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Aparicio I, Iranzo P, Reyes R, Bote H, Saigi M, Bringas M, Bosch-Barrera J, Corral J, Aparisi F, Ruffinelli JC, Jiménez B, Lage Y, López-Castro R, Majem M, Vázquez S, Artal Á, Rodríguez-Pérez Á, Lázaro-Quintela M, Torres JMS, Reguart N, Cucurull M, Gil-Bazo I, Camps C, Nadal E, Del Barrio A, Garrido P, Dómine M, Álvarez R, Muñoz AJ, Calles A. Brief report: High incidence of peridiagnosis thromboembolic events in patients with BRAF-mutant lung cancer. Thromb Res 2023; 232:133-137. [PMID: 37976733 DOI: 10.1016/j.thromres.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION We aimed to determine if advanced BRAF-mutant NSCLC has a higher thromboembolic events (TEE) rate than the expected. METHODS Between 2008 and 2021, 182 patients with BRAF-mutant advanced NSCLC (BRAF V600E, n = 70; BRAF non-V600E, n = 112) were retrospectively identified from 18 centers in Spain. Patients received chemotherapy (n = 147), immunotherapy (n = 69), targeted therapy (n = 42), and immunotherapy + chemotherapy (n = 26). RESULTS Incidence rate of TEE was 26.4 % (95%CI: 19.9 %-32.9 %). A total of 72 TEE were documented among 48 patients, as 18 patients (37.5 %) developed more than one event. Median time to TEE onset was 2 months, 69 % of TEE occurred in the peridiagnostic period (+/- 90 days from cancer diagnosis), and in 16 pts. (33 %) TEE was the form of lung cancer presentation. Although most TEE were only venous (82 %; PE, n = 33; DVT, n = 16), arterial events were reported in 31 % and occurred earlier, or TEE presented in atypical locations (13.9 %). TEE were related to high hospitalization rate (59 %), recurrence (23 %), and mortality (10.4 %) despite appropriate anticoagulant/antiaggregant treatment. Median OS in patients without-TEE was 19.4 months (95%CI: 4.6-34.1), and significantly shorter in patients with arterial-TEE vs venous-TEE vs both of them: 9.9 months (95%CI: 0-23.5) vs 41.7 months (95%CI: 11.3-72.2 m) vs 2.7 months (95%CI: 2.1-3.3), p = 0.001. Neither clinical or molecular features (BRAF V600E/non-V600E), nor cancer treatment was associated to TEE occurrence. Khorana score underperformed to predict thrombosis at cancer diagnosis, as only 19.2 % of patients were classified as high-risk. CONCLUSIONS Thrombotic events represent a new clinical feature of BRAF-mutant lung cancer. Patients with almost a 30 % incidence of TEE should be offered systematic anticoagulation.
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Affiliation(s)
- Inmaculada Aparicio
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Patricia Iranzo
- Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Roxana Reyes
- Medical Oncology Department, Thoracic Oncology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Helena Bote
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain;-H12O-CNIO Lung Cancer Clinical Research Unit, Health Research Institute Hospital Universitario 12 de Octubre (i+12), Madrid, Spain
| | - María Saigi
- Medical Oncology Department, Hospital Germans Trías i Pujol, Institut Català d'Oncologia-ICO, Badalona, Barcelona, Spain
| | - Marianela Bringas
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Joaquim Bosch-Barrera
- Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, 17007 Girona, Spain. Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), 17190, Salt, Spain
| | - Jesús Corral
- Clínica Universidad de Navarra, Department of Oncology, Pamplona, Spain
| | - Francisco Aparisi
- Medical Oncology Department, Hospital General Universitario de Valencia, Department of Medicine, Universitat de València, TRIAL Mixed Unit, Centro Investigación Príncipe Felipe-Fundación Investigación Hospital General Universitario de Valencia. CIBERONC, Valencia, Spain
| | - Jose C Ruffinelli
- Medical Oncology Department, Centre Sanitari i Universitari de Bellvitge, Institut Català d'Oncologia (-ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Yolanda Lage
- Medical Oncology Department; Ramón y Cajal University Hospital, Madrid, Spain
