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Saigí M, Mate JL, Carcereny E, Martínez-Cardús A, Esteve A, Andreo F, Centeno C, Cucurull M, Mesia R, Pros E, Sanchez-Cespedes M. HLA-I levels correlate with survival outcomes in response to immune checkpoint inhibitors in non-small cell lung cancer. Lung Cancer 2024; 189:107502. [PMID: 38359742 DOI: 10.1016/j.lungcan.2024.107502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/16/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVES Immune checkpoint inhibitors (ICIs) have provided a breakthrough in the treatment of non-small cell lung cancer (NSCLC) patients, but only some patients benefit substantively. Identifying definitive predictive biomarkers could overcome this limitation. MATERIALS AND METHODS We selected 146 metastatic NSCLC patients treated with anti-PD-(L)1. Immunohistochemistry of HLA-I, PD-L1 and CD73 was performed in 122 tumor biopsies at diagnosis. The association with patients, tumor parameters, and the predictive value to ICI treatment were determined. RESULTS In our cohort, 42 %, 25 %, and 21 % of the tumors exhibited high levels of HLA-I, PD-L1, and CD73, respectively. Lung adenocarcinomas displayed elevated CD73 levels, compared with lung squamous cell carcinomas (P = 0.026). High PD-L1 was significantly correlated with high levels of HLA-I (P = 0.005) and of CD73 (P = 0.025). Patients with high-level HLA-I tumors exhibited more favorable clinical outcomes following ICI, with a median overall survival of 30.7 months (95 % confidence interval [CI]: 18.3 months-not reached), compared with 18.2 months (95 % CI: 12.4-25.2 months) in patients with low-level HLA-I tumors (P = 0.016). The median progression-free survival (PFS) for patients with high-level HLA-I tumors was 18.5 months (95 % CI: 11.1-57.1 months), longer than patients with low-level HLA-I tumors, whose median PFS was 9.2 months (95 % CI: 7.2-11.9 months) (P = 0.006). In a multivariable analysis, high-level HLA-I was independently associated with lower risk of progression to ICI (HR = 0.46, 95 % CI 0.24-0.87; P = 0.018). CONCLUSIONS High-level HLA-I were associated with better clinical outcomes to ICI in our cohort of NSCLC patients. Therefore, further investigations are warranted to refine this biomarker and validate its efficacy in prospective and larger set of patients.
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Affiliation(s)
- Maria Saigí
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Badalona, Barcelona, Spain; Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain.
| | - Jose L Mate
- Department of Pathology, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain
| | - Enric Carcereny
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Badalona, Barcelona, Spain; Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Anna Martínez-Cardús
- Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Anna Esteve
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Badalona, Barcelona, Spain; Statistics Department, Catalan Institute of Oncology (ICO)-Badalona, Badalona, Barcelona, Spain
| | - Felipe Andreo
- Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Carmen Centeno
- Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Marc Cucurull
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Badalona, Barcelona, Spain; Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Ricard Mesia
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Badalona, Barcelona, Spain; Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Eva Pros
- Cancer Genetics Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Barcelona, Spain
| | - Montse Sanchez-Cespedes
- Cancer Genetics Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Barcelona, Spain.
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Candal-Pedreira C, Ruano-Ravina A, Calvo de Juan V, Cobo M, Trigo JM, Rodríguez-Abreu D, Estival A, Carcereny E, Cucurull M, López Castro R, Medina A, García Campelo R, Cordeiro González P, Sánchez-Gastaldo A, Bosch-Barrera J, Massutí B, Dómine M, Camps C, Ortega AL, Sánchez-Hernández A, Guirado Risueño M, Del Barco Morillo E, Garrido Fernández A, Provencio M. Comparison of Clinical and Genetic Characteristics Between Younger and Older Lung Cancer Patients. Arch Bronconeumol 2024; 60:88-94. [PMID: 38160163 DOI: 10.1016/j.arbres.2023.12.005] [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: 11/06/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The aim of this study was to analyze the clinical and genetic characteristics of young lung cancer cases, and to compare them with those of older cases. METHODS We used the Thoracic Tumors Registry (TTR) as a data source representative of lung cancer cases diagnosed in Spain, and included all cases registered until 9/01/2023 which had information on age at diagnosis or the data needed to calculate it. We performed a descriptive statistical analysis and fitted logistic regressions to analyze how different characteristics influenced being a younger lung cancer patient. RESULTS A total of 26,336 subjects were included. Lung cancer cases <50 years old had a higher probability of being women (OR: 1.38; 95% CI: 1.21-1.57), being in stage III or IV (OR: 1.32; 95% CI: 1.08-1.62), not having comorbidities (OR: 5.21; 95% CI: 4.59-5.91), presenting with symptoms at diagnosis (OR: 1.53; 95% CI: 1.29-1.81), and having ALK translocation (OR: 7.61; 95% CI: 1.25-46.32) and HER2 mutation (OR: 5.71; 95% CI: 1.34-24.33), compared with subjects ≥50 years. Among subjects <35 years old (n=61), our study observed a higher proportion of women (59.0% vs. 26.6%; p<0.001), never smokers (45.8% vs. 10.3%; p<0.001), no comorbidities (21.3% vs. 74.0%; p<0.001); ALK translocation (33.3% vs. 4.4%; p<0.001) and ROS1 mutation (14.3% vs. 2.3%; p=0.01), compared with subjects ≥35 years. CONCLUSIONS Lung cancer displays differences by age at diagnosis which may have important implications for its clinical management.
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Affiliation(s)
- Cristina Candal-Pedreira
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain
| | - Alberto Ruano-Ravina
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
| | | | - Manuel Cobo
- UGC Medical Oncology Intercenters, Regional and Virgen de la Victoria University Teaching Hospitals, Malaga, IBIMA, Malaga, Spain
| | - José Manuel Trigo
- UGC Medical Oncology Intercenters, Regional and Virgen de la Victoria University Teaching Hospitals, Malaga, IBIMA, Malaga, Spain
| | | | - Anna Estival
- Gran Canaria Island Hospital, Las Palmas de Gran Canaria, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalonian Oncology Institute, Badalona-Germans Trias i Pujol Hospital, B-ARGO Group, Spain
| | - Marc Cucurull
- Medical Oncology Department, Catalonian Oncology Institute, Badalona-Germans Trias i Pujol Hospital, B-ARGO Group, Spain
| | - Rafael López Castro
- Medical Oncology Section, Valladolid University Clinical Teaching Hospital, Spain
| | - Andrea Medina
- Medical Oncology Section, Valladolid University Clinical Teaching Hospital, Spain
| | | | | | | | - Joaquim Bosch-Barrera
- Catalonian Oncology Institute, Dr. Josep Trueta University Teaching Hospital, Girona, Spain
| | - Bartomeu Massutí
- Dr. Balmis University Teaching Hospital, Alicante Health Research and Biomedical Institute (ISABIAL), Alicante, Spain
| | - Manuel Dómine
- Jiménez Díaz Foundation University Hospital, IIS-FJD, Madrid, Spain
| | - Carlos Camps
- Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital and Precision Oncology Group (OncoGIR-Pro), Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | | | | | | | - Edel Del Barco Morillo
- Medical Oncology Department, Salamanca University Healthcare Complex-IBSAL, Salamanca, Spain
| | | | - Mariano Provencio
- Oncology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
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Chekhun S, Lopez-Paradís A, Urbizu A, Morán T, Mañes A, Cucurull M, Martínez-Barenys C, Teruel I, Moragas G, Carcereny E, Muñoz Mármol AM, Saigí M. Is oligoprogression a potentially curable disease in epidermal growth factor receptor mutant lung adenocarcinoma? Explor Target Antitumor Ther 2023; 4:1182-1187. [PMID: 38213544 PMCID: PMC10776595 DOI: 10.37349/etat.2023.00191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/17/2023] [Indexed: 01/13/2024] Open
Abstract
Third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) have shown impressive results in EGFR mutant lung cancer (LC) patients in terms of disease control rate with a positive impact on overall survival. Nevertheless, after months of treatment with targeted therapy, progression inevitably occurs. Some patients develop oligoprogression and local treatment is required for optimal disease control while maintaining EGFR-TKIs. This work features a clinical case of a patient harboring an EGFR mutant LC undergoing oligoprogression to EGFR-TKIs, first into the brain and afterward to the primary tumor, requiring local ablative strategies, including primary tumor resection three years after the start of osimertinib. Currently, the patient is still alive and continues with a complete response upon EGFR-TKIs maintenance. Hence, oligoprogression, even in driven oncogenic tumors, represents a distinct biological entity and potential curative disease that deserves particular consideration in multidisciplinary tumor boards. In this case, tumor primary resection after three years of the initial diagnosis represents a paradigm shift in the treatment of EGFR mutant patients.
