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Gebhart G, Keyaerts M, Guiot T, Flamen P, Ruiz-Borrego M, Stradella A, Bermejo B, Escriva-de-Romani S, Calvo Martínez L, Ribelles N, Fernandez-Abad M, Albacar C, Colleoni M, Garrigos L, Atienza de Frutos M, Dalenc F, Prat A, Marmé F, Schmid P, Kerrou K, Braga S, Gener P, Sampayo-Cordero M, Cortés J, Pérez-García JM, Llombart-Cussac A. Optimal [ 18F]FDG PET/CT Cutoff for Pathologic Complete Response in HER2-Positive Early Breast Cancer Patients Treated with Neoadjuvant Trastuzumab and Pertuzumab in the PHERGain Trial. J Nucl Med 2024; 65:708-713. [PMID: 38575192 DOI: 10.2967/jnumed.123.266384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/16/2024] [Indexed: 04/06/2024] Open
Abstract
The PHERGain trial investigated the potential of metabolic imaging to identify candidates for chemotherapy deescalation in human epidermal growth factor receptor 2 (HER2)-positive, invasive, operable breast cancer with at least 1 breast lesion evaluable by [18F]FDG PET/CT. [18F]FDG PET/CT responders were defined as patients with an SUVmax reduction (ΔSUVmax) of at least 40% in all of their target lesions after 2 cycles of trastuzumab and pertuzumab (HP) (with or without endocrine therapy). In total, 227 of 285 patients (80%) included in the HP arm showed a predefined metabolic response and received a total of 8 cycles of HP (with or without endocrine therapy). Pathologic complete response (pCR), defined as ypT0/isN0, was achieved in 37.9% of the patients. Here, we describe the secondary preplanned analysis of the best cutoff of ΔSUVmax for pCR prediction. Methods: Receiver-operating-characteristic analysis was applied to look for the most appropriate ΔSUVmax cutoff in HER2-positive early breast cancer patients treated exclusively with neoadjuvant HP (with or without endocrine therapy). Results: The ΔSUVmax capability of predicting pCR in terms of the area under the receiver-operating-characteristic curve was 72.1% (95% CI, 65.1-79.2%). The optimal ΔSUVmax cutoff was found to be 77.0%, with a 51.2% sensitivity and a 78.7% specificity. With this cutoff, 74 of 285 patients (26%) would be classified as metabolic responders, increasing the pCR rate from 37.9% (cutoff ≥ 40%) to 59.5% (44/74 patients) (P < 0.01). With this optimized cutoff, 44 of 285 patients (15.4%) would avoid chemotherapy in either the neoadjuvant or the adjuvant setting compared with 86 of 285 patients (30.2%) using the original cutoff (P < 0.001). Conclusion: In the PHERGain trial, an increased SUVmax cutoff (≥77%) after 2 cycles of exclusive HP (with or without endocrine therapy) achieves a pCR in the range of the control arm with chemotherapy plus HP (59.5% vs. 57.7%, respectively), further identifying a subgroup of patients with HER2-addicted tumors. However, the original cutoff (≥40%) maximizes the number of patients who could avoid chemotherapy.
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Affiliation(s)
- Geraldine Gebhart
- Nuclear Medicine Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Thomas Guiot
- Nuclear Medicine Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Patrick Flamen
- Nuclear Medicine Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Agostina Stradella
- Medical Oncology Department, Institut Català D'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Begoña Bermejo
- Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Santiago Escriva-de-Romani
- Breast Cancer Group, Medical Oncology Department, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Lourdes Calvo Martínez
- Medical Oncology Department, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Nuria Ribelles
- UGC Oncología Intercentros, Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Instituto de Investigaciones Biomédicas de Málaga, Málaga, Spain
| | - María Fernandez-Abad
- Medical Oncology Department, Ramón y Cajal Hospital, Madrid, Spain
- Alcala de Henares Medical University, Alcala de Henares, Madrid
| | - Cinta Albacar
- Hospital Universitari Sant Joan de Reus, Reus, Spain
| | | | | | - Manuel Atienza de Frutos
- Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - Florence Dalenc
- Institut Claudius Regaud, IUCT-Oncopole, Toulouse Cancer Research Centre, INSERM, Toulouse, France
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
- Translational Genomics and Targeted Therapies Group, IDIBAPS, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Frederik Marmé
- Medical Faculty Mannheim Heidelberg University, University Hospital Mannheim, Heidelberg, Germany
| | - Peter Schmid
- Barts Experimental Cancer Medicine Centre, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
- Barts Hospital NHS Trust, London, United Kingdom
| | - Khaldoun Kerrou
- Nuclear Medicine and PET Center Department, Tenon Hospital IUC-UPMC, APHP, Sorbonne University, Paris, France
| | - Sofia Braga
- Hospital Vila Franca de Xira and Hospitals CUF Institute José de Mello Saúde, Lisbon, Portugal
| | - Petra Gener
- Medica Scientia Innovation Research, Barcelona, Spain
| | | | - Javier Cortés
- Medica Scientia Innovation Research, Barcelona, Spain
- International Breast Cancer Center, Quiron Group, Pangaea Oncology, Barcelona, Spain
- Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - José Manuel Pérez-García
- Medica Scientia Innovation Research, Barcelona, Spain
- International Breast Cancer Center, Quiron Group, Pangaea Oncology, Barcelona, Spain
| | - Antonio Llombart-Cussac
- Medica Scientia Innovation Research, Barcelona, Spain;
- Hospital Universitario Arnau de Vilanova, Universidad Católica de Valencia, Valencia, Spain
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Pérez-García JM, Cortés J, Ruiz-Borrego M, Colleoni M, Stradella A, Bermejo B, Dalenc F, Escrivá-de-Romaní S, Calvo Martínez L, Ribelles N, Marmé F, Cortés A, Albacar C, Gebhart G, Prat A, Kerrou K, Schmid P, Braga S, Di Cosimo S, Gion M, Antonarelli G, Popa C, Szostak E, Alcalá-López D, Gener P, Rodríguez-Morató J, Mina L, Sampayo-Cordero M, Llombart-Cussac A. 3-year invasive disease-free survival with chemotherapy de-escalation using an 18F-FDG-PET-based, pathological complete response-adapted strategy in HER2-positive early breast cancer (PHERGain): a randomised, open-label, phase 2 trial. Lancet 2024; 403:1649-1659. [PMID: 38582092 DOI: 10.1016/s0140-6736(24)00054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/15/2023] [Accepted: 01/09/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND PHERGain was designed to assess the feasibility, safety, and efficacy of a chemotherapy-free treatment based on a dual human epidermal growth factor receptor 2 (HER2) blockade with trastuzumab and pertuzumab in patients with HER2-positive early breast cancer (EBC). It used an 18fluorine-fluorodeoxyglucose-PET-based, pathological complete response (pCR)-adapted strategy. METHODS PHERGain was a randomised, open-label, phase 2 trial that took place in 45 hospitals in seven European countries. It randomly allocated patients in a 1:4 ratio with centrally confirmed, HER2-positive, stage I-IIIA invasive, operable breast cancer with at least one PET-evaluable lesion to either group A, where patients received docetaxel (75 mg/m2, intravenous), carboplatin (area under the curve 6 mg/mL per min, intravenous), trastuzumab (600 mg fixed dose, subcutaneous), and pertuzumab (840 mg loading dose followed by 420 mg maintenance doses, intravenous; TCHP), or group B, where patients received trastuzumab and pertuzumab with or without endocrine therapy, every 3 weeks. Random allocation was stratified by hormone receptor status. Centrally reviewed PET was conducted at baseline and after two treatment cycles. Patients in group B were treated according to on-treatment PET results. Patients in group B who were PET-responders continued with trastuzumab and pertuzumab with or without endocrine therapy for six cycles, while PET-non-responders were switched to receive six cycles of TCHP. After surgery, patients in group B who were PET-responders who did not achieve a pCR received six cycles of TCHP, and all patients completed up to 18 cycles of trastuzumab and pertuzumab. The primary endpoints were pCR in patients who were group B PET-responders after two treatment cycles (the results for which have been reported previously) and 3-year invasive disease-free survival (iDFS) in patients in group B. The study is registered with ClinicalTrials.gov (NCT03161353) and is ongoing. FINDINGS Between June 26, 2017, and April 24, 2019, a total of 356 patients were randomly allocated (71 patients in group A and 285 patients in group B), and 63 (89%) and 267 (94%) patients proceeded to surgery in groups A and B, respectively. At this second analysis (data cutoff: Nov 4, 2022), the median duration of follow-up was 43·3 months (range 0·0-63·0). In group B, the 3-year iDFS rate was 94·8% (95% CI 91·4-97·1; p=0·001), meeting the primary endpoint. No new safety signals were identified. Treatment-related adverse events and serious adverse events (SAEs) were numerically higher in patients allocated to group A than to group B (grade ≥3 62% vs 33%; SAEs 28% vs 14%). Group B PET-responders with pCR presented the lowest incidence of treatment-related grade 3 or higher adverse events (1%) without any SAEs. INTERPRETATION Among HER2-positive EBC patients, a PET-based, pCR-adapted strategy was associated with an excellent 3-year iDFS. This strategy identified about a third of patients who had HER2-positive EBC who could safely omit chemotherapy. FUNDING F Hoffmann-La Roche.
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Affiliation(s)
- José Manuel Pérez-García
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Group, Barcelona 08022, Spain; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
| | - Javier Cortés
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Group, Barcelona 08022, Spain; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | | | - Agostina Stradella
- Medical Oncology Department, Institut Català D'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Begoña Bermejo
- Medical Oncology, Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, Valencia, Spain; Medicine Department, Universidad de Valencia, Spain; Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain
| | - Florence Dalenc
- Oncopole Claudius Regaud- IUCT, Inserm, Department of Medical Oncology, Toulouse, France
| | - Santiago Escrivá-de-Romaní
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Nuria Ribelles
- UGC Oncología Intercentros, Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - Frederik Marmé
- University Hospital Mannheim; Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Cinta Albacar
- Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Geraldine Gebhart
- Department of Nuclear Medicine, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies Group, IDIBAPS, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Khaldoun Kerrou
- APHP, Tenon Hospital IUC-UPMC, Nuclear Medicine and PET Center Department, Sorbonne University, Paris, France; INSERM U938 (Cancer Biology and Therapeutics), Paris, France
| | - Peter Schmid
- Barts Experimental Cancer Medicine Centre, Barts Cancer Institute, Queen Mary University of London, UK; Barts Hospital NHS Trust, London, UK
| | - Sofia Braga
- Unidade de Mama, Instituto CUF de Oncologia, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Serena Di Cosimo
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maria Gion
- University Hospital Ramón y Cajal, Madrid, Spain
| | - Gabriele Antonarelli
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy
| | - Crina Popa
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
| | - Emilia Szostak
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
| | | | - Petra Gener
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
| | | | - Leonardo Mina
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
| | | | - Antonio Llombart-Cussac
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Hospital Arnau de Vilanova, Universidad Católica de Valencia, Valencia, Spain.
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Fernandez-Gonzalez S, Falo C, Pla MJ, Campos M, Ortega-Exposito C, Ortega R, Vicente M, Petit A, Bosch-Schips J, Bajen MT, Reyes G, Martínez E, González-Viguera J, Peñafiel J, Stradella A, Pernas S, Ponce J, Garcia-Tejedor A. Sentinel lymph node biopsy before and after neoadjuvant chemotherapy in cN0 breast cancer patients: impact on axillary morbidity and survival-a propensity score cohort study. Breast Cancer Res Treat 2024:10.1007/s10549-024-07274-1. [PMID: 38635082 DOI: 10.1007/s10549-024-07274-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 01/30/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE In patients with clinically lymph node-negative (cN0) breast cancer, performing sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) has been preferentially embraced in comparison to before NACT. However, survival outcomes associated with both strategies remain understudied. We aimed to compare the axillary lymphadenectomy (ALND) rate, disease-free survival (DFS), and overall survival (OS), between two strategies. METHODS We included 310 patients in a retrospective observational study. SNLB was performed before NACT from December 2006 to April 2014 (107 cases) and after NACT from May 2014 to May 2020 (203 patients). An inverse probability of treatment weighting (IPTW) method was applied to homogenize both groups. Hazard ratios (HR) and odd ratios (OR) are reported with 95% confidence intervals (95%CI). RESULTS The lymphadenectomy rate was 29.9% before NACT and 7.4% after NACT (p < 0.001), with an OR of 5.35 95%CI (2.7-10.4); p = .002. After 4 years of follow-up, SLNB after NACT was associated with lower risk for DFS, HR 0.42 95%CI (0.17-1.06); p = 0.066 and better OS, HR 0.21 CI 95% (0.07-0.67); p = 0.009 than SLNB before NACT. After multivariate analysis, independent adverse prognostic factors for OS included SLNB before NACT, HR 3.095 95%CI (2.323-4.123), clinical nonresponse to NACT, HR 1.702 95% CI (1.012-2.861), and small tumors (cT1) with high proliferation index, HR 1.889 95% (1.195-2.985). CONCLUSION Performing SLNB before NACT results in more ALND and has no benefit for patient survival. These findings support discontinuing the practice of SLNB before NACT in patients with cN0 breast cancer.
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Affiliation(s)
- Sergi Fernandez-Gonzalez
- Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, c/ Feixa Llarga s/n. Hospitalet de Llobregat, CP: 08907, Barcelona, Spain.
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Feixa Llarga, s/n, 08907, l'Hospitalet de Llobregat, Spain.
| | - Catalina Falo
- Department of Medical Oncology, Multidisciplinary Breast Cancer Unit, Institut Català d'Oncologia, Idibell, Barcelona, Spain
| | - Maria J Pla
- Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, c/ Feixa Llarga s/n. Hospitalet de Llobregat, CP: 08907, Barcelona, Spain
| | - Miriam Campos
- Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, c/ Feixa Llarga s/n. Hospitalet de Llobregat, CP: 08907, Barcelona, Spain
| | - Carlos Ortega-Exposito
- Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, c/ Feixa Llarga s/n. Hospitalet de Llobregat, CP: 08907, Barcelona, Spain
| | - Raul Ortega
- Department of Radiology, Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Maria Vicente
- Department of Radiology, Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Ana Petit
- Department of Pathology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Jan Bosch-Schips
- Department of Pathology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Maria Teresa Bajen
- Department of Nuclear Medicine, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Gabriel Reyes
- Department of Nuclear Medicine, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Evelyn Martínez
- Department of Radiation Oncology, Multidisciplinary Breast Cancer Unit, Institut Català d'Oncologia, Barcelona, Spain
| | - Javier González-Viguera
- Department of Radiation Oncology, Multidisciplinary Breast Cancer Unit, Institut Català d'Oncologia, Barcelona, Spain
| | - Judith Peñafiel
- Biostatistics Unit, Institut d'Investigació Biomèdica de Bellvitge, Hospitalet de Llobregat, Spain
| | - Agostina Stradella
- Department of Medical Oncology, Multidisciplinary Breast Cancer Unit, Institut Català d'Oncologia, Idibell, Barcelona, Spain
| | - Sonia Pernas
- Department of Medical Oncology, Multidisciplinary Breast Cancer Unit, Institut Català d'Oncologia, Idibell, Barcelona, Spain
| | - Jordi Ponce
- Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, c/ Feixa Llarga s/n. Hospitalet de Llobregat, CP: 08907, Barcelona, Spain
| | - Amparo Garcia-Tejedor
- Department of Gynecology, Multidisciplinary Breast Cancer Unit, Hospital Universitari Bellvitge, Idibell, c/ Feixa Llarga s/n. Hospitalet de Llobregat, CP: 08907, Barcelona, Spain
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Llombart-Cussac A, Prat A, Pérez-García JM, Mateos J, Pascual T, Escrivà-de-Romani S, Stradella A, Ruiz-Borrego M, de Las Heras BB, Keyaerts M, Galvan P, Brasó-Maristany F, García-Mosquera JJ, Guiot T, Gion M, Sampayo-Cordero M, Di Cosimo S, Pérez-Escuredo J, de Frutos MA, Cortés J, Gebhart G. Clinicopathological and molecular predictors of [ 18F]FDG-PET disease detection in HER2-positive early breast cancer: RESPONSE, a substudy of the randomized PHERGain trial. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06683-0. [PMID: 38587643 DOI: 10.1007/s00259-024-06683-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/10/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND The PHERGain study (NCT03161353) is assessing early metabolic responses to neoadjuvant treatment with trastuzumab-pertuzumab and chemotherapy de-escalation using a [18Fluorine]fluorodeoxyglucose-positron emission tomography ([18F]FDG-PET) and a pathological complete response-adapted strategy in HER2-positive (HER2+) early breast cancer (EBC). Herein, we present RESPONSE, a PHERGain substudy, where clinicopathological and molecular predictors of [18F]FDG-PET disease detection were evaluated. METHODS A total of 500 patients with HER2 + EBC screened in the PHERGain trial with a tumor size > 1.5 cm by magnetic resonance imaging (MRI) were included in the RESPONSE substudy. PET[-] criteria entailed the absence of ≥ 1 breast lesion with maximum standardized uptake value (SUVmax) ≥ 1.5 × SUVmean liver + 2 standard deviation. Among 75 PET[-] patients screened, 21 with SUVmax levels < 2.5 were randomly selected and matched with 21 PET[+] patients with SUVmax levels ≥ 2.5 based on patient characteristics associated with [18F]FDG-PET status. The association between baseline SUVmax and [18F]FDG-PET status ([-] or [+]) with clinicopathological characteristics was assessed. In addition, evaluation of stromal tumor-infiltrating lymphocytes (sTILs) and gene expression analysis using PAM50 and Vantage 3D™ Cancer Metabolism Panel were specifically compared in a matched cohort of excluded and enrolled patients based on the [18F]FDG-PET eligibility criteria. RESULTS Median SUVmax at baseline was 7.2 (range, 1-39.3). Among all analyzed patients, a higher SUVmax was associated with a higher tumor stage, larger tumor size, lymph node involvement, hormone receptor-negative status, higher HER2 protein expression, increased Ki67 proliferation index, and higher histological grade (p < 0.05). [18F]FDG-PET [-] criteria patients had smaller tumor size (p = 0.014) along with the absence of lymph node involvement and lower histological grade than [18F]FDG-PET [+] patients (p < 0.01). Although no difference in the levels of sTILs was found among 42 matched [18F]FDG-PET [-]/[+] criteria patients (p = 0.73), [18F]FDG-PET [-] criteria patients showed a decreased risk of recurrence (ROR) and a lower proportion of PAM50 HER2-enriched subtype than [18F]FDG-PET[+] patients (p < 0.05). Differences in the expression of genes involved in cancer metabolism were observed between [18F]FDG-PET [-] and [18F]FDG-PET[+] criteria patients. CONCLUSIONS These results highlight the clinical, biological, and metabolic heterogeneity of HER2+ breast cancer, which may facilitate the selection of HER2+ EBC patients likely to benefit from [18F]FDG-PET imaging as a tool to guide therapy. TRIAL REGISTRATION Clinicaltrials.gov; NCT03161353; registration date: May 15, 2017.
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Affiliation(s)
- Antonio Llombart-Cussac
- Hospital Arnau de Vilanova, FISABIO, Valencia, Spain.
- Universidad Católica de Valencia, Valencia, Spain.
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain.
| | - Aleix Prat
- Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors Lab., Barcelona, Spain
| | - José Manuel Pérez-García
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
- International Breast Cancer Center, Pangea Oncology, QuironSalud Group, Barcelona, Spain
| | | | - Tomás Pascual
- Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | | | | | | | | | | | - Patricia Galvan
- Translational Genomics and Targeted Therapies in Solid Tumors Lab., Barcelona, Spain
| | - Fara Brasó-Maristany
- Translational Genomics and Targeted Therapies in Solid Tumors Lab., Barcelona, Spain
| | - Juan José García-Mosquera
- Dr. Rosell Oncology Institute (IOR), Dexeus University Hospital, Pangaea Oncology, Quironsalud Group, Barcelona, Spain
| | - Thomas Guiot
- Université Libre de Bruxelles, Hôpital Universitaire de Bruxelles, Institute Jules Bordet, Brussels, Belgium
| | | | | | | | | | - Manuel Atienza de Frutos
- Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
| | - Javier Cortés
- Universidad Católica de Valencia, Valencia, Spain
- International Breast Cancer Center, Pangea Oncology, QuironSalud Group, Barcelona, Spain
- Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
| | - Geraldine Gebhart
- Université Libre de Bruxelles, Hôpital Universitaire de Bruxelles, Institute Jules Bordet, Brussels, Belgium
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5
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Pla H, Felip E, Obadia V, Pernas S, Viñas G, Margelí M, Fort-Culillas R, Del Barco S, Sabaté N, Fort E, Lezcano C, Cirauqui B, Quiroga V, Stradella A, Gil Gil M, Esteve A, Recalde S. Elderly patients with hormone receptor-positive HER2-negative metastatic breast cancer treated with CDK4/6 inhibitors in a multicentre cohort. Clin Transl Oncol 2024:10.1007/s12094-024-03399-3. [PMID: 38519708 DOI: 10.1007/s12094-024-03399-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/24/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Cyclin-dependent kinases 4/6 inhibitors (CDK 4/6i) combined with endocrine therapy have become the gold standard in hormone receptor-positive (HR +) HER2-negative (HER2-) metastatic breast cancer (MBC). However, there is a significant lack of data regarding the efficacy and safety of these treatments in elderly patients. We present the results of a real-world data (RWD) cohort stratified by age at treatment initiation (≥ 70 years compared to patients < 70 years). METHODS Clinico-pathological data of HR + HER2- MBC patients who were candidates for CDK4/6i therapy between January 2017 and December 2020 at the Institut Català d'Oncologia (Spain) were retrospectively collected. The primary goal was to assess Progression-Free Survival (PFS), Overall Survival (OS), and safety outcomes within this patient population. RESULTS A total of 274 patients with MBC who received CDK4/6i treatment were included in the study. Among them, 84 patients (30.8%) were aged ≥ 70 years, with a mean age of 75, while 190 patients (69.2%) were under the age of 70, with a mean age of 55.7 years. The most frequently observed grade 3-4 toxicity was neutropenia, with similar rates in both the < 70 group (43.9%) and the ≥ 70 group (47.9%) (p = 0.728). The median Progression-Free Survival (mPFS) for the first-line CDK4/6i treatment was 22 months (95% CI, 15.4-39.8) in the < 70 group and 20.8 months (95% CI 11.2-NR) in the ≥ 70 group (p = 0.67). Similarly, the median PFS for the second-line CDK4/6i treatment was 10.4 months (95% CI, 7.4-15.1) and 7.1 months (95% CI 4.4-21.3) (p = 0.79), respectively. Median overall survival (mOS) was not reached either for the first- and second-line treatment. CONCLUSIONS Our RWD suggests that elderly patients, when compared to those under 70, experience similar survival outcomes and exhibit comparable tolerance for CDK4/6i therapy.
