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Girard N, Ponce Aix S, Cedres S, Berghmans T, Burgers S, Toffart AC, Popat S, Janssens A, Gervais R, Hochstenbag M, Silva M, Burger IA, Prosch H, Stahel R, Xenophontos E, Pretzenbaher Y, Neven A, Peters S. Efficacy and safety of nivolumab for patients with pre-treated type B3 thymoma and thymic carcinoma: results from the EORTC-ETOP NIVOTHYM phase II trial. ESMO Open 2023; 8:101576. [PMID: 37285717 DOI: 10.1016/j.esmoop.2023.101576] [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: 02/03/2023] [Revised: 04/07/2023] [Accepted: 04/24/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Thymic malignancies are rare intrathoracic tumors, which may be aggressive and difficult to treat. They represent a therapeutic challenge in the advanced/metastatic setting, with limited treatment options after the failure of first-line platinum-based chemotherapy. They are frequently associated with autoimmune disorders that also impact oncological management. MATERIALS AND METHODS NIVOTHYM is an international, multicenter, phase II, two-cohort, single-arm trial evaluating the activity and safety of nivolumab [240 mg intravenously (i.v.) q2 weeks] alone or with ipilimumab (1 mg /kg i.v. q6 weeks) in patients with advanced/relapsed type B3 thymoma or thymic carcinoma, after exposure to platinum-based chemotherapy. The primary endpoint is progression-free survival rate at 6 months (PFSR-6) based on RECIST 1.1 as per independent radiological review. RESULTS From April 2018 to February 2020, 55 patients were enrolled in 15 centers from 5 countries. Ten patients (18%) had type B3 thymoma and 43 (78%) had thymic carcinoma. The majority were male (64%), and the median age was 58 years. Among the 49 eligible patients who started treatment, PFSR-6 by central review was 35% [95% confidence interval (CI) 22% to 50%]. The overall response rate and disease control rate were 12% (95% CI 5% to 25%) and 63% (95% CI 48% to 77%), respectively. Using the Kaplan-Meier method, median progression-free survival and overall survival by local assessment were 6.0 (95% CI 3.1-10.4) months and 21.3 (95% CI 11.6-not estimable) months, respectively. In the safety population of 54 patients, adverse events (AEs) of grade 1/2 were observed in 22 (41%) patients and grade 3/4 in 31 (57%) patients. Treatment-related AEs of grade 4 included one case of neutropenia, one case of immune-mediated transaminitis, and two cases of myocarditis. CONCLUSIONS Nivolumab monotherapy demonstrated an acceptable safety profile and objective activity, although it has been insufficient to meet its primary objective. The second cohort of NIVOTHYM is currently ongoing to assess the combination of nivolumab plus ipilimumab.
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Affiliation(s)
- N Girard
- Thorax Institute Curie Montsouris, Institut Curie, Paris, France and Paris Saclay University, UVSQ, Versailles, France.
| | - S Ponce Aix
- Hospital Universitario 12 De Octubre, Madrid, Spain
| | - S Cedres
- Hospital Universitari Vall d'Hebron-Vall d'Hebron Institut Oncologia, Barcelona, Spain
| | - T Berghmans
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - S Burgers
- The Netherlands Cancer Institute-Antoni Van Leeuwenhoekziekenhuis, Amsterdam, The Netherlands
| | - A-C Toffart
- CHU de Grenoble-La Tronche-Hôpital A. Michallon, Grenoble, France
| | - S Popat
- Royal Marsden Hospital-Chelsea, London, UK
| | - A Janssens
- Universitair Ziekenhuis Antwerpen, Antwerp, Belgium
| | - R Gervais
- Centre Francois Baclesse (CLCC), Caen, France
| | - M Hochstenbag
- Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
| | - M Silva
- Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | | | - H Prosch
- Medical University of Vienna, Vienna, Austria
| | - R Stahel
- ETOP IBCSG Partners Foundation, Berne, Switzerland
| | | | | | - A Neven
- Luxembourg Institute of Health, Competence Center for Methodology and Statistics, Strassen, Luxembourg
| | - S Peters
