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Soriano M, Del Castillo L, Subirá J, Herrera A, Guerrero Á, Gavilá J, Santaballa A, Díaz-García C. P-481 Characterization of the gene expression profile of breast cancer tumours in patients undergoing ovarian stimulation for fertility preservation purposes. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Could controlled ovarian stimulation (COS) protocols with letrozole supplementation induce changes in the molecular footprints of estrogen receptor-positive (ER+) breast cancer (BC) women?
Summary answer
Ovarian stimulation with letrozole and gonadotropins does not change the gene expression profile of estrogen receptor-positive (ER+) breast malignant tumours as compared to non-stimulated patients.
What is known already
Fertility preservation (FP) strategies in ER+ BC patients involve modifications of the classical COS protocols to minimise the impact of estrogen levels during ovarian stimulation. The most common approaches are using the aromatase inhibitor letrozole to block the conversion of testosterone into estradiol in the granulosa cells or the use of tamoxifen to block the ER in the breast tissue. Although retrospective studies suggest that these strategies will have no impact on patient’s survival and disease progression, little is known regarding the effect of the ovarian stimulation on the genomic fingerprints of the exposed cancerous tissue.
Study design, size, duration
Retrospective, non-randomized, comparative study. Gene expression profiles were compared in biopsies at diagnosis and during excision surgery in two groups of ER+ BC patients: Patients undergoing COS for FP before surgery (COS group, n = 10) and patients not undergoing any type of COS (Control group, n = 11). The former received letrozole (5mg/day) supplements during COS. The latter included 7 patients not doing FP and 4 undergoing ovarian cortex cryopreservation. Patients were recruited between 2009 and 2021.
Participants/materials, setting, methods
Single 5-µm sections of formalin-fixed, paraffin-embedded (FFPE) needle core biopsy (NCB) and breast surgery (BS) tumour samples were obtained prior to starting gonadotoxic therapies. Differential gene expression and gene set analysis (GSA) was performed in tumour samples before (NCB-sample) and after COS (BS-sample). Simultaneous, quantitative detection of 2549 genes associated with tumour biology was performed with the HTG EdgeSeq Oncology Biomarker Panel. Tumour cell proliferation was also assessed by Ki67 staining.
Main results and the role of chance
Patients were younger in the COS group (COS: 30.2±3.4 vs Control: 34.5±2.3; p = 0.004). None of the patients experienced any relapse during the observation period. The length of COS was 11.5±3.5 days and 10.6±6.8 MII oocytes were vitrified. The exploratory analysis using principal component analysis revealed no relationships between the two BC biopsy samples and gene expression levels in the experimental groups. The differential expression analysis just revealed 6 genes significantly over-expressed after ovarian stimulation (DUSP1, FOS, EGFR1, NR4A1, JUN and CYR61). From these, DUSP1, FOS, and NR4A1 were also significantly upregulated in the unstimulated group. The GSA showed the cytochrome P450 pathway was significantly enriched after COS. No pathways related to cell proliferation were differentially expressed between groups. However, in unstimulated patients, 6 KEGG pathways were upregulated, with the cytokine-cytokine receptor interaction and the Jak-STAT signalling pathway being the most enriched. Ki67 immunostaining showed no differences in cell proliferation after COS (22.8±7.2 vs 24.0±6.9, p = 0.723). The rate of cell proliferation also remained constant in unstimulated patients (22.9±8.4 vs 25.1±8.1, p = 0.560).
Limitations, reasons for caution
The main limitations of the present study are the retrospective design and the associated risk of bias, although the population is very homogeneous when it comes to clinical characteristics; and the fact that molecular footprints are only interim markers of survival/response to the treatment.
Wider implications of the findings
The present study provides molecular evidence supporting the safety of COS using letrozole for oocyte vitrification in young BC patients undergoing ovarian stimulation. This information is crucial to support patient guidance during discussions about fertility preservation.
Trial registration number
Not applicable
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Affiliation(s)
- M.J Soriano
- Fundación IVI - Instituto de Investigación Sanitaria La Fe IISLAFE, Grupo de investigación en Medicina Reproductiva- Fundación IVI , Valencia, Spain
| | - L.M Del Castillo
- Fundación IVI - Instituto de Investigación Sanitaria La Fe IISLAFE, Grupo de investigación en Medicina Reproductiva- Fundación IVI , Valencia, Spain
- University of Valencia, Dept. Pediatrics- Obstetrics and Gynecology , Valencia, Spain
| | - J Subirá
- IVIRMA Global, IVI Valencia , Valencia, Spain
| | - A Herrera
- Hospital Universitario y Politécnico La Fe, Anatomical Pathology , Valencia, Spain
| | - Á Guerrero
- Fundación Instituto Valenciano de Oncología, Medical Oncology Department , Valencia, Spain
| | - J Gavilá
- Fundación Instituto Valenciano de Oncología, Medical Oncology Department , Valencia, Spain
| | - A Santaballa
- Hospital Universitario y Politécnico La Fe, Medical Oncology , Valencia, Spain
| | - C Díaz-García
- Fundación IVI - Instituto de Investigación Sanitaria La Fe IISLAFE, Grupo de investigación en Medicina Reproductiva- Fundación IVI , Valencia, Spain
- University College London, EGA Institute for Women’s Health , London, United Kingdom
- IVI-RMA Global, IVI London , London, United Kingdom
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Fidalgo JP, Cortés A, García Y, Iglesias M, Sarmiento UB, García EC, Manso L, Santaballa A, Oaknin A, Redondo A, Rubio M, González-Martín A. 734P Neutrophil-lymphocyte ratio predicts survival in platinum-resistant ovarian cancer patients treated with olaparib and pegylated liposomal doxorubicin (PLD): Stratified analysis from the phase II clinical trial ROLANDO, GEICO-1601. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Perez-Fidalgo JA, Cortés A, Guerra E, García Y, Iglesias M, Bohn Sarmiento U, Calvo García E, Manso Sánchez L, Santaballa A, Oaknin A, Redondo A, Rubio MJ, González-Martín A. Olaparib in combination with pegylated liposomal doxorubicin for platinum-resistant ovarian cancer regardless of BRCA status: a GEICO phase II trial (ROLANDO study). ESMO Open 2021; 6:100212. [PMID: 34329939 PMCID: PMC8446804 DOI: 10.1016/j.esmoop.2021.100212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/17/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is limited evidence for the benefit of olaparib in platinum-resistant ovarian cancer (PROC) patients with BRCA wild-type tumors. This study investigated whether this combination of a DNA-damaging chemotherapy plus olaparib is effective in PROC regardless BRCA status. PATIENTS AND METHODS Patients with high-grade serous or endometrioid ovarian carcinoma and one previous PROC recurrence were enrolled regardless of BRCA status. Patients with ≤4 previous lines (up to 5 in BRCA-mut) with at least one previous platinum-sensitive relapse were included; primary PROC was allowed only in case of BRCA-mut. Patients initially received six cycles of olaparib 300 mg b.i.d. (biduum) + intravenous pegylated liposomal doxorubicin (PLD) 40 mg/m2 (PLD40) every 28 days, followed by maintenance with olaparib 300 mg b.i.d. until progression or toxicity. The PLD dose was reduced to 30 mg/m2 (PLD30) due to toxicity. The primary endpoint was progression-free survival (PFS) at 6 months (6m-PFS) by RECIST version 1.1. A proportion of 40% 6m-PFS or more was considered of clinical interest. RESULTS From 2017 to 2020, 31 PROC patients were included. BRCA mutations were present in 16%. The median of previous lines was 2 (range 1-5). The overall disease control rate was 77% (partial response rate of 29% and stable disease rate of 48%). After a median follow-up of 10 months, the 6m-PFS and median PFS were 47% and 5.8 months, respectively. Grade ≥3 treatment-related adverse events occurred in 74% of patients, with neutropenia/anemia being the most frequent. With PLD30 serious AEs were less frequent than with PLD40 (21% versus 47%, respectively); moreover, PLD30 was associated with less PLD delays (32% versus 38%) and reductions (16% versus 22%). CONCLUSIONS The PLD-olaparib combination has shown significant activity in PROC regardless of BRCA status. PLD at 30 mg/m2 is better tolerated in the combination.