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Affiliation(s)
- Helena Pla
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
- Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), Universitat de Girona, Girona, Spain
| | - Eudald Felip
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Verónica Obadia
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Sonia Pernas
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Gemma Viñas
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
- Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), Universitat de Girona, Girona, Spain
| | - Mireia Margelí
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Roser Fort-Culillas
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
- Precision Oncology Group (OncoGIR-Pro), Institut d'Investigació Biomèdica de Girona (IDIBGI), Universitat de Girona, Girona, Spain
| | - Sonia Del Barco
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
- Unitat d'Epidemiologia i Registre de càncer de Girona (UERCG), Institut d'Investigació Institut d'InvestigacióBiomèdica de Girona (IDIBGI), Universitat de Girona, Girona, Spain
| | - Nuria Sabaté
- Department of Pharmacy, Institut Català d'Oncologia (ICO)-H.U.Doctor Josep Trueta, Girona, Spain
| | - Eduard Fort
- Department of Pharmacy, Institut Català d'Oncologia (ICO)-H.U.Bellvitge, Barcelona, Spain
| | - Clara Lezcano
- Department of Pharmacy, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Beatriz Cirauqui
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Vanesa Quiroga
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain
| | - Agostina Stradella
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Miguel Gil Gil
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Anna Esteve
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H. U. Germans Trias i Pujol (HUGTiP), Badalona Applied Research Group in Oncology (B-ARGO), Badalona, Spain.
| | - Sabela Recalde
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge. Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain.
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Gion M, García-Mosquera JJ, Pérez-García JM, Peg V, Ruiz-Borrego M, Stradella A, Bermejo B, Guerrero JA, López-Montero L, Mancino M, Rodríguez-Morató J, Antonarelli G, Sampayo-Cordero M, Llombart-Cussac A, Cortés J. Correlation between trophoblast cell-surface antigen-2 (Trop-2) expression and pathological complete response in patients with HER2-positive early breast cancer treated with neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab. Breast Cancer Res Treat 2024:10.1007/s10549-024-07292-z. [PMID: 38456970 DOI: 10.1007/s10549-024-07292-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/08/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE The prognostic and predictive role of trophoblast cell-surface antigen-2 (Trop-2) overexpression in human epidermal growth factor receptor 2-positive (HER2-positive) breast cancer is currently unknown. We retrospectively analyzed Trop-2 expression and its correlation with clinicopathologic features and pathological complete response (pCR) in HER2-positive early breast cancer (EBC) patients treated with neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab in the PHERGain study. METHODS Trop-2 expression at baseline was determined in formalin-fixed, paraffin-embedded primary tumor biopsies by immunohistochemistry and was first classified into expressing (Trop-2-positive) or not-expressing (Trop-2-negative) tumors. Then, it was classified by histochemical score (H-score) according to its intensity into low (0-9), intermediate (10-49), and high (≥ 50). The association between clinicopathologic features, pCR, and Trop-2 expression was performed with Fisher's exact test. RESULTS Forty-one patients with tissue evaluable for Trop-2 expression were included, with 28 (68.3%) Trop-2-positive tumors. Overall, 17 (41.46%), 14 (34.15%), and 10 (24.40%) tumors were classified as low, intermediate, and high, respectively. Trop-2 expression was significantly associated with decreased pCR rates (50.0% vs. 92.3%; odds ratio [OR] 0.05; 95% CI, 0.002-0.360]; p adjusted = 0.01) but was not correlated with any clinicopathologic features (p ≥ 0.05). Tumors with the highest Trop-2 H-score were less likely to obtain a pCR (OR 0.03; 95% CI, 0.001-0.290, p adjusted < 0.01). This association was confirmed in univariate and multivariate regression analyses. CONCLUSION These findings suggest a potential role of Trop-2 expression as a biomarker of resistance to neoadjuvant chemotherapy plus dual HER2 blockade and may become a strategic target for future combinations in HER2-positive EBC patients.
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Affiliation(s)
- María Gion
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Juan José García-Mosquera
- Dr. Rosell Oncology Institute (IOR), Dexeus University Hospital, Quironsalud Group, Barcelona, Spain
| | - José Manuel Pérez-García
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Group, Barcelona, Spain
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA
| | - Vicente Peg
- Department of Pathology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Spanish Biomedical Research Network Centre in Oncology (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Agostina Stradella
- Institut Català d'Oncologia L'Hospitalet, Hospitalet de Llobregat, Barcelona, Spain
| | - Begoña Bermejo
- Hospital Clínico Universitario de Valencia, Biomedical Research Institute INCLIVA, Valencia, Spain
| | - José Antonio Guerrero
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA
| | - Laura López-Montero
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA
| | - Mario Mancino
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA
| | - José Rodríguez-Morató
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA
| | - Gabriele Antonarelli
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy
| | - Miguel Sampayo-Cordero
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA
| | - Antonio Llombart-Cussac
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain.
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA.
- Hospital Arnau de Vilanova, Valencia, Spain.
- Universidad Católica de Valencia, Valencia, Spain.
| | - Javier Cortés
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Group, Barcelona, Spain.
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain.
- Medica Scientia Innovation Research (MEDSIR), Ridgewood, NJ, USA.
- Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain.
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Ayala de la Peña F, Antolín Novoa S, Gavilá Gregori J, González Cortijo L, Henao Carrasco F, Martínez Martínez MT, Morales Estévez C, Stradella A, Vidal Losada MJ, Ciruelos E. Correction: SEOM-GEICAM-SOLTI clinical guidelines for early-stage breast cancer (2022). Clin Transl Oncol 2024; 26:555-556. [PMID: 37902930 PMCID: PMC10810952 DOI: 10.1007/s12094-023-03334-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Affiliation(s)
- Francisco Ayala de la Peña
- Department of Medical Oncology, Hospital G. Universitario Morales Meseguer, University of Murcia, Av. Marqués de los Vélez, s/n, 30008, Murcia, Spain.
| | - Silvia Antolín Novoa
- Department of Medical Oncology, Complexo Hospitalario Universitario, A Coruña (CHUAC), Coruña, Spain
| | | | | | | | - María Teresa Martínez Martínez
- Medical Oncology Department, INCLIVA Biomedical Research Institute, Hospital Clínico of Valencia, University of Valencia, 46010, Valencia, Spain
| | | | - Agostina Stradella
- Medical Oncology Department, Institut Català d'Oncologia. L'Hospitalet,, Barcelona, Spain
| | | | - Eva Ciruelos
- Medical Oncology Department, Breast Cancer Unit, University Hospital 12 de Octubre, Madrid, Spain and HM Hospitales, Madrid, Spain
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Ayala de la Peña F, Antolín Novoa S, Gavilá Gregori J, González Cortijo L, Henao Carrasco F, Martínez Martínez MT, Morales Estévez C, Stradella A, Vidal Losada MJ, Ciruelos E. SEOM-GEICAM-SOLTI clinical guidelines for early-stage breast cancer (2022). Clin Transl Oncol 2023; 25:2647-2664. [PMID: 37326826 PMCID: PMC10425528 DOI: 10.1007/s12094-023-03215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 06/17/2023]
Abstract
Breast cancer is the leading cause of cancer in women in Spain and its annual incidence is rapidly increasing. Thanks to the screening programs in place, nearly 90% of breast cancer cases are detected in early and potentially curable stages, despite the COVID-19 pandemic possibly having impacted these numbers (not yet quantified). In recent years, locoregional and systemic therapies are increasingly being directed by new diagnostic tools that have improved the balance between toxicity and clinical benefit. New therapeutic strategies, such as immunotherapy, targeted drugs, and antibody-drug conjugates have also improved outcomes in some patient subgroups. This clinical practice guideline is based on a systematic review of relevant studies and on the consensus of experts from GEICAM, SOLTI, and SEOM.
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Affiliation(s)
- Francisco Ayala de la Peña
- Department of Medical Oncology, Hospital G. Universitario Morales Meseguer, University of Murcia, Av. Marqués de los Vélez, s/n, 30008, Murcia, Spain.
| | - Silvia Antolín Novoa
- Department of Medical Oncology, Complexo Hospitalario Universitario, A Coruña (CHUAC), Coruña, Spain
| | | | | | | | - María Teresa Martínez Martínez
- Medical Oncology Department, INCLIVA Biomedical Research Institute, Hospital Clínico of Valencia, University of Valencia, 46010, Valencia, Spain
| | | | - Agostina Stradella
- Medical Oncology Department, Institut Català d'Oncologia. L'Hospitalet,, Barcelona, Spain
| | | | - Eva Ciruelos
- Medical Oncology Department, Breast Cancer Unit, University Hospital 12 de Octubre, Madrid, Spain and HM Hospitales, Madrid, Spain
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9
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Garcia-Tejedor A, Falo C, Fernandez-Gonzalez S, Laplana M, Gil-Gil M, Soler-Monso T, Martinez-Perez E, Calvo I, Calpelo H, Bajen MT, Benitez A, Ortega R, Petit A, Guma A, Campos M, Stradella A, Lopez-Ojeda A, Ponce J, Pla MJ, Pernas S. Management of the axilla in postmenopausal patients with cN0 hormone receptor-positive/HER2-negative breast cancer treated with neoadjuvant endocrine therapy and its prognostic impact. Breast Cancer Res Treat 2023; 199:445-456. [PMID: 37043108 DOI: 10.1007/s10549-023-06926-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE To evaluate the differences in nodal positivity if the sentinel lymph node biopsy (SLNB) is performed before or after neoadjuvant endocrine therapy (NET) in breast cancer patients, and its impact on prognosis. METHODS A retrospective cohort study was performed in a single center including 91 postmenopausal cases with clinically node-negative and hormone receptor-positive/HER2-negative (HR + /HER2-) breast cancer, treated with NET and SLNB. SLNB was done pre-NET until 2014, and post-NET thereafter. Axillary lymph node dissection (ALND) was indicated only in SLNB macrometastasis, although in selected elderly patients, it was omitted. Kaplan-Meier survival curves were estimated in relation to the status of the axilla, and the differences assessed using the log-rank test. RESULTS Between December 2006 and March 2022, SLNB was performed pre-NET in 14 cases and post-NET in 77. Both groups were similar in baseline tumor and patient characteristics. SLNB positivity was similar regardless of whether SLNB was performed before (5/14, 35.7%) or after NET (27/77, 37%), with 2/14 SLN macrometastases in the pre-NET cohort and 17/77 in the post-NET cohort. Only three patients (18.7%) with SLN macrometastasis had > 3 positive nodes following ALND. The 5-year overall survival and distant disease-free survival were 92.4% and 94.8%, respectively, with no significant differences according to SLNB status (p 0.5 and 0.8, respectively). CONCLUSION SLN positivity did not differ according to its timing (before or after NET). Therefore, NET has no effect on lymph node clearance. Furthermore, the prognosis is good regardless of the axillary involvement. Therefore, factors other than axillary involvement may affect the prognosis in these patients.
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Affiliation(s)
- Amparo Garcia-Tejedor
- Department of Gynaecology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Bellvitge Hospital, Ave. Feixa Llarga, sn Hospitalet de Llobregat, 08970, Barcelona, Spain.
| | - Catalina Falo
- Department of Medical Oncology. Multidisciplinary Breast Cancer Unit, Institut Català d'Oncología, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sergi Fernandez-Gonzalez
- Department of Gynaecology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Bellvitge Hospital, Ave. Feixa Llarga, sn Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Maria Laplana
- Department of Oncologic Radiotherapy. Multidisciplinary Breast Cancer Unit, Institut Català d'Oncología. IDIBELL, Barcelona, Spain
| | - Miguel Gil-Gil
- Department of Medical Oncology. Multidisciplinary Breast Cancer Unit, Institut Català d'Oncología, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Soler-Monso
- Department of Pathology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Evelyn Martinez-Perez
- Department of Oncologic Radiotherapy. Multidisciplinary Breast Cancer Unit, Institut Català d'Oncología. IDIBELL, Barcelona, Spain
| | - Iris Calvo
- Department of Gynaecology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Bellvitge Hospital, Ave. Feixa Llarga, sn Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Hugo Calpelo
- Department of Gynaecology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Bellvitge Hospital, Ave. Feixa Llarga, sn Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Maria-Teresa Bajen
- Department of Nuclear Medicine, Multidisciplinary Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Ana Benitez
- Department of Nuclear Medicine, Multidisciplinary Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Raul Ortega
- Department of Radiology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Anna Petit
- Department of Pathology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Anna Guma
- Department of Radiology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Miriam Campos
- Department of Gynaecology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Bellvitge Hospital, Ave. Feixa Llarga, sn Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Agostina Stradella
- Department of Medical Oncology. Multidisciplinary Breast Cancer Unit, Institut Català d'Oncología, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ana Lopez-Ojeda
- Department of Plastic Surgery. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Jordi Ponce
- Department of Gynaecology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Bellvitge Hospital, Ave. Feixa Llarga, sn Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Maria J Pla
- Department of Gynaecology. Multidisciplinary, Breast Cancer Unit. Hospital Universitari Bellvitge, Idibell, Bellvitge Hospital, Ave. Feixa Llarga, sn Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Sonia Pernas
- Department of Medical Oncology. Multidisciplinary Breast Cancer Unit, Institut Català d'Oncología, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
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Meric-Bernstam F, Sweis RF, Kasper S, Hamid O, Bhatia S, Dummer R, Stradella A, Long GV, Spreafico A, Shimizu T, Steeghs N, Luke JJ, McWhirter SM, Müller T, Nair N, Lewis N, Chen X, Bean A, Kattenhorn L, Pelletier M, Sandhu S. Combination of the STING Agonist MIW815 (ADU-S100) and PD-1 Inhibitor Spartalizumab in Advanced/Metastatic Solid Tumors or Lymphomas: An Open-Label, Multicenter, Phase Ib Study. Clin Cancer Res 2023; 29:110-121. [PMID: 36282874 DOI: 10.1158/1078-0432.ccr-22-2235] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/28/2022] [Accepted: 10/21/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE The stimulator of IFN genes (STING) is a transmembrane protein that plays a role in the immune response to tumors. Single-agent STING agonist MIW815 (ADU-S100) has demonstrated immune activation but limited antitumor activity. This phase Ib, multicenter, dose-escalation study assessed the safety and tolerability of MIW815 plus spartalizumab (PDR001), a humanized IgG4 antibody against PD-1, in 106 patients with advanced solid tumors or lymphomas. PATIENTS AND METHODS Patients were treated with weekly intratumoral injections of MIW815 (50-3,200 μg) on a 3-weeks-on/1-week-off schedule or once every 4 weeks, plus a fixed dose of spartalizumab (400 mg) intravenously every 4 weeks. RESULTS Common adverse events were pyrexia (n = 23; 22%), injection site pain (n = 21; 20%), and diarrhea (n = 12; 11%). Overall response rate was 10.4%. The MTD was not reached. Pharmacodynamic biomarker analysis demonstrated on-target activity. CONCLUSIONS The combination of MIW815 and spartalizumab was well tolerated in patients with advanced/metastatic cancers, including in patients with anti-PD-1 refractory disease. Minimal antitumor responses were seen.
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Affiliation(s)
| | | | - Stefan Kasper
- University Hospital Essen, West German Cancer Center, Essen, Germany
| | - Omid Hamid
- The Angeles Clinic and Research Institute, A Cedars Sinai Affiliate, Los Angeles, California
| | | | - Reinhard Dummer
- Universitaetsspital Zuerich Dermatology, Zurich, Switzerland
| | - Agostina Stradella
- Institut Català d'Oncologia - Hospital Duran i Reynals, L'Hospitalet de Llobregat, Catalunya, Spain
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, and Mater and Royal North Shore Hospitals, Sydney, Australia
| | | | | | | | - Jason J Luke
- The University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | - Nitya Nair
- Aduro Biotech, Inc., Berkeley, California
| | - Nancy Lewis
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Xinhui Chen
- Novartis Institutes for BioMedical Research, East Hanover, New Jersey
| | - Andrew Bean
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Lisa Kattenhorn
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Marc Pelletier
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Shahneen Sandhu
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
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11
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Velasco R, Argyriou AA, Marco C, Mariotto S, Stradella A, Hernández J, Pernas S, Ferrari S, Bruna J. Serum neurofilament levels correlate with electrodiagnostic evidence of axonal loss in paclitaxel-induced peripheral neurotoxicity. J Neurol 2023; 270:531-537. [PMID: 36094631 DOI: 10.1007/s00415-022-11377-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 08/13/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Paclitaxel-induced peripheral neurotoxicity (PIPN) typically manifests as a predominantly sensory axonopathy. Nerve conduction studies (NCS) represent the gold standard method to quantify axonal impairment in PIPN. Serum neurofilament light chain (sNfL) levels are emerging biomarkers for quantifying axonal damage in peripheral neuropathies. To date, the association between NCS abnormalities and sNfL levels during paclitaxel-based chemotherapy has not been specifically addressed. METHODS We prospectively conducted longitudinal measurement of sNfL levels in 27 chemotherapy-naïve breast cancer patients and correlated conventional NCS recordings with sNfL in 22 of them, before (T0) and after (T1) 12 cycles of weekly paclitaxel-based therapy. RESULTS PIPN was diagnosed in 24/27 patients (88%) after completion of the 12-week paclitaxel-based chemotherapy regimen. Serum NfL levels (pg/mL) were significantly higher at T1 compared to T0 (T0: 18.50 ± 12.88 vs T1: 255.80 ± 194.16; p < 0.001). The increase of sNfL levels at T1 significantly correlated with the decrease or abolishment of amplitudes recorded from the sural nerve (r = 0.620; p = 0.0035), sensory radial (r = 0.613; p = 0.005), sensory ulnar (r = 0.630; p = 0.005), and peroneal motor (r = 0.568; p = 0.024) nerves. CONCLUSION sNfL levels proportionally increase during chemotherapy administration and significantly correlate with NCS axonal abnormalities in patients with PIPN. A multimodal testing approach employing both sNfL and NCS might improve the PIPN diagnostic accuracy.
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Affiliation(s)
- R Velasco
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge. Catalan Institute of Oncology-L'Hospitalet, Carrer de La Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. .,Institute of Neurosciences and Department of Cell Biology, Physiology and Immunology, Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas, Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - A A Argyriou
- Neurology Department, Agios Andreas General Hospital of Patras, Patras, Greece
| | - C Marco
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge. Catalan Institute of Oncology-L'Hospitalet, Carrer de La Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Mariotto
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Stradella
- Department of Medical Oncology, Breast Cancer Unit, ICO L'Hospitalet (IDIBELL), Barcelona, Spain
| | - J Hernández
- Institute of Neurosciences and Department of Cell Biology, Physiology and Immunology, Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - S Pernas
- Department of Medical Oncology, Breast Cancer Unit, ICO L'Hospitalet (IDIBELL), Barcelona, Spain
| | - S Ferrari
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - J Bruna
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge. Catalan Institute of Oncology-L'Hospitalet, Carrer de La Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.,Institute of Neurosciences and Department of Cell Biology, Physiology and Immunology, Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Wick W, Gamelas Magalhaes J, Dos Santos Leite A, IdBaih A, Vieito Villar M, Tabatabai G, Stradella A, Ghiringhelli F, Burger M, Mildenberger I, Herrlinger U, Touat M, Wen P, Wick A, Toussaint H, Gouttefangeas C, Bonny C, Paillarse JM, Reardon D. 185P Interim analysis of the EOGBM1-18 study: Strong immune response to therapeutic vaccination with EO2401 microbiome derived therapeutic vaccine + nivolumab. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Wick W, IdBaih A, Vieito Villar M, Tabatabai G, Stradella A, Ghiringhelli F, Burger M, Mildenberger I, Herrlinger U, Touat M, Wen P, Wick A, Gouttefangeas C, Maia A, Bonny C, Paillarse JM, Fagerberg J, Reardon D. 170P EO2401 microbiome derived therapeutic vaccine + nivolumab +/- bevacizumab, in neoadjuvant, adjuvant and non-surgery linked treatment of recurrent glioblastoma: Phase I-II EOGBM1-18/ROSALIE study. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Reardon DA, Idbaih A, Vieito M, Tabatabai G, Stradella A, Ghiringhelli F, Burger MC, Mildenberger I, González M, Hervieu A, Martin MG, Renovanz M, Touat M, Wen PY, Wick A, Gouttefangeas C, Maia A, Bonny C, Fagerberg J, Wick W. CTIM-17. EO2401 THERAPEUTIC VACCINE FOR PATIENTS WITH RECURRENT GLIOBLASTOMA: PHASE 1/2 ROSALIE STUDY (NCT04116658). Neuro Oncol 2022. [PMCID: PMC9660704 DOI: 10.1093/neuonc/noac209.249] [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] Open
Abstract
Abstract
EO2401 includes microbial-derived, synthetically produced HLA-A2 restricted peptides with molecular mimicry to antigens (IL13Rα2, BIRC5 and FOXM1) upregulated in glioblastoma, and the CD4 helper peptide UCP2. Patients with glioblastoma at first progression received EO2401 (300µg/peptide, q2weeks x4 then q4weeks), EO2401+nivolumab (3mg/kg q2weeks), or E02401+nivolumab+bevacizumab (10mg/kg q2weeks). Cohort-1 included EO2401x2 then EO2401+nivolumab. EO2401+nivolumab was evaluated in Cohort-2a, as adjuvant treatment in Cohort-2b, and as neoadjuvant/adjuvant treatment in Cohort-2c. Cohort-3 assessed EO2401+nivolumab+bevacizumab. Part 1 included 40 patients (Cohort-1/3, Cohort-2a/23, Cohort-2b/3, Cohort-3/11). Part 2 allowed low-dose-bevacizumab (5mg/kg q2weeks) for symptomatic edema and enrolled 38 patients (Cohort-1/18, Cohort-2a/15, Cohort-2b/3; and recruiting Cohort-2c/2 target 6, Cohort-3/0 target 15).Safety assessment of part 1 showed EO2401+nivolumab+/-bevacizumab to be well tolerated with EO2401 associated toxicity limited to local administration site reactions (48%; all grade 1-2). The nivolumab-/bevacizumab-toxicity was consistent with historical single-agent data. Strong CD8 T cell ELISPOT responses against the 3 vaccine peptides and cross-reactivity against targeted antigens was demonstrated in the majority of evaluable patients. Immune response was confirmed with tetramer staining of specific CD8 either ex vivo or after in vitro stimulation. For part 1, median progression-free survival (mPFS), and median survival (mOS) for EO2401+nivolumab (Cohorts-1/2/2b, n=29 median follow-up [mFU] 14.0 months) were 1.8 and 10.6 months. Patients on EO2401+nivolumab+bevacizumab (n = 11 mFU 9.6 m) had mPFS 5.5 months and 9 patients alive 7-12.4 months. Objective Response Rate/Disease Control Rate for EO2401+nivolumab and EO2401+nivolumab+bevacizumab was 10%/34% and 55%/82%.Median treatment duration for Cohort-2a part 1 was 6.1 weeks (1/23 on treatment), while it was 10.0 weeks (8/15 on treatment) for Cohort-2a part 2. Overall, in part 2, 36% received low-dose-bevacizumab.EO2401 generated strong immune responses and was well tolerated. Addition of standard bevacizumab to EO2401+nivolumab improved PFS and tumor response. Symptom driven low-dose-bevacizumab supported longer treatment durations. Outcome of study part 2 will be presented.