| | | | - Margarita Majem
- Department of Medical Oncology; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sergio Vázquez
- Medical Oncology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Ángel Artal
- Medical Oncology Service, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Ángel Rodríguez-Pérez
- Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Noemí Reguart
- Medical Oncology Department, Thoracic Oncology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Hospital Germans Trías i Pujol, Institut Català d'Oncologia-ICO, Badalona, Barcelona, Spain
| | - Ignacio Gil-Bazo
- Clínica Universidad de Navarra, Department of Oncology, Pamplona, Spain; Instituto Valenciano de Oncología, Department of Oncology, Valencia, Spain
| | - Carlos Camps
- Medical Oncology Department, Hospital General Universitario de Valencia, Department of Medicine, Universitat de València, TRIAL Mixed Unit, Centro Investigación Príncipe Felipe-Fundación Investigación Hospital General Universitario de Valencia. CIBERONC, Valencia, Spain
| | - Ernest Nadal
- Medical Oncology Department, Centre Sanitari i Universitari de Bellvitge, Institut Català d'Oncologia (-ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Pilar Garrido
- Medical Oncology Department; Ramón y Cajal University Hospital, Madrid, Spain
| | - Manuel Dómine
- Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Rosa Álvarez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Andrés J Muñoz
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Antonio Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
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Bernabé-Caro R, García-Campelo R, Garrido P, Palmero R, Artal Á, Bayona C, Rodríguez-Abreu D, López-Brea M, Paredes A, Vicente D, Sánchez Torres J, Majem M, Diz P, Gordo R, Coca M, de Castro J. EP08.02-131 Alectinib after Crizotinib Failure in Patients with Advanced ALK-Positive NSCLC: Results from the Spanish Early Access Program. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.814] [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: 10/14/2022]
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Bernabé-Caro R, Garrido P, García-Campelo R, Palmero R, Artal Á, Bayona C, Rodríguez-Abreu D, López-Brea M, Paredes A, Vicente D, Sánchez Torres JM, Majem M, Diz P, Gordo R, Coca M, de Castro J. Alectinib after failure to crizotinib in patients with ALK-positive non-small cell lung cancer: results from the Spanish early access program. Oncotarget 2022; 13:812-827. [PMID: 35720977 PMCID: PMC9200434 DOI: 10.18632/oncotarget.28244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/19/2022] [Indexed: 11/25/2022] Open
Abstract
This retrospective observational study analyzed the clinical characteristics, treatment patterns and outcomes of 120 patients with advanced ALK-positive non-small-cell lung cancer (ALK+ NSCLC) according to data collected between November 2019 and October 2020 in 38 Spanish hospitals. Patients had progressed after 1–5 prior treatment lines (which included crizotinib in any prior line) and received subsequent therapy with alectinib in a local expanded access program. Median age was 58.7 years, 50% of patients were female, 64.1% had ECOG PS of 0–1, 85% presented stage IV, 95% had adenocarcinoma histology and 20.8% had brain metastases. After a median 9.6 months of alectinib treatment, objective response rate (ORR) was 54.5%, disease control rate (DCR) was 80%, median progression-free survival (PFS) was 9.4 months and median overall survival (OS) was 24.1 months. Patients with brain metastases achieved an intracranial DCR of 71.4%. Adverse events (AEs) were reported in 35.8% of patients (14.2% of AEs were grade ≥3). Over 40% of patients received some treatment after alectinib, most frequently lorlatinib (65.2%) and brigatinib (32.6%). This study provides information on real-world treatment patterns and confirms the tolerability and prolonged PFS and OS observed with alectinib in clinical trials, in unselected pretreated patients with advanced ALK+ NSCLC.