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Affiliation(s)
- J A Perez-Fidalgo
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, Valencia, Spain.
| | - A Cortés
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - E Guerra
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Y García
- Department of Medical Oncology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - M Iglesias
- Department of Medical Oncology, Hospital Son Llatzer, Palma De Mallorca, Spain
| | - U Bohn Sarmiento
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas De Gran Canaria, Spain
| | - E Calvo García
- Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - L Manso Sánchez
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Santaballa
- Department of Medical Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - A Oaknin
- Department of Medical Oncology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - A Redondo
- Department of Medical Oncology, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - M J Rubio
- Department of Medical Oncology, Hospital Universitario Reina Sofia, Córdoba, Spain
| | - A González-Martín
- Department of Medical Oncology Department, Clínica Universidad de Navarra, Madrid, Spain
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Tibau A, Martinez M, Ramos M, De la Cruz-Merino L, Santaballa A, Connor MO, Martinez-Jañez N, Moreno F, Fernandez-Perez I, Virizuela J, Alarcón J, de la Haba-Rodríguez J, Sánchez-Rovira P, Albacar C, Bueno C, Kelly C, Casas M, Bezares S, Rosell L, Albanell J. 94MO Quality of life (QoL) with fulvestrant (FUL)/palbociclib (PAL) versus FUL/placebo (PBO) in postmenopausal women with hormone receptor (HR)+/HER2- endocrine sensitive advanced breast cancer (ABC): Results from GEICAM/2014-12 (FLIPPER) study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Elez E, Ayala F, Felip E, García Campelo R, García Carbonero R, García Donás J, González Del Alba A, González Flores E, Hidalgo J, Isla D, Majem M, Rodríguez Lescure Á, Safont MJ, Santaballa A, Villacampa G, Vera R, Garrido P. Gender influence on work satisfaction and leadership for medical oncologists: a survey of the Spanish Society of Medical Oncology (SEOM). ESMO Open 2021; 6:100048. [PMID: 33556897 PMCID: PMC7872979 DOI: 10.1016/j.esmoop.2021.100048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/20/2022] Open
Abstract
Background Women represent an increasing proportion of the oncology workforce; however, globally this does not translate into leadership roles, reflecting disparities in career opportunities between men and women. The Spanish Society of Medical Oncology (SEOM) undertook a survey to investigate gender disparity in the Spanish oncology context. Design An online survey was made available to SEOM medical oncologists between February and May 2019. It included demographics, professional context and achievements, parenthood and family conciliation issues, workplace gender bias, and approaches to address disparities. Results Of the 316 eligible respondents, 71.5% were women, 59.5% were aged 45 or younger, and 66.1% had children. Among women, 12.4% were division or unit heads, compared with 45.5% of men, with most women (74.3%) being attending medical oncologists, compared with 45.5% of men. More males were professors (34.4% versus 14.2% of females), had a PhD (46.7% versus 28.8%), and/or had led clinical research groups (41.1% versus 9.7%). Spending time overseas after completing a residency was also more common for men than women (34.4% versus 20.4%). Professional satisfaction was similar between genders, driven primarily by patient care and intellectual stimulation. More women (40.7%) considered parenthood to have a strong negative impact on their career, compared with men (9.0%). Main perceived barriers to gender equality included a lack of work–life balance (72.6% women, 44.4% men), bias of peers and superiors (50.0% women, 18.9% men), and different career goals (41.2% women, 24.4% men). Preferred solutions included educational programs and scholarships (52.9%), communication and leadership training (35.8%), childcare at conferences (33.2%), and postmaternity return-to-work incentives (32.0%). Conclusion There is a clear paucity of equal opportunities for female oncologists in Spain. This can be addressed by encouraging professional development and merit recognition particularly for younger female oncologists, and empowering women to be involved in management and leadership of institutions and professional societies. Under-representation of women in leadership roles in oncology is a widely acknowledged issue receiving global attention. This study is a national description of leadership and educational opportunities in terms of gender and family circumstances. Perceptions of gender bias in the workplace gender inequality or family conciliation issues and are described. Initiatives for equal opportunities in oncology are needed supporting female academic career development and recognition.
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Affiliation(s)
- E Elez
- Vall d'Hebron Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
| | - F Ayala
- Hospital Universitario Morales Meseguer, Murcia, Spain
| | - E Felip
- Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | | | | | - J García Donás
- Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain
| | | | | | - J Hidalgo
- Hospital Lluis Alcanyís de Xativa, Valencia, Spain
| | - D Isla
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - M Majem
- Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | | | - M J Safont
- Consorcio Hospital General Universitario, Valencia, Spain
| | - A Santaballa
- Hospital Universitari I Politècnic la Fe, Valencia, Spain
| | - G Villacampa
- Vall d'Hebron Institute of Oncology (VHIO), Medical Oncology Department, Barcelona, Spain
| | - R Vera
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - P Garrido
- Hospital Universitario Ramón y Cajal, Madrid, Spain.
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Oaknin A, Iglesias M, Alarcon J, Villacampa Javierre G, Garcia LG, Santaballa A, Manso L, Romero I, Barretina Ginesta M, Churruca C, García Y, Sanchez A, Marquina G, Pardo B, Redondo A, Rubio M, González Martín A. 880TiP Randomized, open-label, phase II trial of dostarlimab (TSR-042), as maintenance therapy for patients with high-risk locally advanced cervical cancer after chemo-radiation: ATOMICC study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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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Perez Fidalgo J, Cortés A, García Y, Iglesias M, Bohn Sarmiento U, Calvo García E, Manso Sánchez L, Santaballa A, Oaknin A, Redondo A, Rubio M, González Martín A. 832P GEICO1601-ROLANDO trial: A multicentric single arm phase II clinical trial to evaluate the combination of olaparib and pegylated liposomal doxorubicin for platinum-resistant ovarian cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.971] [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: 12/01/2022] Open
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Santaballa A, Pinto Á, Balanyà RP, Ramírez Merino N, Martín IR, Grau SS, Fombella JPB, Cano JM, González CH, Bayo J. SEOM clinical guideline for secondary prevention (2019). Clin Transl Oncol 2020; 22:187-192. [PMID: 32006339 DOI: 10.1007/s12094-020-02302-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/10/2020] [Indexed: 12/19/2022]
Abstract
Cancer is one of the major public health problems in our society. It is estimated that more than 18 million new cases are diagnosed worldwide every year; 280,000 in Spain. Incidence in following a growing trend. This epidemic could be controlled with research into new treatments and, above all, with adequate prevention. Primary prevention could prevent avoid up to half of all cases. For many others, secondary prevention is essential, as it make diagnosis possible in the stages of the disease when it is easily curable. These guidelines present the scientific evidence regarding secondary prevention in tumors in which its use is well-accepted: breast, cervical, colorectal, prostate, lung, ovarian, melanoma, and gastric cancer.
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Affiliation(s)
- A Santaballa
- Medical Oncology Department, Hospital Universitari I Politècnic la Fe, Valencia, Avda. de Fernando Abril Martorell, 106, 46026, Valencia, Spain.
| | - Á Pinto
- Medical Oncology Department, Hospital Universitario la Paz, Madrid, Spain
| | - R P Balanyà
- Medical Oncology Department, Hospital Universitari Dr. Josep Trueta, ICO Girona, Girona, Spain
| | - N Ramírez Merino
- Medical Oncology Department, Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain
| | - I R Martín
- Medical Oncology Department, Hospital Rio Carrión, Palencia, Spain
| | - S S Grau
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - J P B Fombella
- Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J M Cano
- Medical Oncology Department, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - C H González
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - J Bayo
- Medical Oncology Department, Hospital Juan Ramón Jiménez, Huelva, Spain
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Virizuela JA, Garcia AM, de las Peñas R, Santaballa A, Andrés R, Beato C, de la Cruz S, Gavilá J, González-Santiago S, Fernández TL. Replied to “Some remarks to SEOM clinical guidelines on cardiovascular toxicity (2018)”. Clin Transl Oncol 2019; 21:1788-1789. [DOI: 10.1007/s12094-019-02173-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/28/2019] [Indexed: 11/30/2022]
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Salvador-Coloma C, Font De Mora J, Cordón L, Palomar L, Santaballa A. Abstract P3-11-16: Immunosuppressive profiles in liquid biopsy predict response to neoadjuvant chemotherapy in triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-11-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
Despite the recent advances in triple negative breast cancer (TNBC) stratification, TNBC is still a highly heterogeneous subtype that clusters distinct molecular and genetic alterations with diverse responses to neoadjuvant chemotherapy (NAC). Molecular profiling after NAC has unraveled a group of actionable targets in residual TNBC that supports the implementation of targeted therapies in a personalized manner. However, unresponsive or poor NAC responders after first line treatment are committed to poorer outcome. Therefore, early identification of poor NAC responders is essential to select patients that may benefit from alternative therapies, including initial tumor resection before chemotherapy.
MATERIAL AND METHODS
We have conducted a study on 37 non-metastatic TNBC patients at La Fe Hospital that were homogeneously treated with anthracycline and cyclophosphamide followed by paclitaxel. Tissue and blood-derived biopsies were obtained at diagnosis. Metabolites and miRNA exosomes in plasma were analyzed by ultra-performance liquid chromatography-electrospray ionization tandem mass spectrometric and by miRNA 3.0 arrays (Affymetrix) respectively. Immunosuppressive subpopulations of cells were quantified by flow cytometry with specific markers. IDO1 in situ expression was assessed by immunohistochemistry on the tissue biopsies.
