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Fuchs CS, Azevedo S, Okusaka T, Van Laethem JL, Lipton LR, Riess H, Szczylik C, Moore MJ, Peeters M, Bodoky G, Ikeda M, Melichar B, Nemecek R, Ohkawa S, Świeboda-Sadlej A, Tjulandin SA, Van Cutsem E, Loberg R, Haddad V, Gansert JL, Bach BA, Carrato A. A phase 3 randomized, double-blind, placebo-controlled trial of ganitumab or placebo in combination with gemcitabine as first-line therapy for metastatic adenocarcinoma of the pancreas: the GAMMA trial. Ann Oncol 2015; 26:921-927. [PMID: 25609246 DOI: 10.1093/annonc/mdv027] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 12/30/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This double-blind, phase 3 study assessed the efficacy and safety of ganitumab combined with gemcitabine as first-line treatment of metastatic pancreatic cancer. PATIENTS AND METHODS Patients with previously untreated metastatic pancreatic adenocarcinoma were randomly assigned 2 : 2 : 1 to receive intravenous gemcitabine 1000 mg/m(2) (days 1, 8, and 15 of each 28-day cycle) plus placebo, ganitumab 12 mg/kg, or ganitumab 20 mg/kg (days 1 and 15 of each cycle). The primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS), safety, and efficacy by levels of circulating biomarkers. RESULTS Overall, 322 patients were randomly assigned to placebo, 318 to ganitumab 12 mg/kg, and 160 to ganitumab 20 mg/kg. The study was stopped based on results from a preplanned futility analysis; the final results are reported. Median OS was 7.2 months [95% confidence interval (CI), 6.3-8.2] in the placebo arm, 7.0 months (95% CI, 6.2-8.5) in the ganitumab 12-mg/kg arm [hazard ratio (HR), 1.00; 95% CI, 0.82-1.21; P = 0.494], and 7.1 months (95% CI, 6.4-8.5) in the ganitumab 20-mg/kg arm (HR, 0.97; 95% CI, 0.76-1.23; P = 0.397). Median PFS was 3.7, 3.6 (HR, 1.00; 95% CI, 0.84-1.20; P = 0.520), and 3.7 months (HR, 0.97; 95% CI, 0.77-1.22; P = 0.403), respectively. No unexpected toxicity was observed with ganitumab plus gemcitabine. The circulating biomarkers assessed [insulin-like growth factor-1 (IGF-1), IGF-binding protein-2, and -3] were not associated with a treatment effect on OS or PFS by ganitumab. CONCLUSION Ganitumab combined with gemcitabine had manageable toxicity but did not improve OS, compared with gemcitabine alone in unselected patients with metastatic pancreatic cancer. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT01231347.
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LONGO FEDERICO, Pachon V, Guillen C, Ferreiro R, Rodriguez Garrote M, Puertas PR, Madariaga A, Gion M, Lopez Hervas P, Galindo J, Gonzalez Lizarbe E, Varona C, Montans J, Earl J, Grande E, Olmedo Garcia ME, Garrido P, Lobo E, Palacios J, Carrato A. Prognostic factors in advanced gastric cancer after second-line treatment. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
201 Background: Advanced gastric cancer (AGC) is a highly lethal disease worldwide with a median overall survival (OS) of less than 12 months. Ramucirumab was the first targeted agent to show survival benefit in the second-line (2L) treatment of AGD. From the REGARD trial, women exhibited a trend towards a worse survival when compared to men. Methods: We retrospectively analyzed the outcome of a Spanish cohort of 55 AGC patients who had received at least two consecutive chemotherapy lines of treatment at our institution. We preselected some clinical parameters (age, gender, Lauren subtype, Her-2 status, grade of differentiation, primary tumor localization and resection, TNM stage, neoadjuvant/adjuvant administration, mono/polychemotherapy in 2L, irinotecan- or taxane-based 2L, Trastuzumab treatment, and administration of third-lines [3L]) to be tested as potential prognostic factors. We focused our analysis on the gender effect in OS after 2L treatment in AGC. The SPSS software package was used for all statistical analyses (Mann-Whitney U test, Chi Square, Kaplan-Meier, Cox regression). Results: Women, diffuse subtype, poorly differentiated tumors, sub-cardia location, single-agent 2L and 3L administration were the clinical characteristics with a significant shorter OS by the univariable analysis. Median OS of women (5 months, 95%CI 3.9-6.0) was significant lower than that in men (13 months, 95%CI 7.9-18.0) by both Log-Rank and Breslow tests (p 0.002). We found no significant differences in age, progression-free survival or time-on-treatment between men and women. Female gender was significantly associated with more taxane-based 2L and with less 3L treatment administration. When 3L treatment administration was excluded in the multivariable analysis, female gender was the only independent prognostic factor of all the clinical parameters included in our review (HR 0.33, 95%CI 0.15-0.75, p 0.008). Conclusions: Our retrospective study found that gender, Lauren subtype, grade of differentiation, primary tumor location, polychemotherapy and 3L administration may be potential prognostic factors in AGC after 2L treatment. Female gender was an independent prognostic factor in our Spanish cohort.
