical Research Institute INCLIVA. University of Valencia, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Hospital Virgen de la Salud, Toledo, Spain; Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) - H. Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Complejo Hospitalario de Jaén, Jaen, Spain; Onkologikoa, San Sebastián, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Germans Trias i Pujol, Barcelona, Spai
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Tamargo J, Caballero R, Delpón E. New drugs in preclinical and early stage clinical development in the treatment of heart failure. Expert Opin Investig Drugs 2018; 28:51-71. [DOI: 10.1080/13543784.2019.1551357] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, CIBERCV, Madrid,
Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, CIBERCV, Madrid,
Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, CIBERCV, Madrid,
Spain
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Quiroga V, Holgado E, Alonso J, Andres R, Moreno Anton F, Alamo De La Gala M, Henao F, Cirauqui Cirauqui B, Margeli M, Cortes Castan J, Gion Cortes M, Soto A, Benito S, Escudero M, Chiesa M, Caballero R, Bezares Montes S, Carrasco E, De La Cruz Merino L. Run-in-phase results from a multicenter phase II trial to evaluate pembrolizumab (P) and gemcitabine (Gem) in patients (pts) with HER2-negative advanced breast cancer (ABC): GEICAM/2015-04 PANGEA-Breast. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy487.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pérez-Hernández M, Matamoros M, Alfayate S, Nieto-Marín P, Utrilla RG, Tinaquero D, de Andrés R, Crespo T, Ponce-Balbuena D, Willis BC, Jiménez-Vazquez EN, Guerrero-Serna G, da Rocha AM, Campbell K, Herron TJ, Díez-Guerra FJ, Tamargo J, Jalife J, Caballero R, Delpón E. Brugada syndrome trafficking-defective Nav1.5 channels can trap cardiac Kir2.1/2.2 channels. JCI Insight 2018; 3:96291. [PMID: 30232268 DOI: 10.1172/jci.insight.96291] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/03/2018] [Indexed: 12/28/2022] Open
Abstract
Cardiac Nav1.5 and Kir2.1-2.3 channels generate Na (INa) and inward rectifier K (IK1) currents, respectively. The functional INa and IK1 interplay is reinforced by the positive and reciprocal modulation between Nav15 and Kir2.1/2.2 channels to strengthen the control of ventricular excitability. Loss-of-function mutations in the SCN5A gene, which encodes Nav1.5 channels, underlie several inherited arrhythmogenic syndromes, including Brugada syndrome (BrS). We investigated whether the presence of BrS-associated mutations alters IK1 density concomitantly with INa density. Results obtained using mouse models of SCN5A haploinsufficiency, and the overexpression of native and mutated Nav1.5 channels in expression systems - rat ventricular cardiomyocytes and human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) - demonstrated that endoplasmic reticulum (ER) trafficking-defective Nav1.5 channels significantly decreased IK1, since they did not positively modulate Kir2.1/2.2 channels. Moreover, Golgi trafficking-defective Nav1.5 mutants produced a dominant negative effect on Kir2.1/2.2 and thus an additional IK1 reduction. Moreover, ER trafficking-defective Nav1.5 channels can be partially rescued by Kir2.1/2.2 channels through an unconventional secretory route that involves Golgi reassembly stacking proteins (GRASPs). Therefore, cardiac excitability would be greatly affected in subjects harboring Nav1.5 mutations with Golgi trafficking defects, since these mutants can concomitantly trap Kir2.1/2.2 channels, thus unexpectedly decreasing IK1 in addition to INa.
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Affiliation(s)
- Marta Pérez-Hernández
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - Marcos Matamoros
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - Silvia Alfayate
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - Paloma Nieto-Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - Raquel G Utrilla
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - David Tinaquero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - Raquel de Andrés
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa" (UAM-CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Teresa Crespo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - Daniela Ponce-Balbuena
- Departments of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, USA
| | - B Cicero Willis
- Departments of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Eric N Jiménez-Vazquez
- Departments of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Guadalupe Guerrero-Serna
- Departments of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Andre M da Rocha
- Departments of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Katherine Campbell
- Departments of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Todd J Herron
- Departments of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, USA
| | - F Javier Díez-Guerra
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa" (UAM-CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - José Jalife
- Departments of Internal Medicine and Molecular and Integrative Physiology, Center for Arrhythmia Research, University of Michigan, Ann Arbor, Michigan, USA.,Fundación Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBER of Cardiovascular Diseases, Madrid, Spain