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Affiliation(s)
| | - Ahmed Idbaih
- Sorbonne Université, AP-HP, ICM, Hôpital Universitaire La Pitié-Salpêtrière , Paris , France
| | - Maria Vieito
- Vall d’Hebron Institute of Oncology (VHIO) , Barcelona , Spain
| | - Ghazaleh Tabatabai
- Department of Neurology & Interdisciplinary Neuro-Oncology, University Hospital Tübingen, Hertie Institute for Clinical Brain Research , Tübingen , Germany
| | - Agostina Stradella
- Institut Catala D'Oncologia - Hospital Duran i Reynals , Barcelona , Spain
| | | | - Michael C Burger
- Universitätsklinikum Frankfurt Goethe-Universität , Frankfurt , Germany
| | - Iris Mildenberger
- Department of Neurology, Medical Faculty Mannheim, University of Heidelberg , Mannheim , Germany
| | | | | | - Marta Gil Martin
- Institut Catala D'Oncologia - Hospital Duran i Reynals , Barcelona , Spain
| | - Mirjam Renovanz
- Department of Neurology & Interdisciplinary Neuro-Oncology, University Hospital Tübingen, Hertie Institute for Clinical Brain Research , Tübingen , Germany
| | - Mehdi Touat
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix , Service de Neurologie 2-Mazarin, F-75013, Paris , France
| | | | - Antje Wick
- Department of Neurology, University Hospital Heidelberg, and Clinical Cooperation Unit Neuro-Oncology, German Consortium for Translational Cancer Research (DKTK) and German Cancer Research Center (DKFZ). , Heidelberg , Germany
| | | | - Ana Maia
- Department of Immunology, Eberhard-Karls-University , Tübingen , Germany
| | | | | | - Wolfgang Wick
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg , Baden-Wurttemberg , Germany
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Idbaih A, Vieito M, Tabatabai G, Stradella A, Ghiringhelli F, Burger M, Mildenberger I, Fagerberg J, Reardon D, Wick W. PL02.1.A EO2401, a novel microbiome-derived therapeutic vaccine for patients with recurrent glioblastoma: ROSALIE study. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
EO2401 (EO) was designed to activate existing commensal memory T-cells cross-reacting with tumor associated antigens (TAAs). EO includes microbial-derived, synthetically produced peptides corresponding to HLA-A2 restricted epitopes with molecular mimicry to three TAAs upregulated in glioblastoma (GB), IL13Rα2, BIRC5 and FOXM1, with the CD4 helper peptide UCP2 and the adjuvant Montanide. Pre-clinically EO generated strong immune responses and cross-reactive CD8 cells recognizing the targeted TAAs.
Methods
This ongoing Ph 1/2 trial (NCT04116658) investigates the safety and tolerability (primary) of EO (300 µg/peptide, SC Q2W X 4, then Q4W), EO with nivolumab (3 mg/kg Q2W; EN), and EN with bevacizumab (10 mg/kg Q2W; ENB) among four Cohorts (Cs) of pts with GB at first progression/recurrence after radiotherapy/temozolomide. Treatment was delivered until progression, or 24 months. After the Ph 1 of EO followed by EN (C1), C2 investigated EN without (C2a) or with (C2b) surgery while C3 investigated ENB (population as C2a).
Results
Among 40 treated pts (C1 n=3, C2a n=23, C2b n=3, C3 n=11), median age was 60 years, 53% were male, 40% had KPS 90-100%, 35% had O6-methylguanine DNA-methyltransferase promotor hypermethylated tumors, and 5% isocitrate dehydrogenase 1 mutated tumors. All evaluable pts demonstrated strong CD8 T-cell ELISPOT responses against the 3 vaccine peptides; response was shown with tetramer staining of specific CD8 in 24/25 investigated pts after in vitro stimulation and in 19/20 pts directly ex vivo. Cross-reactivity against targeted TAAs was confirmed in 20/21 pts. Majority of response were detected by week 4 after 1st dose and as early as 2 weeks in some pts. EO, EN, and ENB were well tolerated (max exposure EN 86 wks, ENB 47 wks) with EO associated toxicity limited to local administration site reactions (48%; all grade 1-2). The frequency and severity of nivolumab- or bevacizumab-associated AEs was consistent with historical single-agent profiles. With a median follow-up of 13.6 months, median progression-free survival (mPFS), and median survival for EN (C1+C2a+C2b) were 1.8 months (2 ongoing at 7.3, and 18.5 months), and 11.0 months (survival at 12 months 42%), respectively. With a median follow-up of 7.3 months (range, 3.0-10.5), pts on ENB (C3) have mPFS and survival at 6 months of 5.5 months (3 ongoing at 5.6, 7.3 and 9.1 months), and 82% (9/11 alive), respectively. ORR/DCR (ORR+SD) for EN and ENB were 10%/34% and 55%/82%, respectively.
Conclusion
EO2401 generated strong systemic immune responses and was well tolerated in combination with nivolumab ± bevacizumab. Preliminary ORR/DCR and mPFS for ENB, and survival for EN seem encouraging. Updated results from the current 40 patients and results from additional 35 patients who already started treatment with EN with the option for low-dose bevacizumab edema treatment at neurological symptoms will be presented.
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Affiliation(s)
- A Idbaih
- Sorbonne Université, AP-HP, ICM, Hôpital Universitaire La Pitié-Salpêtrière , Paris , France
| | - M Vieito
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO) , Barcelona , Spain
| | | | - A Stradella
- Institut Catala d'Oncologia Hospital Duran i Reynals, , Barcelona , Spain
| | | | - M Burger
- Universitätsklinikum Frankfurt Goethe-Universität , Frankfurt , Germany
| | | | | | - D Reardon
- Dana-Farber Cancer Institute and Harvard Medical School , Boston, MA , United States
| | - W Wick
- Universitätsklinikum Heidelberg and German Cancer Research Center , Heidelberg , Germany
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Velasco R, Marco C, Mariotto S, Stradella A, Hernández J, Argyriou AA, Ferrari S, Bruna J. P14.02.A Serum neurofilaments correlate with axonal loss in paclitaxel-induced peripheral neurotoxicity. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.287] [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: 11/13/2022] Open
Abstract
Abstract
Background
Paclitaxel-induced peripheral neuropathy (PIPN) is a dose-limiting axonal polyneuropathy. Nerve conduction studies (NCS) are unique for the assessment of axonal impairment in PIPN. Neurofilaments (NFs), constituent of the neuronal cytoskeleton, are emerging as axonal damage biomarker. To date, the association between changes in NCS and NfL quantification across paclitaxel treatment in breast cancer patients has not been specifically addressed.
MATERIAL AND METHODS: Prospective longitudinal measurement of sNfL levels and NCS in 27 chemotherapy-naïve breast cancer patients before (V0) and after completion (V1) of 12 cycles of weekly paclitaxel-based therapy.
Results
Serum NfL levels (in pg/mL) increased over the course of treatment in the whole of patients (T0: 18,509 +/- 12,886 vs T1:255,805 +/- 194,165, p<0.001). The increase in sNfL levels at T1 showed a significant moderate correlation with the percentage of decrease in the amplitude of the sural (ρ = 0.6205 (p=0.0035), radial (r=0.6134, p=0.005)), ulnar (ρ = 0.6298 (p=0.005)) and peroneal motor (ρ = 0.5676, p=0.024)) nerve in NCS across treatment.
Conclusion
sNfL levels increase proportionally to the degree of paclitaxel-induced neuroaxonal damage, revealing being a promising blood biomarker able to detect the severity of large nerve fiber degeneration and, therefore, improving the diagnostic accuracy in PIPN.
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Affiliation(s)
- R Velasco
- Neuro-Oncology Unit, Institut Català d′Oncologia-IDIBELL, L′Hospitalet , Barcelona , Spain
- Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Barcelona, Spain , Barcelona , Spain
| | - C Marco
- Neuro-Oncology Unit, Institut Català d′Oncologia-IDIBELL, L′Hospitalet , Barcelona , Spain
| | - S Mariotto
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona , Italy
| | - A Stradella
- Breast Cancer Unit, Institut Català d′Oncologia-IDIBELL, L′Hospitalet , Barcelona , Spain
| | - J Hernández
- Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Barcelona, Spain , Barcelona , Spain
| | - A A Argyriou
- Department of Neurology, "Saint Andrew's" State General Hospital of Patras, Patras, Greece. , Patras , Greece
| | - S Ferrari
- Department of Neuroscience, Biomedicine and Movement Sciences , Verona , Italy
| | - J Bruna
- Neuro-Oncology Unit, Institut Català d′Oncologia-IDIBELL, L′Hospitalet , Barcelona , Spain
- Department of Cell Biology, Physiology and Immunology, Institute of Neurosciences, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Barcelona, Spain , Barcelona , Spain
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Pla H, Recalde Penabad S, Vinas Villaro G, Margeli Vila M, Obadia Gil V, Cirauqui Cirauqui B, Del Barco Berron S, Gil M, Quiroga Garcia V, Teruel-Garcia I, Pernas Simon S, Stradella A, Esteve Gomez A, Felip E. 268P Results from a real-world study of patients (pts) with hormone-receptor (HR)-positive HER2-negative metastatic breast cancer (MBC) treated with CDK4/6 inhibitors (CDK 4/6i) in three institutions. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.307] [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: 11/17/2022] Open
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Wick W, Idbaih A, Tabatabai G, Vieito M, Stradella A, Ghiringhelli F, Burger MC, Mildenberger I, Herrlinger U, Renovanz M, Touat M, Wen PY, Wick A, Bonny C, Fagerberg J, Gouttefangeas C, Maia A, Reardon DA. EO2401, a novel microbiome-derived therapeutic vaccine for patients with recurrent glioblastoma: ROSALIE study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2034 Background: EO2401 (EO) was designed to activate existing commensal memory T-cells cross-reacting with tumor associated antigens (TAAs). EO includes microbial-derived, synthetically produced peptides corresponding to HLA-A2 restricted epitopes with molecular mimicry to three TAAs upregulated in glioblastoma (GB), IL13Rα2, BIRC5 and FOXM1, with the CD4 helper peptide UCP2 and the adjuvant Montanide. Pre-clinically EO generates strong immune responses and cross-reactive CD8 cells recognizing the TAAs. Methods: This ongoing Ph 1/2 trial (NCT04116658) investigates EO (SC q2 wks X 4 then q4 wks), EO with nivolumab (3 mg/kg q2 wks; EN), and EN with bevacizumab (10 mg/kg q2 wks; ENB) among four Cohorts (Cs) of pts with GB at first progression after radiotherapy/temozolomide. After the Ph 1 of EO followed by EN (C1), C2 investigated EN without (C2a) or with (C2b) surgery while C3 investigated ENB (population as C2a). Results: Among 40 treated pts (C1 n = 3, C2a n = 23, C2b n = 3, C3 n = 11), median age was 60, 53% male, 40% had KPS 90-100% and 35% had O6-methylguanine DNA-methyltransferase promotor hypermethylated tumors. All evaluable pts demonstrated strong CD8 T-cell ELISPOT responses against the 3 vaccine peptides, with tetramer staining of specific CD8 detected in 24/25 investigated pts after in vitro stimulation and in 19/20 pts directly ex vivo. Cross-reactivity against targeted TAAs was confirmed in 20/21 pts. Majority of response were detected by week 4 after 1st dose and as early as 2 weeks for some pts. EO, EN, and ENB were well tolerated (max exposure EN 68 wks, ENB 30 wks) with EO associated toxicity limited to local administration site reactions (48%; grade 1-2). The frequency and severity of nivolumab- or bevacizumab-associated AEs was consistent with historical monocompound experience. With a median follow-up of 9.3 months (range, 2.8-15.6), median progression-free survival (PFS), survival at 6 months (OS-6) and at 12 months for EN (C1+C2a+C2b) were 1.8 months (3 ongoing at 5.9, 7.1, and 14.7 months), 85%, and 50.1% (19/29 alive), respectively. With a median follow-up of 3.7 months (range, 2.2-7.2), pts on ENB (C3) have median PFS and OS-6 of 5.5 months (7 ongoing), and 80% (10/11 alive), respectively. ORR for EN and ENB were 10% and 36%, respectively (5 of 7 ongoing). In C2a, 12/23 pts stopped treatment due to neurological symptoms and PD on first MRI (median 5 wks, range 2-8). In C3 (ENB), only 1/11 pts stopped early due to PD. Conclusions: EO2401 generated strong systemic immune responses and was well tolerated in combination with nivolumab +/- bevacizumab. The addition of bevacizumab to EN improved PFS while survival across treatment cohorts is pending ongoing follow-up. To prolong EN exposure that is likely required for therapeutic activity in recurrent GB, the trial has been expanded with additional pts to evaluate low-dose bevacizumab (5 mg/kg q2 wks up to x 6) for early progressive neurological symptoms. Clinical trial information: NCT04116658.
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Affiliation(s)
- Wolfgang Wick
- Universitätsklinikum Heidelberg and German Cancer Research Center, Heidelberg, Germany
| | - Ahmed Idbaih
- Sorbonne Université, AP-HP, ICM, Hôpital Universitaire La Pitié-Salpêtrière, Paris, France
| | | | - María Vieito
- Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Michael C. Burger
- Universitätsklinikum Frankfurt Goethe-Universität, Frankfurt, Germany
| | | | | | | | - Mehdi Touat
- Hôpital Universitaire La Pitié-Salpêtrière, Paris, France
| | | | - Antje Wick
- Universitätsklinikum, Heidelberg, Germany
| | | | | | | | - Ana Maia
- Department of Immunology, Eberhard-Karls-University, Tübingen, Germany
| | - David A. Reardon
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
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Soto JJ, Erasun Lecuona C, Llop Serna S, Mulet Margalef N, Stradella A, Villanueva R, Calvo Campos M, Jove Casulleras M, Cuadra Amor C, Salazar Soler R, Gil-Martin M, Martin-Liberal J, Oliva M. Outcomes of patients (pts) treated with novel immunotherapy (IT) agents in phase 1 clinical trials (Ph1-CT) at early lines for advanced disease. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2581] [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
2581 Background: The overall survival (OS) benefit observed with immune checkpoint inhibitors led to their approval in many tumor types. Given the large number of IT compounds in early clinical development, many pts are offered IT within Ph1-CT even before having exhausted standard of care (SOC) therapies. We assessed outcomes of pts receiving novel IT treatments within Ph1-CT at the Phase 1 Unit of Catalan Institute of Oncology (ICO), Barcelona, Spain. Methods: We retrospectively reviewed a correlative series of pts with advanced/metastatic solid tumors treated with IT within Ph1-CT at ICO from January 2018 to June 2021. Primary endpoint was to assess clinical outcomes measured by median progression-free survival (mPFS) and median OS (mOS) according to number of prior lines (PL) for recurrent/metastatic disease, grade 3-4 toxicity (G3-4 Tox) and age. Data on prior IT (yes vs no) and availability of alternative SOC were evaluated. Overall response rate (ORR) was assessed according to RECIST 1.1. Clinical benefit rate (CBR) was defined as complete/partial response + stable disease for ≥6 months (m). PFS/OS were calculated by Kaplan-Meier method. Log-rank test was used for comparisons. Median PFS of alternative SOC according to historical data was recorded by tumor type and line of treatment. Results: A total of 104 pts received IT within Ph1-CT: IT monotherapy = 39 (37.5%), IT combinations = 65 (62.5%) (IT+IT = 59 [90.8%], IT+targeted therapy = 6 [9.2%]). Median age was 54 y (42-77), 62.5% were men and all had ECOG 0-1. Four most frequent cancers were urothelial (19.2%), colorectal (15.3%), head & neck (12.5%) and glioblastoma (11.5%). Number of PL: 0 = 20 (19.2%) pts, 1 = 37 (35.6%) pts, ≥2 = 47 (45.2%) pts. Nine (8.6%) pts had received prior IT. G3-4 Tox rate for the overall population was 19.2% and for pts who had received prior IT was 33%. ORR was 11.5%; CBR was 24%. Overall mPFS and mOS were 2.7m and 8.6m, respectively. Pts with less PL had greater mPFS and mOS (p < 0.05) (Table). Pts with available alternative SOC had lower mPFS but similar mOS compared to historical SOC (2.6m vs 4.8m, 11.4m vs 11.8m, respectively). G3-4 Tox (yes vs no) and age ( < 70 vs ≥70) did not significantly impact on mOS or mPFS (p = 0.18 and p = 0.83, respectively). At end of Ph1-CT treatment, 47 (45.2%) pts worsened their ECOG status, 15 (14.4%) pts were enrolled in a subsequent trial and 22 (21.1%) pts received SOC. Conclusions: In our cohort of pts treated with novel IT within Ph1-CT, overall clinical outcomes were modest in terms of mPFS, mOS, and CBR. However, pts with less pre-treated tumors seem to achieve higher survival benefit from early treatment with IT within Ph1-CT, although this benefit remains unclear in pts with alternative SOC. [Table: see text]
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Affiliation(s)
- Juan José Soto
- Medical Oncology Department-Phase 1 Functional Unit
- Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Carlos Erasun Lecuona
- Medical Oncology Department-Phase 1 Functional Unit
- Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Sandra Llop Serna
- Medical Oncology Department-Phase 1 Functional Unit
- Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Nuria Mulet Margalef
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Agostina Stradella
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Rafael Villanueva
- Medical Oncology Department-Phase 1 Functional Unit
- Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Mariona Calvo Campos
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Maria Jove Casulleras
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Carmen Cuadra Amor
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Ramon Salazar Soler
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Marta Gil-Martin
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Juan Martin-Liberal
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Marc Oliva
- Medical Oncology Department-Phase 1 Functional Unit
- Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, ON, Spain
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Erasun Lecuona C, Soto JJ, Llop Serna S, Mulet Margalef N, Stradella A, Villanueva R, Calvo Campos M, Jove Casulleras M, Cuadra Amor C, Salazar Soler R, Gil-Martin M, Oliva M, Martin-Liberal J. Analysis of phase I clinical trials (Ph1-CT) new enrollment patterns in the immuno-oncology era. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e14549] [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
e14549 Background: Immuno-Oncology (IO) has revolutionized anticancer therapeutics and changed the early drug development paradigm. Positive results and limited access to IO drugs in some countries have led to increased enrollment in IO Ph1-CT at an earlier timepoint in patients (pts) disease journey. We evaluated the impact of IO era on enrollment patterns in Ph1-CT. Methods: We retrospectively reviewed pts with recurrent/metastatic solid tumors enrolled in Ph1-CT from January 2018 to June 2021 at the Phase 1 Unit of Catalan Institute of Oncology (ICO), Barcelona, Spain. The primary goal was to assess Ph1-CT enrollment patterns, including use of molecular pre-screening/personalized drug matching, and the availability of alternative standard of care (SOC). Overall response rate (ORR) was assessed according to RECIST 1.1. Clinical benefit rate (CBR) was defined as complete/partial response+stable disease for ≥6 months. Median progression-free survival (mPFS) and overall survival (mOS) using Kaplan-Meier method were provided. Results: A total of 175 pts were enrolled in Ph1-CT. Median age was 54 years (range 43-75), Male:Female = 99:76, 99% had ECOG 0-1. The most prevalent tumors were: 32 (18%) breast, 31 (18%) colorectal, 25 (14%) urogenital and 23 (13%) glioblastoma multiforme. One hundred forty-six (83%) pts were enrolled in Ph1-CT with IO (alone or in combination) and 29 (17%) pts with targeted therapy (TT). Molecular pre-screening tests were required in 24 (14%) pts (22 pts IO vs 2 pts TT trial). Eleven (42%) pts were pre-screening failures. Screening failure (SF) rate was 19%, the main reason being clinical worsening for 7 (4%) pts. Thirty-three (19%) pts had an alternative SOC treatment available at time of enrollment. One hundred two (58%) pts had received ≤1 prior lines and 26 (89%) were IO-naïve. Finally, 129 (74%) out of 175 pts enrolled were treated within Ph1-CT. Out of 129 treated pts, ORR was achieved in 18 (14%) pts (3% complete response) and 44 (34%) had stable disease. CBR was observed in 36 (28%) pts. mPFS was 2.8 months and mOS was 10.9 months. Toxicity grade 3-4 occurred in 25 (19%) of pts and 6 (5%) pts had to interrupt treatment. Seventy-one (55%) pts received subsequent therapies: 22 (17%) in Ph1-CT; 49 (38%) SOC. Eleven (9%) pts received IO as subsequent therapy. Decline in ECOG status (baseline vs end of treatment) occurred in 65 (50%) pts. Conclusions: In our cohort of Ph1CT pts, there has been an increasing number of pts enrolled in IO trials compared to TT. Most pts received treatment within Ph1-CT at an earlier timepoint in the course of their disease (1st or 2nd lines). Our results suggest a clear impact of the IO era on the trends of Ph1-CT availability and enrollment patterns.
