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Butta NV, Arias-Salgado EG, Monzón Manzano E, Acuña P, Álvarez Román MT, Buño-Soto A, Ramos Ramos JC, Belda-Iniesta C, Frías J, Carcas AJ, de Soto LM, de Miguel Buckley R, Lora D, García-Morales MT, Borobia AM, Arribas JR, Jiménez Yuste V. No changes in hemostasis after COVID-19-heterologous vaccination schedule: A subanalysis of the phase 2 CombiVacS study. Res Pract Thromb Haemost 2023; 7:100049. [PMID: 36685004 PMCID: PMC9840220 DOI: 10.1016/j.rpth.2023.100049] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/20/2022] [Accepted: 11/07/2022] [Indexed: 01/16/2023] Open
Abstract
Background Several cases of unusual thrombotic events and thrombocytopenia were described after vaccination with recombinant adenoviral vectors encoding the spike protein antigen of SARS-CoV-2. Objectives The objective of this study was to elucidate the impact of a COVID-19 heterologous vaccination schedule, including priming with adenovirus vaccine, on hemostasis profiles. Methods The present study is a subanalysis of the CombiVacS clinical trial initiated in April 2021 that included adult participants previously vaccinated with a single dose of ChAdOx1-S. Between 8 and 12 weeks after vaccination, they were randomly assigned (2:1) to receive either BNT162b2 vaccine (intervention group, n = 99) or continue observation (control group, n = 50). Samples drawn before and 28 days after a vaccination with BNT162b2 were analyzed for platelet count and markers of hemostasis (D-dimer, anti-PF4 antibodies, cfDNA, PAI-1, thrombin generation, and serum capacity to activate platelets). Results Platelet count from all participants after receiving BNT162b2 was within the normal range. Anti-PF4 antibodies were present in 26% and 18% of the subjects from the control and intervention groups, respectively, at day 28. In most cases, the levels of anti-PF4 antibodies were high before receiving BNT162b2. Serum from these participants did not activate platelets from healthy controls. There were no differences between the groups in PAI-1 and cfDNA plasma levels. According to the D-dimer plasma concentration, the thrombin generation test showed that none of the participants had a procoagulant profile. Conclusion Our data suggest that the heterologous vaccination against COVID-19 with ChAdOx1-S and a second dose with BNT162b2 might be safe in terms of haemostasis.
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Affiliation(s)
- Nora V. Butta
- Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
| | - Elena G. Arias-Salgado
- Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
| | - Elena Monzón Manzano
- Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
| | - Paula Acuña
- Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
| | - María Teresa Álvarez Román
- Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Antonio Buño-Soto
- Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, Spain
| | - Juan Carlos Ramos Ramos
- Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
| | | | - Jesús Frías
- Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain,Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain,Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain,VACCELERATE: European Corona Vaccine Trial Accelerator Platform, European Union's Horizon 2020,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Antonio J. Carcas
- Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain,Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain,Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain,VACCELERATE: European Corona Vaccine Trial Accelerator Platform, European Union's Horizon 2020,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Lucía Martínez de Soto
- Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain,Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain
| | - Rosa de Miguel Buckley
- Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain
| | - David Lora
- Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBER de Epidemiología y Salud Pública (CIBERESP), Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - María Teresa García-Morales
- Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBER de Epidemiología y Salud Pública (CIBERESP), Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Alberto M. Borobia
- Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain,Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain,Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain,VACCELERATE: European Corona Vaccine Trial Accelerator Platform, European Union's Horizon 2020,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain,Correspondence Alberto M. Borobia, Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid 28046, Spain
| | - José Ramón Arribas
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain,Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain,José Ramón Arribas, Infectious Diseases Unit, La Paz University Hospital, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Víctor Jiménez Yuste
- Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain,Víctor Jiménez Yuste, Servicio de Hematología y Hemostasia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, Madrid 28046, Spain
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2
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Schwarz M, Torre D, Lozano-Ojalvo D, Tan AT, Tabaglio T, Mzoughi S, Sanchez-Tarjuelo R, Le Bert N, Lim JME, Hatem S, Tuballes K, Camara C, Lopez-Granados E, Paz-Artal E, Correa-Rocha R, Ortiz A, Lopez-Hoyos M, Portoles J, Cervera I, Gonzalez-Perez M, Bodega-Mayor I, Conde P, Oteo-Iglesias J, Borobia AM, Carcas AJ, Frías J, Belda-Iniesta C, Ho JSY, Nunez K, Hekmaty S, Mohammed K, Marsiglia WM, Carreño JM, Dar AC, Berin C, Nicoletti G, Della Noce I, Colombo L, Lapucci C, Santoro G, Ferrari M, Nie K, Patel M, Barcessat V, Gnjatic S, Harris J, Sebra R, Merad M, Krammer F, Kim-Schulze S, Marazzi I, Bertoletti A, Ochando J, Guccione E. Rapid, scalable assessment of SARS-CoV-2 cellular immunity by whole-blood PCR. Nat Biotechnol 2022; 40:1680-1689. [PMID: 35697804 PMCID: PMC10603792 DOI: 10.1038/s41587-022-01347-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 05/02/2022] [Indexed: 12/30/2022]
Abstract
Fast, high-throughput methods for measuring the level and duration of protective immune responses to SARS-CoV-2 are needed to anticipate the risk of breakthrough infections. Here we report the development of two quantitative PCR assays for SARS-CoV-2-specific T cell activation. The assays are rapid, internally normalized and probe-based: qTACT requires RNA extraction and dqTACT avoids sample preparation steps. Both assays rely on the quantification of CXCL10 messenger RNA, a chemokine whose expression is strongly correlated with activation of antigen-specific T cells. On restimulation of whole-blood cells with SARS-CoV-2 viral antigens, viral-specific T cells secrete IFN-γ, which stimulates monocytes to produce CXCL10. CXCL10 mRNA can thus serve as a proxy to quantify cellular immunity. Our assays may allow large-scale monitoring of the magnitude and duration of functional T cell immunity to SARS-CoV-2, thus helping to prioritize revaccination strategies in vulnerable populations.
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Affiliation(s)
- Megan Schwarz
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Therapeutics Discovery, Department of Oncological Sciences and Pharmacological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Denis Torre
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Therapeutics Discovery, Department of Oncological Sciences and Pharmacological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel Lozano-Ojalvo
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anthony T Tan
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Tommaso Tabaglio
- Institute of Molecular and Cell Biology, IMCB, A*STAR, Singapore, Singapore
| | - Slim Mzoughi
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Therapeutics Discovery, Department of Oncological Sciences and Pharmacological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rodrigo Sanchez-Tarjuelo
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- National Center for Microbiology, Carlos III Health Institute, Madrid, Spain
| | - Nina Le Bert
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Joey Ming Er Lim
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Sandra Hatem
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin Tuballes
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carmen Camara
- Department of Immunology, University Hospital La Paz-IdiPAZ, Madrid, Spain
| | | | - Estela Paz-Artal
- Department of Immunology, Research Institution, Sanitaria Hospital, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, Complutense University of Madrid, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - Rafael Correa-Rocha
- Laboratory of Immune-Regulation, Research Institute Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Alberto Ortiz
- Department of Nephrology, IIS-Fundación Jimenez Díaz, Madrid, Spain
| | - Marcos Lopez-Hoyos
- Department of Immunology, Hospital University of Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Jose Portoles
- Department of Nephrology, Hospital of Puerta de Hierro, Madrid, Spain
| | - Isabel Cervera
- National Center for Microbiology, Carlos III Health Institute, Madrid, Spain
| | | | - Irene Bodega-Mayor
- National Center for Microbiology, Carlos III Health Institute, Madrid, Spain
| | - Patricia Conde
- National Center for Microbiology, Carlos III Health Institute, Madrid, Spain
| | - Jesús Oteo-Iglesias
- National Center for Microbiology, Carlos III Health Institute, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - Alberto M Borobia
- Clinical Pharmacology, University Hospital La Paz-IDIPAZ, Platform of Clinical Research Units and Clinical Trials, Spain Faculty of Medicine Autonomous University of Madrid, Madrid, Spain
| | - Antonio J Carcas
- Clinical Pharmacology, University Hospital La Paz-IDIPAZ, Platform of Clinical Research Units and Clinical Trials, Spain Faculty of Medicine Autonomous University of Madrid, Madrid, Spain
| | - Jesús Frías
- Clinical Pharmacology, University Hospital La Paz-IDIPAZ, Platform of Clinical Research Units and Clinical Trials, Spain Faculty of Medicine Autonomous University of Madrid, Madrid, Spain
| | | | - Jessica S Y Ho
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kemuel Nunez
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Therapeutics Discovery, Department of Oncological Sciences and Pharmacological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saboor Hekmaty
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin Mohammed
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William M Marsiglia
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arvin C Dar
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Therapeutics Discovery, Department of Oncological Sciences and Pharmacological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cecilia Berin
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | | | | | | | - Kai Nie
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Core, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manishkumar Patel
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Core, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vanessa Barcessat
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sacha Gnjatic
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Core, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jocelyn Harris
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Core, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Sebra
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Sema4, a Mount Sinai venture, Stamford, CT, USA
- Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Miriam Merad
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Core, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Seunghee Kim-Schulze
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Core, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ivan Marazzi
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Antonio Bertoletti
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore.
| | - Jordi Ochando
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- National Center for Microbiology, Carlos III Health Institute, Madrid, Spain.
| | - Ernesto Guccione
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center for Therapeutics Discovery, Department of Oncological Sciences and Pharmacological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Bioinformatics for Next Generation Sequencing (BiNGS) Shared Resource Facility, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Lassman AB, Sepúlveda-Sánchez JM, Cloughesy TF, Gil-Gil MJ, Puduvalli VK, Raizer JJ, De Vos FY, Wen PY, Butowski NA, Clement PM, Groves MD, Belda-Iniesta C, Giglio P, Soifer HS, Rowsey S, Xu C, Avogadri F, Wei G, Moran S, Roth P. Infigratinib in Patients with Recurrent Gliomas and FGFR Alterations: A Multicenter Phase II Study. Clin Cancer Res 2022; 28:2270-2277. [PMID: 35344029 PMCID: PMC9167702 DOI: 10.1158/1078-0432.ccr-21-2664] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/04/2021] [Accepted: 03/17/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE FGFR genomic alterations (amplification, mutations, and/or fusions) occur in ∼8% of gliomas, particularly FGFR1 and FGFR3. We conducted a multicenter open-label, single-arm, phase II study of a selective FGFR1-3 inhibitor, infigratinib (BGJ398), in patients with FGFR-altered recurrent gliomas. PATIENTS AND METHODS Adults with recurrent/progressive gliomas harboring FGFR alterations received oral infigratinib 125 mg on days 1 to 21 of 28-day cycles. The primary endpoint was investigator-assessed 6-month progression-free survival (PFS) rate by Response Assessment in Neuro-Oncology criteria. Comprehensive genomic profiling was performed on available pretreatment archival tissue to explore additional molecular correlations with efficacy. RESULTS Among 26 patients, the 6-month PFS rate was 16.0% [95% confidence interval (CI), 5.0-32.5], median PFS was 1.7 months (95% CI, 1.1-2.8), and objective response rate was 3.8%. However, 4 patients had durable disease control lasting longer than 1 year. Among these, 3 had tumors harboring activating point mutations at analogous positions of FGFR1 (K656E; n = 2) or FGFR3 (K650E; n = 1) in pretreatment tissue; an FGFR3-TACC3 fusion was detected in the other. Hyperphosphatemia was the most frequently reported treatment-related adverse event (all-grade, 76.9%; grade 3, 3.8%) and is a known on-target toxicity of FGFR inhibitors. CONCLUSIONS FGFR inhibitor monotherapy with infigratinib had limited efficacy in a population of patients with recurrent gliomas and different FGFR genetic alterations, but durable disease control lasting more than 1 year was observed in patients with tumors harboring FGFR1 or FGFR3 point mutations or FGFR3-TACC3 fusions. A follow-up study with refined biomarker inclusion criteria and centralized FGFR testing is warranted.
