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Cedres S, Serna G, Gonzalez-Medina A, Valdivia A, Assaf-Pastrana JD, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Priano I, Fasani R, Guardia X, Gonzalo J, Carbonell C, Frigola J, Amat R, Navarro V, Dienstmann R, Vivancos A, Nuciforo P, Felip E. Expression of TILs and Patterns of Gene Expression from Paired Samples of Malignant Pleural Mesothelioma (MPM) Patients. Cancers (Basel) 2023; 15:3611. [PMID: 37509274 PMCID: PMC10377125 DOI: 10.3390/cancers15143611] [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: 03/15/2023] [Revised: 05/31/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
MPM is an aggressive disease with an immunosuppressive tumor microenvironment, and interest in exploring immunotherapy in this disease has been increasing. In the first line of treatment, the combination of nivolumab and ipilimumab demonstrated an improvement in survival over chemotherapy. The presence of TILs has been recognized as a marker of antitumor immune response to chemotherapy in solid tumors. The aim of our study is to identify the effect of treatment on immune cells and the immune gene profile in MPM. We investigated the changes in expression of TILs in 10 human MPM paired tumor tissues using immunohistochemistry and gene expression analysis from paired untreated and treated samples. In this small series, we demonstrated that during the evolution of disease without any treatment there was an increase in the inflammatory component in tumor samples. After systemic treatment there was a decrease in the number of TILs. We observed that after systemic treatment or disease progression immune gene signatures were suppressed. Our integrated analysis of paired samples with immune profile and genomic changes on MPM suggested that during the evolution of the disease the immune system tends to switch, turning off with treatment.
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Affiliation(s)
- Susana Cedres
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Garazi Serna
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | | | - Augusto Valdivia
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Juan David Assaf-Pastrana
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Patricia Iranzo
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Ana Callejo
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Nuria Pardo
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Alejandro Navarro
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Alex Martinez-Marti
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Ilaria Priano
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Roberta Fasani
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Xavier Guardia
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Javier Gonzalo
- Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Caterina Carbonell
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Joan Frigola
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Ramon Amat
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Victor Navarro
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Lab, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Enriqueta Felip
- Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
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2
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Carbonell C, Frigola J, Pardo N, Callejo A, Iranzo P, Valdivia A, Priano I, Cedrés S, Martinez-Marti A, Navarro A, Lenza L, Soleda M, Gonzalo-Ruiz J, Vivancos A, Sansó M, Carcereny E, Morán T, Amat R, Felip E. Dynamic changes in circulating tumor DNA assessed by shallow whole-genome sequencing associate with clinical efficacy of checkpoint inhibitors in NSCLC. Mol Oncol 2023; 17:779-791. [PMID: 36852704 PMCID: PMC10158763 DOI: 10.1002/1878-0261.13409] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 03/01/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis are the main therapeutic option for patients with advanced non-small cell lung cancer (NSCLC) without a druggable oncogenic alteration. Nevertheless, only a portion of patients benefit from this type of treatment. Here, we assessed the value of shallow whole-genome sequencing (sWGS) on plasma samples to monitor ICI benefit. We applied sWGS on cell-free DNA (cfDNA) extracted from plasma samples of 45 patients with metastatic NSCLC treated with ICIs. Over 150 samples were obtained before ICI treatment initiation and at several time points throughout treatment. From sWGS data, we computed the tumor fraction (TFx) and somatic copy number alteration (SCNA) burden and associated them with ICI benefit and clinical features. TFx at baseline correlated with metastatic lesions at the bone and the liver, and high TFx (≥ 10%) associated with ICI benefit. Moreover, its assessment in on-treatment samples was able to better predict clinical efficacy, regardless of the TFx levels at baseline. Finally, for a subset of patients for whom SCNA burden could be computed, increased burden correlated with diminished benefit following ICI treatment. Thus, our data indicate that the analysis of cfDNA by sWGS enables the monitoring of two potential biomarkers-TFx and SCNA burden-of ICI benefit in a cost-effective manner, facilitating multiple serial-sample analyses. Larger cohorts will be needed to establish its clinical potential.
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Affiliation(s)
- Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Ana Callejo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Patricia Iranzo
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Augusto Valdivia
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Ilaria Priano
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Susana Cedrés
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Alex Martinez-Marti
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Alejandro Navarro
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
| | - Laura Lenza
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Mireia Soleda
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Javier Gonzalo-Ruiz
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Laboratory, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Miriam Sansó
- Balearic Islands Health Research Institute (IdISBa), Palma de Mallorca, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Barcelona, Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Badalona Applied Research Group in Oncology, Institut Germans Trias i Pujol, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Clinical Research Department, Vall d'Hebron Institut d'Oncologia (VHIO), Barcelona, Spain
- Oncology Department, Vall d'Hebron Barcelona Hospital Campus, Spain
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3
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Cedres S, Cruellas M, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Carbonell C, Frigola J, Amat R, Gonzalo J, Navarro V, Dienstmann R, Balmaña J, Felip E. EP07.01-023 Family History of Cancer in a Series of Malignant Pleural Mesothelioma (MPM) Patients (P). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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4
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Cedres S, Romero L, Assaf J, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Molina G, Garcia-Illescas D, Sanchez L, Rosado J, Carbonell C, Frigola J, Amat R, Gonzalo J, Navarro V, Dienstmann R, Felip E. EP07.01-022 Analysis of Second Surgery for Recurrence in Malignant Pleural Mesothelioma (MPM) Patients (P). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ulivi P, Pasini L, Petracci E, Urbini M, Felip E, Stella F, Davoli F, Salvi M, Beau-Faller M, Tebaldi M, Azzali I, Solli P, Lai G, Amat R, Carbonell C, Martinez-Marti A, Pencreach E, Delmonte A, Crinò L. 21P Circulating free and extracellular vesicles-derived microRNA as prognostic biomarkers in resected early-stage non-small cell lung cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.049] [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: 11/15/2022] Open
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Cedres Perez S, Serna G, Assaf Pastrana JD, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Cabrera Galvez C, Gonzalez-Medina A, Fasani R, Guardia X, Gonzalo J, Carbonell C, Frigola J, Amat R, Vivancos A, Nuciforo P, Felip E. T-cell infiltration in matched samples from malignant pleural mesothelioma (MPM) during evolution of disease. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e20595] [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
e20595 Background: MPM is an aggressive cancer associated with asbestos exposure. Chemotherapy has been a mainstay of therapy and recently immunotherapy has been associated with survival improvements. Chemotherapy and immunotherapy influence the tumor microenvironment and some reports have shown increased of TIL after chemotherapy in MPM. The purpose of this study was to determine dynamic changes in the tumor immune environment during mesothelioma evolution and after systemic therapies in paired samples. Methods: We examined 20 matched formalin-fixed paraffin embedded tissue samples from 10 patients (p) with MPM taken at diagnosis and at disease progression (follow-up), including untreated and treated with chemotherapy or immunotherapy. Tissue densities (number of cells/mm2) of key immune effector cells such as total lymphocytes (CD3), cytotoxic T cells (CD8), regulatory T cells (FOXP3) and monocytes/macrophages (CD163) were quantified by image analysis using multiplexed immunohistochemistry (IHC). PD-L1 expression in both tumor cells and immune cells was analysed by singleplex IHC and quantified using the CPS score. Results: Median age was 62 years (range 53-84), 7 p were male and all p presented epithelioid histology. Three matched samples belong to patients that did not receive any systemic treatment between biopsies and the other 7 pair of samples belong to patients treated with chemotherapy +/- immunotherapy. The median interval between paired biopsies was 12 m (3-33 m). Median overall survival was 27.8 months (1 m-NR). Median densities of T cells and macrophages in diagnostic and matched follow-up samples were: CD3+:982 vs 712; CD8+:422 vs 334, FOXP3+: 22 vs 25 and CD163+: 2086 vs 1706. Median PD-L1 CPS was 2.5 and 4 in diagnostic and follow-up samples, respectively. In p receiving treatment between sample pairs, the median densities in diagnostic and follow-up matched samples were: CD3+:979 vs 407; CD8+:467 vs 225, FOXP3+: 25 vs 15, CD163+: 1583 vs 1508, and PD-L1: 2 and 1. In p without any systemic treatment between sample pairs, the median densities were CD3+:1645 vs 2397; CD8+:376 vs 1605, FOXP3+: 19 vs 121, CD163+: 2102 vs 2377, and PD-L1: 3 vs 25. Conclusions: In our small series with paired samples from MPM p, we observed immune cells infiltration changes during MPM evolution with a trend towards a decrease after systemic therapy. Further investigation in tumor microenvironment in MPM to define the most appropriate time for immunotherapy is needed.
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Affiliation(s)
- Susana Cedres Perez
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Garazi Serna
- Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Juan David Assaf Pastrana
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandro Navarro
- Vall d'Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Alex Martinez-Marti
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Roberta Fasani
- Molecular Oncology Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Xavier Guardia
- Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Gonzalo
- Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Vall d’Hebron University Hospital and Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
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Iranzo P, Callejo A, Assaf JD, Molina G, Lopez DE, Garcia-Illescas D, Pardo N, Navarro A, Martinez-Marti A, Cedres S, Carbonell C, Frigola J, Amat R, Felip E. Overview of Checkpoint Inhibitors Mechanism of Action: Role of Immune-Related Adverse Events and Their Treatment on Progression of Underlying Cancer. Front Med (Lausanne) 2022; 9:875974. [PMID: 35707528 PMCID: PMC9189307 DOI: 10.3389/fmed.2022.875974] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/02/2022] [Indexed: 12/02/2022] Open
Abstract
In recent years, immunotherapy-based regimens have been included into the treatment's algorithm of several cancer types. Programmed death-1 (PD-1) and cytotoxic T lymphocyte antigen-4 (CTLA-4) interact with their ligands found on the surface of antigen presenting cells (APC) or tumor cells (PD-L1/2 and CD80/86). Through these interactions, stimulatory or inhibitory signals are established. Immune checkpoint inhibitors (ICIs), block these interactions, and when administered not only as monotherapy but also as part of combination regimens, have shown to improve survival results in multiple advanced cancers leading to an increasing number of patients treated with ICI and, as a consequence, a rise in the number of patients developing immune-related adverse events (irAEs). Presence of irAEs has been associated with greater benefit from treatment, especially when blocking PD-L1. Recent data suggests that treatment benefit persists after discontinuation of ICIs due to a treatment related adverse event, regardless of the grade. Patients experiencing grade 3-4 irAEs are at risk of toxicity recurrence after reintroducing immunotherapy and therefore, the decision to resume the treatment is challenging. In these cases, a multidisciplinary approach is always needed and several factors should be considered. Management of severe toxicities may require systemic corticosteroids which can impact on T-cell function. Due to their immunosuppressive properties, it is necessary to deeper determine how corticosteroids influence responses. In terms of overall survival (OS), the use of steroids as therapy for irAEs seems not to reduce OS and several studies have reported durable responses in patients experiencing autoimmune toxicities treated with corticosteroids.