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Purcell C, Batke SP, Yiotis C, Caballero R, Soh WK, Murray M, McElwain JC. Increasing stomatal conductance in response to rising atmospheric CO2. Ann Bot 2018; 121:1427. [PMID: 29471375 PMCID: PMC6007760 DOI: 10.1093/aob/mcy023] [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] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Purcell C, Batke SP, Yiotis C, Caballero R, Soh WK, Murray M, McElwain JC. Increasing stomatal conductance in response to rising atmospheric CO2. Ann Bot 2018; 121:1137-1149. [PMID: 29394303 PMCID: PMC5946907 DOI: 10.1093/aob/mcx208] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/16/2017] [Indexed: 05/19/2023]
Abstract
Background and Aims Studies have indicated that plant stomatal conductance (gs) decreases in response to elevated atmospheric CO2, a phenomenon of significance for the global hydrological cycle. However, gs increases across certain CO2 ranges have been predicted by optimization models. The aim of this work was to demonstrate that under certain environmental conditions, gs can increase in response to elevated CO2. Methods Using (1) an extensive, up-to-date synthesis of gs responses in free air CO2 enrichment (FACE)experiments, (2) in situ measurements across four biomes showing dynamic gs responses to a CO2 rise of ~50 ppm (characterizing the change in this greenhouse gas over the past three decades) and (3) a photosynthesis-stomatal conductance model, it is demonstrated that gs can in some cases increase in response to increasing atmospheric CO2. Key Results Field observations are corroborated by an extensive synthesis of gs responses in FACE experiments showing that 11.8 % of gs responses under experimentally elevated CO2 are positive. They are further supported by a strong data-model fit (r2 = 0.607) using a stomatal optimization model applied to the field gs dataset. A parameter space identified in the Farquhar-Ball-Berry photosynthesis-stomatal conductance model confirms field observations of increasing gs under elevated CO2 in hot dry conditions. Contrary to the general assumption, positive gs responses to elevated CO2, although relatively rare, are a feature of woody taxa adapted to warm, low-humidity conditions, and this response is also demonstrated in global simulations using the Community Land Model (CLM4). Conclusions The results contradict the over-simplistic notion that global vegetation always responds with decreasing gs to elevated CO2, a finding that has important implications for predicting future vegetation feedbacks on the hydrological cycle at the regional level.
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Affiliation(s)
- C Purcell
- School of Biology and Environmental Science, Earth Institute, University College Dublin, Belfield, Dublin, Ireland
| | - S P Batke
- School of Biology and Environmental Science, Earth Institute, University College Dublin, Belfield, Dublin, Ireland
- Department of Biology, Edge Hill University, St. Helens Road, Ormskirk, UK
| | - C Yiotis
- School of Biology and Environmental Science, Earth Institute, University College Dublin, Belfield, Dublin, Ireland
| | - R Caballero
- Department of Meteorology and Bolin Centre for Climate Research, Stockholm University, Stockholm, Sweden
| | - W K Soh
- School of Biology and Environmental Science, Earth Institute, University College Dublin, Belfield, Dublin, Ireland
| | - M Murray
- School of Biology and Environmental Science, Earth Institute, University College Dublin, Belfield, Dublin, Ireland
| | - J C McElwain
- Botany Department, Trinity College Dublin, College Green, Dublin, Ireland
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Ethier JL, Ocaña A, Rodríguez Lescure A, Ruíz A, Alba E, Calvo L, Ruíz-Borrego M, Santaballa A, Rodríguez CA, Crespo C, Ramos M, Gracia Marco J, Lluch A, Álvarez I, Casas M, Sánchez-Aragó M, Carrasco E, Caballero R, Amir E, Martin M. Outcomes of single versus double hormone receptor-positive breast cancer. A GEICAM/9906 sub-study. Eur J Cancer 2018; 94:199-205. [PMID: 29573665 DOI: 10.1016/j.ejca.2018.02.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 11/24/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Retrospective data suggest better outcomes for patients with double hormonal receptor (oestrogen [ER] and progesterone receptor [PgR])-positive (dHR+) early breast cancer, compared with single hormonal receptor-positive, sHR+, (ER+/PgR- or ER-/PgR+) disease. Here, we evaluate the classification according to intrinsic subtypes and clinical outcomes of sHR+ versus dHR+ in HER2-negative breast cancer patients enrolled in GEICAM/9906 study (NCT00129922). METHODS Archival tumours were retrieved retrospectively for the analysis of ER, PgR and HER2 status and classified into intrinsic subtypes using the PAM50 gene expression assay. Disease-free survival (DFS) and overall survival (OS) were explored using a Cox proportional hazard analysis. RESULTS Data on intrinsic subtypes were available in 571 (50%) patients with ER+ and/or PR+, and HER2-negative primary tumours. The incidence of luminal A and luminal B subtypes were 52%/36% in dHR+ tumours (ER+/PgR+), and 15%/58% in ER+/PgR-tumours. ER-/PgR+ tumours were mainly luminal A (52%). Compared with ER+/PgR+ patients, DFS was similar in ER-/PgR+ (hazard ratio [HR] 1.15, 95% confidence interval [CI] 0.57-2.34, p = 0.70) but worse in ER+/PgR- patients (HR 1.60, 95% CI 1.12-2.28, p < 0.01). Similar results were observed for OS (HR 1.50, p = 0.30 and HR 1.86, p < 0.01, respectively). CONCLUSIONS The ER+/PgR- group is characterised by higher proliferation and worse outcomes. In spite of the ER-/PgR+ subgroup resembles ER+/PgR+ disease in terms of molecular subtypes and outcomes, the small number of patients in this subgroup prevents from drawing any conclusions. TRIAL REGISTRATION EudraCT: 2005-003108-12 (retrospectively registered 28/06/2005). CLINICALTRIALS. GOV IDENTIFIER NCT00129922 (retrospectively registered 10/08/2005).
