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Toledano-Fonseca M, Gómez-España MA, Élez E, Grávalos C, García-Alfonso P, Rodríguez R, Losa F, Alés Díaz I, Graña B, Valladares-Ayerbes M, García-Ortiz MV, Polo E, Salgado M, Rivera F, Safont MJ, Salud A, Ruiz-Casado A, Tabernero JM, Riesco MC, Rodríguez-Ariza A, Aranda E. A signature of circulating microRNAs predicts the response to treatment with FOLFIRI plus aflibercept in metastatic colorectal cancer patients. Biomed Pharmacother 2023; 159:114272. [PMID: 36706629 DOI: 10.1016/j.biopha.2023.114272] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
The benefit of adding the antiangiogenic drug aflibercept to FOLFIRI regime in metastatic colorectal cancer (CRC) patients resistant to or progressive on an oxaliplatin-based therapy has been previously demonstrated. However, the absence of validated biomarkers to predict greater outcomes is a major challenge encountered when using antiangiogenic therapies. In this study we investigated profiles of circulating microRNAs (miRNAs) to build predictive models of response to treatment and survival. Plasma was obtained from 98 metastatic CRC patients enrolled in a clinical phase II trial before receiving FOLFIRI plus aflibercept treatment, and the circulating levels of 754 individual miRNAs were quantified using real-time PCR. A distinct signature of circulating miRNAs differentiated responder from non-responder patients. Remarkably, most of these miRNAs were found to target genes that are involved in angiogenic processes. Accordingly, some of these miRNAs had predictive value and entered in predictive models of response to therapy, progression of disease, and survival of patients treated with FOLFIRI plus aflibercept. Among these miRNAs, circulating levels of hsa-miR-33b-5p efficiently discriminated between responder and non-responder patients and predicted the risk of disease progression. Moreover, the combination of circulating VEGF-A and miR-33b-5p levels improved clinical stratification of metastatic CRC patients who were to receive FOLFIRI plus aflibercept treatment. In conclusion, our study supports circulating miRNAs as valuable biomarkers for predicting better outcomes in metastatic CRC patients treated with FOLFIRI plus aflibercept.
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Affiliation(s)
- M Toledano-Fonseca
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Cancer Network Biomedical Research Center (CIBERONC), Instituto de Salud Carlos III, E28029 Madrid, Spain.
| | - M A Gómez-España
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Department of Medical Oncology, Reina Sofía University Hospital, E14004 Córdoba, Spain.
| | - E Élez
- Department of Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain.
| | - C Grávalos
- Department of Medical Oncology, H. Universitario 12 de Octubre, Instituto de Investigación i+12, Avenida de Córdoba, S/N, 28041 Madrid, Spain.
| | - P García-Alfonso
- Department of Medical Oncology, H. Gregorio Marañón, Calle del Doctor Esquerdo, 46, 28007 Madrid, Spain.
| | - R Rodríguez
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Department of Medical Oncology, Reina Sofía University Hospital, E14004 Córdoba, Spain.
| | - F Losa
- Department of Medical Oncology, ICO-CSI. H. Sant Joan Despí - Moisés Broggi, Carrer d'Oriol Martorell, 12, 08970 Sant Joan Despí, Barcelona, Spain.
| | - I Alés Díaz
- Department of Medical Oncology, Unidad de Gestión Clínica Intercentros de Oncología Médica. Hospitales Universitarios Regional y Virgen de la Victoria. IBIMA, Campus de Teatinos, S/N, 29010 Málaga, Spain.
| | - B Graña
- Department of Medical Oncology, C. H. Universitario, Lugar, Xubias de Arriba, 84, 15006 A Coruña, Spain.
| | - M Valladares-Ayerbes
- Department of Medical Oncology, H. Virgen del Rocío, IBIS, Av. Manuel Siurot s/n, 41013 Sevilla, Spain.
| | - M V García-Ortiz
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Cancer Network Biomedical Research Center (CIBERONC), Instituto de Salud Carlos III, E28029 Madrid, Spain.
| | - E Polo
- Department of Medical Oncology, H. Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain.
| | - M Salgado
- Department of Medical Oncology, C. H. Universitario de Ourense, Calle Ramón Puga Noguerol, 54, 32005 Orense, Spain.
| | - F Rivera
- Department of Medical Oncology, H. Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla, 25, 39008 Santander, Spain.
| | - M J Safont
- Department of Medical Oncology, H. General Universitario, CIBERONC, Universidad de Valencia, Avenida de les Tres Creus, 2, 46014 Valencia, Spain.
| | - A Salud
- Department of Medical Oncology, H. Universitario Arnau de Vilanova, Avenida Alcalde Rovira Roure, 80, 25198 Lérida, Spain.
| | - A Ruiz-Casado
- Department of Medical Oncology, H. Puerta de Hierro Majadahonda, Calle Joaquín Rodrigo, 1, 28222 Majadahonda, Spain.
| | - J M Tabernero
- Department of Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain.
| | - M C Riesco
- Department of Medical Oncology, H. Universitario 12 de Octubre, Instituto de Investigación i+12, Avenida de Córdoba, S/N, 28041 Madrid, Spain.
| | - A Rodríguez-Ariza
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Cancer Network Biomedical Research Center (CIBERONC), Instituto de Salud Carlos III, E28029 Madrid, Spain; Department of Medical Oncology, Reina Sofía University Hospital, E14004 Córdoba, Spain.
| | - E Aranda
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Cancer Network Biomedical Research Center (CIBERONC), Instituto de Salud Carlos III, E28029 Madrid, Spain; Department of Medical Oncology, Reina Sofía University Hospital, E14004 Córdoba, Spain; Department of Medicine, Faculty of Medicine, University of Córdoba, E14004 Córdoba, Spain.
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Jiménez-Fonseca P, Sastre J, García-Alfonso P, Gómez-España MA, Salud A, Gil S, Rivera F, Reina JJ, Quintero G, Valladares-Ayerbes M, Safont MJ, La Casta A, Robles-Díaz L, García-Paredes B, López López R, Guillot M, Gallego J, Alonso-Orduña V, Diaz-Rubio E, Aranda E. Association of Circulating Tumor Cells and Tumor Molecular Profile With Clinical Outcomes in Patients With Previously Untreated Metastatic Colorectal Cancer: A Pooled Analysis of the Phase III VISNÚ-1 and Phase II VISNÚ-2 Randomized Trials. Clin Colorectal Cancer 2023; 22:222-230. [PMID: 36944559 DOI: 10.1016/j.clcc.2023.02.004] [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: 04/06/2022] [Revised: 01/30/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND The bCTC count is a well-established prognostic biomarker in mCRC, as well as in other tumor types. The aim of this analysis was to evaluate the prognostic/predictive role of the bCTC count (≥3 vs. <3) in previously untreated mCRC. PATIENTS AND METHODS The study involved 589 untreated mCRC patients included in the intention-to-treat population of 2 randomized clinical trials (phase III VISNU-1 [NCT01640405] and phase II VISNU-2 [NCT01640444] studies). RESULTS Of the 589 patients, 349 (59.2%) had bCTC≥3 and 240 (40.7%) had bCTC<3. Multivariate analysis showed that the bCTC count is an independent prognostic factor for overall survival (OS) (HR 0.59, 95% CI 0.48-0.72; P = 0.000) and potential for progression-free survival (PFS) (P = 0.0549). Median OS was 32.9 and 19.5 months in patients with bCTC<3 and bCTC≥3 (P <0.001), respectively. This effect was also observed comparing OS in RASwt patients from both studies. Other prognostic factors were: ECOG-PS, primary tumor site, number of metastatic sites and surgery of the primary tumor. Median OS was lower for patients treated with anti-VEGF versus anti-EGFR (22.3 vs. 33.3 months, P <0.0001) while there were no significant differences in PFS according to the targeted treatment received. CONCLUSION This post-hoc analysis of 2 randomized studies confirms the poor prognosis of patients with bCTC≥3 but this is not associated with other adverse independent prognostic factors such as RAS/BRAF mutations.
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Affiliation(s)
- P Jiménez-Fonseca
- Department of Medical Oncology. Hospital Universitario Central de Asturias, ISPA, Oviedo, 33011, Spain.
