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Araujo-Castro M, Biagetti B, Menedez-Torre E, Novoa-Testa I, Cordido F, Pascual-Corrales E, Rodríguez Berrocal V, Guerrero-Pérez F, Vicente A, Percovich Hualpa JC, Garcia Centeno R, González Fernández L, Ollero García MD, Irigaray Echarri A, Moure Rodríguez MD, Novo-Rodríguez C, Calatayud M, Villar R, Bernabéu I, Alvarez-Escola C, Benítez Valderrama P, Tenorio C, Abellán Galiana P, Venegas E, González-Molero I, Iglesias P, Blanco-Carrera C, Vidal-Ostos De Lara F, de Miguel Novoa P, López Mezquita E, Hanzu FA, Aldecoa I, Aznar S, Lamas C, Aulinas A, Queralt Asla A, Gracia Gimeno P, Recio Córdova JM, Aviles M, Asensio-Wandosel D, Sampedro-Núñez M, Camara R, Paja Fano M, Ruz-Caracuel I, Fajardo C, Marazuela M, Puig-Domingo M. Pegvisomant or pasirotide in PRL and GH co-secreting vs GH-secreting Pit-NETs. Endocr Relat Cancer 2024:ERC-24-0043. [PMID: 38713182 DOI: 10.1530/erc-24-0043] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/07/2024] [Indexed: 05/08/2024]
Abstract
AIM To evaluate the efficacy of second-line therapies in patients with acromegaly caused by a growth hormone (GH) and prolactin (PRL) co-secreting pituitary neuroendocrine tumor (GH/PRL-Pit-NET) and compare to those caused by a GH-Pit-NET. METHODS A multicenter retrospective study of patients with acromegaly on treatment with pasireotide or pegvisomant. Patients were classified in two groups: GH/PRL-Pit-NETs when evidence of hyperprolactinemia and immunohistochemistry (IHC) for GH and PRL was positive or if PRL were >200 ng/dL regardless of the PRL-IHC; and GH-Pit-NETs when the previously mentioned criteria were not met. RESULTS A total of 28 cases with GH/PRL-Pit-NETs and 122 with GH-Pit-NETs met the inclusion criteria. GH/PRL-Pit-NETs presented at a younger age, caused hypopituitarism and were invasive more frequently than GH-Pit-NETs. There were 124 patients treated with pegvisomant and 49 with pasireotide at any time. The efficacy of pegvisomant for IGF-1 normalization was of 81.5% and of pasireotide of 71.4%. No differences in IGF-1 control with pasireotide neither with pegvisomant were observed between GH/PRL-Pit-NETs and GH-Pit-NETs. All GH/PRL-Pit-NET cases treated with pasireotide (n=6) and 82.6% (n=19/23) of the cases treated with pegvisomant normalized PRL levels. No differences in the rate of IGF-1 control between pegvisomant and pasireotide were detected in patients with GH/PRL-Pit-NETs (84.9% vs. 66.7%, P=0.178). CONCLUSION Despite the more aggressive behavior of GH/PRL-Pit-NETs than GH-Pit-NETs, no differences in the rate of IGF-1 control with pegvisomant and pasireotide is observed between both groups, and both drugs are effective treatments to control IGF-1 and PRL hypersecretion in these tumors.