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Affiliation(s)
- J L Ethier
- Department of Medical Oncology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada
| | - A Ocaña
- Complejo Hospitalario de Albacete, Albacete, Spain; GEICAM (Spanish Breast Cancer Group), Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain
| | - A Rodríguez Lescure
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Universitario de Elche, Elche, Spain
| | - A Ruíz
- GEICAM (Spanish Breast Cancer Group), Spain; Instituto Valenciano de Oncología, Valencia, Spain
| | - E Alba
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Virgen de La Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain
| | - L Calvo
- GEICAM (Spanish Breast Cancer Group), Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - M Ruíz-Borrego
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Univ. Virgen Del Rocío, Sevilla, Spain
| | - A Santaballa
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Universitario La Fe, Valencia, Spain
| | - C A Rodríguez
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Clínico Universitario de Salamanca, Salamanca (IBSAL), Spain
| | - C Crespo
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Ramón y Cajal, Madrid, Spain
| | - M Ramos
- GEICAM (Spanish Breast Cancer Group), Spain; Centro Oncológico de Galicia, A Coruña, Spain
| | - J Gracia Marco
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital de Cabueñes, Gijón, Spain
| | - A Lluch
- GEICAM (Spanish Breast Cancer Group), Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain; Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - I Álvarez
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital de Donostia, San Sebastián, Spain
| | - M Casas
- GEICAM (Spanish Breast Cancer Group), Spain
| | | | - E Carrasco
- GEICAM (Spanish Breast Cancer Group), Spain
| | | | - E Amir
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - M Martin
- GEICAM (Spanish Breast Cancer Group), Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
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Ponce-Balbuena D, Guerrero-Serna G, Valdivia CR, Caballero R, Diez-Guerra FJ, Jiménez-Vázquez EN, Ramírez RJ, Monteiro da Rocha A, Herron TJ, Campbell KF, Willis BC, Alvarado FJ, Zarzoso M, Kaur K, Pérez-Hernández M, Matamoros M, Valdivia HH, Delpón E, Jalife J. Cardiac Kir2.1 and Na V1.5 Channels Traffic Together to the Sarcolemma to Control Excitability. Circ Res 2018. [PMID: 29514831 DOI: 10.1161/circresaha.117.311872] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
RATIONALE In cardiomyocytes, NaV1.5 and Kir2.1 channels interact dynamically as part of membrane bound macromolecular complexes. OBJECTIVE The objective of this study was to test whether NaV1.5 and Kir2.1 preassemble during early forward trafficking and travel together to common membrane microdomains. METHODS AND RESULTS In patch-clamp experiments, coexpression of trafficking-deficient mutants Kir2.1Δ314-315 or Kir2.1R44A/R46A with wild-type (WT) NaV1.5WT in heterologous cells reduced inward sodium current compared with NaV1.5WT alone or coexpressed with Kir2.1WT. In cell surface biotinylation experiments, expression of Kir2.1Δ314-315 reduced NaV1.5 channel surface expression. Glycosylation analysis suggested that NaV1.5WT and Kir2.1WT channels associate early in their biosynthetic pathway, and fluorescence recovery after photobleaching experiments demonstrated that coexpression with Kir2.1 increased cytoplasmic mobility of NaV1.5WT, and vice versa, whereas coexpression with Kir2.1Δ314-315 reduced mobility of both channels. Viral gene transfer of Kir2.1Δ314-315 in adult rat ventricular myocytes and human induced pluripotent stem cell-derived cardiomyocytes reduced inward rectifier potassium current and inward sodium current, maximum diastolic potential and action potential depolarization rate, and increased action potential duration. On immunostaining, the AP1 (adaptor protein complex 1) colocalized with NaV1.5WT and Kir2.1WT within areas corresponding to t-tubules and intercalated discs. Like Kir2.1WT, NaV1.5WT coimmunoprecipitated with AP1. Site-directed mutagenesis revealed that NaV1.5WT channels interact with AP1 through the NaV1.5Y1810 residue, suggesting that, like for Kir2.1WT, AP1 can mark NaV1.5 channels for incorporation into clathrin-coated vesicles at the trans-Golgi. Silencing the AP1 ϒ-adaptin subunit in human induced pluripotent stem cell-derived cardiomyocytes reduced inward rectifier potassium current, inward sodium current, and maximum diastolic potential and impaired rate-dependent action potential duration adaptation. CONCLUSIONS The NaV1.5-Kir2.1 macromolecular complex pre-assembles early in the forward trafficking pathway. Therefore, disruption of Kir2.1 trafficking in cardiomyocytes affects trafficking of NaV1.5, which may have important implications in the mechanisms of arrhythmias in inheritable cardiac diseases.
