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Alberola V, García Conde J, Jimeno J, Fernandez Martos C, Herranz C, Macheng I, Centelles M, Sánchez J. Phase II Study with High Doses of Epirubicin in Patients with Advanced Rectal Cancer. Tumori 2018; 76:503-4. [PMID: 2256199 DOI: 10.1177/030089169007600518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We tested the possible role of epirubicin, 100 to 130 mg/m2 administered i.v. every 3 weeks, in patients with advanced adenocarcinoma of the rectum untreated with chemotherapy. Sixteen of 17 entered cases were evaluable. No complete or partial responses were observed. The median time to progression was 6 weeks, and the median survival was 36 weeks. Reversible leukopenia was the major toxic side effect. The median epirubicin cumulative dose was 330 mg/m2; no patient had clinical cardiac toxicity. With no responses recorded in 16 evaluable patients, the activity of epirubicin in rectal cancer ranged between 0 and 18%, with 95% probability. Further studies with epirubicin in this tumor are not indicated.
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Affiliation(s)
- V Alberola
- Hospital Clinico, Department of Hematology and Oncology, Valencia, Spain
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de Castro J, Gascón P, Casas A, Muñoz-Langa J, Alberola V, Cucala M, Barón F. Iron deficiency in patients with solid tumours: prevalence and management in clinical practice. Clin Transl Oncol 2014; 16:823-8. [PMID: 24458881 DOI: 10.1007/s12094-013-1155-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/23/2013] [Indexed: 02/01/2023]
Abstract
PURPOSE The objective of the present study was to describe the prevalence and management of anaemia and iron deficiency (ID) in treatment-naïve patients with solid tumours in Spain and the incidence of anaemia over 4 months of cancer treatment in clinical practice. METHODS Multicentre, prospective and observational study in newly diagnosed cancer patients. Data on anaemia and iron parameters and its management were collected prior to the initiation of chemotherapy, at each cycle of chemotherapy and after 4 months of treatment. The main outcomes of the study were the prevalence of anaemia at baseline, its incidence during cancer treatment and the prevalence of absolute ID (AID) and functional ID (FID) prior to chemotherapy initiation. RESULTS A total of 295 patients were included in the study. Anaemia was present at diagnosis in 38.6 % of patients and was treated only in 32.5 % of those. A total of 106 patients (60.2 %) without anaemia at baseline developed anaemia during cancer treatment. Serum ferritin and transferrin saturation data were available for 151 of the patients (51.2 %) included in the study. The overall prevalence of ID was 59 %: 48 patients (31.8 %) presented with AID and 41 patients (27.2 %) presented with FID before starting anti-cancer therapy. Thirty-three of 44 non-anaemic iron-deficient patients did not receive any type of iron supplementation before initiating cancer therapy. CONCLUSIONS Iron parameters are not commonly measured in newly diagnosed cancer patients. A correct evaluation and early management of ID could reduce the incidence of treatment-related anaemia in cancer patients.
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Affiliation(s)
- J de Castro
- Servicio de Oncología Médica, Unidad de Oncología Traslacional, Hospital Universitario La Paz, IDIPAZ, Paseo de la Castellana, 261, 28046, Madrid, Spain,
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Provencio M, Camps C, Cobo M, De las Peñas R, Massuti B, Blanco R, Alberola V, Jimenez U, Delgado JR, Cardenal F, Tarón M, Ramírez JL, Sanchez A, Rosell R. Prospective assessment of XRCC3, XPD and Aurora kinase A single-nucleotide polymorphisms in advanced lung cancer. Cancer Chemother Pharmacol 2012; 70:883-90. [PMID: 23053267 DOI: 10.1007/s00280-012-1985-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 09/17/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE New therapeutic approaches are being developed based on findings that several genetic abnormalities underlying non-small-cell lung cancer (NSCLC) can influence chemosensitivity. The identification of molecular markers, useful for therapeutic decisions in lung cancer, is thus crucial for disease management. The present study evaluated single-nucleotide polymorphisms (SNPs) in XRCC3, XPD and Aurora kinase A in NSCLC patients in order to assess whether these biomarkers were able to predict the outcomes of the patients. METHODS The Spanish Lung Cancer Group prospectively assessed this clinical study. Eligible patients had histologically confirmed stage IV or IIIB (with malignant pleural effusion) NSCLC, which had not previously been treated with chemotherapy, and a World Health Organization performance status (PS) of 0-1. Patients received intravenous doses of vinorelbine 25 mg/m(2) on days 1 and 8, and cisplatin 75 mg/m(2) on day 1, every 21 days for a maximum of 6 cycles. Venous blood was collected from each, and genomic DNA was isolated. SNPs in XRCC3 T241M, XPD K751Q, XPD D312N, AURORA 91, AURORA 169 were assessed. RESULTS The study included 180 patients. Median age was 62 years; 87 % were male; 34 % had PS 0; and 83 % had stage IV disease. The median number of cycles was 4. Time to progression was 5.1 months (95 % CI, 4.2-5.9). Overall median survival was 8.6 months (95 % CI, 7.1-10.1). There was no significant association between SNPs in XRCC3 T241M, XPD K751Q, XPD D312N, AURORA 91, AURORA 169 in outcome or toxicity. CONCLUSIONS Our findings indicate that SNPs in XRCC3, XPD or Aurora kinase A cannot predict outcomes in advanced NSCLC patients treated with platinum-based chemotherapy.
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Affiliation(s)
- M Provencio
- Servicio de Oncología Médica, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
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Gascon P, Casas A, Muñoz J, De Castro J, Alberola V, Cucala M, Barón F. Anaemia-Related Fatigue in Patients with Solid Tumours: a Multicenter, Observational and Prospective Study (Pacs Study). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34108-9] [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: 11/29/2022] Open
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Viñolas N, Provencio M, Reguart N, Cardenal F, Alberola V, Sánchez-Torres JM, Barón FJ, Cobo M, Maestu I, Moreno I, Mesía C, Izquierdo A, Felip E, López-Brea M, Márquez A, Sánchez-Ronco M, Tarón M, Santarpia MC, Rosell R. Single nucleotide polymorphisms in MDR1 gen correlates with outcome in advanced non-small-cell lung cancer patients treated with cisplatin plus vinorelbine. Lung Cancer 2011; 71:191-8. [PMID: 20627363 DOI: 10.1016/j.lungcan.2010.05.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 03/30/2010] [Accepted: 05/02/2010] [Indexed: 10/19/2022]
Abstract
UNLABELLED New therapeutic approaches are being developed based on the findings that several genetic abnormalities underlying NSCLC could influence chemosensitivity. In this study, we assessed whether the presence of polymorphisms in ERCC1, XPD, RRM1 and MDR1 genes can affect the efficacy and the tolerability of cisplatin and vinorelbine in NSCLC patients. MATERIAL AND METHODS Eligible patients had histological confirmed stage IV or IIIB (with malignant pleural effusion) non-small-cell lung cancer (NSCLC) previously untreated with chemotherapy; World Health Organization performance status (PS) 0-1. Patients received intravenous doses of vinorelbine 25 mg/m² on day 1 and 8 and cisplatin 75 mg/m² on day 1, every 21 days, for a maximum of eight cycles. RESULTS 94 patients were included. Median age was 61 years; 84% were male; WHO performance status (PS) was 0 in 24%; and 88% of patients had stage IV disease. The median number of cycles was 6. Overall median survival was 10.92 months (95% CI 9.0-12.9). Overall median time to progression was 5.89 months (95% CI 5.2-6.6). Results of the multivariate analysis for time to progression showed that ECOG 0 (hazard ratio [HR] ECOG 1 vs. ECOG 0, 1.74; p=0.036), MDR13435CC (HR CT vs. CC, 2.01; p=0.017; HR TT vs. CC, 1.54; p=0.22), and decreasing age (HR of age, 0.97; p=0.016) were the most powerful prognostic factors significantly related to lower risk of progression. Whereas ECOG 0 was the only prognostic factor for survival (HR ECOG 1 vs. ECOG 0, 3.02; p=0.001). There was no significant association between any of the SNPs analysed and the occurrence of vinorelbine and cisplatin-related toxicity. CONCLUSION In our results, the most important prognostic factors associated with lower risk of progression were MDR1 3435 CC genotype, PS 0 and younger age.
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Affiliation(s)
- N Viñolas
- Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain.
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Gasent J, Grande E, Casinello J, Provencio M, Laforga J, Alberola V. [Experience with sunitinib in hormone-resistant metastatic prostate cancer that is unresponsive to docetaxel]. Actas Urol Esp 2011; 35:57-60. [PMID: 21256396 DOI: 10.1016/j.acuro.2010.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 06/09/2010] [Accepted: 09/19/2010] [Indexed: 10/26/2022]
Abstract
INTRODUCTION systemic treatment options for patients with hormone-refractory prostate cancer (HRPC) that progress despite the use of Docetaxel are very limited. One of the options of compassionate use currently available is the use of Sunitinib. We present a joint preliminary experience with the use of Sunitinib in this clinical case. PATIENTS AND METHODS a series of eight cases is presented, which sets forth a prospective multicentre experience with Sunitinib in patients with hormone-refractory metastatic and progressive prostate cancer, previously treated with at least a regime of Docetaxel-based chemotherapy. Other alternative chemotherapy regimes had already been tried in some patients. The primary objective of our study was the PSA response rate and our secondary objective was the progression-free period. We administered a dosage of 50mg/day for four-week cycles, followed by a two-week rest per cycle, until we reached a total of eight cycles or up to clinical progression or intolerable toxicity. RESULTS in four cases, the PSA dropped to below 50% of the baseline level at the beginning of the treatment, and five patients presented some decrease in PSA. The progression-free time was 16.4 weeks. Toxicity arising from the treatment was moderate and manageable. CONCLUSIONS despite the limits of this experience, we can say that Sunitinib appears to be an active and safe option in patients with hormone-refractory prostate cancer that is resistant to chemotherapy with Docetaxel.
