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Prat A, Paz-Ares L, Juan M, Felip E, Garralda E, González B, Arance A, Martín-Liberal J, Gavilá J, López-González A, Cejalvo JM, Izarzugaza Y, Amillano K, Corbacho JG, Saura C, Racca F, Hierro C, Sanfeliu E, Gonzalez X, Canes J, Villacampa G, Salvador F, Pascual T, Mesía R, Cervantes A, Tabernero J. SOLTI-1904 ACROPOLI TRIAL: efficacy of spartalizumab monotherapy across tumor-types expressing high levels of PD1 mRNA. Future Oncol 2022; 18:3791-3800. [PMID: 36200668 DOI: 10.2217/fon-2022-0660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Indexed: 11/21/2022] Open
Abstract
Improved selection of cancer patients who are most likely to respond to immune checkpoint inhibitors remains an unmet clinical need. Recently, a positive correlation between levels of PD1 mRNA and clinical outcome in response to PD1 blockade across diverse tumor histologies has been confirmed in several datasets. ACROPOLI is a parallel cohort, non-randomized, phase II study that aims to evaluate the efficacy of the anti-PD1 immune checkpoint inhibitor spartalizumab as monotherapy in metastatic patients with solid tumors that express high levels of PD1 (cohort 1; n = 111). An additional cohort of 30 patients with tumors expressing low levels of PD1, where PD1/PD-L1 antibodies in monotherapy are standard treatment, will also be included (cohort 2). Primary end point is overall response rate in cohort 1. Trial registration number: NCT04802876 (ClinicalTrials.gov).
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Affiliation(s)
- Aleix Prat
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
| | - Luis Paz-Ares
- Hospital Universitario 12 de Octubre, Madrid, Spain
- CIBERONC (Centro de Investigación Biomédica en Red de Cáncer), Instituto de Salud Carlos III, Madrid (Spain)
| | - Manel Juan
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Immunology Department, Immunotherapy Platforms, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Enriqueta Felip
- Vall d'Hebron Hospital Campus, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Elena Garralda
- Vall d'Hebron Hospital Campus, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Blanca González
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Pathology department Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ana Arance
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Joaquín Gavilá
- SOLTI Cancer Research Group, Barcelona, Spain
- Instituto Valenciano de Oncología (IVO), Valencia, Spain
| | | | - Juan Miguel Cejalvo
- Hospital Clínico Universitario de Valencia, INCLIVA (Instituto de investigación sanitaria), Universidad Valencia, Spain
| | - Yann Izarzugaza
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | - Javier García Corbacho
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Cristina Saura
- SOLTI Cancer Research Group, Barcelona, Spain
- Vall d'Hebron Hospital Campus, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Cinta Hierro
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias I Pujol Research Institute (IGTP); Badalona, Barcelona, Spain
| | - Esther Sanfeliu
- SOLTI Cancer Research Group, Barcelona, Spain
- Pathology department Hospital Clinic de Barcelona, Barcelona, Spain
| | - Xavier Gonzalez
- SOLTI Cancer Research Group, Barcelona, Spain
- Institut Oncològic Dr. Rosell. Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Jordi Canes
- SOLTI Cancer Research Group, Barcelona, Spain
| | - Guillermo Villacampa
- SOLTI Cancer Research Group, Barcelona, Spain
- Oncology Data Science, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Tomás Pascual
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ricard Mesía
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias I Pujol Research Institute (IGTP); Badalona, Barcelona, Spain
| | - Andrés Cervantes
- CIBERONC (Centro de Investigación Biomédica en Red de Cáncer), Instituto de Salud Carlos III, Madrid (Spain)
- Hospital Clínico Universitario de Valencia, INCLIVA (Instituto de investigación sanitaria), Universidad Valencia, Spain
| | - Josep Tabernero
- CIBERONC (Centro de Investigación Biomédica en Red de Cáncer), Instituto de Salud Carlos III, Madrid (Spain)
- Vall d'Hebron Hospital Campus, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
- IOB-Hospital Quironsalud Barcelona, Spain