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Affiliation(s)
- Daniela Ponce-Balbuena
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - Guadalupe Guerrero-Serna
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - Carmen R Valdivia
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - Ricardo Caballero
- Department of Pharmacology, School of Medicine, Universidad Complutense, Madrid, Spain (R.C., M.P.-H., M.M., E.D.).,Instituto de Investigación Sanitaria Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain (R.C., M.P.-H., M.M., E.D.)
| | - F Javier Diez-Guerra
- Departamento de Biología Molecular and Centro de Biología Molecular Severo Ochoa (UAM-CSIC), Universidad Autónoma de Madrid, Spain (F.J.D.-G.)
| | - Eric N Jiménez-Vázquez
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - Rafael J Ramírez
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - André Monteiro da Rocha
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - Todd J Herron
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - Katherine F Campbell
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - B Cicero Willis
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | | | - Manuel Zarzoso
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - Kuljeet Kaur
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.)
| | - Marta Pérez-Hernández
- Department of Pharmacology, School of Medicine, Universidad Complutense, Madrid, Spain (R.C., M.P.-H., M.M., E.D.).,Instituto de Investigación Sanitaria Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain (R.C., M.P.-H., M.M., E.D.)
| | - Marcos Matamoros
- Department of Pharmacology, School of Medicine, Universidad Complutense, Madrid, Spain (R.C., M.P.-H., M.M., E.D.).,Instituto de Investigación Sanitaria Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain (R.C., M.P.-H., M.M., E.D.)
| | - Héctor H Valdivia
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.).,Department of Molecular and Integrative Physiology (F.J.A., H.H.V.)
| | - Eva Delpón
- Department of Pharmacology, School of Medicine, Universidad Complutense, Madrid, Spain (R.C., M.P.-H., M.M., E.D.).,Instituto de Investigación Sanitaria Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain (R.C., M.P.-H., M.M., E.D.)
| | - José Jalife
- From the Department of Internal Medicine and Center for Arrhythmia Research (D.P.-B., G.G.-S., C.R.V., E.N.J.-V., R.J.R., A.M.d.R., T.J.H., K.F.C., B.C.W., M.Z., K.K., H.H.V., J.J.) .,University of Michigan, Ann Arbor; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.J.).,CIBERV, Madrid, Spain (J.J.)
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Sanz AF, Alvarez RC, Caballero R, Delpon E, Egido JP, Duran BA, Gil-Fournier B, Ramiro S, Thuissard I, Tamargo J, Lefort M, Martin JA, Cosio F. HCN4 AND GATA5 PREVIOUSLY UNDESCRIBED VARIANTS IN A LARGE KINDRED WITH FAMILIAL ATRIAL FIBRILLATION. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)30869-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Martín M, Hoffman J, Ruiz-Borrego M, Muñoz M, Calvo L, Crownover P, García-Sáenz JA, Alba E, Wang D, Thallinger C, Stradella A, Montaño Á, Adamo B, Antolín S, Moreno-Antón F, Falo C, Ruiz V, Martín N, Caballero R, Carrasco E, Gil-Gil M. Abstract P5-21-23: Evaluation of the drug interaction potential of palbociclib and exemestane – Results from the PEARL pharmacokinetic sub-Study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-21-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Palbociclib (PAL) is an oral cyclin-dependent kinase (CDK) 4/6 inhibitor that is under investigation in multiple oncologic clinical trials and is currently approved for use in combination with aromatase inhibitors (AIs) or fulvestrant (FUL) in patients with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2–) advanced breast cancer (BC).
The PEARL Study is an ongoing international, open label, controlled, randomized Phase 3 study comparing the efficacy and safety of PAL in combination with endocrine therapy (exemestane [EXE] or FUL) versus capecitabine in postmenopausal women with HR+/ HER2– metastatic BC whose disease progressed on AIs. A secondary objective of the study was to evaluate the pharmacokinetics (PK) of PAL (125mg QD, 3 weeks on/1 week off) and EXE (25mg QD, continuously) when coadministered. This is the first study to investigate the drug-drug interaction (DDI) potential of the combination of PAL and the AI EXE.
Methods: Patients (pts) randomized to the PAL+EXE arm of the PEARL Study in seven selected sites had the option of participating in the PK sub-study. Those who enrolled in the PK sub-study received EXE alone in a 7-day lead-in period immediately prior to Cycle 1 Day 1, when both drugs were coadministered on their standard dosing regimens. Sub-study pts were to have 2 pre-dose plasma PK samples drawn at steady-state (ss) during the lead-in period ("EXE Alone") for EXE determination, and 2 ss PK samples drawn for EXE and PAL determination (2 per analyte) during coadministration ("PAL+EXE"). Plasma concentrations of PAL and EXE were measured using validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods. The withinpatient mean concentration of the PK samples which met ss acceptance criteria (WPM-Ctrough) for each analyte were generated for each treatment period as the input for DDI analyses.
