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Scheepbouwer C, Aparicio-Puerta E, Gomez-Martin C, Verschueren H, van Eijndhoven M, Wedekind LE, Giannoukakos S, Hijmering N, Gasparotto L, van der Galien HT, van Rijn RS, Aronica E, Kibbelaar R, Heine VM, Wesseling P, Noske DP, Vandertop WP, de Jong D, Pegtel DM, Hackenberg M, Wurdinger T, Gerber A, Koppers-Lalic D. ALL-tRNAseq enables robust tRNA profiling in tissue samples. Genes Dev 2023; 37:243-257. [PMID: 36810209 PMCID: PMC10111867 DOI: 10.1101/gad.350233.122] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/26/2023] [Indexed: 02/23/2023]
Abstract
Transfer RNAs (tRNAs) are small adaptor RNAs essential for mRNA translation. Alterations in the cellular tRNA population can directly affect mRNA decoding rates and translational efficiency during cancer development and progression. To evaluate changes in the composition of the tRNA pool, multiple sequencing approaches have been developed to overcome reverse transcription blocks caused by the stable structures of these molecules and their numerous base modifications. However, it remains unclear whether current sequencing protocols faithfully capture tRNAs existing in cells or tissues. This is specifically challenging for clinical tissue samples that often present variable RNA qualities. For this reason, we developed ALL-tRNAseq, which combines the highly processive MarathonRT and RNA demethylation for the robust assessment of tRNA expression, together with a randomized adapter ligation strategy prior to reverse transcription to assess tRNA fragmentation levels in both cell lines and tissues. Incorporation of tRNA fragments not only informed on sample integrity but also significantly improved tRNA profiling of tissue samples. Our data showed that our profiling strategy effectively improves classification of oncogenic signatures in glioblastoma and diffuse large B-cell lymphoma tissues, particularly for samples presenting higher levels of RNA fragmentation, further highlighting the utility of ALL-tRNAseq for translational research.
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Affiliation(s)
- Chantal Scheepbouwer
- Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC) location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands;
- Brain Tumor Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | | | - Cristina Gomez-Martin
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Heleen Verschueren
- Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC) location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Brain Tumor Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Monique van Eijndhoven
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Laurine E Wedekind
- Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC) location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Brain Tumor Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Stavros Giannoukakos
- Genetics Department, Faculty of Science, University of Granada, 18071 Granada, Spain
| | - Nathalie Hijmering
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Lisa Gasparotto
- Department of Child and Adolescent Psychiatry, Emma Children's Hospital, Amsterdam UMC, Neuroscience, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Hilde T van der Galien
- Department of Hematology, Medical Center Leeuwarden, 8934 AD Leeuwarden, the Netherlands
- HemoBase Population Registry Consortium, 8934 AD Leeuwarden, the Netherlands
| | - Roos S van Rijn
- Department of Hematology, Medical Center Leeuwarden, 8934 AD Leeuwarden, the Netherlands
- HemoBase Population Registry Consortium, 8934 AD Leeuwarden, the Netherlands
| | - Eleonora Aronica
- Department of (Neuro)Pathology Amsterdam Neuroscience, Amsterdam UMC location University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Robby Kibbelaar
- HemoBase Population Registry Consortium, 8934 AD Leeuwarden, the Netherlands
- Department of Pathology, Pathology Friesland, 8917 EN Leeuwarden, the Netherlands
| | - Vivi M Heine
- Department of Child and Adolescent Psychiatry, Emma Children's Hospital, Amsterdam UMC, Neuroscience, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Pieter Wesseling
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Laboratory for Childhood Cancer Pathology, Princess Máxima Center for Pediatric Oncology, University Medical Center Utrecht, 3584 CS Utrecht, the Netherlands
| | - David P Noske
- Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC) location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Brain Tumor Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - W Peter Vandertop
- Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC) location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Brain Tumor Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Daphne de Jong
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - D Michiel Pegtel
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Michael Hackenberg
- Genetics Department, Faculty of Science, University of Granada, 18071 Granada, Spain
| | - Tom Wurdinger
- Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC) location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Brain Tumor Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Alan Gerber
- Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC) location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
- Brain Tumor Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
| | - Danijela Koppers-Lalic
- Department of Neurosurgery, Cancer Center Amsterdam, Amsterdam University Medical Center (UMC) location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands;
- Brain Tumor Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, the Netherlands