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Affiliation(s)
- Andrew B. Lassman
- Division of Neuro-Oncology, Department of Neurology and Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, New York, New York
- Corresponding Author: Andrew B. Lassman, Columbia University Irving Medical Center, 710 W 168th St, New York, NY 10032. Phone: 212-342-0871; Fax: 212-342-1246; E-mail:
| | | | | | - Miguel J. Gil-Gil
- Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | - Vinay K. Puduvalli
- Division of Neuro-Oncology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jeffrey J. Raizer
- Northwestern University, Department of Neurology, Section of Neuro-Oncology, Chicago, Illinois
| | - Filip Y.F. De Vos
- Department Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Patrick Y. Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | | | | | | | - Pierre Giglio
- Division of Neuro-Oncology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | | | | | - Cindy Xu
- QED Therapeutics, San Francisco, California
| | | | - Ge Wei
- QED Therapeutics, San Francisco, California
| | | | - Patrick Roth
- Department of Neurology & Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland
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4
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Borobia AM, Carcas AJ, Pérez-Olmeda M, Castaño L, Bertran MJ, García-Pérez J, Campins M, Portolés A, González-Pérez M, García Morales MT, Arana-Arri E, Aldea M, Díez-Fuertes F, Fuentes I, Ascaso A, Lora D, Imaz-Ayo N, Barón-Mira LE, Agustí A, Pérez-Ingidua C, Gómez de la Cámara A, Arribas JR, Ochando J, Alcamí J, Belda-Iniesta C, Frías J. Immunogenicity and reactogenicity of BNT162b2 booster in ChAdOx1-S-primed participants (CombiVacS): a multicentre, open-label, randomised, controlled, phase 2 trial. Lancet 2021; 398:121-130. [PMID: 34181880 PMCID: PMC8233007 DOI: 10.1016/s0140-6736(21)01420-3] [Citation(s) in RCA: 259] [Impact Index Per Article: 86.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND To date, no immunological data on COVID-19 heterologous vaccination schedules in humans have been reported. We assessed the immunogenicity and reactogenicity of BNT162b2 (Comirnaty, BioNTech, Mainz, Germany) administered as second dose in participants primed with ChAdOx1-S (Vaxzevria, AstraZeneca, Oxford, UK). METHODS We did a phase 2, open-label, randomised, controlled trial on adults aged 18-60 years, vaccinated with a single dose of ChAdOx1-S 8-12 weeks before screening, and no history of SARS-CoV-2 infection. Participants were randomly assigned (2:1) to receive either BNT162b2 (0·3 mL) via a single intramuscular injection (intervention group) or continue observation (control group). The primary outcome was 14-day immunogenicity, measured by immunoassays for SARS-CoV-2 trimeric spike protein and receptor binding domain (RBD). Antibody functionality was assessed using a pseudovirus neutralisation assay, and cellular immune response using an interferon-γ immunoassay. The safety outcome was 7-day reactogenicity, measured as solicited local and systemic adverse events. The primary analysis included all participants who received at least one dose of BNT162b2 and who had at least one efficacy evaluation after baseline. The safety analysis included all participants who received BNT162b2. This study is registered with EudraCT (2021-001978-37) and ClinicalTrials.gov (NCT04860739), and is ongoing. FINDINGS Between April 24 and 30, 2021, 676 individuals were enrolled and randomly assigned to either the intervention group (n=450) or control group (n=226) at five university hospitals in Spain (mean age 44 years [SD 9]; 382 [57%] women and 294 [43%] men). 663 (98%) participants (n=441 intervention, n=222 control) completed the study up to day 14. In the intervention group, geometric mean titres of RBD antibodies increased from 71·46 BAU/mL (95% CI 59·84-85·33) at baseline to 7756·68 BAU/mL (7371·53-8161·96) at day 14 (p<0·0001). IgG against trimeric spike protein increased from 98·40 BAU/mL (95% CI 85·69-112·99) to 3684·87 BAU/mL (3429·87-3958·83). The interventional:control ratio was 77·69 (95% CI 59·57-101·32) for RBD protein and 36·41 (29·31-45·23) for trimeric spike protein IgG. Reactions were mild (n=1210 [68%]) or moderate (n=530 [30%]), with injection site pain (n=395 [88%]), induration (n=159 [35%]), headache (n=199 [44%]), and myalgia (n=194 [43%]) the most commonly reported adverse events. No serious adverse events were reported. INTERPRETATION BNT162b2 given as a second dose in individuals prime vaccinated with ChAdOx1-S induced a robust immune response, with an acceptable and manageable reactogenicity profile. FUNDING Instituto de Salud Carlos III. TRANSLATIONS For the French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Alberto M Borobia
- Servicio de Farmacología Clínica, Departamento de Farmacología y Terapéutica, Facultad de Medicina, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Antonio J Carcas
- Servicio de Farmacología Clínica, Departamento de Farmacología y Terapéutica, Facultad de Medicina, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Luis Castaño
- Hospital Universitario de Cruces, Biocruces Bizkaia HRI, UPV/EHU, OSAKIDETZA, CIBERDEM, CIBERER, Endo-ERN, Barakaldo-Bilbao, Spain
| | - María Jesús Bertran
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Javier García-Pérez
- Unidad de Inmunopatología del SIDA, Instituto de Salud Carlos III, Madrid, Spain
| | - Magdalena Campins
- Servicio de Medicina Preventiva y Epidemiología, Servicio de Farmacología Clínica, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Portolés
- Servicio de Farmacología Clínica, Hospital Clínico San Carlos, IdISSC, Departamento de Farmacología y Toxicología, Universidad Complutense de Madrid, Madrid, Spain
| | - María González-Pérez
- Laboratorio de Referencia en Inmunología, Instituto de Salud Carlos III, Madrid, Spain
| | - María Teresa García Morales
- Instituto de Investigación Sanitaria Hospital 12 de Octubre, CIBER de Epidemiología y Salud Pública, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Eunate Arana-Arri
- Hospital Universitario de Cruces, Biocruces Bizkaia HRI, UPV/EHU, OSAKIDETZA, CIBERDEM, CIBERER, Endo-ERN, Barakaldo-Bilbao, Spain
| | - Marta Aldea
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Inmaculada Fuentes
- Unidad de Soporte a la Investigación Clínica, Vall d'Hebron Institut de Recerca, Servicio de Farmacología Clínica, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Ascaso
- Servicio de Farmacología Clínica, Hospital Clínico San Carlos, IdISSC, Departamento de Farmacología y Toxicología, Universidad Complutense de Madrid, Madrid, Spain
| | - David Lora
- Instituto de Investigación Sanitaria Hospital 12 de Octubre, CIBER de Epidemiología y Salud Pública, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Natale Imaz-Ayo
- Hospital Universitario de Cruces, Biocruces Bizkaia HRI, UPV/EHU, OSAKIDETZA, CIBERDEM, CIBERER, Endo-ERN, Barakaldo-Bilbao, Spain
| | - Lourdes E Barón-Mira
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Antonia Agustí
- Departmento de Farmacología, Terapéutica y Toxicología, Servicio de Farmacología Clínica, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carla Pérez-Ingidua
- Servicio de Farmacología Clínica, Hospital Clínico San Carlos, IdISSC, Departamento de Farmacología y Toxicología, Universidad Complutense de Madrid, Madrid, Spain
| | - Agustín Gómez de la Cámara
- Instituto de Investigación Sanitaria Hospital 12 de Octubre, CIBER de Epidemiología y Salud Pública, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - José Ramón Arribas
- Servicio de Medicina Interna, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Jordi Ochando
- Laboratorio de Referencia en Inmunología, Instituto de Salud Carlos III, Madrid, Spain
| | - José Alcamí
- Unidad de Inmunopatología del SIDA, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristóbal Belda-Iniesta
- Centro Nacional de Microbiología, and Evaluation and Promotion of Research, Instituto de Salud Carlos III, Madrid, Spain.
| | - Jesús Frías
- Servicio de Farmacología Clínica, Departamento de Farmacología y Terapéutica, Facultad de Medicina, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.
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5
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Rackov G, Iegiani G, Uribe D, Quezada C, Belda-Iniesta C, Escobedo-Lucea C, Silva A, Puig P, González-Rumayor V, Ayuso-Sacido Á. Potential Therapeutic Effects of the Neural Stem Cell-Targeting Antibody Nilo1 in Patient-Derived Glioblastoma Stem Cells. Front Oncol 2020; 10:1665. [PMID: 32974206 PMCID: PMC7468525 DOI: 10.3389/fonc.2020.01665] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
Glioblastoma (GBM) is the most devastating and least treatable brain tumor with median survival <15 months and extremely high recurrence rates. Promising results of immune checkpoint blockade obtained from pre-clinical studies in mice did not translate to clinic, and new strategies are urgently needed, particularly those targeting GBM stem cells (GSCs) that are held responsible for drug resistance and tumor recurrence. Patient-derived GSC cultures are critical for finding effective brain tumor therapies. Here, we investigated the ability of the recently described monoclonal antibody Nilo1 to specifically recognize GSCs isolated from GBM surgical samples. We employed five patient-derived GSC cultures with different stemness marker expression and differentiation potential, able to recapitulate original tumors when xenotransplanted in vivo. To answer whether Nilo1 has any functional effects in patient-derived GSCs lines, we treated the cells with Nilo1 in vitro and analyzed cell proliferation, cell cycle, apoptosis, sphere formation, as well as the expression of stem vs. differentiation markers. All tested GSCs stained positively for Nilo1, and the ability of Nilo1 to recognize GSCs strongly relied on their stem-like phenotype. Our results showed that a subset of patient-derived GSCs were sensitive to Nilo1 treatment. In three GSC lines Nilo1 triggered differentiation accompanied by the induction of p21. Most strikingly, in one GSC line Nilo1 completely abrogated self-renewal and led to Bax-associated apoptosis. Our data suggest that Nilo1 targets a molecule functionally relevant for stemness maintenance and pinpoint Nilo1 as a novel antibody-based therapeutical strategy to be used either alone or in combination with cytotoxic drugs for GSC targeting. Further pre-clinical studies are needed to validate the effectiveness of GSC-specific Nilo1 targeting in vivo.
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Affiliation(s)
- Gorjana Rackov
- IMDEA Nanoscience, Madrid, Spain.,Fundación de Investigación HM Hospitales, Madrid, Spain
| | - Giorgia Iegiani
- Istitute of Applied Molecular Medicine, Faculty of Medicine, San Pablo CEU University, Madrid, Spain
| | - Daniel Uribe
- Molecular Pathology Laboratory, Institute of Biochemistry and Microbiology, Faculty of Sciences, Universidad Austral de Chile, Valdivia, Chile
| | - Claudia Quezada
- Molecular Pathology Laboratory, Institute of Biochemistry and Microbiology, Faculty of Sciences, Universidad Austral de Chile, Valdivia, Chile
| | | | - Carmen Escobedo-Lucea
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.,Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, United States
| | - Augusto Silva
- Market Access Department, Merck Sharp & Dohme, Madrid, Spain
| | | | | | - Ángel Ayuso-Sacido
- IMDEA Nanoscience, Madrid, Spain.,Brain Tumor Laboratory, Fundación Vithas, Hospitales Vithas, Madrid, Spain.,Instituto de Investigaciones Biosanitarias, Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain.,Formerly, Fundación de Investigación HM Hospitales, Institute of Applied Molecular Medicine, Faculty of Medicine, San Pablo CEU University, Madrid, Spain
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6
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García-Romero N, Palacín-Aliana I, Madurga R, Carrión-Navarro J, Esteban-Rubio S, Jiménez B, Collazo A, Pérez-Rodríguez F, Ortiz de Mendivil A, Fernández-Carballal C, García-Duque S, Diamantopoulos-Fernández J, Belda-Iniesta C, Prat-Acín R, Sánchez-Gómez P, Calvo E, Ayuso-Sacido A. Bevacizumab dose adjustment to improve clinical outcomes of glioblastoma. BMC Med 2020; 18:142. [PMID: 32564774 PMCID: PMC7310142 DOI: 10.1186/s12916-020-01610-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 04/29/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Glioblastoma (GBM) is one of the most aggressive and vascularized brain tumors in adults, with a median survival of 20.9 months. In newly diagnosed and recurrent GBM, bevacizumab demonstrated an increase in progression-free survival, but not in overall survival. METHODS We conducted an in silico analysis of VEGF expression, in a cohort of 1082 glioma patients. Then, to determine whether appropriate bevacizumab dose adjustment could increase the anti-angiogenic response, we used in vitro and in vivo GBM models. Additionally, we analyzed VEGFA expression in tissue, serum, and plasma in a cohort of GBM patients before and during bevacizumab treatment. RESULTS We identified that 20% of primary GBM did not express VEGFA suggesting that these patients would probably not respond to bevacizumab therapy as we proved in vitro and in vivo. We found that a specific dose of bevacizumab calculated based on VEGFA expression levels increases the response to treatment in cell culture and serum samples from mice bearing GBM tumors. Additionally, in a cohort of GBM patients, we observed a correlation of VEGFA levels in serum, but not in plasma, with bevacizumab treatment performance. CONCLUSIONS Our data suggest that bevacizumab dose adjustment could improve clinical outcomes in Glioblastoma treatment.
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Affiliation(s)
- N García-Romero
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, 28223, Spain
| | - I Palacín-Aliana
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Atrys Health, Barcelona, 08025, Spain
| | - R Madurga
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, 28223, Spain
| | - J Carrión-Navarro
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, 28223, Spain.,Fundación Vithas, Vithas Hospitals, Madrid, 28043, Spain.,Formerly: Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
| | - S Esteban-Rubio
- Formerly: Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
| | - B Jiménez
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
| | - A Collazo
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
| | - F Pérez-Rodríguez
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
| | | | - C Fernández-Carballal
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - S García-Duque
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
| | | | - C Belda-Iniesta
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
| | - R Prat-Acín
- Departamento de Neurocirugía, Hospital Universitario la Fe, Valencia, Spain
| | - P Sánchez-Gómez
- Neuro-oncology Unit, Instituto de Salud Carlos III-UFIEC, Madrid, Spain
| | - E Calvo
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - A Ayuso-Sacido
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, 28223, Spain. .,Fundación Vithas, Vithas Hospitals, Madrid, 28043, Spain. .,Formerly: Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain. .,Formerly: Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain. .,Formerly: Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain.