To assess the effect of coadministration of PAL on EXE PK, the WPM-Ctrough of EXE was compared within patients between the "PAL+EXE" (Test) and "EXE Alone" (Reference) treatment periods using a one-way analysis of variance (ANOVA) model with treatment as a fixed effect and patient as a random effect. To assess the effect of coadministration of EXE on PAL PK, the WPM-Ctrough of PAL was compared between the "PAL+EXE" period (Test) and historical data (Reference) using an ANOVA model. Analysis of covariance (ANCOVA) models were used to assess the impact of demographic differences between analysis populations in covariates known to impact PAL PK on the ANOVA model conclusions.
Results: A total of 26 pts randomized to the PAL+EXE arm were enrolled in the PK sub-study and had PK samples analysed, of which 23 meet ss acceptance criteria. The ratio of the adjusted geometric means for EXE WPM-Ctrough was 106.9% (90%CI: 82.4-138.8), when EXE was administered with PAL, compared with its administration alone. Likewise, the models to assess potential for EXE to perpetrate DDI on PAL PK showed ratios of adjusted geometric means of 102.4% (90%CI: 82.0-127.9) and 111.6% (90%CI: 90.3137.8), when adjusted for covariates.
Conclusion: The PK data indicate a lack of a clinically meaningful DDI between PAL and EXE when the 2 drugs are coadministered.
Sponsor: GEICAM
Citation Format: Martín M, Hoffman J, Ruiz-Borrego M, Muñoz M, Calvo L, Crownover P, García-Sáenz JA, Alba E, Wang D, Thallinger C, Stradella A, Montaño Á, Adamo B, Antolín S, Moreno-Antón F, Falo C, Ruiz V, Martín N, Caballero R, Carrasco E, Gil-Gil M. Evaluation of the drug interaction potential of palbociclib and exemestane – Results from the PEARL pharmacokinetic sub-Study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-21-23.
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Affiliation(s)
- M Martín
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - J Hoffman
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - M Ruiz-Borrego
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - M Muñoz
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - L Calvo
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - P Crownover
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - JA García-Sáenz
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - E Alba
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - D Wang
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - C Thallinger
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - A Stradella
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - Á Montaño
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - B Adamo
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - S Antolín
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - F Moreno-Antón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - C Falo
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - V Ruiz
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - N Martín
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - R Caballero
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - E Carrasco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
| | - M Gil-Gil
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain; Pfizer, Inc, CA; Hospital Universitario Virgen del Rocío, Madrid, Spain; Hospital Universitari Clinic de Barcelona, Barcelona, Spain; Complejo Hospitalario Universitario A Coruña, A Coruna, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga, Spain; Univ. Klinik für Innere Medizin I, Währinger Gürtel, Vienna, Austria; Institut Catalá d'Oncologia (ICO), L'Hospitalet, Barcelona, Spain; Pfizer, Inc., CT
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de la Cruz L, Sánchez-Margalet V, Berraondo P, Benito S, Escudero MJ, Caballero R, Carrasco E, Galluzzi L, Rojo F. Abstract OT1-01-02: A multicenter phase II trial to evaluate the efficacy and safety of pembrolizumab and gemcitabine in patients with HER2-negative advanced breast cancer: GEICAM/2015-04 PANGEA-Breast. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot1-01-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Treatment options for advanced breast cancer (ABC) are multiple but unable to properly respond to current clinical needs. In particular, improved therapies are needed for triple negative and hormone receptor (HR)-positive but heavily pretreated patients. Pembrolizumab (P) is a human monoclonal antibody that blocks the PD-1/PD-L1 interaction hence potentiates anticancer T cell responses. Gemcitabine (G) is a cytotoxic drug with well-known immunostimulatory properties. Here, we report an ongoing phase II clinical trial to identify the Recommended Phase II Dose (RP2D) and the efficacy of the combination of these two agents in ABC patients. We hypothesize that these agents may synergize to induce responses with long term clinical benefit (ClinicalTrials.gov Identifier: NCT03025880).
Trial Design:
Eligible patients are HER2-negative ABC patients who received prior treatment with anthracyclines and taxanes and two or more prior lines of hormone therapy, if HR-positive disease. Patients with CNS involvement are also eligible if clinically stable. Treatment consists of 21-day cycles with 200 mg P on day 1 and G on days 1 and 8. In the safety dose testing, we use a standard 6+6 design with 2 dose levels (DL) of G: 1250 mg/m2 (DL0) and 1000 mg/m2 (DL1). Patients are treated until radiologic or symptomatic progression, or unacceptable toxicity. The primary objectives are RP2D and objective response rate (ORR) of the combination; secondary objectives include evaluation of safety and tolerability and other efficacy variables (progression-free survival [PFS], clinical benefit rate [CBR], response duration [RD] and overall survival [OS]). Efficacy is measured by RECIST 1.1. and irRECIST. Safety is measured using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) 4.0. As exploratory objectives, immunological biomarkers are analyzed in tumor biopsies and blood samples and correlated with (1) clinical efficacy and (2) disease outcomes.Sequential tumor samples are collected at baseline, cycle 3 and at progression. Blood samples are drawn at baseline, cycle 3, and cycle 6, or at post-treatment visit (whatever occurs first). Tumor samples are characterized for intratumoral and stromal tumor-infiltrating lymphocytes, tumor-associated macrophages and myeloid-derived suppressor cells, PD-L1 expression in tumor cells and stroma. Moreover, molecular and genetic profiling will be performed. Blood samples are characterized for peripheral blood mononuclear cell (PBMC) phenotype (including expression of co-activatory and co-inhibitory receptors), cytokine profile, and activity of other immunosuppressive pathways (e.g., IDO1-dependent tryptophan catabolism). These results will be compared with data from a cohort of healthy volunteers.