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Affiliation(s)
- Patricia Iranzo
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Ana Callejo
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Juan David Assaf
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Gaspar Molina
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Daniel Esteban Lopez
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - David Garcia-Illescas
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Nuria Pardo
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Alejandro Navarro
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Alex Martinez-Marti
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Susana Cedres
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
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Frigola J, Carbonell C, Iranzo P, Pardo N, Callejo A, Cedres S, Martinez-Marti A, Navarro A, Soleda M, Jimenez J, Hernandez-Losa J, Vivancos A, Felip E, Amat R. High levels of chromosomal aberrations negatively associate with benefit to checkpoint inhibition in NSCLC. J Immunother Cancer 2022; 10:jitc-2021-004197. [PMID: 35477861 PMCID: PMC9047699 DOI: 10.1136/jitc-2021-004197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) targeting the programmed cell death 1/programmed death-ligand 1 axis have transformed the management of advanced non-small cell lung cancer (NSCLC). However, many patients do not benefit from this type of treatment, and thus several molecular biomarkers of benefit have been explored. The value of somatic copy number alterations (SCNAs) burden remains elusive. PATIENTS AND METHODS We assembled a cohort of 109 patients with NSCLC treated with ICIs and available tumor samples. We performed shallow whole-genome sequencing on 89 patients to determine genome-wide SCNAs and targeted gene expression analysis on 63 patients to study immune infiltration. We analyzed SCNAs burden in different ways (ie, the fraction of the genome altered or number of events) and studied their association with ICIs benefit based on survival analysis. We correlated SCNAs burden and immune infiltration on 35 patients of our cohort and on patients with lung adenocarcinoma from The Cancer Genome Atlas (TCGA). RESULTS High SCNAs burden, computed in diverse ways, is negatively associated with ICIs progression-free survival (PFS), with the fraction of the genome altered (FGA) by arm and chromosome events showing the strongest association with PFS (p=0.002) (n=77). Nevertheless, we found differences in SCNAs across some clinicopathological features (sample site origin). A multivariate analysis adjusted for relevant characteristics showed that the FGA of arm and chromosome alterations was strongly associated with PFS (HR=2.21, p=3.3 x 10-5). Finally, we confirmed that SCNAs burden negatively correlates with tumor immune infiltration (n=35), although this correlation was not found for the males studied. Similar results were observed in the TCGA cohort. CONCLUSIONS SCNAs burden is a potential biomarker of benefit to ICIs in patients with NSCLC, although there appear to be some nuances worth consideration. Further studies will be needed to establish its role as a biomarker of benefit to ICIs.
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Affiliation(s)
- Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Nuria Pardo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ana Callejo
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Susana Cedres
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Alex Martinez-Marti
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Alejandro Navarro
- Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mireia Soleda
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Jose Jimenez
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Ana Vivancos
- Cancer Genomics Laboratory, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Clinical Research Department, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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9
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Cedres S, Assaf JD, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Marmolejo D, Rezqallah A, Carbonell C, Frigola J, Amat R, Pedrola A, Dienstmann R, Felip E. Efficacy of chemotherapy for malignant pleural mesothelioma according to histology in a real-world cohort. Sci Rep 2021; 11:21357. [PMID: 34725384 PMCID: PMC8560806 DOI: 10.1038/s41598-021-00831-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/18/2021] [Indexed: 11/09/2022] Open
Abstract
CheckMate 743 trial demonstrated survival benefit of immunotherapy in first line in MPM with some differences in the efficacy of chemotherapy according to histology. The objective of this study is to characterize the impact of chemotherapy according to histology in patients diagnosed with MPM at our institution. Clinical records of all MPM patients diagnosed at Vall d'Hebron University Hospital between November 2002 and April 2020 were reviewed. Associations between clinical variables and outcomes were assessed with Cox regression models. Survival data were calculated by the Kaplan-Meier method. 189 patients were included with 76% of tumors classified as epithelioid subtype. First line chemotherapy was offered to 85% of patients. Median survival in overall population was 21.3 months (95% CI 17.2-24.3). We found that patients with epithelioid tumors had better overall survival (OS) and progression free survival (PFS). Median OS of epithelioid patients treated with first line chemotherapy was 26.7 months versus 15.0 months in non-epithelioid patients (HR 2.25 CI 95% 1.4-3.4; p < 0.001). Median PFS for patients with epithelioid tumors treated with chemotherapy was 4.8 months versus 3.6 months in non-epithelioid (HR 1.5 CI 95% 1.0-2.3; p = 0.03). The improvement of outcomes in patients with epithelioid histology was detected in patients treated with cisplatin or carboplatin. Histology was not a predictive factor for the platinum agent sensitivity (p of interaction PFS = 0.09, p of interaction OS = 0.65). In our series, patients with non-epithelioid tumors presented worse prognosis. Although epithelioid tumors exposed to cisplatin had higher PFS, histology was not a clear predictor of chemotherapy efficacy.
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Affiliation(s)
- Susana Cedres
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
| | - Juan-David Assaf
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandro Navarro
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alex Martinez-Marti
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - David Marmolejo
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandra Rezqallah
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Pedrola
- Oncology Data Science (ODysSey Group), Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science (ODysSey Group), Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Enriqueta Felip
- Oncology Department, Hospital Universitari Vall d'Hebron & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.,Thoracic Cancers Translational Genomics Unit, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Meira F, Albiach L, Carbonell C, Martín-Oterino JA, Martín-Ordiales M, Linares L, Macaya I, Agüero D, Ambrosioni J, Bodro M, Cardozo C, Chumbita M, De la Mora M, García-Pouton N, Garcia-Vidal C, González-Cordón A, Hernández-Meneses M, Inciarte A, Laguno M, Leal L, Morata L, Puerta-Alcalde P, Rico V, Letona L, Cózar-Llistó A, Dueñas G, Solá M, Torres B, Rojas J, Moreno A, Moreno-García E, Torres M, Martínez JA, Soriano A, García F. Experience with the use of siltuximab in patients with SARS-CoV-2 infection. Rev Esp Quimioter 2021; 34:337-341. [PMID: 33982984 PMCID: PMC8329576 DOI: 10.37201/req/045.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/04/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The study aims to describe characteristics and clinical outcome of patients with SARS-CoV-2 infection that received siltuximab according to a protocol that aimed to early block the activity of IL-6 to avoid the progression of the inflammatory flare. METHODS Retrospective review of the first 31 patients with SARS-CoV-2 treated with siltuximab, in Hospital Clinic of Barcelona or Hospital Universitario Salamanca, from March to April 2020 with positive polymerase-chain reaction (PCR) from a nasopharyngeal swab. RESULTS The cohort included 31 cases that received siltuximab with a median (IQR) age of 62 (56-71) and 71% were males. The most frequent comorbidity was hypertension (48%). The median dose of siltuximab was 800 mg ranging between 785 and 900 mg. 7 patients received siltuximab as a salvage therapy after one dose of tocilizumab. At the end of the study, a total of 26 (83.9) patients had been discharged alive and the mortality rate was 16.1% but only 1 out of 24 that received siltuximab as a first line option (4%). CONCLUSIONS Siltuximab is a well-tolerated alternative to tocilizumab when administered as a first line option in patients with COVID-19 pneumonia within the first 10 days from symptoms onset and high C-reactive protein.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Soriano
- Alex Soriano, Department of Infectious Diseases, Hospital Clínic of Barcelona. Carrer de Villarroel 170, 08036, Barcelona, Spain.
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Callejo A, Frigola J, Iranzo P, Carbonell C, Diaz N, Marmolejo D, Assaf JD, Cedrés S, Martinez-Marti A, Navarro A, Pardo N, Amat R, Felip E. Interrelations between Patients' Clinicopathological Characteristics and Their Association with Response to Immunotherapy in a Real-World Cohort of NSCLC Patients. Cancers (Basel) 2021; 13:3249. [PMID: 34209601 PMCID: PMC8268100 DOI: 10.3390/cancers13133249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/10/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 12/11/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) have transformed non-small cell lung cancer (NSCLC) treatment. Unfortunately, only some patients benefit from these therapies. Thus, certain clinicopathological characteristics of the patients have been proposed as biomarkers of ICIs response. We assembled a retrospective cohort of 262 NSCLC patients treated with ICIs, compiled relevant clinicopathological characteristics, and studied their associations with treatment outcome using Cox proportional-hazards survival models. Additionally, we investigated the interrelations between clinicopathological features and devised a method to create a compendium associated with ICIs response by selecting those that provide non-redundant information. In multivariate analyses, ECOG performance status (hazard ratio (HR) 1.37 (95% CI 1.11 to 1.68), p < 0.005), LDH (HR 1.24 (95% CI 1.03 to 1.48), p = 0.02)) and PD-L1 negativity were associated with decreased PFS (HR 1.92 (95% CI 1.03 to 3.58), p < 0.04), whereas presentation of immune-related adverse events (irAEs) (HR 0.35 (95% CI 0.22 to 0.55, p < 0.005) or females (HR 0.52 (95% CI 0.33 to 0.80, p < 0.005) had longer progression-free survival. Additionally, numerous clinicopathological indicators were found to be interrelated. Thus, we searched for features that provide non-redundant information, and found the combination of LDH levels, irAEs, and gender to have a better association with ICIs treatment response (cross-validated c-index = 0.66). We concluded that several clinicopathological features showed prognostic value in our real-world cohort. However, some are interrelated, and compendiums of features should therefore consider these interactions. Joint assessment of LDH, irAEs, and gender may be a good prognostic compendium.
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Affiliation(s)
- Ana Callejo
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Joan Frigola
- Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), C/Nazaret 115-117, 08035 Barcelona, Spain; (J.F.); (C.C.)
| | - Patricia Iranzo
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), C/Nazaret 115-117, 08035 Barcelona, Spain; (J.F.); (C.C.)
| | - Nely Diaz
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - David Marmolejo
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Juan David Assaf
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Susana Cedrés
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Alex Martinez-Marti
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Alejandro Navarro
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Nuria Pardo
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
| | - Ramon Amat
- Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), C/Nazaret 115-117, 08035 Barcelona, Spain; (J.F.); (C.C.)
| | - Enriqueta Felip
- Clinical Research Department, Vall d’Hebron Institute of Oncology (VHIO), Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (A.C.); (P.I.); (N.D.); (J.D.A.); (S.C.); (A.M.-M.); (A.N.); (N.P.)
- Oncology Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain;
- Thoracic Cancers Translational Genomics Unit, Vall d’Hebron Institute of Oncology (VHIO), C/Nazaret 115-117, 08035 Barcelona, Spain; (J.F.); (C.C.)
