1
|
Narvaez D, Nadal J, Nervo A, Costanzo V, Paletta C, Petracci F, Rivero S, Ostinelli A, Coló F, Martín L, Fabiano V, Sabatini L, Perazzolo A, Amat M, Chacon M, Waisberg F. The role of modern parameters and their relationship with recurrence risk as assessed by Oncotype DX: real-world evidence. Ecancermedicalscience 2024; 18:1664. [PMID: 38439804 PMCID: PMC10911664 DOI: 10.3332/ecancer.2024.1664] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Indexed: 03/06/2024] Open
Abstract
Genomic analysis through various platforms is an essential tool for determining prognosis and treatment in a significant subgroup of early-stage breast cancer patients with hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative status. Additionally, combined clinical and pathological characteristics can accurately predict the recurrence score (RS), as demonstrated by the University of Tennessee risk nomogram. In this study, we aimed to identify classical clinical-pathological factors associated with high RS in a local population, including modern parameters such as current abemaciclib treatment recommendations, HER2-low status, different Ki-67 cutoff values, and samples obtained from secondary primary tumours. This is a retrospective single-institution study that analysed a total of 215 tumour samples. Among lymph node-negative patients (n = 179), age, Ki67 values, and progesterone receptor status predicted RS after multivariate analysis. HER2-low status was not associated with RS differences (p = 0.41). Among lymph node-positive patients (n = 36), MonarchE inclusion criteria (15) were not associated with a higher RS (p = 0.61), and HER2-low did not reach statistical significance. However, tumours classified as secondary primaries numerically exhibited a higher RS. Based on these findings from our real-world sample, the mere application of clinical and pathological parameters is insufficient to predict RS outcomes. Modern parameters such as HER2-low status or adjuvant abemaciclib recommendations were not associated with RS differences. Regarding the observation of secondary tumours, more evidence is needed to understand whether prior hormone therapy exposure impacts the biological risk of secondary primary tumours.
Collapse
Affiliation(s)
- Dana Narvaez
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | - Jorge Nadal
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | - Adrian Nervo
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | | | | | | | - Sergio Rivero
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | | | - Federico Coló
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | - Loza Martín
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | | | | | - Azul Perazzolo
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | - Mora Amat
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | - Matias Chacon
- Alexander Fleming Institute, Buenos Aires 1425, Argentina
| | | |
Collapse
|
2
|
Narvaez D, Nadal J, Nervo A, Costanzo MV, Paletta C, Petracci FE, Rivero S, Ostinelli A, Freile B, Enrico D, Pombo MT, Amat M, Aguirre ED, Chacon M, Waisberg F. The Emerging Role of Tertiary Lymphoid Structures in Breast Cancer: A Narrative Review. Cancers (Basel) 2024; 16:396. [PMID: 38254885 PMCID: PMC10814091 DOI: 10.3390/cancers16020396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 01/24/2024] Open
Abstract
This narrative review aims to clarify the role of tertiary lymphoid structures in breast cancer. We examine their development, composition, and prognostic value, and current ways of recognizing them. A comprehensive literature review was performed using the PubMed/Medline, Scopus, and EMBASE databases. A significant area of interest in breast cancer research involves targeting immune checkpoint molecules, particularly in the triple-negative subtype, where treatment options remain limited. However, existing biomarkers have limitations in accurately predicting treatment response. In this context, tertiary lymphoid structures (TLSs) emerge as a prognostic biomarker and also as a promising predictive marker for response. TLSs are ectopic lymphoid formations or neo-organogenesis that can develop after prolonged exposure to inflammatory signals mediated by chemokines and cytokines. Their presence is inversely correlated with estrogen receptor (ER) and/or progesterone receptor (PR) expression, but positively associated with a higher pathologic complete response rate and improved overall survival. In certain scenarios, TLS-positive tumors were associated with improved outcomes regardless of the presence of PDL-1 (programmed cell death ligand 1) expression or TILs (tumor-infiltrating lymphocytes).
Collapse
Affiliation(s)
- Dana Narvaez
- Breast Cancer Division, Alexander Fleming Institute, Buenos Aires 1425, Argentina; (J.N.); (A.N.); (M.V.C.); (C.P.); (F.E.P.); (S.R.); (A.O.); (B.F.); (D.E.); (M.T.P.); (M.A.); (E.D.A.); (M.C.); (F.W.)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Donna MLG, León MLC, Colas CG, Gunsett AP, Maniero SF, Osuna DO, Klimovsky E, Coradini L, Enrico D, Chacón M, Waisberg F. Breaking the unvirtuous cycle: barriers and opportunities for research and development in Paraguay. A case study. Front Med (Lausanne) 2023; 10:1266246. [PMID: 38034550 PMCID: PMC10687402 DOI: 10.3389/fmed.2023.1266246] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/24/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Medical research and development (R&D) is an undoubtedly relevant activity to drive innovation, improve healthcare policies and bring patients treatment opportunities for common and rare diseases. Equity and inclusion are matters of concern in research. High-income countries' research teams are more likely to have more impactful publications, grant funding, and clinical trials than middle or low-income countries. Low budget allocations to R&D and existing gaps in regulatory frameworks are some obstacles to growth. This unvirtuous cycle results in scarce advances in common endemic diseases and the underrepresentation of specific populations in innovative therapeutics research. Materials and methods We conducted a policy review and qualitative research to determine the principal characteristics of basic and clinical medical research in Paraguay, as well as barriers and facilitators to improve innovative R&D strategies in this country. To this aim, we examined published articles from 2005 to 2020, the organizational structure of national research agencies, the current regulation framework, and the composition and experience of local research groups and ethical review boards (ERBs). In addition, we performed semi-structured interviews to evaluate perceptions and expectations from different stakeholders, including investigators, ERBs members, sponsor associates, and Regulatory Agency executive staff. Results In 2018, Paraguay ranked 10th out of 12 South American countries in total number of publications and cumulative h-index score. Total Gross Domestic Product (GDP) allocation for R&D was 0.15%, ranking eighth out of 12 in the region. In 2021, the number of trials registered on ClinicalTrials.gov was 52, with only 16 ongoing recruiting studies at that time.Some of the main barriers identified included low incentives for academic careers and lack of experience in pharmaceutical research. An emergent necessity to develop a straight- forward normative framework was detected. Main facilitators included the development of two research initiative programs (PRONII and PROCIENCIA) from CONACYT (National Council of Science and Technology) which were associated with higher budget allocation and total number of publications in the 2011 to 2017 period. A total of six stakeholders participated in the semi-structured surveys. Interviewees highlighted the necessity of a centralized policy to promote R&D, which incorporates investigators and ERBs training, the development of standardized procedures, and the dissemination of research activities. Sponsor associates underlined that real-world evidence may represent a distinctive opportunity to enhance local research. Conclusion Coordinated efforts are needed to break the unvirtuous cycle. There is an increasing interest in enhancing health research in Paraguay, materialized in the creation of specific programs that encourage the collaborative work of healthcare providers, basic scientists, and private investors. Nonetheless, a comprehensive approach is needed also to strengthen regulatory agencies and attract external sponsorship. While modern and currently popular topics, including artificial intelligence, real-world data, and translational research may represent key opportunities to seek investment, special policies should be adopted to prioritize research on the determinants of health in the Paraguayan population.
Collapse
Affiliation(s)
- María Lucila Gonzalez Donna
- Clinical Oncology Unit, Instituto Nacional del Cáncer (INCAN), Ministerio de Salud Pública y Bienestar Social (MSPyBS), Capiatá, Paraguay
| | - María Luisa Cabañas León
- Pathology Unit, Instituto Nacional del Cáncer (INCAN), Ministerio de Salud Pública y Bienestar Social (MSPyBS), Asuncion, Paraguay
| | - Cinthia Gauna Colas
- Clinical Oncology Unit, Instituto Nacional del Cáncer (INCAN), Ministerio de Salud Pública y Bienestar Social (MSPyBS), Capiatá, Paraguay
| | - Alicia Pomata Gunsett
- Pathology Unit, Instituto Nacional del Cáncer (INCAN), Ministerio de Salud Pública y Bienestar Social (MSPyBS), Asuncion, Paraguay
| | - Silvia Ferreira Maniero
- Laboratory Unit, Instituto Nacional del Cáncer (INCAN), Ministerio de Salud Pública y Bienestar Social (MSPyBS), Asuncion, Paraguay
| | - David Olivares Osuna
- Lab Manager at Cancer Heterogeneity and Hierarchies Group., Instituto Josep Carreras (IJC), Badalona, Spain
| | | | - Lucas Coradini
- Family Medicine Resident, Hospital Argerich, Buenos Aires, Argentina
| | - Diego Enrico
- Clinical Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
- Research Department, Equipo Transdisciplinario de Investigación en Cáncer, Buenos Aires, Argentina
| | - Matías Chacón
- Clinical Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
- Research Department, Equipo Transdisciplinario de Investigación en Cáncer, Buenos Aires, Argentina
| | - Federico Waisberg
- Clinical Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
- Research Department, Equipo Transdisciplinario de Investigación en Cáncer, Buenos Aires, Argentina
| |
Collapse
|
4
|
Tissera NS, Esteso F, Luca R, Enrico D, Waisberg F, Rodriguez A, Bruno L, Kucharczyk M, Amat M, García X, Pombo T, Salazar IP, Loria FS, Huertas E, Galli M, Chacón M, O’Connor JM. Atypical pattern of response in rectal cancer after neoadjuvant pembrolizumab treatment: a case report, literature review, and proposed management model. J Gastrointest Oncol 2023; 14:1635-1642. [PMID: 37435212 PMCID: PMC10331748 DOI: 10.21037/jgo-22-1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/17/2023] [Indexed: 07/13/2023] Open
Abstract
Background Immunotherapy is the first-line treatment in patients with advanced microsatellite instability-high (MSI-H) or deficient mismatch repair (dMMR) colorectal cancer (CRC). Although immune checkpoint inhibitors (ICIs) for locally advanced rectal cancer (LARC) are not yet a standard, the results are very encouraging and raise the question of whether patients with clinical complete response (cCR) could receive nonoperative management (NOM). However, different patterns of response have challenged management strategies. Case Description A 34-year-old woman diagnosed with dMMR LARC started treatment with capecitabine 2,000 mg/m2 on day 1 to 14 and oxaliplatin 130 mg/m2 on day 1 and every 21 days. Magnetic resonance imaging (MRI), performed three cycles later, showed local progression of the primary rectal lesion, which at that time had new peritoneal reflex involvement. A new hepatic lesion in segment V was observed. Due to disease progression, she was administered pembrolizumab 200 mg every 21 days. After three cycles, a discordant radiological response was observed on a new MRI scan that showed a complete response of the liver lesion and magnetic resonance tumor regression grade (mrTRG) 1 in the rectum. However, new involvement of the mesentery and enlargement of the regional lymph nodes (LNs) were also evident. A new colonoscopic biopsy was performed, showing no cancerous cells. She underwent surgery on the rectum and liver lesion. Pathology showed a complete response of the rectal wall and liver lesion, but 1 of 22 LNs was positive for adenocarcinoma (ypT0 N1 M0). The patient continued on pembrolizumab, and 14 months after surgery, she had not relapsed. Conclusions Neoadjuvant immunotherapy for rectal cancer requires new recommendations for the assessment of clinical response. Pseudoprogression should be ruled out as an atypical response before deciding on surgical treatment. We propose an algorithm to address pseudoprogression in this setting.