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Affiliation(s)
- Marta Araujo-Castro
- M Araujo-Castro, Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Betina Biagetti
- B Biagetti, Endocrinology and Nutrition Department, Hospital Universitario Vall de Hebrón Barcelona, Barcelona, Spain
| | - Edelmiro Menedez-Torre
- E Menedez-Torre, Endocrinology and Nutrition Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Iría Novoa-Testa
- I Novoa-Testa, Department of Endocrinology and Nutrition, Hospital Universitario de A Coruña, A Coruña, Spain
| | - Fernando Cordido
- F Cordido, Endocrinology and Nutrition, Department of Medicine, School of Health Science, University of A Coruña, A Coruña. Spain., Coruña, Spain
| | | | | | | | - Almudena Vicente
- A Vicente, Endocrinology and Nutrition Department, Hospital Universitario de Toledo, Toledo, Spain
| | - Juan Carlos Percovich Hualpa
- J Percovich Hualpa, Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón Madrid Spain, Madrid, Spain
| | - Rogelio Garcia Centeno
- R Garcia Centeno, Department of Endocrinology, Hospital General Universitario Gregorio Maranon, Madrid, Spain
| | - Laura González Fernández
- L González Fernández, Endocrinology and Nutrition, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Ana Irigaray Echarri
- A Irigaray Echarri, Endocrinology and Nutrition Department, Hospital Universitario Navarra, Pamplona, Spain
| | | | - Cristina Novo-Rodríguez
- C Novo-Rodríguez, Endocrinology and Nutrition Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - María Calatayud
- M Calatayud, Department of Endocrinology and Nutrition, Hospital Universitario Doce de Octubre Madrid Spain, Madrid, Spain
| | - Rocío Villar
- R Villar, Endocrinology and Nutrition Department, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ignacio Bernabéu
- I Bernabéu, Endocrinology and Nutrition Department, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Pamela Benítez Valderrama
- P Benítez Valderrama, Endocrinology and Nutrition Department, Hospital Universitario La Paz, Madrid, Spain
| | - Carmen Tenorio
- C Tenorio, Endocrinology and Nutrition Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pablo Abellán Galiana
- P Abellán Galiana, Endocrinology and Nutrition Department, Hospital Universitario de Castellón, Valencia, Spain
| | - Eva Venegas
- E Venegas, Division of Endocrinology, Virgen del Rocio University Hospital, Sevilla, Spain
| | | | - Pedro Iglesias
- P Iglesias, Endocrinology, Puerta de Hierro University Hospital of Majadahonda, Majadahonda, Spain
| | - Concepción Blanco-Carrera
- C Blanco-Carrera, Service of Endocrinology, Hospital Universitario de Alcalá de Henares, Universidad de Alcalá de Henares, Madrid, Spain
| | - Fernando Vidal-Ostos De Lara
- F Vidal-Ostos De Lara, Endocrinology and Nutrition Department, Hospital Universitario Príncipe de Asturias, Alcala de Henares, Spain
| | - Paz de Miguel Novoa
- P de Miguel Novoa, Department of Endocrinology and Nutrition, Hospital Universitario Clínico San Carlos Madrid Spain, Madrid, Spain
| | - Elena López Mezquita
- E López Mezquita, Endocrinology and Nutrition Department, Hospital Universitario Clínico San Cecilio Granada, Granada, Spain
| | | | - Iban Aldecoa
- I Aldecoa, Pathology Department, FCRB-IDIBAPS-Hospital Clinic Barcelona, Barcelona, Spain
| | - Silvia Aznar
- S Aznar, Endocrinology and Nutrition Department, Hospital Universitario De Albacete, Albacete, Spain
| | - Cristina Lamas
- C Lamas, Department of Endocrinology, Albacete University Hospital Complex, Albacete, Spain
| | - Anna Aulinas
- A Aulinas, Endocrinology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Anna Queralt Asla
- A Queralt Asla, Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Paola Gracia Gimeno
- P Gracia Gimeno, Department of Endocrinology and Nutrition, Hospital Royo Villanova Zaragoza Spain, Zaragoza, Spain
| | - José María Recio Córdova
- J Recio Córdova, Endocrinology and Nutrition Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Mariola Aviles