RESULTS
In order to identify blood-derived liquid biopsy NAC predictor biomarkers in TNBC we have studied blood circulating cells and molecules known for their immunomodulation capacity and found that eMDSC and a profile of tryptophan-derived metabolites predict NAC response. In addition, we identified a circulating exosome miRNA profile that identifies poor NAC responders. Interestingly, this profile of miRNAs target pathways involved in the immune response. IDO1 expression in the tumor inversely correlated with circulating tryptophan levels and directly associated with eMDSC. We also observed a trend correlating IDO1 expression levels with poorer response.
CONCLUSIONS
Our results strongly support the role of immunosuppression in TNBC poor responders and establish an easy and non-invasive tool for the early identification of poor NAC responders, opening the possibility to use alternative strategies.
Acknowledgements:
The authors would like to thank the Cytomics Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain for its technical support.
This work was partially financed with FEDER funds (CIBERONC (CB16/ 12/00284)) and AMACMA breast cancer association.
Citation Format: Salvador-Coloma C, Font De Mora J, Cordón L, Palomar L, Santaballa A. Immunosuppressive profiles in liquid biopsy predict response to neoadjuvant chemotherapy in triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-11-16.
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Affiliation(s)
- C Salvador-Coloma
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Hospital Universitari i Politècnic La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - J Font De Mora
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Hospital Universitari i Politècnic La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - L Cordón
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Hospital Universitari i Politècnic La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - L Palomar
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Hospital Universitari i Politècnic La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - A Santaballa
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Hospital Universitari i Politècnic La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
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Bayo J, Molina R, Pérez J, Pérez-Ruíz E, Aparicio J, Beato C, Berros JP, Bolaños M, Graña B, Santaballa A. SEOM clinical guidelines to primary prevention of cancer (2018). Clin Transl Oncol 2019; 21:106-113. [PMID: 30607789 PMCID: PMC6339664 DOI: 10.1007/s12094-018-02016-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 12/11/2018] [Indexed: 12/29/2022]
Abstract
Cancer is the leading social and healthcare problem of the twenty-first century. The aim of primary prevention is to decrease the incidence of cancer by avoiding the known causes and risk factors. Nevertheless, it has been estimated that cancer diagnoses could be halved through primary prevention measures. A comprehensive review of the scientific evidence regarding the main carcinogens and risk factors and primary prevention recommendations have been put forth based on this evidence. The GRADE scale has been used to classify the grade of evidence. We present the scientific evidence and recommendations for primary prevention of the major modifiable risk factors: smoking, alcohol, diet, obesity, physical activity, occupational and environmental factors, ultraviolet radiation, infections, and socioeconomic factors. Primary prevention is a simple, effective means to lower the incidence of cancer. Preventive measures must be circulated in the fight against cancer.
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Affiliation(s)
- J. Bayo
- Servicio de Oncología Médica, Hospital Juan Ramón Jiménez de Huelva, Ronda Exterior Norte, s/n, 21005 Huelva, Spain
| | - R. Molina
- Servicio de Oncología Médica, Hospital, Universitario Príncipe de Asturias, Madrid, Spain
| | - J. Pérez
- Servicio de Oncología Médica, Hospital Virgen de los Lirios, Alcoy, Spain
| | - E. Pérez-Ruíz
- Servicio de Oncología Médica, Complejo Hospital Costa del Sol, Marbella, Spain
| | - J. Aparicio
- Servicio de Oncología Médica, Hospital Universitari i Politècnic la Fe (Valencia), Valencia, Spain
| | - C. Beato
- Servicio de Oncología Médica, Complejo Hospitalario Regional Virgen Macarena, Seville, Spain
| | - J. P. Berros
- Servicio de Oncología Médica, Hospital, Universitario Central de Asturias, Asturias, Spain
| | - M. Bolaños
- Servicio de Oncología Médica, Hospital Juan Ramón Jiménez de Huelva, Ronda Exterior Norte, s/n, 21005 Huelva, Spain
| | - B. Graña
- Servicio de Oncología Médica, Complexo Hospitalario Universitario A Coruña (CHUAC), Coruna, Spain
| | - A. Santaballa
- Servicio de Oncología Médica, Hospital Universitari i Politècnic la Fe (Valencia), Valencia, Spain
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Bamias A, Gibbs E, Khoon Lee C, Davies L, Dimopoulos M, Zagouri F, Veillard AS, Kosse J, Santaballa A, Mirza MR, Tabaro G, Vergote I, Bloemendal H, Lykka M, Floquet A, Gebski V, Pujade-Lauraine E. Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: exploratory analyses of the AURELIA trial. Ann Oncol 2018; 28:1842-1848. [PMID: 28481967 DOI: 10.1093/annonc/mdx228] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background In the open-label randomized phase III AURELIA trial, adding bevacizumab to chemotherapy for platinum-resistant ovarian cancer (PROC) significantly improved progression-free survival and response rate versus chemotherapy alone, but not overall survival (OS). We explored the effect of bevacizumab use after disease progression (PD) in patients randomized to chemotherapy alone. Patients and methods In AURELIA, 361 women with PROC were randomized to chemotherapy alone or with bevacizumab. Patients initially randomized to chemotherapy were offered bevacizumab after PD. Post hoc analyses assessed efficacy and safety in three subgroups: chemotherapy alone, chemotherapy followed by bevacizumab after PD, and chemotherapy plus bevacizumab at randomization. Results Of the 182 patients randomized to chemotherapy alone, 72 (40%) received bevacizumab after PD and 110 (60%) never received bevacizumab. There were no significant differences in patient and disease characteristics between these subgroups at baseline or the time of PD. Compared with patients never receiving bevacizumab, the risk of death was significantly reduced in patients receiving bevacizumab either upfront with chemotherapy [hazard ratio (HR) = 0.68, 95% confidence interval (CI) 0.52-0.90] or after PD (HR = 0.60, 95% CI 0.43-0.86). The tolerability of bevacizumab was similar with administration upfront or after PD. Conclusions Post-PD bevacizumab use may have confounded OS results in AURELIA. In these exploratory analyses of non-randomized subgroups, bevacizumab use, either with chemotherapy or after PD on chemotherapy alone, improved OS compared with no bevacizumab. Combining bevacizumab with chemotherapy at first appearance of platinum resistance maximises the likelihood of patients receiving this active treatment for PROC. ClinicalTrials.gov: NCT00976911.
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Affiliation(s)
- A Bamias
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - E Gibbs
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - C Khoon Lee
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - L Davies
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - M Dimopoulos
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - F Zagouri
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - A-S Veillard
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - J Kosse
- AGO and Department of Gynaecology, Sana Klinikum Offenbach, Offenbach, Germany
| | - A Santaballa
- GEICO and Medical Oncology Department, University Hospital and Polytechnic, Valencia, Spain
| | - M R Mirza
- NSGO and Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - G Tabaro
- MITO and USCC/Dir. Scientifica, Centro di Riferimento Oncologico, CRO-IRCCS, Aviano, Italy
| | - I Vergote
- BGOG and Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven, Belgium
| | - H Bloemendal
- DGOG and Department of Internal Medicine/Oncology, Meander Medical Center, Amersfoort, The Netherlands
| | - M Lykka
- HECOG and Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - A Floquet
- GINECO and Medical Oncology and Genetics Department, Institut Bergonié, Bordeaux
| | - V Gebski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - E Pujade-Lauraine
- GINECO and Paris Descartes University, AP-HP Central Paris University Hospitals, Paris, France
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13
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Ethier JL, Ocaña A, Rodríguez Lescure A, Ruíz A, Alba E, Calvo L, Ruíz-Borrego M, Santaballa A, Rodríguez CA, Crespo C, Ramos M, Gracia Marco J, Lluch A, Álvarez I, Casas M, Sánchez-Aragó M, Carrasco E, Caballero R, Amir E, Martin M. Outcomes of single versus double hormone receptor-positive breast cancer. A GEICAM/9906 sub-study. Eur J Cancer 2018; 94:199-205. [PMID: 29573665 DOI: 10.1016/j.ejca.2018.02.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 11/24/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Retrospective data suggest better outcomes for patients with double hormonal receptor (oestrogen [ER] and progesterone receptor [PgR])-positive (dHR+) early breast cancer, compared with single hormonal receptor-positive, sHR+, (ER+/PgR- or ER-/PgR+) disease. Here, we evaluate the classification according to intrinsic subtypes and clinical outcomes of sHR+ versus dHR+ in HER2-negative breast cancer patients enrolled in GEICAM/9906 study (NCT00129922). METHODS Archival tumours were retrieved retrospectively for the analysis of ER, PgR and HER2 status and classified into intrinsic subtypes using the PAM50 gene expression assay. Disease-free survival (DFS) and overall survival (OS) were explored using a Cox proportional hazard analysis. RESULTS Data on intrinsic subtypes were available in 571 (50%) patients with ER+ and/or PR+, and HER2-negative primary tumours. The incidence of luminal A and luminal B subtypes were 52%/36% in dHR+ tumours (ER+/PgR+), and 15%/58% in ER+/PgR-tumours. ER-/PgR+ tumours were mainly luminal A (52%). Compared with ER+/PgR+ patients, DFS was similar in ER-/PgR+ (hazard ratio [HR] 1.15, 95% confidence interval [CI] 0.57-2.34, p = 0.70) but worse in ER+/PgR- patients (HR 1.60, 95% CI 1.12-2.28, p < 0.01). Similar results were observed for OS (HR 1.50, p = 0.30 and HR 1.86, p < 0.01, respectively). CONCLUSIONS The ER+/PgR- group is characterised by higher proliferation and worse outcomes. In spite of the ER-/PgR+ subgroup resembles ER+/PgR+ disease in terms of molecular subtypes and outcomes, the small number of patients in this subgroup prevents from drawing any conclusions. TRIAL REGISTRATION EudraCT: 2005-003108-12 (retrospectively registered 28/06/2005). CLINICALTRIALS. GOV IDENTIFIER NCT00129922 (retrospectively registered 10/08/2005).