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Adamo B, Bellet M, Paré L, Pascual T, Vidal M, Pérez Fidalgo JA, Blanch S, Martinez N, Murillo L, Gómez-Pardo P, López-González A, Amillano K, Canes J, Galván P, González-Farré B, González X, Villagrasa P, Ciruelos E, Prat A. Oral metronomic vinorelbine combined with endocrine therapy in hormone receptor-positive HER2-negative breast cancer: SOLTI-1501 VENTANA window of opportunity trial. Breast Cancer Res 2019; 21:108. [PMID: 31533777 PMCID: PMC6751874 DOI: 10.1186/s13058-019-1195-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 02/16/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022] Open
Abstract
Background The biological effect of oral metronomic vinorelbine (mVNB) alone or in combination with endocrine therapy in patients with hormone receptor-positive (HR+)/HER2-negative breast cancer has been scarcely addressed. Methods Postmenopausal women with untreated stage I–III HR+/HER2-negative breast cancer were randomized (1:1:1) to receive 3 weeks of letrozole (LTZ) 2.5 mg/day, oral mVNB 50 mg 3 days/week, or the combination. The primary objective was to evaluate, within PAM50 Luminal A/B disease, if the anti-proliferative effect of LTZ+mVNB was superior to monotherapy. An anti-proliferative effect was defined as the mean relative decrease of the PAM50 11-gene proliferation score in combination arm vs. both monotherapy arms. Secondary objectives included the evaluation of a comprehensive panel of breast cancer-related genes and safety. An unplanned analysis of stromal tumor-infiltrating lymphocytes (sTILs) was also performed. PAM50 analyses were performed using the nCounter®-based Breast Cancer 360™ gene panel, which includes 752 genes and 32 signatures. Results Sixty-one patients were randomized, and 54 paired samples (89%) were analyzed. The main patient characteristics were mean age of 67, mean tumor size of 1.7 cm, mean Ki67 of 14.3%, stage I (55.7%), and grades 1–2 (90%). Most baseline samples were PAM50 Luminal A (74.1%) or B (22.2%). The anti-proliferative effect of 3 weeks of LTZ+mVNB (− 73.2%) was superior to both monotherapy arms combined (− 49.9%; p = 0.001) and mVNB (− 19.1%; p < 0.001). The anti-proliferative effect of LTZ+mVNB (− 73.2%) was numerically higher compared to LTZ (− 65.7%) but did not reach statistical significance (p = 0.328). LTZ+mVNB induced high expression of immune-related genes and gene signatures, including CD8 T cell signature and PDL1 gene and low expression of ER-regulated genes (e.g., progesterone receptor) and cell cycle-related and DNA repair genes. In tumors with ≤ 10% sTILs at baseline, a statistically significant increase in sTILs was observed following LTZ (paired analysis p = 0.049) and LTZ+mVNB (p = 0.012). Grade 3 adverse events occurred in 3.4% of the cases. Conclusions Short-term mVNB is well-tolerated and presents anti-proliferative activity alone and in combination with LTZ. The high expression of immune-related biological processes and sTILs observed with the combination opens the possibility of studying this combination with immunotherapy. Further investigation comparing these biological results with other metronomic schedules or drug combinations is warranted. Trial registration NCT02802748, registered 16 June 2016. Supplementary information Supplementary information accompanies this paper at 10.1186/s13058-019-1195-z.
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Affiliation(s)
- Barbara Adamo
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain
| | - Meritxell Bellet
- Vall d'Hebrón University Hospital/Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.,SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Laia Paré
- Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain.,SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Tomás Pascual
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain.,SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Maria Vidal
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain
| | | | - Salvador Blanch
- Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Laura Murillo
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Patricia Gómez-Pardo
- Vall d'Hebrón University Hospital/Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Jordi Canes
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Patricia Galván
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | | | - Eva Ciruelos
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain. .,Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Villarroel 170, 08035, Barcelona, Spain. .,SOLTI Breast Cancer Research Group, Barcelona, Spain.