- M Aviles, Endocrinology and Nutrition Department, Hospital Universitario Clínico San Cecilio Granada, Granada, Spain
| | - Diego Asensio-Wandosel
- D Asensio-Wandosel, Endocrinology and Nutrition Department, Hospital Universitario Germans Trias i Pujol Cataluña, Barcelona, Spain
| | - Miguel Sampedro-Núñez
- M Sampedro-Núñez, Department of Endocrinology, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Rosa Camara
- R Camara, Department of Endocrinology, Hospital Universitari i Politecnic La Fe, Valencia, Spain
| | - Miguel Paja Fano
- M Paja Fano, Department of Endocrinology, Basurto University Hospital, Bilbao, Spain
| | | | - Carmen Fajardo
- C Fajardo, Department of Endocrinology, Hospital de La Ribera, Alzira, Spain
| | - Mónica Marazuela
- M Marazuela, Endocrinology and Nutrition Department, Hospital Universitario La Princesa Madrid, Madrid, Spain
| | - Manel Puig-Domingo
- M Puig-Domingo, Department of Endocrinology and Nutrition, Germans Trias i Pujol Research Institute and University Hospital, Badalona, Spain
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Niddam R, Vidal-Ostos de Lara F, Zurita-Campos J, Blanco-Carrera C, Rubio JA. Development of hypoglycemia in a patient with type 1 diabetes mellitus: A little-known adverse effect of linezolid. ENDOCRINOL DIAB NUTR 2023; 70:654-656. [PMID: 38036324 DOI: 10.1016/j.endien.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Raquel Niddam
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
| | | | | | | | - Jose Antonio Rubio
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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Díez JJ, Anda E, Sastre J, Pérez-Corral B, Álvarez-Escolá C, Manjón L, Paja M, Sambo M, Santiago-Fernández P, Blanco-Carrera C, Galofré JC, Navarro E, Zafón C, Sanz E, Oleaga A, Bandrés O, Donnay S, Megía A, Picallo M, Sánchez-Ragnarsson C, Baena-Nieto G, Fernández-García JC, Lecumberri B, Vega MSDL, Romero-Lluch AR, Iglesias P. Recovery of parathyroid function in patients with thyroid cancer treated by total thyroidectomy: An analysis of 685 patients with hypoparathyroidism at discharge of surgery. ENDOCRINOL DIAB NUTR 2021; 68:398-407. [PMID: 34742473 DOI: 10.1016/j.endien.2021.10.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We aimed to study the predictive factors for recovery of parathyroid function in hypoparathyroid patients after total thyroidectomy for thyroid cancer. METHODS We designed a retrospective, multicentre and nation-wide analysis of patients with total thyroidectomy who were seen in twenty endocrinology departments from January to March 2018. We selected patients with histologically proven thyroid cancer and retrieved information related to surgical procedure and thyroid cancer features. Survival analysis and Cox regression analysis were used to study the relationship between these variables and the recovery of parathyroid function. RESULTS From 685 patients with hypoparathyroidism at discharge of surgery, 495 (72.3%) recovered parathyroid function over time. Kaplan-Meier analysis showed that this recovery was significantly related to the presence of specialized surgical team (P<0.001), identification of parathyroid glands at surgery (P<0.001), papillary histopathology (P=0.040), and higher levels of postoperative calcium (Ca) (P<0.001) and parathyroid hormone (PTH) (P<0.001). Subjects with gross extrathyroidal extension (P=0.040), lymph node metastases (P=0.004), and surgical re-intervention after initial surgery (P=0.024) exhibited a significant risk of persistence of hypoparathyroidism. Multivariate Cox regression analysis showed that the significant and independent factors for recovery of parathyroid function were postoperative concentrations of Ca (P=0.038) and PTH (P=0.049). The presence of lymph node metastases was a negative predictor of recuperation of parathyroid function (P=0.042) in this analysis. CONCLUSION In patients with thyroid cancer, recovery of parathyroid function after total thyroidectomy was directly related to postoperative Ca and PTH concentrations, and inversely related to lymph node metastases.