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Affiliation(s)
- Sviatoslav Chekhun
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), 08918 Badalona, Spain
| | - Assumpció Lopez-Paradís
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), 08918 Badalona, Spain
| | - Aintzane Urbizu
- Pathology Department, Hospital Universitari Germans Trias i Pujol (HUGTiP), 08918 Badalona, Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), 08918 Badalona, Spain
| | - Anabel Mañes
- Radiotherapy Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Hospital Universitari Germans Trias i Pujol (HUGTiP), 08918 Badalona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), 08918 Badalona, Spain
| | - Carlos Martínez-Barenys
- Thoracic Surgery Department, Hospital Universitari Germans Trias i Pujol (HUGTiP), 08918 Badalona, Spain
| | - Iris Teruel
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), 08918 Badalona, Spain
| | - Gloria Moragas
- Diagnostic Imaging Institute (IDI), Hospital Universitari Germans Trias i Pujol (HUGTiP), 08918 Badalona, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), 08918 Badalona, Spain
| | - Ana Maria Muñoz Mármol
- Pathology Department, Hospital Universitari Germans Trias i Pujol (HUGTiP), 08918 Badalona, Spain
| | - Maria Saigí
- Medical Oncology Department, Catalan Institute of Oncology (ICO), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), 08918 Badalona, Spain
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Aparicio I, Iranzo P, Reyes R, Bote H, Saigi M, Bringas M, Bosch-Barrera J, Corral J, Aparisi F, Ruffinelli JC, Jiménez B, Lage Y, López-Castro R, Majem M, Vázquez S, Artal Á, Rodríguez-Pérez Á, Lázaro-Quintela M, Torres JMS, Reguart N, Cucurull M, Gil-Bazo I, Camps C, Nadal E, Del Barrio A, Garrido P, Dómine M, Álvarez R, Muñoz AJ, Calles A. Brief report: High incidence of peridiagnosis thromboembolic events in patients with BRAF-mutant lung cancer. Thromb Res 2023; 232:133-137. [PMID: 37976733 DOI: 10.1016/j.thromres.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION We aimed to determine if advanced BRAF-mutant NSCLC has a higher thromboembolic events (TEE) rate than the expected. METHODS Between 2008 and 2021, 182 patients with BRAF-mutant advanced NSCLC (BRAF V600E, n = 70; BRAF non-V600E, n = 112) were retrospectively identified from 18 centers in Spain. Patients received chemotherapy (n = 147), immunotherapy (n = 69), targeted therapy (n = 42), and immunotherapy + chemotherapy (n = 26). RESULTS Incidence rate of TEE was 26.4 % (95%CI: 19.9 %-32.9 %). A total of 72 TEE were documented among 48 patients, as 18 patients (37.5 %) developed more than one event. Median time to TEE onset was 2 months, 69 % of TEE occurred in the peridiagnostic period (+/- 90 days from cancer diagnosis), and in 16 pts. (33 %) TEE was the form of lung cancer presentation. Although most TEE were only venous (82 %; PE, n = 33; DVT, n = 16), arterial events were reported in 31 % and occurred earlier, or TEE presented in atypical locations (13.9 %). TEE were related to high hospitalization rate (59 %), recurrence (23 %), and mortality (10.4 %) despite appropriate anticoagulant/antiaggregant treatment. Median OS in patients without-TEE was 19.4 months (95%CI: 4.6-34.1), and significantly shorter in patients with arterial-TEE vs venous-TEE vs both of them: 9.9 months (95%CI: 0-23.5) vs 41.7 months (95%CI: 11.3-72.2 m) vs 2.7 months (95%CI: 2.1-3.3), p = 0.001. Neither clinical or molecular features (BRAF V600E/non-V600E), nor cancer treatment was associated to TEE occurrence. Khorana score underperformed to predict thrombosis at cancer diagnosis, as only 19.2 % of patients were classified as high-risk. CONCLUSIONS Thrombotic events represent a new clinical feature of BRAF-mutant lung cancer. Patients with almost a 30 % incidence of TEE should be offered systematic anticoagulation.
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Affiliation(s)
- Inmaculada Aparicio
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Patricia Iranzo
- Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Roxana Reyes
- Medical Oncology Department, Thoracic Oncology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Helena Bote
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain;-H12O-CNIO Lung Cancer Clinical Research Unit, Health Research Institute Hospital Universitario 12 de Octubre (i+12), Madrid, Spain
| | - María Saigi
- Medical Oncology Department, Hospital Germans Trías i Pujol, Institut Català d'Oncologia-ICO, Badalona, Barcelona, Spain
| | - Marianela Bringas
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Joaquim Bosch-Barrera
- Medical Oncology, Catalan Institute of Oncology, Hospital Universitari Dr. Josep Trueta, 17007 Girona, Spain. Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), 17190, Salt, Spain
| | - Jesús Corral
- Clínica Universidad de Navarra, Department of Oncology, Pamplona, Spain
| | - Francisco Aparisi
- Medical Oncology Department, Hospital General Universitario de Valencia, Department of Medicine, Universitat de València, TRIAL Mixed Unit, Centro Investigación Príncipe Felipe-Fundación Investigación Hospital General Universitario de Valencia. CIBERONC, Valencia, Spain
| | - Jose C Ruffinelli
- Medical Oncology Department, Centre Sanitari i Universitari de Bellvitge, Institut Català d'Oncologia (-ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Yolanda Lage
- Medical Oncology Department; Ramón y Cajal University Hospital, Madrid, Spain
| | | | - Margarita Majem
- Department of Medical Oncology; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sergio Vázquez
- Medical Oncology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Ángel Artal
- Medical Oncology Service, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Ángel Rodríguez-Pérez
- Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Noemí Reguart
- Medical Oncology Department, Thoracic Oncology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Hospital Germans Trías i Pujol, Institut Català d'Oncologia-ICO, Badalona, Barcelona, Spain
| | - Ignacio Gil-Bazo
- Clínica Universidad de Navarra, Department of Oncology, Pamplona, Spain; Instituto Valenciano de Oncología, Department of Oncology, Valencia, Spain
| | - Carlos Camps
- Medical Oncology Department, Hospital General Universitario de Valencia, Department of Medicine, Universitat de València, TRIAL Mixed Unit, Centro Investigación Príncipe Felipe-Fundación Investigación Hospital General Universitario de Valencia. CIBERONC, Valencia, Spain
| | - Ernest Nadal
- Medical Oncology Department, Centre Sanitari i Universitari de Bellvitge, Institut Català d'Oncologia (-ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Pilar Garrido
- Medical Oncology Department; Ramón y Cajal University Hospital, Madrid, Spain
| | - Manuel Dómine
- Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Rosa Álvarez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Andrés J Muñoz
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Antonio Calles
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
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Notario L, Cucurull M, Cerdà G, Sanz C, Carcereny E, Muñoz-Mármol A, Hernández A, Domènech M, Morán T, Sánchez-Céspedes M, Costa M, Mate JL, Esteve A, Saigí M. Characterization of a cohort of metastatic lung cancer patients harboring KRAS mutations treated with immunotherapy: differences according to KRAS G12C vs. non-G12C. Front Oncol 2023; 13:1239000. [PMID: 37916173 PMCID: PMC10616300 DOI: 10.3389/fonc.2023.1239000] [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: 06/12/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023] Open
Abstract
Approximately 20% of lung adenocarcinomas harbor activating mutations at KRAS, an oncogene with the ability to alter the tumor immune microenvironment. In this retrospective study, we examined 103 patients with KRAS-mutant lung adenocarcinoma who were treated with immunotherapy-based regimens and we evaluated the clinical outcomes according to PD-L1 expression and the type of KRAS mutation. Among all patients included, 47% carried KRAS G12C mutation whereas 53% harbored KRAS non-G12C mutations. PD-L1 status was available for 77% of cases, with higher expression among KRAS G12C tumors (p = 0.01). Better overall survival and progression-free survival were observed in high PD-L1 expression tumors, regardless of KRAS mutation type. The heterogeneous nature of KRAS-mutant tumors and the presence of other co-mutations may contribute to different outcomes to immunotherapy-based strategies.