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7
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Aguirre LA, Montalbán-Hernández K, Avendaño-Ortiz J, Marín E, Lozano R, Toledano V, Sánchez-Maroto L, Terrón V, Valentín J, Pulido E, Casalvilla JC, Rubio C, Diekhorst L, Laso-García F, del Fresno C, Collazo-Lorduy A, Jiménez-Munarriz B, Gómez-Campelo P, Llanos-González E, Fernández-Velasco M, Rodríguez-Antolín C, Pérez de Diego R, Cantero-Cid R, Hernádez-Jimenez E, Álvarez E, Rosas R, dies López-Ayllón B, de Castro J, Wculek SK, Cubillos-Zapata C, Ibáñez de Cáceres I, Díaz-Agero P, Gutiérrez Fernández M, Paz de Miguel M, Sancho D, Schulte L, Perona R, Belda-Iniesta C, Boscá L, López-Collazo E. Tumor stem cells fuse with monocytes to form highly invasive tumor-hybrid cells. Oncoimmunology 2020; 9:1773204. [PMID: 32923132 PMCID: PMC7458638 DOI: 10.1080/2162402x.2020.1773204] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The 'cancer cell fusion' theory is controversial due to the lack of methods available to identify hybrid cells and to follow the phenomenon in patients. However, it seems to be one of the best explanations for both the origin and metastasis of primary tumors. Herein, we co-cultured lung cancer stem cells with human monocytes and analyzed the dynamics and properties of tumor-hybrid cells (THC), as well as the molecular mechanisms beneath this fusion process by several techniques: electron-microscopy, karyotyping, CRISPR-Cas9, RNA-seq, immunostaining, signaling blockage, among others. Moreover, mice models were assessed for in vivo characterization of hybrids colonization and invasiveness. Then, the presence of THCs in bloodstream and samples from primary and metastatic lesions were detected by FACS and immunofluorescence protocols, and their correlations with TNM stages established. Our data indicate that the generation of THCs depends on the expression of CD36 on tumor stem cells and the oxidative state and polarization of monocytes, the latter being strongly influenced by microenvironmental fluctuations. Highly oxidized M2-like monocytes show the strongest affinity to fuse with tumor stem cells. THCs are able to proliferate, colonize and invade organs. THC-specific cell surface signature CD36+CD14+PANK+ allows identifying them in matched primary tumor tissues and metastases as well as in bloodstream from patients with lung cancer, thus functioning as a biomarker. THCs levels in circulation correlate with TNM classification. Our results suggest that THCs are involved in both origin and spread of metastatic cells. Furthermore, they might set the bases for future therapies to avoid or eradicate lung cancer metastasis.
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Affiliation(s)
- Luis Augusto Aguirre
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Karla Montalbán-Hernández
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - José Avendaño-Ortiz
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Centre for Biomedical Research Network of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Elvira Marín
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Roberto Lozano
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Víctor Toledano
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Centre for Biomedical Research Network of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Laura Sánchez-Maroto
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Verónica Terrón
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Jaime Valentín
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Elisa Pulido
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - José Carlos Casalvilla
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Carolina Rubio
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Luke Diekhorst
- Department of Neurology and Stroke Centre, Neuroscience and Cerebrovascular Research Laboratory, IdiPAZ, La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - Fernando Laso-García
- Department of Neurology and Stroke Centre, Neuroscience and Cerebrovascular Research Laboratory, IdiPAZ, La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - Carlos del Fresno
- Immunobiology Laboratory, National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | | | | | - Paloma Gómez-Campelo
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Emilio Llanos-González
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - María Fernández-Velasco
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Centre for Biomedical Research Network, CIBER-CV, Madrid, Spain
| | - Carlos Rodríguez-Antolín
- Biomarkers and Experimental Therapeutics in Cancer Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Rebeca Pérez de Diego
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Laboratory of Immunogenetics of Human Diseases, IdiPAZ, Madrid, Spain
| | - Ramón Cantero-Cid
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Enrique Hernádez-Jimenez
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Enrique Álvarez
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Rocío Rosas
- Biomarkers and Experimental Therapeutics in Cancer Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Blanca dies López-Ayllón
- Biomarkers and Experimental Therapeutics in Cancer Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Laboratory of Experimental Models of Human Diseases, Biomedical Research Institute CSIC/UAM, Madrid, Spain
- Centre for Biomedical Research Network, CIBERER, Madrid, Spain
| | - Javier de Castro
- Biomarkers and Experimental Therapeutics in Cancer Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Stefanie K. Wculek
- Immunobiology Laboratory, National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - Carolina Cubillos-Zapata
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Centre for Biomedical Research Network of Respiratory Diseases (CIBERES), Madrid, Spain
| | | | | | - María Gutiérrez Fernández
- Department of Neurology and Stroke Centre, Neuroscience and Cerebrovascular Research Laboratory, IdiPAZ, La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - María Paz de Miguel
- Cell Engineering Laboratory, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - David Sancho
- Immunobiology Laboratory, National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - Leon Schulte
- Institute for Lung Research/iLung, Research Group “Rna-biology of Inflammation & Infection,” Philipps University, Marburg, Germany
| | - Rosario Perona
- Biomarkers and Experimental Therapeutics in Cancer Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Laboratory of Experimental Models of Human Diseases, Biomedical Research Institute CSIC/UAM, Madrid, Spain
- Centre for Biomedical Research Network, CIBERER, Madrid, Spain
| | | | - Lisardo Boscá
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Centre for Biomedical Research Network, CIBER-CV, Madrid, Spain
- Laboratory of Experimental Models of Human Diseases, Biomedical Research Institute CSIC/UAM, Madrid, Spain
| | - Eduardo López-Collazo
- The Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Tumour Immunology Lab, IdiPAZ, La Paz University Hospital, Madrid, Spain
- Centre for Biomedical Research Network of Respiratory Diseases (CIBERES), Madrid, Spain
- CONTACT Eduardo López-Collazo IdiPAZ, La Paz University Hospital, Paseo de La Castellana 261 Madrid, 28046, Spain
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8
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Lassman AB, Sepúlveda-Sánchez JM, Cloughesy T, Gil-Gil JM, Puduvalli VK, Raizer J, De Vos FY, Wen PY, Butowski N, Clement P, Groves MD, Belda-Iniesta C, Steward K, Moran S, Ye Y, Roth P. OS10.6 Infigratinib (BGJ398) in patients with recurrent gliomas with fibroblast growth factor receptor (FGFR) alterations: a multicenter phase II study. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.072] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
FGFR mutations and translocations occur in approximately 10% of glioblastomas (GBMs). FGFR3-TACC3 fusion has been reported as predictive of response to FGFR tyrosine kinase inhibitor therapy both pre-clinically and clinically. Infigratinib (BGJ398) is a selective small-molecule pan-FGFR kinase inhibitor that has demonstrated anti-tumor activity in several solid tumors with FGFR genetic alterations. Therefore, we conducted a phase II trial to test the efficacy of infigratinib in FGFR-altered recurrent GBM (NCT01975701).
METHODS
This open-label trial accrued adults with recurrent high-grade gliomas following failure of initial therapy that harbored FGFR1-TACC1 or FGFR3-TACC3 fusions; activating mutations in FGFR1, 2 or 3; or FGFR1, 2, 3, or 4 amplification. Oral infigratinib was administered 125 mg on days 1–21 every 28 days. Prophylaxis for hyperphosphatemia, a common toxicity, was recommended. The primary endpoint was the 6-month progression-free survival (6mPFS) rate by RANO (locally assessed, estimated by K-M method), with a goal of >40%.
RESULTS
As of the Sep 2017 data cut-off, 26 patients (16 men, 10 women; median age 55 years, range 20–76 years; 50% with ≥2 prior regimens) were treated, and 24 (92.3%) discontinued for disease progression (n=21) or other reasons (n=3). All patients had FGFR1 or FGFR3 gene alterations, and 4 had >1 gene alteration. The estimated 6mPFS rate was 16% (95% CI 5.0–32.5%); median PFS was 1.7 months (95% CI 1.1–2.8 months); median OS was 6.7 months (95% CI 4.2–11.7 months); ORR was 7.7% (95% CI 1.0–25.1%). The best overall response was: partial response 7.7% (FGFR1 mutation n=1; FGFR3 amplification n=1); stable disease 26.9%; progressive disease 50.0%; missing/unknown 15.3%. The most common (>15%) all-grade treatment-related adverse events (AEs) were hyperphosphatemia, fatigue, diarrhea, hyperlipasemia, and stomatitis. There were no grade 4 treatment-related AEs. Eleven patients (42.3%) had treatment-related AEs requiring dose interruptions or reductions (most commonly hyperphosphatemia).
CONCLUSIONS
Infigratinib induced partial response or stable disease in approximately one-third of patients with recurrent GBM and/or other glioma subtypes harboring FGFR alterations. Most AEs were reversible and manageable. Further potential combinations are being explored in patients with proven FGFR-TACC fusion genes and analysis of biomarker data is ongoing.
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Affiliation(s)
- A B Lassman
- Columbia University Irving Medical Center, New York, NY, United States
| | | | - T Cloughesy
- University of California at Los Angeles, Los Angeles, CA, United States
| | - J M Gil-Gil
- Hospital Durans I Reynals. ICO, Hospitalet. Barcelona, Spain
| | - V K Puduvalli
- The Ohio State University, Columbus, OH, United States
| | - J Raizer
- Northwestern University, Evanston, IL, United States
| | - F Y De Vos
- University Medical Center Utrecht Cancer Center, Utrecht University, Utrecht, Netherlands
| | - P Y Wen
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - N Butowski
- University of California San Francisco, San Francisco, CA, United States
| | - P Clement
- UZ Leuven Campus Gasthuisberg, Leuven, Belgium
| | - M D Groves
- Texas Oncology, Austin, TX, United States
| | | | - K Steward
- QED Therapeutics, San Francisco, CA, United States
| | - S Moran
- QED Therapeutics, San Francisco, CA, United States
| | - Y Ye
- QED Therapeutics, San Francisco, CA, United States
| | - P Roth
- University Hospital Zurich, Zurich, Switzerland
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9
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García-Romero N, Madurga R, Rackov G, Palacín-Aliana I, Núñez-Torres R, Asensi-Puig A, Carrión-Navarro J, Esteban-Rubio S, Peinado H, González-Neira A, González-Rumayor V, Belda-Iniesta C, Ayuso-Sacido A. Polyethylene glycol improves current methods for circulating extracellular vesicle-derived DNA isolation. J Transl Med 2019; 17:75. [PMID: 30871557 PMCID: PMC6419425 DOI: 10.1186/s12967-019-1825-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [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: 11/16/2018] [Accepted: 03/01/2019] [Indexed: 12/31/2022] Open
Abstract
Background Extracellular vesicles (EVs) are small membrane-bound vesicles which play an important role in cell-to-cell communication. Their molecular cargo analysis is presented as a new source for biomarker detection, and it might provide an alternative to traditional solid biopsies. However, the most effective approach for EV isolation is not yet well established. Results Here, we study the efficiency of the most common EV isolation methods-ultracentrifugation, Polyethlyene glycol and two commercial kits, Exoquick® and PureExo®. We isolated circulating EVs from the bloodstream of healthy donors, characterized the size and yield of EVs and analyzed their protein profiles and concentration. Moreover, we have used for the first time Digital-PCR to identify and detect specific gDNA sequences, which has several implications for diagnostic and monitoring many types of diseases. Conclusions Our findings present Polyethylene glycol precipitation as the most feasible and less cost-consuming EV isolation technique.
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Affiliation(s)
- N García-Romero
- Fundación de Investigación HM Hospitales, HM Hospitales, C/Oña 10, 28050, Madrid, Spain
| | - R Madurga
- Fundación de Investigación HM Hospitales, HM Hospitales, C/Oña 10, 28050, Madrid, Spain
| | - G Rackov
- Fundación de Investigación HM Hospitales, HM Hospitales, C/Oña 10, 28050, Madrid, Spain.,IMDEA Nanoscience, Madrid, Spain
| | - I Palacín-Aliana
- Fundación de Investigación HM Hospitales, HM Hospitales, C/Oña 10, 28050, Madrid, Spain
| | - R Núñez-Torres
- Spanish National Cancer Research Center (CNIO), 28029, Madrid, Spain
| | | | - J Carrión-Navarro
- Fundación de Investigación HM Hospitales, HM Hospitales, C/Oña 10, 28050, Madrid, Spain
| | - S Esteban-Rubio
- Fundación de Investigación HM Hospitales, HM Hospitales, C/Oña 10, 28050, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
| | - H Peinado
- Spanish National Cancer Research Center (CNIO), 28029, Madrid, Spain
| | - A González-Neira
- Spanish National Cancer Research Center (CNIO), 28029, Madrid, Spain
| | | | - C Belda-Iniesta
- Fundación de Investigación HM Hospitales, HM Hospitales, C/Oña 10, 28050, Madrid, Spain
| | - A Ayuso-Sacido
- Fundación de Investigación HM Hospitales, HM Hospitales, C/Oña 10, 28050, Madrid, Spain. .,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain.