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Guillen C, Earl J, Mocci E, Guerrero C, Montans J, Marquez M, Vazquez Sequeiros E, Gonzalez Gordaliza C, Sanjuanbenito A, MuÑoz MJ, Solera J, Real FX, Malats N, Carrato A. Genetic and phenotypic characterization of families with familial pancreatic cancer and screening of high-risk individuals. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
242 Background: The prognosis of patients diagnosed with Pancreatic Cancer (PC) is dismal with a 5-year survival rate of around 5%. Familial Pancreatic Cancer (FPC) is an autosomal dominant rare syndrome defined as families with two or more first-degree relatives with pancreatic cancer that do not fulfill the criteria of any other inherited tumor syndrome. The Spanish familial pancreatic cancer registry, Pan-Gen-FAM was established in 2009 in order to identify and manage families at high risk of developing PC. Methods: Information on the family history of cancer is collected in order to determine the phenotype of individual families and patients are offered genetic testing of known FPC associated genes pertinent to their familial syndrome. An individualized clinical screening program is devised for the early detection of a pancreatic tumor consisting of periodic monitoring by imaging techniques (EUS and MRI) and the evaluation of minimally-invasive tumor biomarkers approaches including Circulating Tumor Cells (CTC) and circulating free DNA in blood. Results: To date the registry includes 125 individuals representing some 41 families. Of 17 families tested so far BRCA2 germline mutations were detected in 5 families and a BRCA1 mutation in 1 family. 43 individuals underwent clinical screening. More pancreatic abnormalities were found by EUS (41%) than by MRI (31%). The most frequent abnormal findings were parenchymal changes associated with chronic pancreatitis. Eight cystic lesions were identified. One lesion was identified as a well differentiated neuroendocrine tumor and another was shown to have benign cytology and whilst carcinoma was found in a third patient, this patient underwent a subsequent partial pancreatectomy. The remaining patients with cystic lesions are undergoing close clinical observation. Seventy three patients underwent CTC determinations and all patients tested negative. Conclusions: Periodic screening of high risk individuals by EUS and RMI can detect small tumors and premalignant lesions. We hypothesize that these persons will have a higher probability of long-term survival than sporadic cases.
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Wang Z, Zhu B, Zhang M, Parikh H, Jia J, Chung CC, Sampson JN, Hoskins JW, Hutchinson A, Burdette L, Ibrahim A, Hautman C, Raj PS, Abnet CC, Adjei AA, Ahlbom A, Albanes D, Allen NE, Ambrosone CB, Aldrich M, Amiano P, Amos C, Andersson U, Andriole G, Andrulis IL, Arici C, Arslan AA, Austin MA, Baris D, Barkauskas DA, Bassig BA, Beane Freeman LE, Berg CD, Berndt SI, Bertazzi PA, Biritwum RB, Black A, Blot W, Boeing H, Boffetta P, Bolton K, Boutron-Ruault MC, Bracci PM, Brennan P, Brinton LA, Brotzman M, Bueno-de-Mesquita HB, Buring JE, Butler MA, Cai Q, Cancel-Tassin G, Canzian F, Cao G, Caporaso NE, Carrato A, Carreon T, Carta A, Chang GC, Chang IS, Chang-Claude J, Che X, Chen CJ, Chen CY, Chen CH, Chen C, Chen KY, Chen YM, Chokkalingam AP, Chu LW, Clavel-Chapelon F, Colditz GA, Colt JS, Conti D, Cook MB, Cortessis VK, Crawford ED, Cussenot O, Davis FG, De Vivo I, Deng X, Ding T, Dinney CP, Di Stefano AL, Diver WR, Duell EJ, Elena JW, Fan JH, Feigelson HS, Feychting M, Figueroa JD, Flanagan AM, Fraumeni JF, Freedman ND, Fridley BL, Fuchs CS, Gago-Dominguez M, Gallinger S, Gao YT, Gapstur SM, Garcia-Closas M, Garcia-Closas R, Gastier-Foster JM, Gaziano JM, Gerhard DS, Giffen CA, Giles GG, Gillanders EM, Giovannucci EL, Goggins M, Gokgoz N, Goldstein AM, Gonzalez C, Gorlick R, Greene MH, Gross M, Grossman HB, Grubb R, Gu J, Guan P, Haiman CA, Hallmans G, Hankinson SE, Harris CC, Hartge P, Hattinger C, Hayes RB, He Q, Helman L, Henderson BE, Henriksson R, Hoffman-Bolton J, Hohensee C, Holly EA, Hong YC, Hoover RN, Hosgood HD, Hsiao CF, Hsing AW, Hsiung CA, Hu N, Hu W, Hu Z, Huang MS, Hunter