Collapse
Affiliation(s)
- Natalia S. Tissera
- Upper Gastrointestinal Cancer Translational Research Group, Vall’d Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Federico Esteso
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Romina Luca
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Diego Enrico
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
- Research Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Federico Waisberg
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
- Research Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Andrés Rodriguez
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
- Research Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Luisina Bruno
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Mariana Kucharczyk
- Department of Radiology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Mora Amat
- Department of Pathology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Ximena García
- Department of Pathology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Teresa Pombo
- Department of Pathology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | | | | | - Eduardo Huertas
- Department of Surgery, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Mariana Galli
- Department of Radiotherapy, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Matías Chacón
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
- Research Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Juan Manuel O’Connor
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| |
Collapse
|
5
|
Tissera NS, Freile B, Waisberg F, Esteso F, Galli M, Loria FS, Luca R, Pedraza II, Enrico DH, Chacón C, Huertas E, Chacón MR, O’Connor JM. Short-course radiotherapy for rectal cancer: real-world evidence in Argentina. Ecancermedicalscience 2023; 17:1555. [PMID: 37396101 PMCID: PMC10310334 DOI: 10.3332/ecancer.2023.1555] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Indexed: 07/04/2023] Open
Abstract
Background Short-course radiotherapy (SCRT) of 25 Gy in five daily fractions is a recommended strategy in the neoadjuvant setting for resectable locally advanced rectal cancer (LARC), as well as in cases of metastatic disease for local control. There is scarce information regarding the use of SCRT for patients who have received nonoperative management. Objectives To describe the characteristics of patients who received treatment with SCRT for LARC and metastatic rectal cancer, toxicity, and the approach after radiation treatment. Methods This is a retrospective analysis of all patients who underwent SCRT for rectal cancer at the Alexander Fleming Institute from March 2014 to June 2022. Results In total, 44 patients were treated with SCRT. The majority were male (29, 66%), with a median age of 59 years (interquartile range 46-73). Most patients had stage IV disease (26, 59.1%), followed by LARC (18, 40.9%). Most lesions were located in the middle rectum (30, 68%). The majority of LARC patients underwent SCRT followed by consolidation chemotherapy (ChT) (16/18, 89%), while most patients with metastatic disease underwent SCRT followed by consolidation ChT (14/26, 53.8%). A clinical complete response (cCR) was documented in 8/44, 18.2% of patients. Most patients with LARC and cCR were managed by a watch and wait approach (5/18, 27.7%). Local recurrence was observed in LARC cases (2/18, 11.1%). Patients who underwent SCRT following consolidation ChT were more likely to have adverse events (AEs) than those undergoing induction ChT following SCRT (11/30, 36.7% versus 3/12, 25%, p = 0.02). Conclusion In a subgroup of patients diagnosed with LARC and treated with SCRT followed by ChT, surgical treatment could be omitted after they achieved a cCR. Local recurrence was similar to that reported in a previous study. SCRT is a reasonable option for local disease control in stage IV disease, yielding low toxicity rates. Therefore, decisions must be made by a multidisciplinary team. Prospective studies are necessary to reach further conclusions.
Collapse
Affiliation(s)
- Natalia S Tissera
- Upper Gastrointestinal Cancer Translational Research Group, Vall´d Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
- https://orcid.org/0000-0002-3396-6878
| | - Berenice Freile
- Department of Oncology, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0003-3192-126X
| | - Federico Waisberg
- Department of Oncology, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0003-4435-5068
| | - Federico Esteso
- Department of Oncology, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0003-1977-9846
| | - Mariana Galli
- Department of Radiotherapy, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0003-0147-2192
| | - Fernando Sanchez Loria
- Department of Surgery, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0001-9708-0649
| | - Romina Luca
- Department of Oncology, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0001-8564-905X
| | - Ivana Inés Pedraza
- Department of Surgery, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0001-9679-8368
| | - Diego Hernán Enrico
- Department of Oncology, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0003-4121-6855
| | - Carolina Chacón
- Department of Radiotherapy, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0009-0004-8556-6325
| | - Eduardo Huertas
- Department of Surgery, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0003-3473-0928
| | - Matías Rodrigo Chacón
- Department of Oncology, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0001-6872-4185
| | - Juan Manuel O’Connor
- Department of Oncology, Alexander Fleming Institute, CABA C1426, Argentina
- https://orcid.org/0000-0002-6975-5466
| |
Collapse
|
6
|
Freile B, Enrico D, Tsou F, Waisberg F, Rodriguez A, Pombo T, Mendoza A, Salanova R, Chacon M, Pupareli CS, Martin C. PP.05 Access to Genomic Testing and Targeted Therapy in Advanced Non-Small Cell Lung Cancer (NSCLC): A Single-Institution Study. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2023.01.033] [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: 02/26/2023]
|
7
|
Mandó P, Waisberg F, Pasquinelli R, Rivero S, Ostinelli A, Perazzo F. HER2-Directed Therapy in Advanced Breast Cancer: Benefits and Risks. Onco Targets Ther 2023; 16:115-132. [PMID: 36844609 PMCID: PMC9948634 DOI: 10.2147/ott.s335934] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/20/2023] [Indexed: 02/20/2023] Open
Abstract
Around 20% of breast cancers are associated with amplification or overexpression of human epidermal growth factor receptor 2 (HER2). In this setting, anti-HER2-targeted agents are the cornerstone of cancer therapeutic strategies. This includes monoclonal antibodies, tyrosine kinase inhibitors (TKIs) and, recently, antibody-drug conjugates (ADCs). With the advent of these new alternatives, the decision-making process has become more complex, especially with regard to the treatment sequence possibilities. In spite of the fact that overall survival has significantly improved accordingly, resistance to treatment remains a challenge in HER2-positive breast cancer. The introduction of new agents has created awareness regarding new potential specific adverse events, and consequently, their increasing application pose major challenges in daily patient care. This review describes the therapeutic landscape for HER2-positive advanced breast cancer (ABC) and evaluates its benefits and risks in the clinical setting.
Collapse
Affiliation(s)
- Pablo Mandó
- Clinical Oncology Department, Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno” (CEMIC), Ciudad Autónoma de Buenos Aires, Argentina,Correspondence: Pablo Mandó, Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno” (CEMIC), Galvan 4102, Ciudad Autónoma de Buenos Aires, 1431, Argentina, Tel +54 11 61204997, Email
| | - Federico Waisberg
- Clinical Oncology Department, Instituto Alexander Fleming, Ciudad Autónoma de Buenos Aires, Argentina
| | - Rosario Pasquinelli
- Clinical Oncology Department, Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno” (CEMIC), Ciudad Autónoma de Buenos Aires, Argentina
| | - Sergio Rivero
- Clinical Oncology Department, Instituto Alexander Fleming, Ciudad Autónoma de Buenos Aires, Argentina
| | - Alexis Ostinelli
- Clinical Oncology Department, Instituto Alexander Fleming, Ciudad Autónoma de Buenos Aires, Argentina
| | - Florencia Perazzo
- Clinical Oncology Department, Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno” (CEMIC), Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
8
|
Blay JY, Hindi N, Bollard J, Aguiar S, Angel M, Araya B, Badilla R, Bernabeu D, Campos F, Caro-Sánchez CHS, Carvajal B, Carvajal Montoya A, Casavilca-Zambrano S, Castro-Oliden V, Chacón M, Clara M, Collini P, Correa Genoroso R, Costa FD, Cuellar M, Dei Tos AP, Dominguez Malagon HR, Donati D, Dufresne A, Eriksson M, Farias-Loza M, Fernandez P, Frezza AM, Frisoni T, Garcia-Ortega DY, Gelderblom H, Gouin F, Gómez-Mateo MC, Gronchi A, Haro J, Huanca L, Jimenez N, Karanian M, Kasper B, Lopes David BB, Lopez-Pousa A, Lutter G, Martinez-Said H, Martinez-Tlahuel J, Mello CA, Morales Pérez JM, Moura David S, Nascimento AG, Ortiz-Cruz EJ, Palmerini E, Patel S, Pfluger Y, Provenzano S, Righi A, Rodriguez A, Salas R, Santos TTG, Scotlandi K, Soule T, Stacchiotti S, Valverde C, Waisberg F, Zamora Estrada E, Martin-Broto J. Corrigendum to "SELNET clinical practice guidelines for soft tissue sarcoma and GIST" [Cancer Treat. Rev. 102 (2021) 102312]. Cancer Treat Rev 2023; 115:102523. [PMID: 36796283 DOI: 10.1016/j.ctrv.2023.102523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- J Y Blay
- Léon Bérard Center, 28 rue Laennec, 69373 Lyon Cedex 08, France.