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Affiliation(s)
- Reyes Bernabé-Caro
- Department of Medical Oncology, Hospital Virgen del Rocío, Sevilla, Spain
| | - Pilar Garrido
- Department of Medical Oncology, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | | | - Ramón Palmero
- Department of Medical Oncology, ICO Bellvitge, Hospitalet Llobregat, Barcelona, Spain
| | - Ángel Artal
- Department of Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Cristina Bayona
- Department of Medical Oncology, Hospital General Yague, Burgos, Spain
| | - Delvys Rodríguez-Abreu
- Department of Medical Oncology, Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Marta López-Brea
- Department of Medical Oncology, Hospital Marqués de Valdecilla, Santander, Spain
| | - Alfredo Paredes
- Department of Medical Oncology, Hospital Universitario Donostia, Donostia-San Sebastián, Spain
| | - David Vicente
- Department of Medical Oncology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Margarita Majem
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pilar Diz
- Department of Medical Oncology, Complejo Asistencial Universitario de León, León, Spain
| | | | | | - Javier de Castro
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
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Jantus-Lewintre E, Massutí Sureda B, González Larriba JL, Rodríguez-Abreu D, Juan O, Blasco A, Dómine M, Provencio Pulla M, Garde J, Álvarez R, Maestu I, Pérez de Carrión R, Artal Á, Rolfo C, de Castro J, Guillot M, Oramas J, de Las Peñas R, Ferrera L, Martínez N, Serra Ò, Rosell R, Camps C. Prospective Exploratory Analysis of Angiogenic Biomarkers in Peripheral Blood in Advanced NSCLC Patients Treated With Bevacizumab Plus Chemotherapy: The ANGIOMET Study. Front Oncol 2021; 11:695038. [PMID: 34381717 PMCID: PMC8350788 DOI: 10.3389/fonc.2021.695038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/21/2021] [Indexed: 12/24/2022] Open
Abstract
Finding angiogenic prognostic markers in advanced non-small-cell lung cancer is still an unmet medical need. We explored a set of genetic variants in the VEGF-pathway as potential biomarkers to predict clinical outcomes of patients with non-small-cell lung cancer treated with chemotherapy plus bevacizumab. We prospectively analyzed the relationship between VEGF-pathway components with both pathological and prognostic variables in response to chemotherapy plus bevacizumab in 168 patients with non-squamous non-small-cell lung cancer. Circulating levels of VEGF and VEGFR2 and expression of specific endothelial surface markers and single-nucleotide polymorphisms in VEGF-pathway genes were analyzed. The primary clinical endpoint was progression-free survival. Secondary endpoints included overall survival and objective tumor response. VEGFR-1 rs9582036 variants AA/AC were associated with increased progression-free survival (p = 0.012 and p = 0.035, respectively), and with improved overall survival (p = 0.019) with respect to CC allele. Patients with VEGF-A rs3025039 harboring allele TT had also reduced mortality risk (p = 0.049) compared with the CC allele. The VEGF-A rs833061 variant was found to be related with response to treatment, with 61.1% of patients harboring the CC allele achieving partial treatment response. High pre-treatment circulating levels of VEGF-A were associated with shorter progression-free survival (p = 0.036). In conclusion, in this prospective study, genetic variants in VEGFR-1 and VEGF-A and plasma levels of VEGF-A were associated with clinical benefit, progression-free survival, or overall survival in a cohort of advanced non-squamous non-small-cell lung cancer patients receiving chemotherapy plus antiangiogenic therapy.