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Cedres Perez S, Assaf Pastrana JD, Iranzo P, Callejo A, Pardo N, Navarro A, Martinez-Marti A, Marmolejo Castañeda DH, Lostes J, Gonzalo J, Frigola J, Carbonell C, Amat R, Pedrola A, Dienstmann R, Felip E. Analysis of chemotherapy efficacy according to histology in malignant pleural mesothelioma (MPM) patients (p). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e20563] [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
e20563 Background: MPM is a highly aggressive pleural tumor associated with asbestos exposure and with limited survival despite systemic therapy. Histology is a prognostic factor and recently CheckMate 743 trial demonstrated survival benefit of immunotherapy in first line with some differences in the efficacy of chemotherapy according to histology. However, randomized trials who led to the approval of antifolate in mesothelioma did not include analysis of outcomes by histology. The objective of this study is to characterize the impact of chemotherapy according to histology in p with MPM at our institution. Methods: We review 189 MPM p diagnosed at Vall d´Hebron University Hospital between November 2002 and April 2020. Associations between clinical variables and outcome were assessed with Cox regression models and survival data were calculated by the Kaplan-Meier method. Results: Patient’s characteristics: median age 68 years (y) (45-88 y), males: 70%, performance status (PS)1: 69%, asbestos exposure: 75%, epithelioid subtype: 76%. First line chemotherapy was offered to 85% of p (66% cisplatin-pemetrexed and 27% carboplatin-pemetrexed). Median overall survival (OS) in overall population was 21.3 m (95%CI17.2-24.3). Epithelioid histology, PS 0, neutrophil-lymphocyte ratio <5 and treatment with cisplatin vs carboplatin were associated with significant improvements in OS (p<0.001). When we analyzed the survival of patients who received first line chemotherapy according to histology, we found that patients with epithelioid tumors had better PFS and OS. Median PFS for p with epithelioid tumors treated with chemotherapy in first line was 4.8 m versus 3.6 months non-epithelioid (HR1.5 CI95% 1.1-2.3; p=0.03). OS of epithelioid p treated with first line chemotherapy was 26.7 m versus 15.0 m non-epithelioid patients (HR2.25 CI95% 1.4-3.4; p<0.001). We analyzed if the differences in survival according to histology were due to type of systemic treatment received (Table). Conclusions: In our series, p with non-epithelioid tumors presented worse prognosis. We confirmed histology is a prognostic factor with better OS for p with epithelioid tumors. Moreover, we demonstrated better efficacy of chemotherapy in epithelioid tumors, although histology is not a predictive factor for the platinum agent sensitivity (p of interaction PFS=0.09, p of interaction OS= 0.65).[Table: see text]
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Affiliation(s)
- Susana Cedres Perez
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Juan David Assaf Pastrana
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandro Navarro
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alex Martinez-Marti
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Julia Lostes
- Medical Oncology, Hospital Universitari Vall d´Hebron and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Gonzalo
- Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Pedrola
- Oncology Data Science Group, Vall D’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Enriqueta Felip
- Lung Cancer Unit, Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Iranzo P, Callejo A, Marmolejo D, Assaf J, Pardo N, Navarro A, Martinez-Marti A, Cedres S, Mejia ND, Carbonell C, Amat R, Frigola J, Felip E. 127P Real-world evidence and clinical characteristics in patients (pts) with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI). J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01969-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Frigola J, Navarro A, Carbonell C, Callejo A, Iranzo P, Cedrés S, Martinez‐Marti A, Pardo N, Saoudi‐Gonzalez N, Martinez D, Jimenez J, Sansano I, Mancuso FM, Nuciforo P, Montuenga LM, Sánchez‐Cespedes M, Prat A, Vivancos A, Felip E, Amat R. Molecular profiling of long-term responders to immune checkpoint inhibitors in advanced non-small cell lung cancer. Mol Oncol 2021; 15:887-900. [PMID: 33342055 PMCID: PMC8024716 DOI: 10.1002/1878-0261.12891] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 12/12/2022] Open
Abstract
Immunotherapy has transformed advanced non-small cell lung cancer (NSCLC) treatment strategies and has led to unprecedented long-lasting responses in some patients. However, the molecular determinants driving these long-term responses remain elusive. To address this issue, we performed an integrative analysis of genomic and transcriptomic features of long-term immune checkpoint inhibitors (ICIs)-associated responders. We assembled a cohort of 47 patients with NSCLC receiving ICIs that was enriched in long-term responders [>18 months of progression-free survival (PFS)]. We performed whole-exome sequencing from tumor samples, estimated the tumor mutational burden (TMB), and inferred the somatic copy number alterations (SCNAs). We also obtained gene transcription data for a subset of patients using Nanostring, which we used to assess the tumor immune infiltration status and PD-L1 expression. Our results indicate that there is an association between TMB and benefit to ICIs, which is driven by those patients with long-term response. Additionally, high SCNAs burden is associated with poor response and negatively correlates with the presence of several immune cell types (B cells, natural killers, regulatory T cells or effector CD8 T cells). Also, CD274 (PD-L1) expression is increased in patients with benefit, mainly in those with long-term response. In our cohort, combined assessment of TMB and SCNAs burden enabled identification of long-term responders (considering PFS and overall survival). Notably, the association between TMB, SCNAs burden, and PD-L1 expression with the outcomes of ICIs treatment was validated in two public datasets of ICI-treated patients with NSCLC. Thus, our data indicate that TMB is associated with long-term benefit following ICIs treatment in NSCLC and that TMB, SCNAs burden, and PD-L1 are complementary determinants of response to ICIs.
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Affiliation(s)
- Joan Frigola
- Thoracic Cancers Translational Genomics UnitHebron Institute of Oncology (VHIO)Vall dBarcelonaSpain
| | - Alejandro Navarro
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Caterina Carbonell
- Thoracic Cancers Translational Genomics UnitHebron Institute of Oncology (VHIO)Vall dBarcelonaSpain
| | - Ana Callejo
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Patricia Iranzo
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Susana Cedrés
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Alex Martinez‐Marti
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Nuria Pardo
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Nadia Saoudi‐Gonzalez
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Debora Martinez
- Department of Medical OncologyHospital ClinicBarcelonaSpain
- Translational Genomics and Targeted Therapies in Solid TumorsIDIBAPSBarcelonaSpain
| | - Jose Jimenez
- Molecular Oncology GroupVall d'Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Irene Sansano
- Pathology UnitVall d’Hebron University HospitalBarcelonaSpain
| | - Francesco M. Mancuso
- Cancer Genomics LaboratoryVall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Paolo Nuciforo
- Molecular Oncology GroupVall d'Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Luis M. Montuenga
- Program in Solid TumorsCenter for Applied Medical Research (CIMA)PamplonaSpain
- Department of Pathology, Anatomy and PhysiologySchool of MedicineUniversity of NavarraPamplonaSpain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC)MadridSpain
- Navarra Health Research Institute (IDISNA)PamplonaSpain
| | - Montse Sánchez‐Cespedes
- Cancer Genetics GroupJosep Carreras Leukaemia Research Institute (IJC)Campus ICO‐Germans Trias i PujolBadalona, BarcelonaSpain
| | - Aleix Prat
- Department of Medical OncologyHospital ClinicBarcelonaSpain
- Translational Genomics and Targeted Therapies in Solid TumorsIDIBAPSBarcelonaSpain
| | - Ana Vivancos
- Cancer Genomics LaboratoryVall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Enriqueta Felip
- Thoracic Cancers Translational Genomics UnitHebron Institute of Oncology (VHIO)Vall dBarcelonaSpain
- Oncology DepartmentVall d’Hebron University Hospital & Vall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Ramon Amat
- Thoracic Cancers Translational Genomics UnitHebron Institute of Oncology (VHIO)Vall dBarcelonaSpain
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Carbonell C, Chamorro AJ, Marcos M, Guillén del Castillo A, Colunga Argüelles D, Rubio-Rivas M, Argibay A, Marí-Alfonso B, Marín Ballvé A, Castro A, Madroñero-Vuelta AB, Callejas-Moraga EL, Fonollosa-Pla V, Simeón-Aznar CP, Autoimmune Diseases Study Group (Geas) OBORI. AB0558 RISK FACTORS FOR THE DEVELOPMENT OF BREAST CANCER IN SYSTEMIC SCLEROSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2016] [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] [Indexed: 11/03/2022]
Abstract
Background:Prior literature shows a global increase of cancer risk among patients with systemic sclerosis (SSc). Although breast cancer (BC) is one of the most frequent malignancies in SSc patients, the characteristics of this neoplasm among SSc patients is not well established and it is uncertain whether SSc significantly increases the risk of this cancer.Objectives:Describe the characteristics and risk factors for BC among Spanish patients with SSc.Methods:Ambispective and multicenter study of patients with a diagnosis of SSc according to ACR/EULAR criteria and/or LeRoy classification included in the Spanish Scleroderma Registry (RESCLE) from 2006 to 2018. Characteristics of patients with BC were described and incidence was compared with that of the general population.Results:Among 1930 patients with SSc, 206 (10.7%) had cancer. BC was the most frequent tumor location (47 patients of 206 with cancer [22.8%]), followed by lung cancer (29, 14.1%). The risk of BC was increased in patients with SSc compared to the general population (standardized incidence ratio [SIR] 1.31; 95% CI 1.10-1.54;P= 0.003).The comparison of patients with BC and those without cancer showed that patients with BC had older age at diagnosis of SSc (50.9 vs 45.9 years, respectively;P=0.004), were more frequently diagnosed of interstitial lung disease (ILD) (30/47 [63.8%] vs 694/1714 [40.5];P= 0.002) and pulmonary hypertension (12/24 [50.0%] vs 262/917 [28.6%];P= 0.037), had higher frequency of puffy hands as the first manifestation of SSc (4/45 [8.9%] vs 38/1664 [2.3 %];P= 0.023) and had more frequently primary biliary colangitis (PBC) (7 /46 [15.2%] vs 72 /1708 [4.2%];P= 0.004). Regarding autoimmunity profile, patients with SSc and BC had a significantly higher presence of anti-Ro (11/44 [25.0%] vs 214/1528 [14.0%];P= 0.049) and anti-mitochondrial antibodies (7/28 [25.0%] vs 96/837 [11.5%];P= 0.039). Multivariable regression analysis showed an independent association between the puffy hands (OR = 6.40; 95% CI 1.73-23.60;P= 0.005), diagnosis of PBC (OR = 5.70; 95% CI 2.16-15.07;P= 0.001), presence of ILD (OR = 3.29, 95% CI 1.69-6.39;P<0.001) and the presence of the anti-Ro antibody (OR 2.14; 95% CI 1.01-4.56;P= 0.048) with the presence of BC.Conclusion:BC risk was increased in patients with SSc. The development of ILD, PBC, the presence of anti Ro and puffy hands as the first clinical manifestation of SSc were identified as independent factors associated with the development of BC in our cohort.References:Colaci M et al. Breast cancer in systemic sclerosis: results of a cross-linkage of an Italian Rheumatologic Center and a population-based Cancer Registry and review of the literaure. Autoimmun Rev. 2014;13(2):132-7.Zhang JQ et al. The risk of cancer development in systemic sclerosis: a meta-analysis. Cancer Epidemiol. 2013;37(5):523-7.Disclosure of Interests:Cristina Carbonell: None declared, Antonio-J Chamorro: None declared, Miguel Marcos: None declared, Alfredo Guillén del Castillo: None declared, Dolores Colunga Argüelles Consultant of: Actelion pharmaceuticals, GSK, MSD., Manuel Rubio-Rivas: None declared, Ana Argibay: None declared, Begoña Marí-Alfonso: None declared, Adela Marín Ballvé: None declared, Antoni Castro Consultant of: Actelion pharmaceuticals, GSK, MSD., Ana Belén Madroñero-Vuelta: None declared, Eduardo L. Callejas-Moraga: None declared, Vicent Fonollosa-Pla Consultant of: Actelion pharmaceuticals, GSK, MSD., Carmen Pilar Simeón-Aznar Consultant of: Actelion pharmaceuticals, GSK, MSD., on behalf of RESCLE Investigators, Autoimmune Diseases Study Group (GEAS): None declared
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Callejo A, Carbonell C, Iranzo P, Pardo Aranda N, Navarro A, Martinez-Marti A, Cedres Perez S, Gutierrez R, Recasens S, Madrenas R, Sanchez L, Saoudi N, Assaf JD, Masnou M, Frigola J, Amat R, Felip E. Genomic alterations profiling by liquid biopsy and their association to immune checkpoints inhibitors (ICI) response in a cohort of non-small cell lung cancer (NSCLC) patients. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e21524] [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
e21524 Background: In metastatic NSCLC, identification of biomarkers of response to immune checkpoint inhibitors (ICI) is still an unmet need. Liquid biopsy, including the detection of circulating tumor DNA (ctDNA) in patients’ bloodstream, is an emerging tool for detecting and monitoring genetic alterations. Mutations in specific genes as KRAS or STK11, in combination with PDL1, have been suggested as potential biomarkers to select responders to ICI. Methods: Digital NGS of ctDNA was analyzed by Guardant360 in samples from 89 patients with advanced NSCLC treated with ICI between 2017 to 2019. Plasma samples after progression to ICI were obteined from 40 patients and we focus in this subgroup to explore mutations of genes commonly alterated in lung cancer and correlate them with clinical outcomes. Results: Forty patients were included in the analysis with a median age of 64.5 years and 62.5% were diagnosed with adenocarcinoma. Fourteen patients were treated with single agent ICI as first line, 19 patients as second line and 7 in third line. A median of 4 mutations per patient were detected (range 0-13). Mutations (mut) in TP53 were found in 85% of the patients, KRAS in 34%, STK11 in 22% and both genes KRAS and STK11 were alterated in 12.5% of the patients. Globally, median PFS (mPFS) of the patients treated with ICI was 7.5 months. mPFS in patients harboring KRAS mutations was 4.9 m ( vs 10.1 m in patients without KRASmut, logrank test p-value = 0.031) and 4.1 m in those patients with STK11 mutations (vs 9.5 m in patients without STK11mut, logrank test p-value = 0.034). Additionally, mutations in both genes were also associated to statistically significant shorter mPFS 3.9 m vs 9.5 m (logrank test p-value < 0.01). Conclusions: Our results support the idea that tumor alterations identified by liquid biopsy panels can potentially contribute as biomarkers of response to ICI in NSCLC. When analyzing the mutational panorama after ICI treatment, we find that those patients exhibiting KRAS and/or STK11 mutations in their ctDNA have a shorter PFS.