| | - N Hindi
- Research Health Institute Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; Hospital Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain; General de Villalba University Hospital, 28400 Madrid, Spain; General de Villalba University Hospital, 28400 Madrid, Spain
| | - J Bollard
- Léon Bérard Center, 28 rue Laennec, 69373 Lyon Cedex 08, France
| | - S Aguiar
- A.C. Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo, SP 01509-010, Brazil
| | - M Angel
- Instituto Alexander Fleming, Av. Cramer 1180, CP C1426ANZ, Buenos Aires, Argentina
| | - B Araya
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - R Badilla
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - D Bernabeu
- Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - F Campos
- A.C. Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo, SP 01509-010, Brazil
| | - C H S Caro-Sánchez
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso, Av. San Fernando 86, Colonia Niño Jesus, CP 14080 Tlalpan, Mexico
| | - B Carvajal
- Fundación GIST México, Altadena 59, Nápoles, Benito Juárez, 03810 Ciudad de Mexico, CDMX, Mexico
| | - A Carvajal Montoya
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - S Casavilca-Zambrano
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | - V Castro-Oliden
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | - M Chacón
- Instituto Alexander Fleming, Av. Cramer 1180, CP C1426ANZ, Buenos Aires, Argentina
| | - M Clara
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso, Av. San Fernando 86, Colonia Niño Jesus, CP 14080 Tlalpan, Mexico
| | - P Collini
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - R Correa Genoroso
- Hospital Clínico Universitario Virgen de la Victoria, Campus Universitario de Teatinos s/n, 29010 Malaga, Spain
| | - F D Costa
- A.C. Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo, SP 01509-010, Brazil
| | - M Cuellar
- Fundación GIST México, Altadena 59, Nápoles, Benito Juárez, 03810 Ciudad de Mexico, CDMX, Mexico
| | - A P Dei Tos
- Treviso General Hospital Treviso, University of Padua, Padova, Italy
| | - H R Dominguez Malagon
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso, Av. San Fernando 86, Colonia Niño Jesus, CP 14080 Tlalpan, Mexico
| | - D Donati
- IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136 Bologna, Italy
| | - A Dufresne
- Léon Bérard Center, 28 rue Laennec, 69373 Lyon Cedex 08, France
| | - M Eriksson
- Skane University Hospital and Lund University, Lund, Sweden
| | - M Farias-Loza
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | | | - A M Frezza
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - T Frisoni
- IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136 Bologna, Italy
| | - D Y Garcia-Ortega
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso, Av. San Fernando 86, Colonia Niño Jesus, CP 14080 Tlalpan, Mexico
| | - H Gelderblom
- Leiden University Medical Center, Leiden, the Netherlands
| | - F Gouin
- Léon Bérard Center, 28 rue Laennec, 69373 Lyon Cedex 08, France
| | - M C Gómez-Mateo
- Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - A Gronchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - J Haro
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | - L Huanca
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | - N Jimenez
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - M Karanian
- Léon Bérard Center, 28 rue Laennec, 69373 Lyon Cedex 08, France
| | - B Kasper
- University of Heidelberg, Mannheim Cancer Center, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - B B Lopes David
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - A Lopez-Pousa
- Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041 Barcelona, Spain
| | - G Lutter
- Instituto Alexander Fleming, Av. Cramer 1180, CP C1426ANZ, Buenos Aires, Argentina
| | - H Martinez-Said
- Centro Oncologico Integral, Hospital Medica Sur, Planta Baja Torre III - Cons, 305, Col. Toriello Guerra, Deleg. Tlalpan, C.P. 14050 Mexico, D.F, Mexico
| | - J Martinez-Tlahuel
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso, Av. San Fernando 86, Colonia Niño Jesus, CP 14080 Tlalpan, Mexico
| | - C A Mello
- A.C. Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo, SP 01509-010, Brazil
| | - J M Morales Pérez
- Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain
| | - S Moura David
- Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain
| | - A G Nascimento
- A.C. Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo, SP 01509-010, Brazil
| | - E J Ortiz-Cruz
- Hospital Universitario La Paz, MD Anderson Cancer Center, Calle de Arturo Soria, 270, 28033 Madrid, Spain
| | - E Palmerini
- IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136 Bologna, Italy
| | - S Patel
- UT MD Anderson Cancer Center, Houston, TX, USA
| | - Y Pfluger
- Instituto Alexander Fleming, Av. Cramer 1180, CP C1426ANZ, Buenos Aires, Argentina
| | - S Provenzano
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - A Righi
- IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136 Bologna, Italy
| | - A Rodriguez
- Instituto Alexander Fleming, Av. Cramer 1180, CP C1426ANZ, Buenos Aires, Argentina
| | - R Salas
- Fundación GIST México, Altadena 59, Nápoles, Benito Juárez, 03810 Ciudad de Mexico, CDMX, Mexico
| | - T T G Santos
- A.C. Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo, SP 01509-010, Brazil
| | - K Scotlandi
- IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136 Bologna, Italy
| | - T Soule
- Instituto Alexander Fleming, Av. Cramer 1180, CP C1426ANZ, Buenos Aires, Argentina
| | - S Stacchiotti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - C Valverde
- Vall d́Hebrón University Hospital, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - F Waisberg
- Instituto Alexander Fleming, Av. Cramer 1180, CP C1426ANZ, Buenos Aires, Argentina
| | - E Zamora Estrada
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - J Martin-Broto
- Research Health Institute Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; Hospital Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain; General de Villalba University Hospital, 28400 Madrid, Spain; General de Villalba University Hospital, 28400 Madrid, Spain
| |
Collapse
|
9
|
Tissera NS, Freile B, Luca R, Pedraza II, Esteso F, Enrico DH, Waisberg F, Galli M, Chacon C, Sanchez Loria F, Huertas E, Chacon MR, O'Connor JM. Short-course radiotherapy in rectal cancer: A single-center experience in Argentina. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.146] [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: 01/26/2023] Open
Abstract
146 Background: Short-course radiotherapy (SCRT) is an option in the neoadjuvant setting of resectable stage II-III rectal cancer, as well as in stage IV disease for local control without delay to initiate systemic treatment. Short-course radiotherapy is reported to be a comparable strategy for locally advanced rectal cancer. Limited data exist regarding the use of short-course radiation therapy when used as part of a non-surgical watch and wait approach. Methods: This is a retrospective analysis of all patients that underwent SCRT for rectal cancer at the Alexander Fleming Institute from 3/2014 to 6/2022. Results: 44 patients were treated with SCRT, 29 (66%) were male, with a median age of 59 years (46-73). Most of the patients had stage IV disease (26, 59,1%) followed by clinical stage II-III (18, 40,9%). 30 (68%) were localized in the middle with 14 (32%) in the lower rectum, by MRI imaging. In locally advanced disease 5/18 had T4 disease and 7/18 had N≥2. 14/18 patients (89%) underwent SCRT followed by consolidation chemotherapy (ChT) and 4 (11%) had induction ChT followed by SCRT. In metastatic disease 14/26 patients (53.84%) underwent SCRT followed by consolidation ChT, 10 (38.46%) had induction ChT followed by SCRT, and 2 (7.7%) received only SCRT. 29 (65.9%) of patients underwent surgery. 17/29(58.6%) had metastatic disease and 12/29 (41.4%) had locally advanced disease. Pathological response rates in operated patients were 2 (6.9%). 8 (18.2%) cases had a clinical complete response (cCR) (n=6 stage II-III and n=2 stage IV). Five (27.7% of the locally advanced group) patients with cCR underwent watch and wait with 1 local recurrence after 14 months. The remainder is disease free with a median follow-up time of 20 months (IC 95%: 15.14-24.85). Those that underwent SCRT following chemotherapy were more likely to have AEs compared to those that had chemotherapy following SCRT (11/30, 36.7% vs 25%, p=0.02). Conclusions: Our work shows that in a subgroup of patients diagnosed with LARC treated with SCRT followed by Chemotherapy, surgical treatment could be deferred after achieving a complete clinical response. The shorter time involved by SCRT allowed for less treatments with similar toxicity to long-course treatment regimens. SCRT is a reasonable option for local disease control in stage IV disease.
Collapse
Affiliation(s)
| | | | - Romina Luca
- Alexander Fleming Institute, Capital Federal, Argentina
| | | | - Federico Esteso
- Alexander Fleming Institute, Ciudad Autónoma De Buenos Aires, Argentina
| | | | - Federico Waisberg
- Alexander Fleming Institute, Ciudad Autónoma De Buenos Aires, Argentina
| | - Mariana Galli
- Instituto Alexander Fleming, Capital Federal, Argentina
| | - Carolina Chacon
- Alexander Fleming Institute, Ciudad Autónoma De Buenos Aires, Argentina
| | | | - Eduardo Huertas
- Alexander Fleming Institute, Ciudad Autónoma De Buenos Aires, Argentina
| | | | - Juan Manuel O'Connor
- Alexander Fleming Institute, Ciudad Autónoma De Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
10
|
Catani G, Waisberg F, Enrico D, Rodriguez A, Pflüger Y, Galluzzo ML, Centeno MDV, Colmenero I, Amat M, Paganini L, García Herrmann AF, Chacón M. Generalized Lymphatic Anomaly as a Differential Diagnosis of Lytic Lesions. Case Rep Oncol 2023; 16:597-603. [PMID: 37900803 PMCID: PMC10601723 DOI: 10.1159/000530897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/11/2023] [Indexed: 10/31/2023] Open
Abstract
Generalized lymphatic anomaly (GLA) is an infrequent multiorgan disease characterized by the presence of abnormal proliferation of lymphatic vessels. The diagnosis requires histological confirmation, and the treatment is controversial. We are presenting a case of a 28-year-old male patient who was diagnosed with an extragonadal mediastinal nonseminomatous germ cell tumor. He underwent chemotherapy, and during this treatment, radiologic findings evidenced lytic lesions. Multiple biopsies were performed, which revealed the presence of abnormal lymphatic vessels, characteristic of GLA. There are different etiologies of osteolytic lesions, and on some occasions, they mimic a tumoral entity. The clinical suspicion of GLA is the first step in approaching the diagnosis, particularly in young adult patients.
Collapse
Affiliation(s)
- Greta Catani
- Departament of Oncology, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Federico Waisberg
- Departament of Oncology, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Diego Enrico
- Departament of Oncology, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Andrés Rodriguez
- Departament of Oncology, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Yanina Pflüger
- Departament of Oncology, Alexander Fleming Institute, Buenos Aires, Argentina
| | - María Laura Galluzzo
- Department of Pediatric Pathology, Hospital Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - María del Valle Centeno
- Department of Pediatric Pathology, Hospital Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Isabel Colmenero
- Department of Pediatric Pathology, Hospital Infantil Universitario Nino Jesús, Madrid, Spain
| | - Mora Amat
- Department of Oncology Pathology, Alexander Fleming Institute, Buenos Aires, Argentina
| | - Lisandro Paganini
- Department of Radiology, Alexander Fleming Institute, Buenos Aires, Argentina
| | | | - Matías Chacón
- Departament of Oncology, Alexander Fleming Institute, Buenos Aires, Argentina
| |
Collapse
|
11
|
Enrico D, Tsou F, Catani G, Pupareli C, Girotti MR, Ulloa Alvarez DE, Waisberg F, Rodríguez A, Reyes R, Chacón M, Reguart N, Martín C. Overcoming Resistance to Osimertinib by T790M Loss and C797S Acquisition Using Gefitinib in a Patient With EGFR-Mutant NSCLC: A Case Report. JTO Clin Res Rep 2022; 4:100456. [PMID: 36798785 PMCID: PMC9926104 DOI: 10.1016/j.jtocrr.2022.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
Limited strategies are available at disease progression on osimertinib for patients with EGFR-mutant NSCLC. The emergence of the on-target EGFR C797S mutation has been described as one of the most common mechanisms of resistance. In addition, loss of the EGFR T790M mutation has been mainly investigated as a resistance phenomenon to second-line osimertinib exposure. Remarkably, by studying the molecular profile at progression, it has been reported that the presence of the EGFR-sensitizing mutation, concurrently with the T790M, and C797S resulted in resistance to the current available EGFR tyrosine kinase inhibitors. Here, we report the first clinical evidence of gefitinib efficacy at EGFR exon 19 deletion/C797S mutation/T790M loss-mediated resistance to first-line osimertinib. Our findings highlight that dynamic genetic monitoring is a crucial approach in the evolution of EGFR-mutant NSCLC to understand the acquired molecular mechanisms for driving the best treatment strategy.