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Gasent J, Grande E, Casinello J, Provencio M, Laforga J, Alberola V. Experiencia con sunitinib en cáncer de próstata metastásico hormonorresistente sin respuesta a docetaxel. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000100016] [Citation(s) in RCA: 2] [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: 11/11/2022]
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Blasco A, Galan A, Almenar D, Gironés R, Diaz R, Alberola V. Pain, depression, asthenia, and insomnia: Prevalence of this symptoms cluster and its impact on health-related quality of life in a cohort of advanced cancers. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20607] [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
e20607 Background: Pain (P), depression (D), asthenia (A), and insomnia (I), alone or in combination, are some of the most important and invalidating cancer symptoms. But little is known about the relationship between the symptoms of this cluster, and its impact on health-related quality of life (HRQoL). This analysis has been carried out to better know the prevalence of this symptoms cluster and its impact on HRQoL in cancer patients (pts). Methods: An observational and longitudinal multicentre study was carried out on a sample of cancer pts with breast, lung or colon cancer, any site and period of disease duration, receiving chemotherapy. Data were collected at inclusion and 3 months later. Sociodemographic data, key clinical indicators, as well as P, D, A and I complaints or diagnosis were collected. HRQoL was assessed by means of Nottingham Health Profile (NHP) scale (a generic health measure. Analyses were focused on baseline cross-sectional data). Results: A total of 116 pts were analyzed: 73.3 men, 61 years old (SD=9,1), 2.9 years (SD=2,3) since diagnosis, 16.4 % breast, 54.3% lung, and 29.3% colon cancer; 97.4% with metastasis. At least one symptom cluster under study was presented in 69% of pts: >25% a symptom alone, ≈25% two symptoms, >15% three symptoms, <3% all symptoms in the cluster. Pts could be classified in 13 of the 15 symptoms cluster possible combinations (according to their symptoms complaints/diagnosis) ranging from 0.9% to 12.9%. The two symptoms cluster combinations which did not obtain representation included D + I, while the two symptoms cluster combinations more frequents always included pain. It has been observed that a more quantity of symptoms worst physical and psychological NHP scores. Conclusions: The prevalence of the studied symptoms cluster in cancer pts is high (≈70%) and divers in combinations (13 different symptoms profiles). The quantity of prevalent symptoms cluster is clearly associated with HRQoL. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- A. Blasco
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - A. Galan
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - D. Almenar
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - R. Gironés
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - R. Diaz
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - V. Alberola
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
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Alberola V, Gallego O, López-Vivanco G, Mesía C, Oramas J, Trigo JM, Virizuela JA, Camps C, Regueiro P, Massutí B. Improvement in symptoms and quality of life (QoL) for patients (p) with non-small cell lung cancer (NSCLC) treated with erloninib: TargeT study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18140] [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
18140 Background: Erlotinib is an EGFR TKI that is effective in the treatment of advanced NSCLC, in terms of longer survival, better quality of life and delayed symptom progression.We present here the outcome of a group of p from the TargeT study, whose QoL was assessed by the Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire and the Lung Cancer Subscale (LCS). Methods: TargeT study was a multicenter, single-arm phase II study evaluating efficacy, safety, and tolerability of erlotinib (150 m/day) in p with stage IIIB or IV NSCLC, in 1st, 2nd and 3rd line treatment. Primary end-point was time to progression. QoL was a secondary end point as assessed monthly by the Functional Assessment of Cancer Therapy-Lung questionnaire (FACT- L) and its Lung Cancer Subscale. Physical and functional aspects of the QoL were measured by the Trial Outcome Index (TOI), which is the sum of the physical well being, functional well-being and LCS scores from the FACT-L questionnaire. Results: Data from 91 pts were available. QoL analysis showed that 53% of the p (95% IC 37–58%) had improvement in FACT-L or TOI. Similarly, 45% (95% IC35–56%) of improved their symptoms from baseline. Improvement was observed for each individual LCS item and specifically in the pulmonary items. In symptomatic p, shortened of breath was 17,6% at baseline vs 2.2% after treatment (p<0.001) and cough was 24.7% vs 8.8 % (p<0.001) after treatment. Those improvements in symptoms were rapid and, 73% of the patients who improved showed that recovery in the first cycle of treatment. In terms of association between efficacy of erlotinib and QoL, there is a statistically significative relationship between objective response and improvement in TOI or FACT-L (p<0.02). Conclusions: This QoL analysis confirms that erlotinib improves both symptoms and functional aspect of patients with NSCLC. The improvement in QoL is related with objective response. No significant financial relationships to disclose.
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Affiliation(s)
- V. Alberola
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - O. Gallego
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - G. López-Vivanco
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - C. Mesía
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - J. Oramas
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - J. M. Trigo
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - J. A. Virizuela
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - C. Camps
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - P. Regueiro
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
| | - B. Massutí
- Hospital Universitari Arnau de Vilanova, Valencia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Hospital Cruces, Barakaldo, Spain; Hospital del Mar, Barcelona, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Universitario Virgen Macarena, Sevilla, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Roche Farma, S.A., Madrid, Spain; Hospital General Universitario de Alicante, Alicante, Spain
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Provencio M, Camps C, Alberola V, Dómine M, Isla D, De las Peñas R, Etxaniz O, Cobo M, Millán I, Massuti B. Treatment of advanced non-small cell lung cancer in the elderly: Spanish Lung Cancer Group (SLCG) experience. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18012] [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
18012 Background: The number of elderly patients (p) with cancer continues to increase. Approximately two-thirds of p diagnosed with non-small cel lung cancer are > 65 years (y), and nearly 50% are > 70 y. The aim of our study was to discern whether clinical characteristics, toxicity, response rate, treatment and survival are different in p < 70 y vs p = 70 y. Methods: We reviewed the database of 6 SLCG clinical trials with different doublet combinations from 2000 to 2005 Results: Of 1653 p included, only 280 p (17% ) were = 70 y. No significant differences were found between the two groups with respect to gender, stage, response rate or histology. However, a higher frequency of squamous cell carcinoma was found in p = 70y. No differences were found in median number of cycles administered. The only significant difference was found in the higher frequency of grade 3–4 neutropenia among p = 70 y. (Table) Conclusions: p = 70 y were a small percentage of all p included in these clinical trials. However, outcome and toxicities were similar in p = 70y vs <70 y, and “fit” elderly p can be treated with standard doublets. Further research is warranted on genetic differences for customizing treatment in this population. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- M. Provencio
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - C. Camps
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - V. Alberola
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - M. Dómine
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - D. Isla
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - R. De las Peñas
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - O. Etxaniz
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - M. Cobo
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - I. Millán
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
| | - B. Massuti
- Hospital Puerta de Hierro, Madrid, Spain; Hospital General Valencia, Valencia, Spain; Hospital Arnau Vilanova, Valencia, Spain; Fundacion Jimenez Diaz, Madrid, Spain; Hospital Clínico Lozano Blesa Zaragoza, Zaragoza, Spain; Hospital de Castellón, Castellón, Spain; Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Clínico Málaga, Málaga, Spain; Hospital General Alicante, Alicante, Spain
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Domine M, Alberola V, Muñoz-Langa J, Muñoz-Quintana MA, Molina MA, Viñolas N, Gonzalez-Larriba J, López- Brea M, Sanchez JJ, Taron M. TGFBR1*6A germline deletion in gemcitabine (gem)/cisplatin (cis)-treated stage IV non-small cell lung cancer (NSCLC) patients (p). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18171] [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
18171 Background: An in-frame germline deletion variant (TGFBR1*6A) in the TGFBR1 gene results in loss of three alanines within the 9-alanine (*9A) repeat in the receptor. Compared with *9A, *6A is a less effective mediator of TGFB antiproliferative signals. Methods: We examined the germline deletion TGFBR1*6A in 107 gem/cis-treated stage IV NSCLC p. DNA was extracted from peripheral lymphocytes and deletion was analyzed by length analysis of fluorescently labeled PCR products. Results: Median age, 65 (range, 32- 81); male, 100 p (93%. Performance status (PS) 0, 39 p (37%); PS 1, 52 p (48.5%); PS 2, 26 p (24.5%). Adenocarcinoma: 56 p (52%). 71.6% of p had the *9A/*9A genotype; the remaining 28.4% had the *6A/*9A genotype. Response was observed in 37 p (34.5%). Overall median survival (MS) was 8 months (m). There were no differences in response or MS between p harboring the *9A/*9A genotype and those with the *6A/*9A genotype. There was a trend towards longer MS in p with PS 0 with *9A/*9A genotype (11 m) than in thoase with *6A/*9A (3 m) (P=0.06). Conclusions: Although the findings of this study do not identify significant differences between *6A and *9A, the fact that the shorter signal sequence could confer a tumor growth advantage merits further investigation. No significant financial relationships to disclose.