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Affiliation(s)
- Ana Callejo
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Iranzo
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo Aranda
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Alex Martinez-Marti
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Susana Cedres Perez
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Raquel Gutierrez
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, Barcelona, Spain
| | - Sergi Recasens
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | - Raquel Madrenas
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, Barcelona, Spain
| | - Laura Sanchez
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, Barcelona, Spain
| | - Nadia Saoudi
- Medical Oncology Department, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Juan David Assaf
- Medical Oncology Department, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Mar Masnou
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute Oncology, Barcelona, Spain
| | - Joan Frigola
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Iranzo P, Callejo A, Pedrola A, Pardo Aranda N, Navarro A, Martinez-Marti A, Cedres Perez S, Ros J, Assaf JD, Saoudi N, Carbonell C, Amat R, Frigola J, Jimenez J, Dienstmann R, Palmer HG, Vivancos A, Felip E. Immune checkpoint inhibitors (ICI) response in metastatic non-small cell lung cancer (NSCLC) patients with WNT pathway mutations (APC/CTNNB1). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e15137] [Citation(s) in RCA: 1] [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
e15137 Background: APC and CTNNB1 mutations (mut) lead to an aberrant activation of the WNT pathway which has been linked to lack of benefit of immunotherapy in patients (pts) with lung cancer. Our aim is to describe the pts’ characteristics of a NSCLC cohort with APC or CTNNB1 mut and their association with outcomes (Overall survival [OS] and Progression-Free-Survival [PFS]) when treated with ICI. Methods: We selected NSCLC pts with mut in APC or CTNNB1 by targeted NGS (tissue), whole exome sequencing (tissue) or Guardant 360(plasma) between January 2014 and October 2019. Functionality of mut and β-catenin protein expression by immunohistochemistry (IHC) were correlated with outcome. Results: We identified a total of 37 patients with 44 mutually-exclusive mutations in APC (31) or CTNNB1 (6), 25 adenocarcinomas (68%). Of APC mut cohort, 16 had pathogenic mut (52%) and 15 of unknown significance (48%). All 6 CTN NB1 mut were known pathogenic. Median OS (mOS) in metastatic setting was 21.6 months (m) (CI95% 14.9-NR), without differences between APC and CTNNB1 groups (HR 1.5, p = 0.4) or when stratified by mut functionality (HR 1.1, p = 0.8). Globally, 21 pts received treatment with ICI (57%, 19 APC, 2 CTNNB1), median PFS (mPFS) was 5.43m (1.8-21.7), with trend for shorter mPFS in CTNNB1 mut (mPFS 1.7m) vs. APC mut (mPFS 6.6m, HR 1.5, p = 0.1). Among patients treated with ICI, 8 (38%) had coexisting driver targetable alterations ( EGFR, ERBB2 or MET) and 13 (62%) other functional mut were found ( TP53, KRAS, STK11, BRCA2, ATM). mPFS was 3.9m (1.8-NR) in the subgroup with driver mut vs. 6.6m (1.4-NR) for remaining pts (HR 1.36, p = 0.5). In 15 pts β-catenin IHC was performed, being positive in 7 cases (47%), 4 of them received ICI with a mPFS 12.1m. Conclusions: In our experience, benefit with ICI is not influenced by the presence of APC mut, and small numbers of CTNNB1 cohort limit conclusive statements. Additional studies are required to assess WNT pathway activation on top of genomics and correlate with the ICI efficacy.
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Affiliation(s)
- Patricia Iranzo
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Callejo
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Pedrola
- Oncology Data Science Group, Vall D’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Pardo Aranda
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alejandro Navarro
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Alex Martinez-Marti
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Susana Cedres Perez
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Ros
- Medical Oncology Department, Vall d´Hebron University Hospital/Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Juan David Assaf
- Medical Oncology Department, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Nadia Saoudi
- Medical Oncology Department, Vall d´Hebron University Hospital, Barcelona, Spain
| | - Caterina Carbonell
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ramon Amat
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Joan Frigola
- Thoracic Tumors & Head and Neck Cancer Group, Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Jose Jimenez
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Hector G. Palmer
- Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Lab and Molecular Pathology Lab, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Enriqueta Felip
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Ros Montana F, Iranzo P, Pedrola A, Callejo A, Pardo N, Amat R, Carbonell C, Martinez A, Navarro A, Cedres S, Dienstmann R, Palmer H, Vivancos A, Felip E. WNT pathway mutations (APC/CTNNB1) and immune checkpoint inhibitors (ICI) response in metastatic non-small cell lung cancer (NSCLC) patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cedres S, Hernando-Calvo A, Iranzo P, Callejo A, Aranda NP, Navarro A, Martinez-Marti A, Assaf J, Miquel J, Rodriguez G, Monton V, Pedrola A, Viaplana C, Carbonell C, Sanso M, Dienstmann R, Amat R, Vivancos A, Felip E. P1.16-05 Incidence and Outcome of Multiple Primary Cancers (MPC) in a Series of Lung Cancer (LC) Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Carbonell C, Ulsamer A, Vivori C, Papasaikas P, Böttcher R, Joaquin M, Miñana B, Tejedor JR, de Nadal E, Valcárcel J, Posas F. Functional Network Analysis Reveals the Relevance of SKIIP in the Regulation of Alternative Splicing by p38 SAPK. Cell Rep 2019; 27:847-859.e6. [PMID: 30995481 PMCID: PMC6484779 DOI: 10.1016/j.celrep.2019.03.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/21/2019] [Accepted: 03/15/2019] [Indexed: 01/03/2023] Open
Abstract
Alternative splicing is a prevalent mechanism of gene regulation that is modulated in response to a wide range of extracellular stimuli. Stress-activated protein kinases (SAPKs) play a key role in controlling several steps of mRNA biogenesis. Here, we show that osmostress has an impact on the regulation of alternative splicing (AS), which is partly mediated through the action of p38 SAPK. Splicing network analysis revealed a functional connection between p38 and the spliceosome component SKIIP, whose depletion abolished a significant fraction of p38-mediated AS changes. Importantly, p38 interacted with and directly phosphorylated SKIIP, thereby altering its activity. SKIIP phosphorylation regulated AS of GADD45α, the upstream activator of the p38 pathway, uncovering a negative feedback loop involving AS regulation. Our data reveal mechanisms and targets of SAPK function in stress adaptation through the regulation of AS.
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Affiliation(s)
- Caterina Carbonell
- Cell Signaling Research Group, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
| | - Arnau Ulsamer
- Cell Signaling Research Group, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
| | - Claudia Vivori
- Gene Regulation, Stem Cells and Cancer Program, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Panagiotis Papasaikas
- Gene Regulation, Stem Cells and Cancer Program, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - René Böttcher
- Cell Signaling Research Group, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain
| | - Manel Joaquin
- Cell Signaling Research Group, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain
| | - Belén Miñana
- Gene Regulation, Stem Cells and Cancer Program, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Juan Ramón Tejedor
- Gene Regulation, Stem Cells and Cancer Program, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Eulàlia de Nadal
- Cell Signaling Research Group, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain.
| | - Juan Valcárcel
- Gene Regulation, Stem Cells and Cancer Program, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra, Dr. Aiguader 88, 08003 Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Passeig Lluis Companys 23, 08010 Barcelona, Spain.
| | - Francesc Posas
- Cell Signaling Research Group, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain.