- Centre Hospitalier Universitaire Vaudois, Lausanne University, Lausanne, Switzerland
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Cedres S, Cruellas M, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Carbonell C, Frigola J, Amat R, Gonzalo J, Navarro V, Dienstmann R, Balmaña J, Felip E. EP07.01-023 Family History of Cancer in a Series of Malignant Pleural Mesothelioma (MPM) Patients (P). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cedres S, Romero L, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Molina G, Garcia-Illescas D, Sanchez L, Rosado J, Carbonell C, Frigola J, Amat R, Gonzalo J, Navarro V, Dienstmann R, Felip E. EP07.01-022 Analysis of Second Surgery for Recurrence in Malignant Pleural Mesothelioma (MPM) Patients (P). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Girard N, Ponce Aix S, Cedres S, Berghmans T, Burgers S, Toffart A, Popat S, Janssens A, Gervais R, Hochstenbag M, Silva M, Burger I, Prosch H, Stahel R, Govaerts AS, Pochesci A, Neven A, Peters S. LBA66 Efficacy and safety of nivolumab for patients with pre-treated type B3 thymoma and thymic carcinoma: Results from the EORTC-ETOP NIVOTHYM phase II trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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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Iranzo P, Callejo A, Marmolejo D, Assaf J, Pardo N, Navarro A, Martinez-Marti A, Cedres S, Mejia ND, Carbonell C, Amat R, Frigola J, Felip E. 127P Real-world evidence and clinical characteristics in patients (pts) with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI). J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01969-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cedres S, Assaf J, Iranzo P, Callejo A, Pardo N, Navaro A, Martinez-Marti A, Bote H, Marmolejo D, Lostes J, Monton V, Gonzalo J, Pedrola A, Felip E. 198P Analysis of efficacy of immunotherapy according to histology in malignant pleural mesothelioma (MPM) patients. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)02040-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cedres S, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Valdivia A, Filipi-Arriaga F, Monton V, Gonzalo J, Pedrola A, Recasens S, Madrenas R, Feliu B, Roman B, Dienstmann R, Felip E. P24.06 Real World use of Cisplatin and Carboplatin Based Therapy in Patients with Malignant Pleural Mesothelioma (MPM). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cedres S, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Saoudi Gonzalez N, Valdivia A, Monton V, Gonzalo J, Pedrola A, Dienstmann R, Felip E. 1910P Outcomes of systemic therapy after first line therapy in patients (p) with malignant pleural mesothelioma (MPM). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Saoudi Gonzalez N, Navarro A, Villacampa Javierre G, Garcia-Alvarez A, Assaf Pastrana J, Iranzo P, Callejo A, Lostes Bardaji M, Pardo N, Cedres S, Martinez-Marti A, Dienstmann R, Felip E. 1807P Real world data on 442 patients (p) with small cell lung cancer (SCLC) treated in the last ten years at Vall d’Hebron Hospital. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Garcia-Alvarez A, Saoudi N, Villacampa Javierre G, Assaf Pastrana J, Iranzo P, Callejo A, Pardo N, Cedres S, Martinez-Marti A, Dienstmann R, Felip E, Navarro A. 1798P Carboplatin-paclitaxel (CP) chemotheraphy as salvage treatment for small cell lung cancer (SCLC): A real-world evidence analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Santa Gadea OS, Hernando-Calvo A, Berché R, Matos I, Gardeazabal I, Pedrazzoli AA, Villar MV, Braña I, Casal GA, Galvao de Aguiar V, Pedrola A, Martinez GA, Mercadé TM, Capdevila J, Cedres S, Oaknin A, Elez E, Tabernero J, Dienstmann R, Garralda E. 572P Limited efficacy of immunotherapy combination regimens in patients with unselected “cold” tumours enrolled in early clinical trials. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Domingues I, Cedres S, Callejo A, Vivancos A, Martinez-Marti A, Felip E. Long duration of immunotherapy in a STK11 mutated/KRAS wild-type non-small cell lung cancer patient. Pulmonology 2020; 26:49-50. [DOI: 10.1016/j.pulmoe.2019.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 01/22/2023] Open