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10
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García-Romero N, Carrión-Navarro J, Esteban-Rubio S, Lázaro-Ibáñez E, Peris-Celda M, Alonso MM, Guzmán-De-Villoria J, Fernández-Carballal C, de Mendivil AO, García-Duque S, Escobedo-Lucea C, Prat-Acín R, Belda-Iniesta C, Ayuso-Sacido A. DNA sequences within glioma-derived extracellular vesicles can cross the intact blood-brain barrier and be detected in peripheral blood of patients. Oncotarget 2018; 8:1416-1428. [PMID: 27902458 PMCID: PMC5352065 DOI: 10.18632/oncotarget.13635] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [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: 09/20/2016] [Accepted: 11/07/2016] [Indexed: 01/01/2023] Open
Abstract
Tumor-cell-secreted extracellular vesicles (EVs) can cross the disrupted blood-brain barrier (BBB) into the bloodstream. However, in certain gliomas, the BBB remains intact, which might limit EVs release. To evaluate the ability of tumor-derived EVs to cross the BBB, we used an orthotopic xenotransplant mouse model of human glioma-cancer stem cells featuring an intact BBB. We demonstrated that all types of tumor cells-derived EVs−apoptotic bodies, shedding microvesicles and exosomes−cross the intact BBB and can be detected in the peripheral blood, which provides a minimally invasive method for their detection compared to liquid biopsies obtained from cerebrospinal fluid (CSF). Furthermore, these EVs can be readily distinguished from total murine EVs, since they carry human-specific DNA sequences relevant for GBM biology. In a small cohort of glioma patients, we finally demonstrated that peripheral blood EVs cargo can be successfully used to detect the presence of IDH1G395A, an essential biomarker in the current management of human glioma
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Affiliation(s)
- Noemí García-Romero
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,IMDEA Nanoscience, Madrid, Spain
| | - Josefa Carrión-Navarro
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
| | - Susana Esteban-Rubio
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
| | - Elisa Lázaro-Ibáñez
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - María Peris-Celda
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Juan Guzmán-De-Villoria
- Servicio de Radiodiagnóstico, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | - Sara García-Duque
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain
| | - Carmen Escobedo-Lucea
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Ricardo Prat-Acín
- Departamento de Neurocirugía, Hospital Universitario la Fe, Valencia, Spain
| | - Cristóbal Belda-Iniesta
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
| | - Angel Ayuso-Sacido
- Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.,IMDEA Nanoscience, Madrid, Spain.,Facultad de Medicina (IMMA), Universidad San Pablo-CEU, Madrid, Spain
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11
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Cloughesy T, Finocchiaro G, Belda-Iniesta C, Recht L, Brandes AA, Pineda E, Mikkelsen T, Chinot OL, Balana C, Macdonald DR, Westphal M, Hopkins K, Weller M, Bais C, Sandmann T, Bruey JM, Koeppen H, Liu B, Verret W, Phan SC, Shames DS. Randomized, Double-Blind, Placebo-Controlled, Multicenter Phase II Study of Onartuzumab Plus Bevacizumab Versus Placebo Plus Bevacizumab in Patients With Recurrent Glioblastoma: Efficacy, Safety, and Hepatocyte Growth Factor and O6-Methylguanine–DNA Methyltransferase Biomarker Analyses. J Clin Oncol 2017; 35:343-351. [DOI: 10.1200/jco.2015.64.7685] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose Bevacizumab regimens are approved for the treatment of recurrent glioblastoma in many countries. Aberrant mesenchymal-epithelial transition factor (MET) expression has been reported in glioblastoma and may contribute to bevacizumab resistance. The phase II study GO27819 investigated the monovalent MET inhibitor onartuzumab plus bevacizumab (Ona + Bev) versus placebo plus bevacizumab (Pla + Bev) in recurrent glioblastoma. Methods At first recurrence after chemoradiation, bevacizumab-naïve patients with glioblastoma were randomly assigned 1:1 to receive Ona (15 mg/kg, once every 3 weeks) + Bev (15 mg/kg, once every 3 weeks) or Pla + Bev until disease progression. The primary end point was progression-free survival by response assessment in neuro-oncology criteria. Secondary end points were overall survival, objective response rate, duration of response, and safety. Exploratory biomarker analyses correlated efficacy with expression levels of MET ligand hepatocyte growth factor, O6-methylguanine–DNA methyltransferase promoter methylation, and glioblastoma subtype. Results Among 129 patients enrolled (Ona + Bev, n = 64; Pla + Bev, n = 65), baseline characteristics were balanced. The median progression-free survival was 3.9 months for Ona + Bev versus 2.9 months for Pla + Bev (hazard ratio, 1.06; 95% CI, 0.72 to 1.56; P = .7444). The median overall survival was 8.8 months for Ona + Bev and 12.6 months for Pla + Bev (hazard ratio, 1.45; 95% CI, 0.88 to 2.37; P = .1389). Grade ≥ 3 adverse events were reported in 38.5% of patients who received Ona + Bev and 35.9% of patients who received Pla + Bev. Exploratory biomarker analyses suggested that patients with high expression of hepatocyte growth factor or unmethylated O6-methylguanine–DNA methyltransferase may benefit from Ona + Bev. Conclusion There was no evidence of further clinical benefit with the addition of onartuzumab to bevacizumab compared with bevacizumab plus placebo in unselected patients with recurrent glioblastoma in this phase II study; however, further investigation into biomarker subgroups is warranted.
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Affiliation(s)
- Timothy Cloughesy
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Gaetano Finocchiaro
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Cristóbal Belda-Iniesta
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Lawrence Recht
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Alba A. Brandes
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Estela Pineda
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Tom Mikkelsen
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Olivier L. Chinot
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Carmen Balana
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - David R. Macdonald
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Manfred Westphal
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Kirsten Hopkins
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Michael Weller
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Carlos Bais
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Thomas Sandmann
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Jean-Marie Bruey
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Hartmut Koeppen
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Bo Liu
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - Wendy Verret
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - See-Chun Phan
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
| | - David S. Shames
- Timothy Cloughesy, University of California, Los Angeles; Lawrence Recht, Stanford Cancer Center, Stanford; Carlos Bais, Thomas Sandmann, Jean-Marie Bruey, Hartmut Koeppen, Bo Liu, Wendy Verret, See-Chun Phan, and David S. Shames, Genentech, South San Francisco, CA; Tom Mikkelsen, Henry Ford Hospital, Detroit, MI; Gaetano Finocchiaro, Istituto Neurologico Carlo Besta, Milan; Alba A. Brandes, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurologic
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12
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Cloughesy T, Finocchiaro G, Belda-Iniesta C, Recht L, Brandes AA, Pineda E, Mikkelsen T, Chinot O, Balana C, Macdonald D, Westphal M, Hopkins K, Weller M, Bruey JM, Liu B, Verret W. ET-12 * PHASE II STUDY OF ONARTUZUMAB PLUS BEVACIZUMAB VERSUS PLACEBO PLUS BEVACIZUMAB IN PATIENTS WITH RECURRENT GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou255.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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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13
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Gutiérrez-González A, Belda-Iniesta C, Bargiela-Iparraguirre J, Dominguez G, García Alfonso P, Perona R, Sanchez-Perez I. Targeting Chk2 improves gastric cancer chemotherapy by impairing DNA damage repair. Apoptosis 2013; 18:347-60. [PMID: 23271172 DOI: 10.1007/s10495-012-0794-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Our results demonstrate that the addition of cisplatin after paclitaxel-induced mitotic arrest was more effective than individual treatment on gastric adenocarcinoma cells (MKN45). However, the treatment did not induce benefits in cells derived from lymph node metastasis (ST2957). Time-lapse microscopy revealed that cell death was caused by mitotic catastrophe and apoptosis induction, as the use of the caspase inhibitor z-VAD-fmk decreased cell death. We propose that the molecular mechanism mediating this cell fate is a slippage suffered by these cells, given that our Western blot (WB) analysis revealed premature cyclin B degradation. This resulted in the cell exiting from mitosis without undergoing DNA damage repair, as demonstrated by the strong phosphorylation of H2AX. A comet assay indicated that DNA repair was impaired, and Western blotting showed that the Chk2 protein was degraded after sequential treatment (paclitaxel-cisplatin). Based on these results, the modulation of cell death during mitosis may be an effective strategy for gastric cancer therapy.
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14
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Conde E, Angulo B, Izquierdo E, Paz-Ares L, Belda-Iniesta C, Hidalgo M, López-Ríos F. Lung adenocarcinoma in the era of targeted therapies: histological classification, sample prioritization, and predictive biomarkers. Clin Transl Oncol 2013; 15:503-8. [PMID: 23359174 PMCID: PMC3695315 DOI: 10.1007/s12094-012-0983-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 11/27/2012] [Indexed: 01/10/2023]
Abstract
The arrival of targeted therapies has presented both a conceptual and a practical challenge in the treatment of patients with advanced non-small cell lung carcinomas (NSCLCs). The relationship of these treatments with specific histologies and predictive biomarkers has made the handling of biopsies the key factor for success. In this study, we highlight the balance between precise histological diagnosis and the practice of conducting multiple predictive assays simultaneously. This can only be achieved where there is a commitment to multidisciplinary working by the tumor board to ensure that a sensible protocol is applied. This proposal for prioritizing samples includes both recent technological advances and the some of the latest discoveries in the molecular classification of NSCLCs.
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Affiliation(s)
- E. Conde
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico Clara Campal, Hospital Universitario Madrid Sanchinarro, Faculty of Medicine, Universidad San Pablo-CEU, Madrid, Spain
| | - B. Angulo
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico Clara Campal, Hospital Universitario Madrid Sanchinarro, Faculty of Medicine, Universidad San Pablo-CEU, Madrid, Spain
| | - E. Izquierdo
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico Clara Campal, Hospital Universitario Madrid Sanchinarro, Faculty of Medicine, Universidad San Pablo-CEU, Madrid, Spain
| | - L. Paz-Ares
- Department of Oncology, Instituto de Biomedicina de Sevilla (IBIS) and Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - C. Belda-Iniesta
- Department of Oncology, Centro Integral Oncológico Clara Campal, Hospital Universitario Madrid Sanchinarro, Faculty of Medicine, Universidad San Pablo-CEU, Madrid, Spain
| | - M. Hidalgo
- Department of Oncology, Centro Integral Oncológico Clara Campal, Hospital Universitario Madrid Sanchinarro, Faculty of Medicine, Universidad San Pablo-CEU, Madrid, Spain
| | - F. López-Ríos
- Laboratorio de Dianas Terapéuticas, Centro Integral Oncológico Clara Campal, Hospital Universitario Madrid Sanchinarro, Faculty of Medicine, Universidad San Pablo-CEU, Madrid, Spain
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15
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de Castro Carpeño J, Belda-Iniesta C. KRAS mutant NSCLC, a new opportunity for the synthetic lethality therapeutic approach. Transl Lung Cancer Res 2013; 2:142-51. [PMID: 25806225 PMCID: PMC4369862 DOI: 10.3978/j.issn.2218-6751.2013.02.07] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 02/27/2013] [Indexed: 11/14/2022]
Abstract
K-RAS accounts for 90% of RAS mutations in lung adenocarcinomas, the most commonly mutated oncogene in NSCLC, with mutations detected in about 25% of all tumors. Direct inhibition of KRAS has proven clinically challenging. So far, no successful targeted therapy has been developed and remains an elusive target for cancer therapy. Despite significant efforts, currently there are no drugs directly targeting mutated KRAS. Thus, new strategies have emerged for targeting RAS including the use of synthetic lethality. A specific knowledge of individual tumor molecular abnormalities that result in oncogene-specific "synthetic lethal" interactions will allow the rationale to combine promising targeted therapies for KRAS-mutated NSCLC. In this article, we review the new approach based on testing drugs or combinations of agents that work downstream of activated K-RAS.
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Affiliation(s)
- Javier de Castro Carpeño
- Medical Oncology Unit, Department of Translational Oncology, Hospital Universitario La Paz, idiPAZ, Madrid, Spain
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16
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Cejas P, López-Gómez M, Aguayo C, Madero R, Moreno-Rubio J, de Castro Carpeño J, Belda-Iniesta C, Barriuso J, Moreno García V, Díaz E, Burgos E, Gonzalez-Barón M, Feliu J. Analysis of the concordance in the EGFR pathway status between primary tumors and related metastases of colorectal cancer patients:implications for cancer therapy. Curr Cancer Drug Targets 2012; 12:124-31. [PMID: 22229245 DOI: 10.2174/156800912799095162] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 09/28/2011] [Accepted: 11/24/2011] [Indexed: 11/22/2022]
Abstract
Patients with metastatic Colorectal Cancer (mCRC), in which primary tumors are KRAS mutated, have no response to anti-EGFR therapy. However, less than half of mCRC patients with KRAS wild-type primary tumors respond to anti-EGFR therapy. Other downstream effectors of the EGFR pathway are being analyzed to fine-tune KRAS predictive value. However, as the primary tumor is the tissue of analysis that determines the use of anti-EGFR therapy in advanced disease, a high concordance in the status of these effectors between primary tumors and related metastases is required. We analyzed the concordances of downstream EGFR effectors in tumoral pairs of primaries and related metastases in a series of KRAS wild-type patients. One hundred seventeen tumoral pairs from patients with CRC were tested for KRAS mutational status. The level of concordance in the presence of KRAS mutations was 91% between the primary tumor and related metastases. The 70 pairs with KRAS wild-type primary tumors were further analyzed for BRAF and PIK3CA mutational status and for EGFR, PTEN and pAKT expression, and the number of concordant pairs was 70 (100%), 66 (94%), 43 (61%), 46 (66%) and 36 (54%), respectively. Our findings suggest that the mutational status of KRAS, BRAF and PIK3CA in the primary tumor is an adequate surrogate marker of the status in the metastatic disease. On the other hand, the immunohistochemical analysis of EGFR, PTEN and pAKT showed a much higher degree of discordance between primaries and related metastases.