DJ, Inskip PD, Ito H, Jacobs EJ, Jacobs KB, Jenab M, Ji BT, Johansen C, Johansson M, Johnson A, Kaaks R, Kamat AM, Kamineni A, Karagas M, Khanna C, Khaw KT, Kim C, Kim IS, Kim JH, Kim YH, Kim YC, Kim YT, Kang CH, Jung YJ, Kitahara CM, Klein AP, Klein R, Kogevinas M, Koh WP, Kohno T, Kolonel LN, Kooperberg C, Kratz CP, Krogh V, Kunitoh H, Kurtz RC, Kurucu N, Lan Q, Lathrop M, Lau CC, Lecanda F, Lee KM, Lee MP, Le Marchand L, Lerner SP, Li D, Liao LM, Lim WY, Lin D, Lin J, Lindstrom S, Linet MS, Lissowska J, Liu J, Ljungberg B, Lloreta J, Lu D, Ma J, Malats N, Mannisto S, Marina N, Mastrangelo G, Matsuo K, McGlynn KA, McKean-Cowdin R, McNeill LH, McWilliams RR, Melin BS, Meltzer PS, Mensah JE, Miao X, Michaud DS, Mondul AM, Moore LE, Muir K, Niwa S, Olson SH, Orr N, Panico S, Park JY, Patel AV, Patino-Garcia A, Pavanello S, Peeters PHM, Peplonska B, Peters U, Petersen GM, Picci P, Pike MC, Porru S, Prescott J, Pu X, Purdue MP, Qiao YL, Rajaraman P, Riboli E, Risch HA, Rodabough RJ, Rothman N, Ruder AM, Ryu JS, Sanson M, Schned A, Schumacher FR, Schwartz AG, Schwartz KL, Schwenn M, Scotlandi K, Seow A, Serra C, Serra M, Sesso HD, Severi G, Shen H, Shen M, Shete S, Shiraishi K, Shu XO, Siddiq A, Sierrasesumaga L, Sierri S, Loon Sihoe AD, Silverman DT, Simon M, Southey MC, Spector L, Spitz M, Stampfer M, Stattin P, Stern MC, Stevens VL, Stolzenberg-Solomon RZ, Stram DO, Strom SS, Su WC, Sund M, Sung SW, Swerdlow A, Tan W, Tanaka H, Tang W, Tang ZZ, Tardon A, Tay E, Taylor PR, Tettey Y, Thomas DM, Tirabosco R, Tjonneland A, Tobias GS, Toro JR, Travis RC, Trichopoulos D, Troisi R, Truelove A, Tsai YH, Tucker MA, Tumino R, Van Den Berg D, Van Den Eeden SK, Vermeulen R, Vineis P, Visvanathan K, Vogel U, Wang C, Wang C, Wang J, Wang SS, Weiderpass E, Weinstein SJ, Wentzensen N, Wheeler W, White E, Wiencke JK, Wolk A, Wolpin BM, Wong MP, Wrensch M, Wu C, Wu T, Wu X, Wu YL, Wunder JS, Xiang YB, Xu J, Yang HP, Yang PC, Yatabe Y, Ye Y, Yeboah ED, Yin Z, Ying C, Yu CJ, Yu K, Yuan JM, Zanetti KA, Zeleniuch-Jacquotte A, Zheng W, Zhou B, Mirabello L, Savage SA, Kraft P, Chanock SJ, Yeager M, Landi MT, Shi J, Chatterjee N, Amundadottir LT. Imputation and subset-based association analysis across different cancer types identifies multiple independent risk loci in the TERT-CLPTM1L region on chromosome 5p15.33. Hum Mol Genet 2014; 23:6616-33. [PMID: 25027329 PMCID: PMC4240198 DOI: 10.1093/hmg/ddu363] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/30/2014] [Accepted: 07/08/2014] [Indexed: 02/03/2023] Open
Abstract
Genome-wide association studies (GWAS) have mapped risk alleles for at least 10 distinct cancers to a small region of 63 000 bp on chromosome 5p15.33. This region harbors the TERT and CLPTM1L genes; the former encodes the catalytic subunit of telomerase reverse transcriptase and the latter may play a role in apoptosis. To investigate further the genetic architecture of common susceptibility alleles in this region, we conducted an agnostic subset-based meta-analysis (association analysis based on subsets) across six distinct cancers in 34 248 cases and 45 036 controls. Based on sequential conditional analysis, we identified as many as six independent risk loci marked by common single-nucleotide polymorphisms: five in the TERT gene (Region 1: rs7726159, P = 2.10 × 10(-39); Region 3: rs2853677, P = 3.30 × 10(-36) and PConditional = 2.36 × 10(-8); Region 4: rs2736098, P = 3.87 × 10(-12) and PConditional = 5.19 × 10(-6), Region 5: rs13172201, P = 0.041 and PConditional = 2.04 × 10(-6); and Region 6: rs10069690, P = 7.49 × 10(-15) and PConditional = 5.35 × 10(-7)) and one in the neighboring CLPTM1L gene (Region 2: rs451360; P = 1.90 × 10(-18) and PConditional = 7.06 × 10(-16)). Between three and five cancers mapped to each independent locus with both risk-enhancing and protective effects. Allele-specific effects on DNA methylation were seen for a subset of risk loci, indicating that methylation and subsequent effects on gene expression may contribute to the biology of risk variants on 5p15.33. Our results provide strong support for extensive pleiotropy across this region of 5p15.33, to an extent not previously observed in other cancer susceptibility loci.
