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Casas-Arozamena C, Moiola CP, Vilar A, Bouso M, Cueva J, Cabrera S, Sampayo V, Arias E, Abalo A, García Á, Lago-Lestón RM, Oltra S, Díaz E, Ruiz-Bañobre J, López-López R, Moreno-Bueno G, Gil-Moreno A, Colás E, Abal M, Muinelo-Romay L. Noninvasive detection of microsatellite instability in patients with endometrial cancer. Int J Cancer 2023; 152:2206-2217. [PMID: 36650670 DOI: 10.1002/ijc.34435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 01/19/2023]
Abstract
The analysis of mismatch repair proteins in solid tissue is the standard of care (SoC) for the microsatellite instability (MSI) characterization in endometrial cancer (EC). Uterine aspirates (UAs) or circulating-DNA (cfDNA) samples capture the intratumor heterogeneity and provide a more comprehensive and dynamic molecular diagnosis. Thus, MSI analysis by droplet-digital PCR (ddPCR) in UAs and cfDNA can provide a reliable tool to characterize and follow-up the disease. The UAs, paraffin-embedded tumor tissue (FFPE) and longitudinal plasma samples from a cohort of 90 EC patients were analyzed using ddPCR panel and compared to the SoC. A high concordance (96.67%) was obtained between the analysis of MSI markers in UAs and the SoC. Three discordant cases were validated as unstable by ddPCR on FFPE samples. Besides, a good overall concordance (70.27%) was obtained when comparing the performance of the ddPCR assay on UAs and cfDNA in high-risk tumors. Importantly, our results also evidenced the value of MSI analysis to monitor the disease evolution. MSI evaluation in minimally invasive samples shows great accuracy and sensitivity and provides a valuable tool for the molecular characterization and follow-up of endometrial tumors, opening new opportunities for personalized management of EC.
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Affiliation(s)
- Carlos Casas-Arozamena
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Department of Medicine, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Cristian Pablo Moiola
- Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Ana Vilar
- Gynecology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Marta Bouso
- Pathology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Juan Cueva
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Medical Oncology Department, University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Silvia Cabrera
- Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Victoria Sampayo
- Gynecology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Efigenia Arias
- Gynecology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Alicia Abalo
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Ángel García
- Pathology Department, Vall Hebron University Hospital, Barcelona, Spain
| | - Ramón Manuel Lago-Lestón
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Sara Oltra
- Translational Research Group, Foundation MD Anderson International, Madrid, Spain
| | - Eva Díaz
- Translational Research Group, Foundation MD Anderson International, Madrid, Spain
| | - Juan Ruiz-Bañobre
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Medical Oncology Department, University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
- Genomes and Disease, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Rafael López-López
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Medical Oncology Department, University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Gema Moreno-Bueno
- Translational Research Group, Foundation MD Anderson International, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Biochemistry Department, Medicine Faculty, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Antonio Gil-Moreno
- Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Gynecology Department, Vall Hebron University Hospital, Barcelona, Spain
| | - Eva Colás
- Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Miguel Abal
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Laura Muinelo-Romay
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
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Gil-Moreno A, Alonso-Alconada L, Díaz-Feijoo B, Domingo S, Vilar A, Hernández A, Gilabert J, Llueca A, Torné A, de Santiago J, Carbonell-Socias M, Lago V, Arias E, Sampayo V, Siegrist J, Chipirliu A, Sánchez-Iglesias JL, Pérez-Benavente A, Padilla-Iserte P, Santacana M, Matias-Guiu X, Abal M, Lopez-Lopez R. M-TRAP: Safety and performance of metastatic tumor cell trap device in advanced ovarian cancer patients. Gynecol Oncol 2021; 161:681-686. [PMID: 33795131 DOI: 10.1016/j.ygyno.2021.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Despite radical surgery and chemotherapy, most patients with ovarian cancer die due to disease progression. M-Trap is an implantable medical device designed to capture peritoneal disseminated tumor cells with the aim to focalize the disease. This trial analyzed the safety and performance of the device. METHODS This first-in-human prospective, multi-center, non-blinded, single-arm study enrolled 23 women with high-grade serous advanced ovarian cancer. After primary or interval debulking surgery, 3 M-Trap devices were placed in the peritoneum of the abdominal cavity. 18-months post-implantation or at disease progression, devices were initially removed by laparoscopy. The primary safety endpoint was freedom from device and procedure-related major adverse events (MAEs) through 6-months post-implantation compared to an historical control. The primary performance endpoint was histopathologic evidence of tumor cells capture. RESULTS Only one major adverse event was attributable to the device. 18 women were free of device and procedure related MAEs (78.3%). However, the primary safety endpoint was not achieved (p = 0.131), primarily attributable to the greater surgical complexity of the M-Trap patient population. 62% of recurrent patients demonstrated tumor cell capture in at least one device with a minimal tumor cell infiltration. No other long-term device-related adverse events were reported. The secondary performance endpoint demonstrated a lack of disease focalization. CONCLUSIONS The M-Trap technology failed to meet its primary safety objective, although when adjusted for surgical complexity, the study approved it. Likewise, the devices did not demonstrate the anticipated benefits in terms of tumor cell capture and disease focalization in recurrent ovarian cancer.