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Affiliation(s)
- Carlos Erasun Lecuona
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Juan José Soto
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Sandra Llop Serna
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Nuria Mulet Margalef
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Agostina Stradella
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Rafael Villanueva
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Mariona Calvo Campos
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Maria Jove Casulleras
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Carmen Cuadra Amor
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Ramon Salazar Soler
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Marta Gil-Martin
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
| | - Marc Oliva
- Phase 1/Drug Development Program, Catalan Institute of Oncology (ICO) L’Hospitalet, L´Hospitalet De Llobregat, Barcelona, Spain
| | - Juan Martin-Liberal
- Medical Oncology Department, Phase 1 Functional Unit, Catalan Institute of Oncology (ICO), L´Hospitalet De Llobregat, Barcelona, Spain
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21
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Karteri S, Bruna J, Argyriou AA, Mariotto S, Velasco R, Alemany M, Kalofonou F, Alberti P, Dinoto A, Velissaris D, Stradella A, Cavaletti G, Ferrari S, Kalofonos HP. Prospectively Assessing Serum Neurofilament Light Chain Levels As A Biomarker Of Paclitaxel-Induced Peripheral Neurotoxicity In Breast Cancer Patients. J Peripher Nerv Syst 2022; 27:166-174. [PMID: 35384143 DOI: 10.1111/jns.12493] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/24/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
Our aim was to assess the significance of measuring serum neurofilament light chain (sNfL) levels as biomarker of paclitaxel-induced peripheral neurotoxicity (PIPN). We longitudinally measured sNfL in breast cancer patients, scheduled to receive the 12-weekly paclitaxel-based regimen. Patients were clinically examined by means of the Total Neuropathy Score-clinical version (TNSc), while sNfL were quantified, using the highly-sensitive Simoa technique, before starting chemotherapy (Baseline), after 2 (week-2) and 3 (week-3) weekly courses, and at the end of chemotherapy (week-12). Among 59 included patients (mean age: 53.1±11.5 years), 33 (56%) developed grade 0-1 and 26 (44%) grade 2-3 PIPN at week-12. A significant longitudinal increase of sNfL levels from baseline to week-12 was determined, whereas patients wth TNSc grade 2-3 PIPN had significantly increased sNfL levels at week-12, compared to those with grade 0-1. ROC analysis defined a value of NfL of >85 pg/mL at week-3 as the best discriminative determination to predict the development of grade 2-3 PIPN at week-12 (sensitivity 46.2%, specificity 84.8%). The logistic binary regression analysis revealed that age >50 years and the cutoff of >85 pg/mL of sNfL levels at week-3 independently predicted the development of grade 2-3 PIPN at week-12 with a sensitivity of 46%, a specificity of 91%, and a positive and negative predictive values of 75% and 67%, respectively. sNfL levels seem to be a valuable biomarker of neuro-axonal injury in PIPN. Early increase of this biomarker after a 3 weekly chemotherapy course can be a predictive marker of final PIPN severity. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sofia Karteri
- Department of Medicine-Division of Oncology, University Hospital of Patras, Greece
| | - Jordi Bruna
- Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L'Hospitalet (IDIBELL), Barcelona, Spain
| | - Andreas A Argyriou
- Neurology Department, Saint Andrew's General Hospital of Patras, Patras, Greece
| | - Sara Mariotto
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Roser Velasco
- Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L'Hospitalet (IDIBELL), Barcelona, Spain
| | - Montse Alemany
- Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L'Hospitalet (IDIBELL), Barcelona, Spain
| | - Foteini Kalofonou
- Department of Oncology, Imperial NHS Healthcare Trust, Charing Cross Hospital, London, UK
| | - Paola Alberti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy and NEUROMI (Milan Center for Neuroscience), Milan, Italy
| | - Alessandro Dinoto
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Agostina Stradella
- Department of Medical Oncology - Breast Cancer Unit, ICO L'Hospitalet (IDIBELL), Barcelona, Spain
| | - Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy and NEUROMI (Milan Center for Neuroscience), Milan, Italy
| | - Sergio Ferrari
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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22
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Falo C, Azcarate J, Petit A, Vethencourt A, Gonzalez SF, Garcia-Tejedor A, Vazquez S, Perez H, Laplana M, Taco C, Guerra E, Guma A, Ortega R, Stradella A, Recalde S, Fernandez-Ortega A, Villanueva R, Perez FJ, Pla MJ, Campos M, Perez D, Fernandez-Montoliu E, Obadia V, Cejuela M, Gil-Gil M, Pernas S, Varela M, Soler-Monzo T. Abstract P1-08-26: Morphologic characterization of tumor-infiltrating lymphocytes and its relation with pathological response in a series of breast cancer patients treated with primary chemotherapy. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p1-08-26] [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
Introduction: Tumor-Infiltrating Lymphocytes (TILS) is a well-known predictor of response to primary chemotherapy1,2 and a prognostic factor for improved survival in different breast cancer subtypes3. We present data on the association of the level of TILs and morphologic characteristics of such infiltrate with pCR. Material and methods: A series of 477 breast cancer patients (479 tumors) treated with primary chemotherapy at Catalan Institut of Oncolgy - H.U. Bellvitge between January 2009 and December 2016. Chemotherapy consisted on anthracyclines and taxanes (plus trastuzumab if Her-2 positive disease). Levels of percentage of TILs using hematoxylin-eosin-stained sections of diagnostic core-needle biopsy were evaluated according to international guidelines in a prospectively defined retrospective analysis. Characterization of TILS consisted on identification of plasma cells, intraepithelial infiltrate vs stromal infiltrate and homogeneous vs heterogeneous infiltrate. A sub-classification using levels of TILS and heterogeneity was done for statistical purposes. Levels of TILS and their morphological characteristics were examined for their associations with pCR adjusted for predictive clinic-pathological factors, by univariate and multivariate logistic regression, statistical significance set at 0.05. A ROC curve was performed to look for a cut-point of TILs to predict PCR. Results: The mean value of TILs was 23.79% (SD, 24%). TILs were significantly higher in ductal carcinomas (39.1% vs 0%, p=0.007), grade 3 (55.2 vs 17.7%p<0.001), ki 67 >30 (48.8% vs 24.5%, p<0.001), HER2 (56.6%) and triple negative tumors (TNBC)(56.6%) vs luminal (20%), p<0.001). The level of TILS was set in 20% to predict pCR by a ROC curve (S=62.3% E=71%). Characterization of TILs found plasma cells in 41.1% of the samples, intraepithelial infiltrate in 11.2% and homogeneous infiltrate in 60.1%. Homogeneously high infiltrate was found in 20% of the samples. In the univariate analysis pCR was higher in samples with TILs > 20% (15.2% vs 41.5%, OR: 3.96 [95%CI, 2.57-6.10]; P < 0.001); plasma cells (OR 6.61 [95%CI, 1.51-28.8]; P=0.01), intraepithelial TILS (OR: 10.34 [95%CI, 2.22-48.01]; P =0.003), homogeneous high infiltrate (OR: 13.6 [95%CI, 3.04-60.77]; P =0.001). In luminal tumors, TILs over 20% predicted pCR (OR 12.3 [95%CI, 4.0-37.7]; P < 0.001) as well as in TNBC (OR 4.32 [95%CI, 1.77-10.53]; P=0 .001) but not in those cases with HER2 positive tumors (luminalB HER2 + HER2) (OR 1.65 [95%CI, 0.88-3.07]; P=0.118). In the multivariate analyses, levels of TILs > 20% were associated with higher pCR rates (adjusted odds ratio, 2.44 [95%CI, 1.48-4.01]; P < .001). Conclusions: The presence of TILs over 20% at diagnosis is an independent, positive, predictive marker of pCR in early breast cancer treated with neoadjuvant chemotherapy. Interestingly, the predictive information added by TILs >20% was higher in luminal and triple negative tumors compared to HER2 positive cases. Careful morphological characterization of TILS may add valuable predictive information and can be done in current pathologic laboratories with a well-trained breast cancer pathologist. References: 1.J Clin Oncol 2009; 28:105-113. doi: 10.1200/JCO.2009.23.73702.JAMA Oncol. 2015;1(4):448-454. doi:10.1001/jamaoncol.2015.08303.Lancet Oncol 2018: 19: 40-50 http://dx.doi.org/10.1016/S1470-2045(17)30904-X.
N%Age years (mean, sd)Grade*I326.7II19540.7III15152.6Ki 67≤3020442.6>3027557.4Molecular subtype*Luminal A469.6Luminal B HER2 -14329.9Luminal B HER2+9219.2HER+ enriched7615.9Triple negative12225.5Pathologic responseNon-pCR35874.7pCR12125.3
Citation Format: Catalina Falo, Juan Azcarate, Ana Petit, Andrea Vethencourt, Sergi Fernandez Gonzalez, Amparo Garcia-Tejedor, Silvia Vazquez, Hector Perez, Maria Laplana, Charo Taco, Esther Guerra, Anna Guma, Raul Ortega, Agostina Stradella, Sabela Recalde, Adela Fernandez-Ortega, Rafael Villanueva, F Javier Perez, M Jesus Pla, Miriam Campos, Diana Perez, Eulalia Fernandez-Montoliu, Veronica Obadia, Monica Cejuela, Miguel Gil-Gil, Sonia Pernas, Mar Varela, Teresa Soler-Monzo. Morphologic characterization of tumor-infiltrating lymphocytes and its relation with pathological response in a series of breast cancer patients treated with primary chemotherapy [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-08-26.
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Affiliation(s)
| | - Juan Azcarate
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | - Ana Petit
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | | | | | | | | | | | | | - Charo Taco
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | - Esther Guerra
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | - Anna Guma
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | - Raul Ortega
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | | | | | | | | | | | - M Jesus Pla
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | - Miriam Campos
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | - Diana Perez
- Hospital Universitari Bellvitge. Breast Cancer Unit, Barcelona, Spain
| | | | | | | | | | | | - Mar Varela
- Institut Catala d'Oncologia, Barcelona, Spain
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Cejuela M, Stradella A, Petit A, Gargallo P, Bosch J, Carbonell P, Recalde S, Vethencourt A, Fernández A, Falo C, Gil-Gil M, Vazquez S, Villanueva R, Soler T, Calabria I, Pernas S. Abstract P5-07-06: Genomic characterization and tumor evolution in matched(primary-relapse)samplesof patients with METAPLASTIC breast cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p5-07-06] [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
Introduction and objectives. Metaplastic breast cancer is an heterogenous and infrequent disease (0.5-2%). Histologically, it is defined by differentiation of neoplastic epithelium into squamous or mesenchymal-like elements. Although they are mainly triple negative tumors, they present a more aggressive course with less response to chemotherapy and worse prognosis. The aim of our study was to characterize the molecular profile and tumor evolution in matched (primary-relapse) samples of patients (pts) with metaplastic breast cancer. Material and Methods. Genomic profiling of tumor biopsies from different time points in patients with early-stage metaplastic breast cancer who had disease recurrence/progression, and were treated at our institution between 2010 and 2020. Tumor samples were analyzed by DNA- Next Generation Sequencing (NGS; Illumina 2x75bp) using the ActionOncoKitDX panel (Imegen-Health in Code group). It allowed the study of point mutations in 50 genes, CNVs, fusion genes among 8 genes and pharmacogenetic SNPs associated with treatment efficacy or toxicity. It also determined MSI through 110 markers. The results were classified following the recommendations of the ACMG (American College of Medical Genetics). Only pathogenic and likely pathogenic variants were considered for analysis and afterwards we categorized them following the ComPerMed (The Personalized Medicine Commission) criteria. Results. We have analyzed 21 matched diagnosis-relapse tumor samples (8 primary tumor samples, and 13 loco-regional or metastatic disease) from 8 patients. In 4 patients, genomic characterization was performed at 3 different time points of their tumor evolution. Pathogenic alterations identified were mutations in TP53 (in 100% of the samples), TERT promoter (29%), and MYC amplifications (24% of samples, of which 75% were relapse/progression samples). We didn’t find any mutation in PI3KCA, but PTEN was found to have variations in 38% samples (10% mutations and 38% deletions). Amplification of FGFR1 was identified in 13% of the pts (only in the primary tumor). No ERBB2 or EGFR gene amplifications were detected, neither high grade MSI. We did not find a significant increase in point mutations between primary and relapse/progression samples, although gene amplifications were found more frequently in the former ones. Sixty three percent of the cases were Tier I and II category alterations, which could have future implications in the management of this neoplasia. Conclusion. In our series of metaplastic carcinoma, the most frequent pathogenic alterations occurred in cycle regulation’s genes, including TP53 and TERT promoter mutations, and MYC amplifications. Relapse/progression samples were enriched in MYC amplification and inTP53 allelic frequency. Larger studies are required to better characterize these tumors, and identify new strategies to improve the prognosis of these patients.
Citation Format: Mónica Cejuela, Agostina Stradella, Anna Petit, Pablo Gargallo, Jan Bosch, Paula Carbonell, Sabela Recalde, Andrea Vethencourt, Adela Fernández, Catalina Falo, Miguel Gil-Gil, Silvia Vazquez, Rafael Villanueva, Teresa Soler, Inés Calabria, Sonia Pernas. Genomic characterization and tumor evolution in matched(primary-relapse)samplesof patients with METAPLASTIC breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-07-06.
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Affiliation(s)
- Mónica Cejuela
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Agostina Stradella
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Anna Petit
- Pathology Department, Breast Cancer Unit, Catalan Institute of Oncology-H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Pablo Gargallo
- Imegen – A part of Health in Code group, Paterna (Valencia), Spain
| | - Jan Bosch
- Pathology Department, Breast Cancer Unit, Catalan Institute of Oncology-H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Paula Carbonell
- Imegen – A part of Health in Code group, Paterna (Valencia), Spain
| | - Sabela Recalde
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Andrea Vethencourt
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Adela Fernández
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Catalina Falo
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Miguel Gil-Gil
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Silvia Vazquez
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Rafael Villanueva
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Teresa Soler
- Pathology Department, Breast Cancer Unit, Catalan Institute of Oncology-H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Inés Calabria
- Imegen – A part of Health in Code group, Paterna (Valencia), Spain
| | - Sonia Pernas
- Medical Oncology Department, Breast Cancer Unit, Catalan Institute of Oncology -H.U.Bellvitge, L'Hospitalet de Llobregat (Barcelona), Spain
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24
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Vethencourt A, Trinidad EM, Petit A, Soler-Monsó MT, Aleza CG, Urruticochea A, García-Tejedor A, Martinez AG, Obadia V, Vazquez S, Villanueva R, Fernánez A, Cejuela M, Penabad SR, Stradella A, Gil-Gil M, Pernas S, Gonzalez-Suarez E, Falo C. Abstract P2-08-10: First results of the randomized window of opportunity clinical trial D-Biomark: Immunomodulatory effect of denosumab in early breast cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p2-08-10] [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: Most breast cancers (BC) exhibit low immune infiltration and are unresponsive to immunotherapy. Inhibitors of the Receptor Activator of NFkB (RANK) pathway, such as denosumab, used for the treatment of bone metastasis, have been shown to prevent BC, reducing tumor cell proliferation and survival. Our recent data supports that RANK pathway inhibition in BC cells enhances anti-tumor immune response. However, the population of BC patients who may benefit from denosumab remains to be identified. The aim of the study is to evaluate the antiproliferative, proapoptotic and/or immunomodulatory activity of denosumab in early BC and to identify biomarkers of response. Methods: Patients with early stage HER2-negative BC, candidates to tumor excision as first therapeutic approach were included. Patients were randomized 2: 1 to denosumab (two doses of 120mg/Kg subcutaneous denosumab, days 1 and 8 plus oral calcium 1000 mg daily for a month) and control arm (no treatment). Blood and tumor samples were collected at baseline and at surgery (2-4 weeks later). Putative changes in tumor cell proliferation by Ki67 immunohistochemistry (IHC), survival by Cleaved caspase-3 IHC and tumor infiltrating lymphocytes (TILs) quantified in H&E were evaluated between initial biopsy and surgery. RANK and RANKL expression will be analysed by IHC and the infiltrating immune populations will be characterized by specific antibodies (CD3, CD4, CD8, CD20, FoxP3, CD68, PDL1, PD1). We will analyse denosumab driven gene expression changes in tumor samples and tools such as CIBERSORT will be used to characterize the immune infiltrate. To assess the increase in TILs and the variation in Ki 67 and Cleaved caspase-3, the T-test for paired samples was used. A value of p less than 0.05 was defined as statistically significant. Result: We present results from the initial 45 patients enrolled out of 60, 31 cases in the experimental arm and 13 in the control arm. Mean age was 55,97 (range 37-88) years. 38 women with luminal breast cancer were analysed and 7 cases of triple negative BC (5 in experimental arm and 2 in control arm). Clinical and tumor characteristics were well balanced between both groups. No relevant toxicities were reported. There was no reduction of Ki67 in either of the two arms and no changes in Cleaved caspase-3 were observed. Interestingly, a statistically significant increase in TILs was observed in the denosumab treated group (p=0.0092, Paired t test) but not in the control group (p=0.68). 29.03% of patients treated with denosumab showed a ≥10% increase in TILs vs 7.14% in the control group (p=0.13). Denosumab was associated with an effective systemic inhibition of RANKL. No relationship was found between serum RANKL levels at baseline and response to denosumab. RNAseq analysis and immunophenotyping is still in progress. Conclusion: Short term neoadjuvant denosumab induces an immunomodulatory effect with an increase in stromal TILs in early BC. ClinicalTrials.gov Identifier: NCT03691311
Table 1.ResultsBiopsySurgeryKi 67 (mean frequency) Control24.5729.57Ki 67 (mean frequency) Experimental22.3927.90Cleaved caspase 3 (mean area) Control0.260.58Cleaved caspase 3 (mean area) Experimental0.350.42TILs (mean percentage) Control9.3410.29TILs (mean percentage) Experimental8.2913.54TILs incrementControl p=0.68 vs. Experimental p=0.009
Citation Format: Andrea Vethencourt, Eva M Trinidad, Anna Petit, María T Soler-Monsó, Clara Gómez Aleza, Ander Urruticochea, Amparo García-Tejedor, Anna Gumà Martinez, Veronica Obadia, Silvia Vazquez, Rafael Villanueva, Adela Fernánez, Monica Cejuela, Sabela Recalde Penabad, Agostina Stradella, Miguel Gil-Gil, Sonia Pernas, Eva Gonzalez-Suarez, Catalina Falo. First results of the randomized window of opportunity clinical trial D-Biomark: Immunomodulatory effect of denosumab in early breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-08-10.