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Martínez-González MA, Buil-Cosiales P, Corella D, Bulló M, Fitó M, Vioque J, Romaguera D, Martínez JA, Wärnberg J, López-Miranda J, Estruch R, Bueno-Cavanillas A, Arós F, Tur JA, Tinahones F, Serra-Majem L, Martín V, Lapetra J, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, Ros E, Fernández-Aranda F, Botella C, Portillo MP, Lamuela-Raventós RM, Marcos A, Sáez G, Gómez-Gracia E, Ruiz-Canela M, Toledo E, Alvarez-Alvarez I, Díez-Espino J, Sorlí JV, Basora J, Castañer O, Schröder H, Navarrete-Muñoz EM, Zulet MA, García-Rios A, Salas-Salvadó J, Corella D, Estruch R, Fitó M, Martínez-González MA, Ros E, Salas-Salvadó J, Babio N, Ros E, Sánchez-Tainta A, Martínez-González MA, Fitó M, Schröder H, Marcos A, Corella D, Wärnberg J, Martínez-González MA, Estruch R, Fernández-Aranda F, Botella C, Salas-Salvadó J, Razquin C, Bes-Rastrollo M, Sanchez Tainta A, Vázquez Z, SanJulian Aranguren B, Goñi E, Goñi L, Barrientos I, Canales M, Sayón-Orea MC, Rico A, Basterra Gortari J, Garcia Arellano A, Lecea-Juarez O, Carlos Cenoz-Osinaga J, Bartolome-Resano J, Sola-Larraza† A, Lozano-Oloriz E, Cano-Valles B, Eguaras S, Güeto V, Pascual Roquet-Jalmar E, Galilea-Zabalza I, Lancova H, Ramallal R, Garcia-Perez ML, Estremera-Urabayen V, Ariz-Arnedo MJ, Hijos-Larraz C, Fernandez Alfaro C, Iñigo-Martinez B, Villanueva Moreno R, Martin-Almendros S, Barandiaran-Bengoetxea L, Fuertes-Goñi C, Lezaun-Indurain A, Guruchaga-Arcelus MJ, Olmedo-Cruz O, Iñigo-Martínez B, Escriche-Erviti L, Ansorena-Ros R, Sanmatin-Zabaleta R, Apalategi-Lasa J, Villanueva-Telleria J, Hernández-Espinosa MM, Arroyo-Bergera I, Herrera-Valdez L, Dorronsoro-Dorronsoro L, González JI, Sorlí JV, Portolés O, Fernández-Carrión R, Ortega-Azorín C, Barragán R, Asensio EM, Coltell O, Sáiz C, Osma R, Férriz E, González-Monje I, Giménez-Fernández F, Quiles L, Carrasco P, San Onofre N, Carratalá-Calvo A, Valero-Barceló C, Antón F, Mir C, Sánchez-Navarro S, Navas J, González-Gallego I, Bort-Llorca L, Pérez-Ollero L, Giner-Valero M, Monfort-Sáez R, Nadal-Sayol J, Pascual-Fuster V, Martínez-Pérez M, Riera C, Belda MV, Medina A, Miralles E, Ramírez-Esplugues MJ, Rojo-Furió M, Mattingley G, Delgado MA, Pages MA, Riofrío Y, Abuomar L, Blasco-Lafarga N, Tosca R, Lizán L, Guillem-Saiz P, Valcarce AM, Medina MD, Monfort R, de Valcárcel S, Tormo N, Felipe-Román O, Lafuente S, Navío EI, Aldana G, Crespo JV, Llosa JL, González-García L, Raga-Marí R, Pedret Llaberia R, Gonzalez R, Sagarra Álamo R, París Palleja F, Balsells J, Roca JM, Basora Gallisa T, Vizcaino J, Llobet Alpizarte P, Anguera Perpiñá C, Llauradó Vernet M, Caballero C, Garcia Barco M, Morán Martínez MD, García Rosselló J, Del Pozo A, Poblet Calaf C, Arcelin Zabal P, Floresví X, Ciutat Benet M, Palau Galindo A, Cabré Vila JJ, Dolz Andrés F, Boj Casajuana J, Ricard M, Saiz F, Isach A, Sanchez Marin Martinez M, Bulló M, Babio N, Becerra-Tomás N, Mestres G, Basora J, Mena-Sánchez G, Barrubés Piñol L, Gil Segura M, Papandreou C, Rosique Esteban N, Chig S, Abellán Cano I, Ruiz García V, Salas-Huetos A, Hernandez P, Canudas S, Camacho-Barcia L, García-Gavilán J, Diaz A, Castañer O, Muñoz MA, Zomeño MD, Hernaéz A, Torres L, Quifer M, Llimona R, Gal LA, Pérez A, Farràs M, Elosua R, Marrugat J, Vila J, Subirana I, Pérez S, Muñoz MA, Goday A, Chillaron Jordan JJ, Flores Lerroux JA, Benaiges Boix D, Farré M, Menoyo E, Muñoz-Aguayo D, Gaixas S, Blanchart G, Sanllorente A, Soria M, Valussi J, Cuenca A, Forcano L, Pastor A, Boronat A, Tello S, Cabañero M, Franco L, Schröder H, De la Torre R, Medrano C, Bayó J, García MT, Robledo V, Babi P, Canals E, Soldevila N, Carrés L, Roca C, Comas MS, Gasulla G, Herraiz X, Martínez A, Vinyoles E, Verdú JM, Masague Aguade M, Baltasar Massip E, Lopez Grau M, Mengual M, Moldon V, Vila Vergaz M, Cabanes Gómez Ciurana R, Gili Riu M, Palomeras Vidal A, Garcia de la Hera M, González Palacios S, Torres Collado L, Valera Gran D, Compañ Gabucio L, Oncina Canovas A, Notario Barandiaran L, Orozco Beltran D, Pertusa Martínez S, Cloquell Rodrigo B, Hernándis Marsán MV, Asensio A, Altozano Rodado MC, Ballester Baixauli JJ, Fernándis Brufal N, Martínez Vergara MC, Román Maciá J, Candela García I, Pedro Cases Pérez E, Tercero Maciá C, Mira Castejón LA, de los Ángeles García García I, Zazo JM, Gisbert Sellés C, Sánchez Botella C, Fiol M, Moñino M, Colom A, Konieczna J, Morey M, Zamanillo R, Galmés AM, Pereira V, Martín MA, Yáñez A, Llobera J, Ripoll J, Prieto R, Grases F, Costa A, Fernández-Palomeque C, Fortuny E, Noris M, Munuera S, Tomás F, Fiol F, Jover A, Janer JM, Vallespir C, Mattei I, Feuerbach N, del Mar Sureda M, Vega S, Quintana L, Fiol A, Amador M, González S, Coll J, Moyá A, Abete I, Cantero I, Cristobo C, Ibero-Baraibar I, Lezáun Burgui MD, Goñi Ruiz N, Bartolomé Resano R, Cano Cáceres E, Elcarte López T, Echarte Osacain E, Pérez Sanz B, Blanco Platero I, Andueza Azcárate SA, Gimeno Aznar A, Ursúa Sesma E, Ojeda Bilbao B, Martinez Jarauta J, Ugalde Sarasa L, Rípodas Echarte B, Güeto Rubio MV, Fernández-Crehuet Navajas J, Gutiérrez Bedmar M, García Rodriguez A, Mariscal Larrubia A, Carnero Varo M, Muñoz Bravo C, Barón-López FJ, Fernández García JC, Pérez-Farinós N, Moreno-Morales N, del C Rodríguez-Martínez M, Pérez-López J, Benavente-Marín JC, Crespo Oliva E, Contreras Fernández E, Carmona González FJ, Carabaño Moral R, Torres Moreno S, Martín Ruíz MV, Alcalá Cornide M, Fuentes Gómez V, Criado García J, Jiménez Morales AI, Delgado Casado N, Ortiz Morales A, Torres Peña JD, Gómez Delgado FJ, Rodríguez Cantalejo F, Caballero Villaraso J, Alcalá JF, Peña Orihuela PJ, Quintana Navarro G, Casas R, Domenech M, Viñas C, Castro-Barquero S, Ruiz-León AM, Sadurní M, Frontana G, Villanueva P, Gual M, Soriano R, Camafort M, Sierra C, Sacanella E, Sala-Vila A, Cots JM, Sarroca I, García M, Bermúdez N, Pérez A, Duaso I, de la Arada A, Hernández R, Simón C, de la Poza MA, Gil I, Vila M, Iglesias C, Assens N, Amatller M, Rams LL, Benet T, Fernández G, Teruel J, Azorin A, Cubells M, López D, Llovet JM, Gómez ML, Climente P, de Paula L, Soto J, Carbonell C, Llor C, Abat X, Cama A, Fortuny M, Domingo C, Liberal AI, Martínez T, Yañez E, Nieto MJ, Pérez A, Lloret E, Carrazoni C, Belles AM, Olmos C, Ramentol M, Capell MJ, Casas R, Giner I, Muñoz A, Martín R, Moron E, Bonillo A, Sánchez G, Calbó C, Pous J, Massip M, García Y, Massagué MC, Ibañez R, Llaona J, Vidal T, Vizcay N, Segura E, Galindo C, Moreno M, Caubet M, Altirriba J, Fluxà G, Toribio P, Torrent E, Anton JJ, Viaplana A, Vieytes G, Duch N, Pereira A, Moreno MA, Pérez A, Sant E, Gené J, Calvillo H, Pont F, Puig M, Casasayas M, Garrich A, Senar E, Martínez A, Boix I, Sequeira E, Aragunde V, Riera S, Salgado M, Fuentes M, Martín E, Ubieto A, Pallarés F, Sala C, Abilla A, Moreno S, Mayor E, Colom T, Gaspar A, Gómez A, Palacios L, Garrigosa R, García Molina L, Riquelme Gallego B, Cano Ibañez N, Maldonado Calvo A, López Maldonado A, Garrido EM, Baena Dominguez A, García Jiménez F, Thomas Carazo E, Jesús Turnes González A, González Jiménez F, Padilla Ruiz F, Machado Santiago J, Martínez Bellón MD, Pueyos Sánchez A, Arribas Mir L, Rodríguez Tapioles R, Dorador Atienza F, Baena Camus L, Osorio Martos C, Rueda Lozano D, López Alcázar M, Ramos Díaz F, Cruz Rosales Sierra M, Alguacil Cubero P, López Rodriguez A, Guerrero García F, Tormo Molina J, Ruiz Rodríguez F, Rekondo J, Salaverria I, Alonso-Gómez A, Belló MC, Loma-Osorio A, Tojal L, Bruyel P, Goicolea L, Sorto C, Casi Casanellas A, Arnal Otero ML, Ortueta Martínez De Arbulo J, Vinagre Morgado J, Romeo Ollora J, Urraca J, Sarriegui Carrera MI, Toribio FJ, Magán E, Rodríguez A, Castro Madrid S, Gómez Merino MT, Rodríguez Jiménez M, Gutiérrez Jodra M, López Alonso B, Iturralde Iriso J, Pascual Romero C, Izquierdo De La Guerra A, Abbate M, Aguilar I, Angullo E, Arenas A, Argelich E, Bibiloni MM, Bisbal Y, Bouzas C, Busquets C, Capó X, Carreres S, De la Peña A, Gallardo L, Gámez JM, García B, García C, Julibert A, Llompart I, Mascaró CM, Mateos D, Montemayor S, Pons A, Ripoll T, Rodríguez T, Salaberry E, Sureda A, Tejada S, Ugarriza L, Valiño L, Bernal López MR, Macías González M, Ruiz Nava J, Fernández García JC, Muñoz Garach A, Vilches Pérez A, González Banderas A, Alcaide Torres J, Vargas Candela A, León Fernández M, Hernández Robles R, Santamaría Fernández S, Marín JM, Valdés Hernández S, Villalobos JC, Ortiz A, Álvarez-Pérez J, Díaz Benítez EM, Díaz-Collado F, Sánchez-Villegas A, Pérez-Cabrera J, Casañas-Quintana LT, García-Guerra RB, Bautista-Castaño I, Ruano-Rodríguez C, Sarmiento de la Fe F, García-Pastor JA, Macías-Gutiérrez B, Falcón-Sanabria I, Simón-García C, Santana-Santana AJ, Álvarez-Álvarez JB, Díaz-González BV, Castillo Anzalas JM, Sosa-Also RE, Medina-Ponce J, Abajo Olea S, Adlbi Sibai A, Aguado Arconada A, Álvarez L, Carriedo Ule E, Escobar Fernández M, Ferradal García JI, Fernández Vázquez JP, García González M, González Donquiles C, González Quintana C, González Rivero F, Lavinia Popescu M, López Gil JI, López de la Iglesia J, Marcos Delgado A, Merino Acevedo C, Reguero Celada S, Rodríguez Bul M, Vilorio-Marqués L, Santos-Lozano JM, Miró-Moriano L, Domínguez-Espinaco C, Vaquero-Díaz S, García-Corte FJ, Santos-Calonge A, Toro-Cortés C, Pelegrina-López N, Urbano-Fernández V, Ortega-Calvo M, Lozano-Rodríguez J, Rivera-Benítez I, Caballero-Valderrama M, Iglesias-Bonilla P, Román-Torres P, Corchado-Albalat Y, Mayoral-Sánchez E, de Cos AI, Gutierrez S, Artola S, Galdon A, Gonzalo I, Más S, Sierra R, Luca B, Prieto L, Galera A, Gimenez-Gracia M, Figueras R, Poch M, Freixedas R, Trias F, Sarasa I, Fanlo M, Lafuente H, Liceran M, Rodriguez-Sanchez A, Pallarols C, Monedero J, Corbella X, Corbella E, Altés A, Vinagre I, Mestres C, Viaplana J, Serra M, Vera J, Freitas T, Ortega E, Pla I, Ordovás JM, Micó V, Berninches L, Concejo MJ, Muñoz J, Adrián M, de la Fuente Y, Albertos C, Villahoz E, Cornejo ML, Gaforio JJ, Moraleda S, Liétor N, Peis JI, Ureña T, Rueda M, Ballesta MI, Moreno Lopera C, Aragoneses Isabel C, Sirur Flores MA, Ceballos de Diego M, Bescos Cáceres T, Peña Cereceda Y, Martínez Abad M, Cabrera Vela R, González Cerrajero M, Rubio Herrera MA, Torrego Ellacuría M, Barabash Bustelo A, Ortiz Ramos M, Garin Barrutia U, Baños R, García-Palacios A, Cerdá Micó C, Estañ Capell N, Iradi A, Fandos Sánchez M. Cohort Profile: Design and methods of the PREDIMED-Plus randomized trial. Int J Epidemiol 2018; 48:387-388o. [PMID: 30476123 DOI: 10.1093/ije/dyy225] [Citation(s) in RCA: 166] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 01/04/2023] Open
Affiliation(s)
- Miguel A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Pilar Buil-Cosiales
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Monica Bulló
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Clinical Epidemiology and Public Health Department, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Jose López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Cardiology, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Francisco Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Las Palmas de Gran Canaria, Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Jose Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Eating Disorders Unit, Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain
| | - Cristina Botella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - María Puy Portillo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy and Lucio Lascaray Research Center, Universidad del País Vasco (UPV/EHU), Vitoria, Spain
| | - Rosa M Lamuela-Raventós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, -UB, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Ascensión Marcos
- Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Guillermo Sáez
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Odontology, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
| | | | - Miguel Ruiz-Canela
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Estefania Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Ismael Alvarez-Alvarez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Javier Díez-Espino
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - José V Sorlí
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Josep Basora
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Olga Castañer
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Eva María Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Maria Angeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Antonio García-Rios