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Manso L, Moreno Antón F, Izarzugaza Perón Y, Delgado Mingorance JI, Borrega García P, Echarri González MJ, Martínez-Jañez N, López-González A, Olier Garate C, Ballesteros García A, Chacón López-Muñíz I, Ciruelos Gil E, García-Sáenz JA, Paz-Ares L. Safety of eribulin as third-line chemotherapy in HER2-negative, advanced breast cancer pre-treated with taxanes and anthracycline: OnSITE study. Breast J 2019; 25:219-225. [PMID: 30734437 DOI: 10.1111/tbj.13199] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 12/27/2022]
Abstract
Eribulin is active and safe in heavily pre-treated metastatic breast cancer patients. Few safety data have been published in third line. We aimed to report the specific safety profile on third line beyond taxanes and anthracyclines in advanced breast cancer (ABC). A multicenter phase II, prospective study was conducted in anthracyclines and taxanes pre-treated HER2-negative ABC, programmed to receive eribulin as third-line chemotherapy. Adverse events (AEs) were assessed and classified according to CTCAE. In addition, efficacy, in terms of overall survival (OS) and progression-free survival (PFS), and the dynamics of circulating tumor cells (CTCs) during treatment were assessed. 59 patients fulfilled the criteria. All but one showed AEs with a cumulative number of 598 AEs. The most frequent grade 3/4 drug-related AEs were neutropenia (1.7%), febrile neutropenia (0.5%), leukopenia (0.5%), alopecia (0.5%), asthenia (0.3%), elevated gamma glutamyl transferase levels (0.2%), and respiratory tract infection (0.2%). Median PFS was 4 months (95% CI 3.1-5.9) and median OS was 13.6 months (11.8-not reached). The mean number of CTCs in peripheral blood was significantly reduced from baseline to cycle 2 (16.8 vs 5.4 CTCs; P < 0.001). Median OS was significantly longer in <5 baseline CTC patients compared to ≥5 baseline CTC patients (13.1 months [95% CI: 11.8-not reached] vs 12.5 months [95% CI: 7.6-not reached]; P = 0.045). A significant correlation (P = 0.0129) was observed between CTC levels at cycle 2 and death when CTCs were analyzed using cox regression. Eribulin chemotherapy is effective and safe as third line in advanced HER2-negative breast cancer. CTC levels correlate with overall survival.
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Affiliation(s)
- Luis Manso
- Medical Oncology Department, Hospital 12 De Octubre, Madrid, Spain
| | | | | | | | | | | | | | | | - Clara Olier Garate
- Medical Oncology Department, Hospital Fundación Alcorcón, Alcorcón, Spain
| | | | | | - Eva Ciruelos Gil
- Medical Oncology Department, Hospital 12 De Octubre, Madrid, Spain
| | | | - Luis Paz-Ares
- Medical Oncology Department, Hospital 12 De Octubre, Madrid, Spain
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Sánchez-Cousido L, López-González A, Honrado Franco E, Vallejo Pascual E, Sanz O, Lopez Gonzalez L, Delgado I, López-Flores M, García Palomo A. Relationship between androgen receptor and tumor-infiltrating lymphocytes in triple-negative breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mar Muñoz Sánchez MD, Carmen Soriano Rodríguez MD, Molina Garrido MJ, López-González A, García-Palomo A, López-González L, Plata Fernández MY, Caro NL, Rovira PS. Experience with eribulin in HR+/HER2- metastatic breast cancer, including a male patient: case studies. Future Oncol 2018; 14:5-12. [DOI: 10.2217/fon-2017-0355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Numerous patient- and disease-related factors must be considered when deciding a treatment approach for hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer. Hormone therapy (HT) is generally the first option in the absence of compelling reasons for chemotherapy (e.g., rapidly progressive visceral disease). After failure of first-choice HT, alternative HT options are usually attempted until hormone resistance occurs and chemotherapy becomes the treatment of choice. The first two patients presented herein experienced prolonged disease control with third-line eribulin after two lines of HT. The third report involves a case of male breast cancer which typically presents as the HR+/HER2- phenotype. Eribulin in the second line provided prolonged clinical improvement and was well tolerated.
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Affiliation(s)
| | | | | | - Ana López-González
- Medical Oncology Department, Complejo Asistencial Universitario de León, León, Spain
| | - Andrés García-Palomo
- Medical Oncology Department, Complejo Asistencial Universitario de León, León, Spain
| | - Laura López-González
- Medical Oncology Department, Complejo Asistencial Universitario de León, León, Spain
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López-González A, Sillero ID, Flores ML, López-González L, Palomo AG. Fulvestrant in breast cancer: also a good option in triple-positive breast cancer. Breast Cancer Management 2017. [DOI: 10.2217/bmt-2017-0012] [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: 11/21/2022] Open
Abstract
Fulvestrant is indicated in the treatment of locally advanced or metastatic breast cancer in postmenopausal women with hormone receptor-positive breast cancer as second line at the present time, after first line hormone therapy. We present here a case report of a 47-year-old woman diagnosed with infiltrating ductal carcinoma left breast cancer in 1998, stage II, luminal B HER2-positive and a liver and ganglionar relapse 3 years later. After radical treatment, fulvestrant was indicated. She has been 10 years with this treatment, with an excellent tolerance and without showing progression until now.