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Affiliation(s)
- Andrea Vethencourt
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Eva M Trinidad
- Institut d’Investigacio Biomédica de Bellvitge (IDIBELL-ONCOBELL), L’Hospitalet De Llobregat, Barcelona, Spain
| | - Anna Petit
- Hospital Universitari de Bellvitge and Institut Català d'Oncologia., L'Hospitalet de Llobregat, Barcelona, Spain
| | - María T Soler-Monsó
- Hospital Universitari de Bellvitge and Institut Català d'Oncologia., L'Hospitalet de Llobregat, Barcelona, Spain
| | - Clara Gómez Aleza
- Institut d’Investigacio Biomédica de Bellvitge (IDIBELL-ONCOBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Amparo García-Tejedor
- Hospital Universitari de Bellvitge and Institut Català d'Oncologia., L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Gumà Martinez
- Hospital Universitari de Bellvitge and Institut Català d'Oncologia., L'Hospitalet de Llobregat, Barcelona, Spain
| | - Veronica Obadia
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Silvia Vazquez
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Villanueva
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Adela Fernánez
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Monica Cejuela
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Agostina Stradella
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Miguel Gil-Gil
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sonia Pernas
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Catalina Falo
- Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
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Saura Manich C, O'Shaughnessy J, Aftimos P, van den Tweel E, Oesterholt M, Escrivá-de-Romaní S, Quenel Tueux N, Tan T, Lim J, Ladoire S, Armstrong A, Crook T, Stradella A, Bianchi G, Mulder R, Koper N, Turner N. LBA15 Primary outcome of the phase III SYD985.002/TULIP trial comparing [vic-]trastuzumab duocarmazine to physician’s choice treatment in patients with pre-treated HER2-positive locally advanced or metastatic breast cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2088] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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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26
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Balaña C, del Barco Berrón S, Stradella A, Villanueva Vazquez R, Cuesta A, Torres J, Roma J, Taylor R, Escriba P, Llobet E, McNicholl A. 346MO Safety of idroxioleic acid in combination with standard of care (temozolomide and/or radiation therapy) in newly diagnosed glioblastoma patients: A phase Ib trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.010] [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] Open
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Ortega Expósito C, Falo C, Pernas S, Pérez Carton S, Gil Gil M, Ortega R, Pérez Montero H, Stradella A, Martinez E, Laplana M, Salinas S, Luzardo A, Soler T, Fernández Montoli ME, Azcarate J, Guma A, Petit A, Benitez A, Bajen M, Reyes Junca JG, Campos M, Ruiz R, Ponce J, Pla MJ, García Tejedor A. The effect of omitting axillary dissection and the impact of radiotherapy on patients with breast cancer sentinel node macrometastases: a cohort study following the ACOSOG Z0011 and AMAROS trials. Breast Cancer Res Treat 2021; 189:111-120. [PMID: 34089119 DOI: 10.1007/s10549-021-06274-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To report the outcomes of implementing the ACOSOG Z0011 and AMAROS trials relevant to clinical practice, and to define target groups in whom to avoid or recommend axillary radiotherapy (ART). We also aimed to analyse the reduction in morbidity when axillary lymph node dissection (ALND) was omitted. METHODS A retrospective cohort study of T1-T2 patients with macrometastases at sentinel lymph node (SLN) who were treated between 2011 and 2020. Breast surgery included either lumpectomy or mastectomy. Patients with ≤ 2 positive SLN were divided into two cohorts by whether they received ART or not. Survival outcomes and morbidity were analysed by Kaplan-Meyer curves and Cox-regression, respectively. RESULTS 260 pN1a patients were included and ALND was avoided in 167 (64.2%). According the Z0011 results, 72 (43.1%) received no further ART; and based on AMAROS criteria 95 (56.9%) received ART. Median follow-up was 54 months. The 5-year overall survival was 96.8% in the non-RT cohort and 93.4% in the RT cohort (p = 0.19), while the respective 5-year disease-free survivals were 100% and 92.3% (p = 1.06). Lymphedema developed in 3.6% of patients after SLNB versus 43% after ALND (OR 20.25; 95%CI 8.13-50.43). Decreased upper-extremity range of motion appeared in 8.4% of patients after SLNB versus 31.2% after ALND (OR 4.95; 95%CI 2.45-9.98%). CONCLUSIONS Our study confirms that omitting ALND is safe and has high survival rates in patients with T1-T2 tumours and ≤ 2 positive SLNs. Adding ART could be a treatment option for patients who present other risk factors. Avoiding ALND with or without ART was associated with significantly less arm morbidity.
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Affiliation(s)
- Carlos Ortega Expósito
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.
| | - Catalina Falo
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Sonia Pernas
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Samuel Pérez Carton
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Miguel Gil Gil
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Raul Ortega
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Héctor Pérez Montero
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Agostina Stradella
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Evelyn Martinez
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Maria Laplana
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Sira Salinas
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Ana Luzardo
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Teresa Soler
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | | | - Juan Azcarate
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Anna Guma
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Anna Petit
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Ana Benitez
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Maite Bajen
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Jose G Reyes Junca
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Miriam Campos
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Raquel Ruiz
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Jordi Ponce
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Maria J Pla
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Amparo García Tejedor
- Bellvitge University Hospital: Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
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Yee D, LoRusso P, Sablin MP, Prat A, Stradella A, Utriainen M, Oliveira M, Yonemori K, Naito Y, Hardebeck MC, Puig M, Hu J, Biyukov TN, Iwata H. A phase Ib study of xentuzumab plus abemaciclib and fulvestrant in patients (pts) with advanced hormone receptor-positive (HR+), HER2-negative breast cancer (BC) with visceral or non-visceral disease. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.1057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1057 Background: Cyclin-dependent kinase (CDK) 4 & 6 inhibitors plus endocrine therapy (ET) are standard of care for advanced HR+ BC. Combining xentuzumab, an insulin-like growth factor (IGF) ligand-neutralizing antibody, with ET and everolimus, suggested progression-free survival (PFS) benefit in pts with advanced HR+ BC and non-visceral disease. Activation of the IGF pathway leads to an increase in cyclin D1, providing a rationale for combining IGF and CDK4 & 6 inhibition. This prospective, open-label study is investigating xentuzumab plus abemaciclib, a CDK4 & 6 inhibitor, with fulvestrant. In dose-finding cohorts, the recommended phase II dose (RP2D) was determined as xentuzumab 1000 mg weekly intravenously plus abemaciclib 150 mg every 12h orally (Q12h). Here, we report preliminary data on disease control rate (DCR) from two expansion cohorts in pts with advanced HR+ BC with visceral (D1) or non-visceral disease (D2). Methods: Postmenopausal women with advanced/metastatic HR+ BC that had progressed on or after ET (including adjuvant ET) were enrolled. Pts could not have received >1 line of ET or any chemotherapy for metastatic disease. No prior CDK4 & 6 inhibitor therapy was permitted. Pts had to have ≥1 documented visceral metastasis in D1 and no visceral metastases in D2. Pts received xentuzumab weekly plus abemaciclib Q12h (at RP2D) plus fulvestrant 500 mg per label. Protocol primary endpoint was PFS rate at 18 months (mos). Secondary endpoints included DCR (complete response [CR], partial response [PR] and non-CR/non-progressive disease [PD] or stable disease [SD] lasting ≥24 weeks [wks]). Results: In D1/D2, 33/31 pts were treated: median age 60/53 years. 19 pts in D2 had bone-only, non-measurable disease. At data cut-off (Jan 2021), median treatment duration was 7.5/9.2 mos in D1/D2; 40 pts remain on treatment. In D1, DCR was 64%: 17 (52%) pts had PR and 4 (12%) had SD lasting ≥24 wks. In D2, DCR was 55%: 5 (16%) pts had PR, 10 (32%) had non-CR/non-PD lasting ≥24 wks and 2 (7%) had SD lasting ≥24 wks. Median duration of disease control was 10.9 mos in each cohort. Some pts had not reached 24 wks; full DCR data will be presented. Most common AEs are shown in the table (≥33% all-grade in either cohort). No hypo/hyperglycemia was reported. Conclusions: Xentuzumab plus abemaciclib and fulvestrant demonstrated encouraging disease control in pts with advanced HR+ BC with visceral and non-visceral disease. The safety profile was manageable, and consistent with the known profiles of the three agents. Clinical trial information: NCT03099174 .[Table: see text]
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Affiliation(s)
- Douglas Yee
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | | | - Marie Paule Sablin
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France
| | - Aleix Prat
- Hospital Clinic of Barcelona, Barcelona, Spain
| | - Agostina Stradella
- Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Meri Utriainen
- Helsinki University Central Hospital, Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
| | - Mafalda Oliveira
- Vall d'Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | | | - Yoichi Naito
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Marta Puig
- Boehringer Ingelheim España S.A., Barcelona, Spain
| | - Joy Hu
- Boehringer Ingelheim (People’s Republic of China) Investment Co., Ltd., Shanghai, China
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Pérez-García JM, Gebhart G, Ruiz Borrego M, Stradella A, Bermejo B, Schmid P, Marmé F, Escrivá-de-Romani S, Calvo L, Ribelles N, Martinez N, Albacar C, Prat A, Dalenc F, Kerrou K, Colleoni M, Afonso N, Di Cosimo S, Sampayo-Cordero M, Malfettone A, Cortés J, Llombart-Cussac A. Chemotherapy de-escalation using an 18F-FDG-PET-based pathological response-adapted strategy in patients with HER2-positive early breast cancer (PHERGain): a multicentre, randomised, open-label, non-comparative, phase 2 trial. Lancet Oncol 2021; 22:858-871. [DOI: 10.1016/s1470-2045(21)00122-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 10/21/2022]
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Vethencourt A, Trinidad E, Gómez Aleza C, Pernas Simon S, Petit A, Soler T, Urruticoechea A, Gumà Martinez A, García-Tejedor A, Pla M, Capó C, Gil MG, Stradella A, Fernádez A, Recalde Penabad S, Cejuela M, Vazquez S, Iserte A, Falo C, Gonzalez-Suarez E. 14P Immunomodulatory effect of denosumab in early breast cancer: Preliminary results of a randomized window-opportunity clinical trial D-Biomark. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.028] [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: 11/26/2022] Open
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Stradella A, Del Valle J, Brunet J, Lázaro C. Response to letter entitled: Re: ERCC3 a new ovarian cancer susceptibility gene? Eur J Cancer 2021; 150:281-282. [PMID: 33888390 DOI: 10.1016/j.ejca.2021.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Agostina Stradella
- Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Spain; Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Hospitalet de Llobregat, Barcelona, Spain; Medical Oncology Department, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Jesús Del Valle
- Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Spain; Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Spain
| | - Joan Brunet
- Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Spain; Medical Sciences Department, School of Medicine, University of Girona, Girona, Spain
| | - Conxi Lázaro
- Hereditary Cancer Programme, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Spain; Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Spain.
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Gómez-Villarroya L, Serra-Arumí C, Báez-Sáez C, Mena Cervigon M, Tous Belmonte S, Morey Cortes F, Rodríguez Bruzos E, Gil Gil M, Pernas Simón S, Vethencourt Casado A, Vázquez Fernández S, Stradella A, Falo Zamora C, Font Guiteras A. Desarrollo de una estrategia holística para la valoración de la calidad de vida en pacientes con cáncer de mama en las distintas etapas de la enfermedad. PSIC 2021. [DOI: 10.5209/psic.74535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introducción: El cáncer de mama es considerado una enfermedad crónica que impacta de modo importante en la calidad de vida (QoL) de las pacientes. En la actualidad no se dispone de un sistema de evaluación totalmente satisfactorio que refleje la complejidad del cáncer de mama. Además, la mayoría de instrumentos están más orientados a la enfermedad en estadios iniciales que a la enfermedad avanzada. Objetivo: Describir la metodología utilizada para evaluar la calidad de vida y las estrategias de afrontamiento en un grupo representativo de cáncer de mama que incluye tanto pacientes metastásicas como no metastásicas. Método: Estudio prospectivo en pacientes con cáncer de mama del Servicio de Oncología Médica del Institut Català d’Oncologia (ICO) en diferentes estadios de la enfermedad, previo consentimiento informado. Se les aplica un protocolo de aproximadamente una hora de entrevista presencial donde se recoge su información sociodemográfica, y se contestan varios cuestionarios de calidad de vida como el cuestionario QLCA-AFex Font, QLQ-C30, QLQ-BR23 HADS, DME, BRCS, MINI-MAC, LOT-R y OE, que se completan con una entrevista semiestructurada. Resultados: De junio de 2017 a marzo de 2020, 257 pacientes han sido incluidas en el estudio. La media de edad es de 57,9 años (SD 10,1), la mayoría son mujeres (98,8%), con hijos (87,9%) y casadas (65,4%). Respecto al estadiaje clínico 75,5% son no-metastásicas y 24,5% metastásicas. El cumplimiento del protocolo se consiguió en más del 90% de los cuestionarios sin diferencias entre pacientes metastásicas y no metastásicas. Conclusión: Este protocolo multidimensional permite hacer una evaluación integral de la calidad de vida, así como reflejar las necesidades no atendidas y las preocupaciones que muestran las pacientes tanto en estadio precoz como avanzado, complementando los sistemas de valoración actualmente disponibles. Después del análisis de los resultados de este estudio sería interesante poder obtener un cuestionario único con las preguntas más relevantes que pudiera ser aplicado a la práctica clínica.
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O'Shaughnessy J, Schwartzberg L, Piccart M, Rugo HS, Yardley DA, Cortes J, Untch M, Harbeck N, Wright GS, Bondarenko I, Glaspy J, Nowecki Z, Kayali F, Chan A, Levy C, Liu MC, Kim SB, Lemieux J, Manikhas A, Tolaney S, Lim E, Gombos A, Stradella A, Pegram M, Fasching P, Mangel L, Semiglazov V, Dieras V, Gianni L, Danso MA, Vacirca J, Kroll S, O'Connell J, Tang K, Wei T, Seidman A. Abstract GS4-01: Results from CONTESSA: A phase 3 study of tesetaxel plus a reduced dose of capecitabine versus capecitabine alone in patients with HER2-, hormone receptor + (HR+) metastatic breast cancer (MBC) who have previously received a taxane. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-gs4-01] [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
Objectives: The key objectives of CONTESSA are to evaluate the efficacy and safety of tesetaxel plus a reduced dose of capecitabine as an all-oral regimen versus capecitabine alone in patients with HER2-, HR+ MBC previously treated with a taxane.
Rationale: Tesetaxel is a novel, oral taxane with several properties that make it unique, including: oral administration with a low pill burden; a long (8-day) terminal plasma half-life in humans, enabling infrequent, once-every-3 weeks (Q3W) dosing; no observed hypersensitivity reactions; and significant activity against chemotherapy-resistant breast cancer cell lines. More than 1,000 patients have been treated with tesetaxel in clinical studies. Tesetaxel had encouraging monotherapy activity in a Phase 2 study in 38 patients with HER2-, HR+ MBC, with a confirmed objective response rate (ORR) per RECIST 1.1 of 45% and median progression-free survival (PFS) of 5.4 months (Seidman et al, 2018 ASCO Annual Meeting).
Methodology: CONTESSA is a multinational, multicenter, randomized (1:1), Phase 3 registration study comparing tesetaxel (27 mg/m2 on Day 1 of a 21-day cycle) plus a reduced dose of capecitabine (1,650 mg/m2/day on Days 1-14 of a 21-day cycle) to the approved dose of capecitabine alone (2,500 mg/m2/day on Days 1-14 of a 21-day cycle) in patients with HER2-, HR+ MBC who have received no more than one chemotherapy regimen for advanced disease and have received a taxane in the (neo)adjuvant setting. There was no restriction on the disease-free interval following taxane therapy. The primary endpoint is PFS assessed by an Independent Radiologic Review Committee (IRC). CONTESSA was designed with 90% power to detect a 2.5-month improvement in median PFS (HR=0.71). Secondary endpoints are overall survival (OS), ORR and disease control rate.
Results: CONTESSA, which enrolled 685 patients, met the primary endpoint of improved PFS as assessed by the IRC. Median PFS was 9.8 months for tesetaxel plus a reduced dose of capecitabine versus 6.9 months for capecitabine alone, an improvement of 2.9 months [HR=0.716 (95% CI: 0.573-0.895); p=0.003]. ORR was 57% for tesetaxel plus a reduced dose of capecitabine versus 41% for capecitabine alone (p=0.0002). OS data are immature. Tesetaxel plus capecitabine was associated with a manageable side effect profile consistent with previous clinical studies. Grade ≥3 treatment-emergent adverse events (TEAEs) that occurred in ≥5% of patients (tesetaxel plus capecitabine vs. capecitabine alone) were: neutropenia (71.2% vs. 8.3%); diarrhea (13.4% vs. 8.9%); hand-foot syndrome (6.8% vs. 12.2%); febrile neutropenia (12.8% vs. 1.2%); fatigue (8.6% vs. 4.5%); hypokalemia (8.6% vs. 2.7%); leukopenia (10.1% vs. 0.9%); and anemia (8.0% vs. 2.1%). TEAEs resulting in treatment discontinuation in ≥1% of patients (tesetaxel plus capecitabine vs. capecitabine alone) were: neutropenia or febrile neutropenia (4.2% vs. 1.5%); neuropathy (3.6% vs. 0.3%); diarrhea (0.9% vs. 1.5%); and hand-foot syndrome (0.6% vs. 2.1%). Treatment discontinuation due to any adverse event occurred in 23.1% of patients treated with tesetaxel plus capecitabine versus 11.9% of patients treated with capecitabine alone. Grade 2 alopecia occurred in 8.0% of patients treated with tesetaxel plus capecitabine versus 0.3% of patients treated with capecitabine alone. Grade ≥3 neuropathy occurred in 5.9% of patients treated with tesetaxel plus capecitabine versus 0.9% of patients treated with capecitabine alone.
Conclusion: An all-oral regimen of tesetaxel plus a reduced dose of capecitabine significantly improved PFS versus capecitabine alone. Neutropenia was the most frequent Grade ≥3 TEAE. Rates of clinically significant alopecia and neuropathy were low.
Citation Format: Joyce O'Shaughnessy, Lee Schwartzberg, Martine Piccart, Hope S. Rugo, Denise A Yardley, Javier Cortes, Michael Untch, Nadia Harbeck, Gail S. Wright, Igor Bondarenko, John Glaspy, Zbigniew Nowecki, Fadi Kayali, Arlene Chan, Christelle Levy, Mei-Ching Liu, Sung-Bae Kim, Julie Lemieux, Alexey Manikhas, Sara Tolaney, Elaine Lim, Andrea Gombos, Agostina Stradella, Mark Pegram, Peter Fasching, Laszlo Mangel, Vladimir Semiglazov, Veronique Dieras, Luca Gianni, Michael A Danso, Jeff Vacirca, Stew Kroll, Joseph O'Connell, Kevin Tang, Thomas Wei, Andrew Seidman. Results from CONTESSA: A phase 3 study of tesetaxel plus a reduced dose of capecitabine versus capecitabine alone in patients with HER2-, hormone receptor + (HR+) metastatic breast cancer (MBC) who have previously received a taxane [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr GS4-01.
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Affiliation(s)
| | | | - Martine Piccart
- 3Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Hope S. Rugo
- 4University of California San Francisco Comprehensive Cancer Center, San Francisco, CA
| | - Denise A Yardley
- 5Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN
| | - Javier Cortes
- 6IOB Institute of Oncology, Quironsalud Group, Madrid and Barcelona, Spain and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Nadia Harbeck
- 8Brustzentrum der Universität München (LMU), Munich, Germany
| | - Gail S. Wright
- 9Sarah Cannon Research Institute and Florida Cancer Specialists, New Port Richey, FL
| | | | - John Glaspy
- 11University of California Los Angeles Hematology Oncology Center, Los Angeles, CA
| | - Zbigniew Nowecki
- 12Narodowy Instytut Onkologii-Panstwowy Instytut Badawczy, Warsaw, Poland
| | - Fadi Kayali
- 13Florida Cancer Specialists, Fort Myers, FL
| | - Arlene Chan
- 14Breast Cancer Research Centre-Western Australia and Curtin University, Perth, Australia
| | | | - Mei-Ching Liu
- 16Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Sung-Bae Kim
- 17Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of
| | - Julie Lemieux
- 18CHU de Québec-Université Laval, Quebec, QC, Canada
| | - Alexey Manikhas
- 19City Clinical Oncology Dispensary, St. Petersberg, Russian Federation
| | | | - Elaine Lim
- 21National Cancer Centre, Singapore, Singapore
| | - Andrea Gombos
- 3Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Agostina Stradella
- 22Institut Catala d'Oncologia Hospital Duran i Reynals, Barcelona, Spain
| | - Mark Pegram
- 23Stanford Women’s Cancer Center, Palo Alto, CA
| | | | - Laszlo Mangel
- 25University of Pécs Institute Oncotherapy, Pécs, Hungary
| | | | | | - Luca Gianni
- 28I.R.C.C.S. Ospedale San Raffaele, Milan, Italy
| | | | - Jeff Vacirca
- 30New York Cancer and Blood Specialists, New York, NY
| | - Stew Kroll
- 31Odonate Therapeutics, Inc., San Diego, CA
| | | | - Kevin Tang
- 31Odonate Therapeutics, Inc., San Diego, CA
| | - Thomas Wei
- 31Odonate Therapeutics, Inc., San Diego, CA
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Rofes P, Del Valle J, Torres-Esquius S, Feliubadaló L, Stradella A, Moreno-Cabrera JM, López-Doriga A, Munté E, De Cid R, Campos O, Cuesta R, Teulé Á, Grau È, Sanz J, Capellá G, Díez O, Brunet J, Balmaña J, Lázaro C. BARD1 Pathogenic Variants are Associated with Triple-Negative Breast Cancer in a Spanish Hereditary Breast and Ovarian Cancer Cohort. Genes (Basel) 2021; 12:genes12020150. [PMID: 33498765 PMCID: PMC7911518 DOI: 10.3390/genes12020150] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/18/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 12/16/2022] Open
Abstract
Only a small fraction of hereditary breast and/or ovarian cancer (HBOC) cases are caused by germline variants in the high-penetrance breast cancer 1 and 2 genes (BRCA1 and BRCA2). BRCA1-associated ring domain 1 (BARD1), nuclear partner of BRCA1, has been suggested as a potential HBOC risk gene, although its prevalence and penetrance are variable according to populations and type of tumor. We aimed to investigate the prevalence of BARD1 truncating variants in a cohort of patients with clinical suspicion of HBOC. A comprehensive BARD1 screening by multigene panel analysis was performed in 4015 unrelated patients according to our regional guidelines for genetic testing in hereditary cancer. In addition, 51,202 Genome Aggregation Database (gnomAD) non-Finnish, non-cancer European individuals were used as a control population. In our patient cohort, we identified 19 patients with heterozygous BARD1 truncating variants (0.47%), whereas the frequency observed in the gnomAD controls was 0.12%. We found a statistically significant association of truncating BARD1 variants with overall risk (odds ratio (OR) = 3.78; CI = 2.10–6.48; p = 1.16 × 10−5). This association remained significant in the hereditary breast cancer (HBC) group (OR = 4.18; CI = 2.10–7.70; p = 5.45 × 10−5). Furthermore, deleterious BARD1 variants were enriched among triple-negative BC patients (OR = 5.40; CI = 1.77–18.15; p = 0.001) compared to other BC subtypes. Our results support the role of BARD1 as a moderate penetrance BC predisposing gene and highlight a stronger association with triple-negative tumors.