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Affiliation(s)
- M. Domine
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - V. Alberola
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. Muñoz-Langa
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. A. Muñoz-Quintana
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. A. Molina
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - N. Viñolas
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. Gonzalez-Larriba
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. López- Brea
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. J. Sanchez
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Taron
- Fundacion Jimenez Diaz, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Dr. Peset, Valencia, Spain; Instituto Valenciano de Oncología, Valencia, Spain; ICO, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinic, Barcelona, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Marques de Valdecilla, Santander, Cantabria, Spain; Autonomous University of Madrid, Madrid, Spain
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Rosell R, Moran T, Fernanda Salazar M, Mendez P, De Aguirre I, Ramirez JL, Isla D, Cobo M, Camps C, Lopez-Vivanco G, Alberola V, Taron M. The place of targeted therapies in the management of non-small cell bronchial carcinoma. Molecular markers as predictors of tumor response and survival in lung cancer. Rev Mal Respir 2006; 23:16S131-16S136. [PMID: 17268350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This review highlights the numerous molecular biology findings in the field of lung cancer with potential therapeutic impact in both the near and distant future. Abundant pre-clinical and clinical data indicate that BRCA1 mRNA expression is a differential modulator of chemotherapy sensitivity. Low levels predict cisplatin sensitivity and antimicrotubule drug resistance, and the opposite occurs with high levels. The main core of recent research has centered on epidermal growth factor receptor (EGFR) mutations and gene copy numbers. For the first time, EGFR mutations have been shown to predict dramatic responses in metastatic lung adenocarcinomas, with a threefold increase in time to progression and survival in patients receiving EGFR tyrosine-kinase inhibitors. Evidence has also been accumulated on the crosstalk between estrogen and EGFR receptor pathways, paving the way for clinical trials of EGFR tyrosine-kinase inhibitors plus aromatase inhibitors. Understanding the relevance of these findings can help to change the clinical practice in oncology towards customizing chemotherapy and targeted therapies, leading to improvement both in survival and in cost-effectiveness.
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Affiliation(s)
- R Rosell
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
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Juan Vidal O, Alberola V, Muñoz J, De Las Peñas R, Camps C, Massutí B, Garcia Gómez R, Provencio M, Isla D, Sánchez J. Impact of hemoglobin level on the outcome of advanced non-small-cell lung cancer (NSCLC) treated with cisplatin and gemcitabine. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17010] [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
17010 Background: Negative impact of anemia on survival has been described in NSCLC patients (pts) treated with radiotherapy (RT) or concurrent radiochemotherapy, but scarcely data exist in NSCLC treated with chemotherapy (CT). PURPOUSE: To evaluate the prognosis value of baseline hemoglobin (Hb) among pts with advanced NSCLC treated with cisplatin and gemcitabine. Methods: 433 pts included in two trials conducted by the Spanish Lung Cancer Group (176 pts from the arm A of a randomized phase III trial comparing 3 regimens of CT and 257 pts from a phase II trial) were included in this analysis. No significant differences in baseline characteristics, response and survival (median 8.73 and 9.87 months, p=0.46) were observed between pts of the two trials. The baseline Hb and other potential risk factors for survival were analyzed with Cox Proportional Hazards model in an univariate an multivariate analysis. Results: Stage IIIB with positive pleural effusion (25%), stage IV (75%). 85% had ECOG PS 0–1. Median age: 60 years (range 31–82). 89% male. Histology: 41% adenocarcinoma, 39% squamous cell, 6.5% large cell, 14.5% NSCLC not otherwise specified. Median number of cycles received was 4 (range 1–8). Mean Hb level prior CT was 13.2 g/dl (range 8 to 19.6 g/dl). Response rate was 41% and median survival was 9.57 months (95% CI: 8.57–11–57). No statistically differences in survival were observed by stage (IIIB vs IV), age and gender. In the univariate analysis, number of cycles received (≤3 vs. >3 cycles), ECOG (2 vs 0–1), response (SD+PD vs CR+PR), baseline Hb (≤11 vs >11 gr/dl); minimum Hb during the CT (<10 vs ≥10) and second line CT (No vs Yes) emerged as prognostic factors for survival and were introduced in the multivariate model (see Table ). Conclusions: Hb level at the initiation of CT is an independent prognostic factor of survival this homogenous group of advanced NSCLC treated with cisplatin and gemcitabine. Baseline Hb should be considered as prognosis factor for survival in addition to ECOG. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- O. Juan Vidal
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - V. Alberola
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - J. Muñoz
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - R. De Las Peñas
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - C. Camps
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - B. Massutí
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - R. Garcia Gómez
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - M. Provencio
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - D. Isla
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
| | - J. Sánchez
- Hospital Arnau de Vilanova, Valencia, Spain; H. Dr Pesset, Valencia, Spain; H. Provincial, Castelló, Spain; H. General, Valencia, Spain; H. General, Alicante, Spain; H. Gregorio Marañón, Madrid, Spain; H. Puerta de Hierro, Madrid, Spain; H. Clínico, Zaragoza, Spain; H. Germans Trias i Pujol, Barcelona, Spain
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Rosell-Costa R, Alberola V, Camps C, Lopez-Vivanco G, Moran T, Etxaniz O, De Las Peñas R, Gupta J, Taron M, Sanchez J. Clinical outcome of gemcitabine (gem)/cisplatin (cis)- vs docetaxel (doc)/cis-treated stage IV non-small cell lung cancer (NSCLC) patients (p) according to X-ray repair cross-complementing group 3 (XRCC3) polymorphism and age. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7055] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7055 Background: Significant interaction between XRCC1 genotype and age has been reported, with younger subjects having a greater risk of developing lung cancer. Carriers of XRCC3 241 MetMet have higher levels of DNA adducts, leading us to hypothesize that they would be more chemosensitive, especially younger patients. Methods: Real-time PCR assay was used to determine XRCC3 genotype from DNA isolated from baseline blood samples of 878 stage IV NSCLC p (162 treated with gem/cis; 716 with doc/cis). Median age, 60; 266 p (30%) <55; 239 p (39%) 55–66; 273 p (31%) >66. Adenocarcinoma: 459 p (53%). Homozygous variant XRCC3 241 MetMet was found in 124 p (14%), with the same frequency in each of the three age groups. Results: After a median follow-up of 7.6 months (m) (95% CI, 1–47 m), overall median survival (MS) was 9.5 m (95% CI, 8.8–10.2 m), with no differences between the 2 regimens. In all p with XRCC3 241 MetMet, MS was 12.9 m for p treated with gem/cis and 8.4 m for p treated with doc/cis (P = 0.06) (hazard ratio at 2 y = 0.23). In p with XRCC3 241 MetMet <55 y, MS was not reached for p treated with gem/cis and 9.2 m for p treated with doc/cis (P = 0.02), which translated into a 60% difference in survival at 2 y. This difference diminished in p with XRCC3 241 MetMet 55–66 y (MS 12.9 m with gem/cis, 6.9 m with doc/cis [P = 0.09]; 28% difference in survival at 2 y) and disappeared in p >66 y (MS 5.8 m with gem/cis, 7.8 m with doc/cis [P = 0.55]. For the other XRCC3 241 genotypes (ThrThr and ThrMet), no differences in MS were found either overall or broken down by age. Conclusions: XRCC3 241 MetMet is both an easily assessable and robust predictive marker for survival in younger gem/cis-treated NSCLC p. The survival benefit dwindles with increasing age, possibly related to the enhanced DNA repair capacity of older p. No significant financial relationships to disclose.
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Affiliation(s)
- R. Rosell-Costa
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - V. Alberola
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - C. Camps
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - G. Lopez-Vivanco
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - T. Moran
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - O. Etxaniz
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. De Las Peñas
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. Gupta
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Taron
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. Sanchez
- Institut Catala d’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital Provincial de Castellon, Castellon, Spain; Autonomous University of Madrid, Madrid, Spain
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Alberola V, Camps C, Sirera R, Llobat L, Blasco A, Safont MJ, Garde J, Taron M, Sanchez JJ, Rosell R. Prognostic value of blood levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in advanced non-small cell lung cancer (NSCLC) patients. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7196] [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
7196 Background: VEGF and bFGF are among the most important angiogenic factors. We have explored these angiogenesis mediators in plasma and its prognostic significance in advanced NSCLC. Methods: Were enrolled 451 patients with advanced NSCLC, stages IIIB and IV and treated with cisplatin and docetaxel. Blood was collected before chemotherapy. Plasma VEGF and bFGF levels were assessed by commercial ELISA (sensitivity 5 pg/ml). In parallel plasma from 32 age and gender-matched controls was used. Results: Median age was 61 years (35–82) and 84% were males. 99% had performance status 0–1. 84% were in stage IV and 16% in stage IIIB. The histological subtypes were: 32% squamous cell carcinoma, 50% adenocarcinoma, 14% anaplastic large cell, and 4% undifferentiated. 41% of the patients received second line chemotherapy. 1% achieved complete response (CR), 36% partial response (PR), 35% had stable disease (SD) and 28% progressive disease (PD). Patient’s median plasma levels of VEGF (20 pg/ml, [6–203]) differ significantly (p = 0.04) from controls (14 pg/ml, [7–53]), but in contrast bFGF levels were not different, 14 pg/ml [5–960] vs 10 pg/ml [6–278] respectively. There were not differences in patients according to histology, site of metastasis and ECOG; however we could observe a tendency with stage for both factors: bFGF 9 pg/ml [5–24] in stage IIIB vs 15 pg/ml [6–960], p = 0.071 and VEGF 17 pg/ml [6–145] in IIIB vs 21 pg/ml [6–203] in IV, p = 0.086. It could not be observed any differences in response to therapy for both angiogenic factors; CR+PR patients presented median VEGF of 18 pg/ml [6–71] and bFGF 11 pg/ml [6–960] vs 20 pg/ml of VEGF [6–203] and 15 pg/ml of bFGF [5–395] in the SD+PD group. In the multivariate analysis we could not find that VEGF and bFGF plasma levels were predictors for time to progression (TTP) and overall survival (OS). Conclusions: VEGF but not bFGF levels in patients are significantly higher in patients than in controls. In our cohort of patients with advanced NSCLC we have not found any relationship between serum VEGF and bFGF levels with stage, histology, response, site of metastasis, TTP and OS. No significant financial relationships to disclose.