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Affiliation(s)
- Ana López-González
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
| | - Irene Delgado Sillero
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
| | - Mariana Lopez Flores
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
| | - Laura López-González
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
| | - Andres Garcia Palomo
- Complejo Asistencial Universitario de León – Medical Oncology, C/Altos de Nava Leon, Leon 24007, Spain
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Reynosa-Morales LM, Olguín-Coca FJ, Guillén-Trujillo HA, Alonso-Farrera FA, Castro-Borges P, López-González A, Ramos-Torres G. Sustainability evaluation of different techniques for concrete mixing based on quality control. Revista de la Asociación Latinoamericana de Control de Calidad, Patología y Recuperación de la Construcción 2017. [DOI: 10.21041/ra.v7i1.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Sustainability evaluation of different techniques for concrete mixing based on quality controlABSTRACTIn this study emergy analysis, an environmental valuation method was applied to concrete mixing with the purpose of evaluating its dependence on non-renewable natural resources. Three concrete mixing techniques, industrialized, semi-industrialized and manual, were evaluated based on quality control. The quantity of environmental resources used in production was measured in terms of equivalent solar energy. The resulting transformities were compared to show that emergy analysis is sensible to local context and the limits of the reference system. The results obtained show that concrete mixing is highly dependent on external resources. Semi-industrialized concrete was found to be the most sustainable.Keywords: emergy analysis; environmental accounting; sustainability; transformity; concrete.Evaluación de la sustentabilidad de diferentes técnicas de producción de concreto hidráulico basado en su control de calidadRESUMENEn este trabajo, se aplicó un método de valoración ambiental en la producción concreto con el fin de evaluar su dependencia de los recursos naturales no renovables. Tres técnicas de producción basadas en su control de calidad: industrializada, semi-industrializada y manual; se evalualuaron mediante eMergía. Esto se realizó para medir la cantidad de uso de los recursos del medio ambiente en términos de energía solar equivalente. Las Transformidades resultantes se compararon con el fin de poner de manifiesto que el análisis de eMergía es sensible al contexto local y los límites del sistema de referencia. Los resultados obtenidos muestran una alta dependencia en la producción de concreto sobre las fuentes de recursos externos, siendo el concreto semi-industrializado el más sustentable.Palabras clave: Análisis eMergético; contabilidad ambiental; sustentabilidad; transformidad; concreto hidráulico. Avaliaçao da sustentabilidade de tres métodos de produçao de concreto com base no controle de qualidadeRESUMOEste trabalho apresenta um método de avaliação ambiental na produção de concreto, baseado no consumo de recursos naturais não-renováveis. Três técnicas de produção (industrializada, semi-industrializada e manual) foram avaliadas sob o controle de qualidade eMergia. Este conceito foi utilizado para medir a quantidade do uso de recursos do meio ambiente em termos de energia solar equivalente. Os resultados foram comparados a fim de mostrar que a análise eMergia é sensível ao contexto local e aos limites do sistema de referência. Os resultados mostram uma alta dependência da produção de concreto em relação às fontes de recursos externos, sendo o concreto semi-industrializado o mais sustentável, segundo esta análise.Palavras chave: análise eMergética; contabilidade ambiental; sustentabilidade; transformidade; concreto.
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López-González A, Diz P, Gutierrez L, Almagro E, García Palomo A, Provencio M. The role of anthracyclines in small cell lung cancer. Ann Transl Med 2014; 1:5. [PMID: 25332950 DOI: 10.3978/j.issn.2305-5839.2013.01.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 01/22/2013] [Indexed: 11/14/2022]
Abstract
Small cell lung cancer (SCLC) represents the 15% of the totally of lung cancer. The percentage of cases in women is arising due to the differences in smoking patterns; it occurs almost exclusively in smokers and appears to be most common in heavy smokers. The stage of disease at presentation is the most important prognostic factor in patients with SCLC; for patients with extended stage disease, the median survival is around 10 months, and the five-year survival rate is 1 to 2 percent. The standard regimen for patients with extensive disease is cisplatin based chemotherapy. Second line chemotherapy is generally less effective than the initial treatment but it can provide significant palliation for many patients. We make a review here of the different options of second line chemotherapy and the role of anthracyclines in it.