Collapse
Affiliation(s)
- Diego Enrico
- Thoracic Oncology Unit, Department of Medical Oncology, Alexander Fleming Cancer institute, Buenos Aires, Argentina
- Clinical Research Unit, Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
- Corresponding author. Address for correspondence: Diego Enrico, MD, Thoracic Oncology Unit, Department of Medical Oncology, Alexander Fleming Cancer Institute, 1180 Crámer, Buenos Aires (1426), Argentina.
| | - Florencia Tsou
- Thoracic Oncology Unit, Department of Medical Oncology, Alexander Fleming Cancer institute, Buenos Aires, Argentina
- Clinical Research Unit, Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Greta Catani
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Carmen Pupareli
- Thoracic Oncology Unit, Department of Medical Oncology, Alexander Fleming Cancer institute, Buenos Aires, Argentina
| | | | | | - Federico Waisberg
- Clinical Research Unit, Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Andrés Rodríguez
- Clinical Research Unit, Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Roxana Reyes
- Thoracic Oncology Unit, Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Matías Chacón
- Clinical Research Unit, Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Noemí Reguart
- Thoracic Oncology Unit, Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Claudio Martín
- Thoracic Oncology Unit, Department of Medical Oncology, Alexander Fleming Cancer institute, Buenos Aires, Argentina
- Clinical Research Unit, Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| |
Collapse
|
12
|
Blay J, Palmerini E, Bollard J, Aguiar S, Angel M, Araya B, Badilla R, Bernabeu D, Campos F, Chs CS, Carvajal Montoya A, Casavilca-Zambrano S, Castro-Oliden, Chacón M, Clara-Altamirano M, Collini P, Correa Genoroso R, Costa F, Cuellar M, Dei Tos A, Dominguez Malagon H, Donati D, Dufresne A, Eriksson M, Farias-Loza M, Frezza A, Frisoni T, Garcia-Ortega D, Gerderblom H, Gouin F, Gómez-Mateo M, Gronchi A, Haro J, Hindi N, Huanca L, Jimenez N, Karanian M, Kasper B, Lopes A, Lopes David B, Lopez-Pousa A, Lutter G, Maki R, Martinez-Said H, Martinez-Tlahuel J, Mello C, Morales Pérez J, Moura D, Nakagawa S, Nascimento A, Ortiz-Cruz E, Patel S, Pfluger Y, Provenzano S, Righi A, Rodriguez A, Santos T, Scotlandi K, Mlg S, Soulé T, Stacchiotti S, Valverde C, Waisberg F, Zamora Estrada E, Martin-Broto J. Corrigendum to “SELNET clinical practice guidelines for bone sarcoma” Critical reviews in oncology/hematology, vol. 174 (2022), 1–10. Crit Rev Oncol Hematol 2022; 180:103827. [DOI: 10.1016/j.critrevonc.2022.103827] [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: 11/06/2022] Open
|
13
|
Narváez D, Waisberg F, Soule T, Angel M, Bruno L, Girotti MR, Pupareli C, Chacón M, Petracci FE. Precision medicine in the real-world setting. Clinical activity of talazoparib in a woman with hormone receptor-positive HER2-negative metastatic breast cancer with pathogenic mutation in somatic BRCA2. Ecancermedicalscience 2022; 16:1448. [DOI: 10.3332/ecancer.2022.1448] [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] [Received: 05/05/2022] [Indexed: 11/06/2022] Open
|
14
|
Esteso F, Tissera NS, O'Connor JM, Luca R, Huertas E, Sánchez Loria F, Pedraza I, Pairola A, Brancato F, Paganini L, Kucharczyk M, Amat M, Pombo MT, Galli M, Bruno L, Caro L, Rodriguez A, Enrico D, Waisberg F, Chacón M. Implementation of a virtual multicenter gastrointestinal tumor board to reduce cancer disparities in Argentina. World J Clin Oncol 2022; 13:423-428. [PMID: 35949433 PMCID: PMC9244971 DOI: 10.5306/wjco.v13.i6.423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/10/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
Given the increasing complexity of cancer care, multidisciplinary tumor boards have become essential in daily clinical oncology practice. The Project Extension for Community Healthcare Outcomes (ECHO) initiative developed an innovative telementoring model using a "hub and spoke" design consisting of a team of experts (hub) that offers a full service to multiple participants (the spokes) during regularly scheduled sessions discussing patients' clinical cases. The Alexander Fleming Cancer Institute in Buenos Aires was the first hub in Latin America to implement Project ECHO for gastrointestinal tumors. In our 3-year experience, 80 patients from 37 centers were evaluated within Project ECHO and a range of three to five cases were discussed in each meeting. From our perspective, the impact of this novel approach was a remarkable strategy to reduce care disparities by equalizing access to high-quality medical knowledge in a multidisciplinary environment for medical discussions. Additionally, it was shown to have a cost-effective impact directly on the patients and the local health system, since relevant costs were saved after unnecessary treatments, studies and travel expenses were avoided.
Collapse
Affiliation(s)
- Federico Esteso
- Department of Gastrointestinal Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Natalia Soledad Tissera
- Department of Gastrointestinal Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Juan Manuel O'Connor
- Department of Gastrointestinal Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Romina Luca
- Department of Gastrointestinal Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Eduardo Huertas
- Department of Surgery, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | | | - Ivana Pedraza
- Department of Surgery, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Alejandro Pairola
- Department of Surgery, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Fernando Brancato
- Department of Surgery, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Lisandro Paganini
- Department of Radiology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Mariana Kucharczyk
- Department of Radiology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Mora Amat
- Department of Pathology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Maria Teresa Pombo
- Department of Pathology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Mariana Galli
- Department of Radiation Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Luisina Bruno
- Department of Gastrointestinal Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Luis Caro
- Department of Gastroenterology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Andrés Rodriguez
- Department of Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Diego Enrico
- Department of Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Federico Waisberg
- Department of Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| | - Matías Chacón
- Department of Medical Oncology, Instituto Alexander Fleming, Buenos Aires 1426, Argentina
| |
Collapse
|
15
|
Waisberg F, Lopez C, Enrico D, Rodriguez A, Hirsch I, Burton J, Mandó P, Martin C, Chacón M, Seetharamu N. Assessing the methodological quality of quality-of-life analyses in first-line non-small cell lung cancer trials: A systematic review. Crit Rev Oncol Hematol 2022; 176:103747. [PMID: 35717006 DOI: 10.1016/j.critrevonc.2022.103747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Non-cytotoxic therapy has changed the treatment paradigm for advanced non-small cell lung cancer (NSCLC) patients. With unique mechanisms of action, these agents have decidedly improved survival and have demonstrated an improved toxicity profile. However, the real-life experience of the patient, which is commonly assessed by health-related quality of life (HRQoL) measurement, is not clearly established with this new generation of lung cancer treatments. The heterogeneity created by specific patient subgroups and different therapeutics calls for a tailored-approach to analyzing patient-reported outcomes. The objective of this systematic review was to assess the methodological quality of HRQoL analysis in Randomized Clinical Trials (RCTs) involving biologic agents to treat NSCLC. METHODS A systematic literature search was performed using Medline, Embase, and Web of Science databases to identify NSCLC RCTs published between January 1st, 2000 and January 1st, 2020 reporting HRQoL measures. Only RCTs that both enrolled previously untreated patients with advanced NSCLC and had HRQoL analysis were included. RESULTS 4203 abstracts were screened, of which only 85 RCTs met inclusion and exclusion criteria for analysis. The most applied HRQoL assessment tools were the EORTC-QLQ-C30 (47, 55.3 %), and EORTC-QLQ-LC13 (35, 41.2 %). The median number of verified CONSORT-PRO Extension criteria in the included trials was 3, and only in 10 (11.8 %) trials were all criteria well-documented. Notably, only 21 (24.7 %) RCTs performed subgroup analyses to specifically evaluate HRQoL in different patient populations. CONCLUSION QoL reporting in clinical trials is inconsistent and the quality of QoL measures adopted in a majority of trials is suboptimal. Considering the fact that NSCLC is a biologically diverse disease and that the treatments differ based on patient and tumor-specifics, efforts should be pursued to tailor QoL measures for different subsets of this patient population in addition to mandating QoL reporting in clinical trials. We believe that this is necessary to understand the real-life experience of lung cancer patients in the era of personalized medicine.
Collapse
Affiliation(s)
- Federico Waisberg
- Argentine Association of Clinical Oncology (AAOC), Research Department, Argentina; Instituto Alexander Fleming, Buenos Aires, Argentina.
| | - Carlos Lopez
- Zucker School of Medicine at Hofstra/Northwell Health, New York, USA
| | - Diego Enrico
- Argentine Association of Clinical Oncology (AAOC), Research Department, Argentina; Instituto Alexander Fleming, Buenos Aires, Argentina
| | | | - Ian Hirsch
- Argentine Association of Clinical Oncology (AAOC), Research Department, Argentina; Hospital Municipal Alvarez, Buenos Aires, Argentina; Princess Margaret Cancer Centre. Toronto, Canada
| | - Jeannette Burton
- Argentine Association of Clinical Oncology (AAOC), Research Department, Argentina; Hospital Municipal Leonidas Lucero, Bahia Blanca, Argentina
| | - Pablo Mandó
- Argentine Association of Clinical Oncology (AAOC), Research Department, Argentina; Centro de Educación e Investigaciones Médicas (CEMIC), Buenos Aires, Argentina
| | | | - Matias Chacón
- Argentine Association of Clinical Oncology (AAOC), Research Department, Argentina; Instituto Alexander Fleming, Buenos Aires, Argentina
| | | |
Collapse
|
16
|
Lapuchesky LS, Bortz M, Waisberg F, Enrico DH, Bruno LI, Ostinelli CA, Rivero SG, Rodriguez A, Zarba M, Loza M, Fabiano VY, Amat M, Pombo MT, Noro ML, Coló FA, Chacon RD, Chacon MR, Nadal JC, Nervo A, Costanzo MV. CDK4/6 inhibitors outcomes in patients with advanced breast cancer based on HER2-low expression. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.1056] [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
1056 Background: HER2-low expression, defined as HER2 immunohistochemistry (IHC) score of 1+ or 2+ with negative in situ hybridization assay (FISH), accounts for 50% of breast cancers. There is limited and conflicting evidence regarding the efficacy of cyclin-dependent kinase (CDK) 4 and 6 inhibitors in patients with ER+ and HER2-low tumors. This study aimed to investigate the prognostic value of HER2-low expression in patients with ER+/HER2-negative advanced breast cancer treated with CDK 4/6 inhibitors. Methods: We retrospectively selected consecutive patients with ER+/HER2-negative advanced breast cancer treated with CDK 4/6 inhibitors plus endocrine therapy in our institution from May 2015 to Feb 2020. Two cohorts were compared, including HER2-0 (IHC score) and HER2-low (HER2 IHC score 1+ and 2+ [negative FISH]) tumors. Comparisons in progression-free survival (PFS) and overall survival (OS) were performed using a log-rank test. The prognostic value of HER2-low was investigated by the Cox regression model. Results: Among the 186 patients included, median age at treatment was 55 (r 27-84), and majority had ECOG 0 (126, 67.8%). Progesterone receptor was positive in 155 (83.3%) tumors. Of note, most patients received CDK4/6 inhibitors and endocrine therapy as first-line setting (131, 70.4%). Mostly received palbociclib (161, 86.6%), while ribociclib and abemaciclib were used in 23 (12.4%) and 2 (1.08%) patients, respectively. Overall, 27 patients (14.5%) had de novo metastatic disease, 68 (36.6%) had only bone metastases, and 69 (37.1%) had visceral disease. Of the total population, 64 (34.4%) tumors were HER2-low (43 [23.1%] HER2-1+, and 21 [11.3%] HER2-2+), and 122 (65.6%) were HER2-0. Median PFS among patients with HER2-0 and HER-low were 19 mo. (95% CI, 13.9-24.1), and 15.6 mo. (95% CI, 11.1-20.0), p = 0.074, respectively. In patients treated with CDK 4/6 in the first-line setting, no statistically significant differences were observed in terms of PFS and OS between HER2-0 and HER2-low (PFS HR 0.73 [95% CI, 0.47-1.13; p = 0.160], and OS HR 1.04 [95% CI, 0.51-2.14; p = 0.909]). Conclusions: In our study, HER2-low expression did not show a statistically significant impact on patients with ER+/HER2-negative advanced breast cancer treated with CDK 4/6 inhibitors. Our study supports the necessity of real-world evidence and the design of pooled analysis to understand the real implication of this biomarker in patients with ER+/HER2-negative tumors.