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Grosso F, Aerts J, Ramlau R, Cedres S, Mencoboni M, Van Meerbeeck J, Dziadziuszko R, Planchard D, Chella A, Crino L, Krzakowski M, Ceresoli G, Weinberg U. P2.06-01 STELLAR Trial: Radiological Response Patterns of TTFields Plus Chemotherapy in First-Line Treatment of Malignant Pleural Mesothelioma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1619] [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: 10/25/2022]
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Ros Montana F, Iranzo P, Pedrola A, Callejo A, Pardo N, Amat R, Carbonell C, Martinez A, Navarro A, Cedres S, Dienstmann R, Palmer H, Vivancos A, Felip E. WNT pathway mutations (APC/CTNNB1) and immune checkpoint inhibitors (ICI) response in metastatic non-small cell lung cancer (NSCLC) patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cedres S, Hernando-Calvo A, Iranzo P, Callejo A, Aranda NP, Navarro A, Martinez-Marti A, Assaf J, Miquel J, Rodriguez G, Monton V, Pedrola A, Viaplana C, Carbonell C, Sanso M, Dienstmann R, Amat R, Vivancos A, Felip E. P1.16-05 Incidence and Outcome of Multiple Primary Cancers (MPC) in a Series of Lung Cancer (LC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cedres S, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Rodriguez G, Monton V, Gonzalo J, Miquel J, Pedrola A, Dienstmann R, Felip E. Real-world use of systemic therapy in elderly patients with malignant pleural mesothelioma (MPM). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ceresoli G, Aerts J, Dziadziuszko R, Cedres S, Hiddinga B, Van Meerbeeck J, Mencoboni M, Planchard D, Chella A, Crinò L, Krzakowski M, Madrzak J, Ramlau R, Grosso F. STELLAR: Final updated results of a phase II trial of TTFields with chemotherapy for unresectable malignant pleural mesothelioma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz069] [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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Grosso F, Aerts J, Madrzak J, Dziadziuszko R, Ramlau R, Cedres S, Hiddinga B, van Meerbeeck J, Mencoboni M, Planchard D, Chella A, Crino L, Krzakowski M, Ceresoli G. STELLAR: Final results of a phase II trial of TTFields with chemotherapy for first-line treatment of pleural mesothelioma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy301.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ceresoli G, Aerts J, Madrzak J, Dziadziuszko R, Ramlau R, Cedres S, Hiddinga B, Van Meerbeeck J, Mencoboni M, Planchard D, Chella A, Crinò L, Krzakowski M, Grosso F. MA12.06 STELLAR – Final Results of a Phase 2 Trial of TTFields with Chemotherapy for First-Line Treatment of Malignant Pleural Mesothelioma. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Remon J, Martinez-Marti A, Carcereny Costa E, Zeron-Medina Cuairan J, Sansano I, Mate J, Pardo N, Cedres S, Navarro A, Martinez de castro A, Moran T, Felip Font E. Major pathological response after preoperative chemotherapy as a surrogate marker of survival in early-stage non-small cell lung cancer: cohort of NATCH phase III trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx381.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cedres S, Martinez Marti A, Navarro A, Pardo N, Remon J, Matos I, Ochoa de Olza M, Hierro C, Martin Liberal J, Miquel J, Viaplana C, Villacampa Javierre G, Dienstmann R, Felip Font E. Outcomes of malignant pleural mesothelioma (MPM) patients (p) treated with immune-oncology drugs (IO) in clinical trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx389.