| | - J Sastre
- Department of Medical Oncology. Hospital Clínico San Carlos. Instituto de Investigación Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, 28040, Spain
| | - P García-Alfonso
- Department of Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid, 28007, Spain
| | - M A Gómez-España
- Department of Medical Oncology. Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBERONC, Instituto de Salud Carlos III, Córdoba, 14004, Spain
| | - A Salud
- Department of Medical Oncology, Hospital Universitario Arnau de Vilanova, Lérida, 25198, Spain
| | - S Gil
- Department of Medical Oncology. Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, 29010, Spain
| | - F Rivera
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, 39008, Spain
| | - J J Reina
- Department of Medical Oncology, Complejo Hospitalario Virgen de la Macarena, Sevilla, 41009, Spain
| | - G Quintero
- Department of Medical Oncology, Hospital Universitario Lucus Augusti, Lugo, 27003, Spain
| | - M Valladares-Ayerbes
- Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Sevilla, 41013, Spain
| | - M J Safont
- Department of Medical Oncology, Hospital General Universitario de Valencia, CIBERONC, Universidad de Valencia, Valencia, 46014, Spain
| | - A La Casta
- Department of Medical Oncology, Hospital de Donostia, Guipúzcoa, 20014, Spain
| | - L Robles-Díaz
- Department of Medical Oncology. Hospital Universitario 12 de Octubre, Madrid, 28041, Spain
| | - B García-Paredes
- Department of Medical Oncology. Hospital Clínico San Carlos. Instituto de Investigación Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, 28040, Spain
| | - R López López
- Department of Medical Oncology and Translational Medical Oncology Group. Hospital Universitario Santiago de Compostela and Health Research Institute (IDIS), CIBERONC, Santiago de Compostela, 15706, Spain
| | - M Guillot
- Department of Medical Oncology. Hospital Universitario Son Espases, Palma de Mallorca, 07120, Spain
| | - J Gallego
- Department of Medical Oncology, Hospital General Universitario de Elche, Alicante, 03203, Spain
| | - V Alonso-Orduña
- Department of Medical Oncology, Hospital Universitario Miguel Servet. Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, 50009, Spain
| | - E Diaz-Rubio
- Department of Medical Oncology. Hospital Clínico San Carlos. Instituto de Investigación Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, 28040, Spain
| | - E Aranda
- Department of Medical Oncology. Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBERONC, Instituto de Salud Carlos III, Córdoba, 14004, Spain
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Valladares-Ayerbes M, Toledano Fonseca M, Vieitez de Prado J, Inga-Saavedra E, Gil S, Graña Suarez B, García-Paredes B, Salud A, Rivera Herrero F, Salgado Fernandez M, García-Alfonso P, López-López R, Ferreiro Monteagudo R, Sastre J, Diaz-Rubio E, Aranda E. P-99 Circulating RNA detection, circulating tumor cells count, and molecular tumor profiling in a cohort of untreated metastatic colorectal cancer: A prospective multicenter ancillary study to the randomized VISNÚ trials. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Seguí E, Alonso-Orduna V, Sesma A, Martin-Richard M, Salud A, Fernández-Montes A, Fernández-Martos C, Ruiz-Casado A, Gallego J, Aparicio J, Gálvez E, Manzano H, Alcaide-Garcia J, Gallego R, Falco E, Esposito F, Oliveres H, Torres F, Feliu J, Maurel J. 471P Identification and validation of a new prognostic score in metastatic colorectal cancer (mCRC): GEMCAD score. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Camps Herrero C, Batista N, Díaz Fernández N, Escobar Álvarez Y, Gonzalo Gómez A, Isla Casado D, Salud A, Terrasa Pons J, Guillem Porta V. Breakthrough cancer pain: review and calls to action to improve its management. Clin Transl Oncol 2020; 22:1216-1226. [DOI: 10.1007/s12094-019-02268-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 12/08/2019] [Indexed: 02/04/2023]
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Ortega JC, Adaniel C, Morales S, Gasol A, Veas J, Rodriguez A, Blanco AC, Salud A. EP1.01-92 Effectiveness of Second-Line Treatment with Nintedanib + Docetaxel (ND) in Patients with Metastatic Lung Adenocarcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2066] [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: 10/25/2022]
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Carrato A, Benavides M, Massutí B, Ferreiro-Monteagudo R, García Alfonso P, Falcó E, Reboredo M, Cano T, Gallego J, Viéitez JM, Layos L, Salud A, Polo E, Dotor E, Durán-Ogalla G, Rodriguez-Garrote M, Calvo A, Grande E, Aranda E. First-line single-agent regorafenib in frail patients with metastatic colorectal cancer: a pilot phase II study of the Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD). BMC Cancer 2019; 19:533. [PMID: 31159765 PMCID: PMC6547483 DOI: 10.1186/s12885-019-5753-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 05/27/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Treatment of frail patients with advanced colorectal cancer (CRC) is controversial. This pilot phase II trial aimed to assess the efficacy and safety of regorafenib when administered in first-line to frail patients with advanced CRC. METHODS Frail patients without prior advanced colorectal cancer treatment were included in the study. Definition of frailty was defined per protocol based on dependency criteria, presence of chronic comorbid pathologies and/or geriatric features. MAIN OBJECTIVE to assess progression-free survival (PFS) rate at 6 months. Treatment consisted of 28-day cycles of orally administered regorafenib 160 mg/day (3 weeks followed by 1 week rest). RESULTS Forty-seven patients were included in the study. Median age was 81 years (range 63-89). Frailty criteria: dependency was observed in 26 patients (55%), comorbidities in 27 (57%) and geriatric features in 18 (38%). PFS rate at 6 months was 45% (95% confidence interval [CI] 30-60]. Median PFS was 5.6 months (95%CI 2.7-8.4). Median overall survival (OS) was 16 months (95%CI 7.8-24). Complete response, partial response and stable disease were observed in one, two and 21 patients respectively (objective response rate 6.4%; disease control rate 51%). Thirty-nine patients (83%) experienced grade 3-4 adverse events (AEs). The most common grade 3-4 AEs were hypertension (15 patients; 32%), asthenia (14; 30%), hypophosphatemia (6; 13%); diarrhea (4; 8%), hand-foot-skin reaction (4; 8%). There were two toxic deaths (4.2%) (grade 5 rectal bleeding and death not further specified). Dose reduction was required in 26 patients (55%) and dose-delays in 13 patients (28%). CONCLUSIONS The study did not meet the pre-specified boundary of 55% PFS rate at 6 months. Toxicity observed (83% patients experienced grade 3 and 4 AEs) preclude its current use in clinical practice on this setting. Disease control rate and overall survival results are interesting and might warrant further investigation to identify those who benefit from this approach. TRIAL REGISTRATION This trial was prospectively registered at EudraCT ( 2013-000236-94 ). Date of trial registration: April 9th, 2013.
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Affiliation(s)
- A. Carrato
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERONC, Alcala University, Ctra. De Colmenar Viejo, km 9,100, 28034 Madrid, Spain
| | - M. Benavides
- Hospital Regional Universitario Virgen de la Victoria, Málaga, Spain
| | - B. Massutí
- Hospital General Universitario de Alicante, Alicante, Spain
| | - R. Ferreiro-Monteagudo
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERONC, Alcala University, Ctra. De Colmenar Viejo, km 9,100, 28034 Madrid, Spain
| | | | - E. Falcó
- Hospital Son Llatzer, Mallorca, Spain
| | - M. Reboredo
- Complejo Hospitalario Universitario A Coruña, La Coruña, Spain
| | - T. Cano
- Hospital Universitario Reina Sofia, IMIBIC, University of Córdoba, CIBERONC, Instituto de Salud Carlos III, Córdoba, Spain
| | - J. Gallego
- Hospital General Universitario de Elche, Alicante, Spain
| | - J. M. Viéitez
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - L. Layos
- Hospital Germans Trias i Pujol, ICO, Badalona, Spain
| | - A. Salud
- Hospital de Lleida Arnau de Vilanova, Lérida, Spain
| | - E. Polo
- Hospital Miguel Servet, Zaragoza, Spain
| | - E. Dotor
- Corporació Sanitària Parc Taulí, Barcelona, Spain
| | - G. Durán-Ogalla
- Hospital Regional Universitario Virgen de la Victoria, Málaga, Spain
| | - M. Rodriguez-Garrote
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERONC, Alcala University, Ctra. De Colmenar Viejo, km 9,100, 28034 Madrid, Spain
| | - A. Calvo
- Hospital Gregorio Marañón, Madrid, Spain
| | - E. Grande
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERONC, Alcala University, Ctra. De Colmenar Viejo, km 9,100, 28034 Madrid, Spain
| | - E. Aranda
- Hospital Universitario Reina Sofia, IMIBIC, University of Córdoba, CIBERONC, Instituto de Salud Carlos III, Córdoba, Spain
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Santos C, Azuara D, Viéitez JM, Páez D, Falcó E, Élez E, López-López C, Valladares M, Robles-Díaz L, García-Alfonso P, Bugés C, Durán G, Salud A, Navarro V, Capellá G, Aranda E, Salazar R. Phase II study of high-sensitivity genotyping of KRAS, NRAS, BRAF and PIK3CA to ultra-select metastatic colorectal cancer patients for panitumumab plus FOLFIRI: the ULTRA trial. Ann Oncol 2019; 30:796-803. [PMID: 30840064 DOI: 10.1093/annonc/mdz082] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Several studies show the importance of accurately quantifying not only KRAS and other low-abundant mutations because benefits of anti-EGFR therapies may depend on certain sensitivity thresholds. We assessed whether ultra-selection of patients using a high-sensitive digital PCR (dPCR) to determine KRAS, NRAS, BRAF and PIK3CA status can improve clinical outcomes of panitumumab plus FOLFIRI. PATIENTS AND METHODS This was a single-arm phase II trial that analysed 38 KRAS, NRAS, BRAF and PIK3CA hotspots in tumour tissues of irinotecan-resistant metastatic colorectal cancer patients who received panitumumab plus FOLFIRI until disease progression or early withdrawal. Mutation profiles were identified by nanofluidic dPCR and correlated with clinical outcomes (ORR, overall response rate; PFS, progression-free survival; OS, overall survival) using cut-offs from 0% to 5%. A quantitative PCR (qPCR) analysis was also performed. RESULTS Seventy-two evaluable patients were enrolled. RAS (KRAS/NRAS) mutations were detected in 23 (32%) patients and RAS/BRAF mutations in 25 (35%) by dPCR, while they were detected in 7 (10%) and 11 (15%) patients, respectively, by qPCR. PIK3CA mutations were not considered in the analyses as they were only detected in 2 (3%) patients by dPCR and in 1 (1%) patient by qPCR. The use of different dPCR cut-offs for RAS (KRAS/NRAS) and RAS/BRAF analyses translated into differential clinical outcomes. The highest ORR, PFS and OS in wild-type patients with their lowest values in patients with mutations were achieved with a 5% cut-off. We observed similar outcomes in RAS/BRAF wild-type and mutant patients defined by qPCR. CONCLUSIONS High-sensitive dPCR accurately identified patients with KRAS, NRAS, BRAF and PIK3CA mutations. The optimal RAS/BRAF mutational cut-off for outcome prediction is 5%, which explains that the predictive performance of qPCR was not improved by dPCR. The biological and clinical implications of low-frequent mutated alleles warrant further investigations. CLINICALTRIALS.GOV NUMBER NCT01704703. EUDRACT NUMBER 2012-001955-38.