Collapse
Affiliation(s)
| | | | - Federico Waisberg
- Argentine Association of Clinical Oncology, Research Department, Buenos Aires, Argentina
| | - Diego Hernán Enrico
- Argentine Association of Clinical Oncology, Research Department, Buenos Aires, Argentina
| | | | | | | | | | - Martin Zarba
- Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina
| | - Martin Loza
- Instituto Alexander Fleming, Ciudad Autónoma De Buenos Aires, Argentina
| | | | - Mora Amat
- Instituto Alexander Fleming, Buenos Aires, Argentina
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Tissera N, Pflüger Y, Waisberg F, Ángel M, Rodríguez A, Soulé T, Pairola A, Lutter G, Amat M, Enrico D, Chacón M. Desmoid tumour in an inguinal hernia in a patient with a previous diagnosis of melanoma. Ecancermedicalscience 2022; 16:1394. [PMID: 35919234 PMCID: PMC9300401 DOI: 10.3332/ecancer.2022.1394] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Natalia Tissera
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
- https://orcid.org/0000-0002-3396-6878
| | - Yanina Pflüger
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Federico Waisberg
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
- https://orcid.org/0000-0003-4435-5068
| | - Martín Ángel
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
- https://orcid.org/0000-0002-1463-8887
| | - Andrés Rodríguez
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
- https://orcid.org/0000-0002-0880-3153
| | - Tomas Soulé
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Alejandro Pairola
- Department of Surgery, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Guido Lutter
- Department of Pathology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Mora Amat
- Department of Pathology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Diego Enrico
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
- https://orcid.org/0000-0003-4121-6855
| | - Matías Chacón
- Department of Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
- https://orcid.org/0000-0001-6872-4185
| |
Collapse
|
18
|
Blay JY, Palmerini E, Bollard J, Aguiar S, Angel M, Araya B, Badilla R, Bernabeu D, Campos F, Chs CS, Carvajal Montoya A, Casavilca-Zambrano S, Castro-Oliden, Chacón M, Clara-Altamirano MA, Collini P, Correa Genoroso R, Costa FD, Cuellar M, Dei Tos AP, Dominguez Malagon HR, Donati DM, Dufresne A, Eriksson M, Farias-Loza M, Frezza AM, Frisoni T, Garcia-Ortega DY, Gerderblom H, Gouin F, Gómez-Mateo MC, Gronchi A, Haro J, Hindi N, Huanca L, Jimenez N, Karanian M, Kasper B, Lopes A, Lopes David BB, Lopez-Pousa A, Lutter G, Maki RG, Martinez-Said H, Martinez-Tlahuel JL, Mello CA, Morales Pérez JM, Moura DS, Nakagawa SA, Nascimento AG, Ortiz-Cruz EJ, Patel S, Pfluger Y, Provenzano S, Righi A, Rodriguez A, Santos TG, Scotlandi K, Mlg S, Soulé T, Stacchiotti S, Valverde CM, Waisberg F, Zamora Estrada E, Martin-Broto J. SELNET clinical practice guidelines for bone sarcoma. Crit Rev Oncol Hematol 2022; 174:103685. [PMID: 35460913 DOI: 10.1016/j.critrevonc.2022.103685] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 03/09/2022] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 11/29/2022] Open
Abstract
Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient's outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context.
Collapse
Affiliation(s)
- J Y Blay
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France.
| | - E Palmerini
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136, Bologna, Italy
| | - J Bollard
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France
| | - S Aguiar
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - M Angel
- Instituto Alexander Fleming, Av. Cramer 1180. CP, C1426ANZ Buenos Aires, Argentina
| | - B Araya
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - R Badilla
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - D Bernabeu
- Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - F Campos
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - Caro-Sánchez Chs
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP, 14080 Tlalpan Mexico
| | - A Carvajal Montoya
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - S Casavilca-Zambrano
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima, Peru
| | - Castro-Oliden
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima, Peru
| | - M Chacón
- Instituto Alexander Fleming, Av. Cramer 1180. CP, C1426ANZ Buenos Aires, Argentina
| | - M A Clara-Altamirano
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP, 14080 Tlalpan Mexico
| | - P Collini
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - R Correa Genoroso
- Hospital Clínico Universitario Virgen de la Victoria, Campus Universitario de Teatinos s/n, 29010, Malaga, Spain
| | - F D Costa
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - M Cuellar
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP, 14080 Tlalpan Mexico
| | - A P Dei Tos
- Treviso General Hospital Treviso, University of Padua, Padova, Italy
| | - H R Dominguez Malagon
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP, 14080 Tlalpan Mexico
| | - D M Donati
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136, Bologna, Italy
| | - A Dufresne
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France
| | - M Eriksson
- Skane University Hospital and Lund University, Lund, Sweden
| | - M Farias-Loza
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima, Peru
| | - A M Frezza
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - T Frisoni
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136, Bologna, Italy
| | - D Y Garcia-Ortega
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP, 14080 Tlalpan Mexico
| | - H Gerderblom
- Leiden University Medical Center, Leiden, The Netherlands
| | - F Gouin
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France
| | - M C Gómez-Mateo
- Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - A Gronchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - J Haro
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima, Peru
| | - N Hindi
- Research Health Institute Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; Hospital Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain; General de Villalba University Hospital, 28400 Madrid, Spain
| | - L Huanca
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima, Peru
| | - N Jimenez
- Hospital San Vicente de Paúl, Avenue 16, streets 10 and 14, Heredia, Costa Rica
| | - M Karanian
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France
| | - B Kasper
- University of Heidelberg, Mannheim Cancer Center, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - A Lopes
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - B B Lopes David
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - A Lopez-Pousa
- Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041 Barcelona, Spain
| | - G Lutter
- Instituto Alexander Fleming, Av. Cramer 1180. CP, C1426ANZ Buenos Aires, Argentina
| | - R G Maki
- University of Pennsylvania, Abramson Cancer Center, 3400 Civic Center Boulevard, Philadelphia, PA 19104 USA
| | - H Martinez-Said
- Centro Oncologico Integral, Hospital Medica Sur, Planta Baja Torre III - Cons. 305, Col. Toriello Guerra, Deleg. Tlalpan. C.P., 14050, Mexico, D.F
| | - J L Martinez-Tlahuel
- Instituto Nacional de Cancerologia, Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP, 14080 Tlalpan Mexico
| | - C A Mello
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - J M Morales Pérez
- Centro Oncologico Integral, Hospital Medica Sur, Planta Baja Torre III - Cons. 305, Col. Toriello Guerra, Deleg. Tlalpan. C.P., 14050, Mexico, D.F
| | - D S Moura
- Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain
| | - S A Nakagawa
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - A G Nascimento
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - E J Ortiz-Cruz
- Hospital Universitario La Paz, MD Anderson Cancer Center, Calle de Arturo Soria, 270, 28033 Madrid, Spain
| | - S Patel
- UT MD Anderson Cancer Center, Houston, TX, USA
| | - Y Pfluger
- Instituto Alexander Fleming, Av. Cramer 1180. CP, C1426ANZ Buenos Aires, Argentina
| | - S Provenzano
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - A Righi
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136, Bologna, Italy
| | - A Rodriguez
- Instituto Alexander Fleming, Av. Cramer 1180. CP, C1426ANZ Buenos Aires, Argentina
| | - T G Santos
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - K Scotlandi
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136, Bologna, Italy
| | - Silva Mlg
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo 01509-010, Brazil
| | - T Soulé
- Instituto Alexander Fleming, Av. Cramer 1180. CP, C1426ANZ Buenos Aires, Argentina
| | - S Stacchiotti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - C M Valverde
- Vall d´Hebrón University Hospital, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - F Waisberg
- Instituto Alexander Fleming, Av. Cramer 1180. CP, C1426ANZ Buenos Aires, Argentina
| | - E Zamora Estrada
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - J Martin-Broto
- Research Health Institute Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; Hospital Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain; General de Villalba University Hospital, 28400 Madrid, Spain
| |
Collapse
|
19
|
Bruno L, Ostinelli A, Waisberg F, Enrico D, Ponce C, Rivero S, Blanco A, Zarba M, Loza M, Fabiano V, Amat M, Pombo MT, Noro L, Chacón M, Coló F, Chacón R, Nadal J, Nervo A, Costanzo V. Cyclin-Dependent Kinase 4/6 Inhibitor Outcomes in Patients With Advanced Breast Cancer Carrying Germline Pathogenic Variants in DNA Repair-Related Genes. JCO Precis Oncol 2022; 6:e2100140. [PMID: 35235412 DOI: 10.1200/po.21.00140] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE In recent years, unprecedented benefits have been observed with the development of cyclin-dependent kinase (CDK) 4 and 6 inhibitors for the treatment of hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer. However, there is scarce evidence of their value in specific populations, such as patients carrying germline pathogenic variants in DNA repair-related genes. PATIENTS AND METHODS We retrospectively studied the efficacy of CDK 4/6 inhibitors plus endocrine therapy in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer. Three cohorts were compared, including patients harboring germline pathogenic variants in DNA repair-related genes (gBRCA1/2-ATM-CHEK2 mutated), those tested without these mutations (wild type [WT]), and the nontested subgroup. Relevant prognostic factors including age, metastatic site (visceral v nonvisceral), Eastern Cooperative Oncology Group, and prior treatment with CDK 4/6 inhibitors were stratified by univariate and multivariate Cox regression models. RESULTS Among the total population (n = 217), 15 (6.9%) patients carried gBRCA1/2 (n = 10)-ATM (n = 4)-CHEK2 (n = 1) pathogenic variants, 45 (20.7%) were WT, and 157 (72.4%) were nontested. Gene pathogenic variant carriers were younger (P < .001). Most patients (164, 75.6%) had not received prior endocrine therapy in the advanced setting. Median progression-free survival was shorter in patients with evaluated germline pathogenic variants (10.2 months [95% CI, 5.7 to 14.7]), compared with WT and nontested patients (15.6 months [95% CI, 7.8 to 23.4], and (17.6 months [95% CI, 12.9 to 22.2]; P = .002). Consistently, a worse median overall survival was observed in the subgroup with germline pathogenic variants than in the WT group (P = .006). Multivariable analysis showed that mutation status was an independent prognostic factor of progression-free survival (P = .020) and overall survival (P = .012). CONCLUSION In this retrospective real-world study, gBRCA1/2-ATM-CHEK2 pathogenic variants were independently associated with poor outcomes in patients with advanced breast cancer treated with CDK4/6 inhibitors.