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cedres S, Pardo N, Navarro-Mendivil A, Martinez A, Martinez de Castro A, Remon J, Amair F, Zeron J, Vilaro M, Felip E. Brain metastases (BM) development in molecular selected non-small cell lung cancer (NSCLC) patients included in clinical trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aranda NP, Ruiz F, Marti AM, Cedres S, Mendivil AN, fuente I, de Castro AM, Vivancos A, Dienstmann R, Felip E. KRAS mutations(m) in lung adenocarcinoma (AC) patients(p) receiving standard chemotherapy (ch) and immune checkpoint inhibitors (i-CI): Impact of KRAS clonality and coexisting TP53m. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cedres S, Aranda NP, de Castro AM, Mendivil AN, Marti AM, Ortiz C, Racca F, Vilaro M, Carbonell L, Piera A, fuente I, Felip E. Analysis of outcomes and brain metastases (BM) of molecular selected non-small cell lung cancer (NSCLC) patients included in clinical trials. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rusch VW, Chansky K, Kindler HL, Nowak AK, Pass HI, Rice DC, Shemanski L, Galateau-Sallé F, McCaughan BC, Nakano T, Ruffini E, van Meerbeeck JP, Yoshimura M, Rami-Porta R, Asamura H, Ball D, Beer D, Beyruti R, Bolejack V, Chansky K, Crowley J, Detterbeck FC, Eberhardt WEE, Edwards J, Galateau-Sallé F, Giroux D, Gleeson F, Groome P, Huang J, Kennedy C, Kim J, Kim YT, Kingsbury L, Kondo H, Krasnik M, Kubota K, Lerut T, Lyons G, Marino M, Marom EM, van Meerbeeck JP, Mitchell A, Nakano T, Nicholson AG, Nowak A, Peake M, Rice TW, Rosenzweig K, Ruffini E, Rusch VW, Saijo N, Van Schil P, Sculier JP, Shemanski L, Stratton K, Suzuki K, Tachimori Y, Thomas CF, Travis WD, Tsao MS, Turrisi A, Vansteenkiste J, Watanabe H, Wu YL, Baas P, Erasmus J, Hasegawa S, Inai K, Kernstine K, Kindler H, Krug L, Nackaerts K, Pass H, Rice D, Falkson C, Filosso PL, Giaccone G, Kondo K, Lucchi M, Okumura M, Blackstone E, Asamura H, Batirel H, Bille A, Pastorino U, Call S, Cangir A, Cedres S, Friedberg J, Galateau-Sallé F, Hasagawa S, Kernstine K, Kindler H, McCaughan B, Nakano T, Nowak A, Ozturk CA, Pass H, de Perrot M, Rea F, Rice D, Rintoul R, Ruffini E, Rusch V, Spaggiari L, Galetta D, Syrigos K, Thomas C, van Meerbeeck J, Nafteux P, Vansteenkiste J, Weder W, Optiz I, Yoshimura M. The IASLC Mesothelioma Staging Project: Proposals for the M Descriptors and for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Mesothelioma. J Thorac Oncol 2016; 11:2112-2119. [PMID: 27687962 DOI: 10.1016/j.jtho.2016.09.124] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 09/11/2016] [Accepted: 09/11/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The M component and TNM stage groupings for malignant pleural mesothelioma (MPM) have been empirical. The International Association for the Study of Lung Cancer developed a multinational database to propose evidence-based revisions for the eighth edition of the TNM classification of MPM. METHODS Data from 29 centers were submitted either electronically or by transfer of existing institutional databases. The M component as it currently stands was validated by confirming sufficient discrimination (by Kaplan-Meier analysis) with respect to overall survival (OS) between the clinical M0 (cM0) and cM1 categories. Candidate stage groups were developed by using a recursive partitioning and amalgamation algorithm applied to all cM0 cases. RESULTS Of 3519 submitted cases, 2414 were analyzable and 84 were cM1 cases. Median OS for cM1 cases was 9.7 months versus 13.4 months (p = 0.0013) for the locally advanced (T4 or N3) cM0 cases, supporting inclusion of only cM1 in the stage IV group. Exploratory analyses suggest a possible difference in OS for single- versus multiple-site cM1 cases. A recursive partitioning and amalgamation-generated survival tree on the OS outcomes restricted to cM0 cases with the newly proposed (eighth edition) T and N components indicates that optimal stage groupings for the eighth edition will be as follows: stage IA (T1N0), stage IB (T2-3N0), stage II (T1-2N1), stage IIIA (T3N1), stage IIIB (T1-3N2 or any T4), and stage IV (any M1). CONCLUSIONS This first evidence-based revision of the TNM classification for MPM leads to substantial changes in the T and N components and the stage groupings.