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Affiliation(s)
- Lucía Notario
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Germans Trias i Pujol University Hospital (HUGTiP), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Germans Trias i Pujol University Hospital (HUGTiP), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Gabriela Cerdà
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Germans Trias i Pujol University Hospital (HUGTiP), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Carolina Sanz
- Pathology Department, Germans Trias i Pujol University Hospital (HUGTiP), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Germans Trias i Pujol University Hospital (HUGTiP), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Ana Muñoz-Mármol
- Pathology Department, Germans Trias i Pujol University Hospital (HUGTiP), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Ainhoa Hernández
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Germans Trias i Pujol University Hospital (HUGTiP), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Marta Domènech
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Germans Trias i Pujol University Hospital (HUGTiP), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Germans Trias i Pujol University Hospital (HUGTiP), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Montse Sánchez-Céspedes
- Cancer Genetics Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Barcelona, Spain
| | - Marta Costa
- Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Jose-Luis Mate
- Pathology Department, Germans Trias i Pujol University Hospital (HUGTiP), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Anna Esteve
- Statistics Department, Catalan Institute of Oncology (ICO)-Badalona, Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - Maria Saigí
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Germans Trias i Pujol University Hospital (HUGTiP), Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
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Plaja A, Teruel I, Ochoa-de-Olza M, Cucurull M, Arroyo ÁJ, Pardo B, Ortiz I, Gil-Martin M, Piulats JM, Pla H, Fina C, Carbó A, Barretina-Ginesta MP, Martínez-Román S, Carballas E, González A, Esteve A, Romeo M. Prognostic Role of Neutrophil, Monocyte and Platelet to Lymphocyte Ratios in Advanced Ovarian Cancer According to the Time of Debulking Surgery. Int J Mol Sci 2023; 24:11420. [PMID: 37511180 PMCID: PMC10380459 DOI: 10.3390/ijms241411420] [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: 06/05/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Despite a multimodal radical treatment, mortality of advanced epithelial ovarian cancer (AEOC) remains high. Host-related factors, such as systemic inflammatory response and its interplay with the immune system, remain underexplored. We hypothesized that the prognostic impact of this response could vary between patients undergoing primary debulking surgery (PDS) and those undergoing interval debulking surgery (IDS). Therefore, we evaluated the outcomes of two surgical groups of newly diagnosed AEOC patients according to the neutrophil, monocyte and platelet to lymphocyte ratios (NLR, MLR, PLR), taking median ratio values as cutoffs. In the PDS group (n = 61), low NLR and PLR subgroups showed significantly better overall survival (not reached (NR) vs. 72.7 months, 95% confidence interval [CI]: 40.9-95.2, p = 0.019; and NR vs. 56.1 months, 95% CI: 40.9-95.2, p = 0.004, respectively) than those with high values. Similar results were observed in progression free survival. NLR and PLR-high values resulted in negative prognostic factors, adjusting for residual disease, BRCA1/2 status and stage (HR 2.48, 95% CI: 1.03-5.99, p = 0.043, and HR 2.91, 95% CI: 1.11-7.64, p = 0.03, respectively). In the IDS group (n = 85), ratios were not significant prognostic factors. We conclude that NLR and PLR may have prognostic value in the PDS setting, but none in IDS, suggesting that time of surgery can modulate the prognostic impact of baseline complete blood count (CBC).
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Affiliation(s)
- Andrea Plaja
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Iris Teruel
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Maria Ochoa-de-Olza
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Álvaro Javier Arroyo
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Beatriz Pardo
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Irene Ortiz
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Marta Gil-Martin
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Josep María Piulats
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-L'Hospitalet, Hospital Duran i Reynals, Institut d'Investigació de Bellvitge (IDIBELL), 08908 Barcelona, Spain
| | - Helena Pla
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Girona, Girona Biomedical Research Institut d'Investigació Biomèdica de Girona (IDIBGi), 17007 Girona, Spain
| | - Claudia Fina
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Girona, Girona Biomedical Research Institut d'Investigació Biomèdica de Girona (IDIBGi), 17007 Girona, Spain
| | - Anna Carbó
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Girona, Girona Biomedical Research Institut d'Investigació Biomèdica de Girona (IDIBGi), 17007 Girona, Spain
| | - Maria-Pilar Barretina-Ginesta
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Girona, Girona Biomedical Research Institut d'Investigació Biomèdica de Girona (IDIBGi), 17007 Girona, Spain
| | - Sergio Martínez-Román
- Obstetrics and Gynecologycal Department, Hospital Germans Trias i Pujol, 08916 Badalona, Spain
| | - Elvira Carballas
- Obstetrics and Gynecologycal Department, Hospital Germans Trias i Pujol, 08916 Badalona, Spain
| | - Andrea González
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Anna Esteve
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
| | - Margarita Romeo
- Medical Oncology Department, Institut Català d'Oncologia (ICO)-Badalona, Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació Germans Trias i Pujol (IGTP), 08916 Badalona, Spain
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7
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Zapardiel I, Gracia Segovia M, Macuks R, Mancari R, Achimas-Cadariu P, Corrado G, Bartusevicius A, Sukhin V, Muruzabal JC, Coronado Martín PJ, Gardella B, Piek JM, Concin N, Arab C, Papatheodorou D, Polterauer S, Iacoponi S, Nieto T, Lopez-Sanclemente MC, Trukhan H, Gil MM, Bakinovskaya I, Dalamanava A, Cucurull M, Rovski D, Baquedano L, Chiva L, Mardas M, Mavrichev SA, Klat J, Lopez de la Manzanara CA, Yildirim Y. Prognostic factors in patients with uterine sarcoma: the SARCUT study. Int J Gynecol Cancer 2023:ijgc-2022-004204. [PMID: 37192761 DOI: 10.1136/ijgc-2022-004204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma. METHODS This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007. RESULTS The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93). CONCLUSION Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.