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Affiliation(s)
- V. Alberola
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - C. Camps
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - R. Sirera
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - L. Llobat
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - A. Blasco
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - M. J. Safont
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - J. Garde
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - M. Taron
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - J. J. Sanchez
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
| | - R. Rosell
- Hospital Arnau de Vilanova, Valencia, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Universidad Autonoma de Madrid, Madrid, Spain
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Taron M, Alberola V, Lopez Vivanco G, Camps C, De Las Peñas R, Alonso G, Provencio M, Salvatierra A, Sanchez J, Rosell R. Excision cross-complementing group 1 (ERCC1) single nucleotide polymorphisms (SNPs) and survival in cisplatin (cis)/docetaxel (doc)-treated stage IV non-small cell lung cancer (NSCLC) patients (p): A Spanish Lung Cancer Group study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7053] [Citation(s) in RCA: 2] [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
7053 Background: SNPs are the result of historical errors in DNA replication or repair that have been inherited through generations and are now shared among individuals. ERCC1 belongs to the nucleotide excision repair pathway. We examined whether ERCC1 SNPs 118 C/T and C8092A affect the repair of cis DNA lesions and thereby influence survival in cis-treated NSCLC p. Methods: SNP genotyping of ERCC1 118C/T and C8092A was performed by the TaqMan assay, and results were correlated with median survival (MS) in 706 cis/doc-treated stage IV NSCLC p. Results: Characteristics: 590 male, 116 female; performance status (PS) 0: 216 p (30.6%), PS 1: 480 p (68%), PS 2: 10 p (1.4%); adenocarcinoma, 371 p (53%). Overall response rate: 30%. After a median follow-up of 7.8 months (m) (range, 1–47 m), overall MS was 8.9 m. SNP frequencies: 118 T/T, 40.2%; C/T, 45.4%; C/C, 14.4%; C8092A C/C, 57.6%; C/A, 36%; A/A, 6.4%. MS according to 118 C/T SNP: T/T, 8.9 m; C/T, 9.5 m; C/C, 10 m (P = 0.51). MS according to C8092A SNP: C/C, 9.3 m; C/A, 10.2 m; A/A, 7.2 m (P = 0.05). When stratified by PS, the association between C8092A and MS is stronger for p with PS 0: C/C, 15.9 m; C/A, 13.8 m; A/A, 8.7 m (P = 0.04). Conclusions: This is the largest study to date reporting the effect of ERCC1 C8092A SNP on MS in stage IV NSCLC p treated with a single regimen. The uncommon A/A genotype predicts poor survival in p treated with dis/doc. No significant financial relationships to disclose.
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Affiliation(s)
- M. Taron
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - V. Alberola
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - G. Lopez Vivanco
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - C. Camps
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. De Las Peñas
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - G. Alonso
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Provencio
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - A. Salvatierra
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - J. Sanchez
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. Rosell
- Institut Catala D’Oncologia, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Cruces de Baracaldo, Vizcaya, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital Juan Canalejo, La Coruña, Spain; Hospital Puerta del Hierro, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain
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de las Peñas R, Sanchez-Ronco M, Alberola V, Taron M, Camps C, Garcia-Carbonero R, Massuti B, Queralt C, Botia M, Garcia-Gomez R, Isla D, Cobo M, Santarpia M, Cecere F, Mendez P, Sanchez JJ, Rosell R. Polymorphisms in DNA repair genes modulate survival in cisplatin/gemcitabine-treated non-small-cell lung cancer patients. Ann Oncol 2006; 17:668-75. [PMID: 16407418 DOI: 10.1093/annonc/mdj135] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Impaired DNA repair capacity may favorably affect survival in cisplatin/gemcitabine-treated non-small-cell lung cancer (NSCLC) patients. We investigated the association of survival with genetic polymorphisms in X-ray repair cross-complementing group 1 and group 3 (XRCC3), xeroderma pigmentosum group D (XPD), excision repair cross-complementing group 1, ligase IV, ribonucleotide reductase, TP53, cyclooxygenase-2, interleukin-6, peroxisome proliferator-activated receptor gamma, epidermal growth factor, methylene-tetra-hydrofolate reductase and methionine synthase. PATIENTS AND METHODS One hundred and thirty-five stage IV or IIIB (with malignant pleural effusion) NSCLC patients treated with cisplatin/gemcitabine from different hospitals of the Spanish Lung Cancer Group were genotyped for 14 different polymorphisms in 13 genes. Polymorphisms were detected by the TaqMan method, using genomic DNA extracted from baseline blood samples. RESULTS Median survival was significantly increased in patients harboring XRCC3 241 MetMet: 16 months versus 10 months for patients with ThrMet and 14 months for those with ThrThr (P = 0.01). The risk of death ratio was significantly lower for MetMet than for ThrMet patients (hazard ratio, 0.43; P = 0.01). In the multivariate Cox model, XRCC3 241 remained an independent prognostic factor (hazard ratio: XRCC3 241 MetMet, 0.44; P = 0.01), and XPD 751 and XRCC1 399 also emerged as significant prognostic factors (hazard ratios: XPD 751 LysGln, 0.46, P = 0.03; XRCC1 399 ArgGln, 0.61, P = 0.04). No other association was observed between genotype and survival. CONCLUSION XRCC3 241 MetMet is an independent determinant of favorable survival in NSCLC patients treated with cisplatin/gemcitabine. A simple molecular assay to determine the XRCC3 241 genotype can be useful for customizing chemotherapy.
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Sirera R, Camps C, Bremnes R, Alberola V, Rodenas V, Safont M, Blasco A, Taros M, Sanchez J, Rosell R. PD-026 The analysis of serum DNA concentration by means of hTERT quantification: A useful prognostic factor in advanced non-small cell lung cancer (NSCLC). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80359-9] [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: 10/25/2022]
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Camps C, Sirera R, Bremnes R, Llobat L, Safont M, Blasco A, Alberola V, Taron M, Sanchez J, Rosell R. PD-004 Serum levels of vascular endothelial growth factor andepidermal growth factor receptor in advanced non-small cell lung cancer: Its correlation with clinical characteristics. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80336-8] [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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20
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Garrido P, Resell R, Arellano A, Ramos A, Massuti T, Andreu J, Cardenal F, Arnaiz A, Amador M, Alberola V. PD-042 Induction (I) or consolidation (C) chemotherapy withdocetaxel (D) and gemcitabine (G) plus concomitant chemoradiotherapy (CT/TRT) with docetaxel and carboplatin (Cb) for unresectable stage III non-small cell lung cancer (NSCLC) patients (p). Initial report of the randomized phase II trial SLCG 0008. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80375-7] [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: 10/25/2022]
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21
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Moran T, de Castellanos D, Gomez C, Valero P, Alberola V, Gonzalez-Larriba J, Massuti B, Maestu I, Izquierdo A, Queralt C. PD-149 Epidermal growth factor receptor (EGFR)-activating mutations(mut) and response to gefitinib in lung adenocarcinomas. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80482-9] [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: 11/25/2022]
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22
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Muñoz-Langa J, Juan O, Olmos S, Albert A, Molins C, Carañana V, Almenar D, Campos JM, Bosch C, Alberola V. Once-weekly dosing of epoetin alfa are similar to three-times-weekly dosing to improve hemoglobin levels in chemotherapy patients: Results From multicenter prospective cohort study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. Muñoz-Langa
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - O. Juan
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - S. Olmos
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - A. Albert
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - C. Molins
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - V. Carañana
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - D. Almenar
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - J. M. Campos
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - C. Bosch
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
| | - V. Alberola
- Hosp Univ Dr. Peset, Valencia, Spain; Hosp Arnau de Vilanova, Valencia, Spain
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Ramirez JL, Rosell R, Taron M, Gupta J, Alberola V, de las Penas R, Sanchez JM, Moran T, Isla D, Catot S. 14-3-3 σ (σ) methylation (M) in pre-treatment serum DNA of cisplatin (cis)/gemcitabine (gem)-treated non-small-cell lung cancer (NSCLC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. L. Ramirez
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - R. Rosell
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - M. Taron
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - J. Gupta
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - V. Alberola
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - R. de las Penas
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - J. M. Sanchez
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - T. Moran
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - D. Isla
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
| | - S. Catot
- Inst Catala d’Oncologia, Badalona, Spain; Hosp Arnau de Vilanova de Valencia, Valencia, Spain; Hosp Provincial de Castellon, Castellon, Spain; Hosp Clinico Univ Lozano Blesa, Zaragoza, Spain
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Berrocal A, Sirera R, Camps C, Bremnes RM, Alberola V, Bayo P, Safont MJ, Blasco A, Taron M, Sanchez JJ, Rosell R. The quantification of DNA in the serum is a useful prognostic factor in advanced non-small cell lung cancer (NSCLC) patients. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Berrocal
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - R. Sirera
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - C. Camps
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - R. M. Bremnes
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - V. Alberola
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - P. Bayo
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - M. J. Safont
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - A. Blasco