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Affiliation(s)
- Antonio Gil-Moreno
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain.
| | | | - Berta Díaz-Feijoo
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Santiago Domingo
- Department of Gynecology Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ana Vilar
- Department of Gynecology, University Hospital of Santiago de Compostela, Spain
| | - Alicia Hernández
- Department of Gynecology, University Hospital La Paz, Madrid, Spain
| | - Juan Gilabert
- Department of Obstetrics and Gynecology, Hospital General Universitario de Valencia, Universidad de Valencia, Valencia, Spain
| | - Antoni Llueca
- Department of Obstetrics and Gynecology, Hospital General Universitari de Castelló, Castelló de la Plana, Spain
| | - Aureli Torné
- Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | | | - Melchor Carbonell-Socias
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Víctor Lago
- Department of Gynecology Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Efigenia Arias
- Department of Gynecology, University Hospital of Santiago de Compostela, Spain
| | - Victoria Sampayo
- Department of Gynecology, University Hospital of Santiago de Compostela, Spain
| | - Jaime Siegrist
- Department of Gynecology, University Hospital La Paz, Madrid, Spain
| | - Anca Chipirliu
- Department of Obstetrics and Gynecology, Hospital General Universitario de Valencia, Universidad de Valencia, Valencia, Spain
| | - Jose Luis Sánchez-Iglesias
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Assumpció Pérez-Benavente
- Department of Gynecologic Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Biomedical Research Group in Gynecology, Vall Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, CIBERONC, Barcelona, Spain
| | - Pablo Padilla-Iserte
- Department of Gynecology Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Maria Santacana
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, CIBERONC, Lleida, Spain
| | - Xavier Matias-Guiu
- Department of Pathology and Molecular Genetics and Research Laboratory, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, CIBERONC, Lleida, Spain
| | - Miguel Abal
- Nasasbiotech, S.L., A Coruña, Spain; Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), CIBERONC, Santiago de Compostela, Spain
| | - Rafael Lopez-Lopez
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), CIBERONC, Santiago de Compostela, Spain.
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Casas-Arozamena C, Díaz E, Moiola CP, Alonso-Alconada L, Ferreiros A, Abalo A, López Gil C, Oltra SS, de Santiago J, Cabrera S, Sampayo V, Bouso M, Arias E, Cueva J, Colas E, Vilar A, Gil-Moreno A, Abal M, Moreno-Bueno G, Muinelo-Romay L. Genomic Profiling of Uterine Aspirates and cfDNA as an Integrative Liquid Biopsy Strategy in Endometrial Cancer. J Clin Med 2020; 9:E585. [PMID: 32098121 PMCID: PMC7073542 DOI: 10.3390/jcm9020585] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/04/2020] [Accepted: 02/19/2020] [Indexed: 12/17/2022] Open
Abstract
The incidence and mortality of endometrial cancer (EC) have risen in recent years, hence more precise management is needed. Therefore, we combined different types of liquid biopsies to better characterize the genetic landscape of EC in a non-invasive and dynamic manner. Uterine aspirates (UAs) from 60 patients with EC were obtained during surgery and analyzed by next-generation sequencing (NGS). Blood samples, collected at surgery, were used for cell-free DNA (cfDNA) and circulating tumor cell (CTC) analyses. Finally, personalized therapies were tested in patient-derived xenografts (PDXs) generated from the UAs. NGS analyses revealed the presence of genetic alterations in 93% of the tumors. Circulating tumor DNA (ctDNA) was present in 41.2% of cases, mainly in patients with high-risk tumors, thus indicating a clear association with a more aggressive disease. Accordingly, the results obtained during the post-surgery follow-up indicated the presence of ctDNA in three patients with progressive disease. Moreover, 38.9% of patients were positive for CTCs at surgery. Finally, the efficacy of targeted therapies based on the UA-specific mutational landscape was demonstrated in PDX models. Our study indicates the potential clinical applicability of a personalized strategy based on a combination of different liquid biopsies to characterize and monitor tumor evolution, and to identify targeted therapies.