A maximum of 65 patients will be included. The study is approved by the ethical committee and Competent Authority of Spain and already open for patient recruitment in 2 of the 10 participating sites.
Keywords:
Breast
HER2 negative
Pembrolizumab
Immunotherapy
Citation Format: de la Cruz L, Sánchez-Margalet V, Berraondo P, Benito S, Escudero MJ, Caballero R, Carrasco E, Galluzzi L, Rojo F. A multicenter phase II trial to evaluate the efficacy and safety of pembrolizumab and gemcitabine in patients with HER2-negative advanced breast cancer: GEICAM/2015-04 PANGEA-Breast [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-01-02.
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Affiliation(s)
- L de la Cruz
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - V Sánchez-Margalet
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - P Berraondo
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - S Benito
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - MJ Escudero
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - R Caballero
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - E Carrasco
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - L Galluzzi
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - F Rojo
- Hospital Universitario Virgen de la Macarena, GEICAM Spanish Breast Cancer Group, Sevilla, Spain; Centro de Investigación Medica Aplicada (CIMA), Pamplona, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Weill Cornell Medical College, Sandra and Edward Meyer Cancer Center, Université Paris Descartes/Paris V, NY; IIS-Fundacion Jimenez Diaz-UAM. GEICAM Spanish Breast Cancer Group, Madrid, Spain
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Utrilla RG, Nieto-Marín P, Alfayate S, Tinaquero D, Matamoros M, Pérez-Hernández M, Sacristán S, Ondo L, de Andrés R, Díez-Guerra FJ, Tamargo J, Delpón E, Caballero R. Kir2.1-Nav1.5 Channel Complexes Are Differently Regulated than Kir2.1 and Nav1.5 Channels Alone. Front Physiol 2017; 8:903. [PMID: 29184507 PMCID: PMC5694551 DOI: 10.3389/fphys.2017.00903] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/25/2017] [Indexed: 12/27/2022] Open
Abstract
Cardiac Kir2.1 and Nav1.5 channels generate the inward rectifier K+ (IK1) and the Na+ (INa) currents, respectively. There is a mutual interplay between the ventricular INa and IK1 densities, because Nav1.5 and Kir2.1 channels exhibit positive reciprocal modulation. Here we compared some of the biological properties of Nav1.5 and Kir2.1 channels when they are expressed together or separately to get further insights regarding their putative interaction. First we demonstrated by proximity ligation assays (PLAs) that in the membrane of ventricular myocytes Nav1.5 and Kir2.1 proteins are in close proximity to each other (<40 nm apart). Furthermore, intracellular dialysis with anti-Nav1.5 and anti-Kir2.1 antibodies suggested that these channels form complexes. Patch-clamp experiments in heterologous transfection systems demonstrated that the inhibition of the Ca2+/calmodulin-dependent protein kinase II (CaMKII) decreased the INa and the IK1 generated by Nav1.5 and Kir2.1 channels when they were coexpressed, but not the IK1 generated by Kir2.1 channels alone, suggesting that complexes, but not Kir2.1 channels, are a substrate of CaMKII. Furthermore, inhibition of CaMKII precluded the interaction between Nav1.5 and Kir2.1 channels. Inhibition of 14-3-3 proteins did not modify the INa and IK1 densities generated by each channel separately, whereas it decreased the INa and IK1 generated when they were coexpressed. However, inhibition of 14-3-3 proteins did not abolish the Nav1.5-Kir2.1 interaction. Inhibition of dynamin-dependent endocytosis reduced the internalization of Kir2.1 but not of Nav1.5 or Kir2.1-Nav1.5 complexes. Inhibition of cytoskeleton-dependent vesicular trafficking via the dynein/dynactin motor increased the IK1, but reduced the INa, thus suggesting that the dynein/dynactin motor is preferentially involved in the backward and forward traffic of Kir2.1 and Nav1.5, respectively. Conversely, the dynein/dynactin motor participated in the forward movement of Kir2.1-Nav1.5 complexes. Ubiquitination by Nedd4-2 ubiquitin-protein ligase promoted the Nav1.5 degradation by the proteasome, but not that of Kir2.1 channels. Importantly, the Kir2.1-Nav1.5 complexes were degraded following this route as demonstrated by the overexpression of Nedd4-2 and the inhibition of the proteasome with MG132. These results suggested that Kir2.1 and Nav1.5 channels closely interact with each other leading to the formation of a pool of complexed channels whose biology is similar to that of the Nav1.5 channels.