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - M. Taron
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - J. J. Sanchez
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - R. Rosell
- Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Hosp Arnau de Vilanova, Valencia, Spain; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
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25
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Alberola V, Camps C, Sirera R, Bremnes RM, Bayo P, Blasco A, Berrocal A, Safont MJ, Taron M, Sanchez JJ, Rosell R. Correlation of blood levels of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor and hemoglobin with response to therapy in advanced non-small cell lung cancer patients (NSCLC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V. Alberola
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - C. Camps
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - R. Sirera
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - R. M. Bremnes
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - P. Bayo
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - A. Blasco
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - A. Berrocal
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - M. J. Safont
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - M. Taron
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - J. J. Sanchez
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
| | - R. Rosell
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Gen Univ, Valencia, Spain; Univ Hosp of Northern Norway, Tromso, Norway; Inst Catala d’Oncologia, Barcelona, Spain; Univ Autonoma de Madrid, Madrid, Spain
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Juan O, Muñoz-Langa J, Albert A, Almenar D, Carañana V, Olmos S, Vidal J, Molins C, Llorente R, Alberola V. Risk model for severe anemia in patients with non-hematologic cancer receiving conventional chemotherapy: Results from a multicenter prospective cohort study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- O. Juan
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - J. Muñoz-Langa
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - A. Albert
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - D. Almenar
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - V. Carañana
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - S. Olmos
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - J. Vidal
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - C. Molins
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - R. Llorente
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
| | - V. Alberola
- Hosp Arnau de Vilanova, Valencia, Spain; Hosp Univ Dr Peset, Valencia, Spain
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Garrido P, Massutí B, Cardenal F, Moran T, Alberola V, Maeztu I, Dómine M, Isla D, Arellano A, Ramos A. Induction (I) or consolidation (C) chemotherapy with docetaxel (D) and gemcitabine (G) plus concomitant chemoradiotherapy (CT/TRT) with docetaxel and carboplatin (Cb) for unresectable stage III non-small cell lung cancer (NSCLC) patients (p). Initial report of the randomized phase II trial SLCG 0008. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. Garrido
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - B. Massutí
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - F. Cardenal
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - T. Moran
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - V. Alberola
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - I. Maeztu
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - M. Dómine
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - D. Isla
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - A. Arellano
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
| | - A. Ramos
- Hosp Ramon y Cajal, Madrid, Spain; Hosp Alicante, Alicante, Spain; ICO, Barcelona, Spain; Hosp Germans Trias i Pujol, Badalona, Barcelona, Spain; Hosp Arnau Vilanova, Valencia, Spain; Hosp Virgen de los Lirios, Alcoy, Alicante, Spain; Fundación Jimenez Díaz, Madrid, Spain; Hosp Clínico, Zaragoza, Spain
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Cortes-Funes H, Gomez C, Rosell R, Valero P, Garcia-Giron C, Velasco A, Izquierdo A, Diz P, Camps C, Castellanos D, Alberola V, Cardenal F, Gonzalez-Larriba JL, Vieitez JM, Maeztu I, Sanchez JJ, Queralt C, Mayo C, Mendez P, Moran T, Taron M. Epidermal growth factor receptor activating mutations in Spanish gefitinib-treated non-small-cell lung cancer patients. Ann Oncol 2005; 16:1081-6. [PMID: 15851406 DOI: 10.1093/annonc/mdi221] [Citation(s) in RCA: 196] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND North American and Japanese non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) activation via tyrosine kinase (TK) mutations respond dramatically to gefitinib treatment. To date, however, the frequency and effect of EGFR TK mutations have not been examined in European patients. PATIENTS AND METHODS Eighty-three Spanish advanced NSCLC patients who had progressed after chemotherapy, were treated with compassionate use of gefitinib. Patients were selected on the basis of available tumor tissue. Tumor genomic DNA was retrieved from paraffin-embedded tissue obtained by laser capture microdissection. EGFR mutations in exons 19 and 21 were examined by direct sequencing. RESULTS EGFR mutations were found in 10 of 83 (12%) of patients. All mutations were found in adenocarcinomas, more frequently in females (P=0.007) and non-smokers (P=0.01). Response was observed in 60% of patients with mutations and 8.8% of patients with wild-type EGFR (P=0.001). Time to progression for patients with mutations was 12.3 months, compared with 3.6 months for patients with wild-type EGFR (P=0.002). Median survival was 13 months for patients with mutations and 4.9 months for those with wild-type EGFR (P=0.02). CONCLUSIONS EGFR TK mutational analysis is a novel predictive test for selecting lung adenocarcinoma patients for targeted therapy with EGFR TK inhibitors.
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Lena MD, Ramlau R, Hansen O, Lorusso V, Wagner L, Barni S, Cristovao MM, Huber R, Alberola V, Mitrovic M, Colin C, Gasmi J. Phase II trial of oral vinorelbine in combination with cisplatin followed by consolidation therapy with oral vinorelbine in advanced NSCLC. Lung Cancer 2005; 48:129-35. [PMID: 15777980 DOI: 10.1016/j.lungcan.2004.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2004] [Revised: 10/13/2004] [Accepted: 10/14/2004] [Indexed: 11/28/2022]
Abstract
BACKGROUND Among the cytotoxic agents commonly combined with cisplatin in the treatment of advanced NSCLC, vinorelbine has led to significant outcome improvements. Adding more than four cycles of the combination regimen increase toxicities. The availability of an oral form of vinorelbine appeared as a particularly convenient way to provide a consolidation treatment to patients who have achieved an objective response or stable disease. PATIENTS AND METHODS This multi-centre phase II open-label, non-comparative study was designed to evaluate the treatment with four cycles of the combination chemotherapy with oral vinorelbine at the dose of 60 mg/m2 on day 1 and day 8 for the first cycle and then 80 mg/m2 plus cisplatin 80 mg/m2 on day 1 every 3 weeks followed for patients with objective response or stable disease by consolidation therapy with oral vinorelbine at 80 mg/m2 weekly on patients with unresectable localised or metastatic non-small-cell lung cancer (NSCLC). The primary endpoint was tumor response. The secondary objectives were progression free-survival, overall survival and toxicity assessment. Visual analogue scales (VAS) filled by the patients were also used to evaluate subjective changes under treatment, reflecting patients' clinical benefit. RESULTS Fifty-six patients enrolled into the study from April 2001 to April 2002 received the combination regimen. Twenty-five patients (43.9%) also received the subsequent consolidation treatment. Partial tumor responses were obtained in 13 patients (26.5%, 95% CI 15.0-41.1) of 49 evaluable patients. Stable disease was observed in 22 (44.9%) of patients. The median duration of response was 6 months (95% CI 4.3-8.2). The median progression free-survival was 4.2 months (95% CI 2.8-6). The median overall survival time was 10 months (95% CI 7.4-14) and the 1 year survival was 42.6%. The main toxicities recorded were haematological. Grade 3 and 4 neutropenia were observed in 16 patients (29.1%). Nausea, vomiting and fatigue were the major non-haematological toxicities reported. Among the symptoms recorded by the patients on VAS scales (appetite, fatigue, pain, cough, dyspnea, haemoptysis), except anorexia, all symptoms were improved during the combination therapy and in the consolidation phase. CONCLUSION This study confirms that the efficacy of the cisplatin/oral vinorelbine combination in NSCLC is comparable to cisplatin/I.V. vinorelbine. This study also suggests that consolidation therapy with vinorelbine alone may probably prolong the efficacy of the combination regimen. The convenience offered to patients by an oral form of vinorelbine is a definite asset for consolidation therapy.
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Affiliation(s)
- M De Lena
- Ospedale Oncologico di Bari, Bari, Italy
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Camps C, Felip E, Sanchez JM, Massuti B, Artal A, Paz-Ares L, Carrato A, Alberola V, Blasco A, Baselga J, Astier L, Voi M, Rosell R. Phase II trial of the novel taxane BMS-184476 as second-line in non-small-cell lung cancer. Ann Oncol 2005; 16:597-601. [PMID: 15684226 DOI: 10.1093/annonc/mdi120] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the tolerability and efficacy of BMS-184476, an analog of paclitaxel, in patients with advanced non-small-cell lung cancer (NSCLC) progressing or relapsing following at least one prior chemotherapy regimen. PATIENTS AND METHODS Fifty-six previously treated advanced NSCLC patients received BMS-184476 at a dose of 60 mg/m(2) administered intravenously over 1 h every 21 days. RESULTS The median number of cycles delivered per patient was five (range one to 17). Dose reduction was required in only 3.8% of cycles. Grade 4 neutropenia occurred in 19.6% of patients, but no grade 4 thrombocytopenia or anemia was reported. Febrile neutropenia was observed in only two (3.6%) patients and there were no life-threatening events. Grade 3/4 peripheral sensory-motor neuropathy was reported in 9% of patients. Other non-hematological toxicities, such as nausea and vomiting, myalgia and arthralgia, diarrhea, and mucositis, were uncommon. Partial responses were observed in eight (14.3%) patients and stable disease in 33 (58.9%). Median progression-free survival was 3.7 months [95% confidence interval (CI) 2.7-5.4] and median overall survival was 10 months (95% CI 6-13.4). CONCLUSIONS BMS-184476 was well tolerated at the dose of 60 mg/m(2) and showed evidence of antitumor activity in previously treated NSCLC.
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Affiliation(s)
- C Camps
- Hospital General Universitario de Valencia, Valencia, Spain.