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Affiliation(s)
- Ana López-González
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Pilar Diz
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Lourdes Gutierrez
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Elena Almagro
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Andrés García Palomo
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Mariano Provencio
- 1 Medical Oncology, Hospital Universitario León, Spain ; 2 Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
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López-González A, Salas C, Provencio M, Córdoba M, Gamallo C. Aldehyde dehydrogenases in early stage lung cancer: nuclear expression. Clin Transl Oncol 2014; 16:931-4. [PMID: 24643706 DOI: 10.1007/s12094-014-1173-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 02/21/2014] [Indexed: 12/12/2022]
Abstract
PURPOSE Aldehyde dehydrogenase enzymes are a family of intracellular enzymes that participate in cellular detoxification, differentiation and drug resistance through the oxidation of cellular aldehydes. The isoform 1 (ALDH1) has been proved useful for the identification of cancer stem cells. The ALDH1 cytoplasmatic expression has been associated with poor prognostis in several tumours, such as non-small cell lung cancer. The role of the ALDH1 nuclear expression remains unknown. METHODS We conducted a historical cohort study in 89 patients diagnosed of stage I non-small cell lung cancer treated with surgery between 2009 and 2004 in the Thoracic Surgery Department in the Universitary Hospital Puerta de Hierro. We selected from this sample those cases with nuclear expression of the ALDH1. RESULTS Three of the 89 (3.3 %) patients showed a nuclear expression of the ALDH1. The three of them are still alive with a median time of follow up of 73 months (more than 6 years). CONCLUSION We have identified ALDH1 as a nuclear protein in early stage non-small cell lung cancer. It might have a function in cell cycle control, associating a better prognosis to these patients. More studies are necessary to clarify the role of nuclear expression of ALDH1.
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Affiliation(s)
- A López-González
- Medical Oncology, Complejo Asistencial Universitario León, León, Spain,
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Silva J, Garcia V, López-González A, Provencio M. MicroRNAs as molecular markers in lung cancer. Int J Cancer Ther Oncol 2013. [DOI: 10.14319/ijcto.0101.11] [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: 11/05/2022] Open
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López-González A, Almagro E, Salas C, Varela A, Provencio M. Use of a tyrosine kinase inhibitor as neoadjuvant therapy for non-small cell lung cancer: A case report. Respir Med Case Rep 2013; 9:8-10. [PMID: 26029620 PMCID: PMC3949555 DOI: 10.1016/j.rmcr.2013.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/28/2013] [Accepted: 02/12/2013] [Indexed: 01/13/2023] Open
Abstract
We report here a 66-year-old woman diagnosed with bronchioloalveolar carcinoma of the right lung cT4N2M0. The patient was from the Philippines, had never smoked, and tested positive for an EGFR mutation. She received gefitinib as neoadjuvant therapy for two months and displayed a partial response. The tumour was resected by performing a right pneumonectomy. The residual viable tumour accounted for less than 10%. Adjuvant chemotherapy with carboplatin-taxol was administered for four cycles. Fifteen months post-surgery, two brain metastases were found. Gefitinib was prescribed, and one month later complete radiological response was assessed. The patient remains asymptomatic and without visible disease four months later. Controlled randomised trials are needed to clarify the role of these target therapies in the neoadjuvant setting.
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Affiliation(s)
| | - E Almagro
- Medical Oncology, H. Puerta de Hierro-Majadahonda, Spain
| | - C Salas
- Pathological Anatomy, Puerta de Hierro-Majadahonda, Spain
| | - A Varela
- Thoracic Surgery, Puerta de Hierro-Majadahonda, Spain
| | - M Provencio
- Medical Oncology, H. Puerta de Hierro-Majadahonda, Spain
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López-González A, Ibeas Millán P, Cantos B, Provencio M. Surveillance of resected non-small cell lung cancer. Clin Transl Oncol 2012; 14:721-5. [PMID: 22855136 DOI: 10.1007/s12094-012-0841-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 02/06/2012] [Indexed: 01/03/2023]
Abstract
Lung cancer is the most common cancer in the world. 15 % of all patients with lung cancer are diagnosed at an early stage, and surgery is the treatment of choice for them. 40 % of all patients survive more than 5 years after surgery, and most of them die as a result of systemic disease. Half of all recurrences are diagnosed within the first 24 months after curative treatment, and 90 % in the first 5 years. Despite this, it is not standardized who should do the monitoring, what additional tests are needed and how often should they be performed. We present here a review on the various recommendations in clinical guidelines.