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Affiliation(s)
- Eloisa Jantus-Lewintre
- Departamento de Biotecnología, Universitat Politècnica de València, Unidad Mixta TRIAL, Fundación para la Investigación del Hospital General Universitario de Valencia/Centro de Investigación Príncipe Felipe, CIBERONC, Valencia, Spain
| | | | | | - Delvys Rodríguez-Abreu
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Oscar Juan
- Servicio de Oncología Médica, Hospital Politécnico y Universitario La Fe, Valencia, Spain
| | - Ana Blasco
- Consorcio Hospital General Universitario de Valencia, CIBERONC, Valencia, Spain
| | - Manuel Dómine
- Servicio de Oncología Médica, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | - Javier Garde
- Departamento de Oncología Médica, Hospital Arnau de Vilanova, Valencia, Spain
| | - Rosa Álvarez
- Departamento de Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Inmaculada Maestu
- Departamento de Oncología Médica, Hospital Universitari Doctor Peset, Valencia, Spain
| | | | - Ángel Artal
- Servicio de Oncología Médica, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Christian Rolfo
- Experimental Therapeutics Program, Greenbaum Comprehensive Cancer Center, University of Maryland, School of Medicine, Baltimore, MD, United States
| | - Javier de Castro
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | - Mónica Guillot
- Servicio de Oncología Médica, Hospital Son Espases, Palma de Mallorca, Spain
| | - Juana Oramas
- Departamento de Oncología Médica, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Ramón de Las Peñas
- Departamento de Oncología Médica, Hospital Provincial de Castelló, Castellón, Spain
| | - Lioba Ferrera
- Servicio de Oncología Médica, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Natividad Martínez
- Departamento de Oncología, Hospital General Universitario de Elche, Elche, Spain
| | - Òlbia Serra
- Departamento de Oncología Médica, Hospital General de l' Hospitalet, L'Hospitalet de Llobregat, Spain
| | - Rafael Rosell
- Programa de la Biología del Cáncer y Medicina de Precisión, Institut de Recerca Germans Trias i Pujol, Badalona, Spain/Instituto Oncológico Dr. Rosell, Barcelona, Spain
| | - Carlos Camps
- Departamento de Medicina, Universitat Politècnica de València, Unidad Mixta TRIAL, Fundación para la Investigación del Hospital General Universitario de Valencia/Centro de Investigación Príncipe Felipe, CIBERONC, Valencia, Spain
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5
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Garrido P, Paz-Ares L, Majem M, Morán T, Trigo JM, Bosch-Barrera J, Garcίa-Campelo R, González-Larriba JL, Sánchez-Torres JM, Isla D, Viñolas N, Camps C, Insa A, Juan Ó, Massuti B, Paredes A, Artal Á, López-Brea M, Palacios J, Felip E. LungBEAM: A prospective multicenter study to monitor stage IV NSCLC patients with EGFR mutations using BEAMing technology. Cancer Med 2021; 10:5878-5888. [PMID: 34296539 PMCID: PMC8419773 DOI: 10.1002/cam4.4135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The aim of LungBEAM was to determine the value of a novel epidermal growth factor receptor (EGFR) mutation test in blood based on BEAMing technology to predict disease progression in advanced non-small cell lung cancer (NSCLC) patients treated with first- or second-generation EGFR-tyrosine kinase inhibitors (EGFR-TKIs). Another goal was to monitor the dynamics of EGFR mutations, as well as to track EGFR exon 20 p.T790M (p.T790M) resistance during treatment, as critical indicators of therapeutic efficacy and patient survival. METHODS Stage IV NSCLC patients with locally confirmed EGFR-TKI sensitizing mutations (ex19del and/or L858R) in biopsy tissue who were candidates to receive first- or second-generation EGFR-TKI as first-line therapy were included. Plasma samples were obtained at baseline and every 4 weeks during treatment until a progression-free survival (PFS) event or until study completion (72-week follow-up). The mutant allele fraction (MAF) was determined for each identified mutation using BEAMing. RESULTS A total of 68 of the 110 (61.8%) patients experienced a PFS event. Twenty-six patients (23.6%) presented with an emergent p.T790M mutation in plasma at some point during follow-up, preceding radiologic progression with a median of 76 (interquartile ratio: 54-111) days. Disease progression correlated with the appearance of p.T790M in plasma with a hazard ratio (HR) of 1.94 (95% confidence interval [CI], 1.48-2.54; p < 0.001). The HR for progression in patients showing increasing plasma sensitizing mutation levels (positive MAF slope) versus patients showing either decreasing or unchanged plasma mutation levels (negative or null MAF slopes) was 3.85 (95% CI, 2.01-7.36; p < 0.001). CONCLUSION Detection and quantification of EGFR mutations in circulating tumor DNA using the highly sensitive BEAMing method should greatly assist in optimizing treatment decisions for advanced NSCLC patients.