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Affiliation(s)
- Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | | | - Ronalds Macuks
- Riga East Clinical University Hospital Latvian Oncology Center, Riga, Latvia
| | - Rosanna Mancari
- Gynecologic Oncology Department, IRCCS, Milan, Italy
- Gynecologic Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patriciu Achimas-Cadariu
- Gynecologic Oncology Department, The Oncology Institute 'Prof Dr Ion Chiricuta' Cluj-Napoca, Cluj-Napoca, Romania
| | - Giacomo Corrado
- Policlinico Universitario Agostino Gemelli Dipartimento Scienze della Salute della Donna e del Bambino, Roma, Italy
| | - Arnoldas Bartusevicius
- Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vladyslav Sukhin
- Oncology, Radiology and Radiation Medicine, V N Karazin Kharkiv National University, Harkiv, Ukraine
- Oncogynecology, Grigoriev Institute for Medical Radiology NAMS of Ukraine, Harkiv, Ukraine
| | - Juan C Muruzabal
- Gynecologic Oncology Unit, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Barbara Gardella
- Gynecologic Oncology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Jurgen M Piek
- Gynecologic Oncology Department, Catharina Hospital and Catharina Cancer Institute, Eindhoven, Netherlands
| | - Nicole Concin
- Department of Gynecology and Obstetrics, Innsbruck Medical Univeristy, Innsbruck, Austria
- Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Clemente Arab
- Gynecologic Oncology Department, Hospital Luis Tisné. Universidad de Chile, Santiago, Chile
| | | | - Stephan Polterauer
- Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology, Vienna, Austria
| | - Sara Iacoponi
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Teresa Nieto
- Gynecologic Oncology Department, Hospital Universitario Santa Cristina, Madrid, Spain
| | - Martha C Lopez-Sanclemente
- Gynecologic Oncology Department, Torrecárdenas Hospital Complex, Almeria, Andalucía, Spain
- Gynecologic Oncology Department, Clinica Diatros, Barcelona, Spain
| | - Hanna Trukhan
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Maria M Gil
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Irina Bakinovskaya
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Alena Dalamanava
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Marc Cucurull
- Catalan Institute of Oncology, L'Hospitalet de Llobregat, Catalunya, Spain
| | - Dzmitry Rovski
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Laura Baquedano
- Gynecologic Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Luis Chiva
- Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
| | - Marcin Mardas
- Department of Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | | | - Jaroslav Klat
- Obstetrics and Gynecology Department, University Hospital Ostrava, Ostrava, Moravskoslezský, Czech Republic
| | | | - Yusuf Yildirim
- Gynecologic Oncology Department, Tepecik Training and Research Hospital Clinics, Konak, Izmir, Turkey
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8
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Felip E, Pradenas E, Romeo M, Marfil S, Trinité B, Urrea V, Hernández A, Ballana E, Cucurull M, Mateu L, Massanella M, Clotet B, Morán T, Blanco J. Impact of chemotherapy and/or immunotherapy on neutralizing antibody response to SARS-CoV-2 mRNA-1237 vaccine in patients with solid tumors. Mol Oncol 2023; 17:686-694. [PMID: 36495129 PMCID: PMC9877816 DOI: 10.1002/1878-0261.13359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/02/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Patients with solid tumors have been a risk group since the beginning of the SARS-CoV-2 pandemic due to more significant complications, hospitalizations or deaths. The immunosuppressive state of cancer treatments or the tumor itself could influence the development of post-vaccination antibodies. This study prospectively analyzed 89 patients under chemotherapy and/or immunotherapy, who received two doses of the mRNA-1237 vaccine, and were compared with a group of 26 non-cancer individuals. Information on adverse events and neutralizing antibodies against the ancestral strain of SARS-CoV-2 (WH1) have been analyzed. Local reactions accounted for 65%, while systemic reactions accounted for 46% of oncologic individuals/cancer patients. Regarding the response to vaccination, 6.7% of cancer patients developed low neutralizing antibody levels. Lower levels of neutralizing antibodies between cancer and non-cancer groups were significant in individuals without previous SARS-CoV-2 infection, but not in previously infected individuals. We also observed that patients receiving chemotherapy or chemoimmunotherapy have significantly lower levels of neutralizing antibodies than non-cancer individuals. In conclusion, our study confirms the importance of prioritizing cancer patients receiving anticancer treatment in SARS-CoV-2 vaccination programs.
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Affiliation(s)
- Eudald Felip
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | | | - Margarita Romeo
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | | | | | | | - Ainhoa Hernández
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Ester Ballana
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Germans Trias i Pujol Research Institute (IGTP)BadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
| | - Marc Cucurull
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Lourdes Mateu
- Infectious Diseases DepartmentHospital Universitari Germans Trias i PujolBadalonaSpain
- Fundació Lluita contra les InfeccionsHospital Universitari Germans Trias i PujolBadalonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Marta Massanella
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Bonaventura Clotet
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Julià Blanco
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Germans Trias i Pujol Research Institute (IGTP)BadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
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9
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Cortellini A, Tabernero J, Mukherjee U, Salazar R, Sureda A, Maluquer C, Ferrante D, Bower M, Sharkey R, Mirallas O, Plaja A, Cucurull M, Mesia R, Dalla Pria A, Newsom-Davis T, Van Hemelrijck M, Sita-Lumsden A, Apthorp E, Vincenzi B, Di Fazio GR, Tonini G, Pantano F, Bertuzzi A, Rossi S, Brunet J, Lambertini M, Pedrazzoli P, Biello F, D'Avanzo F, Lee AJX, Shawe-Taylor M, Rogers L, Murphy C, Cooper L, Andaleeb R, Khalique S, Bawany S, Ahmed S, Carmona-García MC, Fort-Culillas R, Liñan R, Zoratto F, Rizzo G, Perachino M, Doonga K, Gaidano G, Bruna R, Patriarca A, Martinez-Vila C, Pérez Criado I, Giusti R, Mazzoni F, Antonuzzo L, Santoro A, Parisi A, Queirolo P, Aujayeb A, Rimassa L, Diamantis N, Bertulli R, Fulgenzi CAM, D'Alessio A, Ruiz-Camps I, Saoudi-Gonzalez N, Garcia Illescas D, Medina I, Fox L, Gennari A, Aguilar-Company J, Pinato DJ, Swallow J, Hanbury G, Chung C, Patel M, Dettorre G, Belessiotis K, Saorise D, Jones E, Apthorp E, Moss C, Russell B, Townsend S, Jackson A, Loizidou A, Piccart M, Pommeret F, Colomba-Blameble E, Prat A, Cruz CA, Reyes R, Segui E, Marco-Hernández J, Viladot M, Harbeck N, Wuerstlein R, Henze F, Mahner S, Felip E, Scotti L, Marrari A, Grosso F, Fusco V, Delfanti S, Rossi M, Zambelli A, Tondini C, Chiudinelli L, Franchi M, Libertini M, Provenzano S, Generali D, Grisanti S, Baggi A, Tovazzi V, Ficorella C, Porzio G, Saponara M, Filetti M, Tucci M, Berardi R, Cantini L, Paoloni F, Guida A, Bracarda S, Iglesias M, Sanchez de Torre A, Tagliamento M. SARS-CoV-2 omicron (B.1.1.529)-related COVID-19 sequelae in vaccinated and unvaccinated patients with cancer: results from the OnCovid registry. Lancet Oncol 2023; 24:335-346. [PMID: 36898391 PMCID: PMC9991062 DOI: 10.1016/s1470-2045(23)00056-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND COVID-19 sequelae can affect about 15% of patients with cancer who survive the acute phase of SARS-CoV-2 infection and can substantially impair their survival and continuity of oncological care. We aimed to investigate whether previous immunisation affects long-term sequelae in the context of evolving variants of concern of SARS-CoV-2. METHODS OnCovid is an active registry that includes patients aged 18 years or older from 37 institutions across Belgium, France, Germany, Italy, Spain, and the UK with a laboratory-confirmed diagnosis of COVID-19 and a history of solid or haematological malignancy, either active or in remission, followed up from COVID-19 diagnosis until death. We evaluated the prevalence of COVID-19 sequelae in patients who survived COVID-19 and underwent a formal clinical reassessment, categorising infection according to the date of diagnosis as the omicron (B.1.1.529) phase from Dec 15, 2021, to Jan 31, 2022; the alpha (B.1.1.7)-delta (B.1.617.2) phase from Dec 1, 2020, to Dec 14, 2021; and the pre-vaccination phase from Feb 27 to Nov 30, 2020. The prevalence of overall COVID-19 sequelae was compared according to SARS-CoV-2 immunisation status and in relation to post-COVID-19 survival and resumption of systemic anticancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974. FINDINGS At the follow-up update on June 20, 2022, 1909 eligible patients, evaluated after a median of 39 days (IQR 24-68) from COVID-19 diagnosis, were included (964 [50·7%] of 1902 patients with sex data were female and 938 [49·3%] were male). Overall, 317 (16·6%; 95% CI 14·8-18·5) of 1909 patients had at least one sequela from COVID-19 at the first oncological reassessment. The prevalence of COVID-19 sequelae was highest in the pre-vaccination phase (191 [19·1%; 95% CI 16·4-22·0] of 1000 patients). The prevalence was similar in the alpha-delta phase (110 [16·8%; 13·8-20·3] of 653 patients, p=0·24), but significantly lower in the omicron phase (16 [6·2%; 3·5-10·2] of 256 patients, p<0·0001). In the alpha-delta phase, 84 (18·3%; 95% CI 14·6-22·7) of 458 unvaccinated patients and three (9·4%; 1·9-27·3) of 32 unvaccinated patients in the omicron phase had sequelae. Patients who received a booster and those who received two vaccine doses had a significantly lower prevalence of overall COVID-19 sequelae than unvaccinated or partially vaccinated patients (ten [7·4%; 95% CI 3·5-13·5] of 136 boosted patients, 18 [9·8%; 5·8-15·5] of 183 patients who had two vaccine doses vs 277 [18·5%; 16·5-20·9] of 1489 unvaccinated patients, p=0·0001), respiratory sequelae (six [4·4%; 1·6-9·6], 11 [6·0%; 3·0-10·7] vs 148 [9·9%; 8·4-11·6], p=0·030), and prolonged fatigue (three [2·2%; 0·1-6·4], ten [5·4%; 2·6-10·0] vs 115 [7·7%; 6·3-9·3], p=0·037). INTERPRETATION Unvaccinated patients with cancer remain highly vulnerable to COVID-19 sequelae irrespective of viral strain. This study confirms the role of previous SARS-CoV-2 immunisation as an effective measure to protect patients from COVID-19 sequelae, disruption of therapy, and ensuing mortality. FUNDING UK National Institute for Health and Care Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.