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Affiliation(s)
- Juan J Díez
- Department of Endocrinology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - Emma Anda
- Department of Endocrinology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Julia Sastre
- Department of Endocrinology, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Begoña Pérez-Corral
- Department of Endocrinology, Complejo Asistencial Universitario de León, León, Spain
| | | | - Laura Manjón
- Department of Endocrinology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Miguel Paja
- Department of Endocrinology, Hospital Universitario de Basurto, Bilbao, Spain
| | - Marcel Sambo
- Department of Endocrinology, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | - Concepción Blanco-Carrera
- Department of Endocrinology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Juan C Galofré
- Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Elena Navarro
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Carles Zafón
- Department of Endocrinology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Eva Sanz
- Department of Endocrinology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Amelia Oleaga
- Department of Endocrinology, Hospital Universitario de Basurto, Bilbao, Spain
| | - Orosia Bandrés
- Department of Endocrinology, Hospital Royo Villanova, Zaragoza, Spain
| | - Sergio Donnay
- Department of Endocrinology, Fundación Hospital de Alcorcón, Alcorcón, Madrid, Spain
| | - Ana Megía
- Department of Endocrinology, Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Ciberdem, Tarragona, Spain
| | - María Picallo
- Department of Endocrinology, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | - Gloria Baena-Nieto
- Department of Endocrinology, Hospital de Jerez, Jerez de la Frontera, Cádiz, Spain
| | | | - Beatriz Lecumberri
- Department of Endocrinology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Ana R Romero-Lluch
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Pedro Iglesias
- Department of Endocrinology, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Araujo-Castro M, Garcia Centeno R, López-García MC, Lamas C, Álvarez-Escolá C, Calatayud Gutiérrez M, Blanco-Carrera C, de Miguel Novoa P, Valdés N, Gracia Gimeno P, Fernández-Ladreda MT, Mínguez Ojeda C, Percovich Hualpa JC, Mora M, Vidal Ó, Serrano Romero A, Hanzu FA, Gómez Dos Santos V. Risk factors for intraoperative complications in pheochromocytomas. Endocr Relat Cancer 2021; 28:695-703. [PMID: 34379605 DOI: 10.1530/erc-21-0230] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 07/31/2021] [Accepted: 08/11/2021] [Indexed: 11/08/2022]
Abstract
We aimed to identify presurgical and surgical risk factors for intraoperative complications in patients with pheochromocytomas. A retrospective study of patients with pheochromocytomas who underwent surgery in ten Spanish hospitals between 2011 and 2021 was performed. One hundred and sixty-two surgeries performed in 159 patients were included. The mean age was 51.6 ± 16.4 years old and 52.8% were women. Median tumour size was 40 mm (range 10-110). Laparoscopic adrenalectomy was performed in 148 patients and open adrenalectomy in 14 patients. Presurgical alpha- and beta-blockade was performed in 95.1% and 51.9% of the surgeries, respectively. 33.3% of the patients (n = 54) had one or more intraoperative complications. The most common complication was the hypertensive crisis in 21.0%, followed by prolonged hypotension in 20.0%, and hemodynamic instability in 10.5%. Patients pre-treated with doxazosin required intraoperative hypotensive treatment more commonly than patients pre-treated with other antihypertensive drugs (51.1% vs 26.5%, P = 0.002). Intraoperative complications were more common in patients with higher levels of urine metanephrine (OR = 1.01 for each 100 μg/24 h, P = 0.026) and normetanephrine (OR = 1.00 for each 100 μg/24 h, P = 0.025), larger tumours (OR = 1.4 for each 10 mm, P < 0.001), presurgical blood pressure > 130/80 mmHg (OR = 2.25, P = 0.027), pre-treated with doxazosin (OR = 2.20, P = 0.023) and who had not received perioperative hydrocortisone (OR = 3.95, P = 0.008). In conclusion, intraoperative complications in pheochromocytoma surgery are common and can be potentially life-threatening. Higher metanephrine and normetanephrine levels, larger tumour size, insufficient blood pressure control before surgery, pre-treatment with doxazosin, and the lack of treatment with perioperative hydrocortisone are associated with higher risk of intraoperative complications.