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Affiliation(s)
- Valerie W Rusch
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Kari Chansky
- Cancer Research And Biostatistics, Seattle, Washington
| | - Hedy L Kindler
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, Illinois
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia; Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Harvey I Pass
- Department of Cardiothoracic Surgery, New York University Medical Center, New York, New York
| | - David C Rice
- Department of Thoracic and Cardiovascular Surgery, M.D. Anderson Cancer Center, Houston, Texas
| | | | | | - Brian C McCaughan
- Sydney Cardiothoracic Surgeons, Royal Prince Alfred Medical Centre, Sydney, New South Wales, Australia
| | - Takashi Nakano
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Enrico Ruffini
- Department of Surgical Sciences, City of Health and Science Hospital, University of Turin, Turin, Italy
| | - Jan P van Meerbeeck
- Department of Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
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Nowak AK, Chansky K, Rice DC, Pass HI, Kindler HL, Shemanski L, Billé A, Rintoul RC, Batirel HF, Thomas CF, Friedberg J, Cedres S, de Perrot M, Rusch VW, Rami-Porta R, Asamura H, Ball D, Beer D, Beyruti R, Bolejack V, Chansky K, Crowley J, Detterbeck F, Eberhardt WEE, Edwards J, Galateau-Sallé F, Giroux D, Gleeson F, Groome P, Huang J, Kennedy C, Kim J, Kim YT, Kingsbury L, Kondo H, Krasnik M, Kubota K, Lerut A, Lyons G, Marino M, Marom EM, van Meerbeeck J, Mitchell A, Nakano T, Nicholson AG, Nowak A, Peake M, Rice T, Rosenzweig K, Ruffini E, Rusch V, Saijo N, Van Schil P, Sculier JP, Shemanski L, Stratton K, Suzuki K, Tachimori Y, Thomas CF, Travis W, Tsao MS, Turrisi A, Vansteenkiste J, Watanabe H, Wu YL, Baas P, Erasmus J, Hasegawa S, Inai K, Kernstine K, Kindler H, Krug L, Nackaerts K, Pass H, Rice D, Falkson C, Filosso PL, Giaccone G, Kondo K, Lucchi M, Okumura M, Blackstone E, Asamura H, Batirel H, Bille A, Pastorino U, Call S, Cangir A, Cedres S, Friedberg J, Galateau-Salle F, Hasagawa S, Kernstine K, Kindler H, McCaughan B, Nakano T, Nowak A, Ozturk CA, Pass H, de Perrot M, Rea F, Rice D, Rintoul R, Ruffini E, Rusch V, Spaggiari L, Galetta D, Syrigos K, Thomas C, van Meerbeeck J, Nafteux P, Vansteenkiste J, Weder W, Optiz I, Yoshimura M. The IASLC Mesothelioma Staging Project: Proposals for Revisions of the T Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma. J Thorac Oncol 2016; 11:2089-2099. [PMID: 27687963 DOI: 10.1016/j.jtho.2016.08.147] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 08/18/2016] [Accepted: 08/20/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The current T component for malignant pleural mesothelioma (MPM) has been predominantly informed by surgical data sets and consensus. The International Association for the Study of Lung Cancer undertook revision of the seventh edition of the staging system for MPM with the goal of developing recommendations for the eighth edition. METHODS Data elements including detailed T descriptors were developed by consensus. Tumor thickness at three pleural levels was also recorded. An electronic data capture system was established to facilitate data submission. RESULTS A total of 3519 cases were submitted to the database. Of those eligible for T-component analysis, 509 cases had only clinical staging, 836 cases had only surgical staging, and 642 cases had both available. Survival was examined for T categories according to the current seventh edition staging system. There was clear separation between all clinically staged categories except T1a versus T1b (hazard ratio = 0.99, p = 0.95) and T3 versus T4 (hazard ratio = 1.22, p = 0.09), although the numbers of T4 cases were small. Pathological staging failed to demonstrate a survival difference between adjacent categories with the exception of T3 versus T4. Performance improved with collapse of T1a and T1b into a single T1 category; no current descriptors were shifted or eliminated. Tumor thickness and nodular or rindlike morphology were significantly associated with survival. CONCLUSIONS A recommendation to collapse both clinical and pathological T1a and T1b into a T1 classification will be made for the eighth edition staging system. Simple measurement of pleural thickness has prognostic significance and should be examined further with a view to incorporation into future staging.