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Fu YP, Kohaar I, Moore LE, Lenz P, Figueroa JD, Tang W, Porter-Gill P, Chatterjee N, Scott-Johnson A, Garcia-Closas M, Muchmore B, Baris D, Paquin A, Ylaya K, Schwenn M, Apolo AB, Karagas MR, Tarway M, Johnson A, Mumy A, Schned A, Guedez L, Jones MA, Kida M, Hosain GMM, Malats N, Kogevinas M, Tardon A, Serra C, Carrato A, Garcia-Closas R, Lloreta J, Wu X, Purdue M, Andriole GL, Grubb RL, Black A, Landi MT, Caporaso NE, Vineis P, Siddiq A, Bueno-de-Mesquita HB, Trichopoulos D, Ljungberg B, Severi G, Weiderpass E, Krogh V, Dorronsoro M, Travis RC, Tjønneland A, Brennan P, Chang-Claude J, Riboli E, Prescott J, Chen C, De Vivo I, Govannucci E, Hunter D, Kraft P, Lindstrom S, Gapstur SM, Jacobs EJ, Diver WR, Albanes D, Weinstein SJ, Virtamo J, Kooperberg C, Hohensee C, Rodabough RJ, Cortessis VK, Conti DV, Gago-Dominguez M, Stern MC, Pike MC, Van Den Berg D, Yuan JM, Haiman CA, Cussenot O, Cancel-Tassin G, Roupret M, Comperat E, Porru S, Carta A, Pavanello S, Arici C, Mastrangelo G, Grossman HB, Wang Z, Deng X, Chung CC, Hutchinson A, Burdette L, Wheeler W, Fraumeni J, Chanock SJ, Hewitt SM, Silverman DT, Rothman N, Prokunina-Olsson L. The 19q12 bladder cancer GWAS signal: association with cyclin E function and aggressive disease. Cancer Res 2014; 74:5808-18. [PMID: 25320178 PMCID: PMC4203382 DOI: 10.1158/0008-5472.can-14-1531] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A genome-wide association study (GWAS) of bladder cancer identified a genetic marker rs8102137 within the 19q12 region as a novel susceptibility variant. This marker is located upstream of the CCNE1 gene, which encodes cyclin E, a cell-cycle protein. We performed genetic fine-mapping analysis of the CCNE1 region using data from two bladder cancer GWAS (5,942 cases and 10,857 controls). We found that the original GWAS marker rs8102137 represents a group of 47 linked SNPs (with r(2) ≥ 0.7) associated with increased bladder cancer risk. From this group, we selected a functional promoter variant rs7257330, which showed strong allele-specific binding of nuclear proteins in several cell lines. In both GWASs, rs7257330 was associated only with aggressive bladder cancer, with a combined per-allele OR = 1.18 [95% confidence interval (CI), 1.09-1.27, P = 4.67 × 10(-5)] versus OR = 1.01 (95% CI, 0.93-1.10, P = 0.79) for nonaggressive disease, with P = 0.0015 for case-only analysis. Cyclin E protein expression analyzed in 265 bladder tumors was increased in aggressive tumors (P = 0.013) and, independently, with each rs7257330-A risk allele (P(trend) = 0.024). Overexpression of recombinant cyclin E in cell lines caused significant acceleration of cell cycle. In conclusion, we defined the 19q12 signal as the first GWAS signal specific for aggressive bladder cancer. Molecular mechanisms of this genetic association may be related to cyclin E overexpression and alteration of cell cycle in carriers of CCNE1 risk variants. In combination with established bladder cancer risk factors and other somatic and germline genetic markers, the CCNE1 variants could be useful for inclusion into bladder cancer risk prediction models.