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Affiliation(s)
- J L Ethier
- Department of Medical Oncology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada
| | - A Ocaña
- Complejo Hospitalario de Albacete, Albacete, Spain; GEICAM (Spanish Breast Cancer Group), Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain
| | - A Rodríguez Lescure
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Universitario de Elche, Elche, Spain
| | - A Ruíz
- GEICAM (Spanish Breast Cancer Group), Spain; Instituto Valenciano de Oncología, Valencia, Spain
| | - E Alba
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Virgen de La Victoria, Málaga, Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain
| | - L Calvo
- GEICAM (Spanish Breast Cancer Group), Spain; Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - M Ruíz-Borrego
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Univ. Virgen Del Rocío, Sevilla, Spain
| | - A Santaballa
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Universitario La Fe, Valencia, Spain
| | - C A Rodríguez
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Clínico Universitario de Salamanca, Salamanca (IBSAL), Spain
| | - C Crespo
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital Ramón y Cajal, Madrid, Spain
| | - M Ramos
- GEICAM (Spanish Breast Cancer Group), Spain; Centro Oncológico de Galicia, A Coruña, Spain
| | - J Gracia Marco
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital de Cabueñes, Gijón, Spain
| | - A Lluch
- GEICAM (Spanish Breast Cancer Group), Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain; Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - I Álvarez
- GEICAM (Spanish Breast Cancer Group), Spain; Hospital de Donostia, San Sebastián, Spain
| | - M Casas
- GEICAM (Spanish Breast Cancer Group), Spain
| | | | - E Carrasco
- GEICAM (Spanish Breast Cancer Group), Spain
| | | | - E Amir
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - M Martin
- GEICAM (Spanish Breast Cancer Group), Spain; Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
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Salvador-Coloma C, Hernándiz A, Tejedor S, Miró V, Palomar L, Salvador A, Sepúlveda P, Santaballa A. Abstract P3-14-07: Early detection of chemotherapy-induced cardiotoxicity in breast cancer patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-14-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
The incidence of cardiotoxicity in patients receiving treatment for breast cancer is unknown. There is not enough evidence about early detection and appropriate management of cardiotoxicity. The aim of this study is to identify early markers of risk of cardiac toxicity.
MATERIAL AND METHOD
Prospective study was conducted between 2014 and 2017 based on a cohort of 97 patients diagnosed with breast cancer treated with chemotherapy. Analytical biomarkers (natriuretic peptide, ultra-sensitive T troponin), echocardiogram parameters (left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS)) and electrocardiogram were performed. Analytical biomarkers were measured each chemotherapy cycle and cardiology test were performed before starting chemotherapy, 3 months afterwards, and then every six months during 5 years.
Cardiotoxicity was defined as a reduction in basal LVEF >10% with LVEF<55% in asymptomatic patients or >5% with LVEF<55% in symptomatic patients.
RESULTS
Patients characteristics are shown in table 1
Patients characteristicsVariablesNo cardiotoxicity (n=88)Cardiotoxicity (n=12)Gender (women/men)88/012/0Median age (range)53 years (29-79)47 years (37-70)Smoker (former smoker)13 (3)2 (2)Arterial hypertension202Dyslipemia160Diabetes62Previous chemotherapy11Prior mediastinal radiation therapy01
. All patients had the basal LVEF in normal range. Median follow-up was 26.5 months (13,5-39,6 months). A total of 10.3% had cardiotoxicity with reduction in basal LVEF >10% with LVEF<55% being asymptomatic and 2.1% were symptomatic. Five of these patients were treated with heart failure therapy: 5 with ACE (angiotensin converting enzyme) inhibitors and 3 with beta- blockers. Two of those (40%) who received specific treatment recovered basal LVEF-levels, 2 maintained LVEF dysfunction, and 1 died during follow-up due to tumor-related causes. In 83.3% of patients, cardiotoxicity occurred within the first year of follow-up.
In 50 patients SLG was calculated, in 30% it was lower than -12% in some measurement phase. In 5 cases the LVEF fell below 55% and the LRP decreased by 12% coincided.
The others patients, although they did not develop cardiotoxicity according to the established criteria, a decrease of the LVEF is observed during the treatment and in the first control, between 3-7%, which subsequently tends to recover spontaneously.
miRNA 21-5p, miRNA-133b, miRNA 210-3p, miRNA 423-5p, and miRNA-663b were analyzed. A model has been evaluated where a correlation between the levels of miRNA-133b, miRNA-21-5p and miRNA-210-3p and the decrease of LVEF in relation to treatment was observed.
CONCLUSIONS
Control by echocardiography and serum markers allowed us to detect early cardiotoxicity events and provide us an opportunity to start heart failure therapy on time with the aim of improving the control and evolution of it.Levels of miR-133b, miR-21-5p and miR-210 may alert for a risk of cardiotoxicity and can help to make decisions about treatments.
Acknowledgements: Project funded by European Comission (Hecatos FP7-HEALTH-2013-INNOVATION-1. Reference: CP-IP 602156-1) and RETICS program (RD12/0019/0025) cofunded by FEDER "una manera de hacer Europa”.
Citation Format: Salvador-Coloma C, Hernándiz A, Tejedor S, Miró V, Palomar L, Salvador A, Sepúlveda P, Santaballa A. Early detection of chemotherapy-induced cardiotoxicity in breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-14-07.
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Affiliation(s)
- C Salvador-Coloma
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - A Hernándiz
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - S Tejedor
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - V Miró
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - L Palomar
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - A Salvador
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - P Sepúlveda
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - A Santaballa
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Servicio de Oncología Médica. Hospital Universitario y Politécnico La Fe, Valencia, Spain
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16
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García J, De La Haba J, Servitja S, Santaballa A, De Paz L, Plata Y, Garau I, Florián J, Chacón JI, García P, Zamora P, Orcajo L, Rodríguez-Villanueva J, San José B, Martínez E, Seguí MA. Abstract P6-09-33: CASCADE study: Rapid survival decline per treatment line in metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-09-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Appraisal of the impact that current therapeutic strategies of advanced breast cancer (ABC) have on the survival expectancy, is vital to understand the prognosis of this disease. This entails assessing simultaneously the tumour phenotype and the therapeutic approach used per line of treatment. CASCADE is an epidemiological, retrospective, multicenter study aimed to retrieve demographic and clinical information from a representative cohort of ABC patients treated within the Spanish National Healthcare System.
MATERIAL AND METHODS: 13 Spanish public hospitals serving nearly 5M inhabitants (~10% of the national population) identified 422 ABC patients between 01/2007 and 12/2008 who received active treatment for their disease and were followed until death, lost to follow-up, or until December 2013. Overall Survival (OS) was analysed per tumour immunotype and treatment line from the diagnosis until a minimum of 10 patients were still evaluable. OS resulting from the different therapeutic approaches per line was also revised. Data collected included demographical, pathological, diagnostic, and therapeutic information for the entire follow-up. Descriptive statistics were applied (Methods previously described in SABCS 2015 Poster P3-07-39).
RESULTS: Remarkably, by the 2nd line of treatment, on average, one third of the OS is already gone. Tumour type imposes clear differences in this decline rate. As expected, triple-negative patients have the shortest survival expectancy at diagnosis, but their OS attrition rate is the slowest compared to the other subgroups (Table 1).
Table 1. OS per tumour type and line of treatment in ABC.PopulationOS from ABC Diagnosis (months)OS from 1L (months)OS from 2L (months)OS from 3L (months)OS from 4L (months)OS from 5L (months)Whole (N=422)33.532.622.616.613.513.3HER2-/HR+ (N=187)38.637.122.415.612.610.2Triple-negative (N=67)19.016.515.814.110.29.5HER2+/HR+ (N=72)34.433.729.421.620.318.9HER2+/HR- (N=53)36.335.423.113.19.314.1
OS time derived from the five mayor therapeutic approaches used at any given line, could only be registered for chemotherapy, hormone therapy and chemo + anti-HER2 therapy. Regardless of their treatment history, patients treated exclusively with hormone therapy portray a less aggressive behaviour than those treated with chemotherapy only, resembling the natural history of HER2-/HR+ and triple-negative phenotypes (Table 2).