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Affiliation(s)
- Pilar Garrido
- Medical Oncology Department, IRYCIS Hospital Universitario Ramón y Cajal, Universidad Alcalá, Madrid, Spain.,CIBERONC, Madrid, Spain
| | - Luis Paz-Ares
- CIBERONC, Madrid, Spain.,Medical Oncology Department, Hospital Universitario 12 de Octubre and i+12 Research Institute, Madrid, Spain.,Lung Cancer Group, Clinical Research Program, Spanish National Cancer Research Center (CNIO), Madrid, Spain.,Complutense University, Madrid, Spain
| | - Margarita Majem
- Medical Oncology Department, Hospital De La Santa Creu I Sant Pau, Barcelona, Spain.,Spanish Lung Cancer Group (GECP), Barcelona, Spain
| | - Teresa Morán
- Spanish Lung Cancer Group (GECP), Barcelona, Spain.,ICO Badalona, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - José Manuel Trigo
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Joaquim Bosch-Barrera
- Medical Oncology, Catalan Institute of Oncology (ICO), Dr. Josep Trueta Hospital of Girona, Girona, Spain
| | | | | | | | - Dolores Isla
- Medical Oncology Department, Hospital Universitario Lozano Blesa, Zaragoza, Spain
| | - Núria Viñolas
- Medical Oncology Department, Hospital Clinic i Provincial, Barcelona, Spain
| | - Carlos Camps
- CIBERONC, Madrid, Spain.,Medical Oncology Department, Hospital General Universitario de Valencia, Universidad de Valencia, Valencia, Spain
| | - Amelia Insa
- Medical Oncology Department, Hospital Clínico Universitario, Valencia, Spain
| | - Óscar Juan
- Medical Oncology Department, Hospital Universitario La Fe, Valencia, Spain
| | - Bartomeu Massuti
- Medical Oncology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Alfredo Paredes
- Medical Oncology Department, Hospital Universitario Donostia, Donostia-San Sebastián, Spain
| | - Ángel Artal
- Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Marta López-Brea
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - José Palacios
- CIBERONC, Madrid, Spain.,Pathology Department, IRYCIS Hospital Universitario Ramón y Cajal, Universidad Alcalá, Madrid, Spain
| | - Enriqueta Felip
- Medical Oncology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Vicente-Baz D, Paredes A, Morán T, Massuti B, Reguart N, Álvarez R, Insa A, Juan-Vidal O, Artal Á, Esteban E, García-Campelo R, Ortega-Granados AL, Diz P, González-Larriba JL, Terrasa J, de Las Peñas R, Rodríguez-Abreu D, Callejo Á, Márquez G, Provencio M. ASTRIS, a large real-world study to evaluate the efficacy of osimertinib in epidermal growth factor receptor T790M mutation-positive non-small cell lung cancer patients: Clinical characteristics and genotyping methods in a Spanish cohort. Rev Esp Patol 2020; 53:140-148. [PMID: 32650965 DOI: 10.1016/j.patol.2019.11.002] [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] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/06/2019] [Accepted: 11/06/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Osimertinib has proven efficacy in EGFR T790M mutation-positive non-small cell lung cancer (NSCLC) patients; however, its benefits have not been evaluated in a real-world setting. METHODS ASTRIS is a single-arm, open-label, multinational study to evaluate the efficacy and safety of osimertinib for the treatment of EGFR T790M mutation-positive NSCLC. We present the study design and preliminary cut-off analysis results (as of October 2017) describing the baseline characteristics and methodology for T790M mutation detection in the Spanish cohort. RESULTS The Spanish cohort included 131 patients from a total 3014 patients. Forty patients (28.1%) were still undergoing therapy at the time of cut-off; 68.7% were women and 97.7% were Caucasian, with a mean age of 64.8 (SD 11.7) years. The most common type of sample for evaluating T790M mutations was tissue (55.0%), and samples were obtained from the primary tumor in 61.1% of cases. Mutation analysis was performed by the local laboratory in 60.3% of cases and using the Roche Cobas® EGFR assay in 43.5% of cases. CONCLUSIONS ASTRIS is expected to confirm the benefits of osimertinib in a real-world setting. Data on real-world practices for the detection of the EGFR T790M mutation may provide additional information for the designing of guidelines for best practices.