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Affiliation(s)
- Carlos Casas-Arozamena
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (C.C.-A.); (A.A.); (J.C.); (M.A.)
| | - Eva Díaz
- Foundation MD Anderson International, C/Gómez Hemans 2, 28033 Madrid, Spain; (E.D.); (S.S.O.); (G.M.-B.)
| | - Cristian Pablo Moiola
- Biomedical Research Group in Gynecology, Vall d’Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, 119-129 Pg. Vall d’Hebron, 08035 Barcelona, Spain; (C.P.M.); (S.C.); (E.C.); (A.G.-M.)
| | | | - Alba Ferreiros
- Nasasbiotech, S.L., Canton Grande 3, 15003 A Coruña, Spain; (L.A.-A.); (A.F.)
| | - Alicia Abalo
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (C.C.-A.); (A.A.); (J.C.); (M.A.)
| | - Carlos López Gil
- Biomedical Research Group in Gynecology, Vall d’Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, 119-129 Pg. Vall d’Hebron, 08035 Barcelona, Spain; (C.P.M.); (S.C.); (E.C.); (A.G.-M.)
| | - Sara S. Oltra
- Foundation MD Anderson International, C/Gómez Hemans 2, 28033 Madrid, Spain; (E.D.); (S.S.O.); (G.M.-B.)
| | - Javier de Santiago
- Department of Gynecology, MD Anderson Cancer Center, 28029 Madrid, Spain;
| | - Silvia Cabrera
- Biomedical Research Group in Gynecology, Vall d’Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, 119-129 Pg. Vall d’Hebron, 08035 Barcelona, Spain; (C.P.M.); (S.C.); (E.C.); (A.G.-M.)
| | - Victoria Sampayo
- Department of Gynecology, University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (V.S.); (E.A.); (A.V.)
| | - Marta Bouso
- Department of Pathology, University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Efigenia Arias
- Department of Gynecology, University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (V.S.); (E.A.); (A.V.)
| | - Juan Cueva
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (C.C.-A.); (A.A.); (J.C.); (M.A.)
| | - Eva Colas
- Biomedical Research Group in Gynecology, Vall d’Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, 119-129 Pg. Vall d’Hebron, 08035 Barcelona, Spain; (C.P.M.); (S.C.); (E.C.); (A.G.-M.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Ana Vilar
- Department of Gynecology, University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (V.S.); (E.A.); (A.V.)
| | - Antonio Gil-Moreno
- Biomedical Research Group in Gynecology, Vall d’Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, 119-129 Pg. Vall d’Hebron, 08035 Barcelona, Spain; (C.P.M.); (S.C.); (E.C.); (A.G.-M.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Miguel Abal
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (C.C.-A.); (A.A.); (J.C.); (M.A.)
- Nasasbiotech, S.L., Canton Grande 3, 15003 A Coruña, Spain; (L.A.-A.); (A.F.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Gema Moreno-Bueno
- Foundation MD Anderson International, C/Gómez Hemans 2, 28033 Madrid, Spain; (E.D.); (S.S.O.); (G.M.-B.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
- Department of Biochemistry, Autonomic University of Madrid (UAM), Biomedical research Institute ‘Alberto Sols’ (CSIC-UAM), IdiPaz, Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Laura Muinelo-Romay
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (C.C.-A.); (A.A.); (J.C.); (M.A.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
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