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Affiliation(s)
- Anna K Nowak
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia; Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
| | - Kari Chansky
- Cancer Research And Biostatistics, Seattle, Washington
| | | | - Harvey I Pass
- Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, New York
| | - Hedy L Kindler
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, Illinois
| | | | - Andrea Billé
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Robert C Rintoul
- Department of Thoracic Oncology, Papworth Hospital National Health Service Foundation Trust, Cambridge, United Kingdom
| | - Hasan F Batirel
- Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Charles F Thomas
- Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Joseph Friedberg
- Department of Thoracic Surgery, University of Maryland Cancer Center, Baltimore, Maryland
| | - Susana Cedres
- Medical Oncology Department, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Marc de Perrot
- Division of Thoracic Surgery, Toronto General Hospital, and Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Valerie W Rusch
- Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Cedres S, Navarro A, Martinez A, Martinez P, Ortiz C, Fariñas L, Felip E. Statin Use and Survival in Malignant Pleural Mesothelioma (MPM). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv052.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cedres S, Ponce Aix S, Zugazagoitia J, Anguita A, Sansano I, Navarro Mendivil A, Martinez A, Martinez P, Fidalgo P, Felip E. Analysis of Expression of Programmed Cell Death 1 Ligand 1 (Pd-L1) in Malignant Pleural Mesothelioma (Mpm). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.66] [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: 11/14/2022] Open
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Martínez P, Declara IM, Martinez-Marti A, Cedres S, Navarro A, Fico M, De la Morena P, Salcedo M, Romero L, Felip E. 116P RETROSPECTIVE ANALYSIS OF PATIENTS WITH THYMIC MALIGNANCIES TREATED AT THE VALL D'HEBRON UNIVERSITY HOSPITAL. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70336-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cedres S, Castro DT, Stjepanovic N, Martinez P, Martinez A, Salcedo M, Montero M, Felip E. Expression of Wilmśtumour Gene (WT1) is Associated with Survival in Malignant Pleural Mesothelioma: Retrospective Analysis in a Single Center Series. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34078-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Castro DT, Cedres S, Argiles G, Nunez I, Rodriguez-Freixinos V, Mulet N, Lara M, Martinez P, Tabernero J, Felip E. 1443 POSTER High Blood Neutrophil-to-lymphocyte Ratio as an Indicator of Poor Prognosis in Advanced Non Small Cell Lung Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70936-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Felip E, Salcedo M, Murtra-Garrell N, Navarro A, Teixido C, Hernandez-Losa J, Cedres S, Martinez P, Lopez E, Montero MA, Freixinos V, Argiles G, Nuñez I, Peg V, Pallisa E, Canela M, Tabernero J, Ramon y Cajal S, Tallada N. Expression of ErbB2 and ErbB3 in resected non-small cell lung cancer (NSCLC) patients (pts). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Martinez P, Hernandez-Losa J, Castellvi J, Tallada N, Cedres S, Montero MA, Rodriguez-Freixinos V, Nuñez I, Argiles G, Mulet-Margalef N, Torrejon D, Ramon y Cajal S, Felip E. ALK rearrangement in a selected population of advanced non-small cell lung cancer patients: FISH and inmunohistochemistry diagnostic methods, prevalence, and clinical outcomes. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Felip E, Ranson M, Cedres S, Brewster M, Mcnally V, Venturi M, Passioukov A, Ross G, Galdermans D. Biomarker analyses from a phase l study of pertuzumab combined with erlotinib in patients (pts) with non-small cell lung cancer (NSCLC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Quispe IR, Ramos FJ, Bilbao I, Macarulla T, Cedres S, Charco R, Lázaro J, Moreiras M, Moreiras M, Tabernero J. Long-term overall survival (os) and prognostic factors of patients (pts) with surgery of liver metastases from colorectal cancer origin (lm/crc): Retrospective analysis of a Spanish single institution. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15052 Background: Hepatectomy is the only potentially curative treatment for LM/CRC. Long-term survival following liver resection (LR) has improved. The aim of this study was to analyze prognostic factors and OS after LR Methods: A retrospective review of the medical records of pts who underwent LR for LM/CRC from 1997 to 2007 was conducted. Multiple potential prognostic factors for survival were analyzed: synchronic vs. metachronic, post-op chemotherapy (CT) vs. no, lymph node (LN) status of primary tumor, R0 vs. R1–2 resection, gender, location of primary tumor, number and size of metastases, and unilobar vs. bilobar disease. Results: 190 pts (colon 130, rectum 60) underwent LR. Pts’ characteristics: 123 male, 67 female; median age 63 yrs (32–85); 95 pts synchronic, 95 metachronic; 145 pts (76%) received post-op CT; LN status was pN0 in 61 (32%) pts, pN1 in 74 (39%) and pN2 in 52 (27%). A R0 resection was performed in 164 (86%) and R1 in 25 (13%). Post-op mortality was 2.6%.Median OS was 68 months with 5- and 10-year OS of 52% and 31%, and 5- and 10-year disease free survival of 36% and 18%. 5-year OS differed between metachronic and synchronic (64% vs. 39%; p<0.001); LN-status (73% for pN0 vs. 41% for pN1–2; p<0.001); R0/R1–2 surgery (58% for R0 vs. 21% for R1- 2; p=0.002). With a median follow-up of 70 months, 71 (37%) pts remained free of disease, 60 (32%) had new metachronic LM/CRC, 18 (9.5%) had LM/CRC and extrahepatic disease and 36 (19%) had extrahepatic disease alone. Non-significant factors for prognosis were gender, location of primary tumor, number and size of metastases, bilobar disease and adjuvant CT. Conclusions: Pts with LM/CRC who undergo liver resection can achieve long-term OS, our data identifying as prognostic factors: LN status, synchronic/metachronic disease and Type of resection (R0). No significant financial relationships to disclose.