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Affiliation(s)
- C Santos
- Translational Research Laboratory, Institut Català d'Oncologia Oncobell Program-IDIBELL, L'Hospitalet de Llobregat; Department of Medical Oncology, Institut Català d'Oncologia Oncobell Program-IDIBELL, CIBERONC, L'Hospitalet de Llobregat
| | - D Azuara
- Translational Research Laboratory, Institut Català d'Oncologia Oncobell Program-IDIBELL, L'Hospitalet de Llobregat
| | - J M Viéitez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo
| | - D Páez
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona
| | - E Falcó
- Department of Medical Oncology, Hospital Son Llàtzer, Palma de Mallorca
| | - E Élez
- Department of Medical Oncology, Hospital Vall d'Hebrón, Barcelona
| | - C López-López
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander
| | - M Valladares
- Department of Medical Oncology, Hospital Universitario de A Coruña, A Coruña
| | - L Robles-Díaz
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid
| | - P García-Alfonso
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid
| | - C Bugés
- Department of Medical Oncology, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Institut Català d'Oncologia-Hospital Germans Trias i Pujol
| | - G Durán
- Department of Medical Oncology, Hospital Universitario Virgen de la Victoria, Málaga
| | - A Salud
- Department of Medical Oncology, Hospital Universitari Arnau de Vilanova, Lleida
| | - V Navarro
- Clinical Research Unit, Institut Català d'Oncologia, L'Hospitalet de Llobregat
| | - G Capellá
- Translational Research Laboratory, Institut Català d'Oncologia Oncobell Program-IDIBELL, L'Hospitalet de Llobregat
| | - E Aranda
- Department of Medical Oncology, IMIBIC, Hospital Universitario Reina Sofía, Universidad de Córdoba, CIBERONC, Córdoba, Spain
| | - R Salazar
- Translational Research Laboratory, Institut Català d'Oncologia Oncobell Program-IDIBELL, L'Hospitalet de Llobregat; Department of Medical Oncology, Institut Català d'Oncologia Oncobell Program-IDIBELL, CIBERONC, L'Hospitalet de Llobregat.
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Cordoba Ortega J, Salud A, Morales S, Veas J, Rodriguez A. TTF1 status in non-small cell lung cancer adenocarcinoma: A prognostic factor. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz072.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cordoba Ortega J, Salud A, Morales S, Veas J, Rodriguez A. High blood platelets levels (BPL): A prognostic factor in patients with early or locally advanced non-small cell lung cancer (NSCLC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz064.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Morales S, Velasco A, Gasol A, Córdoba F, Vidal J, Serrate A, Valls J, Samame JC, Gisbert R, Moral D, Llombart-Cussac A, Salud A, Matias-Guiu X. Circulating tumor cells (CTCs) and cytokeratin 19 (CK19) mRNA as prognostic factors in heavily pretreated patients with metastatic breast cancer. Cancer Treat Res Commun 2018; 16:13-17. [PMID: 31298997 DOI: 10.1016/j.ctarc.2018.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 01/09/2018] [Accepted: 04/03/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Circulating tumor cell (CTC) count and cytokeratin 19 (CK19) mRNA expression have a prognostic value for patients with metastatic breast cancer (MBC), but their clinical utility remains controversial. We studied CTC count and CK19 mRNA expression in the peripheral blood samples from heavily pretreated patients with MBC and their correlations with prognosis and response to the subsequent line of therapy. METHODS This prospective observational study included 67 consecutive patients with MBC who were on progression to systemic therapy, and criteria for a new line of systemic treatment were proposed outside a clinical trial. CTC counts and CK19 mRNA expression were measured by the CellSearch® and RT-PCR methods, respectively, before and after the first cycle of treatment. Progression-free survival (PFS) was defined as the time elapsed between the initiation of the treatment and either the date of clinical or radiological tumor progression or death from any cause or the last follow-up. Cox proportional hazards regression model was used to assess the univariate prognostic value of CTC and CK19 mRNA expression on PFS and Kaplan-Meier estimates. A multivariate Cox model was also used to additionally account for phenotype and visceral disease. RESULTS The mean age was 60 (range 35-86) years, and the average number of previous treatments was 3 (range 1-10); 42 patients (62.6%) were ER+ and 38 patients (56.7%) had visceral disease. The median PFS rate was 8 months (95% CI: 3.7-8.2). Univariate analyses showed a significant effect of the initial value of CK19 mRNA expression (HR = 2.00; 95% CI: 1.05-3.8; p = 0.03) and for the second value of CTC (HR = 2.18; 95% CI: 1.22-3.9; p = 0.009) but did not reach statistical significance for the initial value of CTC and the second value of CK19 mRNA expression. The estimated PFS rates at 6 and 12 months were 75% and 31% for patients with a low initial value of CK19 mRNA expression and 36% and 10% for those with a high initial value of CK19 mRNA expression, respectively (p: 0.022). Further, the estimated PFS rates at 6 and 12 months were 86% and 65% for patients with a low second value of CTC and 76% and 47% for those with a high second value of CTC, respectively (p: 0.004). In the multivariate analysis adjusted for phenotype, visceral disease, and the last treatment performed, only the effect of the second value of CTC remained significant (HR = 2.7, p = 0.004). CONCLUSIONS CK19 mRNA expression and CTC count appeared clinically meaningful in pretreated patients with MBC, even when adjusted for phenotype and visceral disease involvement. These results support the use of CK19 and CTC as relevant biomarkers for predicting clinical response in MBC.
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Affiliation(s)
- S Morales
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain.
| | - A Velasco
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - A Gasol
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - F Córdoba
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - J Vidal
- Hospital Arnau de Vilanova de Valencia, Spain
| | - A Serrate
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - J Valls
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - J C Samame
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - R Gisbert
- Hospital Arnau de Vilanova de Valencia, Spain
| | - D Moral
- Hospital Arnau de Vilanova de Valencia, Spain
| | | | - A Salud
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - X Matias-Guiu
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
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Abstract
Between 1982 and 1990, 2388 brochoscopic examinations were carried out in patients with cancer in our hospital. A diagnosis of endobronchial metastasis was established in 30 patients (2.09 %), with the following primary tumors in descending order of frequency: breast, large bowel, melanoma, neuroblastoma, leiomyosarcoma and endometrial. Despite the rarity of endobronchial metastases secondary to colon adenocarcinoma, we were able to study 3 cases from our Center. In one case the diagnosis of endobronchial metastasis was simultaneous with that of the primary tumor, and in the other 2 this metastatic complication occurred 16 and 42 months, after the original diagnosis. When this complication occurred, the stage of the disease was advanced in all 3 cases: 2 were Dukes’ stage C and one stage D. Although this metastatic location usually implies a very negative prognosis as regards life expectancy, it did not seem to significantly reduce the latter in our patients.
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Affiliation(s)
- A Rovirosa Casino
- Radiotherapy and Oncology Department, University Valle de Hebron General Hospital, Autonoma University of Barcelona, Spain
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Patel UB, Brown G, Machado I, Santos-Cores J, Pericay C, Ballesteros E, Salud A, Isabel-Gil M, Montagut C, Maurel J, Ramón-Ayuso J, Martin N, Estevan R, Fernandez-Martos C. MRI assessment and outcomes in patients receiving neoadjuvant chemotherapy only for primary rectal cancer: long-term results from the GEMCAD 0801 trial. Ann Oncol 2017; 28:344-353. [PMID: 28426108 DOI: 10.1093/annonc/mdw616] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [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: 01/03/2023] Open
Abstract
Background Primary chemotherapy has been tested as a possible approach for patients with high risk features but predicted clear mesorectal margins on preoperative MRI assessment. This study investigates the prognostic relevance of baseline and post-treatment MRI and pathology staging in rectal cancer patients undergoing primary chemotherapy. Patients and methods Forty-six patients with T3 tumour > =2 mm from the mesorectal fascia were prospectively treated with Neoadjuvant Capecitabine, Oxaliplatin and Bevacizumab prior to surgery between 2009 and 2011. The baseline and post-treatment MRI: T, Nodal and Extra-mural venous invasion (EMVI) status were recorded as well as post-treatment MRI Tumour regression grade (TRG) and modified-RECIST assessment of tumour length. The post-treatment pathology (yp) assessments of T3 substage, N, EMVI and TRG status were also recorded. Three-year disease-free survival (DFS) and cumulative incidence of recurrence were estimated by using the Kaplan-Meier product-limit method, and Cox proportional hazards models were used to determine associations between staging and response on MRI and pathology with survival outcomes. Results About 46 patients underwent neoadjuvant chemotherapy alone for high risk margin safe primary rectal cancer. The median follow-up was 41 months, 5 patients died and 11 patients experienced relapse (2 local, 8 distant and 1 both). In total 23/46 patients were identified with MRI features of EMVI at baseline. mrEMVI positive status carried independent prognostic significance for DFS (P = 0.0097) with a hazard ratio of 31.33 (95% CI: 2.3-425.4). The histopathologic factor that was of independent prognostic importance was a final ypT downstage of ypT3a or less, hazard ratio: 14.0 (95% CI: 1.5-132.5). Conclusions mrEMVI is an independent prognostic factor at baseline for poor outcomes in rectal cancer treated with neoadjuvant chemotherapy while ≤ypT3a is associated with an improvement in DFS. Future preoperative therapy evaluation in rectal cancer patients will need to stratify treatment according to baseline EMVI status as a crucial risk factor for recurrence in patients with predicted CRM clear rectal cancer.