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Affiliation(s)
- Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, London, UK; Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy.
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | - Ramon Salazar
- Catalan Institute of Oncology (ICO), University of Barcelona, Bellvitge Biomedical Research Institute (IDIBELL), CIBERONC, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Sureda
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Clara Maluquer
- Haematology Department, ICO Hospitalet, Hospitalet de Llobregat, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Daniela Ferrante
- Unit of Medical Statistics, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Rachel Sharkey
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Oriol Mirallas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Andrea Plaja
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Marc Cucurull
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Ricard Mesia
- Medical Oncology Department, B-ARGO Group, IGTP, Catalan Institute of Oncology, Badalona, Spain
| | - Alessia Dalla Pria
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Thomas Newsom-Davis
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Mieke Van Hemelrijck
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK; Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | | | - Bruno Vincenzi
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Giuseppina Rita Di Fazio
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Giuseppe Tonini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Francesco Pantano
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Sabrina Rossi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Matteo Lambertini
- Medical Oncology Department, UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Francesca D'Avanzo
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Alvin J X Lee
- Cancer Division, University College London Hospitals, London, UK
| | | | - Lucy Rogers
- Cancer Division, University College London Hospitals, London, UK
| | - Cian Murphy
- Cancer Division, University College London Hospitals, London, UK
| | - Lee Cooper
- Cancer Division, University College London Hospitals, London, UK
| | - Ramis Andaleeb
- Cancer Division, University College London Hospitals, London, UK
| | - Saira Khalique
- Cancer Division, University College London Hospitals, London, UK
| | - Samira Bawany
- Cancer Division, University College London Hospitals, London, UK
| | - Sarah Ahmed
- Cancer Division, University College London Hospitals, London, UK
| | - M Carmen Carmona-García
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Roser Fort-Culillas
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Raquel Liñan
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | | | - Gianpiero Rizzo
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marta Perachino
- Medical Oncology Department, UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genova, Genova, Italy
| | - Kris Doonga
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Riccardo Bruna
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | | | | | | | | | | | - Armando Santoro
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alessandro Parisi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Queirolo
- Melanoma and Sarcoma Medical Treatment Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Rossella Bertulli
- Medical Oncology 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia A M Fulgenzi
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Antonio D'Alessio
- Department of Surgery and Cancer, Imperial College London, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Isabel Ruiz-Camps
- Department of Infectious Diseases, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Nadia Saoudi-Gonzalez
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - David Garcia Illescas
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - Irene Medina
- Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Laura Fox
- Department of Hematology, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Ospedale Maggiore della Caritá, Novara, Italy
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain; Department of Infectious Diseases, Vall d'Hebron University Hospital and Institute of Oncology, Barcelona, Spain
| | - David J Pinato
- Department of Surgery and Cancer, Imperial College London, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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Hernandez A, Notario L, Quirant B, Felip E, Boigues M, Saigí M, Cucurull M, Torres P, Martinez M, Castella RG, Esteban MR, Martin MB, Carcereny E, Domenech M, Estival A, Pous A, López-Paradís A, Romeo M, Moran T. OA06.04 Immune Response after SARS-CoV-2 Vaccination in Lung Cancer Patients. Update of the Covid Lung Vaccine Cohort. J Thorac Oncol 2022. [PMCID: PMC9452014 DOI: 10.1016/j.jtho.2022.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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11
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Saigí M, Carcereny E, Morán T, Cucurull M, Domènech M, Hernandez A, Martinez-Cardús A, Pros E, Sanchez-Cespedes M. Biological and clinical perspectives of the actionable gene fusions and amplifications involving tyrosine kinase receptors in lung cancer. Cancer Treat Rev 2022; 109:102430. [DOI: 10.1016/j.ctrv.2022.102430] [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: 03/21/2022] [Revised: 05/20/2022] [Accepted: 06/15/2022] [Indexed: 11/02/2022]
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12
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Pinato DJ, Aguilar-Company J, Ferrante D, Hanbury G, Bower M, Salazar R, Mirallas O, Sureda A, Plaja A, Cucurull M, Mesia R, Townsend S, Jackson A, Dalla Pria A, Newsom-Davis T, Handford J, Sita-Lumsden A, Apthorp E, Vincenzi B, Bertuzzi A, Brunet J, Lambertini M, Maluquer C, Pedrazzoli P, Biello F, Sinclair A, Bawany S, Khalique S, Rossi S, Rogers L, Murphy C, Belessiotis K, Carmona-García MC, Sharkey R, García-Illescas D, Rizzo G, Perachino M, Saoudi-Gonzalez N, Doonga K, Fox L, Roldán E, Gaidano G, Ruiz-Camps I, Bruna R, Patriarca A, Martinez-Vila C, Cantini L, Zambelli A, Giusti R, Mazzoni F, Caliman E, Santoro A, Grosso F, Parisi A, Queirolo P, Aujayeb A, Rimassa L, Prat A, Tucci M, Libertini M, Grisanti S, Mukherjee U, Diamantis N, Fusco V, Generali D, Provenzano S, Gennari A, Tabernero J, Cortellini A, Evans JS, Swallow J, Chung C, Patel M, Dettorre G, Ottaviani D, Chowdhury A, Merry E, Chopra N, Lee AJX, Sng CCT, Yu T, Shawe-Taylor M, Bain HDC, Wong YNS, Galazi M, Benafif S, Dileo P, Earnshaw I, Patel G, Wu A, Soosaipillai G, Cooper L, Andaleeb R, Dolly S, Apthorp E, Srikandarajah K, Jones E, Van Hemelrijck M, Moss C, Russell B, Chester J, Loizidou A, Piccart M, Cruz CA, Reyes R, Segui E, Marco-Hernández J, Viladot M, Eremiev S, Fort-Culillas R, Garcia I, Liñan R, Roqué Lloveras A, Harbeck N, Wuerstlein R, Henze F, Mahner S, Felip E, Pous A, D'Avanzo F, Scotti L, Krengli M, Marrari A, Delfanti S, Maconi A, Betti M, Tonini G, Di Fazio GR, Tondini C, Chiudinelli L, Franchi M, Libertini M, Bertulli R, Baggi A, Tovazzi V, Ficorella C, Porzio G, Saponara M, Filetti M, Zoratto F, Paoloni F, Berardi R, Guida A, Bracarda S, Iglesias M, Sanchez de Torre A, Tagliamento M, Colomba E, Pommeret F. Outcomes of the SARS-CoV-2 omicron (B.1.1.529) variant outbreak among vaccinated and unvaccinated patients with cancer in Europe: results from the retrospective, multicentre, OnCovid registry study. Lancet Oncol 2022; 23:865-875. [PMID: 35660139 PMCID: PMC9162476 DOI: 10.1016/s1470-2045(22)00273-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND The omicron (B.1.1.529) variant of SARS-CoV-2 is highly transmissible and escapes vaccine-induced immunity. We aimed to describe outcomes due to COVID-19 during the omicron outbreak compared with the prevaccination period and alpha (B.1.1.7) and delta (B.1.617.2) waves in patients with