Collapse
Affiliation(s)
- Luisina Bruno
- Genetic Counselling Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Alexis Ostinelli
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Federico Waisberg
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Research Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Diego Enrico
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Research Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Carolina Ponce
- Genetic Counselling Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Department of Breast Surgery, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Sergio Rivero
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Albano Blanco
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Martín Zarba
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Martín Loza
- Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Department of Breast Surgery, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Verónica Fabiano
- Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Department of Breast Surgery, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Mora Amat
- Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Department of Pathology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - María Teresa Pombo
- Department of Pathology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Laura Noro
- Department of Laboratory Medicine, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Matías Chacón
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Research Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Federico Coló
- Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Department of Breast Surgery, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Reinaldo Chacón
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Jorge Nadal
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Adrián Nervo
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Victoria Costanzo
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires, Argentina.,Breast Cancer Unit, Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| |
Collapse
|
20
|
Falco A, Leiva M, Blanco A, Cefarelli G, Rodriguez A, Melo J, Cayol F, Rizzo MM, Sola A, Rodríguez Montani H, Chacon M, Enrico D, Waisberg F. First-line cisplatin, docetaxel, and cetuximab for patients with recurrent or metastatic head and neck cancer: A multicenter cohort study. World J Clin Oncol 2022; 13:147-158. [PMID: 35316930 PMCID: PMC8894270 DOI: 10.5306/wjco.v13.i2.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/04/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The targeted therapy cetuximab [directed at the epidermal growth factor receptor (EGFR)] in combination with 5-fluorouracil and platinum-based chemotherapy (the EXTREME regimen) has shown substantial efficacy for patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Thus, this scheme has been established as the preferred first-line option for these patients. However, more recently, a new strategy combining platinum, taxanes, and cetuximab (the TPEx regimen) has demonstrated similar efficacy with a more favorable toxicity profile in clinical trials.
AIM To evaluate the safety and efficacy of the TPEx scheme as first-line therapy in advanced SCCHN in a multicenter cohort study.
METHODS This retrospective multicenter cohort study included patients with histologically confirmed recurrent or metastatic SCCHN treated with first-line TPEx at five medical centers in Argentina between January 1, 2017 and April 31, 2020. Chemotherapy consisted of four cycles of docetaxel, cisplatin, and cetuximab followed by cetuximab maintenance therapy. Clinical outcomes and toxicity profiles were collected from medical charts. Treatment response was assessed by the investigator in accordance with Response Evaluation Criteria in Solid Tumors (version 1.1). Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0).
RESULTS Twenty-four patients were included. The median age at diagnosis was 58 years (range: 36-77 years). The majority of patients (83.3%) received at least four chemotherapy cycles in the initial phase. In the included group, the overall response rate was 62.5%, and 3 patients achieved a complete response (12.5%). The median time to response was 2.4 mo [95% confidence interval (CI): 1.3-3.5]. With a median follow-up of 12.7 mo (95%CI: 8.8-16.6), the median progression-free survival (PFS) was 6.9 mo (95%CI: 6.5-7.3), and the overall survival rate at 12 mo was 82.4%. Patients with documented tumor response showed a better PFS than those with disease stabilization or progression [8.5 mo (95%CI: 5.5-11.5) and 4.5 mo (95%CI: 2.5-6.6), respectively; P = 0.042]. Regarding the safety analysis, two-thirds of patients reported at least one treatment-related adverse event, and 25% presented grade 3 toxicities. Of note, no patient experienced grade 4 adverse events.
CONCLUSION TPEx was an adequately tolerated regimen in our population, with low incidence of grade 3-4 adverse events. The median PFS were consistent with those in recent reports of clinical trials evaluating this treatment combination. This regimen may be considered an attractive therapeutic strategy due to its simplified administration, decreased total number of chemotherapy cycles, and treatment tolerability.
Collapse
Affiliation(s)
- Agustín Falco
- Department of Medical Oncology, Head and Neck Unit, Alexander Fleming Cancer Institute, Buenos Aires 1428, Argentina
| | - Mariano Leiva
- Department of Medical Oncology, Head and Neck Unit, Alexander Fleming Cancer Institute, Buenos Aires 1428, Argentina
| | - Albano Blanco
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Guido Cefarelli
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Andrés Rodriguez
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Juan Melo
- Department of Medical Oncology, Hospital Italiano de Buenos Aires, Buenos Aires 1199, Argentina
| | - Federico Cayol
- Department of Medical Oncology, Hospital Italiano de Buenos Aires, Buenos Aires 1199, Argentina
| | - Manglio Miguel Rizzo
- Department of Medical Oncology, Hospital Universitario Austral, Pilar 1629, Argentina
| | - Alejandro Sola
- Department of Medical Oncology, Fundación Centro Oncológico de Integración Regional, Mendoza 5500, Argentina
| | - Hernán Rodríguez Montani
- Department of Medical Oncology, Hospital Italiano Rosario; Sanatorio de la Mujer, Rosario 2001, Argentina
| | - Matías Chacon
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Diego Enrico
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| | - Federico Waisberg
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina
| |
Collapse
|
21
|
Blay JY, Hindi N, Bollard J, Aguiar S, Angel M, Araya B, Badilla R, Bernabeu D, Campos F, Caro-Sánchez CHS, Carvajal B, Carvajal Montoya A, Casavilca-Zambrano S, Castro-Oliden V, Chacón M, Clara M, Collini P, Correa Genoroso R, Costa FD, Cuellar M, Dei Tos AP, Dominguez Malagon HR, Donati D, Dufresne A, Eriksson M, Farias-Loza M, Fernandez P, Frezza AM, Frisoni T, Garcia-Ortega DY, Gelderblom H, Gouin F, Gómez-Mateo MC, Gronchi A, Haro J, Huanca L, Jimenez N, Karanian M, Kasper B, Lopes David BB, Lopez-Pousa A, Lutter G, Martinez-Said H, Martinez-Tlahuel J, Mello CA, Morales Pérez JM, Moura David S, Nascimento AG, Ortiz-Cruz EJ, Palmerini E, Patel S, Pfluger Y, Provenzano S, Righi A, Rodriguez A, Salas R, Santos TTG, Scotlandi K, Soule T, Stacchiotti S, Valverde C, Waisberg F, Zamora Estrada E, Martin-Broto J. SELNET clinical practice guidelines for soft tissue sarcoma and GIST. Cancer Treat Rev 2022; 102:102312. [PMID: 34798363 DOI: 10.1016/j.ctrv.2021.102312] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/30/2021] [Indexed: 12/12/2022]
Affiliation(s)
- J Y Blay
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France.