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De Lena M, Ramlau R, Hansen O, Wagner L, Barni S, Alberola V, Huber R, Mitrovic M, Gasmi J, Pouget JC. Phase II of oral vinorelbine (NVB oral) in combination with Cisplatin (P) followed by NVB oral single agent as consolidation therapy in advanced non small-cell lung cancer (NSCLC): A Patient's Benefit Analysis. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. De Lena
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - R. Ramlau
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - O. Hansen
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - L. Wagner
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - S. Barni
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - V. Alberola
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - R. Huber
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - M. Mitrovic
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - J. Gasmi
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
| | - J.-C. Pouget
- IRCCS Oncologico di Bari, Bari, Italy; Greatpoland Lung Disease Centre, Poznan, Poland; Odense University Hospital, Odense, Denmark; Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt, Germany; Azienda Ospedaliera Treviglio Caravaggio, Treviglio, Italy; Hospital Arnau de Vilanova, Valencia, Spain; Lugwig-Maximilians Universität, Munich, Germany; Institut de Recherche Pierre Fabre, Boulogne, France
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Alberola V, Ramirez JL, De Aguirre I, Rosell R, de las Penas R, Camps C, Cobo M, Taron M, Sanchez-Ronco M, Marti JL. Methylene-tetrahydrofolate reductase (MTHFR) single nucleotide polymorphism (SNP) in gemcitabine (gem)/cisplatin (cis)-treated non-small-cell lung cancer (NSCLC) patients (p). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V. Alberola
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - J. L. Ramirez
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - I. De Aguirre
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - R. Rosell
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - R. de las Penas
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - C. Camps
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - M. Cobo
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - M. Taron
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - M. Sanchez-Ronco
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
| | - J. L. Marti
- Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Universitario Carlos Haya, Malaga, Spain; Autonomous University of Madrid, Madrid, Spain; Hospital General de Alicante, Alicante, Spain
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Sarries C, Alberola V, De Las Penas R, Camps C, Massuti B, Garcia-Gomez R, Insa A, Sanchez-Ronco M, Taron M, Rosell R. Combined DNA repair gene single nucleotide polymorphisms (SNPs) in gemcitabine (gem)/cisplatin (cis)-treated non-small-cell lung cancer (NSCLC) patients (p). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C. Sarries
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - V. Alberola
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. De Las Penas
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - C. Camps
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - B. Massuti
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. Garcia-Gomez
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - A. Insa
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Sanchez-Ronco
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - M. Taron
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
| | - R. Rosell
- Institut Catala d'Oncologia, Hospital Gemans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Provincial de Castellon, Castellon, Spain; Hospital General de Valencia, Valencia, Spain; Hospital General de Alicante, Alicante, Spain; Hospital General Gregorio Marañon, Madrid, Spain; Hospital Clinico Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain
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Nunez L, Isla D, Rosell R, Taron M, Artal A, Bover I, Alberola V, Camps C, Sanchez JJ, Munoz MA. TP53 codon 72 single nucleotide polymorphism (SNP) in gemcitabine (gem)/cisplatin (cis)-treated non-small-cell lung cancer (NSCLC) patients (p). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- L. Nunez
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - D. Isla
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - R. Rosell
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - M. Taron
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - A. Artal
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - I. Bover
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - V. Alberola
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - C. Camps
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - J. J. Sanchez
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
| | - M. A. Munoz
- Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospial Son Llatzer, Palma de Mallorca (Balear Islands), Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Autonomous University of Madrid, Madrid, Spain; Instituto Valenciano de Oncologia, Valencia, Spain
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Juan O, Albert A, Villarroya T, Sánchez R, Casan R, Caranana V, Campos JM, Alberola V. Weekly paclitaxel for advanced non-small cell lung cancer patients not suitable for platinum-based therapy. Neoplasma 2003; 50:204-9. [PMID: 12937854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Platinum-based combinations are efficacious in the treatment of advanced non-small cell lung cancer (NSCLC) but their toxicity makes them unsuitable for elderly and for patients with co-morbidities. We assessed the efficacy and toxicity of low-dose of paclitaxel in patients who were elderly or who had contraindications against cisplatin therapy. Seventy-one patients (median age 68; range 42-82 years) with unresectable NSCLC were treated with weekly paclitaxel (80 mg/m2) infusion (1 h) for several cycles without intervening rest periods. Thirty-seven patients had PS 1 and 34 had PS 2 status. A total of 614 courses were administered (median 9, range 2-20). There were no episodes of grade 4 toxicities and only 1 patient had grade 3 thrombopenia. Grade 3 anemia or neutropenia were not observed and severe non-hematological toxicity was uncommon: grade 1-2 fatigue in 52%; grade 1-2 motor neuropathy in 42% and grade 3 in 5.5%; grade 1-2 sensory neuropathy in 46.3% of patients. Twenty-seven of the 67 evaluable patients (40.3%) had an objective response, whereas 26 patients (38.8%) had stable disease. The median overall survival for the entire group was 8.4 months (95% CI = 5.6 to 11.2) and the 1-year and 2-year survival was 37.4% and 12.1%, respectively. The median time-to-progression was 5.4 months (95% CI = 3.3 to 7.4). Our data show that low-dose weekly paclitaxel is active and well tolerated in this group of patients with NSCLC and poor prognosis and, as such, is useful for patients in whom platinum-based combinations are not suitable.
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Affiliation(s)
- O Juan
- Department of Medical Oncology, Hospital Arnau de Vilanova, 46015 Valencia, Spain.
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Alberola V, Camps C, Provencio M, Isla D, Rosell R, Vadell C, Bover I, Ruiz-Casado A, Azagra P, Jiménez U, González-Larriba JL, Diz P, Cardenal F, Artal A, Carrato A, Morales S, Sanchez JJ, de las Peñas R, Felip E, López-Vivanco G. Cisplatin plus gemcitabine versus a cisplatin-based triplet versus nonplatinum sequential doublets in advanced non-small-cell lung cancer: a Spanish Lung Cancer Group phase III randomized trial. J Clin Oncol 2003; 21:3207-13. [PMID: 12947054 DOI: 10.1200/jco.2003.12.038] [Citation(s) in RCA: 152] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To compare the survival benefit obtained with cisplatin plus gemcitabine, a cisplatin-based triplet, and nonplatinum sequential doublets in advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Stage IIIB to IV NSCLC patients were randomly assigned to receive cisplatin 100 mg/m2 day 1 plus gemcitabine 1,250 mg/m2 days 1 and 8, every 3 weeks for six cycles (CG); cisplatin 100 mg/m2 day 1 plus gemcitabine 1,000 mg/m2 and vinorelbine 25 mg/m2 days 1 and 8, every 3 weeks for six cycles (CGV); or gemcitabine 1,000 mg/m2 plus vinorelbine 30 mg/m2 days 1 and 8, every 3 weeks for three cycles, followed by vinorelbine 30 mg/m2 days 1 and 8 plus ifosfamide 3 g/m2 day 1, every 3 weeks for three cycles (GV-VI). RESULTS Five hundred fifty-seven patients were assigned to treatment (182 CG, 188 CGV, 187 GV-VI). Response rates were significantly inferior for the nonplatinum sequential doublet (CG, 42%; CGV, 41%; GV-VI, 27%; CG v GV-VI, P =.003). No differences in median survival or time to progression were observed. Toxicity was higher for the triplet: grade 3 to 4 neutropenia (GC, 32%; CGV, 57%; GV-VI, 27%; P <.05); neutropenic fever (CG, 4%; CGV, 19%; GV-VI, 5%; P <.0001); grade 3 to 4 thrombocytopenia (CG, 19%; CGV, 23%; GV-VI, 3%; P =.0001); and grade 3 to 4 emesis (GC, 22%; GCV, 32%; GV-VI, 6%; P <.0001). CONCLUSION On the basis of these results, CG remains a standard regimen for first-line treatment of advanced NSCLC.
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Affiliation(s)
- V Alberola
- Hospital Arnau de Vilanova, San Clemente 12, 46015 Valencia, Spain.
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Juan O, Campos JM, Carañana V, Sanchez JJ, Casañ R, Alberola V. A randomized, crossover comparison of standard-dose versus low-dose lenograstim in the prophylaxis of post-chemotherapy neutropenia. Support Care Cancer 2001; 9:241-6. [PMID: 11430419 DOI: 10.1007/s005200000197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this trial was to compare the severity of neutropenia, the frequency of hospital admission for fever or infection, and the use of antibiotics among patients treated with a standard dose of lenograstim (263 microg/day of Euprotin) and others treated with half of this dose (131.5 microg/day) and the cost-effectiveness of each of the two doses. In this single-center study, 44 patients with solid tumors, who were all receiving standard-dose chemotherapy regimens following previous neutropenia or were at high risk of neutropenia, were randomized to receive lenograstim at a dose of 263 microg or 131.5 microg daily in the first cycle and then crossed over to the alternate dose for the following cycle. Crossover to the alternate dose was repeated for patients who received more than two cycles. Lenograstim was administered from day +5 to day +14. The absolute neutrophil count (ANC) was assessed on days +5, +8, +12 and +15 of each cycle. Statistical analysis was performed using a general lineal model for repeated samples. In all, 120 cycles were administered, with a median of 3 cycles (range 1-6). Only 4 patients received only 1 cycle. No statistically significant difference (P=0.324) in ANC was observed between standard-dose (mean 5.3, 10.7, 8.3, 11.4 x 10(9)/l) and low-dose (5.0, 8.6, 5.4, 7.5 x 10(9)/l) treatment at days +5, +8, +12 and + 15. Neutropenia grade III-IV was more common in patients receiving the low than in those receiving the standard dose of lenograstim (20% vs 12%, respectively), but the difference did not reach statistical significance (P=0.1). The incidence of fever and frequency of hospital admission were not affected by the dose of lenograstim: 3 patients presented with fever with the standard dose (all of those were admitted to hospital) and 2 patients with the low dose (1 was admitted). ANC in both groups (standard and low doses) was independent of chemotherapy line (first versus second or more). Lenograstim at a dose of 131.5 microg/day is as effective as the standard dose in limiting the severity of neutropenia and in preventing episodes of fever and hospital admissions after chemotherapy for solid tumors. The lower dose of lenograstim is cost-effective in neutropenia prophylaxis. Starting its administration on day +5 reduces costs while maintaining efficacy.
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Affiliation(s)
- O Juan
- Department of Oncology, Hospital Arnau de Vilanova, Spain.