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Sangro B, Numata K, Huang Y, Gomez-Martin C, Hiraoka A, Moriguchi M, Shen Y, Horvath A, Feely W, Young T, Neely J, Kudo M. P-61 Relatlimab + nivolumab in patients with advanced hepatocellular carcinoma who are naive to immuno-oncology therapy but progressed on tyrosine kinase inhibitors, a phase 2, randomized, open-label study: RELATIVITY-073. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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López FL, Barrio RY, Olarte PE, Gomez-Martin C. P-350 Maintenance trastuzumab in the setting of second-line treatment in HER2 overexpressing metastatic gastric and gastroesophageal junction adenocarcinoma: Experience of our centre. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.432] [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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Riesco-Martinez M, Díaz-Serrano A, Gomez-Martin C, Alfonso JA, Cabrera ES, Garcia-Carbonero R. The role of antiangiogenic therapy in advanced gastro-esophageal cancer: a systematic review and meta-analysis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ghanem I, Blazquez M, Higuera O, Lema L, Rodriguez N, Gomez-Martin C, Mata A, Lora D, Custodio A, Feliu J. P-328 Which is the best first approach for liver-only synchronic metastasis rectal cancer? Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gomez-Martin C, Plaza J, Del Valle E, Valladares FP, Fonseca PJ, Salud A, Leon A, Rivera F, Garralda E, Lopez-Rios F. HER2 Status in advanced Gastric Carcinoma Patients Treated with Trastuzumab. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33276-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Rodriguez Garzotto A AA, Iglesias Docampo LC, Gravalos Castro C, Lopez-Martin JA, Agullo Ortuno T, Diaz Garcia V, Homet B, Ciruelos Gil EM, Manso L, Mendiola C, Gomez-Martin C, Hitt R, Gomez Camara A, Cortes-Funes H. Phase II trial of topical heparin as treatment for patients (pts) with hand-foot syndrome (HFS) induced by capecitabine (CAP). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19671] [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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De Velasco G, Gomez-Martin C, Ghanem I, Garralda E, Homet B, Hoyos S, Cortes-Funes H. A pragmatic review of palliative chemotherapy regimens in locally advanced or metastatic pancreatic cancer: Efficacy and experience in a single institution. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19639] [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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Garralda E, Castroagudin JF, Bustamante J, Salcedo M, Sangro B, Herrero I, Testillano M, Matilla A, Cortes-Funes H, Gomez-Martin C. Sorafenib (Sor) and mTOR inhibitors (mTORinh) combination for hepatocarcinoma recurrence after liver transplantation. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14574] [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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Finn RS, Poon RTP, Yau T, Klumpen H, Chen L, Kang Y, Kim T, Gomez-Martin C, Rodriguez-Lope C, Kunz T, Paquet T, Asubonteng K, Winkler RE, Anak O, Sellami DB, Bruix J. Phase I study of everolimus in combination with sorafenib in patients with advanced hepatocellular carcinoma (HCC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4074] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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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Gomez-Martin C, Garcia-Garcia E, Suarez-Gauthier A, Conde E, Lopez-Rios F. 6652 Comparison of fluorescence in situ hybridization and dual colour chromogenic in situ hybridization for the assessment of HER2 status on gastric cancer biopsies. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71373-4] [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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Castellano DE, Gomez-Martin C, Cubedo Cervera R, Garcia Lopez J, Gomez-Sanz R, Gravalos C, Nuñez Sobrino J, Cortes-Funes H. Exploratory study of the subcutaneous fat gene expression profile in patients with metastatic pancreatic carcinoma treated with standard gemcitabine chemotherapy regimen. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e22220] [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
e22220 Background: Most clinical trials are designed to assess the antitumor effect of the chemoterapeutic intervention. There are few examples where the endpoint is to assess the biology of the host response to the treatment of the tumor. A large number of patients with pancreatic cancer present features of the cachexia syndrome and specially a marked weight loss. It has been postulated that a “cytokine storm” is the cause of the profound effect that this cancer has on distant tissues. This trial analyzed changes in the subcutaneous fat gene expression profile in relation with the clinical benefit variable with standard gemcitabine (G) treatment. Methods: Patients with histology confirmed advanced pancreatic cancer, adequate organ function and written informed consent. Eligible pts were intended for a subcutaneous fat biopsy pretreatment and after 7 weeks of gemcitabine 1000 mg/m2 together with response assessment. Clinical benefit (CB) (pain, analgesic consumption, Karnofsky and weight), QLQ-C30, serum cytokines and tumor markers were evaluated pretreatment, at 4 and 8 weeks. Fat gene expression profile was analyzed using Affimetrix U133Plus2.0 with the corresponding bioinformatic software. Serum cytokines where analyzed with xMAP technology with the Luminex 200 platform. Results: 16 pts [8 m, 8 f, median age 62 yrs (range 47–72)]. Median weight change -0.75 kg (range -4.5 to 2). Nine pts had pre and post treatment biopsies and 7 only pretreatment. Three pts achieved CB at 8 weeks. Objective responses: 0 CR, 0 PR, 31% SD and 68%PD. Toxicity was similar to the one reported in gemcitabine's label. It was possible to extract quality RNA for microarray from subcutaneous fat use from all samples but 1. The limited number of samples precluded to obtain genes clearly involved in cachexia, however the IL-8 expression (p0.03) was significantly correlated with CB response either to gene and serum profile. Conclusions: It is feasible to study prospectively the impact of cancer treatment on different tissue biomarkers and correlated with standard antitumor evaluation system. The reduced number of samples in this exploratory trial precludes producing significant biological conclusions. No significant financial relationships to disclose.