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Affiliation(s)
- A López-González
- Servicio Oncología Médica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
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López-González A, Huelves M, García AL, Provencio M. Skeletal muscle metastasis from NSCLC. J Thorac Dis 2012; 4:232-4. [PMID: 22833837 PMCID: PMC3378221 DOI: 10.3978/j.issn.2072-1439.2011.06.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 06/18/2011] [Indexed: 01/22/2023]
Affiliation(s)
- Ana López-González
- Department of Medical Oncology, Hospital Puerta de Hierro. Madrid, Spain
| | - Miriam Huelves
- Department of Medical Oncology, Hospital Puerta de Hierro. Madrid, Spain
| | - Ana López García
- Department of Pathological Anatomy, Hospital Puerta de Hierro, Madrid, Spain
| | - Mariano Provencio
- Department of Medical Oncology, Hospital Puerta de Hierro. Madrid, Spain
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Pancucci G, Miranda-Lloret P, Plaza-Ramírez M, López-González A, Rovira-Lillo V, Beltrán-Giner A. Artrodesis combinada anterior y posterior en paciente con parálisis cerebral atetósica que desarrolla mielopatía cervical degenerativa: Caso clínico y revisión de la literatura. Neurocirugia (Astur) 2011. [DOI: 10.4321/s1130-14732011000300004] [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: 11/11/2022]
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Pancucci G, Miranda-Lloret P, Plaza-Ramírez ME, López-González A, Rovira-Lillo V, Beltrán-Giner A. [Combined anterior-posterior arthrodesis en patient with athetoid cerebral palsy who developed spondylotic cervical mielopathy. Case report and review of literature]. Neurocirugia (Astur) 2011; 22:245-250. [PMID: 21743945] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Spondylotic cervical mielopathy is a common complication in young patients with Cerebral Child Palsy with an important dystonic and athetoid component. Its surgical treatment is a challenge, due to elevate incidence of early faliure of the arthrodesis, both in anterior and posterior approaches. We report an historical review about the treatment of cervical mielopathy in this subgroup of patients and a clinical case in which we decided to realize decompression and arthtrodesis by a combined anterior and posterior approach, with lateral-mass screw placement, using botulinium toxin injections in the postoperative period, achieving a good clinical outcome.
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Affiliation(s)
- G Pancucci
- Unidad de patología raquimedular. Servicio de Neurocirugía. Hospital Universitario La Fe. Valencia.
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López-González A, Egui Rojo MA, Maximiano C, Martínez-Salamanca JI, González Hernando C, Sánchez Yuste R, Bonilla F, Carballido Rodríguez JA. Evolución natural del carcinoma embrionario. ARCH ESP UROL 2010. [DOI: 10.4321/s0004-06142010000900009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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López-González A, Egui Rojo MA, Maximiano C, Martínez-Salamanca JI, González Hernando C, Sánchez Yuste R, Bonilla F, Carballido Rodríguez JA. Natural progression of embryonal carcinoma. ARCH ESP UROL 2010; 63:803-807. [PMID: 21098905] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE We report a rare case of advanced testicular cancer that describes the natural progression of testicular cancer without medical treatment. This study also describes the effectiveness of chemotherapy, which was the approach used for treatment. METHODS 37 year old male with history of mental retardation, presented to the emergency room with an ulcer on his right scrotum that had been present for a few months. He was diagnosed of pT4 embryonal carcinoma by biopsy. CT scan showed multiple lung nodes. He was treated with five cycles of Bleomycin/Etoposide/Cisplatin with complete response after treatment. RESULTS Testicular tumors are the most frequent solid tumors in males between the ages of 20 and 39 years old. Testicular tumors represent 1% of all neoplasias diagnosed in males and 0.1% of all male deaths due to cancer. Several studies have reported the current real incidence rate of testicular tumors has increased to 3%, which accounts for the diagnosis of 450 new cases of testicular cancer a year in Spain. CONCLUSIONS The cure rate for patients with intermediate risk non-seminoma is around 70% following a conventional treatment approach of four cycles of BEP. The present case is noteworthy because, in our experience, testicular tumors are diagnosed at an early stage without extensively affecting the skin or simulating another type of epithelial tumor. As a result, the present study describes the natural progression of testicular cancer.
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Affiliation(s)
- Ana López-González
- Department of Urology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain.