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Affiliation(s)
- I. R. Quispe
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - F. J. Ramos
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - I. Bilbao
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - T. Macarulla
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - S. Cedres
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - R. Charco
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - J. Lázaro
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - M. Moreiras
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - M. Moreiras
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
| | - J. Tabernero
- Hospital Univesitario Vall d′Hebrón, Barcelona, Spain
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Felip E, Ranson M, Cedres S, Dean E, De Droogh E, Brewster M, McNally VA, Ross G, Galdermans D. A phase I, dose escalation study to determine the maximum tolerated dose of erlotinib when combined with pertuzumab in previously treated non-small-cell lung cancer patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.19134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cedres S, Pereda G, Bagattini J. T05-O-04 Association between erectile dysfunction and coronary artery disease. Sexologies 2008. [DOI: 10.1016/s1158-1360(08)72740-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Prat A, Del Campo J, Peralta S, Cedres S, Perez A, Gil A, Martinez-Palones J, Garcia A, Baselga J. Validation of CA-125 concentration nadir within the normal range following primary treatment as a predictor of survival for epithelial ovarian cancer (EOC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.16007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
16007 Background: Recent studies suggest that the CA-125 nadir within the normal range after surgery and chemotherapy treatment is a predictor of survival (Crawford, ASCO 2004; Crawford, Ann Oncol 2005) and relapse (Markman, J Clin Oncol 2006). In order to validate these previous findings, we have conducted a retrospective analysis of patients (pts) treated in our institution for EOC. Methods: Between March 1, 1997, and October 30, 2005, all pts treated for EOC at Vall d'Hebron University Hospital were identified from the tumor registry database and screened retrospectively for their standard prognostic factors (age at diagnosis (=65 vs. >65), stage (III-IV vs. IC-II), and suboptimal vs. optimal cytorreduction). Inclusion criteria: an elevated CA-125 at time of diagnosis (>35 U/mL); primary treatment (PT) that consisted in surgery and intravenous carboplatin/paclitaxel for a maximum of 6–9 cycles; complete clinical and radiological response to initial treatment with normalization of CA-125 (=35 U/mL); and disease status at the time of last follow-up. Standard Kaplan-Meier methods were used to plot the progression-free survival (PFS) of members of each of the nadir groups. The relative contribution of the different potential correlates of prognosis was assessed by the Cox proportional hazards method. Results: 123 pts were identified: 64 Group A (=10 U/mL), 42 Group B (11–20 U/mL), 17 Group C (21–35 U/mL). Median age: 56. Stage IC 25%, II 13%, III 52%, IV 10%. Median follow-up 39.2 months (m). Median PFS was 69.7 m, 27.7 m, and 15.8 m for A, B and C, respectively (p< .0001, log-rank test). The Cox model showed a highly-significant impact on PFS in relation to CA-125 nadir levels, residual tumor after surgery and stage. Hazard ratios (HR) for PFS (95% CI) of B vs. A, C vs. B, and C vs. A were 1.98 (p= .034), 2.35 (p= .02), and 4.67 (p< .001), respectively. HR for PFS (95% CI) of suboptimal vs. optimal cytorreduction and stage III-IV vs. IC-II were 1.84 (p= .058) and 3.2 (p= .002), respectively. Conclusions: The CA-125 nadir in the normal range following PT for EOC is a reproducible predictor of PFS in stage IC-IV. Prospective studies of maintenance-consolidation therapies or different approaches in selected pts based on CA-125 nadir seem warranted. No significant financial relationships to disclose.
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Affiliation(s)
- A. Prat
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - J. Del Campo
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - S. Peralta
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - S. Cedres
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - A. Perez
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - A. Gil
- Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - A. Garcia
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - J. Baselga
- Vall d'Hebron University Hospital, Barcelona, Spain
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