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Affiliation(s)
- U B Patel
- Radiology Department, London North-West Healthcare NHS Trust, London
| | - G Brown
- Radiology Department, The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - I Machado
- Department of Pathology, Valencia Institute of Oncology, Valencia, Spain
| | - J Santos-Cores
- Department of Radiology, Fundacion InstitutoValenciano de Oncologia, Valencia, Spain
| | - C Pericay
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - E Ballesteros
- Department of Radiology, Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
| | - A Salud
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - M Isabel-Gil
- Department of Radiology, Hospital Universitari Arnau de Vilanova, Lleida
| | - C Montagut
- Department of Medical Oncology Department, Hospital del Mar, Barcelona
| | - J Maurel
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - J Ramón-Ayuso
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona
| | - N Martin
- Department of Pivotal, Madrid, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | - R Estevan
- Department of Surgery, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | - C Fernandez-Martos
- Department of Medical Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
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Pineda E, Salud A, Vila-Navarro E, Safont MJ, Llorente B, Aparicio J, Vera R, Escudero P, Casado E, Bosch C, Bohn U, Pérez-Carrión R, Carmona A, Ayuso JR, Ripollés T, Bouzas R, Gironella M, García-Albéniz X, Feliu J, Maurel J. Dynamic soluble changes in sVEGFR1, HGF, and VEGF promote chemotherapy and bevacizumab resistance: A prospective translational study in the BECOX (GEMCAD 09-01) trial. Tumour Biol 2017. [DOI: 10.1177/1010428317705509] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Estela Pineda
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - A Salud
- Department of Medical Oncology, Arnau de Vilanova Hospital, Lleida, Spain
| | - E Vila-Navarro
- Department of Gastrointestinal and Pancreatic Oncology, CIBERehd-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Clínic Hospital, Barcelona, Spain
| | - MJ Safont
- Department of Medical Oncology, General University Hospital of Valencia, Valencia, Spain
| | - Beatriz Llorente
- Department of Medical Oncology, Hospital Universitario de Burgos, Spain
| | - J Aparicio
- Department of Medical Oncology, La Fe University Hospital, Valencia, Spain
| | - R Vera
- Department of Medical Oncology, De Navarra Hospital, Pamplona, Spain
| | - P Escudero
- Department of Medical Oncology, Lozano Blesa Hospital, Zaragoza, Spain
| | - E Casado
- Department of Medical Oncology, Infanta Sofía Hospital, Madrid, Spain
| | - C Bosch
- Department of Medical Oncology, Pesset Hospital, Valencia, Spain
| | - U Bohn
- Department of Medical Oncology, Doctor Negrin University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - R Pérez-Carrión
- Department of Medical Oncology, Hospital Universitario Quirón Madrid, Madrid, Spain
| | - A Carmona
- Department of Medical Oncology, Morales Meseguer University Hospital, Murcia, Spain
| | - JR Ayuso
- Department of Radiology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - T Ripollés
- Department of Radiology, Pesset Hospital, Valencia, Spain
| | - R Bouzas
- Department of Radiology, Hospital Alvaro Cunqueiro, Vigo, Spain
| | - M Gironella
- Department of Gastrointestinal and Pancreatic Oncology, CIBERehd-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Clínic Hospital, Barcelona, Spain
| | - X García-Albéniz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J Feliu
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | - J Maurel
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
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Alonso V, Emperador PE, Urena MM, Gallego J, Rodriguez J, Fernández J, Salud A, Falcó E, Manzano H, Zanui M, Gil M, Sarmiento UB, Martos CF, Calderero V, Ferrer A, Cuatrecasas M, Rojo F, Feliu J, Maurel J, García-Albéniz X. Prospective evaluation of BRAF, PI3K and PTEN as predictive and prognostic biomarkers in first-line advanced KRAS wild-type colorectal cancer treated with FOLFOX or FOLFIRI plus bi-weekly cetuximab. GEMCAD 10-02. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Maurel J, Martos CF, Richard MM, Alonso V, Méndez CM, Salud A, Pericay C, Aparicio J, Gallego J, Carmona A, Casado E, Manzano H, Horndler C, Rubini M, Cuatrecasas M, García-Albéniz X, Feliu J. PULSE, a phase 2 study of mFOLFOX6-panitumumab (P) with biomarker stratification as first-line chemotherapy (CT), in patients (pts) with KRAS (exon 2) metastatic colorectal cancer (mCRC). A GEMCAD 09-03 study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Sastre J, Díaz-Beveridge R, García-Foncillas J, Guardeño R, López C, Pazo R, Rodriguez-Salas N, Salgado M, Salud A, Feliu J. Clinical guideline SEOM: hepatocellular carcinoma. Clin Transl Oncol 2015; 17:988-95. [PMID: 26607931 PMCID: PMC4689753 DOI: 10.1007/s12094-015-1451-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 11/07/2015] [Indexed: 02/07/2023]
Abstract
Hepatocellular carcinoma (HCC) represents the second leading cause of cancer-related death worldwide. Surveillance with abdominal ultrasound every 6 months should be offered to patients with a high risk of developing HCC: Child-Pugh A-B cirrhotic patients, all cirrhotic patients on the waiting list for liver transplantation, high-risk HBV chronic hepatitis patients (higher viral load, viral genotype or Asian or African ancestry) and patients with chronic hepatitis C and bridging fibrosis. Accurate diagnosis, staging and functional hepatic reserve are crucial for the optimal therapeutic approach. Characteristic findings on dynamic CT/MR of arterial hyperenhancement with "washout" in the portal venous or delayed phase are highly specific and sensitive for a diagnosis of HCC in patients with previous cirrhosis, but a confirmed histopathologic diagnosis should be done in patients without previous evidence of chronic hepatic disease. BCLC classification is the most common staging system used in Western countries. Surgical procedures, local therapies and systemic treatments should be discussed and planned for each patient by a multidisciplinary team according to the stage, performance status, liver function and comorbidities. Surgical interventions remain as the only curative procedures but both local and systemic approaches may increase survival and should be offered to patients without contraindications.
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Affiliation(s)
- J Sastre
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, Prof. Martín Lagos, s/n, 28040, Madrid, Spain.
| | - R Díaz-Beveridge
- Medical Oncology Department, Hospital Universitari I Politècnic la Fe, Valencia, Spain
| | - J García-Foncillas
- Medical Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - R Guardeño
- Medical Oncology Department, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
| | - C López
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - R Pazo
- Medical Oncology Department, Hospital Universitario Miguel Servet, Saragossa, Spain
| | - N Rodriguez-Salas
- Medical Oncology Department, Hospital Universitario la Paz, Madrid, Spain
| | - M Salgado
- Medical Oncology Department, Complexo Hospitalario de Ourense (CHOU), Madrid, Spain
| | - A Salud
- Medical Oncology Department, Hospital Universitari Arnau de Villanova de Lleida, Lleida, Spain
| | - J Feliu
- Medical Oncology Department, Hospital Universitario la Paz, Madrid, Spain
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Fernandez-Martos C, Garcia-Albeniz X, Pericay C, Maurel J, Aparicio J, Montagut C, Safont M, Salud A, Vera R, Massuti B, Escudero P, Alonso V, Bosch C, Martin M, Minsky B. Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trial. Ann Oncol 2015; 26:1722-8. [DOI: 10.1093/annonc/mdv223] [Citation(s) in RCA: 205] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/02/2015] [Indexed: 12/17/2022] Open
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García Alfonso P, Ortiz M, Durán G, Falcó E, Muñoz A, García-Paredes B, Salgado M, López-Ladrón A, Vieitez de Prado J, Valladares M, Salud A, Guillén-Ponce C, Lopez R, Robles L, Juárez A, Serrano S, Montagut C, Zanui M, Gil Raga M, La Casta A, Benavides M, Aranda E. P-272 Phase II study of Regorafenib as single agent for the treatment of patients with metastatic colorectal cancer with any RAS or BRAF mutation and previously treated with FOLFOXIRI plus bevacizumab. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.269] [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: 11/12/2022] Open
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20
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Alonso-Orduna V, Marmol M, Escudero P, Salud A, Safont M, Méndez J, Girón CG, Martín M, Fernandez-Martos C, Albéniz XG, Feliu J, Maurel J. A Validation of Current Prognostic Scores in Metastatic Colorectal Cancer (Mcrc) and a New Prognostic Score (A Gemcad Study). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gomez-Martin C, Plaza J, Del Valle E, Valladares FP, Fonseca PJ, Salud A, Leon A, Rivera F, Garralda E, Lopez-Rios F. HER2 Status in advanced Gastric Carcinoma Patients Treated with Trastuzumab. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33276-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Fernandez-Martos C, Pericay C, Salud A, Massuti B, Alonso V, Safont MJ, Vera R, Escudero MP, Maurel J, Aparicio J. Three-year outcomes of GCR-3: A phase II randomized trial comparing conventional preoperative chemoradiation (CRT) followed by surgery and postoperative adjuvant chemotherapy (CT) with induction CT followed by CRT and surgery in locally advanced rectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3552] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pericay C, Losa F, Pisa A, Alfaro J, Cirera L, Salud A, Falco E, Dotor E, Vicente P, Casado E, Oliva JC, Saigí E. Phase II study with docetaxel (D), cisplatin (C), and continuous capecitabine (CAP) combination (TCX) in advanced gastric cancer: Preliminary data. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14611] [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: 11/20/2022] Open
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Muñoz A, Pericay C, Llorente B, Alonso V, Dueñas R, Roca J, Rivera F, Falco E, Alvarez I, Salud A. Phase II study of bevacizumab (B) plus oxaliplatin (Ox) plus capecitabine (C) followed by bevacizumab (B) plus erlotinib (E) as first-line treatment in metastatic colorectal cancer (mCRC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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25
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Feliu J, Safont MJ, Salud A, Losa F, García-Girón C, Bosch C, Escudero P, López R, Madroñal C, Bolaños M, Gil M, Llombart A, Castro-Carpeño J, González-Barón M. Capecitabine and bevacizumab as first-line treatment in elderly patients with metastatic colorectal cancer. Br J Cancer 2010; 102:1468-73. [PMID: 20424611 PMCID: PMC2869164 DOI: 10.1038/sj.bjc.6605663] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [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: 01/18/2009] [Revised: 03/24/2010] [Accepted: 03/24/2010] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The efficacy and safety of capecitabine and bevacizumab in elderly patients with metastatic colorectal cancer (mCRC) considered unsuitable for receiving first-line chemotherapy with an irinotecan or oxaliplatin-based combination were assessed in a phase II, open, multicentre, uncontrolled study. METHODS Treatment consisted of capecitabine 1250 mg m(-2) (or 950 mg m(-2) for patients with a creatinine clearance of 30-50 ml min(-1)) twice daily on days 1-14 and bevacizumab (7.5 mg kg(-1)) on day 1 every 3 weeks. RESULTS A total of 59 patients aged >or=70 years with mCRC were enrolled. In an intention-to-treat analysis, the overall response rate was 34%, with 71% of patients achieving disease control. Median progression-free survival and overall survival were 10.8 months and 18 months, respectively. In all, 32 patients (54%) had grade 3/4 adverse events (AEs), the most common being hand-foot syndrome (19%), diarrhoea (9%) and deep venous thrombosis (7%). Four patients died because of treatment-related AEs. A relationship was detected between creatinine clearance CONCLUSION Bevacizumab combined with capecitabine represents a valid therapeutic alternative in elderly patients considered to be unsuitable for receiving polychemotherapy.