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Rosell R, Sánchez JM, Tarón M, O'Brate A, Gutiérrez JL, Monzó M, Felip E, Sánchez JJ, Alberola V. Novel approaches in the treatment of non-small-cell lung cancer. Oncology (Williston Park) 2001; 15:52-60. [PMID: 11301850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
A wealth of data indicates that certain genetic abnormalities can target specific cytotoxic drugs and intervene at an early step as a mechanism of resistance in the treatment of non-small-cell lung cancer. Therefore prescribing certain combinations of cytotoxic anticancer agents to a vast majority of these patients is futile. Genetic abnormalities have been found to be useful surrogate markers for response, particularly in colorectal cancer: thymidylate synthase mRNA and ERCC1 mRNA levels. In addition, beta-tubulin mutations may also confer paclitaxel resistance in patients. An important target to be explored for gemcitabine resistance is the assessment of a particular region in chromosome 11p15.5 wherein lies the ribonucleotide reductase gene that could affect gemcitabine metabolism. Shedding light on this genetic framework, several proposed customized chemotherapy studies could help validate the relevance of these markers.
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Affiliation(s)
- R Rosell
- Medical Oncology Service, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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Isla D, Rosell R, Sánchez JJ, Carrato A, Felip E, Camps C, Artal A, González-Larriba JL, Azagra P, Alberola V, Martin C, Massutí B. Phase II trial of paclitaxel plus gemcitabine in patients with locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol 2001; 19:1071-7. [PMID: 11181671 DOI: 10.1200/jco.2001.19.4.1071] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Given the cisplatin-related myelotoxicity and nonhematologic toxicities, we were prompted to undertake a study of the noncisplatin combination of paclitaxel plus gemcitabine to evaluate the efficacy, tolerance, and survival of this combination in patients with locally advanced and metastatic non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Patients received gemcitabine 2,000 mg/m(2) and paclitaxel 150 mg/m(2) on days 1 and 15 of a 28-day cycle, for a maximum of eight cycles. RESULTS Between December 1997 and June 1998, 89 untreated NSCLC patients were enrolled; 30 (34%) had stage IIIB disease (23 with malignant pleural effusion and seven without), and 59 (66%) had stage IV disease. Eighty-six percent of patients had a performance status of 0 or 1. The median number of cycles administered was four (range, one to eight cycles). The mean dose-intensity for both paclitaxel and gemcitabine was nearly 100%. Hematologic and nonhematologic toxicities were mild. Thirty-eight patients received second-line chemotherapy after completion of the study. The overall intent-to-treat response rate was 32.2%, with a higher response rate for stage IIIB patients (43.3%) than for stage IV patients (26.3%). Overall median survival was 9.9 months, and 1-year survival was 38.8% (14.2 months for stage IIIB and 7.7 months for stage IV; P =.007). Median survival was 10.2 months for patients with a performance status of 0 or 1 and 4.8 months for patients with a performance status of 2 (P =.007). CONCLUSION A biweekly paclitaxel/gemcitabine regimen was well tolerated, with an acceptable response rate and a reasonable median survival time, especially in patients with good performance status. It merits further exploration in future studies.
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Affiliation(s)
- D Isla
- Hospital Clínico Lozano Blesa and Hospital Miguel Servet, Zaragoza
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40
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Rosell R, O'Brate A, Sánchez J, Isla D, Felip E, Camps C, González-Larriba J, Antón A, Carrato A, Azagra P, Alberola V, Massuti B. Assessment of tubulin mutations in a phase II study of biweekly gemcitabine/paclitaxel (T) in advanced non-small-cell lung cancer (NSCLC). Lung Cancer 2000. [DOI: 10.1016/s0169-5002(00)80159-2] [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: 10/27/2022]
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Alberola V, Camps C, Provencio M, Isla D, Vadell C, Pérez Carrión R, González-Larriba J, Azagra P, Diz P, Artal A, Sánchez J, Rosell R. Cisplatin/gemcitabine (CG) vs cisplatin/gemcitabine/vinorelbine (CGV) vs sequential doublets of gemcitabine/vinorelbine followed by ifosfamide/vinorelbine (GV/IV) in advanced non-small cell lung cancer. Interim analysis of a Spanish Lung Cancer Group (SLCG) phase III trial. Lung Cancer 2000. [DOI: 10.1016/s0169-5002(00)80196-8] [Citation(s) in RCA: 3] [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: 11/25/2022]
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Sacristán JA, Kennedy-Martin T, Rosell R, Cardenal F, Antón A, Lomas M, Alberola V, Massuti B, Carrato A, Minshall M. Economic evaluation in a randomized phase III clinical trial comparing gemcitabine/cisplatin and etoposide/cisplatin in non-small cell lung cancer. Lung Cancer 2000; 28:97-107. [PMID: 10717327 DOI: 10.1016/s0169-5002(99)00120-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Information on the relative cost-effectiveness of treatments for cancer is being increasingly sought as pressure on health care resources increases. The objective of this study was to assess the cost-effectiveness of gemcitabine/cisplatin (GC) versus cisplatin/etoposide (CE) in patients with advanced non-small cell lung cancer (NSCLC), using resource utilization data collected in conjunction with the first randomized clinical trial comparing both combinations. METHODS Efficacy and medical care resource utilization data were collected prospectively in an open-label, multicenter, randomized, comparative, phase III trial conducted in Spain which compared gemcitabine/cisplatin and cisplatin/etoposide in 135 chemonaive patients with Stage IIIB or IV NSCLC. There were no differences between both regimens when survival was used as primary end-point, so a cost-minimization analysis was used to compare them. In addition, cost-effectiveness analyses were conducted when percentage of responses and time to progression were used as secondary end-points. RESULTS There were no differences between both regimens when survival was selected as the efficacy end-point. Despite the higher chemotherapy cost of GC when compared to CE, there were no differences in total direct costs (584523 pts for GC and 589630 pts for CE; P=NS) between both regimens. Potential savings with GC were mainly associated with a decrease in hospitalization rate. There were differences in favor of GC when response rate (40.6% for GC and 21.9% for CE; P<0.05) and time to disease progression (8.7 months for GC and 7.2 months for CE; P<0. 05) were used as clinical end-points. GC presented a favorable cost-effectiveness profile when compared to CE. CONCLUSIONS This prospective economic evaluation conducted alongside a clinical trial offers valuable preliminary information on the potential efficiency of the combination gemcitabine-cisplatin in NSCLC. Future assessments based on larger clinical trials focused on survival and naturalistic economic studies conducted in real clinical practice settings are necessary to confirm these findings.
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Affiliation(s)
- J A Sacristán
- From Hospital Germans Trias i Pujol, Badalona (Barcelona) Hospital Duran i Reynals, Barcelona Hospital Miguel Servet, Zaragoza, Spain.
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Felip E, Rosell R, Alberola V, Gómez-Codina J, Maestre J, Astudillo J, Camps C, Gonzalez-Larriba JL, Moreno I, Paredes A, Artal A, García-Gómez R, Garrido P, Cardenal F, Barneto I, Sánchez JJ. Preoperative High-Dose Cisplatin Versus Moderate- Dose Cisplatin Combined with Ifosfamide and Mitomycin in Stage IIIA (N2) Non–Small-Cell Lung Cancer: Results of a Randomized Multicenter Trial. Clin Lung Cancer 2000; 1:287-93. [PMID: 14733634 DOI: 10.3816/clc.2000.n.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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]
Abstract
Preoperative chemotherapy has become an accepted treatment for stage IIIA (N2) non small-cell lung cancer (NSCLC). The majority of induction regimens employ cisplatin, although the importance of cis-platin dose in combination is unclear. A randomized trial was conducted to address whether higher pre-operative cisplatin doses result in improved survival and increased pathologic complete response in NSCLC. Patients with stage IIIA clinically enlarged and biopsy-proven N2 lesions were randomly assigned to receive either high-dose cisplatin (HDCP) (100 mg/m2) or moderate-dose cisplatin (MDCP) (50 mg/ m2) in combination with ifosfamide (3 g/m2) and mitomycin (6 mg/m2). Disease was restaged after 3 cycles, and those patients with response or stable disease underwent thoracotomy. From March 1993 to February 1997, 83 patients were randomized: 46 received HDCP, and 37 received MDCP. Clinical characteristics were well matched. Radiographic response rate was 59% for HDCP patients and 30% for MDCP patients (P = 0.01). Thoracotomy was performed in 71 patients (86%), 58 of whom had resectable disease. Complete resection rate was 61% in the HDCP group, and 51% in the MDCP group (P = 0.5). Postoperative mortality was 11%. Pathologic complete response was observed in one patient who received MDCP. Median survival in the HDCP and MDCP groups was 13 and 11 months, respectively (P = 0.3). In conclusion, higher radiographic response rate is observed in patients who receive HDCP, but this study fails to show any significant improvement in either overall survival or pathologic complete response in this group of patients.