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
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Rubio-Rivas M, Corbella X, Pestaña-Fernández M, Tolosa-Vilella C, Guillen-Del Castillo A, Colunga-Argüelles D, Trapiella-Martínez L, Iniesta-Arandia N, Castillo-Palma MJ, Sáez-Comet L, Egurbide-Arberas MV, Ortego-Centeno N, Freire M, Vargas-Hitos JA, Ríos-Blanco JJ, Todolí-Parra JA, Rodríguez-Carballeira M, Marín-Ballvé A, Segovia-Alonso P, Pla-Salas X, Madroñero-Vuelta AB, Ruiz-Muñoz M, Fonollosa-Pla V, Simeón-Aznar CP, Callejas Moraga E, Calvo E, Carbonell C, Castillo MJ, Chamorro AJ, Colunga D, Corbella X, Egurbide MV, Espinosa G, Fonollosa V, Freire M, García Hernández FJ, González León R, Guillén Del Castillo A, Iniesta N, Lorenzo R, Madroñero AB, Marí B, Marín A, Ortego-Centeno N, Pérez Conesa M, Pestaña M, Pla X, Ríos Blanco JJ, Rodríguez Carballeira M, Rubio Rivas M, Ruiz Muñoz M, Sáez Comet L, Segovia P, Simeón CP, Soto A, Tarí E, Todolí JA, Tolosa C, Trapiella L, Vargas Hitos JA, Verdejo G. First clinical symptom as a prognostic factor in systemic sclerosis: results of a retrospective nationwide cohort study. Clin Rheumatol 2017; 37:999-1009. [PMID: 29214548 DOI: 10.1007/s10067-017-3936-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/07/2017] [Accepted: 11/27/2017] [Indexed: 12/21/2022]
Abstract
The objective of the study is to determine the importance of the mode of onset as prognostic factor in systemic sclerosis (SSc). Data were collected from the Spanish Scleroderma Registry (RESCLE), a nationwide retrospective multicenter database created in 2006. As first symptom, we included Raynaud's phenomenon (RP), cutaneous sclerosis, arthralgia/arthritis, puffy hands, interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), and digestive hypomotility. A total of 1625 patients were recruited. One thousand three hundred forty-two patients (83%) presented with RP as first symptom and 283 patients (17%) did not. Survival from first symptom in those patients with RP mode of onset was higher at any time than those with onset as non-Raynaud's phenomenon: 97 vs. 90% at 5 years, 93 vs. 82% at 10 years, 83 vs. 62% at 20 years, and 71 vs. 50% at 30 years (p < 0.001). In multivariate analysis, factors related to mortality were older age at onset, male gender, dcSSc subset, ILD, PAH, scleroderma renal crisis (SRC), heart involvement, and the mode of onset with non-Raynaud's phenomenon, especially in the form of puffy hands or pulmonary involvement. The mode of onset should be considered an independent prognostic factor in systemic sclerosis and, in particular, patients who initially present with non-Raynaud's phenomenon may be considered of poor prognosis.
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Affiliation(s)
- Manuel Rubio-Rivas
- Department of Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Xavier Corbella
- Department of Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Melany Pestaña-Fernández
- Department of Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carles Tolosa-Vilella
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain
| | | | - Dolores Colunga-Argüelles
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | - Nerea Iniesta-Arandia
- Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatología, Hospital Clínic, Barcelona, Spain
| | - María Jesús Castillo-Palma
- Collagenosis and Pulmonary Hypertension Unit, Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Luis Sáez-Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Mayka Freire
- Thrombosis and Vasculitis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | | | | | | | | | - Adela Marín-Ballvé
- Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Pablo Segovia-Alonso
- Department of Internal Medicine, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Xavier Pla-Salas
- Department of Internal Medicine, Consorci Hospitalari de Vic, Barcelona, Spain
| | | | - Manuel Ruiz-Muñoz
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Vicent Fonollosa-Pla
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carmen Pilar Simeón-Aznar
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Reyes C, Tebe C, Martinez-Laguna D, Ali MS, Soria-Castro A, Carbonell C, Prieto-Alhambra D. One and two-year persistence with different anti-osteoporosis medications: a retrospective cohort study. Osteoporos Int 2017; 28:2997-3004. [PMID: 28714038 DOI: 10.1007/s00198-017-4144-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 07/04/2017] [Indexed: 12/30/2022]
Abstract
UNLABELLED Adherence to anti-osteoporosis medications is poor. We carried out a cohort study using a real-world population database to estimate the persistence of anti-osteoporosis drugs. Unadjusted 2-year persistence ranged from 10.3 to 45.4%. Denosumab users had a 40% lower risk of discontinuation at 2 years compared to alendronate users. PURPOSE The purpose of this study was to estimate real-world persistence amongst incident users of anti-osteoporosis medications. METHODS This is a retrospective cohort using data from anonymised records and dispensation data ( www.sidiap.org ). Eligibility comprised the following: women aged ≥50, incident users of anti-osteoporosis medication (2012), with data available for at least 12 months prior to therapy initiation. Exclusions are other bone diseases/treatments and uncommon anti-osteoporosis drugs (N < 100). Follow-up was from first pharmacy dispensation until cessation, end of study, censoring or switching. Outcomes are 2- and 1-year persistence with a permissible gap of up to 90 days. Persistence with alendronate was compared to other bisphosphonates, strontium ranelate, selective oestrogen receptor modulators, teriparatide and denosumab. Cox models were used to estimate hazard ratios of therapy cessation according to drug used after adjustment for age, sex, BMI, smoking, alcohol drinking, Charlson co-morbidity index, previous fractures, use of anti-osteoporosis medication/s, oral corticosteroids and socio-economic status. RESULTS A total of 19,253 women were included. Unadjusted 2-year persistence [95% CI] ranged from 10.3% [9.1-11.6%] (strontium ranelate) to 45.4% [43.1-47.8%] (denosumab). One-year persistence went from 35.8% [33.9%-37.7%] (strontium ranelate) to 65.8% [63.6%-68.0%] (denosumab). At the end of the first year and compared to alendronate users, both teriparatide and denosumab users had reduced cessation risk (adjusted HR 0.76, 95% CI 0.67-0.86 and 0.54, 95% CI 0.50-0.59 respectively) while at the end of the second year, only denosumab had a lower risk of discontinuation (adjusted HR 0.60, 95% CI 0.56-0.64). CONCLUSIONS Unadjusted 2-year persistence is suboptimal. However, both teriparatide and denosumab users had better 1-year persistence and only denosumab had 2-year better persistence compared to alendronate users. Unmeasured confounding by indication might partially explain our findings.
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Affiliation(s)
- C Reyes
- GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l'Aparell Locomotor) Research Group, IDIAP Jordi Gol (Universitat Autònoma de Barcelona), CIBER Fes, Av Gran Via de les Corts Catalanes, 587, Atic, 08007, Barcelona, Spain
| | - C Tebe
- Bellvitge Biomedical Research Institute (IDIBELL), Avinguda Granvia, 199-203, 08908, L'Hospitalet de Llobregat, Spain
- Faculty of Medicine and Health Sciences, Rovira i Virgili University, Reus, Spain
| | - D Martinez-Laguna
- GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l'Aparell Locomotor) Research Group, IDIAP Jordi Gol (Universitat Autònoma de Barcelona), CIBER Fes, Av Gran Via de les Corts Catalanes, 587, Atic, 08007, Barcelona, Spain
- Atenció Primària Barcelona, Institut Català de la Salut (ICS), Balmes 22, 08007, Barcelona, Spain
| | - M S Ali
- Musculoskeletal Pharmaco and Device Epidemiology, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
| | - A Soria-Castro
- GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l'Aparell Locomotor) Research Group, IDIAP Jordi Gol (Universitat Autònoma de Barcelona), CIBER Fes, Av Gran Via de les Corts Catalanes, 587, Atic, 08007, Barcelona, Spain
- Atenció Primària Barcelona, Institut Català de la Salut (ICS), Balmes 22, 08007, Barcelona, Spain
| | - C Carbonell
- GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l'Aparell Locomotor) Research Group, IDIAP Jordi Gol (Universitat Autònoma de Barcelona), CIBER Fes, Av Gran Via de les Corts Catalanes, 587, Atic, 08007, Barcelona, Spain
- Atenció Primària Barcelona, Institut Català de la Salut (ICS), Balmes 22, 08007, Barcelona, Spain
| | - D Prieto-Alhambra
- GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l'Aparell Locomotor) Research Group, IDIAP Jordi Gol (Universitat Autònoma de Barcelona), CIBER Fes, Av Gran Via de les Corts Catalanes, 587, Atic, 08007, Barcelona, Spain.
- Musculoskeletal Pharmaco and Device Epidemiology, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK.
- Musculoskeletal Research Unit, IMIM-Parc Salut Mar, Universitat Autònoma de Barcelona, Doctor Aiguader 88, 08003, Barcelona, Spain.
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Garzón-Tovar L, Cano-Sarabia M, Carné-Sánchez A, Carbonell C, Imaz I, Maspoch D. A spray-drying continuous-flow method for simultaneous synthesis and shaping of microspherical high nuclearity MOF beads. REACT CHEM ENG 2016. [DOI: 10.1039/c6re00065g] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A novel spray-drying continuous-flow method allows the synthesis of high-nuclearity MOFs as well as multivariate MOFs in the form of compact microspherical superstructures (beads) in good yields and high porosity.
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Affiliation(s)
- L. Garzón-Tovar
- Catalan Institute of Nanoscience and Nanotechnology (ICN2)
- CSIC and The Barcelona Institute of Science and Technology
- 08193 Barcelona
- Spain
| | - M. Cano-Sarabia
- Catalan Institute of Nanoscience and Nanotechnology (ICN2)
- CSIC and The Barcelona Institute of Science and Technology
- 08193 Barcelona
- Spain
| | - A. Carné-Sánchez
- Catalan Institute of Nanoscience and Nanotechnology (ICN2)
- CSIC and The Barcelona Institute of Science and Technology
- 08193 Barcelona
- Spain
| | - C. Carbonell
- Catalan Institute of Nanoscience and Nanotechnology (ICN2)
- CSIC and The Barcelona Institute of Science and Technology
- 08193 Barcelona
- Spain
| | - I. Imaz
- Catalan Institute of Nanoscience and Nanotechnology (ICN2)
- CSIC and The Barcelona Institute of Science and Technology
- 08193 Barcelona
- Spain
| | - D. Maspoch
- Catalan Institute of Nanoscience and Nanotechnology (ICN2)
- CSIC and The Barcelona Institute of Science and Technology
- 08193 Barcelona
- Spain
- ICREA
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Garzón-Tovar L, Carné-Sánchez A, Carbonell C, Imaz I, Maspoch D. Optimised room temperature, water-based synthesis of CPO-27-M metal-organic frameworks with high space-time yields. J Mater Chem A Mater 2015; 3:20819-20826. [PMID: 27293584 PMCID: PMC4902134 DOI: 10.1039/c5ta04923g] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The exceptional porosity of Metal-Organic Frameworks (MOFs) could be harnessed for countless practical applications. However, one of the challenges currently precluding the industrial exploitation of these materials is a lack of green methods for their synthesis. Since green synthetic methods obviate the use of organic solvents, they are expected to reduce the production costs, safety hazards and environmental impact typically associated with MOF fabrication. Herein we describe the stepwise optimisation of reaction parameters (pH, reagent concentrations and reaction time) for the room temperature, water-based synthesis of several members of the CPO-27/MOF-74-M series of MOFs, including ones made from Mg(II), Ni(II), Co(II) and Zn(II) ions. Using this method, we built MOFs with excellent BET surface areas and unprecedented Space-Time Yields (STYs). Employing this approach, we have synthesised CPO-27-M MOFs with record BET surface areas, including 1279 m2 g-1 (CPO-27-Zn), 1351 m2 g-1 (CPO-27-Ni), 1572 m2 g-1 (CPO-27-Co), and 1603 m2 g-1 (CPO-27-Mg). We anticipate that our method could be applied to produce CPO-27-Ni, -Mg, -Co and -Zn with STYs of 44 Kg m-3 day-1, 191 Kg m-3 day-1, 1462 Kg m-3 day-1 and a record 18720 Kg m-3 day-1, respectively.