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Affiliation(s)
- J Feliu
- Medical Oncology Department, Hospital La Paz/Autónoma University School of Medicine. IdiPAZ. RETIC, P degrees de la Castellana, Madrid 261- 28046, Spain.
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Bielsa S, Panadés MJ, Egido R, Rue M, Salud A, Matías-Guiu X, Rodríguez-Panadero F, Porcel JM. [Accuracy of pleural fluid cytology in malignant effusions]. ACTA ACUST UNITED AC 2009; 25:173-7. [PMID: 18604333 DOI: 10.4321/s0212-71992008000400005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess the usefulness of repeat cytological examination of pleural fluid (PF) for diagnosing malignancy as well as the influence of time length between analyses, effusion's size and pleural fluid biochemistries on the diagnostic yield of cytology. METHODS Retrospective analysis of 1,427 patients with pleural effusion (PE), including 466 patients with malignant PE. In this latter group, the time length between cytological analysis, the size of the PE, and the biochemical characteristics of PF were recorded. RESULTS The first cytological analysis had a sensitivity of 48.5%. If this was negative, a second PF specimen was diagnostic in 28.6% of cases, whereas submission of a third PF specimen allowed 10.3% of additional diagnosis. The incidence of positive results depended on the primary tumor (e.g. 66.5% in adenocarcinomas, 30.8% in mesotheliomas), but neither on the time length between cytological analyses nor on the effusion's size. A multivariate analysis showed that a PF to serum glucose ratio </= 0.75 was associated with a higher diagnostic yield of cytology (74 vs. 47%, p < 0.001). CONCLUSION At least a second PF specimen should be submitted immediately for cytologic analyis in all PE of unknown cause, when the first analysis is not contributory. To delay this second analysis does not increase diagnostic yield. The percentage of cases in which cytologic study of the PF established the diagnosis of malignant PE depends on the tumor type and on certain PF biochemical characteristics such as the PF to serum glucose ratio.
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Affiliation(s)
- S Bielsa
- Servicio de Medicina Interna, IRBLLEIDA, Lleida, Spain
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Fernandez-Martos C, Aparicio J, Salud A, Alonso V, Massuti B, Safont M, Vera R, Escudero P, Maurel J, Pericay C. Multicenter randomized phase II study of chemoradiation (CRT) followed by surgery (S) and chemotherapy (CT) versus induction CT followed by CRT and S in high-risk rectal cancer: GCR-3 final efficacy and safety results. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4103 Background: In locally advanced RC the optimal therapeutic sequence remains an important clinical question. Induction CT prior to CRT and S may be associated with better efficacy and compliance. Methods: Eligible pts had medium or distal high risk RC defined by MRI and/or US: Tumors within 2mm of mesorectal fascia, distal T3 at/below levators, resectable T4 and T3N+. Pts, stratified by center, were randomized assigned to receive either Arm A : capecitabine (Cap) 825 mg/m2 BID 5 d/w, oxaliplatin (Ox) 50 mg/m2 IV weekly x 5 and concomitant RT: 50.4 Gy in 28 fractions. S was planned 5–6 w after CRT. Post-op four cycles of Cap 1,000 mg/m2 bid days 1 to 14; Ox 130 mg/m2 day 1 or Arm B: Induction CapOx followed by CRT and S. Two parallel, Simon 2-stage designs: α=0.05 β=0.1; 24 evaluable pts/arm 1st stage and 54 pts/arm for 2nd stage. Primary endpoint: pathological complete response (pCR). Secondary endpoints included toxicity and treatment compliance. Results: 108 Pts were randomly assigned (arm A/B, 52/56), and 103 were assessable (49/54) from 14 sites. Median age 62/60 years, Male 65/70%. During treatment period 6 pts died A/B: 2 vascular, 1 suicide/ 3 post-op. Pts with any grade ¾ toxicity during CRT were arm A/B: 29% (14/49) and 23% (12/53). Any grade ¾ toxicity during adjuvant/induction CT were 51% (19/37) and 17% (9/54); χ2,p= 0.0004. On an intent-to-treat basis the pCR for Arm A/B was achieved in seven (13.5%; 95% CI, 5.6%-25.8%) and eight (14.3%; 95% CI, 6.4%-26.2%). R0 resections were achieved in 92% (45/49) and 88% (48/54). 51% (25/49) and 93% (50/54) received all four cycles of adjuvant/induction CT (χ2;p<0.0001). Relative Median Dose intensity of adjuvant /induction CT was 0.74/0.96 (Wilcoxon; p<0.0001) for Cap and 0.75/1.0 (Wilcoxon; p<0.0001) for Ox. Conclusions: Induction CT prior to CRT has more favorable compliance and toxicity profiles. Furthermore, there is no compromise in pCR and R0 resection rates. Larger trials evaluating this strategy are justified. [Table: see text]
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Affiliation(s)
- C. Fernandez-Martos
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - J. Aparicio
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - A. Salud
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - V. Alonso
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - B. Massuti
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - M. Safont
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - R. Vera
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - P. Escudero
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - J. Maurel
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - C. Pericay
- Fundación Instituto Valenciano de Oncologia, Valencia, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital General Universitario, Alicante, Spain; Hospital General Universitario, Valencia, Spain; Hospital de Navarra, Pamplona, Spain; Hospital Clínico Lozano Blesa, Valencia, Spain; Hospital Clinic, Barcelona, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain
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Nogue M, Salud A, Vicente P, Pericay C, Arriví A, Roca JM, Losa F, Ponce J, Safont MJ, Guasch I. Addition of bevacizumab to induction plus concomitant capecitabine-oxaliplatin (XELOX) chemoradiotherapy (CRT) in MRI poor prognosis locally advanced rectal cancer: Avacross study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4100 Background: Concomitant CRT with 5-FU followed 6–8 weeks later by TME surgery is well accepted standard treatment for locally advancer rectal cancer. This approach focuses only into local control. Trimodal induction approaches with chemo, radiation and anti VEGFR therapy may induce additional tumor growth delay. Methods: Eligible patients (pts) had high-risk rectal adenocarcinoma defined by MRI: distal T3 at/below levators, T3 at any other level within 2 mm of mesorectal fascia, resectable T4 and any T3 with nodal metastases. We excluded pts with any antecedent of heart disease. Treatment consisted in four 21 day cycles of oxaliplatin 130 mg/m2 d 1, bevacizumab 7.5 mg/kg d 1 and capecitabine 1000 mg/m2/12 h d 1–14. After 3–4 weeks they received concomitant RT (50.4 Gy in 28 fractions) with capecitabine 825 mg/m2/12 h plus bevacizumab 5 mg/kg, three biweekly doses. TME was planned 6–8 weeks after CRT. Primary end point was pathologic complete response rate with standarized pathology examination. Results: From July 2007 to July 2008, 47 pts were enrolled. Median age was 58 (30–78). Median KPS was 90%. Clinical stage was T3N1: 51.1%, T3N2: 25.5%, T4N0–2: 10.6%, T3N0: 8.5% of pts. 40 pts completed the induction phase: G 3–4 toxicity were diarrhea 12.7%, neutropenia 8.5%, peripheral neuropathy 6.3% and thrombocytopenia 4.2%.. 39 pts completed the CRT phase. Grade 3–4 toxicity were rectitis, linfopenia and hipertrigliceridemia in 2.5% of pts. Until now we have data on 35 resections, 2 with only one induction cycle. R0 resections were achieved in 34 pts (R1 resection in a patient with only one induction cycle). There were 7 wound complications and 10 pts required surgical reintervention. pCR were obtained in 13 pts (37,1 %, 95% CI:21.1–53.2) with 18 (51.4%) additional pts with only residual microscopic foci. There were two treatment related-deaths: one sudden death and one grade 4 diarrhea and diabetic ketoacidosis. Conclusions: Preliminary results show that our preoperative schedule appears feasible, with impressive activity level (pCR + Tmic of 88.5%), achieving downstaging in nearly all pts. Toxicity was manageable, nevertheless we stress caution with cardiac and GI events and surgical complications. No significant financial relationships to disclose.