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Guillen-Ponce C, Lopez R, Macarulla T, Rivera F, Cubillo A, Carrato A, Brozos E, Sauri Nadal T, López C, Hidalgo M. A Phase (Ph) I/II Trial to Evaluate the Efficacy (E) and Safety (S) of Nab-Paclitaxel (Nab-P) in Combination (Co) with Gemcitabine (G) for the Treatment (Tr) of Frail (Fr) Patients (P) with Advanced or Metastatic Pancreatic Cancer (Apc): Safety Results of the Phase I Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.85] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Carrato A, Falcone A, Ducreux M, Valle J, Parnaby A, Djazouli K, Alnwick-Allu K, Hutchings A. Premature Mortality in Pancreatic Cancer: Analysis of Lost Life-Years and Quality-Adjusted Life-Years (Qalys) in Europe. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Carrato A. Clinical Issues in Patients Receiving Oral Tumour Therapy: How Can we Improve Adherence? Ann Oncol 2014. [DOI: 10.1093/annonc/mdu320.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Hidalgo M, Jameson M, Carrato A, Cooray P, Parnis F, Grimson P, Jeffery G, Stagg R, Dupont J, Tebbutt N. A Ph 1B Study of the Anti-Cancer Stem Cell Agent Demcizumab (Dem) & Gemcitabine (Gem) +/- Paclitaxel Protein Bound Particles (Nab-Paclitaxel) in Pts with Pancreatic Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abad A, Sureda BM, Grávalos C, Escudero P, Guillen-Ponce C, Gómez A, Safont M, Plazas JG, Sastre J, Pericay C, Dueñas R, López C, Losa F, Valladares-Ayerbes M, Flores EG, Díaz LR, Layos L, Carrato A, Aranda E. Ras Analysis of the Planet Study: Phase Ii Trial of Panitumumab (P) Plus Folfox4 or Folfiri in Subjects with Wild-Type (Wt) Kras Colorectal Cancer (Crc) and Liver-Limited Disease (Lld). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Olmedo M, Mezquita L, Earl J, Benito A, Santon A, Longo F, Vallejo C, MuÑoz G, Gorospe L, Soria A, Gordoa TA, Grande E, Roberts E, Gomez A, Cortez P, Alcalde R, Muñoz J, Cortés A, Carrato A, Garrido P. Monitoring Circulating Tumor Cells (Ctc) in Lung Cancer: Preliminary Results. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.81] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vaz M, Del Toro J, Cerco J, Urzaiz L, Carrato A, Gomez A, Pian H, De Pedro M. Glioblastoma in Elderly Patients: Survival Outcome. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu330.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Caballero C, Jantus-Lewintre E, Carrato A, García-Foncillas J, Gascón P, Blasco A, Moreno-Nogueira JA, Guillem V, López R, Codes M, Antón A, Díaz-Rubio E, Camps C. Oncological translational research in the Spanish national health system: the INTRO study. Clin Transl Oncol 2014; 16:686-95. [DOI: 10.1007/s12094-013-1138-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 11/12/2013] [Indexed: 11/30/2022]
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Camps-Herrero C, Paz-Ares L, Codes M, López-López R, Antón-Torres A, Gascón-Vilaplana P, Guillem-Porta V, Carrato A, Cruz-Hernández JJ, Caballero-Díaz C, Blasco-Cordellat A, Moreno-Nogueira JA, Díaz-Rubio E. Social value of a quality-adjusted life year (QALY) in Spain: the point of view of oncologists. Clin Transl Oncol 2014; 16:914-20. [DOI: 10.1007/s12094-014-1170-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 02/19/2014] [Indexed: 11/25/2022]
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Abad A, Massutí B, Grávalos C, Escudero P, Guillén-Ponce C, Layos L, Gomez M, Safont M, Gallego J, Sastre J, Pericay C, Dueñas R, López-López C, Losa F, Valladares M, González-Flores E, Yuste A, Robles L, Sáenz A, Cano T, Carrato A, Aranda E. Panitumumab Plus FOLFOX4 or Panitumumab Plus Folfiri in Subjects with Wild-Type KRAS (EXON 2) Colorectal Cancer and Multiple or Unresectable Liver-Limited Metastases: Data from the Randomized, Phase II Planet Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu164.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Carrato A, Falcone A, Ducreux M, Valle JW, Parnaby A, Djazouli K, Alnwick-Allu K, Hutchings A. Proportional shortfall due to pancreatic cancer in Europe: Survival and quality of life analysis based on a systematic review. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Longo F, Grande E, Guillen C, Pachon V, Rodriguez Garrote M, Ferreiro R, Vaz MA, Alcalde R, Gomez A, Roberts E, Cortez P, Cortes A, Munoz J, Garcia De Paredes M, Guerrero C, Earl J, Olmedo Garcia ME, Garrido P, Palacios J, Carrato A. Survival surrogates in gastric cancer after first- and second-line chemotherapy treatment: A Spanish retrospective study from one institution. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Grande E, Guillen-Ponce C, Vieitez de Prado JM, Reboredo M, Duran G, Massuti Sureda B, Layos L, Salud A, Falco E, Alonso V, Garcia Alfonso P, Ortiz MJ, Sastre J, Rivera F, Gallego J, Robles L, Gonzalez Astorga B, Dotor E, Carrato A, Aranda E. Regorafenib as a single agent for first-line treatment of frail and/or unfit for polychemotherapy patients with metastatic colorectal cancer (mCRC): A study of the Spanish Cooperative Group for digestive tumor therapy (TTD). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.tps3651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abad A, Massuti B, Gravalos C, Escudero P, Guillen C, Manzano JL, Gomez M, Safont MJ, Gallego Plazas J, Sastre J, Pericay C, Dueñas R, López-López C, Losa F, Valladares Ayerbes M, González E, Yuste A, Carrato A, Aranda E. Phase II trial of panitumumab plus FOLFOX4 or FOLFIRI in subjects with KRAS wild-type colorectal cancer and liver-limited disease: The PLANET study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.3560] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pineda S, Milne RL, Calle ML, Rothman N, López de Maturana E, Herranz J, Kogevinas M, Chanock SJ, Tardón A, Márquez M, Guey LT, García-Closas M, Lloreta J, Baum E, González-Neira A, Carrato A, Navarro A, Silverman DT, Real FX, Malats N. Genetic variation in the TP53 pathway and bladder cancer risk. a comprehensive analysis. PLoS One 2014; 9:e89952. [PMID: 24818791 PMCID: PMC4018346 DOI: 10.1371/journal.pone.0089952] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 01/24/2014] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Germline variants in TP63 have been consistently associated with several tumors, including bladder cancer, indicating the importance of TP53 pathway in cancer genetic susceptibility. However, variants in other related genes, including TP53 rs1042522 (Arg72Pro), still present controversial results. We carried out an in depth assessment of associations between common germline variants in the TP53 pathway and bladder cancer risk. MATERIAL AND METHODS We investigated 184 tagSNPs from 18 genes in 1,058 cases and 1,138 controls from the Spanish Bladder Cancer/EPICURO Study. Cases were newly-diagnosed bladder cancer patients during 1998-2001. Hospital controls were age-gender, and area matched to cases. SNPs were genotyped in blood DNA using Illumina Golden Gate and TaqMan assays. Cases were subphenotyped according to stage/grade and tumor p53 expression. We applied classical tests to assess individual SNP associations and the Least Absolute Shrinkage and Selection Operator (LASSO)-penalized logistic regression analysis to assess multiple SNPs simultaneously. RESULTS Based on classical analyses, SNPs in BAK1 (1), IGF1R (5), P53AIP1 (1), PMAIP1 (2), SERINPB5 (3), TP63 (3), and TP73 (1) showed significant associations at p-value≤0.05. However, no evidence of association, either with overall risk or with specific disease subtypes, was observed after correction for multiple testing (p-value≥0.8). LASSO selected the SNP rs6567355 in SERPINB5 with 83% of reproducibility. This SNP provided an OR = 1.21, 95%CI 1.05-1.38, p-value = 0.006, and a corrected p-value = 0.5 when controlling for over-estimation. DISCUSSION We found no strong evidence that common variants in the TP53 pathway are associated with bladder cancer susceptibility. Our study suggests that it is unlikely that TP53 Arg72Pro is implicated in the UCB in white Europeans. SERPINB5 and TP63 variation deserve further exploration in extended studies.