Table 2. OS per pharmacological approach and line of treatment in ABC.Pharmacological treatmentOS from 1L (months)OS from 2L (months)OS from 3L (months)OS from 4L (months)OS from 5L (months)OS from 6L (months)OS from 7L (months)Chemotherapy (N=155)25.012.513.310.88.310.87.2Hormone therapy (N=92)44.030.922.311.214.0--Chemo + Anti-HER2 thp. (N=57)36.927.218.814.125.8--Chemo + Other Targeted thp. (N=44)19.721.014.121.1---Chemo + Hormone thp. (N=38)44.325.0-----Other Targeted thp.: anti-angiogenic antibody, mTOR inhibitor, anti-EGFR antibody, etc.
CONCLUSION: Chances to benefit from effective treatments may be jeopardized if their start is postponed to late lines. Only the most widely used therapies and, ultimately chemotherapy, hold until very late in the treatment of the advanced disease.
Citation Format: García J, De La Haba J, Servitja S, Santaballa A, De Paz L, Plata Y, Garau I, Florián J, Chacón JI, García P, Zamora P, Orcajo L, Rodríguez-Villanueva J, San José B, Martínez E, Seguí MA. CASCADE study: Rapid survival decline per treatment line in metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-33.
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Affiliation(s)
- J García
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J De La Haba
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - S Servitja
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - A Santaballa
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - L De Paz
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - Y Plata
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - I Garau
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J Florián
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - JI Chacón
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - P García
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - P Zamora
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - L Orcajo
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J Rodríguez-Villanueva
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - B San José
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - E Martínez
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - MA Seguí
- Complejo Hospitalario, Orense, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital San Agustín, Avilés, Asturias, Spain; Hospital La Paz, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; OXON Epidemiology, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Castellón, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
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Santaballa A, Martín M. SEOM guidelines 2016: an update. Clin Transl Oncol 2016; 18:1161-1162. [DOI: 10.1007/s12094-016-1592-z] [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: 11/29/2022]
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Santaballa A, Barretina P, Casado A, García Y, González-Martín A, Guerra E, Laínez N, Martinez J, Redondo A, Romero I. SEOM Clinical Guideline in ovarian cancer (2016). Clin Transl Oncol 2016; 18:1206-1212. [PMID: 27905052 PMCID: PMC5138249 DOI: 10.1007/s12094-016-1588-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 11/17/2016] [Indexed: 12/01/2022]
Abstract
Despite remarkable advances in the knowledge of molecular biology and treatment, ovarian cancer (OC) is the first cause of death due to gynecological cancer and the fifth cause of death for cancer in women in Spain. The aim of this guideline is to summarize the current evidence and to give evidence-based recommendations for clinical practice.
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Affiliation(s)
- A. Santaballa
- Servicio de Oncología Médica, Hospital Universitari I Politècnic La Fe, Avda de Fernando Abril Martorell, n. 106, 46026 Valencia, Spain
| | - P. Barretina
- Servicio de Oncología Médica, Institut Català d’Oncologia, Girona, Spain
| | - A. Casado
- Servicio de Oncología Médica, Hospital Clínico Universitario, San Carlos, Madrid, Spain
| | - Y. García
- Servicio de Oncología Médica, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | | | - E. Guerra
- Servicio de Oncología Médica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - N. Laínez
- Servicio de Oncología Médica, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - J. Martinez
- Servicio de Oncología Médica, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - A. Redondo
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | - I. Romero
- Servicio de Oncología Médica, Fundación Insituto Valenciano de Oncología, Valencia, Spain
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Muñoz M, Santaballa A, Seguí MA, Beato C, de la Cruz S, Espinosa J, Fonseca PJ, Perez J, Quintanar T, Blasco A. SEOM Clinical Guideline of fertility preservation and reproduction in cancer patients (2016). Clin Transl Oncol 2016; 18:1229-1236. [PMID: 27896641 PMCID: PMC5138251 DOI: 10.1007/s12094-016-1587-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/30/2022]
Abstract
Chemotherapy and radiotherapy often result in reduced fertility in cancer patients. With increasing survival rates, fertility is an important quality-of-life concern for many young cancer patients. Around 70–75% of young cancer survivors are interested in parenthood but the numbers of patients who access fertility preservation techniques prior to treatment are significantly lower. Moreover, despite existing guidelines, healthcare professionals do not address fertility preservation issues adequately. There is a critical need for improvements in clinical care to ensure patients are well informed about infertility risks and fertility preservation options and to support them in their reproductive decision-making prior to cancer treatment.
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Affiliation(s)
- M Muñoz
- Servicio de Oncología Médica, Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Hospital Clínic de Barcelona, Villarroel, 170-08036, Barcelona, Spain.
| | - A Santaballa
- Hospital Universitari I Politècnic la Fe, Valencia, Spain
| | - M A Seguí
- Corporació Sanitària Parc Taulì, Sabadell, Spain
| | - C Beato
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S de la Cruz
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - J Espinosa
- Hospital General de Ciudad Real, Ciudad Real, Spain
| | - P J Fonseca
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Perez
- Hospital General Universitario de Elche y Vega Baja, Elche, Spain
| | - T Quintanar
- Hospital General Universitario de Elche y Vega Baja, Elche, Spain
| | - A Blasco
- Hospital General Universitario de Valencia, Valencia, Spain
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Fernandez AO, Templeton A, Casas M, Sánchez-Aragó M, Caballero R, Lescure AR, Ruiz A, Alba E, Calvo L, Ruiz M, Santaballa A, Rodríguez C, Crespo C, Ramos M, Marco JG, Lluch-Hernandez A, Alvarez I, Carrasco E, Amir E, Martin M. Prognostic role for derived neutrophil-to-lymphocyte ratio in early breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.02] [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: 11/14/2022] Open
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Coloma CS, Sepúlveda P, Hernandiz A, Tejedor S, Palomar L, Ruiz A, Miro V, De Cueva H, Ontoria-Oviedo I, Salvador A, Castel V, Santaballa A. Anthracycline mediated cardiotoxicity: Detection of miRNA based early biomarkers for the prediction of myocardial injury. Hecatos study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.69] [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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De Arias LP, Teijido PG, Servitja S, Santaballa A, García J, Fernández YP, Garau I, Florian J, Chacón I, Haba J, Zamora P, Rincon LO, Rodríguez-Villanueva J, Seguí M, Martínez E. CASCADE study: pronounced decline in treatment efficacy through the metastatic life of breast cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.27] [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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Coloma CS, Cañete A, Balaguer J, Montero L, Viguer R, Santaballa A. Breast cancer in young women survivors of pediatric cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw385.15] [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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Zamora P, Servitja S, Santaballa A, García J, de Paz L, Plata Y, Garau I, Florian J, Chacón I, de la Haba J, García P, Artime E, Rodríguez-Villanueva J, Velasco A, Martínez E, Segui MA. Abstract P3-07-39: CASCADE study: Treatment and clinical outcomes of metastatic breast cancer by tumor immunophenotypes. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-39] [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: 11/16/2022]
Abstract
Abstract
BACKGROUND: Currently available therapeutic armamentarium for locally advanced and/or metastatic breast cancer (LA/MBC) allows an increasing tailored approach for each of the major tumor immunophenotypes. Nevertheless, there is scarce information about how these subgroups fare and how the alternative therapeutic approaches are actually being used during the disease course. CASCADE is an epidemiological, retrospective, and multicenter study aimed to retrieve demographic and clinical information from a representative cohort of LA/MBC patients treated within the Spanish National Healthcare System.
MATERIALS AND METHODS: Several strategies were used to identify patients diagnosed with LA/MBC for the first time between 01/2007 and 12/2008 in 13 Spanish public hospitals covering nearly 5'000'000 inhabitants (>10% of the national population) and followed throughout their metastatic lifetime until death, lost to follow-up, or until December 2013. Data collected included demographical and clinical information for each line of treatment. Descriptive statistics were applied to analyze the information.
RESULTS: We identified 443 LA/MBC patients. Median age at diagnosis was 59 years (CI95%: 49.5 - 71.6). Significant differences in dropout rates per line of treatment were found according to the tumor intrinsic immunophenotype. Patients reaching a 4th line were: whole study population 38.4%, HER2-/HR+ 42.8%, HER2+/HR- 41.5%, HER2+/HR+ 39.5%, and Triple-negative 31.9%. Median Overall survival (OS) and per line Progression Free Survival (PFS) for each line of treatment by tumor subtype were:
Median OS and per line PFS by tumor subtype Subtype (%)OS (months)PFS (months)PFS (months)PFS (months)PFS (months)PFS (months)Treatment line--1L2L3L4L5LWhole PopulationAll33.57.25.94.33.73.0HER2-/HR+43.838.68.85.84.43.33.0HER2+/HR-12.036.37.46.74.34.03.0HER2+/HR+17.234.411.27.94.95.83.5Triple-negative16.319.04.03.52.43.32.9
Percent use of the four major pharmacological families per line of LA/MBC treatment was:
Pharmacological families used per line of LA/MBC treatmentTreatment line1L2L3L4L5L6L7LChemotherapy75.463.075.979.487.976.178.6Anti-HER219.721.919.420.618.720.921.4Hormone therapy37.939.225.318.811.217.916.7Other targeted therapy13.09.612.212.47.511.914.3
CONCLUSION: Our study identifies differences in OS and PFS among BC immunophenotypes, with Triple-negatives faring the poorest. Among therapeutic families, chemotherapy clearly prevails along the disease lifetime, with hormone therapy being primarily used during the initial lines of treatment.