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Affiliation(s)
- M. Nogue
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - A. Salud
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - P. Vicente
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - C. Pericay
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - A. Arriví
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - J. M. Roca
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - F. Losa
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - J. Ponce
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - M. J. Safont
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
| | - I. Guasch
- Hospital General de Vic, Vic, Spain; Hospital Arnau Villanova, Lleida, Spain; Hospital General de Granollers, Granollers, Spain; Corporació Sanitaria Parc Taulí, Sabadell, Spain; Hospital Son Llazter, Mallorca, Spain; Hospital Mutua de Terrasa, Terrasa, Spain; Hospital General de L`Hospitalet, Hospitaletq, Spain; Hospital Virgen de los Lirios, Alicante, Spain; Hospital General de Valencia, Valencia, Spain; Hospital Sant Joan de Deu, Manresa, Spain
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Feliu J, Safont M, Salud A, Losa F, García-Girón C, Bosch C, Escudero P, López R, Madroñal C, González-Barón M. Phase II study to evaluate the efficacy of capecitabine combined with bevacizumab as first-line treatment in elderly patients with advanced or metastatic colorectal adenocarcinoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4119 Background: Colorectal adenocarcinoma is the most common cancer in subjects over 70 years old. New therapies have been developed but limited data about their activity are available in elderly population. Results obtained with capecitabine have shown an appropriate safety and efficacy profile in these patients. The aim of the present study is to evaluate the overall response rate in that patient's population who presents colorectal adenocarcinoma and are treated with the combination of capecitabine+BVZ. Methods: This is a multicentric, non-controlled, open label, phase II clinical trial. Capecitabine(1250mg/m2 bid, orally)+BVZ(7.5mg/kg, intravenously) treatment was administered in 3-week length cycles until disease progression. Capecitabine dose was reduced to 1000mg/m2 when the creatinine clearance was between 30 and 50ml/min. Results: A total of 59 patients were included (57.6%, male). Mean age was 76±4.1 years. ECOG status was 0–1 in 96.5 % of the patients. Activities of daily living: moderate to severe dependence and functional incapacity in 24.5% and 5.6% of the patients by Lawton and Barthel scales, respectively. Comorbidities: hypertension (61%), venous thrombosis (5.1%), cardiac disease (5.1%) and acute cerebrovascular accident history (3.4%). Metastases were detected in liver (84.7%), lung (45.8%), local/regional (18.6%) and other locations (5.1%). Mean number of cycles of capecitabine+BVZ was 6.8±6.1. Most frequent grade 3–4 toxicities observed were hand-foot-syndrome (18.6%), diarrhea (8.5%), deep venous thrombosis (6.8%), pain (5.1%) and mucositis (3.4%). Four patients died due to toxicity (mucositis, digestive hemorrhage, hematological toxicity and sepsis, respectively). Metastasis resection was performed in 10.2% of the patients. Treatment response was: 33.3% partial response and 59.0% stable disease. Median progression-free survival was 10.8 months. Conclusions: The combination capecitabine+BVZ in elderly patients appears to have a manageable safety profile and achieves promising results in terms of response rates and progression free-survival. No significant financial relationships to disclose.
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Affiliation(s)
- J. Feliu
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - M. Safont
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - A. Salud
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - F. Losa
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - C. García-Girón
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - C. Bosch
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - P. Escudero
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - R. López
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - C. Madroñal
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
| | - M. González-Barón
- Hospital Universitario La Paz, Madrid, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de Lleida Arnau Vilanova, Lerida, Spain; Hospital de la Creu Roja, Hospitalet de Llobregat, Spain; Hospital General Yagüe, Burgos, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Clínica Corochán, Barcelona, Spain
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Fernandez-Martos C, Pericay C, Salud A, Alonso V, Massuti B, Safont M, Vera R, Escudero P, Maurel J, Aparicio J. Randomized phase II trial comparing two strategies in high-risk rectal cancer (RC): Chemoradiation (CRT) followed by total mesorectal excision (TME) and adjuvant chemotherapy (CT) or induction CT followed by CRT and TME— Preliminary results of the multicenter GCR-3 study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Alonso V, Lambea J, Salud A, Valencia J, Mira M, Polo S, Escudero P, Sierra E, Monzon A. Preoperative chemoradiotherapy with capecitabine and oxaliplatin in locally advanced rectal carcinoma: A phase II trial. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4044 Background: The aim of this phase II trial was to assess the impact of preoperative external radiation therapy combined with Capecitabine and Oxaliplatin on pathologic tumor response, sphincter preservation and tumor control in patients with locally advanced rectal carcinoma. Methods: Sixty-seven patients with locally advanced rectal carcinoma (T3/T4 or N+) received radiotherapy (50.4 Gy/28 fractions) and chemotherapy with Capecitabine 825 mg/m2/12 hours on days 1–5 + Oxaliplatin 50 mg/m2 on day 1 every week (weeks 1–6). Surgery with TME was performed 6–7 weeks after the end of the treatment. Adjuvant chemotherapy was administered after surgery according investigator‘s crtiteria. Results: Patients have been recruited between February 2005 and June 2006. 47 male/20 female. Median age 67 years (range 38–79). Performance status (ECOG) 0 in 45 patients. Clinical stage (determined by EUS+CT or RMI): cT2 3p/cT3 58p/cT4 6p/cN+ 47p. Tumor location (from anal verge): = 5 cm in 27p. Median CEA level 3,69 ng/ml (0,7–391). Surgery (performed in 65 patients) consisted of low anterior resection in 37p, abdominal perineal resection in 28p. Tumor downstaging was observed in 52p (78%), 50 (76,9%) had negative lymph nodes, including 13p with complete pathological response (19,4%) and ten with only microfoci of tumor remaining (14,9%). 80% of the patients received adjuvant chemotherapy. Main adverse effects (NCI-CTC): diarrhea G3/4 25%, sensitive peripheral neurotoxicity G1 60%, skin G2 9%, skin G3 3%, nausea/vomiting G2 7.5%, fatigue G2 50%, fatigue G3 4%, neutropenia G3/4 4%. Conclusions: Those results show that preoperative chemoradiotherapy with capecitabine and oxaliplatin is a well tolerated regimen for locally advanced operable rectal cancer leading to a high probability of tumor downstaging. No significant financial relationships to disclose.
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Affiliation(s)
- V. Alonso
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
| | - J. Lambea
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
| | - A. Salud
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
| | - J. Valencia
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
| | - M. Mira
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
| | - S. Polo
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
| | - P. Escudero
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
| | - E. Sierra
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
| | - A. Monzon
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain
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Salud A, Alonso V, Lambea J, Valencia J, Mira M, Polo S, Escudero P, Sierra E, Lao J. Preoperative chemoradiotherapy with capecitabine and oxaliplatin in locally advanced rectal carcinoma: Preliminary results. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.13543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
13543 Background: Preoperative chemoradiotherapy has shown to improve local control and sphincter preservation with decreased acute toxicity compared with postoperative treatment in locally advanced rectal carcinoma. The primary endpoint of this phase II trial was pathologic tumor response. Secondary endpoints were sphincter preservation and toxicity. Methods: Inclusion criteria: rectal adenocarcinoma <12 cms from anal verge, clinical stage T3–4 and/or N+, adequate renal, hematological and liver function. Planned sample for this trial was 43 patients. Treatment scheme: pelvic radiotherapy (50.4 Gy/28 fractions) and chemotherapy: Capecitabine 825 mg/m2/12 hours on days 1–5 + Oxaliplatin 50 mg/m2 on day 1 every week (weeks 1–6). Surgery with TME was performed between 6–8 weeks after the end of the treatment. Adjuvant chemotherapy was administered after surgery according each center criteria. Results: 37 patients have been recruited between February and December 2005. 26 male/11 female. Median age 70 years (range 38–79). Clinical stage (determined by EUS+CT or RMI): cT2 1p/cT3 33p/cT4 3p/cN+ 27p. Tumor location (from anal verge): ≤ 5 cm in 15p, >5 cm in 22p. Surgery (performed in 26 patients) consisted of low anterior resection in 13p and abdominal-perineal resection in 13p. Tumor downstaging was observed in 17p (65%), 20 (77%) had negative lymph nodes, including 6p with complete pathological response (23%) and four with only microfoci of tumor remaining (15%). Main adverse effects (NCI-CTC): diarrhea G3–4 19%, sensitive peripheral neurotoxicity G1 38%, skin G2 11%, nausea/vomiting G2 11%, fatigue/malaise G3 4%, neutropenia G3 7%. Conclusions: Preliminary results show that preoperative chemoradiotherapy with capecitabine and oxaliplatin is a well tolerated regimen for locally advanced operable rectal cancer leading to a high probability of tumor downstaging. No significant financial relationships to disclose.