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Affiliation(s)
- Marta Araujo-Castro
- Neuroendocrinology Unit, Department of Endocrinology and Nutrition, Instituto Ramón y Cajal de Investigación Sanitaria (IRICYS), Hospital Universitario Ramón y Cajal, Madrid, Spain
- Department of Health Science, Universidad de Alcalá, Madrid, Spain
| | - Rogelio Garcia Centeno
- Department of Endocrinology & Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | - Cristina Lamas
- Department of Endocrinology & Nutrition, Hospital Universitario de Albacete, Albacete, Spain
| | | | | | | | - Paz de Miguel Novoa
- Department of Endocrinology & Nutrition, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Nuria Valdés
- Department of Endocrinology & Nutrition, Hospital Universitario de Cabueñes, Asturias, Spain
| | - Paola Gracia Gimeno
- Department of Endocrinology & Nutrition, Hospital Royo Villanova, Zaragoza, Spain
| | | | - César Mínguez Ojeda
- Department of Urology, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Mireia Mora
- Department of Endocrinology & Nutrition, Hospital Clinic, Barcelona, Spain
- Group of Endocrine Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Óscar Vidal
- Department of General Surgery, Hospital Clinic, Barcelona, Spain
| | - Ana Serrano Romero
- Department of Anesthesia, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Felicia Alexandra Hanzu
- Department of Endocrinology & Nutrition, Hospital Clinic, Barcelona, Spain
- Group of Endocrine Disorders, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Álvarez-Escolá C, Venegas-Moreno EM, García-Arnés JA, Blanco-Carrera C, Marazuela-Azpiroz M, Gálvez-Moreno MÁ, Menéndez-Torre E, Aller-Pardo J, Salinas-Vert I, Resmini E, Torres-Vela EM, Gonzalo-Redondo MÁ, Vílchez-Joya R, de Miguel-Novoa MP, Halperín-Rabinovich I, Páramo-Fernández C, de la Cruz-Sugranyes G, Houchard A, Picó-Alfonso AM. ACROSTART: A retrospective study of the time to achieve hormonal control with lanreotide Autogel treatment in Spanish patients with acromegaly. ACTA ACUST UNITED AC 2019; 66:320-329. [PMID: 30773338 DOI: 10.1016/j.endinu.2018.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 07/03/2018] [Revised: 11/28/2018] [Accepted: 12/06/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The ACROSTART study was intended to determine the time to achieve normalization of GH and IGF-I levels in responding patients with acromegaly administered different dosage regimens of lanreotide Autogel (Somatuline® Autogel®). METHODS From March 2013 to October 2013, clinical data from 57 patients from 17 Spanish hospitals with active acromegaly treated with lanreotide for ≥4 months who achieved hormonal control (GH levels <2.5ng/ml and/or normalized IGF-I levels in ≥2 measurements) were analyzed. The primary objective was to determine the time from start of lanreotide treatment to hormonal normalization. RESULTS Median patient age was 64 years, 21 patients were male, 39 patients had undergone surgery, and 14 patients had received radiotherapy. Median hormonal values at start of lanreotide treatment were: GH, 2.6ng/ml; IGF-I, 1.6×ULN. The most common starting dose of lanreotide was 120mg (29 patients). The main initial regimens were 60mg/4 weeks (n=13), 90mg/4 weeks (n=6), 120mg/4 weeks (n=13), 120mg/6 weeks (n=6), and 120mg/8 weeks (n=9). An initial treatment regimen with a long interval (≥6 weeks) was administered in 25 patients. Mean duration of lanreotide treatment was 68 months (7-205). Median time to achieve hormonal control was 4.9 months. Injections were managed without healthcare assistance in 13 patients. Median number of visits to endocrinologists until hormonal control was achieved was 3. Fifty-one patients were "satisfied"/"very satisfied" with treatment and 49 patients did not miss any dose. CONCLUSIONS Real-life treatment with lanreotide Autogel resulted in early hormonal control in responding patients, with high treatment adherence and satisfaction despite disparity in starting doses and dosing intervals.