Citation Format: Zamora P, Servitja S, Santaballa A, García J, de Paz L, Plata Y, Garau I, Florian J, Chacón I, de la Haba J, García P, Artime E, Rodríguez-Villanueva J, Velasco A, Martínez E, Segui MA. CASCADE study: Treatment and clinical outcomes of metastatic breast cancer by tumor immunophenotypes. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-39.
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Affiliation(s)
- P Zamora
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - S Servitja
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - A Santaballa
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J García
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - L de Paz
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - Y Plata
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - I Garau
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J Florian
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - I Chacón
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J de la Haba
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - P García
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - E Artime
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J Rodríguez-Villanueva
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - A Velasco
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - E Martínez
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - MA Segui
- Hospital La Paz, Madrid, Spain; Hospital del Mar, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
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Servitja S, Zamora P, Santaballa A, García J, de Paz L, Plata Y, Garau I, Florian J, Chacón I, de la Haba J, García P, San José B, Rodríguez-Villanueva J, Orcajo L, Martínez E, Segui MA. Abstract P5-08-43: CASCADE study: Longer overall survival in the novo versus recidivant patients with locally advanced/metastatic breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-08-43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Current treatment strategies for locally advanced and/or metastatic breast cancer (LA/MBC) are meant to prolong survival while maintaining or improving the quality of life. Nevertheless, there is a lack of recent data regarding the actual clinical management and its impact on the prognosis of these patients. It is unknown whether prior diagnosis and treatment of early breast cancer (EBC) make any difference in the outcome of the advanced disease. CASCADE is an epidemiological, retrospective, and multicenter study aimed at retrieving this information from a representative cohort of LA/MBC patients treated within the Spanish National Healthcare System.
MATERIALS AND METHODS: Thirteen Spanish public hospitals covering nearly 5'000'000 inhabitants (>10% of the national population) applied several combined systematic strategies to identify patients firstly diagnosed with LA/MBC between 01/2007 and 12/2008. Once identified, patients were followed throughout their metastatic lifetime until death, lost to follow-up, or until December 2013, whichever occurs first. Data collected included demographical, pathological, diagnostic, and therapeutic information for each line of treatment. Descriptive statistics were applied.
RESULTS: We identified 443 LA/MBC patients; median age at diagnosis was 59 years (CI95%: 49.5 - 71.6). Previous history of early BC was reported in 69.3% of them with a median disease-free interval of 38 months. Median Overall Survival (OS) for the whole study population was 33.5 months, while numbers for advanced cases originally diagnosed as EBC or the novo LA/MBC were 31.7 (CI95%: 26.8 - 36.0) and 38.8 months (CI95% 32.8 - 45.3; p = 0.0138) respectively. Main tumor immunohistochemical subtypes for EBC and the novo LA/MBC were: HER2+/HR- 11.3% and 15.3%, HER2+/HR+ 16.2% and 19.1%, HER2-/HR+ 41.2% and 51.1%, and Triple-negative 17.9% and 11.5%, respectively.
At the end of the study follow-up (Dec 2013) 78.2% of the patients had died. Breakdown of the decaying percentage and OS for the entire study population, early-, and the novo diagnosed LA/MBC from the beginning of each line of treatment was:
OS according to the type of diagnosisTreatment line1L2L3L4L5L6L7LWhole pulation Patients (%)95.370.253.538.424.215.19.5Whole pulation OS (months)32.622.616.613.513.312.48.5Early diag. LA/MBC OS (months))30.921.015.612.912.49.17.5The novo diag. LA/MBC OS (months)37.625.921.618.714.016.913.8
CONCLUSION: Our study's OS data supports the hypothesis that highly effective current neo/adjuvant treatment may cure most treatment-sensitive early tumors, allowing only those more aggressive to develop to LA/MBC, which then will fare worse than those of the novo metastatic diagnosis.
Citation Format: Servitja S, Zamora P, Santaballa A, García J, de Paz L, Plata Y, Garau I, Florian J, Chacón I, de la Haba J, García P, San José B, Rodríguez-Villanueva J, Orcajo L, Martínez E, Segui MA. CASCADE study: Longer overall survival in the novo versus recidivant patients with locally advanced/metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-08-43.
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Affiliation(s)
- S Servitja
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - P Zamora
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - A Santaballa
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J García
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - L de Paz
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - Y Plata
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - I Garau
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J Florian
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - I Chacón
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J de la Haba
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - P García
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - B San José
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - J Rodríguez-Villanueva
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - L Orcajo
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - E Martínez
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
| | - MA Segui
- Hospital del Mar, Barcelona, Spain; Hospital La Paz, Madrid, Spain; Hospital La Fe, Valencia, Spain; Complejo Hospitalario, Orense, Spain; Hospital Arquitecto Marcide, Ferrol, A Coruña, Spain; Hospital Médico Quirúrgico, Jaén, Spain; Hospital Son Llàtzer, Son Ferriol, Palma de Mallorca, Spain; Hospital de Barbastro, Barbastro, Huesca, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital Reina Sofía, Córdoba, Spain; Hospital San Agustín, Avilés, Asturias, Spain; OXON Epidemiology, Madrid, Spain; EISAI Pharmaceuticals, Madrid, Spain; Hospital Provincial, Castellón de la Plana, Spain; Hospital Parc Taulí, Sabadell, Barcelona, Spain
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Bruixola G, García R, Gomez F, Escoín C, Palomar L, de la Cueva H, Martínez J, Santaballa A. Transarterial chemoembolization with doxorubicin-loaded drug-eluting beads (DEBDOX) in the treatment of breast cancer liver metastases: A pilot study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv115.03] [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: 11/12/2022] Open
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Romero I, Lopez Guerrero J, Palacios J, Ojeda B, Illueca C, Gutierrez Pecharromán A, Blanch S, Cristóbal E, Garcia Casado M, Vieites B, Ruiz Díaz I, Vera Sempere F, Pastor F, Andrada E, Culubret M, Hardisson D, Calvo E, Churruca C, Santaballa A, Poveda A. Genomic Characterization of Early Stages of Ovarian Cancer with Emphasis in Low-Grade Endometroid and Low-Grade Serous Histologies. a Study By Spanish Group for Ovarian Cancer Research (Geico). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu359.2] [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: 11/13/2022] Open
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Santaballa A, La De Cueva H, Salvador C, Martinez AG, Guarin M, Lorente D, Palomar L, Aznar I, Dobon F, Bello P. Advantages of One Step Nucleic Acid Amplification (OSNA) Whole Node Assay in Sentinel Lymph Node (SLN) Analysis in Breast Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32847-7] [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] Open
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Zamora P, Pérez-Carrión R, Manso L, Crespo C, Mendiola C, Alvarez-López I, Margeli M, Bayo-Calero JL, González-Farre X, Santaballa A, Ciruelos EM, Afonso R, Lao J, Catalán G, Alvarez-Gallego JV, Miramón-López J, Salvador-Bofill FJ, Ruiz-Borrego M. P5-14-22: Prospective Observational Study To Describe the Clinicopathological and Biological Characteristics and the Management of Metastatic Breast Cancer Patients Who Experienced Complete or Partial Remission or Disease Stabilization during at Least 3 Years. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p5-14-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Trastuzumab has shown an improvement in survival outcomes among patients with HER2+ metastatic breast cancer (MBC). Identification of pathological, clinical factors and tumor genetic profile that may predict long-term remission has become a key-issue. We aimed to describe the clinicopathological and biological characteristics of MBC patients who experienced complete response (CR), partial response (PR), or stable disease (SD) during at least 3 years and their management in routine clinical practice.
Methods: Multicenter, observational, cross-sectional study. Data were collected from women with HER2+ MBC treated with a trastuzumab-based regimen who maintained a partial or complete remission or disease stabilization beyond 3 years. The interim results from the first 65 patients evaluated are presented.