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Affiliation(s)
- Paula Rofes
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28929 Madrid, Spain
| | - Jesús Del Valle
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28929 Madrid, Spain
| | - Sara Torres-Esquius
- Hereditary Cancer Genetics Group, Vall d’Hebron Institute of Oncology (VHIO), Medical Oncology Department, University Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain; (S.T.-E.); (J.B.)
| | - Lídia Feliubadaló
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28929 Madrid, Spain
| | - Agostina Stradella
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Medical Oncology Department, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
| | - José Marcos Moreno-Cabrera
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28929 Madrid, Spain
| | - Adriana López-Doriga
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology, 08908 L’Hospitalet de Llobregat, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Elisabet Munté
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28929 Madrid, Spain
| | - Rafael De Cid
- Genomes for Life-GCAT Lab Group, IGTP, Institut Germans Trias i Pujol (IGTP), 08916 Badalona, Spain;
| | - Olga Campos
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
| | - Raquel Cuesta
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
| | - Álex Teulé
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
| | - Èlia Grau
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Hereditary Cancer Program, Catalan Institute of Oncology, IGTP, 08916 Badalona, Spain
| | - Judit Sanz
- Genetic Counselling Unit, Medical Oncology Department, Althaia Xarxa Assistencial Universitària de Manresa, 08243 Manresa, Spain;
| | - Gabriel Capellá
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28929 Madrid, Spain
| | - Orland Díez
- Catalan Health Institute, Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain;
- Hereditary Cancer Genetics Group, Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Joan Brunet
- Medical Oncology Department, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBGI, 17007 Girona, Spain
- Medical Sciences Department, School of Medicine, University of Girona, 17007 Girona, Spain
| | - Judith Balmaña
- Hereditary Cancer Genetics Group, Vall d’Hebron Institute of Oncology (VHIO), Medical Oncology Department, University Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain; (S.T.-E.); (J.B.)
| | - Conxi Lázaro
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, 08908 L’Hospitalet de Llobregat, Spain; (P.R.); (J.D.V.); (L.F.); (A.S.); (J.M.M.-C.); (E.M.); (O.C.); (R.C.); (Á.T.); (G.C.)
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, 08908 L’Hospitalet de Llobregat, Spain;
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28929 Madrid, Spain
- Correspondence: ; Tel.: +34-93-2607145
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Garcia-Tejedor A, Fernandez-Gonzalez S, Ortega R, Gil-Gil M, Perez-Montero H, Fernandez-Montolí E, Stradella A, Recalde S, Soler T, Petit A, Bajen MT, Benitez A, Guma A, Campos M, Pla MJ, Martinez E, Laplana M, Pernas S, Perez-Sildekova D, Catala I, Ponce J, Falo C. Can we avoid axillary lymph node dissection in N2 breast cancer patients with chemo-sensitive tumours such as HER2 and TNBC? Breast Cancer Res Treat 2020; 185:657-666. [PMID: 33068198 DOI: 10.1007/s10549-020-05970-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/05/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To find a group of cN2 patients or patients with high axillary burden who become ypN0 after neoadjuvant chemotherapy (NACT) and who may benefit from avoiding a lymphadenectomy. METHODS A retrospective observational cohort study was conducted with 221 clinically staged N2 patients or patients with at least 3 suspicious lymph nodes found by ultrasound at diagnosis. The predictive factors for ypN0 analysed were age, MRI-determined tumour size, histological subtype, the Nottingham histologic grade, surrogate molecular subtype, ki-67 and vascular invasion when present. Clinical and radiological responses after NACT were also evaluated. Univariate and multivariate analyses by logistic regression were performed. Distant disease-free survival (DDFS) was calculated in relation to the status of the axillary lymph nodes after NACT. RESULTS After NACT, 89 patients (40.3%) had axillary pathologic complete response (pCR) (ypN0) and 132 (59.7%) had residual axillary disease (ypN+). Molecular surrogate subtype, Ki-67 expression, and the clinical and radiological responses to NACT were the only independent factors associated with ypN0. Axillary pCR was observed more often in HER2-positive and triple-negative tumours than in luminal ones (OR 7.5 and 3.6, respectively). DDFS was 88.7% (95% CI 80.7-96.7%) for ypN0 and 56.2% (95% CI 32.1-80.3%) for ypN+ (p = 0.09). CONCLUSIONS In HER2-positive and triple-negative breast cancer patients staged as cN2 or with high axillary burden before NACT, a sentinel lymph node biopsy after NACT could be recommended if there is a clinical and radiological response.
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Affiliation(s)
- Amparo Garcia-Tejedor
- Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain.
| | - Sergi Fernandez-Gonzalez
- Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Raul Ortega
- Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Miguel Gil-Gil
- Multidisciplinary Breast Cancer Unit, Department of Oncology, Institut Català d'Oncología, Barcelona, Spain
| | - Hector Perez-Montero
- Multidisciplinary Breast Cancer Unit, Department of Oncologic Radiotherapy, Institut Català d'Oncología, Barcelona, Spain
| | - Eulalia Fernandez-Montolí
- Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Agostina Stradella
- Multidisciplinary Breast Cancer Unit, Department of Oncology, Institut Català d'Oncología, Barcelona, Spain
| | - Sabela Recalde
- Multidisciplinary Breast Cancer Unit, Department of Oncology, Institut Català d'Oncología, Barcelona, Spain
| | - Teresa Soler
- Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Anna Petit
- Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Maria Teresa Bajen
- Multidisciplinary Breast Cancer Unit, Department of Nuclear Medicine, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Ana Benitez
- Multidisciplinary Breast Cancer Unit, Department of Nuclear Medicine, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Anna Guma
- Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Miriam Campos
- Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Maria J Pla
- Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Evelyn Martinez
- Multidisciplinary Breast Cancer Unit, Department of Oncologic Radiotherapy, Institut Català d'Oncología, Barcelona, Spain
| | - Maria Laplana
- Multidisciplinary Breast Cancer Unit, Department of Oncologic Radiotherapy, Institut Català d'Oncología, Barcelona, Spain
| | - Sonia Pernas
- Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Diana Perez-Sildekova
- Multidisciplinary Breast Cancer Unit, Department of Plastic and Restorative Surgery, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Isabel Catala
- Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
| | - Jordi Ponce
- Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
| | - Catalina Falo
- Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
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Vargas-Parra G, Del Valle J, Rofes P, Gausachs M, Stradella A, Moreno-Cabrera JM, Velasco A, Tornero E, Menéndez M, Muñoz X, Iglesias S, López-Doriga A, Azuara D, Campos O, Cuesta R, Darder E, de Cid R, González S, Teulé A, Navarro M, Brunet J, Capellá G, Pineda M, Feliubadaló L, Lázaro C. Comprehensive analysis and ACMG-based classification of CHEK2 variants in hereditary cancer patients. Hum Mutat 2020; 41:2128-2142. [PMID: 32906215 DOI: 10.1002/humu.24110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 05/22/2020] [Revised: 08/13/2020] [Accepted: 09/06/2020] [Indexed: 12/11/2022]
Abstract
CHEK2 variants are associated with intermediate breast cancer risk, among other cancers. We aimed to comprehensively describe CHEK2 variants in a Spanish hereditary cancer (HC) cohort and adjust the American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG-AMP) guidelines for their classification. First, three CHEK2 frequent variants were screened in a retrospective Hereditary Breast and Ovarian Cancer cohort of 516 patients. After, the whole CHEK2 coding region was analyzed by next-generation sequencing in 1848 prospective patients with HC suspicion. We refined ACMG-AMP criteria and applied different combined rules to classify CHEK2 variants and define risk alleles. We identified 10 CHEK2 null variants, 6 missense variants with discordant interpretation in ClinVar database, and 35 additional variants of unknown significance. Twelve variants were classified as (likely)-pathogenic; two can also be considered "established risk-alleles" and one as "likely risk-allele." The prevalence of (likely)-pathogenic variants in the HC cohort was 0.8% (1.3% in breast cancer patients and 1.0% in hereditary nonpolyposis colorectal cancer patients). Here, we provide ACMG adjustment guidelines to classify CHEK2 variants. We hope that this study would be useful for variant classification of other genes with low effect variants.
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Affiliation(s)
- Gardenia Vargas-Parra
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Jesús Del Valle
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Paula Rofes
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Mireia Gausachs
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain
| | - Agostina Stradella
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Medical Oncology Department, Catalan Institute of Oncology, IDIBELL, Barcelona, Spain
| | - José M Moreno-Cabrera
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Angela Velasco
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Eva Tornero
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Mireia Menéndez
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Xavier Muñoz
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Silvia Iglesias
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Adriana López-Doriga
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology, Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Daniel Azuara
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Olga Campos
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Raquel Cuesta
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Esther Darder
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Rafael de Cid
- Programa de Medicina Predictiva i Personalitzada del Càncer-Institut Germans Trias i Pujol (PMPPC-IGTP), Genomes for Life-GCAT Lab Group, Badalona, Spain
| | - Sara González
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Alex Teulé
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Matilde Navarro
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Joan Brunet
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Medical Sciences Department, School of Medicine, University of Girona, Girona, Spain
| | - Gabriel Capellá
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Marta Pineda
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Lídia Feliubadaló
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Conxi Lázaro
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, Badalona, Spain.,Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
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Stradella A, Johnson M, Goel S, Chandana S, Galsky M, Calvo E, Moreno V, Park H, Arkenau T, Cervantes A, Fariñas-Madrid L, Mileshkin L, Fu S, Plummer R, Evans J, Horvath L, Prawira A, Qu K, Pelham R, Barve M. 530MO Clinical benefit in biomarker-positive patients (pts) with locally advanced or metastatic solid tumours treated with the PARP1/2 inhibitor pamiparib in combination with low-dose (LD) temozolomide (TMZ). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Palomero L, Galván-Femenía I, de Cid R, Espín R, Barnes DR, Cimba, Blommaert E, Gil-Gil M, Falo C, Stradella A, Ouchi D, Roso-Llorach A, Violan C, Peña-Chilet M, Dopazo J, Extremera AI, García-Valero M, Herranz C, Mateo F, Mereu E, Beesley J, Chenevix-Trench G, Roux C, Mak T, Brunet J, Hakem R, Gorrini C, Antoniou AC, Lázaro C, Pujana MA. Immune Cell Associations with Cancer Risk. iScience 2020; 23:101296. [PMID: 32622267 PMCID: PMC7334419 DOI: 10.1016/j.isci.2020.101296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/23/2020] [Accepted: 06/15/2020] [Indexed: 01/21/2023] Open
Abstract
Proper immune system function hinders cancer development, but little is known about whether genetic variants linked to cancer risk alter immune cells. Here, we report 57 cancer risk loci associated with differences in immune and/or stromal cell contents in the corresponding tissue. Predicted target genes show expression and regulatory associations with immune features. Polygenic risk scores also reveal associations with immune and/or stromal cell contents, and breast cancer scores show consistent results in normal and tumor tissue. SH2B3 links peripheral alterations of several immune cell types to the risk of this malignancy. Pleiotropic SH2B3 variants are associated with breast cancer risk in BRCA1/2 mutation carriers. A retrospective case-cohort study indicates a positive association between blood counts of basophils, leukocytes, and monocytes and age at breast cancer diagnosis. These findings broaden our knowledge of the role of the immune system in cancer and highlight promising prevention strategies for individuals at high risk.
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Affiliation(s)
- Luis Palomero
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Ivan Galván-Femenía
- GCAT-Genomes for Life, Germans Trias i Pujol Health Sciences Research Institute (IGTP), Program for Predictive and Personalized Medicine of Cancer (IMPPC), Badalona, Catalonia 08916, Spain
| | - Rafael de Cid
- GCAT-Genomes for Life, Germans Trias i Pujol Health Sciences Research Institute (IGTP), Program for Predictive and Personalized Medicine of Cancer (IMPPC), Badalona, Catalonia 08916, Spain
| | - Roderic Espín
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Daniel R Barnes
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Cimba
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Eline Blommaert
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Miguel Gil-Gil
- Department of Medical Oncology, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Catalina Falo
- Department of Medical Oncology, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Agostina Stradella
- Department of Medical Oncology, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Dan Ouchi
- Jordi Gol University Institute for Research Primary Healthcare (IDIAP Jordi Gol), Barcelona, Catalonia 08007, Spain; Autonomous University of Barcelona, Bellaterra, Catalonia 08913, Spain
| | - Albert Roso-Llorach
- Jordi Gol University Institute for Research Primary Healthcare (IDIAP Jordi Gol), Barcelona, Catalonia 08007, Spain; Autonomous University of Barcelona, Bellaterra, Catalonia 08913, Spain
| | - Concepció Violan
- Jordi Gol University Institute for Research Primary Healthcare (IDIAP Jordi Gol), Barcelona, Catalonia 08007, Spain; Autonomous University of Barcelona, Bellaterra, Catalonia 08913, Spain
| | - María Peña-Chilet
- Clinical Bioinformatics Area, Fundación Progreso y Salud (FPS), Bioinformatics in Rare Diseases (BiER), CIBERER, INB-ELIXIR-es, Hospital Virgen del Rocío, Seville 41013, Spain
| | - Joaquín Dopazo
- Clinical Bioinformatics Area, Fundación Progreso y Salud (FPS), Bioinformatics in Rare Diseases (BiER), CIBERER, INB-ELIXIR-es, Hospital Virgen del Rocío, Seville 41013, Spain
| | - Ana Isabel Extremera
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Mar García-Valero
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Carmen Herranz
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Francesca Mateo
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain
| | - Elisabetta Mereu
- CNAG-CRG, Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Catalonia 08003, Spain
| | - Jonathan Beesley
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
| | | | - Cecilia Roux
- Princess Margaret Cancer Centre, The Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, Toronto, ON M5G 2M9, Canada
| | - Tak Mak
- Princess Margaret Cancer Centre, The Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, Toronto, ON M5G 2M9, Canada
| | - Joan Brunet
- Hereditary Cancer Program, Catalan Institute of Oncology, Biomedical Research Institute of Girona (IDIBGI), Girona, Catalonia 17190, Spain
| | - Razq Hakem
- Princess Margaret Cancer Centre, Department of Medical Biophysics, University Health Network and University of Toronto, Toronto, ON M5G 2C1, Canada
| | - Chiara Gorrini
- Princess Margaret Cancer Centre, The Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, Toronto, ON M5G 2M9, Canada
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK.
| | - Conxi Lázaro
- Hereditary Cancer Program, Catalan Institute of Oncology, Oncobell, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, and Spanish Biomedical Research Network Centre in Oncology (CIBERONC), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Miquel Angel Pujana
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Catalonia 08908, Spain.
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Cuyàs E, Fernández-Arroyo S, Buxó M, Pernas S, Dorca J, Álvarez I, Martínez S, Pérez-Garcia JM, Batista-López N, Rodríguez-Sánchez CA, Amillano K, Domínguez S, Luque M, Morilla I, Stradella A, Viñas G, Cortés J, Verdura S, Brunet J, López-Bonet E, Garcia M, Saidani S, Joven J, Martin-Castillo B, Menendez JA. Metformin induces a fasting- and antifolate-mimicking modification of systemic host metabolism in breast cancer patients. Aging (Albany NY) 2020; 11:2874-2888. [PMID: 31076561 PMCID: PMC6535060 DOI: 10.18632/aging.101960] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/04/2019] [Indexed: 01/01/2023]
Abstract
Certain dietary interventions might improve the therapeutic index of cancer treatments. An alternative to the “drug plus diet” approach is the pharmacological reproduction of the metabolic traits of such diets. Here we explored the impact of adding metformin to an established therapeutic regimen on the systemic host metabolism of cancer patients. A panel of 11 serum metabolites including markers of mitochondrial function and intermediates/products of folate-dependent one-carbon metabolism were measured in paired baseline and post-treatment sera obtained from HER2-positive breast cancer patients randomized to receive either metformin combined with neoadjuvant chemotherapy and trastuzumab or an equivalent regimen without metformin. Metabolite profiles revealed a significant increase of the ketone body β-hydroxybutyrate and of the TCA intermediate α-ketoglutarate in the metformin-containing arm. A significant relationship was found between the follow-up levels of homocysteine and the ability of treatment arms to achieve a pathological complete response (pCR). In the metformin-containing arm, patients with significant elevations of homocysteine tended to have a higher probability of pCR. The addition of metformin to an established anti-cancer therapeutic regimen causes a fasting-mimicking modification of systemic host metabolism. Circulating homocysteine could be explored as a clinical pharmacodynamic biomarker linking the antifolate-like activity of metformin and biological tumor response.
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Affiliation(s)
- Elisabet Cuyàs
- Program Against Cancer Therapeutic Resistance (ProCURE), Metabolism and Cancer Group, Catalan Institute of Oncology, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Salvador Fernández-Arroyo
- Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, IISPV, Rovira i Virgili University, Reus, Spain
| | - Maria Buxó
- Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Sonia Pernas
- Department of Medical Oncology, Breast Unit, Catalan Institute of Oncology-Hospital Universitari de Bellvitge-Bellvitge Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Dorca
- Medical Oncology, Catalan Institute of Oncology, Girona, Spain
| | - Isabel Álvarez
- Medical Oncology Service, Hospital Universitario Donostia, Donostia-San Sebastián, Spain.,Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
| | - Susana Martínez
- Medical Oncology Department, Hospital de Mataró, Mataró, Barcelona, Spain
| | | | - Norberto Batista-López
- Medical Oncology Service, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | - César A Rodríguez-Sánchez
- Medical Oncology Service, Hospital Universitario de Salamanca, Salamanca, Spain.,Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Kepa Amillano
- Medical Oncology, Hospital Universitari Sant Joan, Reus, Spain
| | - Severina Domínguez
- Medical Oncology Service, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - Maria Luque
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Idoia Morilla
- Department of Medical Oncology, Breast Unit, Catalan Institute of Oncology-Hospital Universitari de Bellvitge-Bellvitge Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Agostina Stradella
- Department of Medical Oncology, Breast Unit, Catalan Institute of Oncology-Hospital Universitari de Bellvitge-Bellvitge Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Gemma Viñas
- Medical Oncology, Catalan Institute of Oncology, Girona, Spain
| | - Javier Cortés
- IOB Institute of Oncology, Hospital Quirónsalud, Madrid and Barcelona, Spain.,Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Sara Verdura
- Program Against Cancer Therapeutic Resistance (ProCURE), Metabolism and Cancer Group, Catalan Institute of Oncology, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Joan Brunet
- Medical Oncology, Catalan Institute of Oncology, Girona, Spain.,Hereditary Cancer Programme, Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain.,Hereditary Cancer Programme, Catalan Institute of Oncology (ICO), Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Eugeni López-Bonet
- Department of Anatomical Pathology, Dr. Josep Trueta Hospital of Girona, Girona, Spain
| | - Margarita Garcia
- Clinical Research Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Samiha Saidani
- Unit of Clinical Research, Catalan Institute of Oncology, Girona, Spain
| | - Jorge Joven
- Unitat de Recerca Biomèdica, Hospital Universitari de Sant Joan, IISPV, Rovira i Virgili University, Reus, Spain
| | | | - Javier A Menendez
- Program Against Cancer Therapeutic Resistance (ProCURE), Metabolism and Cancer Group, Catalan Institute of Oncology, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), Girona, Spain
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Pérez-García J, Soberino J, Racca F, Gion M, Stradella A, Cortés J. Atezolizumab in the treatment of metastatic triple-negative breast cancer. Expert Opin Biol Ther 2020; 20:981-989. [PMID: 32450725 DOI: 10.1080/14712598.2020.1769063] [Citation(s) in RCA: 18] [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: 12/14/2022]
Abstract
INTRODUCTION Triple-negative breast cancer (TNBC) accounts for approximately 10%-15% of all diagnosed breast cancers and is associated with an aggressive natural history and poor clinical outcomes. Immunotherapy using immune checkpoint inhibitors has emerged as an effective therapeutic option for TNBC. The results of the IMpassion130 trial have recently led to the approval of the combination of atezolizumab and nab-paclitaxel in the first-line treatment of patients with unresectable locally advanced or metastatic, PD-L1-positive TNBC. AREAS COVERED This article summarizes the clinical development and ongoing research on atezolizumab in the treatment of metastatic TNBC. Results of atezolizumab monotherapy trials and data from combination studies with chemotherapy in the advanced setting are reviewed, with special focus on the design, methods, and key findings of the IMpassion130 trial. EXPERT OPINION The approval of atezolizumab plus nab-paclitaxel represents an important advance in the treatment of metastatic TNBC. This combination has a favorable risk-benefit profile and is associated with clinically meaningful outcomes. However, further research is needed to identify better predictive biomarkers of response as well as novel immunotherapeutic strategies with atezolizumab and other anticancer drugs.