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Affiliation(s)
- A. Salud
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
| | - V. Alonso
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
| | - J. Lambea
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
| | - J. Valencia
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
| | - M. Mira
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
| | - S. Polo
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
| | - P. Escudero
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
| | - E. Sierra
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
| | - J. Lao
- University Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clinico, Zaragoza, Spain; Clinica Quirón, Zaragoza, Spain
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Feliu J, Salud A, Escudero P, Lopez-Gómez L, Bolaños M, Galán A, Vicent JM, Yubero A, Losa F, De Castro J, de Mon MA, Casado E, González-Barón M. XELOX (capecitabine plus oxaliplatin) as first-line treatment for elderly patients over 70 years of age with advanced colorectal cancer. Br J Cancer 2006; 94:969-75. [PMID: 16552438 PMCID: PMC2361238 DOI: 10.1038/sj.bjc.6603047] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The purpose of this phase II trial was to determine the efficacy and safety of the XELOX (capecitabine/oxaliplatin) regimen as first-line therapy in the elderly patients with metastatic colorectal cancer (MCRC). A total of 50 patients with MCRC aged > or = 70 years received oxaliplatin 130 mg m(-2) on day 1 followed by oral capecitabine 1000 mg m(-2) twice daily on days 1-14 every 3 weeks. Patients with creatinine clearance 30-50 ml min(-1) received a reduced dose of capecitabine (750 mg m(-2) twice daily). By intent-to-treat analysis, the overall response rate was 36% (95% CI, 28-49%), with three (6%) complete and 15 (30%) partial responses. In total, 18 patients (36%) had stable disease and 14 (28%) progressed. The median times to disease progression and overall survival were 5.8 months (95% CI, 3.9-7.8 months) and 13.2 months (95% CI, 7.6-16.9 months), respectively. Capecitabine was well tolerated: grade 3/4 adverse events were observed in 14 (28%) patients: 11 (22%) diarrhoea, eight (16%) asthenia, seven (14%) nausea/vomiting, three (6%) neutropenia, three (6%) thrombocytopenia, and two (4%) hand-foot syndrome. There was one treatment-related death from diarrhoea and sepsis. In conclusion, XELOX is well tolerated in elderly patients, with respectable efficacy and a meaningful clinical benefit response. Given its ease of administration compared with combinations of oxaliplatin with 5-FU/LV, it represents a good therapeutic option in the elderly.
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Affiliation(s)
- J Feliu
- Service of Medical Oncology, H La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, Madrid 28046, Spain.
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Feliu J, Castañón C, Salud A, Mel JR, Escudero P, Pelegrín A, López-Gómez L, Ruiz M, González E, Juárez F, Lizón J, Castro J, González-Barón M. Phase II randomised trial of raltitrexed-oxaliplatin vs raltitrexed-irinotecan as first-line treatment in advanced colorectal cancer. Br J Cancer 2006; 93:1230-5. [PMID: 16265344 PMCID: PMC2361515 DOI: 10.1038/sj.bjc.6602860] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The purpose of this phase II randomised trial was to determine which of two schemes, raltitrexed-irinotecan or raltitrexed-oxaliplatin, offered better activity and less toxicity in patients with advanced colorectal cancer (CRC). A total of 94 patients with previously untreated metastatic CRC were included and randomised to receive raltitrexed 3 mg m−2 followed by oxaliplatin 130 mg m−2 on day 1 (arm A), or CPT-11 350 mg m−2 followed by raltitrexed 3 mg m−2 (arm B). In both arms treatment was repeated every 3 weeks. Intent-to-treat (ITT) analysis showed an overall response rate of 46% (95% CI, 29.5–57.7%) for arm A, and 34% (95% CI, 19.8–48.4%) for arm B. Median time to progression was 8.2 months for arm A and 8.8 months for arm B. After a median follow-up of 14 months, 69% of patients included in arm A were still alive, compared to 59% of those included in arm B. Overall, 31 patients (65%) experienced some episode of toxicity in arm A and 32 patients (70%) in arm B, usually grade 1–2. The most common toxicity was hepatic, with 29 patients (60%) in arm A and 24 patients (62%) in arm B, and was grade 3–4 in four (8%) and four (9%) patients, respectively. In all, 14 patients (29%) from arm A and 24 patients (52%) from arm B had some grade of diarrhoea (P<0.03). Neurologic toxicity was observed in 31 patients (64%) in arm A, and was grade 3–4 in five patients (10%), while a cholinergic syndrome was detected in nine patients (19%) in arm B. There were no differences in haematologic toxicity. One toxic death (2%) occurred in arm A and three (6.5%) in arm B. In conclusion, both schemes have high efficacy as first-line treatment in metastatic CRC and their total toxicity levels are similar. Regimens with raltitrexed seem a reasonable alternative to fluoropyrimidines.
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Affiliation(s)
- J Feliu
- Service of Medical Oncology, La Paz, Paseo de la Castellana 261, Madrid 28046, Spain.
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Salud A, Escudero P, Feliú J, López-Gómez L, Bolaños M, Galán A, Yubero A, Vicent JM, Losa F, González Barón M. XELOX (capecitabine and oxaliplatin) as 1 st line treatment for elderly patients (pts) with advanced/metastatic colorectal cancer (MCRC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3620] [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)
- A. Salud
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - P. Escudero
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - J. Feliú
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - L. López-Gómez
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - M. Bolaños
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - A. Galán
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - A. Yubero
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - J. M. Vicent
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - F. Losa
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
| | - M. González Barón
- Hosp Arnau de Vilanova, Lleida, Spain; Hosp Lozano Blesa, Zaragoza, Spain; Hosp La Paz, Madrid, Spain; Hosp Virgen de la Salud, Toledo, Spain; Hosp San Pedro de Alcántara, Cáceres, Spain; Hosp de Sagunto, Valencia, Spain; Hosp Obispo Polanco, Teruel, Spain; Hosp Gen Univ de Valencia, Valencia, Spain; Hosp de la Creu Roja, Barcelona, Spain
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Alonso V, Salud A, Escudero P, Bueso P, Mira M, Valencia J, Polo S, Ruiz de Lobera A, Lao J, Lastra R. Phase II trial of preoperative chemoradiotherapy with irinotecan and infusional 5-fluorouracil in locally advanced operable rectal carcinoma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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)
- V. Alonso
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - A. Salud
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - P. Escudero
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - P. Bueso
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - M. Mira
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - J. Valencia
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - S. Polo
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - A. Ruiz de Lobera
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - J. Lao
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
| | - R. Lastra
- Hosp Miguel Servet, Zaragoza, Spain; Hosp Arnau de Vilanova, Lerida, Spain; Hosp Clinico de Zaragoza, Zaragoza, Spain; Hosp de Barbastro, Barbastro, Spain
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Saigi E, Batiste-Alentorn E, Diaz N, Galan A, Salud A, Campos JM, Losa F, Gallen M, Massuti B, Asensio D. Phase II study of weekly irinotecan (CPT-11) associated to protracted oral tegafur (TGF) in previously untreated, advanced colorectal cancer (ACRC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3725] [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)
- E. Saigi
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - E. Batiste-Alentorn
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - N. Diaz
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - A. Galan
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - A. Salud
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - J. M. Campos
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - F. Losa
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - M. Gallen
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - B. Massuti
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
| | - D. Asensio
- Consorci Sanitari Parc Tauli, Sabadell, Spain; Hosp Gen de Vic, Vic, Spain; Hosp Virgen de la Arreixaca, El Palmar, Spain; Hosp de Sagunto, Puerto de Sagunto, Spain; Hosp Univ Arnau de Vilanova, Lleida, Spain; Hosp Arnau de Vilanova, Valencia, Spain; Hosp de L’Hospitalet, L’Hospitalet, Spain; Hosp del Mar, Barcelona, Spain; Hosp Gen Univ de Alicante, Alicante, Spain; Prasfarma/Almirall, Barcelona, Spain
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Alonso V, Salud A, Escudero P, Valencia J, Mira M, Ruiz de Lobera A, Lambea J, Grandez R, Tres A, Anton A. Preoperative chemoradiation with oxaliplatin and 5-fluorouracil in locally advanced rectal carcinoma. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
- V. Alonso
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - A. Salud
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - P. Escudero
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - J. Valencia
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - M. Mira
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - A. Ruiz de Lobera
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - J. Lambea
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - R. Grandez
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - A. Tres
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
| | - A. Anton
- Hospital Miguel Servet, Zaragoza, Spain; Hospital Arnau de Vilanova, Lerida, Spain; Hospital Clinico, Zaragoza, Spain
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Grávalos C, García-Girón C, León AI, Salud A, Esteban B, Sevilla I, Maurel J, Murias A, García-Rico E, Cortés-Funes HG. TOMOX compared to FOLFOX4 as first-line treatment in patients (pts) with advanced colorectal cancer (ACRC): Preliminary results of a multicenter randomized phase II trial. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3599] [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)
- C. Grávalos
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - C. García-Girón
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - A. I. León
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - A. Salud
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - B. Esteban
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - I. Sevilla
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - J. Maurel
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - A. Murias
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - E. García-Rico
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
| | - H. G. Cortés-Funes