| | - N Hindi
- Research Health Institute Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; Hospital Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain; General de Villalba University Hospital, 28400 Madrid, Spain
| | - J Bollard
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France
| | - S Aguiar
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo - SP 01509-010, Brazil
| | - M Angel
- Instituto Alexander Fleming. Av. Cramer 1180. CP C1426ANZ, Buenos Aires, Argentina
| | - B Araya
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - R Badilla
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - D Bernabeu
- Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - F Campos
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo - SP 01509-010, Brazil
| | - C H S Caro-Sánchez
- Instituto Nacional de Cancerologia. Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP 14080, Tlalpan Mexico
| | - B Carvajal
- Fundación GIST México, Altadena 59, Nápoles, Benito Juárez, 03810 Ciudad de Mexico, CDMX, Mexico
| | - A Carvajal Montoya
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - S Casavilca-Zambrano
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | - V Castro-Oliden
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | - M Chacón
- Instituto Alexander Fleming. Av. Cramer 1180. CP C1426ANZ, Buenos Aires, Argentina
| | - M Clara
- Instituto Nacional de Cancerologia. Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP 14080, Tlalpan Mexico
| | - P Collini
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - R Correa Genoroso
- Hospital Clínico Universitario Virgen de la Victoria, Campus Universitario de Teatinos s/n, 29010 Malaga, Spain
| | - F D Costa
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo - SP 01509-010, Brazil
| | - M Cuellar
- Fundación GIST México, Altadena 59, Nápoles, Benito Juárez, 03810 Ciudad de Mexico, CDMX, Mexico
| | - A P Dei Tos
- Treviso General Hospital Treviso, University of Padua, Padova, Italy
| | - H R Dominguez Malagon
- Instituto Nacional de Cancerologia. Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP 14080, Tlalpan Mexico
| | - D Donati
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136 Bologna, Italy
| | - A Dufresne
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France
| | - M Eriksson
- Skane University Hospital and Lund University, Lund, Sweden
| | - M Farias-Loza
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | | | - A M Frezza
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - T Frisoni
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136 Bologna, Italy
| | - D Y Garcia-Ortega
- Instituto Nacional de Cancerologia. Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP 14080, Tlalpan Mexico
| | - H Gelderblom
- Leiden University Medical Center, Leiden, the Netherlands
| | - F Gouin
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France
| | - M C Gómez-Mateo
- Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - A Gronchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - J Haro
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | - L Huanca
- Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Lima 34, Peru
| | - N Jimenez
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - M Karanian
- Léon Bérard Center, 28 rue Laennec 69373 Lyon Cedex 08, France
| | - B Kasper
- University of Heidelberg, Mannheim Cancer Center, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - B B Lopes David
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - A Lopez-Pousa
- Hospital de la Santa Creu i Sant Pau, Carrer de Sant Quintí, 89, 08041 Barcelona, Espagne
| | - G Lutter
- Instituto Alexander Fleming. Av. Cramer 1180. CP C1426ANZ, Buenos Aires, Argentina
| | - H Martinez-Said
- Centro Oncologico Integral, Hospital Medica Sur, Planta Baja Torre III - Cons. 305, Col. Toriello Guerra, Deleg. Tlalpan. C.P. 14050, Mexico, D.F
| | - J Martinez-Tlahuel
- Instituto Nacional de Cancerologia. Torre Nueva de Hospitalización, primer piso. Av. San Fernando 86, Colonia Niño Jesus. CP 14080, Tlalpan Mexico
| | - C A Mello
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo - SP 01509-010, Brazil
| | - J M Morales Pérez
- Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain
| | - S Moura David
- Hospital Universitario Virgen del Rocio, Av Manuel Siurot s/n, 41013 Sevilla, Spain
| | - A G Nascimento
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo - SP 01509-010, Brazil
| | - E J Ortiz-Cruz
- Hospital Universitario La Paz, MD Anderson Cancer Center, Calle de Arturo Soria, 270 28033 Madrid, Spain
| | - E Palmerini
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136 Bologna, Italy
| | - S Patel
- UT MD Anderson Cancer Center, Houston, TX, USA
| | - Y Pfluger
- Instituto Alexander Fleming. Av. Cramer 1180. CP C1426ANZ, Buenos Aires, Argentina
| | - S Provenzano
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - A Righi
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136 Bologna, Italy
| | - A Rodriguez
- Instituto Alexander Fleming. Av. Cramer 1180. CP C1426ANZ, Buenos Aires, Argentina
| | - R Salas
- Fundación GIST México, Altadena 59, Nápoles, Benito Juárez, 03810 Ciudad de Mexico, CDMX, Mexico
| | - T T G Santos
- A.C.Camargo Cancer Center, Rua prof Antonio Prudente, 211 - Liberdade, São Paulo - SP 01509-010, Brazil
| | - K Scotlandi
- IRCCS Istituto Ortopedico Rizzoli, University of Bologna, Via Pupilli, 1, 40136 Bologna, Italy
| | - T Soule
- Instituto Alexander Fleming. Av. Cramer 1180. CP C1426ANZ, Buenos Aires, Argentina
| | - S Stacchiotti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
| | - C Valverde
- Vall d́Hebrón University Hospital, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - F Waisberg
- Instituto Alexander Fleming. Av. Cramer 1180. CP C1426ANZ, Buenos Aires, Argentina
| | - E Zamora Estrada
- Hospital Dr. R. A. Calderón Guardia, 7-9 Av, 15-17 St, Aranjuez, San José, Costa Rica
| | - J Martin-Broto
- Research Health Institute Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; Hospital Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain; General de Villalba University Hospital, 28400 Madrid, Spain
| |
Collapse
|
22
|
Angel MO, Colombo Bonadio R, Harada G, Waisberg F, Enrico D, Arrieta O, Corrales L, Martin C, Werutsky G, Barrios C, Ricaurte L, Cardona AF. Mentoring as an opportunity to improve research and cancer care in Latin America (AAZPIRE project). ESMO Open 2021; 5:e000988. [PMID: 33234553 PMCID: PMC7689104 DOI: 10.1136/esmoopen-2020-000988] [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: 08/15/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 11/04/2022] Open
Abstract
Effective networking and mentoring are critical determinants of professional satisfaction and success in oncology. There are multiple benefits associated with established mentoring programs. However, these are scarce in Latin America (LATAM). The AAZPIRE project meeting was held to encourage the discussion of mentorship strategies in our region, to create new learning frameworks, and improve cancer care. A group of 30 young oncologists and investigators, together with seven members of LACOG and CLICaP experts of 8 LATAM countries, were reunited to share views and define opportunities, barriers, and possible solutions to implement mentorship programs in LATAM. For each of the mentioned topics, key points were obtained by consensus, and a literature review was conducted to support group conclusions. This article analyses mentoring in LATAM countries and its role on promoting leadership. It will address conceptual frameworks, limitations, and opportunities from the perspectives of both mentor and mentee. The creation of regional and international group stimulation programs and joint projects that impact health policies are attractive, starting points to implement mentorship scenarios.
Collapse
Affiliation(s)
- Martín Osvaldo Angel
- Genitourinary Oncology Unit, Instituto Alexander Fleming Instituto Privado de Oncología, Buenos Aires, Argentina.
| | - Renata Colombo Bonadio
- Oncology, Universidade de São Paulo Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, Sao Paulo, Brazil
| | | | - Federico Waisberg
- Oncology, Instituto Alexander Fleming Instituto Privado de Oncología, Buenos Aires, Argentina
| | - Diego Enrico
- Oncology, Instituto Alexander Fleming Instituto Privado de Oncología, Buenos Aires, Argentina
| | - Oscar Arrieta
- Thoraxic Oncology Unit, Instituto Nacional de Cancerología, Mexico, Mexico
| | - Luis Corrales
- Medical Oncology, Center for Research and Management of Cancer, San Jose, Costa Rica
| | - Claudio Martin
- Thoraxic Oncology Unit, Instituto Alexander Fleming Instituto Privado de Oncología, Buenos Aires, Argentina
| | | | | | - Luisa Ricaurte
- Pathology Department, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Andres F Cardona
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogota, Colombia.
| | | |
Collapse
|
23
|
Guercovich A, Piazzioni G, Waisberg F, Mandó P, Angel M. Burnout syndrome in medical oncologists during the COVID-19 pandemic: Argentinian national survey. Ecancermedicalscience 2021; 15:1213. [PMID: 33912238 PMCID: PMC8057778 DOI: 10.3332/ecancer.2021.1213] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Indexed: 11/16/2022] Open
Abstract
Burnout (BO) syndrome is a condition that results in physical and mental distress. The current COVID-19 pandemic is strongly affecting the mental health of the general population. We aimed to assess the incidence of BO among medical oncologists and determine factors associated with burnout levels during the current pandemic. METHODS A digital survey was created for this study. The Spanish-validated version of Maslach BO Inventory was incorporated to define BO. Social and demographic information was analysed to remove duplicated answers. RESULTS A total of 188 Argentinian medical oncologists from 16 cities participated in the survey. The median age of the participants was 43 years (IQR 38-50) and a similar distribution between male and female was observed. At the time of the survey, Argentina was in the third month of strict lockdown. Most of the participants practiced in both public and private practice facilities (55.3%) and the majority reported more than 10 years of experience (53.2%). Twenty-five percent (43) of subjects reported high levels of DP, 39.9% (75) reported high levels of EE and 53.7% (101) reported low levels of PA. BO Maslach criteria were fulfilled by 14.9% (28). We compared this result with other burnout assessment tools. Using the Gil-Monte and Neira tool, BO-associated domains were altered in 77.1%, 42% and 42% for EE, DP, and PA domains, respectively. Concomitantly, under Neira assessment a domain impairment was appreciated in 77.1%, 76% and 54% respectively. BO criteria were met by 30.3% (57) according to Gil-Monte and 47.9% (90) to Neira. CONCLUSION BO is a multifaceted issue with a negative impact on physicians, patients, and institutions. During the COVID-19 pandemic, BO criteria was met in a considerable proportion of survey respondents using MBI, and Peiro and Neiro tools and younger age, use of antidepressants and psychological medications and income reduction arose as statistically significant factors after multivariate analysis.
Collapse
Affiliation(s)
- Andres Guercovich
- Centro Oncológico Integral (COI), Neuquén Q8300XAC, Argentina
- Member of Asociación Argentina de Oncología Clínica (AAOC)
| | - Gonzalo Piazzioni
- Psychologist, Instituto Austral de Salud Mental, Neuquén Q8300XAC, Argentina
| | - Federico Waisberg
- Instituto Alexander Fleming, CABA, Buenos Aires C1426ANZ, Argentina
- Member of Asociación Argentina de Oncología Clínica (AAOC)
| | - Pablo Mandó
- Breast and Gynecological Tumor Unit, Centro Universitario CEMIC, CABA, Buenos Aires C1431FWN, Argentina
- Member of Asociación Argentina de Oncología Clínica (AAOC)
| | - Martín Angel
- Clinical Oncologist, GenitoUrinary Tumor Unit, Instituto Alexander Fleming, CABA, Buenos Aires C1426ANZ, Argentina
- Member of Asociación Argentina de Oncología Clínica (AAOC)
- https://orcid.org/0000-0002-1463-8887
| |
Collapse
|
24
|
Mandó P, Hirsch I, Waisberg F, Ostinelli A, Luca R, Pranevicene B, Ferreyra Camacho A, Enrico D, Chacon M. Appraising the quality of meta-analysis for breast cancer treatment in the adjuvant setting: A systematic review. Cancer Treat Res Commun 2021; 27:100358. [PMID: 33957603 DOI: 10.1016/j.ctarc.2021.100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Breast cancer is the tumor with highest incidence in women worldwide and adjuvant treatment is extremely important to achieve disease control. Given the relevance of systematic reviews, their rigor should be warranted to avoid biased conclusions. Our objective was to investigate the methodological quality of meta-analysis of early breast cancer adjuvant treatment. MATERIAL AND METHODS Comprehensive searches were performed using electronic databases from 1/1/2007 to 11/12/2018. All studies identified as a systematic review with meta-analysis investigating the efficacy of breast cancer adjuvant treatments were included. Two reviewers independently assessed titles and abstracts, then full-texts for eligibility. Quality was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) version 2 tool. RESULTS Of 950 citations retrieved, 66 studies (7.0%) were deemed eligible. Methodological quality was highly variable, median AMSTAR score 8.5 (IQR 7-9.5) and range 0-16. There was a weak positive correlation between journal impact factor and AMSTAR score (r = 0.17) and citation rate and AMSTAR score (r = 0.16). Cochrane Systematic Reviews were of higher quality than reviews from other journals. Overall confidence was critically low for 61 (92.4%) studies, and the least well-reported domains were the statement of conflict of interest and funding source for the included studies (4.6%), the report of a pre-defined study protocol (15.2%), and the description of details of excluded studies (6.1%). CONCLUSIONS Our findings reinforce concerns about the design, conduction and interpretation of meta-analysis in current literature. Methodological quality should be carefully considered and journal editors, decision makers and readers in general, must follow a critical approach to this studies.