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Affiliation(s)
| | | | | | - Concepción Blanco-Carrera
- Endocrinology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Mónica Marazuela-Azpiroz
- Endocrinology Department, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Instituto Princesa, Madrid, Spain
| | | | - Edelmiro Menéndez-Torre
- Endocrinology and Nutrition Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Javier Aller-Pardo
- Endocrinology Department, Neuroendocrinology & Endocrine Oncology Unit, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Isabel Salinas-Vert
- Endocrinology and Nutrition Department, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Eugenia Resmini
- Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747), IIB-Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Ricardo Vílchez-Joya
- Endocrinology and Nutrition Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - María Paz de Miguel-Novoa
- Endocrinology Department, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | | | - Aude Houchard
- Statistics Department, IPSEN PHARMA, Boulogne-Billancourt, France
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Sampedro-Núñez M, Serrano-Somavilla A, Adrados M, Cameselle-Teijeiro JM, Blanco-Carrera C, Cabezas-Agricola JM, Martínez-Hernández R, Martín-Pérez E, Muñoz de Nova JL, Díaz JÁ, García-Centeno R, Caneiro-Gómez J, Abdulkader I, González-Amaro R, Marazuela M. Analysis of expression of the PD-1/PD-L1 immune checkpoint system and its prognostic impact in gastroenteropancreatic neuroendocrine tumors. Sci Rep 2018; 8:17812. [PMID: 30546030 PMCID: PMC6292913 DOI: 10.1038/s41598-018-36129-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 09/07/2018] [Accepted: 11/15/2018] [Indexed: 12/17/2022] Open
Abstract
The immune checkpoint based therapy targeting the programmed death-1 (PD-1) receptor and its PD-L1 ligand has recently been approved for the therapy of different malignant conditions, but not yet for gastroenteropancreatic neuroendocrine tumors (GEP-NETs). In this context, we evaluated the expression of PD-1 and PD-L1 in GEP-NETs and its potential correlations with clinical outcomes. Expression of PD-1/PD-L1 was analyzed by immunohistochemistry in 116 GEP-NETs and 48 samples of peritumoral tissue. In addition, the expression of these molecules was assessed by flow cytometry in peripheral blood mononuclear cells (PBMC) from patients with GEP-NETs (n = 32) and healthy controls (n = 32) and in intratumoral mononuclear cells (TMCs) (n = 3). Expression of PD-L1 and PD-1 was detected by immunohistochemistry in 6% and 1% of tumor tissue samples, respectively, and in 8% of peritumoral tissue samples, for both markers. We also observed that PD-1 expression by TMCs was associated with metastatic disease at diagnosis, and the levels of circulating PD-1+ PBMCs were associated with progressive disease upon follow-ups. In addition, circulating PD-1+ PBMCs were significantly correlated with PD-L1 expression by tumor cells. Our data suggest that PD-1/PD-L1 is expressed in 1 to 8% of GEP-NETs, and that this feature is significantly associated with disease evolution (p < 0.01).
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Affiliation(s)
- Miguel Sampedro-Núñez
- Services of Endocrinology, Immunology and Molecular Biology Unit, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Instituto Princesa, 28006, Madrid, Spain
| | - Ana Serrano-Somavilla
- Services of Endocrinology, Immunology and Molecular Biology Unit, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Instituto Princesa, 28006, Madrid, Spain
| | - Magdalena Adrados
- Service of Pathology, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, 28006, Madrid, Spain
| | - José M Cameselle-Teijeiro
- Service of Pathology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Santiago de Compostela, 15706, Spain
| | - Concepción Blanco-Carrera
- Service of Endocrinology, Hospital Universitario de Alcalá de Henares, Universidad de Alcalá de Henares, 28805, Madrid, Spain
| | - José Manuel Cabezas-Agricola
- Service of Endocrinology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Santiago de Compostela, 15706, Spain
| | - Rebeca Martínez-Hernández
- Services of Endocrinology, Immunology and Molecular Biology Unit, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Instituto Princesa, 28006, Madrid, Spain
| | - Elena Martín-Pérez
- Service of Surgery, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Instituto Princesa, 28006, Madrid, Spain
| | - José Luis Muñoz de Nova
- Service of Surgery, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Instituto Princesa, 28006, Madrid, Spain
| | - José Ángel Díaz
- Service of Endocrinology, Hospital Clinico San Carlos, Universidad Complutense de Madrid, Madrid, 28040, Spain
| | | | - Javier Caneiro-Gómez
- Service of Pathology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Santiago de Compostela, 15706, Spain
| | - Ihab Abdulkader
- Service of Pathology, Hospital Clinico Universitario, Universidad de Santiago de Compostela, Santiago de Compostela, 15706, Spain
| | - Roberto González-Amaro
- Department of Immunology, School of Medicine, Universidad Autónoma de San Luis Potosí, 78210 S.L.P., San Luis, Mexico.,Research Center of Health Sciences and Biomedicine, Universidad Autónoma de San Luis Potosí, 78210 S.L.P., San Luis, Mexico
| | - Mónica Marazuela
- Services of Endocrinology, Immunology and Molecular Biology Unit, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Instituto Princesa, 28006, Madrid, Spain.
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