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Affiliation(s)
| | | | - Teresa Morán
- ICO - Badalona Hospital Universitari Germans Trias I Pujol, Universitat Autònoma de Barcelona (UAB), IGTP, B-ARGOS, Badalona, Spain
| | | | | | - Rosa Álvarez
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Amelia Insa
- Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Ángel Artal
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Emilio Esteban
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Pilar Diz
- Complejo Asistencial Universitario de León, León, Spain
| | | | - Josefa Terrasa
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | | | | | | | - Mariano Provencio
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Spain.
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7
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Provencio M, Carcereny E, Artal Á. Consensus on the use of immune-related response criteria to evaluate the efficacy of immunotherapy in non-small cell lung cancer. Clin Transl Oncol 2019; 21:1464-1471. [PMID: 30903517 DOI: 10.1007/s12094-019-02072-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 02/23/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Many methods used to assess the effectiveness of immune checkpoint (programmed death-ligand 1 or cytotoxic T-lymphocyte-associated protein 4) inhibitors for non-small cell lung cancer (NSCLC) are insufficient, as the therapeutic benefit of these agents is often underestimated. Consequently, immune-related evaluation criteria have been developed to better reflect their efficacy. The aim of this consensus was to obtain the opinion of lung cancer experts on the adequacy of immune-response criteria for evaluating the efficacy of these treatments. METHODS Through two rounds of a modified Delphi consensus, 18 Spanish lung cancer experts participated in a 15-item questionnaire regarding the use of immunotherapies for NSCLC and the assessment criteria used to evaluate their effectiveness. RESULTS Consensus was achieved on 80% of the items in the questionnaire. The panelists agreed that although the Response Evaluation Criteria in Solid Tumors (RECIST) are standard for the evaluation of solid tumors, immune-related response criteria would be useful for measuring the efficacy of immunotherapy. In addition, they considered that an overall survival (OS) rate at 2-5 years is the most useful end point for assessing the benefit of immunotherapy, as clinical benefit may extend beyond the RECIST criteria-defined progression of disease. CONCLUSIONS Although immune-related response criteria have been developed to better evaluate the efficacy of immunotherapy, their use has not been validated and is restricted to investigational applications. However, they may prove to be a useful tool for measuring the efficacy of immunotherapy agents in NSCLC, especially the OS rate at 2-5 years.
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Affiliation(s)
- M Provencio
- Medical Oncology Department, Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla 1, 28222, Majadahonda, Madrid, Spain.
| | - E Carcereny
- Medical Oncology Department, Hospital Instituto Catalán de Oncología Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Á Artal
- Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
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8
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Garrido P, Sánchez M, Belda Sanchis J, Moreno Mata N, Artal Á, Gayete Á, Matilla González JM, Galbis Caravajal JM, Isla D, Paz-Ares L, Seijo LM. Reflections on the Implementation of Low-Dose Computed Tomography Screening in Individuals at High Risk of Lung Cancer in Spain. Arch Bronconeumol 2017; 53:568-573. [PMID: 28416207 DOI: 10.1016/j.arbres.2017.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 10/25/2016] [Revised: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 12/17/2022]
Abstract
Lung cancer (LC) is a major public health issue. Despite recent advances in treatment, primary prevention and early diagnosis are key to reducing the incidence and mortality of this disease. A recent clinical trial demonstrated the efficacy of selective screening by low-dose computed tomography (LDCT) in reducing the risk of both lung cancer mortality and all-cause mortality in high-risk individuals. This article contains the reflections of an expert group on the use of LDCT for early diagnosis of LC in high-risk individuals, and how to evaluate its implementation in Spain. The expert group was set up by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), the Spanish Society of Thoracic Surgery (SECT), the Spanish Society of Radiology (SERAM) and the Spanish Society of Medical Oncology (SEOM).