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Affiliation(s)
- L. Garzón-Tovar
- ICN2 (ICN-CSIC), Institut Catala de Nanociencia i Nanotecnologia, Esfera UAB 08193 Bellaterra, Spain
| | - A. Carné-Sánchez
- ICN2 (ICN-CSIC), Institut Catala de Nanociencia i Nanotecnologia, Esfera UAB 08193 Bellaterra, Spain
| | - C. Carbonell
- ICN2 (ICN-CSIC), Institut Catala de Nanociencia i Nanotecnologia, Esfera UAB 08193 Bellaterra, Spain
| | - I. Imaz
- ICN2 (ICN-CSIC), Institut Catala de Nanociencia i Nanotecnologia, Esfera UAB 08193 Bellaterra, Spain
| | - D. Maspoch
- ICN2 (ICN-CSIC), Institut Catala de Nanociencia i Nanotecnologia, Esfera UAB 08193 Bellaterra, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08100 Barcelona, Spain
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Aronica E, Zurolo E, Iyer A, de Groot M, Anink J, Carbonell C, van Vliet EA, Baayen JC, Boison D, Gorter JA. Upregulation of adenosine kinase in astrocytes in experimental and human temporal lobe epilepsy. Epilepsia 2011; 52:1645-55. [PMID: 21635241 DOI: 10.1111/j.1528-1167.2011.03115.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Adenosine kinase (ADK) represents the key metabolic enzyme for the regulation of extracellular adenosine levels in the brain. In adult brain, ADK is primarily present in astrocytes. Several lines of experimental evidence support a critical role of ADK in different types of brain injury associated with astrogliosis, which is also a prominent morphologic feature of temporal lobe epilepsy (TLE). We hypothesized that dysregulation of ADK is an ubiquitous pathologic hallmark of TLE. METHODS Using immunocytochemistry and Western blot analysis, we investigated ADK protein expression in a rat model of TLE during epileptogenesis and the chronic epileptic phase and compared those findings with tissue resected from TLE patients with mesial temporal sclerosis (MTS). KEY FINDINGS In rat control hippocampus and cortex, a low baseline expression of ADK was found with mainly nuclear localization. One week after the electrical induction of status epilepticus (SE), prominent up-regulation of ADK became evident in astrocytes with a characteristic cytoplasmic localization. This increase in ADK persisted at least for 3-4 months after SE in rats developing a progressive form of epilepsy. In line with the findings from the rat model, expression of astrocytic ADK was also found to be increased in the hippocampus and temporal cortex of patients with TLE. In addition, in vitro experiments in human astrocyte cultures showed that ADK expression was increased by several proinflammatory molecules (interleukin-1β and lipopolysaccharide). SIGNIFICANCE These results suggest that dysregulation of ADK in astrocytes is a common pathologic hallmark of TLE. Moreover, in vitro data suggest the existence of an additional layer of modulatory crosstalk between the astrocyte-based adenosine cycle and inflammation. Whether this interaction also can play a role in vivo needs to be further investigated.
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Affiliation(s)
- Eleonora Aronica
- Department of (Neuro) Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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27
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Zurolo E, Iyer A, Maroso M, Carbonell C, Anink JJ, Ravizza T, Fluiter K, Spliet WGM, van Rijen PC, Vezzani A, Aronica E. Activation of Toll-like receptor, RAGE and HMGB1 signalling in malformations of cortical development. Brain 2011; 134:1015-32. [PMID: 21414994 DOI: 10.1093/brain/awr032] [Citation(s) in RCA: 160] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Recent evidence in experimental models of seizures and in temporal lobe epilepsy support an important role of high-mobility group box 1 and toll-like receptor 4 signalling in the mechanisms of hyperexcitability leading to the development and perpetuation of seizures. In this study, we investigated the expression and cellular distribution of toll-like receptors 2 and 4, and of the receptor for advanced glycation end products, and their endogenous ligand high-mobility group box 1, in epilepsy associated with focal malformations of cortical development. Immunohistochemistry showed increased expression of toll-like receptors 2 and 4 and receptor for advanced glycation end products in reactive glial cells in focal cortical dysplasia, cortical tubers from patients with the tuberous sclerosis complex and in gangliogliomas. Toll-like receptor 2 was predominantly detected in cells of the microglia/macrophage lineage and in balloon cells in focal cortical dysplasia, and giant cells in tuberous sclerosis complex. The toll-like receptor 4 and receptor for advanced glycation end products were expressed in astrocytes, as well as in dysplastic neurons. Real-time quantitative polymerase chain reaction confirmed the increased receptors messenger RNA level in all pathological series. These receptors were not detected in control cortex specimens. In control cortex, high-mobility group box 1 was ubiquitously detected in nuclei of glial and neuronal cells. In pathological specimens, protein staining was instead detected in the cytoplasm of reactive astrocytes or in tumour astrocytes, as well as in activated microglia, predictive of its release from glial cells. In vitro experiments in human astrocyte cultures showed that nuclear to cytoplasmic translocation of high-mobility group box 1 was induced by interleukin-1β. Our findings provide novel evidence of intrinsic activation of these pro-inflammatory signalling pathways in focal malformations of cortical development, which could contribute to the high epileptogenicity of these developmental lesions.
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Affiliation(s)
- Emanuele Zurolo
- Department of (Neuro) Pathology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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Espuña Pons M, Castro Díaz D, Carbonell C, Dilla T. [Comparison between the "ICIQ-UI Short Form" Questionnaire and the "King's Health Questionnaire" as assessment tools of urinary incontinence among women]. Actas Urol Esp 2007; 31:502-10. [PMID: 17711169 DOI: 10.1016/s0210-4806(07)73674-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 11/25/2022]
Abstract
INTRODUCTION In our country there are a few available instruments to diagnose urinary incontinence (UI) from the patient's perspective. The King's Health Questionnaire (KHQ) and the "International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form" (ICIQ-UI SF) are the most widespread among that. The present study aimed to compare the clinical utility between KHQ and ICIQ-UI SF with regard to the urodynamic test. MATERIAL AND METHODS Cross-sectional study performed in 116 women who completed the ICIQ-UI SF, the KHQ and the urodynamic test and were diagnosed according to each test. Sensibility and specificity values of symptom dimension of the ICIQ-UI SF and the KHQ were analyzed with regard to the urodynamic test. In addition, correlation scores between the both compared measures were calculated. RESULTS Mean age (SD) of women was 54 years (SD = 13.99). KHQ and ICIQ-UI SF mean scores were 39.93 (22.11) and 13.76 (4.11), respectively. Correlation between both measures was moderated (r = 0.6; p < 0.001). Percentages of pts with symptoms suggesting Stress UI (SUI), Urge UI (UUI) and Mixed UI (MUI) according to each instrument were: 33.7, 17.3 & 49 (KHQ); 40.4, 15.4 & 44.2 (ICIQ-UI SF). Patients' distribution according to urodynamic test was: SUI 41.3%, UUI 20.2%, MUI 26.9% and 11.5% with other diagnosis. Sensibility and specificity values of both questionnaires were very similar, but feasibility was worse for the KHQ (7.76% of pts did not complete the questionnaire) than for the ICIQ-UI SF (2.59% did not complete the questionnaire). CONCLUSIONS Because of its better feasibility, clinical use of ICIQ-UI SF is recommended against KHQ for UI evaluation.
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Affiliation(s)
- M Espuña Pons
- Institut Clínic de Ginecología, Obstetricia iNeonatología, Hospital Cliníc, Barcelona University.
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Espuña Pons M, Castro Díaz D, Carbonell C, Dilla T. Comparación entre el cuestionario "ICIQ-UI Short Form" y el "King's Health Questionnaire" como instrumentos de evaluación de la incontinencia urinaria en mujeres. Actas Urol Esp 2007. [DOI: 10.4321/s0210-48062007000500010] [Citation(s) in RCA: 4] [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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Carbonell C. Ethics of art therapy and use of patient-produced art. Eur Psychiatry 2007. [DOI: 10.1016/j.eurpsy.2007.01.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rodríguez D, Aguilera C, Aguilera C, Aguilera C, Vallano A, Vallano A, Vallano A, Carbonell C. Avances y controversias en el tratamiento farmacológico de la osteoporosis. Aten Primaria 2004. [DOI: 10.1016/s0212-6567(04)78909-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Romera M, Lafuente A, Carbonell C. Osteoporosis. Aten Primaria 2002. [DOI: 10.1016/s0212-6567(02)70530-1] [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: 11/24/2022] Open
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Guisado J, Carbonell C, Donaire L, De Miguel J, Vaz F. [Wernicke-Korsakoff syndrome: malignant tumour as triggering factor]. Actas Esp Psiquiatr 2001; 29:279-81. [PMID: 11470064] [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: 02/20/2023]
Abstract
Gastrectomy, alcoholism and malignant tumour are three predisponing risk factors for the development of Wernicke-Korsakoff syndrome. We described the clinical case of a patient with history of alcoholism that developed Wernicke-Korsakoff syndrome 30 years after undergoing gastrectomy. This patient had, in the last year, a diagnostic for prostatic adenocarcinoma and changes in dietary habits. We presented the clinical and neuropathological features of the Wernicke-Korsakoff syndrome. As well as some aspects in the treatment and prognosis.
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Affiliation(s)
- J Guisado
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Extremadura, Badajoz
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Colomer Rubio E, Sánchez Roy R, Pareja Martínez A, Perla C, Villarroya T, Cerdá Nicolás M, Carbonell C. [Alien hand syndrome in Creutzfeldt-Jakob disease]. Neurologia 2001; 16:223-6. [PMID: 11412722] [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: 02/20/2023] Open
Abstract
Alien hand syndrome is defined by uncontrolable actions of the arm and hand that seem to have a purpose. It is usually associated with acute focal lesions after a stroke or surgery of the corpus callosum. It has been described in chronic dementiating diseases such as cortico-basal degeneration, Alzheimer's disease, orthochromatic leukodystrophy and Marchiafava-Bignami disease. We now report a patient with Creutzfeldt-Jakob disease and alien hand syndrome, which appeared after the cognitive alterations and had characteristics of the frontal type of alien hand affecting the dominant upper limb. In the three cases described previously in the literature the alien hand affected the non-dominant hand and the abnormal movement appeared before dementia was clinically obvious. The non specific nature and poorly localising sign of alien hand is remarked. Alien hand should be added the list of features of Creutzfeldt-Jakob disease.