Results: Median age: 59 (52-70) years. Metastatic disease was diagnosed after a median of 23.5 (1.6−48.8) months since primary tumor diagnosis. The predominant tumor type was ductal carcinoma (89.2%) and 47% showed histological grade III. Mean tumor size: 3.6±2.2cm (anatomical pathology), 5.1±2.8cm (imaging studies). Hormonal status: Progesterone receptor positive 46% and estrogen receptor positive 43%. Most common metastatic sites: lung (23%), liver (17%) and bone (14%). Overexpression of HER2 was assessed by IHC in 97% of patients, of whom 94% were HER2+ (3+) and 17% had FISH+ HER2 status. Tumor was positive for p53 and Ki67 in 23% and 41.5%, respectively. Surgery was performed on 83% of patients, of which 73% underwent radical mastectomy; 96% had their axillary nodes removed. Surgery of metastases was performed on 7.8%. First line chemotherapy was received by 91% with the most frequent schemes being paclitaxel (24%), vinorelbine (15%) and paclitaxel/carboplatine (14%). First line hormonal therapy and radiotherapy was used in 45% and 12%, respectively. All patients received first line trastuzumab, administered on a weekly schedule in 51%. Trastuzumab was used in combination in most of patients (89.2%) with a median number of cycles of 18 (7.0−41.5) and during a median of 53.3±25 months. 66% of patients achieved a CR, 21% PR and 13% had SD. Median time since trastuzumab was initiated to CR, PR or SD was 5 (4-7) months. Median duration of CR, PR or SD was 56 (44.5−78.0) months. Trastuzumab was maintained beyond CR, PR or SD in 99% during a median of 46.5 (35-67) months. 75% of patients continue on treatment with trastuzumab. Only 2 patients discontinued trastuzumab due to toxicity. At the time of the analysis, 19% had progressed, 57% were alive and free of disease and among patients on treatment (93%), 54% were on trastuzumab. Cardiac toxicity was the most common toxicity (36%) among those suffering at least one (22%).
Conclusions: The preliminary findings support that trastuzumab provides a substantial long-term survival benefit with a manageable safety profile in HER2+ MBC patients. This study adds to the evidence that there may be benefit in continuing trastuzumab after achieving remission or disease stabilization. Final results will be presented in the forthcoming congress.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-14-22.
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Affiliation(s)
- P Zamora
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - R Pérez-Carrión
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - L Manso
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - C Crespo
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - C Mendiola
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - I Alvarez-López
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - M Margeli
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - JL Bayo-Calero
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - X González-Farre
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - A Santaballa
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - EM Ciruelos
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - R Afonso
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - J Lao
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - G Catalán
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - JV Alvarez-Gallego
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - J Miramón-López
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - FJ Salvador-Bofill
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
| | - M Ruiz-Borrego
- 1Hospital La Paz, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Donostia, San Sebastián, Spain; Hospital Germans Trias i Pujol, Badalona, Spain; Hospital Juan Ramón Jiménez, Huelva, Spain; Hospital Clinic de Barcelona, Barcelona, Spain; Hospital La Fe, Valencia, Spain; Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Son Llàtzer, Mallorca, Spain; Complejo Hospitalario de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda, Spain; Hospital Virgen de Valme, Sevilla, Spain; Hospital Virgen del Rocío, Sevilla, Spain
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Ojeda B, Casado A, Tibau A, Redondo A, Beltran M, Garcia-Martinez E, Santaballa A, Pardo B, Lianes P, Bover I, Garcia-Donas J, Churruca CM, Cueva JF, Sanchez-Heras AB, Gordon-Santiago MM, Arcusa Lanza A, Lopez-Rodriguez A, Caballero C, Ortega-Izquierdo ME, González-Martín A. Bevacizumab alone or with chemotherapy in highly pretreated, relapsed, epithelial ovarian cancer patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15590] [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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Antón A, Ruiz A, Plazaola A, Calvo L, Seguí M, Santaballa A, Muñoz M, Sánchez P, Miguel A, Carrasco E, Lao J, Camps J, Alfaro J, Antolín S, Cámara M. Phase II clinical trial of liposomal-encapsulated doxorubicin citrate and docetaxel, associated with trastuzumab, as neoadjuvant treatment in stages II and IIIA HER2-overexpressing breast cancer patients. GEICAM 2003-03 study. Ann Oncol 2011; 22:74-79. [DOI: 10.1093/annonc/mdq317] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [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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Gonzalvez ML, Diaz N, Redondo A, Calvo EG, Illarramendi JJ, Munarriz B, Del Campo J, Castellanos Diez J, Santaballa A, Lopez-Vivanco G. Epidemiologic study to evaluate the treatment of palmar-plantar erythrodysesthesia (PPE) in patients (pts) with ovarian cancer (OC) or metastatic breast cancer (MBC) treated with pegylated liposomal doxorubicin (PLD). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e12014] [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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Jara-Sanchez C, Ruiz A, Martin M, Martínez del Prado P, Santaballa A, Llombart-Cussac A, Batista J, Pollán M, Carrasco EM, Lluch A. Spanish Breast Cancer Research Group (GEICAM) hospital-based study on breast cancer outcomes: El Álamo project (1990-2001). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e12016] [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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Gonzalez-Martin A, Casado A, Blanco-Sanchez I, Bover I, Herrero A, Santaballa A, Caballero C, Churruca C, Calvo E, Ojeda B. 8025 Correlation of Topo II alpha expression and amplification with efficacy of pegylated liposomal doxorubicin in a GEICO phase II trial for platinum-resistant (PR) recurrent ovarian carcinoma (ROC). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71547-2] [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: 11/27/2022] Open
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Ciruelos EM, López-Vivanco G, Peláez I, Rifa J, Santaballa A, González S, Segui MA, Jara C, Alvarez I, Cortés-Funes H. Efficacy and safety of the administration of bevacizumab in combination with first-line chemotherapy for the treatment of advanced breast carcinoma: ATHENA MO19391 study results in Spanish patients. Breast Cancer Res 2009. [PMCID: PMC4284910 DOI: 10.1186/bcr2307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rubio M, Santaballa A, Garcia Y, Gonzalez A, Bover I, Calvo E, Contreras JA, del Campo J, De Juan A, Poveda A. Phase II study of weekly topotecan in recurrent or metastatic cervical cancer: a GEICO study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5591] [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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Oltra A, Santaballa A, Munárriz B, Pastor M, Montalar J. Cost-Benefit Analysis of a Follow-up Program in Patients with Breast Cancer: A Randomized Prospective Study. Breast J 2007; 13:571-4. [DOI: 10.1111/j.1524-4741.2007.00506.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Diaz R, Reynes G, Tormo A, Segura A, Santaballa A, Ponce J, Giménez A, De Juan M, Artes F, Fleitas T. Neoadjuvant and combined chemoradiotherapy followed by surgery in locally advanced esophageal cancer: A single-centre experience. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15086 Background: Concomitant chemoradiotherapy (CT-RT) with CDDP-5FU CT is a standard treatment in locally advanced esophageal cancer (EC). Long-term results are poor. The role of neoadjuvant CT (nCT) and of radical surgery after CT-RT is unclear. Methods: Single-institution, prospective trial in pts with stage II-IVA EC (TNM). PS 0–1. Staging: CT scan, barium x-ray, esophagoscopy and endoscopic ultrasound. Treatment schema: 1 cycle of neoadjuvant CT (CDDP 100 mg/m2 d1 and 5-FU 1,000 mg/m2/24 h d1–5); after 21 days, 50 Gy of RT (1.8 cGy/day, M to F) and 2 cycles of reduced-dose CT (CDDP 15 mg/m2 d1–5 and 5-FU 800 mg/m2/24 h d1–5, q21 days). In pts deemed resectable, surgery was done after 4–6 weeks. In the remainder, a 10 Gy boost was given with 1 cycle of modified CT. Primary endpoint: clinical and pathological response rate (RR) after 1st phase. Secondary endpoints: OS and toxicity rates. Results: 71 pts accrued between 1998 and 2006. Median age 61 yrs (r 44–80). 96% males. 85% squamous cell carcinomas. Middle third: 51%; upper third: 27%; lower third 22%. Gastric involvement: 11%. cT3: 46%, cT4: 28%. cN positive: 48%. Grade 3–4 toxicity with nCT and CT-RT: mucositis (9 and 19.5%), emesis (9 and 9%) and infection (6 and 9%). Full dose CT-RT: 87%. Clinical RR after 1st phase: CR 50%, PR 25%, SD 9%, PD 7%. Confirmation (CT- biopsy): 69%. Surgery: 30%. Reasons for no surgery: comorbidity (11%) and age (10%). Pathologic RR: CR 39%, microscopic rest 39% and macroscopic rest 22%. Downstaging 50%. No pN positive. 3 pts had unresectable disease. 62% received 2nd phase RT boost, 31% with CT. Clinical RR: CR 69%, PR 6%, PD 25%. Median follow-up 50 m (r 6–129 m). Median OS 10.5 m (r 7.4–12.8 m). 4-year OS of 18%. 47% deaths due to progression, 5% treatment-related deaths and 10% in the postoperative period. Only a clinical CR after 1st phase was found to improve OS (13.5 vs 7 m, p 0.0141). Conclusions: This regimen is well tolerated and offers a high response rate. Clinical response evaluation overestimates the pathologic response rate. In our series, the possible survival benefit of surgery is offset by the postoperative death rate. No significant financial relationships to disclose.