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Affiliation(s)
- José Pérez-García
- IOB Institute of Oncology, Quironsalud Group , Madrid & Barcelona, Spain.,Medica Scientia Innovation Research (MedSIR) , Barcelona, Spain
| | - Jesús Soberino
- IOB Institute of Oncology, Quironsalud Group , Madrid & Barcelona, Spain
| | - Fabricio Racca
- IOB Institute of Oncology, Quironsalud Group , Madrid & Barcelona, Spain
| | - María Gion
- IOB Institute of Oncology, Quironsalud Group , Madrid & Barcelona, Spain.,Hospital Universitario Ramón y Cajal , Madrid, Spain
| | - Agostina Stradella
- IOB Institute of Oncology, Quironsalud Group , Madrid & Barcelona, Spain.,Institut Català d'Oncologia, Hospitalet de Llobregat , Barcelona, Spain
| | - Javier Cortés
- IOB Institute of Oncology, Quironsalud Group , Madrid & Barcelona, Spain.,Medica Scientia Innovation Research (MedSIR) , Barcelona, Spain.,Vall d´Hebron Institute of Oncology (VHIO) , Barcelona, Spain
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Cortes J, Gebhart G, Ruiz Borrego M, Stradella A, Bermejo B, Escrivá S, Calvo Martínez L, Ribelles N, Martinez N, Albacar C, Prat A, Dalenc F, Khaldoun K, Schmid P, Colleoni M, Marmé F, Afonso N, Sampayo-Cordero M, Pérez-García JM, Llombart-Cussac A. Chemotherapy (CT) de-escalation using an FDG-PET/CT (F-PET) and pathological response-adapted strategy in HER2[+] early breast cancer (EBC): PHERGain Trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.503] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
503 Background: Dual trastuzumab plus pertuzumab (HP) has shown promising pathologic complete response (pCR) rates in HER2[+] EBC although lower to CT regimens. Identification of new markers of sensitivity to HP could help to de-escalate CT. PHERGain assessed early metabolic response by F-PET to neoadjuvant HP and the opportunity of CT de-escalation with a response-adapted strategy in patients (pts) with HER2[+] EBC. Methods: PHERGain randomized (1:4 ratio) centrally-confirmed HER2[+] stage I-III EBC pts to receive either docetaxel (T), carboplatin (C), and HP (cohort A) or HP ± endocrine therapy (ET) (cohort B). Randomization was stratified by hormone receptor (HR) status. Pts with subclinical metastases by F-PET were included in a different cohort (cohort C). Centrally-reviewed F-PET was performed prior to randomization and after 2 cycles of TX (cohorts A/B). Cohort A pts completed a total of 6 cycles regardless of F-PET results. Cohort B/PET-responder (RX) pts continued with HP ± ET for 6 cycles, while PET-non-RX pts were switched to receive 6 cycles of TCHP. After surgery, cohort B/PET-RX pts who did not achieve a pCR received 6 cycles of TCHP and all pts from cohorts A/B completed 18 cycles of HP. Cohort C pts received 6 cycles of TCHP. Co-primary endpoints were breast/axilla pCR rate (ypT0/isN0) among cohort B/PET-RX pts and 3-year invasive disease-free survival (iDFS) in pts allocated to cohort B. Results: A total of 376 pts were included (71 pts in cohort A, 285 pts in cohort B, and 20 pts in cohort C). In cohort B, median age was 50 years, 49.2% had node-positive disease, and 67.4% had HR+ tumors. pCR in cohort A was achieved in 41 pts (57.7%, 95% CI 47.4-69.4%) and it was observed in 101 pts included in cohort B (35.4%, 95% CI 29.9-41.3%). Among cohort B pts, 227 (79.6%) were PET-RX; 86 of them (37.9%, 95% CI 31.6-44.5%) obtained a pCR. Among PET-non-RX pts, 15 (25.9%, 95% CI 15.3-39%) achieved a pCR after adding CT (TCHP). PET-RX pCR by HR status was 44.3% for HR[-] and 35% for HR[+] (p = 0.184). The incidence of commonly reported adverse events (AEs) was higher in pts allocated to cohort A (grade≥3 AEs 58.8 vs 12%; serious AEs 29.4 vs 4.6%). The rate of pts with a ≥10% global health status decline in cohorts A and B were 40.8 and 23.5%, respectively. Conclusions: F-PET identify pts with HER2[+] EBC who are more likely to benefit from CT-free dual HER2-blockade with HP. Follow-up is ongoing for iDFS endpoint. Depending on the results of this second co-primary endpoint, this strategy could select a group of HER2[+] EBC pts who would not need CT. Clinical trial information: NCT03161353 .
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Affiliation(s)
- Javier Cortes
- IOB Institute of Oncology, Hospital Quirónsalud, Medica Scientia Innovation Research, and Vall d’Hebron University of Oncology, Barcelona, Spain
| | - Geraldine Gebhart
- Institut Jules Bordet–Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Begoña Bermejo
- Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Santiago Escrivá
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Nuria Ribelles
- UGC Oncología Intercentros, Hospitales Universitarios Regional y Virgen de la Victoria de Malaga, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | | | - Cinta Albacar
- Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - Florence Dalenc
- Department of Medical Oncology, Institut Claudius Regaud, IUCT-Oncopole, CRCT, Inserm, Toulouse, France
| | - Kerrou Khaldoun
- Nuclear Medicine and PET center Dept- APHP, Tenon Hospital IUC-UPMC, Sorbonne University, Paris, France
| | - Peter Schmid
- Barts ECMC, Barts Cancer Institute, Queen Mary University of London, and Barts Hospital NHS Trust, London, United Kingdom
| | - Marco Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Frederik Marmé
- Leitung Sektion Translationale Gynäkologische Onkologie Nationales Centrum für Tumorerkrankungen und Universitätsfrauenklinik Heidelberg, Heidelberg, Germany
| | - Noemia Afonso
- Department of Medical Oncology, Portuguese Institute of Oncology of Porto, Porto, Portugal
| | | | - José Manuel Pérez-García
- IOB, Institute of Oncology, QuironSalud Group, Madrid and Barcelona, Medica Scientia Innovation Research (MedSIR) Barcelona, Spain and Ridgewood, New Jersey, Barcelona, Spain
| | - Antonio Llombart-Cussac
- Hospital Arnau de Vilanova, Universidad Catolica, Medica Scientia Innovation Research (MedSIR), Valencia, Spain
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Tolaney SM, Bondarenko I, Chan A, Dacosta NA, Izarzugaza Y, Kim GM, Liu MC, Perez MEVA, Lu YS, Oliveira M, Ow SGW, Pavic M, Rugo HS, Schwartzberg LS, Stradella A, Tan TJY, Wright-Browne V, O'Connell JP, Wei T, Mittendorf EA. CONTESSA TRIO: A multinational, multicenter, phase (P) II study of tesetaxel (T) plus three different PD-(L)1 inhibitors in patients (Pts) with metastatic triple-negative breast cancer (TNBC) and tesetaxel monotherapy in elderly pts with HER2-metastatic breast cancer (MBC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.tps1111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS1111 Background: Chemotherapy treatments with robust efficacy that preserve quality of life are needed. T is a novel, oral taxane that has potential advantages over currently available taxanes, including: oral administration with a low pill burden and once every 3 week (Q3W) dosing; no observed hypersensitivity reactions; preclinical evidence of central nervous system (CNS) penetration; and improved activity against chemotherapy-resistant tumors. More than 600 pts have been treated with T in clinical studies. T had robust monotherapy activity in a P2 study in 38 pts with HER2-, HR+ MBC, with a confirmed objective response rate (ORR) per RECIST 1.1 of 45%. Methods: CONTESSA TRIO is a 2-cohort, multinational, multicenter, P2 study. In Cohort 1, 90 pts (potential expansion to up to 150 pts) with metastatic TNBC who have not received prior chemotherapy for advanced disease will be randomized 1:1:1 to receive T at 27 mg/m2 Q3W plus either: (1) nivolumab at 360 mg Q3W; (2) pembrolizumab at 200 mg Q3W; or (3) atezolizumab at 1,200 mg Q3W. Nivolumab and pembrolizumab (PD-1 inhibitors) and atezolizumab (a PD-L1 inhibitor) are approved for the treatment of multiple types of cancer; atezolizumab, in combination with nab-paclitaxel, was recently approved in the US for the treatment of metastatic TNBC. The dual primary endpoints for Cohort 1 are ORR and progression-free survival (PFS). A sample size of 30 pts in each PD-(L)1 inhibitor treatment group has approximately 70% power to detect an ORR difference of ≥ 35% between the treatment group with the highest ORR and the treatment group with the lowest ORR. Secondary endpoints include duration of response (DoR) and overall survival (OS). Efficacy results for each of the 3 PD-(L)1 inhibitor combinations will be assessed for correlation with the results of each of the 3 approved PD-L1 diagnostic assays. CONTESSA TRIO is the first randomized clinical study to compare 3 approved PD-(L)1 inhibitors. In Cohort 2, 40 elderly pts (potential expansion to up to 60 pts) with HER2- MBC who have not received prior chemotherapy for advanced disease will receive T monotherapy at 27 mg/m2 Q3W. The primary endpoint for Cohort 2 is ORR. A sample size of 40 will allow the ORR to be estimated with a maximum standard error of < 8%. Secondary endpoints include PFS, DoR and OS. Pts with CNS metastases are eligible for both cohorts. The study was initiated in March 2019. Clinical trial information: NCT03952325 .
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Affiliation(s)
| | | | - Arlene Chan
- Breast Cancer Research Centre-Western Australia and Curtin University, Perth, Australia
| | | | - Yann Izarzugaza
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Gun Min Kim
- Yonsei University Health System Severance Hospital, Seoul, South Korea
| | - Mei-Ching Liu
- Koo Foundation Sun Yat-sen Cancer Center, Taipei, Taiwan
| | | | - Yen-Shen Lu
- National Taiwan University Hospital, Taipei, Taiwan
| | | | | | - Michel Pavic
- McPeak-Sirois Group, Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, QC, Canada
| | - Hope S. Rugo
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | | | | | | | | | | | - Thomas Wei
- Odonate Therapeutics, Inc., San Diego, CA
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Llombart Cussac A, Prat A, Pérez-García J, Mateos J, Pascual T, Escrivà-De-Romani S, Stradella A, Ruiz-Borrego M, Bermejo De Las Heras B, Keyaerts M, Sampayo-Cordero M, Malfettone A, Cortés R, Galván P, Cortés J, Gebhart G. 101P Predictors of 18F-fluorodeoxyglucose (F) positron-emission tomography (PET)-driven disease detection in patients (pts) with HER2[+] early breast cancer (EBC). A substudy of the PHERGain trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.040] [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] Open
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Franco CF, Stradella A, Navarro V, Linares J, Peñabad SR, Fargas RV, Parra MS, Ortega AF, Vethencourt A, Zamora CF, Fernandez SV, Vazquez RV, Galdeano M, Gil-Gil M. Abstract P2-20-08: Validation and comparison of breast graded prognostic assessment score and modified breast graded prognostic assessment in patients with brain metastases as prognostic tool. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-20-08] [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: Brain metastases (BM) occur in 15-35% of patients (p) with metastatic breast cancer (MBC), confering bad prognosis and the major limitation of life expectancy and quality of life. Nevertheless, there is a wide prognostic spectrum within this group of p. Clinical scores have been developed trying to classify according to its prognosis. Initially, the Breast Graded Prognostic Assessment (B-GPA, Sperduto et al, 2012) Then, it was adapted by adding the number of brain metastases, which is called modified Breast Graded Prognostic Assessment (mB-GPA, Subbiah et al 2015). We tried to validate these scores and compare them to determine which is the best prognostic predictor tool.
Method: This is an ambispective study including all patients diagnosed of breast cancer’s brain metastases treated in a single cancer comprehensive center. Identification of patients and updates of follow up were performed through Radiation Oncology department registries and Pathology records. Both clinical and pathological data were collected. B-GPA and mB-GPA were calculated for each P. We analyze the survival after BM (SaBM) determining it as the time from the moment of diagnosis of the BM until the death due to the disease or any other cause. The Kaplan-Meier method was used to calculate SaBM and the univariate analyses was conducted using the Cox proportional hazard regression model. ROC curves were performed to compare both scores.
Results: We included 169 P with a median age of 50 years (29-81). At last follow-up (April 2019) 90% of the P had died. Histological subtypes: 41.8% were luminal-like, 36.1% Her2 positive and 22% triple negative tumors. 25% of these P were diagnosed with stage IV. Nineteen percent of p presented only BM as the first site of relapse. A third of the P presented more than 3 brain metastases. WBRT was applied to 68.2% P, while stereotactic radiosurgery and surgery was performed in 18.2% and 18.2% respectively. The median SaBM was 12 months (m) (95% Confidence Interval (CI) [8.0-16.0m]. In the univariated analysis SaBM was longer in Her2 P than Luminal and TN P (26 m vs 11m and 8m p=0.01). Regarding the number of lesions, more than 3 present worse survival than p with 2-3 and only one metastasis (8m vs 11m vs 22m p=0.046). In the univariated analysis B-GPA and mGPA showed significant correlation with prognosis. Patients in group 4 of B-GPA (3.5-4 points) presented a better SaBM than the other groups, being statistically significant (see table 1)
Likewise, group 4 of mB-GPA (3.5-4 points) showed a better stadistically significant survival (see table 1). The ROC curves showed that GPA and mGPA have very similar prognostic capabilities, perhaps slightly in favor of modified GPA (GPA: 0.269 and mGPA: 0.286)
Conclusion: Our series validates the previous results regarding the GPA scores that allow discriminating risk groups with significant different survival. In our series mB-GPA was slightly better predictor of prognostic. In the univariate analysis B-GPA and mB-GPA, number of lesions and histological subtypes were the most important prognosis factors for MBC patients with BM. This situation can allow us to choose and better adjust the therapeutic effort in each patient, which has to be valued by a multidisciplinary team.
Table 1: SaBM regarding GPA scoresB-GPA(group)N°SaBM (months)CI 95% (m)p value0-1 (1)580-18.91.5-2 (2)2164.5-7.52.5-3 (3)29199.3-28.63.5-4 (4)263626.7-46.2p=<0.001mB-GPA (group)N°SaBM (months)CI 95% (m)p value0-1 (1)1040-10.71.5-2 (2)3072.5-11.52.5-3 (3)352717.5-36.53.5-4 (4)73733.5-40.5p=<0.001
Citation Format: Carles Fabregat Franco, Agostina Stradella, Valentin Navarro, Jennifer Linares, Sabela Recalde Peñabad, Roser Velasco Fargas, Marta Simó Parra, Adela Fernandez Ortega, Andrea Vethencourt, Catalina Falo Zamora, Silvia Vazquez Fernandez, Rafael Villanueva Vazquez, Manuel Galdeano, Miguel Gil-Gil. Validation and comparison of breast graded prognostic assessment score and modified breast graded prognostic assessment in patients with brain metastases as prognostic tool [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-20-08.
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Tolaney S, Blum J, Bondarenko I, Chan A, DaCosta N, Feng YH, Izarzugaza Y, Kim SB, Liu MC, Lopéz MEP, Oliveira M, Ow SGW, Pavic M, Rugo H, Schwartzberg L, Stradella A, Kroll S, O'Connell J, Wei T, Mittendorf E. Abstract OT1-08-08: CONTESSA TRIO: A multinational, multicenter, phase 2 study of tesetaxel plus 3 different PD-(L)1 inhibitors in patients with metastatic triple-negative breast cancer (TNBC) and tesetaxel monotherapy in elderly patients with HER2- metastatic breast cancer (MBC). Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-ot1-08-08] [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: Chemotherapy treatments with robust efficacy that preserve quality of life are needed. Tesetaxel is a novel, oral taxane that has potential advantages over currently available taxanes, including: oral administration with a low pill burden and once every 3 week (Q3W) dosing; no observed hypersensitivity reactions; preclinical evidence of central nervous system (CNS) penetration; and improved activity against chemotherapy-resistant tumors. More than 600 patients have been treated with tesetaxel in clinical studies. Tesetaxel had robust monotherapy activity in a Phase 2 study in 38 patients with HER2-, HR+ MBC, with a confirmed objective response rate (ORR) per RECIST 1.1 of 45%. CONTESSA TRIO investigates tesetaxel plus 3 different PD-(L)1 inhibitors in patients with TNBC and tesetaxel monotherapy in elderly patients with HER2- MBC.
Trial design: CONTESSA TRIO is a 2-cohort, multinational, multicenter, Phase 2 study.
In Cohort 1, 90 patients (with potential expansion to up to 150 patients) with metastatic TNBC who have not received prior chemotherapy for advanced disease will be randomized 1:1:1 to receive tesetaxel at 27 mg/m2 Q3W plus either: (1) nivolumab at 360 mg Q3W; (2) pembrolizumab at 200 mg Q3W; or (3) atezolizumab at 1,200 mg Q3W. Nivolumab and pembrolizumab (PD-1 inhibitors) and atezolizumab (a PD-L1 inhibitor) are approved for the treatment of multiple types of cancer; atezolizumab, in combination with nab-paclitaxel, was recently approved in the U.S. for the treatment of metastatic TNBC. The dual primary endpoints for Cohort 1 are ORR and progression-free survival (PFS). A sample size of 30 patients in each PD-(L)1 inhibitor treatment group has approximately 70% power to detect an ORR difference of 35% or greater between the treatment group with the highest ORR and the treatment group with the lowest ORR. An increase in the sample size to 50 patients in each treatment group will increase the power to approximately 85%. Secondary endpoints include duration of response (DoR) and overall survival (OS). Efficacy results for each of the 3 PD-(L)1 inhibitor combinations will be assessed for correlation with the results of each of the 3 approved PD-L1 diagnostic assays. CONTESSA TRIO is the first randomized clinical study to compare 3 approved PD-(L)1 inhibitors.
In Cohort 2, 40 elderly patients (with potential expansion to up to 60 patients) with HER2- MBC who have not received prior chemotherapy for advanced disease will receive tesetaxel monotherapy at 27 mg/m2 Q3W. The primary endpoint for Cohort 2 is ORR. A sample size of 40 will allow the ORR to be estimated with a maximum standard error of < 8%. An increase in the sample size to 60 patients will decrease the maximum standard error to < 6.5%. Secondary endpoints include PFS, DoR and OS.
Patients with CNS metastases are eligible for both cohorts. The Study was initiated in March 2019. For further information on this trial, email joconnell@odonate.com or visit clinicaltrials.gov (NCT03952325).
Citation Format: Sara Tolaney, Joanne Blum, Igor Bondarenko, Arlene Chan, Noshir DaCosta, Yin-Hsun Feng, Yann Izarzugaza, Sung-Bae Kim, Mei-Ching Liu, Maria Eva Peréz Lopéz, Mafalda Oliveira, Samuel Guan Wei Ow, Michel Pavic, Hope Rugo, Lee Schwartzberg, Agostina Stradella, Stew Kroll, Joseph O'Connell, Thomas Wei, Elizabeth Mittendorf. CONTESSA TRIO: A multinational, multicenter, phase 2 study of tesetaxel plus 3 different PD-(L)1 inhibitors in patients with metastatic triple-negative breast cancer (TNBC) and tesetaxel monotherapy in elderly patients with HER2- metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr OT1-08-08.
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Affiliation(s)
| | - Joanne Blum
- 2Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX
| | | | - Arlene Chan
- 4Breast Cancer Research Centre-Western Australia and Curtin University, Perth, Australia
| | - Noshir DaCosta
- 5New York Cancer and Blood Specialists, East Setauket, NY
| | | | - Yann Izarzugaza
- 7Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Sung-Bae Kim
- 8Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of
| | - Mei-Ching Liu
- 9Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | | | | | | | - Michel Pavic
- 13McPeak-Sirois Group, Centre Hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, QC, Canada
| | - Hope Rugo
- 14University of California San Francisco Comprehensive Cancer Center, San Francisco, CA
| | | | - Agostina Stradella
- 16Institut Catala d'Oncologia Hospital Duran i Reynals, Barcelona, Spain
| | - Stew Kroll
- 17Odonate Therapeutics, Inc., San Diego, CA
| | | | - Thomas Wei
- 17Odonate Therapeutics, Inc., San Diego, CA
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Patel VL, Busch EL, Friebel TM, Cronin A, Leslie G, McGuffog L, Adlard J, Agata S, Agnarsson BA, Ahmed M, Aittomäki K, Alducci E, Andrulis IL, Arason A, Arnold N, Artioli G, Arver B, Auber B, Azzollini J, Balmaña J, Barkardottir RB, Barnes DR, Barroso A, Barrowdale D, Belotti M, Benitez J, Bertelsen B, Blok MJ, Bodrogi I, Bonadona V, Bonanni B, Bondavalli D, Boonen SE, Borde J, Borg A, Bradbury AR, Brady A, Brewer C, Brunet J, Buecher B, Buys SS, Cabezas-Camarero S, Caldés T, Caliebe A, Caligo MA, Calvello M, Campbell IG, Carnevali I, Carrasco E, Chan TL, Chu ATW, Chung WK, Claes KBM, Collaborators GS, Collaborators E, Cook J, Cortesi L, Couch FJ, Daly MB, Damante G, Darder E, Davidson R, de la Hoya M, Puppa LD, Dennis J, Díez O, Ding YC, Ditsch N, Domchek SM, Donaldson A, Dworniczak B, Easton DF, Eccles DM, Eeles RA, Ehrencrona H, Ejlertsen B, Engel C, Evans DG, Faivre L, Faust U, Feliubadaló L, Foretova L, Fostira F, Fountzilas G, Frost D, García-Barberán V, Garre P, Gauthier-Villars M, Géczi L, Gehrig A, Gerdes AM, Gesta P, Giannini G, Glendon G, Godwin AK, Goldgar DE, Greene MH, Gutierrez-Barrera AM, Hahnen E, Hamann U, Hauke J, Herold N, Hogervorst FBL, Honisch E, Hopper JL, Hulick PJ, Investigators KC, Investigators H, Izatt L, Jager A, James P, Janavicius R, Jensen UB, Jensen TD, Johannsson OT, John EM, Joseph V, Kang E, Kast K, Kiiski JI, Kim SW, Kim Z, Ko KP, Konstantopoulou I, Kramer G, Krogh L, Kruse TA, Kwong A, Larsen M, Lasset C, Lautrup C, Lazaro C, Lee J, Lee JW, Lee MH, Lemke J, Lesueur F, Liljegren A, Lindblom A, Llovet P, Lopez-Fernández A, Lopez-Perolio I, Lorca V, Loud JT, Ma ESK, Mai PL, Manoukian S, Mari V, Martin L, Matricardi L, Mebirouk N, Medici V, Meijers-Heijboer HEJ, Meindl A, Mensenkamp AR, Miller C, Gomes DM, Montagna M, Mooij TM, Moserle L, Mouret-Fourme E, Mulligan AM, Nathanson KL, Navratilova M, Nevanlinna H, Niederacher D, Nielsen FCC, Nikitina-Zake L, Offit K, Olah E, Olopade OI, Ong KR, Osorio A, Ott CE, Palli D, Park SK, Parsons MT, Pedersen IS, Peissel B, Peixoto A, Pérez-Segura P, Peterlongo P, Petersen AH, Porteous ME, Pujana MA, Radice P, Ramser J, Rantala J, Rashid MU, Rhiem K, Rizzolo P, Robson ME, Rookus MA, Rossing CM, Ruddy KJ, Santos C, Saule C, Scarpitta R, Schmutzler RK, Schuster H, Senter L, Seynaeve CM, Shah PD, Sharma P, Shin VY, Silvestri V, Simard J, Singer CF, Skytte AB, Snape K, Solano AR, Soucy P, Southey MC, Spurdle AB, Steele L, Steinemann D, Stoppa-Lyonnet D, Stradella A, Sunde L, Sutter C, Tan YY, Teixeira MR, Teo SH, Thomassen M, Tibiletti MG, Tischkowitz M, Tognazzo S, Toland AE, Tommasi S, Torres D, Toss A, Trainer AH, Tung N, van Asperen CJ, van der Baan FH, van der Kolk LE, van der Luijt RB, van Hest LP, Varesco L, Varon-Mateeva R, Viel A, Vierstraete J, Villa R, von Wachenfeldt A, Wagner P, Wang-Gohrke S, Wappenschmidt B, Weitzel JN, Wieme G, Yadav S, Yannoukakos D, Yoon SY, Zanzottera C, Zorn KK, D'Amico AV, Freedman ML, Pomerantz MM, Chenevix-Trench G, Antoniou AC, Neuhausen SL, Ottini L, Nielsen HR, Rebbeck TR. Association of Genomic Domains in BRCA1 and BRCA2 with Prostate Cancer Risk and Aggressiveness. Cancer Res 2020; 80:624-638. [PMID: 31723001 PMCID: PMC7553241 DOI: 10.1158/0008-5472.can-19-1840] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/07/2019] [Accepted: 11/08/2019] [Indexed: 12/15/2022]
Abstract
Pathogenic sequence variants (PSV) in BRCA1 or BRCA2 (BRCA1/2) are associated with increased risk and severity of prostate cancer. We evaluated whether PSVs in BRCA1/2 were associated with risk of overall prostate cancer or high grade (Gleason 8+) prostate cancer using an international sample of 65 BRCA1 and 171 BRCA2 male PSV carriers with prostate cancer, and 3,388 BRCA1 and 2,880 BRCA2 male PSV carriers without prostate cancer. PSVs in the 3' region of BRCA2 (c.7914+) were significantly associated with elevated risk of prostate cancer compared with reference bin c.1001-c.7913 [HR = 1.78; 95% confidence interval (CI), 1.25-2.52; P = 0.001], as well as elevated risk of Gleason 8+ prostate cancer (HR = 3.11; 95% CI, 1.63-5.95; P = 0.001). c.756-c.1000 was also associated with elevated prostate cancer risk (HR = 2.83; 95% CI, 1.71-4.68; P = 0.00004) and elevated risk of Gleason 8+ prostate cancer (HR = 4.95; 95% CI, 2.12-11.54; P = 0.0002). No genotype-phenotype associations were detected for PSVs in BRCA1. These results demonstrate that specific BRCA2 PSVs may be associated with elevated risk of developing aggressive prostate cancer. SIGNIFICANCE: Aggressive prostate cancer risk in BRCA2 mutation carriers may vary according to the specific BRCA2 mutation inherited by the at-risk individual.