Collapse
Affiliation(s)
- Pablo Mandó
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina; CEMIC, Galvan 4102, Ciudad de Buenos Aires, CP 1431, Argentina.
| | - Ian Hirsch
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina; Hospital General de Agudos Teodoro Álvarez, Juan Felipe Aranguren 2701, Ciudad de Buenos Aires, CP1406, Argentina
| | - Federico Waisberg
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina
| | - Alexis Ostinelli
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina; Instituto Alexander Fleming, Cramer 1180, Ciudad de Buenos Aires, CP1426, Argentina
| | - Romina Luca
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina
| | - Belen Pranevicene
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina
| | - Augusto Ferreyra Camacho
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina
| | - Diego Enrico
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina
| | - Matías Chacon
- Argentine Association of Clinical Oncology, Gorostiaga 2450, Ciudad de Buenos Aires, CP1426, Argentina; Instituto Alexander Fleming, Cramer 1180, Ciudad de Buenos Aires, CP1426, Argentina
| |
Collapse
|
25
|
Enrico D, Waisberg F, Burton J, Mandó P, Chacón M. Analysis of adverse events attribution and reporting in cancer clinical trials: A systematic review. Crit Rev Oncol Hematol 2021; 160:103296. [PMID: 33675904 DOI: 10.1016/j.critrevonc.2021.103296] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/08/2021] [Accepted: 02/27/2021] [Indexed: 11/29/2022] Open
Abstract
We systematically reviewed the quality of AEs reports in published oncology trials analyzing also the bias in the attribution process. We searched MEDLINE, PubMed (2000-2019) selecting randomized, double-blind, placebo-controlled, and phase 3 cancer trials using exclusively targeted therapy or immunotherapy-related drugs. The proportion of publications with complete AE reports (including both all-cause and drug-related AE data) and the AEs attribution ratio (patients with drug-related over all-cause AE) were investigated. Among 60 trials (38,174 patients) included, 40 (66.6 %) presented an incomplete report of AEs attribution. Journals with the lowest impact factor were significantly associated with deficient reports of grade 3-4 AEs (p = 0.02). Under placebo administration, the median incidence of all-grade drug-related AEs was 49 % (IQR 39-56). The median attribution ratio for all-grade AEs in the active and placebo arms was 88.9 % (IQR 79.8-93) and 53.9 % (IQR 43.4-60.9), respectively. The AEs reporting and attribution process appear to be more unreliable than expected.
Collapse
Affiliation(s)
- Diego Enrico
- Argentine Association of Clinical Oncology (AAOC), Research department, Argentina.
| | - Federico Waisberg
- Argentine Association of Clinical Oncology (AAOC), Research department, Argentina
| | - Jeannette Burton
- Argentine Association of Clinical Oncology (AAOC), Research department, Argentina
| | - Pablo Mandó
- Argentine Association of Clinical Oncology (AAOC), Research department, Argentina
| | - Matías Chacón
- Argentine Association of Clinical Oncology (AAOC), Research department, Argentina
| |
Collapse
|
26
|
Waisberg F, Lopez C, Burton J, Hirsch I, Enrico D, Mandó P, Martin C, Chacón M, Seetharamu N. MA04.04 Assessing the Methodological Quality of Quality-of-Life Analyses in First-Line Lung Cancer Trials: A Systematic Review. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Martin‐Broto J, Hindi N, Aguiar S, Badilla‐González R, Castro‐Oliden V, Chacón M, Correa‐Generoso R, de Álava E, Donati DM, Eriksson M, Falla‐Jimenez M, German G, Gobo Silva ML, Gouin F, Gronchi A, Haro‐Varas JC, Jiménez‐Brenes N, Kasper B, Lopes de Mello CA, Maki R, Martínez‐Delgado P, Martínez‐Said H, Martinez‐Tlahuel JL, Morales‐Pérez JM, Muñoz‐Casares FC, Nakagawa SA, Ortiz‐Cruz EJ, Palmerini E, Patel S, Moura DS, Stacchiotti S, Sunyach MP, Valverde CM, Waisberg F, Blay J. Sarcoma European and Latin American Network (SELNET) Recommendations on Prioritization in Sarcoma Care During the COVID-19 Pandemic. Oncologist 2020; 25:e1562-e1573. [PMID: 32888360 PMCID: PMC7543334 DOI: 10.1634/theoncologist.2020-0516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/14/2020] [Indexed: 01/12/2023] Open
Abstract
Background The COVID‐19 outbreak has resulted in collision between patients infected with SARS‐CoV‐2 and those with cancer on different fronts. Patients with cancer have been impacted by deferral, modification, and even cessation of therapy. Adaptive measures to minimize hospital exposure, following the precautionary principle, have been proposed for cancer care during COVID‐19 era. We present here a consensus on prioritizing recommendations across the continuum of sarcoma patient care. Material and Methods A total of 125 recommendations were proposed in soft‐tissue, bone, and visceral sarcoma care. Recommendations were assigned as higher or lower priority if they cannot or can be postponed at least 2–3 months, respectively. The consensus level for each recommendation was classified as “strongly recommended” (SR) if more than 90% of experts agreed, “recommended” (R) if 75%–90% of experts agreed and “no consensus” (NC) if fewer than 75% agreed. Sarcoma experts from 11 countries within the Sarcoma European‐Latin American Network (SELNET) consortium participated, including countries in the Americas and Europe. The European Society for Medical Oncology‐Magnitude of clinical benefit scale was applied to systemic‐treatment recommendations to support prioritization. Results There were 80 SRs, 35 Rs, and 10 NCs among the 125 recommendations issued and completed by 31 multidisciplinary sarcoma experts. The consensus was higher among the 75 higher‐priority recommendations (85%, 12%, and 3% for SR, R, and NC, respectively) than in the 50 lower‐priority recommendations (32%, 52%, and 16% for SR, R, and NC, respectively). Conclusion The consensus on 115 of 125 recommendations indicates a high‐level of convergence among experts. The SELNET consensus provides a tool for sarcoma multidisciplinary treatment committees during the COVID‐19 outbreak. Implications for Practice The Sarcoma European‐Latin American Network (SELNET) consensus on sarcoma prioritization care during the COVID‐19 era issued 125 pragmatical recommendations distributed as higher or lower priority to protect critical decisions on sarcoma care during the COVID‐19 pandemic. A multidisciplinary team from 11 countries reached consensus on 115 recommendations. The consensus was lower among lower‐priority recommendations, which shows reticence to postpone actions even in indolent tumors. The European Society for Medical Oncology‐Magnitude of Clinical Benefit scale was applied as support for prioritizing systemic treatment. Consensus on 115 of 125 recommendations indicates a high level of convergence among experts. The SELNET consensus provides a practice tool for guidance in the decisions of sarcoma multidisciplinary treatment committees during the COVID‐19 outbreak. The COVID‐19 pandemic has caused deferral, modification, or cessation of treatment for patients with cancer. This article presents a consensus on prioritizing recommendations across the continuum of sarcoma patient care.
Collapse
Affiliation(s)
- Javier Martin‐Broto
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)SevillaSpain
- Department of Medical Oncology, University Hospital Virgen del RocioSevilleSpain
| | - Nadia Hindi
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)SevillaSpain
- Department of Medical Oncology, University Hospital Virgen del RocioSevilleSpain
| | - Samuel Aguiar
- Department of Pelvic Surgery, A.C. Camargo Cancer CenterSão PauloBrazil
| | | | - Victor Castro‐Oliden
- Department of Medical Oncology, Instituto Nacional de Enfermedades NeoplásicasLimaPeru
| | - Matias Chacón
- Department of Medical Oncology, Alexander Fleming Cancer InstituteBuenos AiresArgentina
| | | | - Enrique de Álava
- Pathology Department, University Hospital Virgen del RocíoSevilleSpain
- CIBERONCMadridSpain
- Department of Normal and Pathological Cytology and Histology, School of Medicine, University of SevilleSevilleSpain
| | - Davide María Donati
- Unit of Orthopedic Pathology and Osteoarticular Tissue Regeneration, Rizzoli Orthopedic InstituteBolognaItaly
| | - Mikael Eriksson
- Department of Medical Oncology, Skane University Hospital‐LundLundSweden
| | - Martin Falla‐Jimenez
- Department of Breast and Soft Tissues Surgery, Instituto Nacional de Enfermedades NeoplásicasLimaPeru
| | - Gisela German
- Department of Medical Oncology, Hospital Oncológico ProvincialCórdobaArgentina
| | | | - Francois Gouin
- Department of Orthopedic Surgery, Centre León BérardLyonFrance
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori and University of MilanMilanItaly
| | | | | | - Bernd Kasper
- Department of Medical Oncology, Mannheim University Medical CenterMannheimGermany
| | | | - Robert Maki
- Department of Medical Oncology, Abramson Cancer Center, University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Paula Martínez‐Delgado
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)SevillaSpain
| | - Hector Martínez‐Said
- Department of Medical Oncology, Instituto Nacional de CancerologíaMexico CityMexico
| | | | | | | | - Suely A. Nakagawa
- Department of Orthopedics, A.C. Camargo Cancer CenterSão PauloBrazil
| | | | - Emanuela Palmerini
- Department of Medical Oncology, Rizzoli Orthopedic InstituteBolognaItaly
| | - Shreyaskumar Patel
- Department of Melanoma Medical Oncology, University of Texas M. D. Anderson Cancer CenterHoustonTexasUSA
| | - David S. Moura
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)SevillaSpain
| | - Silvia Stacchiotti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori and University of MilanMilanItaly
| | | | | | - Federico Waisberg
- Department of Medical Oncology, Alexander Fleming Cancer InstituteBuenos AiresArgentina
| | - Jean‐Yves Blay
- Department of Medical Oncology, Centre León BérardLyonFrance
| |
Collapse
|
28
|
Chacón M, Pfluger Y, Angel M, Waisberg F, Enrico D. Uncommon Subtypes of Malignant Melanomas: A Review Based on Clinical and Molecular Perspectives. Cancers (Basel) 2020; 12:E2362. [PMID: 32825562 PMCID: PMC7565756 DOI: 10.3390/cancers12092362] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/25/2020] [Accepted: 07/29/2020] [Indexed: 12/26/2022] Open
Abstract
Malignant melanoma represents the most aggressive type of skin cancer. Modern therapies, including targeted agents and immune checkpoint inhibitors, have changed the dismal prognosis that characterized this disease. However, most evidence was obtained by studying patients with frequent subtypes of cutaneous melanoma (CM). Consequently, there is an emerging need to understand the molecular basis and treatment approaches for unusual melanoma subtypes. Even a standardized definition of infrequent or rare melanoma is not clearly established. For that reason, we reviewed this challenging topic considering clinical and molecular perspectives, including uncommon CMs-not associated with classical V600E/K BRAF mutations-malignant mucosal and uveal melanomas, and some unusual independent entities, such as amelanotic, desmoplastic, or spitzoid melanomas. Finally, we collected information regarding melanomas from non-traditional primary sites, which emerge from locations as unique as meninges, dermis, lymph nodes, the esophagus, and breasts. The aim of this review is to summarize and highlight the main scientific evidence regarding rare melanomas, with a particular focus on treatment perspectives.
Collapse
Affiliation(s)
- Matías Chacón
- Department of Medical Oncology, Alexander Fleming Cancer Institute, Buenos Aires 1426, Argentina; (Y.P.); (M.A.); (F.W.); (D.E.)
| | | | | | | | | |
Collapse
|
29
|
Affiliation(s)
| | - Diego Enrico
- Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Martín Angel
- Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| | - Matías Chacón
- Alexander Fleming Cancer Institute, Buenos Aires, Argentina
| |
Collapse
|
30
|
Enrico D, Waisberg F, Burton J, Mando P, Chacón M. Placebo adverse events (AEs) in targeted and immune cancer therapy in the adjuvant and advanced setting: A systematic review and meta-analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.084] [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: 11/14/2022] Open
|