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López-González A, Cantos B, Tejerina E, Provencio M. Activity of trabectidin in desmoplastic small round cell tumor. Med Oncol 2010; 28 Suppl 1:S644-6. [PMID: 20924717 DOI: 10.1007/s12032-010-9687-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Accepted: 09/10/2010] [Indexed: 11/30/2022]
Abstract
Desmoplastic small round cell tumor (DSRCT) is a rare and aggressive cancer that typically arises in teenage boys. As a result of its low prevalence, there have been few studies of its treatment and impact on survival. Here, we report the case of a patient who was refractory to multiple drugs but remains stable with trabectedin. To our knowledge, this is the first published report that supports antitumoral activity of trabectedin in DSRCT.
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Affiliation(s)
- Ana López-González
- Medical Oncology, Hospital Universitario Puerta de Hierro, Madrid, Spain
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López-González A, Sánchez A, Yebra M, Provencio M. False-positive interpretations in respiratory cytopathology. Clin Rheumatol 2009; 32 Suppl 1:S15-7. [PMID: 19784711 DOI: 10.1007/s10067-009-1281-1] [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: 08/18/2009] [Accepted: 09/09/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Ana López-González
- Servicio de Oncología Médica, Hospital Universitario Puerta de Hierro-Majadahonda, San Martín de Porres, 4, Madrid 28035, Spain
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López-González A, Resurrección Giner M. Idiopathic spinal epidural lipomatosis: urgent decompression in an atypical case. Eur Spine J 2007; 17 Suppl 2:S225-7. [PMID: 17876611 PMCID: PMC2525894 DOI: 10.1007/s00586-007-0465-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Revised: 08/16/2007] [Accepted: 08/28/2007] [Indexed: 10/22/2022]
Abstract
Symptomatic spinal epidural lipomatosis (SEL) is very rare and frequently associated to chronic exogenous steroid use, obesity and Cushing syndrome. The idiopathic cases where no identifiable association with SEL are found constitute only 17% of all cases. The usual clinical manifestations of this entity consist of dorsal or lumbar pain with paresthesias and weakness in lower limbs, but acute symptoms of myelopathy are exceptional. We report a case of acute paraparesis and urinary retention caused by thoracic SEL in a 55-year-old male who did not have any recognized predisposing factor for this condition. Urgent surgical decompression was performed in order to relieve the symptoms. Slow but progressive improvement was assessed after surgery. We consider this case to be exceptional due to the needing to perform an urgent decompressive laminectomy to treat a rapidly progressive myelopathy caused by idiopathic SEL.
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Affiliation(s)
- A López-González
- Department of Neurosurgery, Hospital Universitario La Fe, Avenida Campanar, 21, 46009, Valencia, Spain.
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López-González A, Galeano I, Gutiérrez A, Giner R, Alvarez-Garijo JA, Cabanes J. [Association between cerebral infarction and malignant glioma]. Rev Neurol 2005; 40:34-7. [PMID: 15696424] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
INTRODUCTION It is very rare for cerebral infarction to be the first symptom of an intracranial tumour. Only three cases have been reported in which cerebral infarction is thought to have been caused by the arterial compromise triggered by incipient high grade gliomas that are not yet visible in radiological tests. CASE REPORT A 46-year-old male with no relevant medical history or cardiovascular risk factors who presented with acute hemiplegia on the right-hand side of the body and a significantly impaired level of consciousness. Computerised axial tomography of the brain showed a left frontal malignant ischemic infarct that exerted an important mass effect. The patient was submitted to a left-side frontoparietal decompressive craniectomy. Post-operative progress was good and the patient even recovered his normal level of consciousness, although he was left with right hemiparesis and conduction dysphasia. Seven months after the craniectomy the patient experienced a progressive deterioration with symptoms of endocranial hypertension. Magnetic resonance imaging of the brain revealed the presence of a highly malignant tumour in the previously infarcted territory. A histological study of the excised lesion showed it to be a glioblastoma multiforme. CONCLUSIONS The proximity in time, as well as the identical location of the two lesions, led us to think that the glioblastoma, although not yet visible in radiological explorations, affected a branch of the middle cerebral artery and gave rise to the infarct. Therefore, in the presence of a cerebral infarct in patients with no risk factors for suffering a brain vascular pathology, it is advisable to carry out a radiological follow-up so as to be able to diagnose a possible lesion due to a tumour.
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Affiliation(s)
- A López-González
- Servicio de Neurocirugía, Hospital Universitario La Fe, Valencia, España.
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