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Affiliation(s)
- P Cejas
- Service of Medical Oncology, La Paz University Hospital (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain.
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17
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Cortés-Sempere M, de Miguel MP, Pernía O, Rodriguez C, de Castro Carpeño J, Nistal M, Conde E, López-Ríos F, Belda-Iniesta C, Perona R, Ibanez de Caceres I. IGFBP-3 methylation-derived deficiency mediates the resistance to cisplatin through the activation of the IGFIR/Akt pathway in non-small cell lung cancer. Oncogene 2012; 32:1274-83. [PMID: 22543588 DOI: 10.1038/onc.2012.146] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although many cancers initially respond to cisplatin (CDDP)-based chemotherapy, resistance frequently develops. Insulin-like growth factor-binding protein-3 (IGFBP-3) silencing by promoter methylation is involved in the CDDP-acquired resistance process in non-small cell lung cancer (NSCLC) patients. Our purpose is to design a translational-based profile to predict resistance in NSCLC by studying the role of IGFBP-3 in the phosphatidyl inositol 3-kinase (PI3K) signaling pathway. We have first examined the relationship between IGFBP-3 expression regulated by promoter methylation and activation of the epidermal growth factor receptor (EGFR), insulin-like growth factor-I receptor (IGFIR) and PI3K/AKT pathways in 10 human cancer cell lines and 25 NSCLC patients with known IGFBP-3 methylation status and response to CDDP. Then, to provide a helpful tool that enables clinicians to identify patients with a potential response to CDDP, we have calculated the association between our diagnostic test and the true outcome of analyzed samples in terms of cisplatin IC50; the inhibitory concentration that kills 50% of the cell population. Our results suggest that loss of IGFBP-3 expression by promoter methylation in tumor cells treated with CDDP may activate the PI3K/AKT pathway through the specific derepression of IGFIR signaling, inducing resistance to CDDP. This study also provides a predictive test for clinical practice with an accuracy and precision of 0.84 and 0.9, respectively, (P=0.0062). We present a biomarker test that could provide clinicians with a robust tool with which to decide on the use of CDDP, improving patient clinical outcomes.
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Affiliation(s)
- M Cortés-Sempere
- Instituto de Investigaciones Biomedicas CSIC/UAM, CIBER de Enfermedades Raras CIBERER, Madrid, Spain
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Casado E, Garcia VM, Sánchez JJ, Gómez Del Pulgar MT, Feliu J, Maurel J, Castelo B, Moreno Rubio J, López RAB, García-Cabezas MÁ, Burgos E, de Castro J, Belda-Iniesta C, López-Gómez M, Gómez-Raposo C, Zambrana F, Sereno M, Fernández-Martos C, Vázquez P, Lacal JC, González-Barón M, Cejas P. Upregulation of trefoil factor 3 (TFF3) after rectal cancer chemoradiotherapy is an adverse prognostic factor and a potential therapeutic target. Int J Radiat Oncol Biol Phys 2012; 84:1151-8. [PMID: 22516806 DOI: 10.1016/j.ijrobp.2012.01.083] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 01/25/2012] [Accepted: 01/28/2012] [Indexed: 01/10/2023]
Abstract
PURPOSE Management of locally advanced rectal cancer (RC) consists of neoadjuvant chemoradiotherapy (CRT) with fluoropyrimidines, followed by total mesorectal excision. We sought to evaluate the expression of selected genes, some of which were derived from a previous undirected SAGE (serial analysis of gene expression)-based approach, before and after CRT, to identify mechanisms of resistance. METHODS This retrospective cohort study included 129 consecutive patients. Quantitative polymerase chain reaction of 53 candidate genes was performed on the biopsy specimen before treatment and on the surgical specimen after CRT. A paired-samples t test was performed to determine genes that were significantly changed after CRT. The result was correlated with patients' disease-free survival. RESULTS Twenty-two genes were significantly upregulated, and two were significantly downregulated. Several of the upregulated genes have roles in cell cycle control; these include CCNB1IP1, RCC1, EEF2, CDKN1, TFF3, and BCL2. The upregulation of TFF3 was associated with worse disease-free survival on multivariate analyses (hazard ratio, 2.64; P=.027). Patients whose surgical specimens immunohistochemically showed secretion of TFF3 into the lumen of the tumoral microglands had a higher risk of relapse (hazard ratio, 2.51; P=.014). In vitro experiments showed that DLD-1 cells stably transfected with TFF3 were significantly less sensitive to 5-fluorouracil and showed upregulation of genes involved in the transcriptional machinery and in resistance to apoptosis. CONCLUSION Upregulation of TFF3 after CRT for RC is associated with a higher risk of relapse. The physiological role of TFF3 in restoring the mucosa during CRT could be interfering with treatment efficacy. Our results could reveal not only a novel RC prognostic marker but also a therapeutic target.
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Affiliation(s)
- Enrique Casado
- Unidad de Oncología, Hospital Infanta Sofía, Madrid, Spain.
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Sereno M, Cejas P, Moreno V, Belda-Iniesta C, López R, Nistal M, Feliu J, De Castro Carpeño J. ERCC1 and topoisomerase I expression in small cell lung cancer: prognostic and predictive implications. Int J Oncol 2012; 40:2104-10. [PMID: 22344449 DOI: 10.3892/ijo.2012.1378] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 01/17/2012] [Indexed: 11/06/2022] Open
Abstract
Small cell lung cancer is the most aggressive lung cancer subtype. The standard treatment approach is based on cisplatin regimens. Although response rates to treatment are approximately 60-80%, the median survival is still very poor. Excision repair cross complementation group 1 (ERCC1) is an enzyme that removes cisplatin-induced DNA adducts and has been related with prognosis and cisplatin response. Topotecan is the standard treatment as second-line therapy and it is an inhibitor of topoisomerase I (TOP I). We selected 76 patients with small cell lung (SCLC) to analyze the ERCC1 and TOP I mRNA expression. ERCC1 was studied both by quantitative PCR and immunohistochemistry. A significant association was found between the inmunohistochemistry expression of ERCC1 and the lack of platinum response (p=0.001). Moreover, low levels of TOP I RNA were shown to be linked to cisplatin response (p=0.002). In the survival analysis, a significant correlation between a better PFS with a low TOP I RNA expression as well as a negative ERCC1 inmunostaining were found, in both cases with a significant p-value (p=0.02 and 0.009, respectively). In summary, our results suggest the use of ERCC1 immunohistochemistry and TOP I mRNA analysis to predict cisplatin response and prognosis in SCLC patients.
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Affiliation(s)
- Maria Sereno
- Department of Medical Oncology, Infanta Sofía Hospital, 28702 San Sebastian De Los Reyes, Madrid, Spain.
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Abstract
Metformin is a biguanine, the most widely used antidiabetic drug for the treatment of type 2 diabetes. Some studies suggest that metformin decreases the incidence of cancer and cancer-related mortality in diabetic patients. Metformin activates the AMP-activated protein kinase (AMPK) pathway, a major sensor of the energy status of the cell and an inhibitor of mammalian target of rapamycin (mTOR) catalytic activity, inducing a decrease in blood glucose by decreasing hepatic gluconeogenesis and stimulating glucose uptake in the muscle. Some preclinical data supports the inhibition of tumour cancer cell growth associated with mTOR inhibition and a decrease in phosphorylation of S6K, rpS6 and 4E-BP1. Here we have summarised some of the preclinical data and data of many clinical trials that are exploring the true value of metformin for cancer patients, mainly breast and prostate cancer.
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Affiliation(s)
- Cristóbal Belda-Iniesta
- Biomarkers and Experimental Therapeutics of Cancer Group, IdiPAZ, University Hospital La Paz, Madrid, Spain.
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Perona R, López-Ayllón BD, de Castro Carpeño J, Belda-Iniesta C. A role for cancer stem cells in drug resistance and metastasis in non-small-cell lung cancer. Clin Transl Oncol 2011; 13:289-93. [PMID: 21596655 DOI: 10.1007/s12094-011-0656-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The cancer stem cell (CSC) theory is currently a very important field in cancer research. This theory states that tumours are organised in a hierarchical manner with a subpopulation of limited number called CSCs with the ability to self-renew and undergo asymmetrical divisions, giving rise to a differentiated progeny that represents most of the tumour populations. CSCs are metastatic and chemoresistant, two features that very likely contribute to the poor response of locally advanced lung cancer. CSCs have been identified in non-small-cell lung cancer cell lines as well as those from patient primary samples. A correlation has been found in terms of chemoresistance and bad prognosis in patient-derived samples enriched with CSCs, indicating that these cells are an important target for future therapy combinations. Therefore, understanding the biology and exploring cell markers and signalling pathways specific for CSCs of lung cancer may help in achieving progress in the treatment of the disease.
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Affiliation(s)
- Rosario Perona
- Instituto de Investigaciones Biomédicas CSIC/UAM, CIBER de Enfermedades Raras, IdiPAZ, Madrid, Spain.
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Gough SCL, Belda-Iniesta C, Poole C, Weber M, Russell-Jones D, Hansen BF, Mannucci E, Tuomilehto J. Insulin therapy in diabetes and cancer risk: current understanding and implications for future study: proceedings from a meeting of a European Insulin Safety Consensus Panel, convened and sponsored by Novo Nordisk, held Tuesday October 5, 2010 at The Radisson Edwardian Heathrow Hotel, Hayes, Middlesex, UK. Adv Ther 2011; 28 Suppl 5:1-18. [PMID: 21863297 DOI: 10.1007/s12325-011-0047-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Interest in the possibility of certain insulin treatments having the potential to modify cancer development and prognosis was reawakened in 2009, following publication of several epidemiological studies addressing this issue. This interest extends to how diabetes itself and cancer might be linked, and makes desirable an exchange of expert views and knowledge to enhance understanding in this subject among those treating diabetes and cancer, or those developing diabetes therapies. METHODS A European meeting was convened with participants invited based on known relevant interests in endocrinology, oncology, epidemiology, and insulin analog design and investigation. Experts in these fields were invited to present on relevant topics, with open discussions held after each presentation. RESULTS Concern over the potential mitogenic properties of certain insulin analogs has arisen from some (but not all) epidemiological studies, although confounding factors render interpretation controversial. Future epidemiological studies are likely to strengthen confidence in drawing conclusions. Meanwhile, pharmacological studies, and a consideration of cancer pathophysiology, implicate increased insulin-like growth factor-1 receptor affinity, and/or deranged insulin receptor interaction/signaling properties as possible a priori causes for concern with some insulin analogs. Again, interpretation of the body of pharmacological evidence is confounded by the array of test systems and methodologies used, and by studies frequently succumbing to methodological pitfalls. Reassuringly, most available insulin analogs do not differ in their receptor interaction response profile to human insulin, and for those that do there are reasons to question any potential clinical relevance. Nevertheless, it is desirable that new experimental models are devised that can better determine the likely clinical consequences of any variance in receptor response profile versus human insulin. CONCLUSION More data are required to increase our understanding of this issue. To facilitate and disseminate such understanding, close cooperation and communication between diabetologists, epidemiologists, oncologists, and insulin engineers will be essential.
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Casado E, García VM, Sánchez JJ, Blanco M, Maurel J, Feliu J, Fernández-Martos C, de Castro J, Castelo B, Belda-Iniesta C, Sereno M, Sánchez-Llamas B, Burgos E, García-Cabezas MÁ, Manceñido N, Miquel R, García-Olmo D, González-Barón M, Cejas P. A combined strategy of SAGE and quantitative PCR Provides a 13-gene signature that predicts preoperative chemoradiotherapy response and outcome in rectal cancer. Clin Cancer Res 2011; 17:4145-54. [PMID: 21467161 DOI: 10.1158/1078-0432.ccr-10-2257] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [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
PURPOSE Preoperative chemoradiotherapy (CRT) is the treatment of choice for rectal cancer (RC), but half of the patients do not respond, suffer unnecessary toxicities, and surgery delays. We aimed to develop a model that could predict a clinically meaningful response to CRT by using formalin-fixed paraffin-embedded (FFPE) biopsies. EXPERIMENTAL DESIGN We first carried out an exploratory screening of candidate genes by using SAGE technology to evaluate dynamic changes in the RC transcriptome in selected refractory patients before and after CRT. Next, 53 genes (24 from SAGE and 29 from the literature) were analyzed by qPCR arrays in FFPE initial biopsies from 94 stage II/III RC patients who were preoperatively treated with CRT. Tumor response was defined by using Dworak's tumor regression grade (2-3-4 vs. 0-1). Multivariate Cox methods and stepwise algorithms were applied to generate an optimized predictor of response and outcome. RESULTS In the training cohort (57 patients), a 13-gene signature predicted tumor response with 86% accuracy, 87% sensitivity, and 82% specificity. In a testing cohort (37 patients), the model correctly classified 6 of 7 nonresponders, with an overall accuracy of 76%. A signature-based score identified patients with a higher risk of relapse in univariate (3-year disease-free survival 64% vs. 90%, P = 0.001) and multivariate analysis (HR = 4.35 95% CI: 1.2-15.75, P = 0.02), in which it remained the only statistically significant prognostic factor. CONCLUSIONS A basal 13-gene signature efficiently predicted CRT response and outcome. Multicentric validation by the GEMCAD collaborative group is currently ongoing. If confirmed, the predictor could be used to improve patient selection in RC studies.