cancer in Europe. METHODS In this retrospective analysis of the multicentre OnCovid Registry study, we recruited patients aged 18 years or older with laboratory-confirmed diagnosis of SARS-CoV-2, who had a history of solid or haematological malignancy that was either active or in remission. Patient were recruited from 37 oncology centres from UK, Italy, Spain, France, Belgium, and Germany. Participants were followed up from COVID-19 diagnosis until death or loss to follow-up, while being treated as per standard of care. For this analysis, we excluded data from centres that did not actively enter new data after March 1, 2021 (in France, Germany, and Belgium). We compared measures of COVID-19 morbidity, which were complications from COVID-19, hospitalisation due to COVID-19, and requirement of supplemental oxygen and COVID-19-specific therapies, and COVID-19 mortality across three time periods designated as the prevaccination (Feb 27 to Nov 30, 2020), alpha-delta (Dec 1, 2020, to Dec 14, 2021), and omicron (Dec 15, 2021, to Jan 31, 2022) phases. We assessed all-cause case-fatality rates at 14 days and 28 days after diagnosis of COVID-19 overall and in unvaccinated and fully vaccinated patients and in those who received a booster dose, after adjusting for country of origin, sex, age, comorbidities, tumour type, stage, and status, and receipt of systemic anti-cancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974, and is ongoing. FINDINGS As of Feb 4, 2022 (database lock), the registry included 3820 patients who had been diagnosed with COVID-19 between Feb 27, 2020, and Jan 31, 2022. 3473 patients were eligible for inclusion (1640 [47·4%] were women and 1822 [52·6%] were men, with a median age of 68 years [IQR 57-77]). 2033 (58·5%) of 3473 were diagnosed during the prevaccination phase, 1075 (31·0%) during the alpha-delta phase, and 365 (10·5%) during the omicron phase. Among patients diagnosed during the omicron phase, 113 (33·3%) of 339 were fully vaccinated and 165 (48·7%) were boosted, whereas among those diagnosed during the alpha-delta phase, 152 (16·6%) of 915 were fully vaccinated and 21 (2·3%) were boosted. Compared with patients diagnosed during the prevaccination period, those who were diagnosed during the omicron phase had lower case-fatality rates at 14 days (adjusted odds ratio [OR] 0·32 [95% CI 0·19-0·61) and 28 days (0·34 [0·16-0·79]), complications due to COVID-19 (0·26 [0·17-0·46]), and hospitalisation due to COVID-19 (0·17 [0·09-0·32]), and had less requirements for COVID-19-specific therapy (0·22 [0·15-0·34]) and oxygen therapy (0·24 [0·14-0·43]) than did those diagnosed during the alpha-delta phase. Unvaccinated patients diagnosed during the omicron phase had similar crude case-fatality rates at 14 days (ten [25%] of 40 patients vs 114 [17%] of 656) and at 28 days (11 [27%] of 40 vs 184 [28%] of 656) and similar rates of hospitalisation due to COVID-19 (18 [43%] of 42 vs 266 [41%] of 652) and complications from COVID-19 (13 [31%] of 42 vs 237 [36%] of 659) as those diagnosed during the alpha-delta phase. INTERPRETATION Despite time-dependent improvements in outcomes reported in the omicron phase compared with the earlier phases of the pandemic, patients with cancer remain highly susceptible to SARS-CoV-2 if they are not vaccinated against SARS-CoV-2. Our findings support universal vaccination of patients with cancer as a protective measure against morbidity and mortality from COVID-19. FUNDING National Institute for Health and Care Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.
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Cucurull M, Notario L, Sanchez-Cespedes M, Hierro C, Estival A, Carcereny E, Saigí M. Targeting KRAS in Lung Cancer Beyond KRAS G12C Inhibitors: The Immune Regulatory Role of KRAS and Novel Therapeutic Strategies. Front Oncol 2022; 11:793121. [PMID: 35096591 PMCID: PMC8793278 DOI: 10.3389/fonc.2021.793121] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
Approximately 20% of lung adenocarcinomas harbor KRAS mutations, an oncogene that drives tumorigenesis and has the ability to alter the immune system and the tumor immune microenvironment. While KRAS was considered “undruggable” for decades, specific KRAS G12C covalent inhibitors have recently emerged, although their promising results are limited to a subset of patients. Several other drugs targeting KRAS activation and downstream signaling pathways are currently under investigation in early-phase clinical trials. In addition, KRAS mutations can co-exist with other mutations in significant genes in cancer (e.g., STK11 and KEAP1) which induces tumor heterogeneity and promotes different responses to therapies. This review describes the molecular characterization of KRAS mutant lung cancers from a biologic perspective to its clinical implications. We aim to summarize the tumor heterogeneity of KRAS mutant lung cancers and its immune-regulatory role, to report the efficacy achieved with current immunotherapies, and to overview the therapeutic approaches targeting KRAS mutations besides KRAS G12C inhibitors.
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Affiliation(s)
- Marc Cucurull
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Barcelona, Spain.,Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Barcelona, Spain
| | - Lucia Notario
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Barcelona, Spain.,Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Barcelona, Spain
| | | | - Cinta Hierro
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Barcelona, Spain.,Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Barcelona, Spain
| | - Anna Estival
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Barcelona, Spain.,Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Barcelona, Spain
| | - Enric Carcereny
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Barcelona, Spain.,Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Barcelona, Spain
| | - Maria Saigí
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Barcelona, Spain.,Badalona·Applied Research Group in Oncology (B·ARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Barcelona, Spain
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Plaja A, Moran T, Carcereny E, Saigi M, Hernández A, Cucurull M, Domènech M. Small-Cell Lung Cancer Long-Term Survivor Patients: How to Find a Needle in a Haystack? Int J Mol Sci 2021; 22:ijms222413508. [PMID: 34948300 PMCID: PMC8707503 DOI: 10.3390/ijms222413508] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/28/2022] Open
Abstract
Small-cell lung cancer (SCLC) is an aggressive malignancy characterized by a rapid progression and a high resistance to treatments. Unlike other solid tumors, there has been a scarce improvement in emerging treatments and survival during the last years. A better understanding of SCLC biology has allowed for the establishment of a molecular classification based on four transcription factors, and certain therapeutic vulnerabilities have been proposed. The universal inactivation of TP53 and RB1, along with the absence of mutations in known targetable oncogenes, has hampered the development of targeted therapies. On the other hand, the immunosuppressive microenvironment makes the success of immune checkpoint inhibitors (ICIs), which have achieved a modest improvement in overall survival in patients with extensive disease, difficult. Currently, atezolizumab or durvalumab, in combination with platinum–etoposide chemotherapy, is the standard of care in first-line setting. However, the magnitude of the benefit is scarce and no predictive biomarkers of response have yet been established. In this review, we describe SCLC biology and molecular classification, examine the SCLC tumor microenvironment and the challenges of predictive biomarkers of response to new treatments, and, finally, assess clinical and molecular characteristics of long-term survivor patients in order to identify possible prognostic factors and treatment vulnerabilities.