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Affiliation(s)
- R. Diaz
- University Hospital La Fe, Valencia, Spain
| | - G. Reynes
- University Hospital La Fe, Valencia, Spain
| | - A. Tormo
- University Hospital La Fe, Valencia, Spain
| | - A. Segura
- University Hospital La Fe, Valencia, Spain
| | | | - J. Ponce
- University Hospital La Fe, Valencia, Spain
| | - A. Giménez
- University Hospital La Fe, Valencia, Spain
| | - M. De Juan
- University Hospital La Fe, Valencia, Spain
| | - F. Artes
- University Hospital La Fe, Valencia, Spain
| | - T. Fleitas
- University Hospital La Fe, Valencia, Spain
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Lluch A, Chirivella I, Insa A, Martinez-Ruiz F, Santaballa A, Herranz C, Ibañez J, Miranda J, Pons C, Sala D. Impact of mammographic screening in staging, treatment and prognosis of breast cancer: Early assessment. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10537 Background: The use of breast cancer mammographic screening (MS) leads to early detection and has been shown to reduce the mortality rate and to increase the proportion of breast-conserving surgery. The aim of this study is to analyze the impact of mammography in the staging, treatment and prognosis of breast carcinoma. Methods: In 1993, a population-based mammographic screening among women aged from 45 to 70 years was introduced in the community of Valencia. We examined the effects of this MS program by the comparison of two populations. The first one included all the women with screen-detected invasive breast carcinoma between 1993 and 2002 in the community of Valencia. The second one was comprised of all the women with invasive breast carcinoma, diagnosed in the same period, aged 45–70, not attending the MS and treated at H. Clinico of Valencia. Results: Between January, 1993 and December, 2002, 2313 new invasive breast cancer patients were detected by the MS program in the community of Valencia, and 1349 women aged 45–70, not attending de MS were diagnosed with invasive breast carcinoma in H.Clinico of Valencia. The median follow-up period was 45.5 months for the screen-detected breast cancer and 51.9 months for not screen-detected patients. The screen-detected tumors had smaller pathological size (pT1 tumors 70.2% vs 40.5%, p < 0.0001), were more likely to have pathologically confirmed negative nodal status (66.4% vs 52.2%, p < 0.0001) and stage I disease (55.3% vs 26.1%, p < 0.0001). Breast-conserving surgery was performed in 50.4% of patients with screen-detected tumors and in 31.9% of women who had not undergone MS (p < 0.0001). The 5-year estimated survival was 95.5% (SE 0.57) for women with screen-detected breast cancer and 85.5% (SE 1.17) for those with not screen-detected tumors (p < 0.0001). Conclusions: Our data demonstrate a better prognosis in terms of 5-year survival in screen-detected breast cancer patients that may explain why breast carcinoma mortality rates have decreased in recent decades. These patients have also been found to have smaller tumors, a more favorable tumor stage and a higher proportion of breast-conserving surgery. No significant financial relationships to disclose.
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Affiliation(s)
- A. Lluch
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - I. Chirivella
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - A. Insa
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - F. Martinez-Ruiz
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - A. Santaballa
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - C. Herranz
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - J. Ibañez
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - J. Miranda
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - C. Pons
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
| | - D. Sala
- Universitary Clinic Hospital, Valencia, Spain; Breast Cancer Screening Group of Valencia, Valencia, Spain
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Díaz R, Santaballa A, Munárriz B, Calderero V. Hepatic resection in breast cancer metastases: should it be considered standard treatment? Breast 2004; 13:254-8. [PMID: 15177433 DOI: 10.1016/j.breast.2003.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2003] [Revised: 08/29/2003] [Accepted: 11/06/2003] [Indexed: 11/17/2022] Open
Abstract
A 34-year-old woman was diagnosed in October 1994 with a stage I breast cancer and treated with conservative surgery, locoregional radiotherapy and adjuvant chemotherapy. Nonetheless, 47 months after the initial diagnosis, an isolated liver metastasis was diagnosed in segments VII and VIII. A subsegmentectomy was performed, and chemotherapy with doxorubicin and paclitaxel was given for five cycles. High-dose chemotherapy with peripheral stem cell rescue was then administered and tamoxifen hormonal therapy was begun. Now, 54 months after the liver recurrence, the patient remains free of disease. Isolated liver metastases from breast cancer are rare and should be treated with surgical resection if possible, in the context of multimodality programs with hormonal and chemotherapy. According to the small series published in the literature, an improvement of 27-57 months in median survival rates can be expected when such treatment replaces standard therapies, although a selection bias cannot be excluded.
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Affiliation(s)
- R Díaz
- Medical Oncology Unit, University Hospital La Fe, Av. Campanar 19-21, 46009 Valencia, Spain.
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Segura A, Pastor M, Santaballa A, Yuste A, López P, Aparicio J. Cisplatin plus vinorelbine for patients with advanced head and neck squamous cell carcinoma. Oncologist 2000; 5:177-8. [PMID: 10794811 DOI: 10.1634/theoncologist.5-2-177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- A Segura
- Department of Medical Oncology, Hospital Universitario La Fe, Valencia, Spain
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Aparicio J, Segura A, Montalar J, Garcerá S, Oltra A, Santaballa A, Yuste A, Pastor M, Munárriz B. Long-term results after combined modality treatment for non-metastatic osteosarcoma. Cancer Immunol Immunother 1999; 16:255-60. [PMID: 10618688 DOI: 10.1007/bf02785871] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Since the introduction of multimodality treatment, the prognosis of patients with high-grade non-metastatic osteosarcoma has significantly improved. A retrospective review was performed to assess the long-term results of this approach in a single centre setting, and to investigate the impact of potential clinical prognostic factors. Between 1985 and 1993, 35 patients with stage II-A and II-B osteosarcoma underwent preoperative chemotherapy (high-dose methotrexate), wide surgery, and adjuvant chemotherapy (cisplatin-doxorubicin/bleo-mycin-cyclophosphamide-dactinomycin) (modified T-10A protocol). There were 19 males and 16 females. Median patient age was 17 y (range 12-42). Primary tumour sites were the extremities (83%) and axial bones (17%). In spite of an unfavourable grade 3-4 histologic response rate to high-dose methotrexate of 12%, 31 (88%) patients were able to undergo limb-sparing surgery and 28 (80%) were rendered disease free after the planned therapy. Median follow-up was 8 y. The actuarial overall survival and disease-free survival rates were 64% and 49% at 5 y, and 59% and 49% at 10 y, respectively. Tumour size and primary site were significant prognostic factors for survival in univariate analyses. In conclusion, long-term survival after combined modality treatment can be achieved in more than 60% of patients with localised osteosarcoma, including non-appendicular lesions. Limb-sparing surgery is a realistic goal for most cases. The prognostic value of tumour necrosis and the efficacy of neoadjuvant chemotherapy should be interpreted according to individual high-dose methotrexate scheduling.
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Affiliation(s)
- J Aparicio
- Department of Medical Oncology, Hospital Universitario La Fe, Valencia, Spain.
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Montalar J, Segura A, Bosch C, Galán A, Juan O, Santaballa A, Molins C. Cefepime monotherapy as initial treatment for patients with febrile neutropenia. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81914-5] [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: 11/16/2022]
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Abstract
BACKGROUND Refractory or relapsing Hodgkin's disease is associated with a poor prognosis. There is no widely accepted salvage chemotherapy regimen for these patients. However, the addition of high-dose chemotherapy followed by autologous hematopoietic transplantation (AHT) has proven of benefit to them. A prospective clinical trial was carried out to evaluate the efficacy and toxicity of ESHAP (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin). PATIENTS AND METHODS Twenty-two patients with refractory (5) or relapsing Hodgkin's disease (17) were entered and scheduled to receive three courses of ESHAP. Patients suitable for AHT were then given high-dose chemotherapy with CBV (cyclophosphamide, carmustine, and etoposide) plus AHT, whereas responding, non-AHT-suitable patients completed six ESHAP courses. RESULTS Nine patients achieved complete responses and seven partial responses (overall response rate 73%) with ESHAP. Grade 3-4 myelotoxicity was seen in 13 patients (59%). Nine patients received CBV plus AHT. At a median follow-up time of 50 months (range 6-96), seven patients (32%) are alive and disease-free. Three patients died of toxic effects of ESHAP (1) or CBV (2). Actuarial overall survival and disease-free survival were 35% and 27% at three years. CONCLUSIONS ESHAP is an active regimen for relapsing Hodgkin's disease, with myelosuppression as its dose-limiting toxicity. An increased risk of treatment-related mortality when it is combined with high-dose chemotherapy can not be ruled out.
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Affiliation(s)
- J Aparicio
- Department of Medical Oncology, Hospital Universitario La Fe, Valencia, Spain.
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