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Affiliation(s)
- Enrique Casado
- Unidad de Oncología; Unidad de Gastroenterología, Hospital Infanta Sofía, Spain.
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Martinez Marín V, Lopez Santiago S, De Castro J, Cruzado JA, Belda-Iniesta C, Cano J, Barriuso Feijoo J, Feliu M, Smith J, Feliu J. Study on the deterioration of verbal memory in colon cancer patients after receiving adjuvant chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.509] [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
509 Background: Usually, patients treated with chemotherapy (CT) complain about memory loss. This was mainly studied on patients receiving adjuvant CT for breast cancer. However there are no data on adjuvant treatment of colon cancer (CC). The aim of this study is to investigate whether adjuvant CT induces in CC patients impaired memory, particularly the verbal one. Methods: 77 patients diagnosed with stage II-III CC who received adjuvant CT for 6 months with FOLFOX-4 were included between January 2008 and May 2010. Verbal memory was investigated pre-and post-treatment by the Test Barcelona. Peña-Casanova, (1990). Results: Data of 54 patients who completed the analysis pre-and post-treatment were collected. Population characteristics are: male (61%), mean age of 66, less than 5 years of education (58.3%), stage II/III (43/57%) treated with FOLFOX-4/Xeloda (85/15%). Analysis of verbal memory performance can be seen in the table. Conclusions: We found a clear verbal memory impairment after adjuvant CT in CC patients, although the number of words Learning decreases without reaching statistical significance. Remembering of stories is significantly deteriorated after the administration of QT, affecting the patient immediate recall of stories, even when given clues. So it is the delayed recall (after 5′). This can have a negative impact on the patient's life in tasks involving immediate or delayed recall of events. This interesting finding must be tested in larger series and placebo controlled randomized trials. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- V. Martinez Marín
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - S. Lopez Santiago
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - J. De Castro
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - J. A. Cruzado
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - C. Belda-Iniesta
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - J. Cano
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - J. Barriuso Feijoo
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - M. Feliu
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - J. Smith
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
| | - J. Feliu
- Department of Clinical Oncology, La Paz University Hospital, Madrid, Spain; University of Psicology, UCM, Madrid, Spain; Translational Oncology Unit IIB/CSIC/HULa Paz, Madrid, Spain
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Feliu J, Borrega P, León A, López-Gómez L, López M, Castro J, Belda-Iniesta C, Barriuso J, Martínez V, González-Barón M. Phase II study of a fixed dose-rate infusion of gemcitabine associated with erlotinib in advanced pancreatic cancer. Cancer Chemother Pharmacol 2010; 67:215-21. [PMID: 20927525 DOI: 10.1007/s00280-010-1472-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 09/13/2010] [Indexed: 12/21/2022]
Abstract
PURPOSE To evaluate the feasibility, toxicity and efficacy of the combination regimen consisting of gemcitabine-FDR infusion plus erlotinib, in ACP patients. METHODS Forty-two patients with histologically confirmed, locally advanced or metastatic pancreatic cancer were included in this phase II trial. Main objectives were to assess the efficacy and safety of this regimen. Therapeutic regimen consisted of gemcitabine 1,200 mg/m(2) in 120-min infusion on days 1, 8 and 15, plus erlotinib 100 mg orally once daily. Cycles were repeated every 28 days. RESULTS A total of 160 courses of gemcitabine-FDR erlotinib were administered (median 3.8 courses per patient). The most common grade 3-4 AEs were neutropenia (21%), thrombocytopenia (10%), skin rash (10%) and asthenia (10%). Complete response was achieved in one patient (2%) and 11 (26%) achieved a partial response. Stable disease and progression disease were observed in 11 patients (26%) and 19 (45%), respectively. Median time to progression was 5 months (95%CI: 3.9-5.8 months) and median overall survival was 8 months (95% CI: 5.1-10.8). One-year survival rate was 35%. CONCLUSIONS A regimen consisting of gemcitabine-FDR infusion plus erlotinib is active and well tolerated in APC patients. However, the results do not justify the conduct of a Phase III trial.
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Affiliation(s)
- J Feliu
- Medical Oncology Department, Hospital Universitario La Paz, IDIPAZ, Pº de Castellana 261, 28046 Madrid, Spain.
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Moncho-Amor V, Ibañez de Cáceres I, Bandres E, Martínez-Poveda B, Orgaz JL, Sánchez-Pérez I, Zazo S, Rovira A, Albanell J, Jiménez B, Rojo F, Belda-Iniesta C, García-Foncillas J, Perona R. DUSP1/MKP1 promotes angiogenesis, invasion and metastasis in non-small-cell lung cancer. Oncogene 2010; 30:668-78. [PMID: 20890299 DOI: 10.1038/onc.2010.449] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
DUSP1/MKP1 is a dual-specific phosphatase that regulates MAPKs activity, with an increasingly recognized role in tumor biology. To understand more about the involvement of DUSP1 in lung cancer, we performed gene expression analyses of parental and DUSP1-interfered H460 non-small-cell lung cancer (NSCLC) cells. Downregulation of DUSP1 induced changes in the expression levels of genes involved in specific biological pathways, including angiogenesis, MAP kinase phosphatase activity, cell-cell signaling, growth factor and tyrosine-kinase receptor activity. Changes in the expression of some of these genes were due to modulation of c-Jun-N-terminal kinase and/or p38 activity by DUSP1. Complementary functional assays were performed to focus on the implication of DUSP1 in angiogenesis and metastasis. In H460 cells, interference of DUSP1 resulted in a diminished capacity to invade through Matrigel, to grow tumors in nude mice and also to induce metastasis through tail-vein injection. Furthermore, the angiogenic potential of H460 cells was also impaired, correlating with a decrease in VEGFC production and indicating that DUSP1 could be required to induce angiogenesis. Finally, we studied whether a similar relationship occurred in patients. In human NSCLC specimens, DUSP1 was mainly expressed in those tumor cells close to CD31 vascular structures and a statistically significant correlation was found between VEGFC and DUSP1 expression. Overall, these results provide evidence for a role of DUSP1 in angiogenesis, invasion and metastasis in NSCLC.
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Affiliation(s)
- V Moncho-Amor
- Instituto de Investigaciones Biomedicas CSIC/UAM, CIBER de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain
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Cortés M, de Miguel M, Belda-Iniesta C, Nistal M, Perona R, Ibanez de Caceres I. 199 IGFBP-3 promoter methylation activates the PI3K/Akt intracellular signaling pathway in CDDP resistant cell lines. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71006-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sanchez-Pérez I, Peralta-Sastre A, Manguan-Garcia C, Gonzalez-Gutierrez A, Belda-Iniesta C, Perona R. 485 Checkpoint kinase 1 modulates sensitivity to chemotherapy in aneuploid cell lines. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71286-6] [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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De Castro J, Belda-Iniesta C, Sanchez J, Machado-Pinilla R, Rodríguez-Fanjúl V, Feliu J, Ibañez de Cáceres I, Nistal M, Perona R, Cejas P. A combined strategy of serial analysis of gene expression (SAGE) and quantitative PCR (qPCR) to identify four genes that predict outcome in non-small cell lung cancer patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e17502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cejas P, Lopez-Gomez M, Aguayo C, Madero R, De Castro J, Belda-Iniesta C, Barriuso J, Burgos E, Gonzalez-Baron M, Feliu J. Analysis of EGFR pathway mediators in KRAS wild-type primary tumors is not representative of their status in related metastases. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ibanez de Caceres I, Cortes-Sempere M, Moratilla C, Machado-Pinilla R, Rodriguez-Fanjul V, Manguán-García C, Cejas P, López-Ríos F, Paz-Ares L, de CastroCarpeño J, Nistal M, Belda-Iniesta C, Perona R. IGFBP-3 hypermethylation-derived deficiency mediates cisplatin resistance in non-small-cell lung cancer. Oncogene 2009; 29:1681-90. [DOI: 10.1038/onc.2009.454] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Cejas P, López-Gómez M, Aguayo C, Madero R, de Castro Carpeño J, Belda-Iniesta C, Barriuso J, Moreno García V, Larrauri J, López R, Casado E, Gonzalez-Barón M, Feliu J. KRAS mutations in primary colorectal cancer tumors and related metastases: a potential role in prediction of lung metastasis. PLoS One 2009; 4:e8199. [PMID: 20020061 PMCID: PMC2792724 DOI: 10.1371/journal.pone.0008199] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Indexed: 12/20/2022] Open
Abstract
Background KRAS mutations in colorectal cancer primary tumors predict resistance to anti-Epidermal Growth Factor Receptor (EGFR) monoclonal antibody therapy in patients with metastatic colorectal cancer, and thus represent a true indicator of EGFR pathway activation status. Methodology/Principal Findings KRAS mutations were retrospectively studied using polymerase chain reactions and subsequent sequencing of codons 12 and 13 (exon 2) in 110 patients with metastatic colorectal tumors. These studies were performed using tissue samples from both the primary tumor and their related metastases (93 liver, 84%; 17 lung, 16%). All patients received adjuvant 5-Fluorouracil-based polychemotherapy after resection of metastases. None received anti-EGFR therapy. Mutations in KRAS were observed in 37 (34%) of primary tumors and in 40 (36%) of related metastases, yielding a 94% level of concordance (kappa index 0.86). Patients with primary tumors possessing KRAS mutations had a shorter disease-free survival period after metastasis resection (12.0 vs 18.0 months; P = 0.035) than those who did not. A higher percentage of KRAS mutations was detected in primary tumors of patiens with lung metastases than in patients with liver metastases (59% vs 32%; p = 0.054). To further evaluate this finding we analyzed 120 additional patients with unresectable metastatic colorectal cancer who previously had their primary tumors evaluated for KRAS mutational status for clinical purposes. Separately, the analysis of these 120 patients showed a tendency towards a higher degree of KRAS mutations in primary tumors of patients with lung metastases, although it did not reach statistical significance. Taken together the group of 230 patients showed that KRAS was mutated significantly more often in the primary tumors of patients with lung metastases (57% vs 35%; P = 0.006). Conclusions/Significance Our results suggest a role for KRAS mutations in the propensity of primary colorectal tumors to metastasize to the lung.
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Affiliation(s)
- Paloma Cejas
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | - Miriam López-Gómez
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
- Department of Medical Oncology, Infanta Sofía Hospital, Madrid, Spain
| | - Cristina Aguayo
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | - Rosario Madero
- Biostatistics Unit, La Paz University Hospital, Madrid, Spain
| | | | | | - Jorge Barriuso
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | | | - Javier Larrauri
- Department of Pathology, La Paz University Hospital, Madrid, Spain
| | - Rocío López
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | - Enrique Casado
- Department of Medical Oncology, Infanta Sofía Hospital, Madrid, Spain
| | | | - Jaime Feliu
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
- * E-mail:
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De Castro J, Cejas P, Belda-Iniesta C, Ramirez-Merino N, Barriuso J, Hernandez-Agudo E, Feliu J, Moreno-Garcia V, Martinez-Marin V, Gonzalez-Baron M. Is hepcidin involved in anemia of advanced non-small cell lung carcinoma (NSCLC) patients treated with platin-based chemotherapy? An exploratory study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e19086] [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
e19086 Background: Anemia is a common complication in NSCLC patients. Hepcidin, a liver-produced peptide, acts to cause a block on cellular iron export by internalisation and degradation of ferroportin.This results in iron sequestration and interrupts iron delivery to erythroid precursor cells thus causing anemia. To date there are no studies addressing whether hepcidin expression contributes to the anemia in NSCLC. Methods: to investigate whether hepcidin is implicated in NSCLC anemia, hemoglobin (Hb), iron metabolism and serum hepcidin levels, were studied in newly diagnosed advanced NSCLC patients. Blood samples of each patients were collected before starting cisplatin based chemotherapy treatment. Serum was separate by centrifugation at 2,500 g for 10 min at 4ºC. Hepcidin was detected by a solid phase enzyme-linked immunosorbent assay (ELISA) on the serum of each patient. The ELISA test is based on the principle of competitive binding. The microtiter wells are coated with a polyclonal antibody directed towards an antigenic site on the hepcidin prohormone molecule. Endogenous hepcidin prohormone of patient sample competes with a hepcidin prohormone biotin conjugate for binding to the coated antibody. Hepcidin absolute quantitation was achieved using a standard curve. Hepcidin results were correlated with serum parameters related to iron metabolism. Results: In a exploratory analysis, 20 patients with advanced NSCLC were selected for hepcidin prohormone detection. Only 10% were anemic at the diagnosis but 70% developped anemia during the treatment. 50% of the patients had iron deficiency. 70% received treatment for anemia (40% erythropoetin and iron, 20% iron, 10% erythropoetin). Median serum hepcidin levels was 151 ng/ml (range 99–308). The serum hepcidin level correlated with serum ferritin but no correlation was found with other iron metabolism parameters. An inverse correlation was seen between serum hepcidin level and Hb evolution after 4 cycles of chemotherapy. Conclusions: These results support a potential relationship between hepcidin expression and anemia in NSCLC patients. Further confirmatory study is ongoing and final results will be presented in the meeting. No significant financial relationships to disclose.