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Affiliation(s)
- Vivek L Patel
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | - Evan L Busch
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tara M Friebel
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Dana-Farber Cancer Institute. Boston, Massachusetts
| | - Angel Cronin
- Dana-Farber Cancer Institute. Boston, Massachusetts
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Julian Adlard
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Simona Agata
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Bjarni A Agnarsson
- Department of Pathology, Landspitali University Hospital, 101, Reykjavik, Iceland
- School of Medicine, University of Iceland, Reykjavik, Iceland
| | - Munaza Ahmed
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Kristiina Aittomäki
- Department of Clinical Genetics, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Elisa Alducci
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Adalgeir Arason
- Department of Pathology, Landspitali University Hospital, 101, Reykjavik, Iceland
- BMC (Biomedical Centre), Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Norbert Arnold
- Department of Gynaecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
| | - Grazia Artioli
- ULSS 3 Serenissima, U.O.C. Oncologia ed Ematologia Oncologica, Mirano, Venice, Italy
| | - Brita Arver
- Department of Oncology, Karolinska Institutet, Stockholm, Sweden
| | - Bernd Auber
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Jacopo Azzollini
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Judith Balmaña
- High Risk and Cancer Prevention Group, Vall d'Hebron Institute of Oncology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Rosa B Barkardottir
- Department of Pathology, Landspitali University Hospital, 101, Reykjavik, Iceland
- BMC (Biomedical Centre), Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Daniel R Barnes
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Alicia Barroso
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Daniel Barrowdale
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | | | - Javier Benitez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Birgitte Bertelsen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Marinus J Blok
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Istvan Bodrogi
- Department of Chemotherapy, National Institute of Oncology, Budapest, Hungary
| | - Valérie Bonadona
- Unité de Prévention et d'Epidémiologie Génétique, Centre Léon Bérard, Lyon, France
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Davide Bondavalli
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Susanne E Boonen
- Clinical Genetic Unit, Department of Paediatrics, Zealand University Hospital, Roskilde, Denmark
| | - Julika Borde
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Ake Borg
- Department of Oncology, Lund University and Skåne University Hospital, Lund, Sweden
| | - Angela R Bradbury
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Angela Brady
- North West Thames Regional Genetics Service, Kennedy Galton Centre, The North West London Hospitals NHS Trust, Middlesex, United Kingdom
| | - Carole Brewer
- Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, United Kingdom
| | - Joan Brunet
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBGI (Institut d'Investigació Biomèdica de Girona), Catalan Institute of Oncology, CIBERONC, Girona, Spain
| | | | - Saundra S Buys
- Department of Medicine, Huntsman Cancer Institute, Salt Lake City, Utah
| | | | - Trinidad Caldés
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Almuth Caliebe
- Institute of Human Genetics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
| | - Maria A Caligo
- Section of Molecular Genetics, Department of Laboratory Medicine, University Hospital of Pisa, Pisa, Italy
| | - Mariarosaria Calvello
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ian G Campbell
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ileana Carnevali
- UO Anatomia Patologica, Ospedale di Circolo-Università dell'Insubria, Varese, Italy
| | - Estela Carrasco
- High Risk and Cancer Prevention Group, Vall d'Hebron Institute of Oncology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Tsun L Chan
- Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Centre, Happy Valley, Hong Kong
- Department of Pathology, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
| | - Annie T W Chu
- Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Centre, Happy Valley, Hong Kong
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, New York
| | | | | | - Embrace Collaborators
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jackie Cook
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield, United Kingdom
| | - Laura Cortesi
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Giuseppe Damante
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Esther Darder
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBGI (Institut d'Investigació Biomèdica de Girona), Catalan Institute of Oncology, CIBERONC, Girona, Spain
| | - Rosemarie Davidson
- Department of Clinical Genetics, South Glasgow University Hospitals, Glasgow, United Kingdom
| | - Miguel de la Hoya
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Lara Della Puppa
- Division of Functional Onco-genomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Orland Díez
- Oncogenetics Group, Clinical and Molecular Genetics Area, Vall d'Hebron Institute of Oncology (VHIO), University Hospital, Barcelona, Spain
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Nina Ditsch
- Department of Gynecology and Obstetrics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Susan M Domchek
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alan Donaldson
- Clinical Genetics Department, St Michael's Hospital, Bristol, United Kingdom
| | - Bernd Dworniczak
- Institute of Human Genetics, University of Münster, Münster, Germany
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Diana M Eccles
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Rosalind A Eeles
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Hans Ehrencrona
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden
| | - Bent Ejlertsen
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - D Gareth Evans
- Division of Evolution and Genomic Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health and Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust and Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Laurence Faivre
- Unité d'oncogénétique, Centre de Lutte Contre le Cancer, Centre Georges-François Leclerc, Dijon, France
| | - Ulrike Faust
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Lídia Feliubadaló
- Molecular Diagnostic Unit, Hereditary Cancer Program, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - George Fountzilas
- Second Department of Medical Oncology, EUROMEDICA General Clinic of Thessaloniki, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Debra Frost
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Vanesa García-Barberán
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Pilar Garre
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | | | - Lajos Géczi
- Department of Chemotherapy, National Institute of Oncology, Budapest, Hungary
| | - Andrea Gehrig
- Centre of Familial Breast and Ovarian Cancer, Department of Medical Genetics, Institute of Human Genetics, University of Würzburg, Würzburg, Germany
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - Paul Gesta
- Service Régional Oncogénétique Poitou-Charentes, CH Niort, Niort, France
| | - Giuseppe Giannini
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Gord Glendon
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Andrew K Godwin
- Department of Pathology and Laboratory Medicine, Kansas University Medical Center, Kansas City, Kansas
| | - David E Goldgar
- Department of Dermatology, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Angelica M Gutierrez-Barrera
- Department of Breast Medical Oncology and Clinical Genetics Program, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eric Hahnen
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Hauke
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Natalie Herold
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Frans B L Hogervorst
- Family Cancer Clinic, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Ellen Honisch
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter J Hulick
- Center for Medical Genetics, NorthShore University HealthSystem, Evanston, Illinois
- The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - KConFab Investigators
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hebon Investigators
- The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON), Coordinating center: The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Louise Izatt
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Agnes Jager
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Paul James
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
| | - Ramunas Janavicius
- Hematology, Oncology and Transfusion Medicine Center, Department of Molecular and Regenerative Medicine, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
| | - Uffe Birk Jensen
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Esther M John
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Vijai Joseph
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Karin Kast
- Department of Gynecology and Obstetrics, Technical University of Dresden, Dresden, Germany
| | - Johanna I Kiiski
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sung-Won Kim
- Department of Surgery, Daerim Saint Mary's Hospital, Seoul, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Kwang-Pil Ko
- Department of Preventive Medicine, Gacheon University College of Medicine, Incheon, Republic of Korea
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Lotte Krogh
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Torben A Kruse
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Ava Kwong
- Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Centre, Happy Valley, Hong Kong
- Department of Surgery, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Department of Surgery, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
| | - Mirjam Larsen
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Christine Lasset
- Unité de Prévention et d'Epidémiologie Génétique, Centre Léon Bérard, Lyon, France
| | - Charlotte Lautrup
- Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark
| | - Conxi Lazaro
- Molecular Diagnostic Unit, Hereditary Cancer Program, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Jihyoun Lee
- Department of Surgery, Soonchunhyang University College of Medicine and Soonchunhyang University Hospital, Seoul, Korea
| | - Jong Won Lee
- Department of Surgery, Ulsan University College of Medicine and Asan Medical Center, Seoul, Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University College of Medicine and Soonchunhyang University Hospital, Seoul, Korea
| | - Johannes Lemke
- Institute of Human Genetics, University Hospital Leipzig, Leipzig, Germany
| | - Fabienne Lesueur
- Service de Génétique, Institut Curie, Paris, France
- Genetic Epidemiology of Cancer Team, Inserm U900, Paris, France
- Institut Curie, Paris, France
- Mines ParisTech, Fontainebleau, France
| | | | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Patricia Llovet
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Adria Lopez-Fernández
- High Risk and Cancer Prevention Group, Vall d'Hebron Institute of Oncology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Irene Lopez-Perolio
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Victor Lorca
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Jennifer T Loud
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Edmond S K Ma
- Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Centre, Happy Valley, Hong Kong
- Department of Pathology, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
| | - Phuong L Mai
- Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Veronique Mari
- Département d'Hématologie-Oncologie Médicale, Centre Antoine Lacassagne, Nice, France
| | - Lynn Martin
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Laura Matricardi
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Noura Mebirouk
- Service de Génétique, Institut Curie, Paris, France
- Genetic Epidemiology of Cancer Team, Inserm U900, Paris, France
- Institut Curie, Paris, France
- Mines ParisTech, Fontainebleau, France
| | - Veronica Medici
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Alfons Meindl
- Department of Gynecology and Obstetrics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Arjen R Mensenkamp
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Clare Miller
- Department of Clinical Genetics, Alder Hey Hospital, Liverpool, United Kingdom
| | - Denise Molina Gomes
- Service de Biologie de la Reproduction, Cytogénétique et Génétique Médicale, CHI Poissy - Saint Germain, Poissy, France
| | - Marco Montagna
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Thea M Mooij
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Lidia Moserle
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Katherine L Nathanson
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marie Navratilova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Dieter Niederacher
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Finn C Cilius Nielsen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Kenneth Offit
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Edith Olah
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
| | | | - Kai-Ren Ong
- West Midlands Regional Genetics Service, Birmingham Women's Hospital Healthcare NHS Trust, Birmingham, United Kingdom
| | - Ana Osorio
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Claus-Eric Ott
- Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Michael T Parsons
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Inge Sokilde Pedersen
- Section of Molecular Diagnostics, Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | - Bernard Peissel
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Ana Peixoto
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - Pedro Pérez-Segura
- Department of Oncology, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM - the FIRC (Italian Foundation for Cancer Research) Institute of Molecular Oncology, Milan, Italy
| | | | - Mary E Porteous
- South East of Scotland Regional Genetics Service, Western General Hospital, Edinburgh, United Kingdom
| | - Miguel Angel Pujana
- Translational Research Laboratory, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, in Fondazione IRCCS (Istituto Di Ricovero e Cura a Carattere Scientifico) Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Juliane Ramser
- Division of Gynaecology and Obstetrics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | | | - Muhammad U Rashid
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Kerstin Rhiem
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Piera Rizzolo
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Mark E Robson
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Matti A Rookus
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Caroline M Rossing
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Catarina Santos
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - Claire Saule
- Service de Génétique, Institut Curie, Paris, France
| | - Rosa Scarpitta
- Section of Genetic Oncology, Department of Laboratory Medicine, University and University Hospital of Pisa, Pisa, Italy
| | - Rita K Schmutzler
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Hélène Schuster
- Unité d'Oncogénétique, Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - Leigha Senter
- Clinical Cancer Genetics Program, Division of Human Genetics, Department of Internal Medicine, The Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Caroline M Seynaeve
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Payal D Shah
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Priyanka Sharma
- Department of Internal Medicine, Division of Oncology, University of Kansas Medical Center, Westwood, Kansas
| | - Vivian Y Shin
- Department of Surgery, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval, Research Centre, Québec City, Québec, Canada
| | - Christian F Singer
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | | | - Katie Snape
- Medical Genetics Unit, St George's, University of London, London, United Kingdom
| | - Angela R Solano
- INBIOMED, Faculty of Medicine/CONICET and CEMIC, Department of Clinical Chemistry, Medical Direction, University of Buenos Aires, Buenos Aires, Argentina
| | - Penny Soucy
- Department of Internal Medicine, Division of Oncology, University of Kansas Medical Center, Westwood, Kansas
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Amanda B Spurdle
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Doris Steinemann
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
| | - Dominique Stoppa-Lyonnet
- Service de Génétique, Institut Curie, Paris, France
- Department of Tumour Biology, INSERM U830, Paris, France
- Université Paris Descartes, Paris, France
| | - Agostina Stradella
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Lone Sunde
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Sutter
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Yen Y Tan
- Department of OB/GYN, Medical University of Vienna, Vienna, Austria
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
- Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Soo Hwang Teo
- Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
- Breast Cancer Research Unit, Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | | | - Marc Tischkowitz
- Program in Cancer Genetics, Departments of Human Genetics and Oncology, McGill University, Montréal, Quebec, Canada
- Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Silvia Tognazzo
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Amanda E Toland
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, Ohio
| | | | - Diana Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Human Genetics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Angela Toss
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alison H Trainer
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
| | - Nadine Tung
- Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Christi J van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Lizet E van der Kolk
- Family Cancer Clinic, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Rob B van der Luijt
- Department of Medical Genetics, University Medical Center, Utrecht, the Netherlands
| | - Liselotte P van Hest
- Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Liliana Varesco
- Unit of Hereditary Cancer, Department of Epidemiology, Prevention and Special Functions, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) AOU San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Raymonda Varon-Mateeva
- Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alessandra Viel
- Division of Functional Onco-genomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Roberta Villa
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - Philipp Wagner
- Department of Women's Health, Tubingen University Hospital, Tubingen, Germany
| | - Shan Wang-Gohrke
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Barbara Wappenschmidt
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | | | - Greet Wieme
- Centre for Medical Genetics, Ghent University, Ghent, Belgium
| | | | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Sook-Yee Yoon
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Cristina Zanzottera
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Kristin K Zorn
- Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Anthony V D'Amico
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Laura Ottini
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | | | - Timothy R Rebbeck
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
- Dana-Farber Cancer Institute. Boston, Massachusetts
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Sirvén MB, Fernández-Ortega A, Stradella A, Morilla I, Falo C, Vázquez S, Castany R, Villanueva R, Recalde S, Pérez VN, Gil-Gil M, Pernas S. Real-world efficacy and safety of eribulin in advanced and pretreated HER2-negative breast cancer in a Spanish comprehensive cancer center. BMC Pharmacol Toxicol 2019; 20:68. [PMID: 31753013 PMCID: PMC6868802 DOI: 10.1186/s40360-019-0367-x] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/25/2019] [Indexed: 01/15/2023] Open
Abstract
Background Eribulin improves survival in pre-treated HER2-negative advanced breast cancer (ABC). However, limited data exist on co-morbidities and central nervous system (CNS) efficacy. The purpose of this study was to review eribulin’s efficacy and safety in everyday clinical practice with special focus on age, body mass index (BMI) and central nervous system (CNS) activity. Methods An observational study was conducted in a series of HER2-negative ABC patients treated from January’14-December’17 outside a clinical trial. Objective Response Rate (ORR), Progression Free Survival (PFS), Overall Survival (OS), and association of clinical and pathological variables with outcome were evaluated. Results Ninety-five women were treated with at least one cycle of eribulin. Median age was 57 (33–83), and 18% were obese. Median number of prior chemotherapies for ABC was 3 (2–5) and 76% of patients had visceral metastases, including 21% with CNS involvement. Most tumors were estrogen receptor-positive (79%). ORR and stable disease (SD) at 6 months were 26.2 and 37.5%, respectively. Remarkably, relevant CNS efficacy was observed with eribulin: 20% of patients obtained partial response and 25% SD. Treatment was generally well tolerated and manageable, with 29% grade 3 and 10.9% grade 4 toxicities. Median PFS and OS were 4.1 months (CI95% 3.2–4.9) and 11.1 months (CI95% 9.5–14.7), respectively. Triple-negative disease, > 2organs involved and being younger than 70 years old were independent prognosis factors for worse OS in multivariate analysis. Most patients (75%) progressed in pre-existing metastases sites. Conclusion In everyday clinical practice, eribulin’s efficacy seems similar to pivotal trials. CNS-efficacy was observed. TNBC, > 2 organs involved and being younger than 70 years old were independent prognosis factors for worse OS. Remarkably, less incidence of grade 4-toxicity compared to previous studies was found.
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Affiliation(s)
- Milana Bergamino Sirvén
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Adela Fernández-Ortega
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Agostina Stradella
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Idoia Morilla
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Catalina Falo
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Silvia Vázquez
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Roser Castany
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Villanueva
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sabela Recalde
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Miguel Gil-Gil
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sonia Pernas
- Department of Medical Oncology-Breast Cancer Unit, Insitut Catala d'Oncologia (ICO)-H.U.Bellvitge- IDIBELL, Avinguda Gran Via 199-203, 08908-L'Hospitalet de Llobregat, Barcelona, Spain.
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48
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Pernas S, Petit A, Climent F, Paré L, Perez-Martin J, Ventura L, Bergamino M, Galván P, Falo C, Morilla I, Fernandez-Ortega A, Stradella A, Rey M, Garcia-Tejedor A, Gil-Gil M, Prat A. Corrigendum: PAM50 Subtypes in Baseline and Residual Tumors Following Neoadjuvant Trastuzumab-Based Chemotherapy in HER2-Positive Breast Cancer: A Consecutive-Series From a Single Institution. Front Oncol 2019; 9:967. [PMID: 31598491 PMCID: PMC6773977 DOI: 10.3389/fonc.2019.00967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 09/11/2019] [Indexed: 12/02/2022] Open
Affiliation(s)
- Sonia Pernas
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Anna Petit
- Department of Pathology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Fina Climent
- Department of Pathology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Laia Paré
- Department of Medical Oncology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J Perez-Martin
- Clinical Research Unit, Institut Català d'Oncologia (ICO)-L'Hospitalet, Barcelona, Spain
| | - Luz Ventura
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Milana Bergamino
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Patricia Galván
- Department of Medical Oncology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Catalina Falo
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Idoia Morilla
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Adela Fernandez-Ortega
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Agostina Stradella
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Montse Rey
- Department of Pharmacy, Institut Català d'Oncologia (ICO)-L'Hospitalet, Barcelona, Spain
| | - Amparo Garcia-Tejedor
- Department of Gynecology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Miguel Gil-Gil
- Department of Medical Oncology-Breast Cancer Unit, Institut Català d'Oncologia (ICO)-H.U.Bellvitge-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
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Recalde S, Quiroga V, del Barco S, Falo C, Dorca J, Margeli M, Stradella A, Soler T, Te García IR, Viñas G, Fernandez A, Vázquez RV, Vethencourt A, Marin MR, Gil-Gil M. Influence of age on the indication of adjuvant chemotherapy in early breast cancer using Oncotype DX. An analysis of 240 patients treated in the Institut Catala d’Oncologia (ICO) hospitals. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.034] [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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Stradella A, Johnson M, Goel S, Chandana S, Galsky M, Calvo E, Moreno V, Park H, Arkenau HT, Cervantes A, Madrid LF, Mileshkin L, Plummer R, Evans J, Horvath L, Prawira A, Pelham R, Mu S, Andreu-Vieyra C, Barve M. Updated results of the PARP1/2 inhibitor pamiparib in combination with low-dose (ld) temozolomide (TMZ) in patients (pts) with locally advanced or metastatic solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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