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Calvo V, Carcereny E, Abreu DR, Lopez-Castro R, Guirado M, Camps C, Cobo M, Ortega A, Bernabé R, Massuti B, Mosquera J, Del Barco E, Gonzalez - Larriba J, Bosch - Barrera J, Ojeda CG, Domine M, Juan O, Martínez-Cutillas M, Benítez G, Collazo-Lorduy A, Cucurull M, Provencio M. OA14.01 Family History of Cancer and Lung Cancer: Information from the Thoracic Tumors Registry (TTR Study). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Plaja A, Moran T, Carcereny E, Bernat A, Martinez Cardus A, Hernández A, Saigi M, Estival Gonzalez A, Cucurull M, Domenech Vinolas M. 1658P Clinical characteristics of long-term survivors (LTS) in small cell lung cancer (SCLC) patients (p) with extended disease (ED). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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17
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Domènech M, Muñoz Marmol AM, Mate JL, Estival A, Moran T, Cucurull M, Saigi M, Hernandez A, Sanz C, Hernandez-Gallego A, Urbizu A, Martinez-Cardus A, Bernat A, Carcereny E. Correlation between PD-L1 expression and MET gene amplification in patients with advanced non-small cell lung cancer and no other actionable oncogenic driver. Oncotarget 2021; 12:1802-1810. [PMID: 34504652 PMCID: PMC8416561 DOI: 10.18632/oncotarget.28045] [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: 05/31/2021] [Accepted: 07/28/2021] [Indexed: 12/25/2022] Open
Abstract
Non-small cell lung cancers (NSCLC) are the most common type of lung cancer and can be classified according to the presence of mutually exclusive oncogenic drivers. The majority of NSCLC patients present a non-actionable oncogenic driver, and treatment resistance through the amplification of the METproto-oncogene (MET) or the expression of programmed cell death protein 1 ligand (PD-L1) is common. Herein, we investigated the relation between MET gene amplification and PD-L1 expression in patients with advanced NSCLC and no other actionable oncogenic driver (i.e., EGFR, ALK, ROS1). Our retrospective observational study analyzed data from 48 patients (78% men, median age 66 years) admitted to the Germans Trias i Pujol Hospital, Spain, between July 2015 and February 2019. Patients presenting MET amplification showed a higher proportion of PD-L1 expression (93% vs. 39%; p < 0.001) and overexpression (64% vs. 27%; p = 0.020) than those with non-amplified MET. PD-L1 expression was not significantly different when analyzed by sex (p = 0.624), smoking history (p = 0.429), and Eastern Cooperative Oncology Group Performance Status (p = 0.597) Overall survival rates were not significantly affected by MET amplification (high and intermediate amplification vs low amplification and non-amplificated) (p = 0.252) nor PD-L1 expression (> vs =< 50%) (p = 0.893). In conclusion, a positive correlation was found between MET gene amplification and PD-L1 expression and highly expressed (above 50%) in patients with NSCLC and no other actionable oncogenic driver. It could be translated as new guided-treatment oportunities for these patients.
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Affiliation(s)
- Marta Domènech
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain.,Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Ana M Muñoz Marmol
- Pathology Department, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - Jose Luis Mate
- Pathology Department, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - Anna Estival
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain.,Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Teresa Moran
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain.,Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain.,Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Maria Saigi
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain.,Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Ainhoa Hernandez
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain.,Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Carolina Sanz
- Pathology Department, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | | | - Aintzane Urbizu
- Pathology Department, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - Anna Martinez-Cardus
- Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Adrià Bernat
- Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain.,Badalona Applied Research Group in Oncology (BARGO), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
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Provencio M, Mazarico Gallego JM, Calles A, Antoñanzas M, Pangua C, Mielgo Rubio X, Nadal E, Castro RL, López-Martín A, Del Barco E, Dómine M, Franco F, Diz P, Sandoval C, Girona ES, Sullivan I, Sala MÁ, Ledo GG, Cucurull M, Mosquera J, Martínez M, Chara LE, Arriola E, Herrera BE, Jarabo JR, Álvarez RÁ, Baena J, Cao MG. Lung cancer patients with COVID-19 in Spain: GRAVID study. Lung Cancer 2021; 157:109-115. [PMID: 34016490 PMCID: PMC8118702 DOI: 10.1016/j.lungcan.2021.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Patients with cancer may be at increased risk of more severe COVID-19 disease; however, prognostic factors are not yet clearly identified. The GRAVID study aimed to describe clinical characteristics, outcomes, and predictors of poor outcome in patients with lung cancer and COVID-19. METHODS Prospective observational study that included medical records of patients with lung cancer and PCR-confirmed COVID-19 diagnosis across 65 Spanish hospitals. The primary endpoint was all-cause mortality; secondary endpoints were hospitalization and admission to intensive care units (ICU). RESULTS A total of 447 patients with a mean age of 67.1 ± 9.8 years were analysed. The majority were men (74.3 %) and current/former smokers (85.7 %). NSCLC was the most frequent type of cancer (84.5 %), mainly as adenocarcinoma (51.0 %), and stage III metastatic or unresectable disease (79.2 %). Nearly 60 % of patients were receiving anticancer treatment, mostly first-line chemotherapy. Overall, 350 (78.3 %) patients were hospitalized for a mean of 13.4 ± 11.4 days, 9 (2.0 %) were admitted to ICU and 146 (32.7 %) died. Advanced disease and the use of corticosteroids to treat COVID-19 during hospitalization were predictors of mortality. Hospitalized, non-end-of-life stage patients with lymphocytopenia and high LDH had an increased risk of death. Severity of COVID-19 correlated to higher mortality, ICU admission, and mechanical ventilation rates. CONCLUSIONS Mortality rate was higher among patients treated with corticosteroids during hospitalization, while anticancer therapy was not associated with an increased risk of hospitalization or death. Tailored approaches are warranted to ensure effective cancer management while minimizing the risk of exposure to SARS-CoV-2.
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Affiliation(s)
| | | | - Antonio Calles
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | - Ernest Nadal
- Institut Catala d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | - Manuel Dómine
- Hospital Universitario Fundación Jiménez Diaz, IIS-FJD, Madrid, Spain
| | - Fernando Franco
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Pilar Diz
- Complejo Asistencial Universitario de León, León, Spain
| | | | | | | | | | | | - Marc Cucurull
- Institut Catala d'Oncologia (ICO), Hospital Universitari Germans Trias i Pujol, B-ARGO, IGTP, Badalona, Barcelona, Spain
| | | | | | | | | | | | | | | | - Javier Baena
- Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - María González Cao
- Instituto Oncológico Dr Rosell, Hospital Universitario Dexeus, Barcelona, Spain
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19
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Pous A, Izquierdo C, Cucurull M, Sánchez S, Lezcano C, Domenech M, Llobera L, Plaja A, Moran T. Immune-checkpoint inhibitors for lung cancer patients amid the COVID-19 pandemic: a case report of severe meningoencephalitis after switching to an extended-interval higher flat-dose nivolumab regimen. Transl Lung Cancer Res 2021; 10:1917-1923. [PMID: 34012801 PMCID: PMC8107731 DOI: 10.21037/tlcr-20-1315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Alternative dosage regimens for some anticancer therapies have been proposed in the midst of the SARS-COV-2 pandemic in order to protect the patients from attending to health care facilities. Flat-dosing of several immune-checkpoint inhibitors (ICIs), including nivolumab, have been established. Although generally well tolerated with no new safety signals, new dosages can associate novel individual toxicities. As the use of ICIs is increasing in cancer patients, the present case report is a reminder for clinicians of potential novel toxicities, as well as the need for an interdisciplinary approach for their recognition and treatment. We report the occurrence of a severe neurologic toxicity in a patient with non-small cell lung cancer (NSCLC) who developed should be changed to which occurred after two doses of extended higher interval flat-dose nivolumab despite two years of clinical stability on prior nivolumab regimen. Patient developed fever, language impairment and altered mental status. The work-up tests excluded other potential causes and the most likely diagnosis was meningoencephalitis. Fortunately, with medical treatment, which consisted of high dose steroids, the patient recovered to his baseline situation and symptoms did not recurred, even though nivolumab was resumed. Alternate ICI regimens may have unique immune-related adverse event profiles.