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Affiliation(s)
- E Colomer Rubio
- Servicio de Medicina Interna. Hospital Arnau de Vilanova. Valencia
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35
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Glóver López G, Bernabé M, Carbonell C. Diagnóstico del síndrome X frágil. Rev Neurol 2001. [DOI: 10.33588/rn.33s1.2001329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Carbonell C. [Depression among the elderly]. Actas Esp Psiquiatr 2000; 28:1-2. [PMID: 11270014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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37
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Carbonell C. [Depression in the elderly]. Actas Esp Psiquiatr 2000; 28:1-2. [PMID: 11450404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Abstract
This review considers the evidence supporting the use of somatic therapies (medications and electroconvulsive therapy) in the treatment of acute mania associated with bipolar disorder. Data from randomized, controlled clinical trials have established the efficacy of lithium, divalproex sodium, and carbamazepine in the treatment of acute mania. The use of combinations of mood stabilizers in the treatment of acute mania has not been well examined in controlled trials. Conventional antipsychotics and some atypical antipsychotics are frequently used as initial or adjunctive treatment. Similarly, benzodiazepines are frequently used as adjunctive agents. Preliminary data suggest that some calcium channel blockers and several anticonvulsants, e.g., lamotrigine, gabapentin, and topiramate, may have therapeutic value in the treatment of acute mania. In contrast, electroconvulsive therapy is generally accepted as being highly effective despite the lack of controlled evidence.
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Affiliation(s)
- P E Keck
- Biological Psychiatry Program, Department of Psychiatry, University of Cincinnati College of Medicine, PO Box 670559, 231 Bethesda Avenue, 45267-0559, Cincinnati, OH, USA
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Franulic A, Horta E, Maturana R, Scherpenisse J, Carbonell C. Organic personality disorder after traumatic brain injury: cognitive, anatomic and psychosocial factors. A 6 month follow-up. Brain Inj 2000; 14:431-9. [PMID: 10834338 DOI: 10.1080/026990500120538] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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: 10/17/2022]
Abstract
OBJECTIVE The purpose of the study is to describe psychosocial adjustment in patients who present Organic Personality Disorder (OPD) after TBI in relation to patients with TBI without OPD. METHOD The group included patients who were admitted as inpatients in the Neurology Service. Exclusion criteria were: previous personality disorders; previous alcohol and drugs addiction, history of head injury and other neurological diseases. For this purpose, a semi-structured interview based on the ICD-10 was applied to the patient or significant other during the 1st or 2nd week after the accident. Selected patients were evaluated with psychological and psychosocial tests and questionnaires 6 months after head injury, among them: WAIS, Benton Test, Rey Osterrieth Test, Wisconsin Cards, Psychosocial Scale and Neurobehavioural Rating Scale (NRS-27). RESULTS No significant differences were observed in relation to demographic characteristics, type of head injury, GCS, or psychometric results. Significant differences were found in the answers to neurobehavioural and psychosocial questionnaires, showing more impairment in patients with OPD. CONCLUSIONS The results show that, in this group, patients with OPD after TBI present more psychosocial adjustment and emotional problems than patients with TBI without OPD diagnosis. The difference found is independent of cognitive impairments.
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Affiliation(s)
- A Franulic
- Mental Health Service, Hospital del Trabajador, Santiago de Chile.
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40
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Calpe JL, Chiner E, Sánchez E, Armero V, Puigcerver MT, Carbonell C, Vilar A. [Microepidemics of tuberculosis; apropos of 2 school outbreaks in the area 15 of the Valencia community]. Arch Bronconeumol 1997; 33:566-71. [PMID: 9508472 DOI: 10.1016/s0300-2896(15)30514-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 02/06/2023]
Abstract
Schools are settings with high concentrations of young people with little exposure to Mycobacterium tuberculosis and greater risk of developing disease when infection occurs as the result of sporadic localized outbreaks. We studied two outbreaks in two elementary schools (A and B) after two cases of bacilliferous pulmonary tuberculosis were detected in teachers in 1990 and 1994. Contacts were trace din school A by the primary care physician and in school B by the pneumologist and public health authorities. Contacts were classified as belonging to the risk group (RG) or the low risk group (LRG). The RG was composed of 187 contacts in school A and 59 in school B. Individuals in the LRG numbered 429 and 116 respectively. Mantoux positives numbered 108 in the RG and 45 in the LRG in school A (p < 0.001). In school B 50 RG individuals and 29 LRG individuals were positive (p < 0.001). The proportion of Mantoux positives was greater in the RG of school B than in the RG of school A (p < 0.01), probably owing to longer time of evolution of disease and possible laryngeal involvement in the index case. Likewise, tuberculin positives were fewer in the LRG of school A than in the LRG of school B (p < 0.001), owing to the small size of the LRG in school A. Thirteen cases of tuberculosis were seen in school A, six of which called for drug prophylaxis after contacts were traced. The nature of the index case and the conditions of exposure are both important in such outbreaks, demonstrating the need to act appropriately to trace contacts, preferably under the supervision of a pneumologists.
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Affiliation(s)
- J L Calpe
- Seccione de Neumología, Hospital de la Marina Baixa, Alicante
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Tuset C, Gutiérrez M, Carbonell C, Tuset T, Soriano V. Human T-cell lymphotropic virus infection in pregnant women in Spain. Eur J Clin Microbiol Infect Dis 1997; 16:771-3. [PMID: 9405953 DOI: 10.1007/bf01709264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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42
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Usera MA, Bellod P, Carbonell C, Echeita A. [Multiple outbreaks caused by Salmonella serotype Enteritidis in a restaurant]. Enferm Infecc Microbiol Clin 1995; 13:68-9. [PMID: 7893800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Ena J, Amador C, Pasquau F, Carbonell C, Benito C, Gutiérrez F, Vilar A. Once-a-month administration of intravenous pentamidine to patients infected with human immunodeficiency virus as prophylaxis for Pneumocystis carinii pneumonia. Clin Infect Dis 1994; 18:901-4. [PMID: 8086550 DOI: 10.1093/clinids/18.6.901] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [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: 01/28/2023] Open
Abstract
We reviewed the charts of 52 patients infected with human immunodeficiency virus (HIV) who received at least three consecutive doses of intravenous pentamidine as prophylaxis for Pneumocystis carinii infections. Pentamidine isethionate was administered intravenously over 60-90 minutes once a month, at a dosage of 4 mg/kg, in 250 mL of 5% dextrose in water. During 387 months of administration of primary prophylaxis to 37 patients, no cases of P. carinii pneumonia were observed. During 200 months of administration of secondary prophylaxis to 15 patients, only one case of P. carinii pneumonia was diagnosed (6.0 cases per 100 patient-years). Side effects associated with the intravenous pentamidine were mild and did not necessitate withdrawal of the drug. Once-a-month administration of intravenous pentamidine is a valid alternative as prophylaxis for P. carinii pneumonia for patients who are intolerant of sulfonamides.
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Affiliation(s)
- J Ena
- Servicio de Medicina Interna, Hospital SVS de Villajoyosa, Alicante, Spain
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González-Seijo JC, Ramos YM, Lastra I, De Dios JL, Avellanosa I, Carbonell C. [Design of a program to prevent adolescent suicide]. Actas Luso Esp Neurol Psiquiatr Cienc Afines 1994; 22:100-8. [PMID: 7484292] [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: 01/25/2023]
Abstract
In the last decades a notorious increase in suicidal behaviors has been observed in youth. It has become an international health problem which justifies all prevention initiatives that are put forward in some western countries. The authors, given their experience in assessing and treating suicidal youth, design a prevention program addressed to suicidal risk groups, and whose aim is to curb down suicidal rates among adolescents in their Sanitary Area. This program applied in Child and Adolescent Mental Health Center is structured in five levels: Assessing, initial treatment, therapeutical intervention in the medium and long run, other interventions in the community, and evolution.
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González-Seijo JC, Ramos YM, Lastra I, Carbonell C. Lorazepam in treatment of catatonic schizophrenia. Pharmacopsychiatry 1993; 26:132. [PMID: 8234453 DOI: 10.1055/s-2007-1014358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Llibre JM, Tor J, Manterola JM, Carbonell C, Roset J. Risk stratification for dissemination of tuberculosis in HIV-infected patients. Q J Med 1992; 82:149-57. [PMID: 1620815] [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: 12/27/2022]
Abstract
The location of tuberculosis (TB) early in the course of HIV-induced immunosuppression was located, and an attempt was made to determine the correlation between the degree of immune suppression and prognostic variables to stratify the risk for dissemination of TB in HIV-infected patients. Clinical and laboratory characteristics were reviewed in 73 HIV-infected patients with TB admitted between 1984 and 1990. The presence of Mycobacterium tuberculosis was investigated in different clinical samples to verify the diagnostic yield of different sources. TB was extrapulmonary in 46.6 per cent of patients in whom it was their first opportunistic infection, and in 46.7 per cent of patients with previously diagnosed AIDS (p = NS). TB was frequently associated with other opportunistic infections, particularly oesophageal candidiasis (p = 0.006). Patients with localized extrapulmonary or disseminated TB presented more often with cytopenias, hypoalbuminaemia and oral thrush. The existence of extrapulmonary TB or another opportunistic coinfection allowed AIDS to be diagnosed in the same admission in 30 patients and a mean of 8.4 months later in another eight. Extrapulmonary TB was found to be as common in early HIV infection as in patients with established AIDS. Haematological derangements were common in these patients, and cytopenias, hypoalbuminaemia and oral thrush were useful predictors of TB dissemination. The location of TB and its dissemination were not significantly linked to a more advanced CDC stage of HIV infection or a more profound fall in CD4 count.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J M Llibre
- Infectious Diseases Unit, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Spain
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Affiliation(s)
- I Betlloch
- Servei de Medicina Interna, Hospital de La Vila Joiosa, Benidorm, Spain
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Chiner E, Larramendi C, Carbonell C, Calpe JL, Rosado L, Vilar A. [Respiratory distress and multiple organ failure after intravesical instillation of BCG]. An Med Interna 1991; 8:349-51. [PMID: 1932496] [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: 12/29/2022]
Abstract
A case of probable hypersensitivity reaction with multi-organic failure, following bladder installation of BCG, in a male with a diagnosis of bladder carcinoma is presented. The patient developed respiratory, renal and liver failure as well as leukocytosis, thrombopenia and an increase in muscular enzymes. It was resolved with hemodynamic support. The rare complication, occasionally described in medical literature and its probable pathogenic mechanisms are discussed.
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Affiliation(s)
- E Chiner
- Sección de Neumolgía, Hospital de la Vila Joiosa-Benidorm, Alicante
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Carbonell C, Viejo A, Varona C, Vilar A. [Eosinophilia-myalgia syndrome associated with L-tryptophan use. The first reported case in Spain]. Med Clin (Barc) 1991; 96:716. [PMID: 2072782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
In this study we have used a qualitative approach partially based on the Delphi technique to establish the ten priorities for health in the Valencian Community for the next five years. Two rounds of mail surveys were made sending questionnaires to 1834 people including Health Councillors of the Town Halls, nurses and doctors of the three valencian provinces. The overall response rate was 28.3%. The priorities which were perceived as most important by the respondents were the development of primary care, improvements in the management of health services and the development of preventive medicine. The fourth and fifth places of the ranking were: improvements of emergency services and increasing the budget devoted to hospital care. The 6th priority was preventive measures in cardiovascular diseases, the 7th actions against drug abuse, the 8th special attention to childhood and ageing populations and the last two priorities were protection of the environment and infectious diseases prevention. We consider this approach as useful to obtain additional valuable information complementary to the information obtained from traditional statistics or health surveys specially in the areas of management, diseases prevention and actions towards special groups of population.
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Affiliation(s)
- C Carbonell
- Departamento de Salud Comunitaria, Facultad de Medicina, Universidad de Alicante
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