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Affiliation(s)
- J. De Castro
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
| | - P. Cejas
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
| | - C. Belda-Iniesta
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
| | - N. Ramirez-Merino
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
| | - J. Barriuso
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
| | | | - J. Feliu
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
| | - V. Moreno-Garcia
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
| | - V. Martinez-Marin
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
| | - M. Gonzalez-Baron
- Hospital La Paz, Madrid, Spain; Fundación Jimenez Diaz, Madrid, Spain
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Moreno Garcia V, Cejas P, Feliu J, De Castro J, Belda-Iniesta C, Barriuso J, Larrauri J, Gonzalez Baron M, Casado E. Immunohistochemical analysis of tumor regression grade for rectal cancer after neoadjuvant chemoradiotherapy. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e22089] [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
e22089 Background: Tumor regression grade (TRG) as defined by Rodel et al. has been suggested as an independent prognostic factor for rectal carcinoma patients treated by preoperative chemoradiotherapy (CRT). However TRG 2 and 3 determination, semiquantitatively defined as more/less than 50% tumor regression, respectively, do not clearly correlate with prognosis. TRG 2 vs 3 discrimination is largely subjective hurdling prognostic analysis. The purpose of our study was to find an immunohistochemical pattern to better stratify these patients according to prognosis in term of disease free survival (DFS) and overall survival (OS). Methods: Immunohistochemistry of EGFR, VEGF, CD133, p53 and Ki67 was evaluated by tissue microarrays on surgical specimens from 88 patients. Preoperative chemotherapy was UFT-LV (30%) or oxaliplatin-based (70%) plus pelvic radiotherapy (50 Gy) followed by mesorectal excision. TRG was determined by the amount of viable tumor versus fibrosis, ranging from TRG 4 when no viable tumor cells were detected, to TRG 1 when regression was less than 25%. TRG 2 and 3 were defined as described above. Univariate analyses were performed according to the Kaplan-Meier method. Comparisons between curves were evaluated by the log-rank test. Cox regression was used for the multivariate analysis. Results: At a median follow-up of 39 months, the TRG was an independent predictor of DFS (p=0.05) and OS (p=0.001) but no differences were found between TRG 2 and 3 in terms of DFS (p=0.74) or OS (p=0.41). Our results show an immunohistochemical bad prognostic profile for tumors TRG 2 and 3 configured by double negativity of EGFR and CD133 expression (less than 5% of tumor cells membrane immunoreactivity for both antibodies). 3-year DFS and OS for these patients (vs. TRG 2 and 3 not-double negative) were 33 vs 65% (p=0.05) [HR=2.4 (95%CI, 0.9–6.1) p=0.06] and 77 vs 95% (p=0.06) [HR=4.1 (95%CI, 0.7–21.5) p=0.09]. Conclusions: The EGFR/CD133 double negative rectal tumors with TRG 2 or 3 after chemoradiotherapy show a higher risk of relapse or death. These results can help clinicians to determine better individual prognosis and are worth to confirm prospectively. No significant financial relationships to disclose.
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Affiliation(s)
- V. Moreno Garcia
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
| | - P. Cejas
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
| | - J. Feliu
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
| | - J. De Castro
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
| | - C. Belda-Iniesta
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
| | - J. Barriuso
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
| | - J. Larrauri
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
| | - M. Gonzalez Baron
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
| | - E. Casado
- University Hospital La Paz, Madrid, Spain; Hospital Infanta Sofia, Madrid, Spain
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Hernando E, Sarmentero-Estrada J, Koppie T, Belda-Iniesta C, Ramírez de Molina V, Cejas P, Ozu C, Le C, Sánchez JJ, González-Barón M, Koutcher J, Cordón-Cardó C, Bochner BH, Lacal JC, Ramírez de Molina A. A critical role for choline kinase-alpha in the aggressiveness of bladder carcinomas. Oncogene 2009; 28:2425-35. [PMID: 19448670 DOI: 10.1038/onc.2009.91] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Bladder cancer is one of the most common causes of death in industrialized countries. New tumor markers and therapeutic approaches are still needed to improve the management of bladder cancer patients. Choline kinase-alpha (ChoKalpha) is a metabolic enzyme that has a role in cell proliferation and transformation. Inhibitors of ChoKalpha show antitumoral activity and are expected to be introduced soon in clinical trials. This study aims to assess whether ChoKalpha plays a role in the aggressiveness of bladder tumors and constitutes a new approach for bladder cancer treatment. We show here that ChoKalpha is constitutively altered in human bladder tumor cells. Furthermore, in vivo murine models, including an orthotopic model to mimic as much as possible the physiological conditions, revealed that increased levels of ChoKalpha potentiate both tumor formation (P< or =0.0001) and aggressiveness of the disease on different end points (P=0.011). Accordingly, increased levels of ChoKalpha significantly reduce survival of mice with bladder cancer (P=0.05). Finally, treatment with a ChoKalpha-specific inhibitor resulted in a significant inhibition of tumor growth (P=0.02) and in a relevant increase in survival (P=0.03).
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Affiliation(s)
- E Hernando
- Molecular Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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González Barón M, Feyjóo M, Carulla Torrent J, Camps C, Escobar Y, Belda-Iniesta C. Study of the prevalence of tumour-related asthenia in Spanish cancer patients. Clin Transl Oncol 2008; 10:351-8. [PMID: 18558582 DOI: 10.1007/s12094-008-0211-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Asthenia is the most prevalent symptom in oncological patients but it is underestimated by the majority of healthcare professionals. The aim of the present study is to estimate the prevalence of tumour-related asthenia in the Spanish population, while defining the associated factors. METHODS An epidemiological, multicentre, cross-sectional study was conducted in oncology services from Spain, including 712 cancer patients (58.4+/-13.5 years). RESULTS 42.5% patients showed asthenia. This prevalence appeared to be tumour-related (p<0.05) and increased among patients with a more advanced stage of disease or with a worsening of performance status (p<0.001). The prevalence of asthenia increased in the presence of the following factors: chemotherapy (in the past: 52.1% vs. 31.0%; at the time of the study: 46.1% vs. 38.2%), symptomatic treatment (in the past: 60.4% vs. 39.8%; at the time of the study: 61.3% vs. 38.6%), present interferon treatment (100%), anaemia (59.7% vs. 31.3%), dehydration/waterelectrolyte imbalance (58.3% vs. 41.6%), respiratory failure (61.4% vs. 39.7%), liver disease (59.5% vs. 41.3%), malnutrition (76.1% vs. 38.7%), pain (57.7% vs. 27.0%), anxiety (56.1% vs. 38.6%), depression (57.9% vs. 40.0%) and sleep disturbances (51.1% vs. 39.4%). A multivariate logistic regression showed that a model including performance status, patient circumstance, chemotherapy, anaemia, pain and anxiety correctly diagnosed asthenia in 70.9% of cases. CONCLUSIONS The physiopathology of tumour-related asthenia remains relatively unknown, despite its high prevalence and considerable quality of life impact. Determining factors related to asthenia in clinical practice can favour the use of concrete treatments and improve the conditions of cancer patients.
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Affiliation(s)
- M González Barón
- Medical Oncology Division, University Hospital La Paz, Madrid, Spain.
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Belda-Iniesta C, de Castro Carpeño J, Sereno M, González-Barón M, Perona R. Epidermal growth factor receptor and glioblastoma multiforme: molecular basis for a new approach. Clin Transl Oncol 2008; 10:73-7. [PMID: 18258505 DOI: 10.1007/s12094-008-0159-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
High-grade gliomas are the most common primary malignant brain tumours. Surgery, radiotherapy and chemotherapy are the cornerstone of actual treatment. In spite of large therapeutic efforts, overall survival is still poor. New molecular data allow a new molecular classification for high-grade gliomas and open a therapeutic window for targeted therapy. Molecular diagnostic tools may provide a basis for receptor-based therapies and enough information to personalise future treatments. In this regard, epidermal growth factor receptor (EGFR) is a target that will play a critical role in the management of glioma patients. This review summarises basic and preclinical data that support future use of therapies against EGFR.
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Affiliation(s)
- Cristóbal Belda-Iniesta
- Translational Oncology Unit (CSIC/UAM) at Medical Oncology Division, University Hospital La Paz, Universidad Autonoma de Madrid, Madrid, Spain.
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López M, Feliú J, Espinosa E, Castelo B, de Castro J, Belda-Iniesta C, Sereno M, Madero R, Lobo F, González Barón M. Use of Internet among cancer patients and their relatives in Spain. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Castañón C, Alonso V, Vieitez J, Esquerdo G, Pérez-Carrión R, Belda-Iniesta C, Rubio M, Roca J, García G, Salut A. Clinical profile of patients with metastatic colorectal adenocarcinoma treated with bevacizumab in first-line: AVATRAN study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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40
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De Castro J, Belda-Iniesta C, Machado-Pinilla R, Cejas P, Rodriguez-Fanjul V, Sáenz EC, Feliú J, Paz-Ares LG, González-Barón M, Perona R. Use of global expression profile from non-small cell lung carcinoma (NSCLC) surgical samples to predict response to pemetrexed (P). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.2542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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41
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Gómez-Raposo C, Nistal M, De Castro Carpeño J, Sosa Rotundo G, Belda-Iniesta C, Casado E, González Barón M. Retroperitoneal Castleman's disease with colon cancer. A rare association. Clin Transl Oncol 2008; 10:238-40. [PMID: 18411199 DOI: 10.1007/s12094-008-0189-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Castleman's disease (CD) is a rare disorder of uncertain aetiology characterised by massive proliferation of lymphoid tissue usually localised as mediastinal masses, although abdominal involvement has been reported. Localised forms are usually associated with a good prognosis, but several more aggressive multifocal variants have been observed. Two different histologic subtypes have been described: the hyaline vascular type, more common in unicentric CD and usually asymptomatic, and the plasma cell form. Unicentric CD may be associated with an increased risk of lymphoma, but there was no reported increased risk of other malignancies. A patient with plasma cell subtype unicentric CD localised in retroperitoneum associated with an adenocarcinoma of ileocaecal valve and liver metastasis is reported.
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Affiliation(s)
- César Gómez-Raposo
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain.
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Feliu J, Firvida JL, Castro J, Madroñal C, Rodríguez-Jaráiz A, Salgado M, Belda-Iniesta C, Casado E, García-Mata J, González-Barón M. Combination therapy with docetaxel and low dose of cisplatin in elderly patients with advanced non-small cell lung cancer: multicenter phase II study. Cancer Chemother Pharmacol 2008; 63:403-9. [DOI: 10.1007/s00280-008-0749-z] [Citation(s) in RCA: 4] [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] [Received: 01/28/2008] [Accepted: 03/17/2008] [Indexed: 10/22/2022]
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de Castro J, Belda-Iniesta C, Isla D, Dómine M, Sánchez A, Batiste E, Barón MG. Early intervention with epoetin beta prevents severe anaemia in lung cancer patients receiving platinum-based chemotherapy: A subgroup analysis of the NeoPrevent study. Lung Cancer 2008; 59:211-8. [PMID: 17875340 DOI: 10.1016/j.lungcan.2007.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 06/26/2007] [Revised: 08/02/2007] [Accepted: 08/06/2007] [Indexed: 11/26/2022]
Abstract
The NeoPrevent study showed that early intervention with epoetin beta could prevent severe anaemia in patients with solid tumours receiving platinum-based chemotherapy. An early intervention strategy may be particularly warranted in patients with lung cancer, as anaemia is very common in these patients and can be severe. The purpose of this study was to examine the efficacy and safety of epoetin beta in the subpopulation of patients with lung cancer included in the NeoPrevent study. Patients were enrolled if baseline haemoglobin (Hb) levels were <or=13 g/dl (men) or <or=12 g/dl (women), or fell to these levels during platinum-based chemotherapy. Patients received epoetin beta 150 IU/kg three times weekly, until 4 weeks after last chemotherapy cycle. The anaemia prevention response was measured as the proportion of patients with an Hb response (Hb increase of >1g/dl) plus the proportion whose Hb was maintained at +/-1g/dl of baseline. Quality of life (QoL) was measured using the linear analogue scale assessment. The NeoPrevent study included 255 patients in total, and the results for the 102 patients with lung cancer (non-small-cell lung cancer 64%; small-cell lung cancer 36%) are presented here. The overall anaemia prevention response was 90%, with Hb response in 60% of patients and maintenance of baseline Hb level in 30%. Only 9% of patients required transfusions. QoL improved significantly in patients with Hb response (p<0.01) and was maintained in non-responders (p>or=0.578). Epoetin beta was effective in preventing severe anaemia in lung cancer patients receiving platinum-based chemotherapy.