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Affiliation(s)
- Raquel G Utrilla
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - Paloma Nieto-Marín
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - Silvia Alfayate
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - David Tinaquero
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - Marcos Matamoros
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - Marta Pérez-Hernández
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | | | - Lorena Ondo
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - Raquel de Andrés
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa" (UAM-CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - F Javier Díez-Guerra
- Departamento de Biología Molecular and Centro de Biología Molecular "Severo Ochoa" (UAM-CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan Tamargo
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - Eva Delpón
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology, School of Medicine, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.,CIBERCV, Madrid, Spain
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Molinero L, Albanell J, Koeppen H, Martinez de Dueñas E, Halligan D, Guerrero A, Chacón López-Muñiz J, Perez R, Antolin S, Blancas I, Muñoz M, Oltra A, LÓpez de Ceballos M, Sánchez-Aragó M, Caballero R, Carrasco E, González-Angulo A, Lluch A, Mittendorff E, Rojo F. Analysis of stroma and immune-related gene expression patterns during breast cancer (BC) progression. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx391.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ocana Fernandez A, Ruiz Borrego M, Gil Martin M, Antolin S, Atienza M, Montaño A, Ribelles N, Guerrero A, Muñoz M, Fernández-Pérez I, Urruticoechea A, Falcon Gonzalez A, Pernas Simon S, Prato Varela J, Escudero M, Benito S, Caballero R, Carrasco E, Rojo F, Pandiella A. A phase II trial of dasatinib (D) in combination with trastuzumab (T) and paclitaxel (P) in the first line treatment of HER2 positive metastatic breast cancer (MBC) patients (pts): GEICAM/2010-04. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rojo F, Ruiz Borrego M, Hui M, Trigo Perez J, Cazet A, Karsdal M, Urruticoechea A, Antolin S, García-Saenz J, O’Toole S, Blach A, Perez-Ramos L, Bezares S, Sánchez-Aragó M, Caballero R, Bager C, Swarbrick A, Martin Jimenez M. Tumor microenvironment biomarkers as therapeutic strategies for TNBC. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx391.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Delpon E, Tinaquero D, Alfayate S, Nieto-Marin P, Utrilla R, Matamoros M, Perez-Hernandez M, Tamargo M, Toquero J, Cosio F, Peinado R, Perez-Villacastin J, Bernal J, Tamargo J, Caballero R. P6281A DLG1 polymorphism shortens the action potential duration and the QT interval. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6281] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Caballero R, Alfayate S, Utrilla R, Nieto-Marin P, Tinaquero D, Perez-Hernandez M, Matamoros M, Herron T, Campbell K, Lopez-Sendon J, Peinado R, Jalife J, Tamargo J, Delpon E. P5836A mutation in the gene encoding the tbx5 transcription factor is associated with the Brugada Syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5836] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fraile Sanz A, Casado Alvarez R, Caballero R, Delpon E, Perea J, Alcon B, Gil-Fournier B, Ramiro-Leon S, Pavon R, Lesmes F, Thuissard I, Lefort M, Tamargo J, Alonso J, G Cosio F. P1584A HCN4 previously undescribed variant in a large kindred with familial atrial fibrillation. Europace 2017. [DOI: 10.1093/ehjci/eux158.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Weigand A, Horn A, Caballero R, Stern A, Wilker E, Press D, Pascual-Leone A, Fox M. Prefrontal-limbic connectivity predicts antidepressant efficacy of individual rTMS sites. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Moreno F, Martínez-Jañez N, Garau I, Guerra JA, Alarcón J, Bermejo B, Gonzalez-Cortijo L, Bueno C, Lao J, Bezares S, Rosell L, Blanch A, Caballero R, Carrasco E, Rojo F, Martín M, O'Connor M, Hernando A, Albanell J. Abstract OT3-02-07: A phase II study to compare fulvestrant (F) 500mg plus placebo versus (vs) F 500mg plus palbociclib (P) as first line treatment for postmenopausal women with hormone receptor (HR)-positive advanced breast cancer (BC) sensitive to endocrine therapy (ET). “The FLIPPER study” (GEICAM/2014-12). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot3-02-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Delaying/overcoming resistance to ET in HR-positive HER2-negative BC patients (pts) is a major need to futhrt improve safe and efficacious treatment options. F is a selective estrogen receptor (ER) downregulator currently indicated for the treatment of HR-positive metastatic BC in postmenopausal women with disease progression following anti-estrogen therapy. In FIRST trial F 500mg improved median time to progression (TTP) over anastrozole (23.4 vs 13.1 months, respectively) in untreated metastatic BC. P is a selective reversible inhibitor of cyclin-dependent kinase 4/6. FDA granted its accelerated approval based on progression-free survival (PFS) in combination with letrozole for postmenopausal women with ER-positive and HER2-negative advanced BC as initial ET (PALOMA-1). In another study, after progression to ET, P in combination with F resulted in longer PFS than F alone (PALOMA-3).