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Affiliation(s)
- Anna Pous
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Cristina Izquierdo
- Neurology Department. Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Marc Cucurull
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,Institut Germans Trias i Pujol, Barcelona, Spain.,Badalona Applied Research Group in Oncology, Barcelona, Spain
| | - Silvia Sánchez
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Clara Lezcano
- Pharmacy Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Marta Domenech
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,Institut Germans Trias i Pujol, Barcelona, Spain.,Badalona Applied Research Group in Oncology, Barcelona, Spain
| | - Laia Llobera
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Andrea Plaja
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Teresa Moran
- Medical Oncology Department, Catalan Institute of Oncology Badalona, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,Institut Germans Trias i Pujol, Barcelona, Spain.,Badalona Applied Research Group in Oncology, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona (UAB), Campus Can Ruti, Barcelona, Spain
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España S, Pérez Montes de Oca A, Marques-Pamies M, Cucurull M, Domenech M, Velarde JM, Salinas I, Moran T, Etxaniz O. Endocrine adverse events related to immune-oncology agents: retrospective experience of a single institution. Transl Lung Cancer Res 2020; 9:103-110. [PMID: 32206558 PMCID: PMC7082288 DOI: 10.21037/tlcr.2019.12.17] [Citation(s) in RCA: 8] [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] [Indexed: 12/14/2022]
Abstract
Background Immune-oncology agents (IOA) represent a turning point in the treatment of several solid tumors (ST). Although their toxicity compares favorably with other treatments, IOA associate immune-related adverse events (IR-AE), among which endocrine-related AE stand out. We retrospectively evaluated the occurrence of endocrine (E) IR-AE in a cohort of patients with several ST treated with IOA. In addition, we assessed the correlation between likelihood of survival and the occurrence of IR-AE. Methods We collected data on clinical and molecular characteristics, efficacy and AE of 260 patients with ST treated with IOA from 2013 to 2017. We excluded patients with prior conditions or treatments potentially affecting thyroid test results. Results Lung cancer was the most prevalent diagnosis (70.2%). EIR-AE appeared in 18.1% of patients (total of 38 EIR-AE) and consisted of hypothyroidism, hyperthyroidism, pituitary disorders and type 1 diabetes mellitus in 60.5%, 21.1%, 15.8% and 2.6% of patients, respectively. EIR-AE were associated mainly to nivolumab, nivolumab plus ipilimumab (41.2% and 26.5%) and appeared after a median of 4.2 cycles of treatment. Specific therapy was required in 65.8% patients. There were significant differences in both progression-free survival (PFS) and overall survival (OS) for patients who experienced EIR-AE compared to those who did not [PFS: 56.7 (NC–NC) vs. 27.7 (14.3–41.3) months, P=0.008; OS: NC (NC–NC) vs. 31.4 (20.7–42.1) months, P=0.001]. Conclusions The incidence of EIR-AE in our study is similar to other series. Patients who develop EIR-AE might have a better prognosis compared to those who do not experience them.
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Affiliation(s)
- Sofia España
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | | | - Marc Cucurull
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Marta Domenech
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Badalona-Applied Research Group in Oncology (B-ARGO), Fundació Institut Germans Trias i Pujol (IGTP), Badalona, Spain
| | | | - Isabel Salinas
- Endocrinology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Teresa Moran
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Badalona-Applied Research Group in Oncology (B-ARGO), Fundació Institut Germans Trias i Pujol (IGTP), Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Olatz Etxaniz
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.,Badalona-Applied Research Group in Oncology (B-ARGO), Fundació Institut Germans Trias i Pujol (IGTP), Badalona, Spain
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21
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Carcereny E, Esteve A, Estival A, Domenech M, Angelats L, Erasun C, Gonzalez A, Plaja A, Garcia N, España S, Cucurull M, Ferrando A, Pous A, Notario L, Martin SS, Garcia CV, Moran T. EP1.01-37 Platinum-Based Chemotherapy (CT) Rechallenge in Advanced Non Small Cell Lung Cancer (NSCLC) Patients (p): A Single Institution Experience. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2010] [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: 11/30/2022]
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22
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Lecuona CE, Gonzalez A, Esteve A, Domenech M, Felip E, Cucurull M, Angelats L, España S, Ferrando A, Plaja A, Notario L, Pous A, Moran T, Carcereny E. P1.16-44 Multiple Primary Cancers (MPC) in a Cohort of Lung Cancer (LC) Patients (P): Incidence and Clinical Features. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1270] [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: 11/30/2022]
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23
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Cucurull M, Felip E, Garcia JJ, Erasun C, Angelats L, Teruel I, Martinez-Román S, Hernández J, Esteve A, España S, Romeo M. Prognostic value of monocyte to lymphocyte ratio (MLR) in epithelial ovarian cancer (EOC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e17066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17066 Background: Identifying high-risk early-stage EOC patients (p) is a major issue. Also, controversy about the role of neoadjuvant chemotherapy prior to surgery in advanced EOC is still ongoing. A high MLR is related to poorer outcomes in several cancers, and also in ovarian cancer according to limited retrospective series. We explored the clinical value of MLR in a cohort of EOC p. Methods: We included all EOC p diagnosed in our center, from January 2008 to April 2017, who had undergone radical treatment. Overall survival (OS) was assessed by Kaplan Meyer. Maximally selected rank statistics was used to determine the MLR cut-off value for the greatest OS discrimination. The hazard ratio (HR) of death of MLR was explored by multivariate Cox regression models, adjusted by age at diagnosis, stage I/II versus (vs) III/IV, high grade serous carcinomas (HGSC) vs other, primary surgery vs interval surgery after neoadjuvant chemotherapy (PS, IS), residual disease < 1 vs > 1cm, year of diagnosis, and hemoglobin, neutrophils, platelets and MLR at diagnosis. Results: 124 p were included. Median age at diagnosis was 58.7 years; 55.6% were HGSC;67.7% stage III/IV; 69.3% received PS; 14.3% had residual disease > 1cm. Median OS was 75 months. MLR was the laboratory parameter that more significantly impacted on OS in our model (p = 0.02). Optimal MLR cut-off was 0.38. The MLR > 0.38 group (MLR-hi) had a higher-risk of death (HR = 2.9; 95% IC: 1.3–6.5) with respect to those with MLR < = 0.38 (MLR-lo). Median OS were 100 and 35 months, respectively. In the MLR-lo group, median age at diagnosis was 56.9 years (vs 61.9 in the MLR-hi, p 0.047), 44.8% were HGSC (vs 61.2%, p 0.134), and 49.97% were stages I/II (vs 14.2%, p 0.001). MLR-hi p who had undergone PS or IS had similar OS (p = 0.63). In contrast, among MLR-lo p, PS showed significantly higher OS than IS (p < 0.0001). Conclusions: In our cohort, MLR was an independent prognostic factor in EOC. Its potential role to identify high-risk early-stage p and to predict worse outcomes after PS among advanced-stage p need to be explored in larger cohorts.
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Affiliation(s)
- Marc Cucurull
- Medical Oncology Department, Institut Català d’Oncologia (ICO) Badalona, B-ARGO, Badalona, Spain
| | - Eudald Felip
- Medical Oncology Department, Institut Català d’Oncologia (ICO) Badalona, B-ARGO, Barcelona, Spain
| | - Juan Jose Garcia
- Instituto Oncológico Dr Rosell, Quirón Dexeus University Hospital, Badalona, Spain
| | - Carlos Erasun
- Medical Oncology Department, Institut Català d’Oncologia (ICO) Badalona, B-ARGO, Badalona, Spain
| | - Laura Angelats
- Medical Oncology Department, Institut Català d’Oncologia (ICO) Badalona, B-ARGO, Badalona, Spain
| | - Iris Teruel
- Medical Oncology Department, Institut Català d’Oncologia (ICO) Badalona, B-ARGO, Badalona, Spain
| | - Sergi Martinez-Román
- Gynecology Department, Hospital Germans Trias I Pujol, Badalona, Badalona, Spain
| | - Joaquin Hernández
- Cancer Statitics Department, Hospital-based Cancer Registry, Institut Català d’Oncologia Badalona, Badalona, Spain
| | - Anna Esteve
- Cancer Statistics Department, Catalan Institute of Oncology-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Sofia España
- Medical Oncology Department, Institut Català d’Oncologia (ICO) Badalona, B-ARGO, Badalona, Spain
| | - Margarita Romeo
- Medical Oncology Department, Institut Català d’Oncologia (ICO) Badalona, B-ARGO, Badalona, Spain
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Felip-Falgàs E, Teruel I, García Mosquera JJ, Erasun C, Quiroga Garcia V, Angelats L, España S, Cucurull M, Cirauqui B, Vila MM. Clinical algorithm to predict who may benefit from CDK4/6 inhibitors in patients (p) with estrogen receptor positive and HER-2 negative (ER+/Her2-) metastatic breast cancer (MBC). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13060] [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: 11/20/2022] Open
Affiliation(s)
- Eudald Felip-Falgàs
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Iris Teruel
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Juan José García Mosquera
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Carlos Erasun
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Vanesa Quiroga Garcia
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Laura Angelats
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Sofia España
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Marc Cucurull
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Beatriz Cirauqui
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Mireia Margeli Vila
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
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