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Affiliation(s)
- E Felip
- Hospital Vall d'Hebron, Barcelona, Spain
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Monzó M, Rosell R, Sánchez JJ, Lee JS, O'Brate A, González-Larriba JL, Alberola V, Lorenzo JC, Núñez L, Ro JY, Martín C. Paclitaxel resistance in non-small-cell lung cancer associated with beta-tubulin gene mutations. J Clin Oncol 1999; 17:1786-93. [PMID: 10561216 DOI: 10.1200/jco.1999.17.6.1786] [Citation(s) in RCA: 207] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The mechanisms that cause chemoresistance in non-small-cell lung cancer (NSCLC) patients have yet to be clearly elucidated. Paclitaxel is a tubulin-disrupting agent that binds preferentially to beta-tubulin. Tubulins are guanosine triphosphate (GTP)-binding proteins. Beta-tubulin is a GTPase, whereas alpha-tubulin has no enzyme activity. We reasoned that polymerase chain reaction (PCR) and DNA sequencing of the beta-tubulin gene could reveal more information regarding the connection between beta-tubulin mutations and primary paclitaxel resistance. PATIENTS AND METHODS Constitutional genomic DNA and paired tumor DNA were isolated from 49 biopsies from 43 Spanish and six American stage IIIB and IV NSCLC patients who had been treated with a 3-hour, 210 mg/m(2) paclitaxel infusion and a 24-hour, 200 mg/m(2) infusion, respectively. Oligonucleotides specific to beta-tubulin were designed for PCR amplification and sequencing of GTP- and paclitaxel-binding beta-tubulin domains. RESULTS Of 49 patients with NSCLC, 16 (33%; 95% confidence interval [CI], 20.7% to 45.3%) had beta-tubulin mutations in exons 1 (one patient) or 4 (15 patients). None of the patients with beta-tubulin mutations had an objective response, whereas 13 of 33 (39.4%; 95% CI, 22.8% to 56%; P = 0.01) patients without beta-tubulin mutations had complete or partial responses. Median survival was 3 months for the 16 patients with beta-tubulin mutations and 10 months for the 33 patients without beta-tubulin mutations (P =.0001). CONCLUSION We have identified beta-tubulin gene mutations as a strong predictor of response to the antitubulin drug paclitaxel; these mutations may represent a novel mechanism of resistance and should be examined prospectively in future trials of taxane-based therapy in NSCLC.
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Affiliation(s)
- M Monzó
- Department of Pathology and the Laboratory of Molecular Biology of Cancer, Medical Oncology Service, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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Cardenal F, López-Cabrerizo MP, Antón A, Alberola V, Massuti B, Carrato A, Barneto I, Lomas M, García M, Lianes P, Montalar J, Vadell C, González-Larriba JL, Nguyen B, Artal A, Rosell R. Randomized phase III study of gemcitabine-cisplatin versus etoposide-cisplatin in the treatment of locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol 1999; 17:12-8. [PMID: 10458212 DOI: 10.1200/jco.1999.17.1.12] [Citation(s) in RCA: 354] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We conducted a randomized trial to compare gemcitabine-cisplatin with etoposide-cisplatin in the treatment of patients with advanced non-small-cell lung cancer (NSCLC). The primary end point of the comparison was response rate. PATIENTS AND METHODS A total of 135 chemotherapy-naive patients with advanced NSCLC were randomized to receive either gemcitabine 1,250 mg/m2 intravenously (IV) days 1 and 8 or etoposide 100 mg/m2 IV days 1 to 3 along with cisplatin 100 mg/m2 IV day 1. Both treatments were administered in 21-day cycles. One hundred thirty-three patients were included in the intent-to-treat analysis of response. RESULTS The response rate (externally validated) for patients given gemcitabine-cisplatin was superior to that for patients given etoposide-cisplatin (40.6% v 21.9%; P = .02). This superior response rate was associated with a significant delay in time to disease progression (6.9 months v 4.3 months; P = .01) without an impairment in quality of life (QOL). There was no statistically significant difference in survival time between both arms (8.7 months for gemcitabine-cisplatin v 7.2 months for etoposide-cisplatin; P = .18). The overall toxicity profile for both combinations of drugs was similar. Nausea and vomiting were reported more frequently in the gemcitabine arm than in the etoposide arm. However, the difference was not significant. Gemcitabine-cisplatin produced less grade 3 alopecia (13% v 51%) and less grade 4 neutropenia (28% v 56% ) but more grade 3 and 4 thrombocytopenia (56% v 13%) than did etoposide-cisplatin. However, there were no thrombocytopenia-related complications in the gemcitabine arm. CONCLUSION Compared with etoposide-cisplatin, gemcitabine-cisplatin provides a significantly higher response rate and a delay in disease progression without impairing QOL in patients with advanced NSCLC.
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Affiliation(s)
- F Cardenal
- Hospital Duran i Reynals, Barcelona, Spain
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López Cabrerizo M, Cardenal F, Artal A, Lomas M, Alberola V, Massuti B, Barnetto I, Díaz N, Lianes P, Montalar J, Vadell C, González J, Carrato A, Antón A, Aranda E, Garcia M, Rosell R. 27 Gemcitabine plus cisplatin versus etoposide plus cisplatin in advanced non-small cell lung cancer: A randomized trial by the Spanish lung cancer group. Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)89306-3] [Citation(s) in RCA: 2] [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: 10/18/2022]
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Rosell R, Monzó M, Martínez-Roca M, González-Larriba J, Alberola V, Font A, Pifarré A, Sánchez M, Benito D. 43 β-Tubulin gene mutation-mediated paclitaxel resistance in non-small cell lung cancer (NSCLC). Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)89322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Le Chevalier T, Pujol J, Douilard J, Alberola V, Monnier A, Rivière A, Cigolari S, Ruffié P, Panizo A, Guillem V, Besson P, Danel P, Brisgand D, Berthaud P, Larriba J, Martinez A. 39 Six year follow up of the European Multicentre Randomised Study comparing Navelbine (NVB) alone vs NVB + Cisplatin (CDDP) vs Vindesine (VDS) + CDDP in 612 patients (pts) with advanced non-small cell lung cancer (NSCLC). Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)89318-x] [Citation(s) in RCA: 2] [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: 10/18/2022]
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Vizcarra E, Lluch A, Cibrián R, Jarque F, Alberola V, Belloch V, García-Conde J. Value of CA 15.3 in breast cancer and comparison with CEA and TPA: a study of specificity in disease-free follow-up patients and sensitivity in patients at diagnosis of the first metastasis. Breast Cancer Res Treat 1996; 37:209-16. [PMID: 8825132 DOI: 10.1007/bf01806502] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The specificity and sensitivity of a tumor marker (TM) are important in establishing its potential clinical utility for a specific type of neoplasm. CA 15.3 is a TM specific for breast cancer; it is defined by two monoclonal antibodies (DF3 and 115D8), whose specificity, in disease-free follow-up patients, and sensitivity, in patients at diagnosis of first metastasis, have been evaluated in the present study and compared with those of carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA). Serum concentrations of all three TMs were quantified in 618 individuals: 80 healthy controls, 421 patients with local breast cancer who became free of disease following locoregional treatment, and 117 patients with disseminated disease at diagnosis of metastasis. Radioimmunoassay (RIA) was the method employed, and the cut-off values obtained were 30 U/ml for CA 15.3, 5 ng/ml for CEA, and 120 U/I for TPA. The results showed CA 15.3 and CEA specificities to be analogous (95.7 and 95.5%, respectively). TPA specificity (81.9%) was lower (p < 0.001). During adjuvant therapy, CA 15.3 serum levels were seen to increase, followed by a normalization of concentration after terminating therapy. On the other hand, CA 15.3 and TPA sensitivities (64.1 and 67.5%, respectively) were greater than for CEA (44.4%, p < 0.01). It is concluded that CA 15.3 is a useful TM for breast cancer, as it offers a greater sensitivity than CEA and a higher specificity than TPA. Combining CA 15.3 and CEA fails to increase CA 15.3 sensitivity, while combining CA 15.3 with TPA increases false-positives and so likewise offers no additional benefit.
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Affiliation(s)
- E Vizcarra
- Department of Medicine, Valencia University, Spain
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Le Chevalier T, Brisgand D, Pujol JL, Douillard JY, Monnier A, Rivière A, Chomy P, Le Groumellec A, Ruffie P, Gottfried M, Gaspard MH, Chevreau C, Alberola V, Cigolari S, Besson F, Martinez A, Besenval M, Berthaud P, Tursz T. [Results of a randomized study comparing combination of navelbine-cisplatin to combination of vindesine-cisplatin and to navelbine alone in 612 patients with inoperable non-small cell lung cancer]. Bull Cancer 1996; 83:385-94. [PMID: 8680091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The combination of vindesine and cisplatin is considered a reference regimen in advanced NSCLC which has yielded a significant improvement in the duration of survival. A phase II study of a new semi-synthetic vinca alkaloid, Navelbine, reported an unusually high 29% response rate in stage III-IV NSCLC and a phase I-II study established the feasibility of the combination of Navelbine and cisplatin. We, therefore, designed a prospective randomized trial to compare Navelbine and cisplatin (NVB-P) to vindesine and cisplatin (VDS-P) and to evaluate whether the best of these regimens affords a survival benefit compared to Navelbine alone (NVB), an outpatient regimen. Forty-five centers included 612 patients in this study: 206 in NVB-P, 200 in VDS-P and 206 in NVB. Navelbine was given at a dose of 30 mg/m2 weekly, cisplatin at 120 mg/m2 on day 1, day 29 and then every 6 weeks and vindesine at 3 mg/m2 weekly for 6 weeks and then every other week. Treatment was continued until progression or toxicity. Patients' characteristics were similar in the three groups with 59% of patients presenting with metastatic disease. An objective response rate was observed in 30% of patients in NVB-P versus 19% in VDS-P (P = .02) and 14% in NVB (P < .001). The median duration of survival was 40 weeks in NVB-P compared to 32 weeks in VDS-P and 31 weeks in NVB. The comparison of survival between the three groups demonstrated an advantage for NVB-P compared to VDS-P (P = .04) and NVB (P = .02). Neutropenia was significantly higher in the NVB-P group (P < .001) and neurotoxicity more frequent with VDS-P (P < .004). Since our results have demonstrated that NVB-P yields a longer survival duration and a higher response rate than VDS-P or NVB alone, with acceptable toxicity, this combination should be considered a reference regimen in advanced NSCLC.
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