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Affiliation(s)
- Pilar Garrido
- Servicio de Oncología Médica, Hospital Ramón y Cajal, Madrid, España.
| | - Marcelo Sánchez
- Servicio de Radiodiagnóstico, Hospital Clínic, Barcelona, España
| | - José Belda Sanchis
- Servicio Mancomunado de Cirugía Torácica, Hospitales Universitari Mútua Terrassa, Sant Pau i Santa Creu y Mar, Barcelona, España
| | - Nicolás Moreno Mata
- Servicio de Cirugía Torácica, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Ángel Artal
- Servicio de Oncología Médica, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Ángel Gayete
- Servicio de Radiodiagnóstico, Hospital del Mar, Barcelona, España
| | | | | | - Dolores Isla
- Servicio de Oncología Médica, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Luis Paz-Ares
- Servicio de Oncología Médica, Hospital Universitario 12 de Octubre, Madrid, España
| | - Luis M Seijo
- Servicio de Neumología, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria, CIBERES, Madrid, España
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9
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Lao J, Madani J, Puértolas T, Álvarez M, Hernández A, Pazo-Cid R, Artal Á, Antón Torres A. Liposomal Doxorubicin in the treatment of breast cancer patients: a review. J Drug Deliv 2013; 2013:456409. [PMID: 23634302 PMCID: PMC3619536 DOI: 10.1155/2013/456409] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 02/10/2013] [Indexed: 01/03/2023]
Abstract
Drug delivery systems can provide enhanced efficacy and/or reduced toxicity for anticancer agents. Liposome drug delivery systems are able to modify the pharmacokinetics and biodistribution of cytostatic agents, increasing the concentration of the drug released to neoplastic tissue and reducing the exposure of normal tissue. Anthracyclines are a key drug in the treatment of both metastatic and early breast cancer, but one of their major limitations is cardiotoxicity. One of the strategies designed to minimize this side effect is liposome encapsulation. Liposomal anthracyclines have achieved highly efficient drug encapsulation and they have proven to be effective and with reduced cardiotoxicity, as a single agent or in combination with other drugs for the treatment of either anthracyclines-treated or naïve metastatic breast cancer patients. Of particular interest is the use of the combination of liposomal anthracyclines and trastuzumab in patients with HER2-overexpressing breast cancer. In this paper, we discuss the different studies on liposomal doxorubicin in metastatic and early breast cancer therapy.
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Affiliation(s)
- Juan Lao
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
- Aragón Institute of Health Sciences, Avda. San Juan Bosco, 13, planta 1, 50009 Zaragoza, Spain
| | - Julia Madani
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
- Aragón Institute of Health Sciences, Avda. San Juan Bosco, 13, planta 1, 50009 Zaragoza, Spain
| | - Teresa Puértolas
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
- Aragón Institute of Health Sciences, Avda. San Juan Bosco, 13, planta 1, 50009 Zaragoza, Spain
| | - María Álvarez
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - Alba Hernández
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - Roberto Pazo-Cid
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
- Aragón Institute of Health Sciences, Avda. San Juan Bosco, 13, planta 1, 50009 Zaragoza, Spain
| | - Ángel Artal
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
- Aragón Institute of Health Sciences, Avda. San Juan Bosco, 13, planta 1, 50009 Zaragoza, Spain
| | - Antonio Antón Torres
- Medical Oncology Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
- Aragón Institute of Health Sciences, Avda. San Juan Bosco, 13, planta 1, 50009 Zaragoza, Spain
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10
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Gascón P, Almenárez J, Artal Á, Camps C, Fírvida JL, Garrido P, González Larriba JL, Montalar J. Management of lung cancer-associated anaemia: the Spanish Lung Cancer Anaemia Survey (SLCAS). Clin Transl Oncol 2011; 13:328-34. [DOI: 10.1007/s12094-011-0662-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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