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Affiliation(s)
- Javier de Castro
- Servicio de Oncología Médica, Hospital Universitario La Paz (Madrid), Paseo de la Castellana, 261, 28046 Madrid, Spain.
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Ramírez de Molina A, Sarmentero-Estrada J, Belda-Iniesta C, Tarón M, Ramírez de Molina V, Cejas P, Skrzypski M, Gallego-Ortega D, de Castro J, Casado E, García-Cabezas MA, Sánchez JJ, Nistal M, Rosell R, González-Barón M, Lacal JC. Expression of choline kinase alpha to predict outcome in patients with early-stage non-small-cell lung cancer: a retrospective study. Lancet Oncol 2007; 8:889-97. [PMID: 17851129 DOI: 10.1016/s1470-2045(07)70279-6] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Adequate prognostic markers to predict outcome of patients with lung cancer are still needed. The aim of this study was to assess whether choline kinase alpha (ChoKalpha) gene expression could identify patients with different prognoses. ChoKalpha is an enzyme involved in cell metabolism and proliferation and has a role in oncogene-mediated transformation in several human tumours, including lung cancer. METHODS 60 patients with non-small-cell lung cancer (NSCLC) who had undergone surgical resection in a single centre were enrolled into the study as the training group. We used real-time reverse-transcriptase PCR (RT-PCR) to measure ChoKalpha gene expression and analyse the association between ChoKalpha expression and survival in evaluable patients. Additionally, a second group of 120 patients with NSCLC from a different hospital were enrolled into the study as the validation group. We did an overall analysis of all 167 patients who had available tissue to confirm the cut-off point for future studies. The primary endpoints were lung-cancer-specific survival and relapse-free survival. FINDINGS Seven of the 60 patients in the training group were not evaluable due to insufficient tissue. In the 53 evaluable patients, the cut-off for those with ChoKalpha overexpression was defined by receiver operator under the curve (ROC) methodology. 4-year lung-cancer-specific survival was 54.43% (95% CI 28.24-80.61) for 25 patients with ChoKalpha expression above the ROC-defined cut-off compared with 88.27% (75.79-100) for 28 patients with concentrations of the enzyme below this cut-off (hazard ratio [HR] 3.14 [0.83-11.88], p=0.07). In the validation group, six of the 120 enrolled patients were not evaluable due to insufficient tissue. For the other 114 patients, 4-year lung-cancer-specific survival was 46.66% (32.67-59.65) for those with ChoKalpha expression above the ROC-defined cut-off compared with 67.01% (50.92-81.11) for patients with concentrations of ChoKalpha below the cut-off (HR 1.87 [1.01-3.46], p=0.04). A global analysis of all 167 patients further confirmed the association between ChoKalpha overexpression and worse clinical outcome of patients with NSCLC: 4-year lung-cancer-specific survival for ChoKalpha expression above the ROC-defined cut-off was 49.00% (36.61-60.38) compared with 70.52% (59.80-76.75) for those with concentrations of ChoKalpha below the cut-off (HR 1.98 [1.14-3.45], p=0.01). The overall analysis confirmed the cut-off for ChoKalpha expression should be 1.91-times higher than concentrations noted in healthy tissues when ChoKalpha is used as an independent predictive factor of relapse-free and lung-cancer-specific survival in patients with early-stage NSCLC. INTERPRETATION ChoKalpha expression is a new prognostic factor that could be used to help identify patients with early-stage NSCLC who might be at high risk of recurrence, and to identify patients with favourable prognosis who could receive less aggressive treatment options or avoid adjuvant systemic treatment. New treatments that inhibit ChoKalpha expression or activity in patients with lung cancer should be studied further.
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Affiliation(s)
- Ana Ramírez de Molina
- Translational Oncology Unit, CSIC-UAM-La Paz, National Center of Biotechnology, Madrid, Spain
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Casado E, De Castro J, Belda-Iniesta C, Cejas P, Feliu J, Sereno M, González-Barón M. Molecular markers in colorectal cancer: genetic bases for a customised treatment. Clin Transl Oncol 2007; 9:549-54. [DOI: 10.1007/s12094-007-0102-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Belda-Iniesta C, de Castro Carpeño J, Carrasco JA, Moreno V, Casado Sáenz E, Feliu J, Sereno M, García Río F, Barriuso J, González Barón M. New screening method for lung cancer by detecting volatile organic compounds in breath. Clin Transl Oncol 2007; 9:364-8. [PMID: 17594950 DOI: 10.1007/s12094-007-0068-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Lung cancer is a frequent cause of cancer-related deaths in the world. There is no valid screening process and this limits its detection to the late stages, with consequently high mortality rates. Volatile organic compounds (VOC) are chemical compounds (mainly the products of cell catabolism) found as gases in the human breath. Different methods have been developed to analyse VOCs and to compare them in healthy subjects and lung cancer patients. In this review, we summarise the different techniques used to analyse VOC. Many reports have been published with promising results similar to those achieved with accepted screening methods such as mammography. These methods show good perspectives on lung cancer screening.
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Affiliation(s)
- C Belda-Iniesta
- Translational Oncology Unit (CSIC/UAM), Medical Oncology Division, University Hospital La Paz, Madrid, Spain.
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47
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Cejas P, García-Cabezas MA, Casado E, Belda-Iniesta C, De Castro J, Fresno JA, Sereno M, Barriuso J, Espinosa E, Zamora P, Feliu J, Redondo A, Hardisson DA, Renart J, González-Barón M. Phospholipid hydroperoxide glutathione peroxidase (PHGPx) expression is downregulated in poorly differentiated breast invasive ductal carcinoma. Free Radic Res 2007; 41:681-7. [PMID: 17516241 DOI: 10.1080/10715760701286167] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Phospholipid Hydroperoxide Glutathione Peroxidase (PHGPx) is the only known enzyme able to reduce lipid peroxides bound to cell membranes. Moreover it has been involved in apoptosis and can influence intracellular signaling. To investigate the possible relationship between PHGPx and human cancer we have quantified PHGPx expression levels by real-time quantitative PCR and immunohistochemistry in tissue samples of human breast invasive ductal carcinoma from 34 patients compared with their own controls of benign breast tissue. PHGPx expression levels were compared with the clinical and pathological data of these patients. The results showed that PHGPx expression levels are downregulated in poorly differentiated (grade 3) breast invasive ductal carcinoma (P = 0.0043). PHGPx expression levels decreased gradually with tumor grade from grade 1 to grade 3. We also found a downregulation of PHGPx in cases that showed p53 accumulation compared with cases without p53 immunostaining (P = 0.0011). PHGPx was also downregulated in cases without progesterone receptors (PR) immunostaining compared with cases with PR immunostaining (P = 0.0165). Grade 3, p53 immunostaining and absence of PR immunostaining are poor prognostic factors. These results suggest that PHGPx downregulation could be related with a poorer prognosis in breast invasive ductal carcinoma.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/enzymology
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/enzymology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/pathology
- Cell Differentiation
- Down-Regulation
- Female
- Gene Expression Regulation, Enzymologic
- Glutathione Peroxidase/genetics
- Glutathione Peroxidase/metabolism
- Humans
- Immunoenzyme Techniques
- Middle Aged
- Phospholipid Hydroperoxide Glutathione Peroxidase
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- RNA, Neoplasm/genetics
- RNA, Neoplasm/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- P Cejas
- Medical Oncology Service, Hospital Universitario La Paz, Madrid, Spain
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Belda-Iniesta C, Perona R, Carpeño JDC, Cejas P, Casado E, Manguan-García C, Ibanez de Caceres I, Sanchez-Perez I, Andreu FB, Ferreira JA, Aguilera A, de la Peña J, Perez-Sánchez E, Madero R, Feliu J, Sereno M, González-Barón M. Human recombinant erythropoietin does not promote cancer growth in presence of functional receptors expressed in cancer cells. Cancer Biol Ther 2007; 6:1600-5. [PMID: 17938574 DOI: 10.4161/cbt.6.10.4726] [Citation(s) in RCA: 11] [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] [Indexed: 11/19/2022] Open
Abstract
Human recombinant erythropoietin (hrEPO) therapy might be associated with tumor progression and death. This effect has been suggested to be secondary to rhEPO binding to its receptor (EPOR) expressed on cancer cells. However, there are several concerns about EPOR functionality when expressed on cancer cells. In this paper we have provided evidence that EPOR expressed in cancer cells could be implicated in proliferation events because a transfection of EPOR siRNA to EPOR-expressing bladder cancer cells resulted in a marked reduction in cell growth. However, these cell lines do not grow in the presence of hrEPO. Furthermore, bladder cancer patients that expressed EPOR in tumor samples had a reduced survival in absence of rhEPO treatment. Therefore, EPOR is implicated in bladder cancer growth but this effect appears to be independent from rhEPO supplementation. Reports which suggest that rhEPO promotes cancer growth due to the expression of EPOR in cancer cells must be observed with caution since in the presence of functional EPOR rhEPO does not promote growth.
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Affiliation(s)
- Cristóbal Belda-Iniesta
- Translational Oncology Unit (CSIC/UAM), Medical Oncology Division, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.
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Gonzalez-Baron M, Blanco M, Feliu J, Gómez C, Casado E, Castro J, Belda-Iniesta C, Garrido M, Aguayo C, Campos MA. Cetuximab and irinotecan in patients with colorectal cancer refractory to oxaliplatin and irinotecan. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.14600] [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
14600 Background: Patients with chemotherapy-resistant metastasic colorectal cancer have a poor prognosis with few therapeutic options. The purpose of this work is to evaluate the results of treatment with cetuximab and irinotecan in this group of patients. Methods: Between January 01 and July 06, 24 patients were treated in our centre with cetuximab. 19 patients received irinotecan 180 mg/m2 every two weeks with cetuximab at standard doses: 400 mg/m2 loading dose over 2 hours, then 250 mg/m2 over 1 hour weekly, and 5 patients received FOLFIRI schedule and cetuximab at the same doses as previously. Results: Characteristics of the 24 patients were: male/female 15/9; median age 63 years old (range 48–75); performance status 0–1 (10 patients), and 2–3 (14 patients). The median number of chemotherapy regimens preceding first cetuximab administration was 2 (range 1 to 4).12% had received one chemotherapy line, 64% two chemotherapy lines, 16% three chemotherapy lines and 8% received four chemotherapy lines. EGFR status was positive in all patients. The median of administrated cycles was 7.5 (range 2–26). There were 4 objective responses (16%; 95% CI: 5–38.5%) and 7 patients with stable disease (29%). The median progression free survival was 3.2 months and median overall survival was 7.8 months (95% CI: 3–14). The treatment was well tolerated. 6% of the patients had not cutaneous toxicity with the cetuximab treatment, 14 (25%) had a cutaneous toxicity grade 1 or 2 while 25% had a grade 3 or 4 toxicity, that lead to dose reduction in three cases and treatment drop out in one case. Other adverse effects with the treatment included four cases (17%) with diarrhoea grade 3, all of them in treatments with irinotecan, two patients (8%) suffered vomits grade 3, and one patient with grade 3 trombopenia. Conclusions: This therapeutic survey in an unselected population is in accordance with the results of the BOND survey for OS, tumour responses and toxicity. No significant financial relationships to disclose.
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Abstract
Gliomas are the most common primary brain tumours. In keeping with the degree of aggressiveness, gliomas are divided into four grades, with different biological behaviour. Furthermore, as different gliomas share a predominant histological appearance, the final classification includes both, histological features and degree of malignancy. For example, gliomas of astrocytic origin (astrocytomas) are classified into pilocytic astrocytoma (grade I), astrocytoma (grade II), anaplastic astrocytoma (grade III) and glioblastoma multiforme (GMB) (grade IV). Tumors derived from oligodendrocytes include grade II (oliogodendrogliomas) and grade III neoplasms (oligoastrocytoma). Each subtype has a specific prognosis that dictates the clinical management. In this regard, a patient diagnosed with an oligodendroglioma totally removed has 10-15 years of potential survival. On the opposite site, patients carrying a glioblastoma multiforme usually die within the first year after the diagnosis is made. Therefore, different approaches are needed in each case. Obviously, prognosis and biological behaviour of malignant gliomas are closely related and supported by the different molecular background that possesses each type of glioma. Furthermore, the ability that allows several low-grade gliomas to progress into more aggressive tumors has allowed cancer researchers to elucidate several pathways implicated in molecular biology of these devastating tumors. In this review, we describe classical pathways involved in human malignant gliomas with special focus with recent advances, such as glioma stem-like cells and expression patterns from microarray studies.
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Affiliation(s)
- Cristóbal Belda-Iniesta
- Translational Oncology Unit (CSIC/UAM) at Medical Oncology Division, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Spain.
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