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital General Yagüe, Burgos, Spain; Fundación Jiménez Díaz, Madrid, Spain; H. Arnau de Vilanova, Lleida, Spain; Hospital General de Segovia, Segovia, Spain; Hospital Virgen de la Victoria, Málaga, Spain; Hospital Clinic i Provincial, Barcelona, Spain; Hospital Insular de las Palmas, Las Palmas, Spain; Hospital de Montepríncipe, Madrid, Spain
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López-Gómez L, Escudero P, Yubero A, Feliú J, Salud A, Galán A, Bolaños M, Vicent JM, Losa F, González-Barón M. XELOX (capecitabine and oxaliplatin) as 1st line treatment for elderly patients (pts) with advanced/metastatic colorectal cancer (MCRC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3688] [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)
- L. López-Gómez
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - P. Escudero
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - A. Yubero
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - J. Feliú
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - A. Salud
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - A. Galán
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - M. Bolaños
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - J. M. Vicent
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - F. Losa
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
| | - M. González-Barón
- Hospital Virgen de la Salud, Toledo, Spain; Hospital Clínico Lozano Blesa, Zaragoza, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital La Paz, Madrid, Spain; Hospital Arnau de Villanova, Lleida, Spain; Hospital de Sagunto, Valencia, Spain; Hospital San Pedro de Alcántara, Cáceres, Spain; Hospital General Universitario de Valencia, Valencia, Spain; Hospital de la Creu Roja, Barcelona, Spain
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Salud A, Saigi E, Batiste-Alentorn E, Losa F, Cirera L, Mendez M, Campos JM, Galan A, Escudero MP, Nogue M. Randomized phase IV trial of oral tegafur and low dose leucovorin versus intravenous 5-fluorouracil and leucovorin in the treatment of advanced colorectal cancer (ACC): Final results. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
- A. Salud
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - E. Saigi
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - E. Batiste-Alentorn
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - F. Losa
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - L. Cirera
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - M. Mendez
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - J. M. Campos
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - A. Galan
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - M. P. Escudero
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - M. Nogue
- Hospital Arnau de Vilanova, Lleida, Spain; Consorci Hospitalari Parc Tauli, Barcelona, Spain; Hospital General de Vic, Barcelona, Spain; Hospital de la Creu Roja, Barcelona, Spain; Hospital Mutua de Terrassa, Barcelona, Spain; Hospital de Mostoles, Madrid, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital de Sagunto, Valencia, Spain; Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
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Muñoz A, Salud A, Alonso V, Escudero P, Sanz JJ, Martín C, Rivera F, Yubero A, García-Girón C, López-Vivanco G. Final analysis of irinotecan (CPT-11) and capecitabine (X) as first-line treatment of locally advanced (LA) or metastatic colorectal cancer (MCRC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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)
- A. Muñoz
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - A. Salud
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - V. Alonso
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - P. Escudero
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - J. J. Sanz
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - C. Martín
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - F. Rivera
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - A. Yubero
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - C. García-Girón
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
| | - G. López-Vivanco
- Hospital de Cruces, Barakaldo, Spain; Hospital Arnau de Vilanova, Lleida, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Clínico de Zaragoza, Zaragoza, Spain; Hospital San Jorge, Huesca, Spain; Hospital Espíritu Santo, Barcelona, Spain; Hospital Marqués de Valdecilla, Santander, Spain; Hospital Obispo Polanco, Teruel, Spain; Hospital General Yagüe, Burgos, Spain
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Feliu J, Salud A, Escudero P, López-Gómez L, Pericay C, Castañón C, de Tejada MRL, Rodríguez-García JM, Martínez MP, Martín MS, Sánchez JJ, Barón MG. Irinotecan plus raltitrexed as first-line treatment in advanced colorectal cancer: a phase II study. Br J Cancer 2004; 90:1502-7. [PMID: 15083176 PMCID: PMC2409728 DOI: 10.1038/sj.bjc.6601713] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
To evaluate the efficacy and toxicity of irinotecan (CPT-11) in combination with raltitrexed as first-line treatment of advanced colorectal cancer (CRC). A total of 91 previously untreated patients with advanced CRC and measurable disease were enrolled in this phase II study. The median age was 62 years (range 31–77); male/female 54/37; ECOG performance status was 0 in 50 patients (55%), one in 39 (43%) and two in two (2%). Treatment consisted of CPT-11 350 mg m−2 in a 30-min intravenous infusion on day 1, followed after 30 min by a 15-min infusion of raltitrexed 3 mg m−2. Measurements of efficacy included the following: response rate, time to disease progression and overall survival. Of the 83 evaluable patients valuable to objective response, there were five complete responses (6%) and 23 partial responses (28%), for an overall response rate of 34% (95% CI: 25.9–46.5%). In all, 36 patients (43%) had stable disease, whereas 19 (23%) had a progression. The median time to progression was 11.1 months and the median overall survival was 15.6 months. A total of 487 cycles of chemotherapy were delivered with a median of five per patient. Grade 3–4 WHO toxicities were as follows: diarrhoea in 13 patients (15%), nausea/vomiting in four (4%), transaminase increase in six (7%), stomatitis in two (2%), febrile neutropenia in three (3%), anaemia in five (6%) and asthenia in three (3%). The combination CPT-11–raltitrexed is an effective, well-tolerated and convenient regimen as front-line treatment of advanced CRC.
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Affiliation(s)
- J Feliu
- Medical Oncology Service, Hospital La Paz, P de la Castellana, 261-28046 Madrid, Spain.
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Porcel JM, Salud A, Balil A. [Unilateral exophthalmos secondary to orbital metastasis as initial manifestation of breast cancer]. An Med Interna 2002; 19:159-60. [PMID: 12012774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Milla A, Escudero P, Salud A, Feliu J, Pericay C, Chacon I, Dorta J, Sanz M, Murias A, Gonzalez-Baron M. An ongoing phase II study of tomudex (raltitrexed) plus irinotecan in advanced colorectal cancer. Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)81603-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jiménez-Bonilla J, Maldonado A, Morales S, Salud A, Zomeño M, Román J, Belon J, Moya F. Clinical Impact of 18F-FDG-PET in the Suspicion of Recurrent Ovarian Carcinoma Based on Elevated Tumor Marker Serum Levels. Clin Positron Imaging 2000; 3:231-236. [PMID: 11378435 DOI: 10.1016/s1095-0397(01)00053-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Purpose: To retrospectively evaluate the contribution of 18F-fluorodeoxy-glucose-positron emission tomography (FDG-PET) to the diagnosis and clinical management of patients who were suspected of recurrent ovarian carcinoma, based on elevated tumor markers levels with normal or equivocal computed tomography (CT) or nuclear magnetic resonance (NMR).Procedures: 20 patients with these characteristics underwent FDG-PET. PET findings were confirmed in 14, in 7 by surgery, and in the other 7 by clinical course.Results: Recurrence was confirmed in 12 patients, all with FDG-PET positive. In other 2, recurrence was rule out and in 1, FDG-PET was negative. FDG-PET accuracy was 93% with 4 surgeries avoided and guided other 6.Conclusions: FDG-PET is an useful technique for detecting recurrent ovarian carcinoma suspected by elevated tumor markers levels and normal or equivocal results in the morphologic imaging techniques and has an important clinical impact on the management of these patients.
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Abstract
BACKGROUND AND OBJECTIVES Parameters that allow prediction of the disease course in colorectal cancer would aid the development of improved treatment strategies. For this reason, we evaluated the prognostic value of flow cytometric DNA ploidy and S-phase fraction (SPF) and P-glycoprotein (Pgp) expression in this type of tumor. METHODS The prognostic significance of DNA ploidy, SPF, and Pgp expression on paraffin-embedded sections from 107 patients with colorectal carcinoma was determined. The mean follow-up was 36.6 months (range = 3-72 months). DNA ploidy and SPF were evaluated by flow cytometry and Pgp by immunohistochemistry using monoclonal antibody C219. The Cox regression model was used to adjust for several clinical and pathologic covariates. RESULTS Of the 107 carcinomas examined, 44 (41.1%) were classified as DNA diploid and 63 (58.9%) as DNA aneuploid. DNA ploidy pattern was significantly related to tumor site (P = 0.010), tumor stage (P = 0.016), and vascular invasion (P = 0.015) but not to other clinicopathologic variables. Patients with DNA diploid tumors showed a better survival rate than did those with aneuploid tumors. After stage IV disease was excluded, patients with diploid tumors also presented a better disease-free and overall survival than did patients with aneuploid tumors. Mean SPF of the whole series was 13.5% (median = 11.3%, range = 1.4%-29.9%). Aneuploid tumors had a higher median SPF than did diploid tumors (17 vs. 6.2; P = 0.0001). SPF was only related significantly with tumor location (P = 0.026). In the multivariate analysis, SPF was a significant independent prognostic factor for overall survival (P = 0.01). When stage IV was excluded, SPF was also an independent prognostic variable for both disease-free (P = 0. 02) and overall (P = 0.01) survival. Of 107 tumors, 61 (57%) were positive for Pgp expression, but no relation was found between this and other clinicopathologic parameters. Pgp expression had no influence on survival. CONCLUSIONS Our results suggest that flow cytometric DNA ploidy and SPF are significant and independent prognostic factors in patients with colorectal carcinoma, whereas Pgp expression is not.
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Affiliation(s)
- A Salud
- Department of Medical Oncology, University Hospital Arnau de Vilanova, Lleida, Spain
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Salud A, Porcel JM, Vidal-Pla R, Bellmunt J. [Pulmonary metastasising benign leiomyoma evolving to chronic respiratory failure]. Med Clin (Barc) 1997; 109:358. [PMID: 9379773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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