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de Maturana EL, Chanok SJ, Picornell AC, Rothman N, Herranz J, Calle ML, García-Closas M, Marenne G, Brand A, Tardón A, Carrato A, Silverman DT, Kogevinas M, Gianola D, Real FX, Malats N. Whole genome prediction of bladder cancer risk with the Bayesian LASSO. Genet Epidemiol 2014; 38:467-76. [PMID: 24796258 DOI: 10.1002/gepi.21809] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 03/05/2014] [Accepted: 03/20/2014] [Indexed: 11/11/2022]
Abstract
To build a predictive model for urothelial carcinoma of the bladder (UCB) risk combining both genomic and nongenomic data, 1,127 cases and 1,090 controls from the Spanish Bladder Cancer/EPICURO study were genotyped using the HumanHap 1M SNP array. After quality control filters, genotypes from 475,290 variants were available. Nongenomic information comprised age, gender, region, and smoking status. Three Bayesian threshold models were implemented including: (1) only genomic information, (2) only nongenomic data, and (3) both sources of information. The three models were applied to the whole population, to only nonsmokers, to male smokers, and to extreme phenotypes to potentiate the UCB genetic component. The area under the ROC curve allowed evaluating the predictive ability of each model in a 10-fold cross-validation scenario. Smoking status showed the highest predictive ability of UCB risk (AUCtest = 0.62). On the other hand, the AUC of all genetic variants was poorer (0.53). When the extreme phenotype approach was applied, the predictive ability of the genomic model improved 15%. This study represents a first attempt to build a predictive model for UCB risk combining both genomic and nongenomic data and applying state-of-the-art statistical approaches. However, the lack of genetic relatedness among individuals, the complexity of UCB etiology, as well as a relatively small statistical power, may explain the low predictive ability for UCB risk. The study confirms the difficulty of predicting complex diseases using genetic data, and suggests the limited translational potential of findings from this type of data into public health interventions.
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Vergnenègre A, Carrato A, Thomas M, Jernigan C, Medina J, Cruciani G. Real-world healthcare resource utilization in a European non-small cell lung cancer population: the EPICLIN-Lung study. Curr Med Res Opin 2014; 30:463-70. [PMID: 24188056 DOI: 10.1185/03007995.2013.860373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is a lack of data on health resource assessment in non-small cell lung cancer (NSCLC) to inform clinical decision-making. The Epidemiological Study to Describe NSCLC Clinical Management Pattern in Europe-Lung (EPICLIN-Lung) study provides information on healthcare resource utilization associated with different NSCLC treatment strategies in real-life clinical settings. METHODS This multinational, multicenter, non-interventional study (NCT00831909) was conducted in eight European countries in 2009-2010. Patients with confirmed NSCLC were enrolled and followed for 12 months or until death. Information was collected on patient and disease characteristics, diagnosis and treatment patterns. Healthcare resource utilization was described in relation to diagnostic patterns and treatment received. RESULTS Data were available for 3508 patients (median age=65.0 years, male=77.6%, Caucasian=98.4%, adenocarcinoma=43.8%, stage IV=48.6%, 10.8% never smoked). The overall mean number of hospitalization days was 16.4 (standard deviation (SD)=18.42). Patients were followed up for a mean of 245.8 (131.4) days. Most patients (96.0%) underwent imaging procedures, most commonly scanning (93.9%). Surgery was associated with a mean of 12.5 (9.33) hospitalization days, with lobectomy and extended procedures (20.3%) being the most common surgery types. Radiotherapy resulted in a mean of 11.6 (14.12) hospitalization days. The majority of radiotherapy was palliative (56.0%), which resulted in fewer (mean 9.5 [11.12]) hospitalization days. Administration of systemic treatment resulted in a mean of 6.5 (8.04) hospitalization days, 1.7 (3.59) visits for disease-related events, 2.3 (1.83) adverse events and 5.4 (5.86) blood-specific resources. The key limitations of this study are those inherent to its non-interventional nature and wide regional focus, and the lack of cost-effectiveness data. CONCLUSIONS EPICLIN-Lung provides important, Europe-wide information on drivers of healthcare resource use in different treatment strategies for NSCLC.