The high median TTP achieved with F alone (FIRST) coupled with the significant benefit of adding P to F (PALOMA-3) suggest that F 500mg in combination with P in the first-line setting may significantly improve long-term disease control.
Trial Design:This is an international, randomized, double-blind, multicentre phase II study comparing F 500mg in combination with P vs F 500mg plus placebo as first line therapy in postmenopausal women with HR-positive, HER2-negative metastatic BC who have received ≥5 years of adjuvant ET for early disease and remained disease free for >12 months following its completion or have “de novo” metastatic disease. HR and HER2 status will be based on central testing on the most recent tumour biopsy. Patients will be randomized 1:1. The primary objective is to compare the efficacy of both treatment arms in terms of PFS at 1 year according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 by investigator assessment. As secondary efficacy objectives,PFS, Objective Response Rate (ORR), Clinical Benefit Rate (CBR), Overall Survival (OS), and 1-year and 2-year survival probabilities, have been considered. Other secondary objectives include the comparison of safety, tolerability and health-related quality of life between the treatment arms. As exploratory objectives, the identification of promising biomarkers related with response to study therapy and primary/acquired drug resistance. Pts will be stratified by the site of disease (visceral vs non-visceral) and disease presentation at study entry (recurrent disease vs metastatic “de novo”). With a sample size of 190 pts, the analysis would have 80% power to detect a difference between both treatment arms, assuming PFS proportions of 0.545 and 0.695, respectively. This study is sponsored by GEICAM and Cancer Trials Ireland (formerly ICORG) is also participating. Recruitment started in February 2016 with 14 pts included. Analysis of the primary endpoint is planned for Q1 2018. ClinicalTrials.gov identifier:NCT02690480.
Citation Format: Moreno F, Martínez-Jañez N, Garau I, Guerra JA, Alarcón J, Bermejo B, Gonzalez-Cortijo L, Bueno C, Lao J, Bezares S, Rosell L, Blanch A, Caballero R, Carrasco E, Rojo F, Martín M, O'Connor M, Hernando A, Albanell J. A phase II study to compare fulvestrant (F) 500mg plus placebo versus (vs) F 500mg plus palbociclib (P) as first line treatment for postmenopausal women with hormone receptor (HR)-positive advanced breast cancer (BC) sensitive to endocrine therapy (ET). “The FLIPPER study” (GEICAM/2014-12) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT3-02-07.
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Affiliation(s)
- F Moreno
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - N Martínez-Jañez
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - I Garau
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - JA Guerra
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - J Alarcón
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - B Bermejo
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - L Gonzalez-Cortijo
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - C Bueno
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - J Lao
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - S Bezares
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - L Rosell
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - A Blanch
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - R Caballero
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - E Carrasco
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - F Rojo
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - M Martín
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - M O'Connor
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - A Hernando
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
| | - J Albanell
- Hospital Clínico Universitario San Carlos, Madrid, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Son Llátzer, Palma de Mallorca, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Son Espasses, Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Hospital Universitario Quirón Madrid, Madrid, Spain; Hospital Universitario Infanta Cristina, Madrid, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; GEICAM (Spanish Breast Cancer Group), Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón-Universidad Complutense de Madrid, Madrid, Spain; ICORG (Cancer Trials Ireland), Ireland; Hospital del Mar - IMAS, Barcelona, Spain
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de la Cruz-Merino L, Chiesa M, Caballero R, Rojo F, Palazón N, Carrasco FH, Sánchez-Margalet V. Breast Cancer Immunology and Immunotherapy: Current Status and Future Perspectives. Int Rev Cell Mol Biol 2016; 331:1-53. [PMID: 28325210 DOI: 10.1016/bs.ircmb.2016.09.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cancer immunology has gained renewed interest in the past few years due to emerging findings on mechanisms involved in tumoral immune evasion. Indisputably, immune edition is currently considered a critical hallmark of cancer. Basic research has revealed new targets which can be modulated in the clinical setting with new compounds and strategies. As recent evidence confirms, breast cancer (BC) is a complex and heterogeneous disease in which host immune responses play a substantial role. T-infiltrating lymphocytes measurement is suggested as a powerful new tool necessary to predict early BC evolution, especially in HER2-positive and triple negative subtypes. However, T-infiltrating lymphocytes, genomic platforms, and many other biomarkers in tissue and peripheral blood (e.g., regulatory T cells and myeloid-derived suppressor cells) are not the only factors being evaluated regarding their potential role as prognostic and/or predictive factors. Many ongoing clinical trials are exploring the activity of immune checkpoint modulators in BC treatment, both in the advanced and neoadjuvant setting. Although this field is expanding with exciting new discoveries and promising clinical results-and creating great expectations-there remain many uncertainties yet to be addressed satisfactorily before this long awaited therapeutic promise can come to fruition.
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Affiliation(s)
| | - M Chiesa
- GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain
| | - R Caballero
- GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain
| | - F Rojo
- Fundación Jiménez Díaz, Madrid, Spain
| | - N Palazón
- GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain
| | - F H Carrasco
- GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain
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