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Carrato A, Vergnenègre A, Thomas M, McBride K, Medina J, Cruciani G. Clinical management patterns and treatment outcomes in patients with non-small cell lung cancer (NSCLC) across Europe: EPICLIN-Lung study. Curr Med Res Opin 2014; 30:447-61. [PMID: 24168104 DOI: 10.1185/03007995.2013.860372] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Throughout Europe, physicians face similar challenges in non-small cell lung cancer (NSCLC) management, but comprehensive international information on usual clinical practice is lacking so the burden of NSCLC is not fully understood. METHODS This multinational, multicentre, non-interventional study (NCT00831909) was conducted in eight European countries. Patients with confirmed NSCLC were consecutively enrolled from January to March 2009 and followed for 12 months or until death. Information was collected on patient and disease characteristics, diagnosis and treatment patterns, and clinical outcomes. Spontaneously reported adverse events (AEs) were also recorded. RESULTS Data were available for 3508 patients. Most patients (77.5%) were male, median (range) age was 65.0 years (21.6-90.7), the majority of patients had a World Health Organization performance status of ≤1 (74.7%), and 10.8% were never smokers. The most prevalent histologies were adenocarcinoma (43.8%) and squamous-cell carcinoma (29.4%). Most patients presented with advanced disease (11.6% with stage IIIA, 18.7% with stage IIIB, 48.6% with stage IV). In stage IV disease, median progression-free survival and overall survival (months) by first-line treatment cluster were platinum regimens: 6.5, 10.8; non-platinum regimens: 4.3, 8.5; regimens with bevacizumab 8.7, 12.9; investigational regimens: 5.6, 10.8; best supportive care: 5.4, 6.6. The most frequently reported severe (Common Terminology Criteria for Adverse Events v3.0>2) AEs were blood/bone marrow (16.0%) and pulmonary/upper respiratory (7.8%). Key limitations of this study related to its non-interventional nature and wide regional focus; for example, achieving a representative sample of the overall NSCLC population, variation in recruitment between countries, and data based on information from medical records derived from routine visits. CONCLUSIONS The Epidemiological Study to Describe NSCLC Clinical Management Pattern in Europe-Lung (EPICLIN-Lung) study provides new insights into the descriptive patterns and clinical management strategies for NSCLC across Europe, and how they affect patient outcomes.
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Figueroa JD, Ye Y, Siddiq A, Garcia-Closas M, Chatterjee N, Prokunina-Olsson L, Cortessis VK, Kooperberg C, Cussenot O, Benhamou S, Prescott J, Porru S, Dinney CP, Malats N, Baris D, Purdue M, Jacobs EJ, Albanes D, Wang Z, Deng X, Chung CC, Tang W, Bas Bueno-de-Mesquita H, Trichopoulos D, Ljungberg B, Clavel-Chapelon F, Weiderpass E, Krogh V, Dorronsoro M, Travis R, Tjønneland A, Brenan P, Chang-Claude J, Riboli E, Conti D, Gago-Dominguez M, Stern MC, Pike MC, Van Den Berg D, Yuan JM, Hohensee C, Rodabough R, Cancel-Tassin G, Roupret M, Comperat E, Chen C, De Vivo I, Giovannucci E, Hunter DJ, Kraft P, Lindstrom S, Carta A, Pavanello S, Arici C, Mastrangelo G, Kamat AM, Lerner SP, Barton Grossman H, Lin J, Gu J, Pu X, Hutchinson A, Burdette L, Wheeler W, Kogevinas M, Tardón A, Serra C, Carrato A, García-Closas R, Lloreta J, Schwenn M, Karagas MR, Johnson A, Schned A, Armenti KR, Hosain G, Andriole G, Grubb R, Black A, Ryan Diver W, Gapstur SM, Weinstein SJ, Virtamo J, Haiman CA, Landi MT, Caporaso N, Fraumeni JF, Vineis P, Wu X, Silverman DT, Chanock S, Rothman N. Genome-wide association study identifies multiple loci associated with bladder cancer risk. Hum Mol Genet 2014; 23:1387-98. [PMID: 24163127 PMCID: PMC3919005 DOI: 10.1093/hmg/ddt519] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 09/24/2013] [Accepted: 10/16/2013] [Indexed: 11/12/2022] Open
Abstract
Candidate gene and genome-wide association studies (GWAS) have identified 11 independent susceptibility loci associated with bladder cancer risk. To discover additional risk variants, we conducted a new GWAS of 2422 bladder cancer cases and 5751 controls, followed by a meta-analysis with two independently published bladder cancer GWAS, resulting in a combined analysis of 6911 cases and 11 814 controls of European descent. TaqMan genotyping of 13 promising single nucleotide polymorphisms with P < 1 × 10(-5) was pursued in a follow-up set of 801 cases and 1307 controls. Two new loci achieved genome-wide statistical significance: rs10936599 on 3q26.2 (P = 4.53 × 10(-9)) and rs907611 on 11p15.5 (P = 4.11 × 10(-8)). Two notable loci were also identified that approached genome-wide statistical significance: rs6104690 on 20p12.2 (P = 7.13 × 10(-7)) and rs4510656 on 6p22.3 (P = 6.98 × 10(-7)); these require further studies for confirmation. In conclusion, our study has identified new susceptibility alleles for bladder cancer risk that require fine-mapping and laboratory investigation, which could further understanding into the biological underpinnings of bladder carcinogenesis.
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Carrato A, Gallego-Plazas J, Guillén-Ponce C. Capecitabine plus oxaliplatin for the treatment of colorectal cancer. Expert Rev Anticancer Ther 2014; 8:161-74. [DOI: 10.1586/14737140.8.2.161] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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