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Affiliation(s)
- D. E. Castellano
- Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Puerta de Hierro, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain
| | - C. Gomez-Martin
- Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Puerta de Hierro, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain
| | - R. Cubedo Cervera
- Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Puerta de Hierro, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain
| | - J. Garcia Lopez
- Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Puerta de Hierro, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain
| | - R. Gomez-Sanz
- Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Puerta de Hierro, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain
| | - C. Gravalos
- Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Puerta de Hierro, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain
| | - J. Nuñez Sobrino
- Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Puerta de Hierro, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain
| | - H. Cortes-Funes
- Hospital Universitario 12 de Octubre, Madrid, Spain; Clínica Puerta de Hierro, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain
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Gomez-Martin C, Camara JC, Cortes H, Jara C, Gravalos C, Rubio B, Amador ML, Hidalgo M. A phase I study of erlotinib, bevacizumab and gemcitabine in patients with advanced pancreatic cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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
4611 Background: Erlotinib is an EGFR TKI active in combination with gemcitabine in p with advanced pancreatic cancer (PC). The combination of gemcitabine and bevacizumab is also active in PC. A phase I of gemcitabine, bevacizumab and erlotinib in p with unresectable locally advanced or metastatic PC is being conducted. Methods: Two cohorts of 6 patients with advanced PC have been treated either with erlotinib (150 mg/day po), bevacizumab (5 mg/Kg iv, days 1 and 15, every 28 days), and either 10 mg/m2/min infusion of gemcitabine 850 mg/m2 or 1,000 mg/m2 days 1 and 15 every 28 days. P received a maximum of 6 cycles of 28 days. Cohort 1: Daily erlotinib 150 mg po + bevacizumab 5 mg/kg iv days 1 and 15 + gemcitabine 850 mg/m2 over 10 mg/m2/min infusion days 1 and 15. Cohort 2: daily erlotinib 150 mg po + bevacizumab 5 mg/kg iv days 1 and 15 + gemcitabine 100 mg/m2 over 10 mg/m2/min infusion days 1 and 15. Results: 12 p have been included in this study (6 cohort 1 and 6 cohort 2), being evaluable for toxicity. 11 p have concluded the study and 7 have received complete treatment as per protocol. Median age 62.6 yrs (range 38–71); male/female: 5/7 (42%/58%); stage III/IV: 3/9 (25%/75%); Karnofsky index 100%/80%: 2/10. 3 of 6 p in cohort 1 developed gr. 3 asthenia (50%), 2 p gr. 3 neutropenia (33.3%), whereas 1 p had grade 3 leucopenia and gr. 3 skin rash. In cohort 2, most severe adverse events were: 1 case of grade 4 GGT elevation, 1 p gr. 3 skin rash and 1 p. experienced asthenia gr. 3. No severe hematological toxicity in cohort 2 was reported. One p of each cohort required dose reduction of erlotinib, both due to skin rash. Mild diarrhea was reported in 11 of 12 p evaluated. No dose limiting toxicities has been reported. All p were available for response: 2 p reached partial response (both included in cohort 1) and 7 showed stabilization (3 and 4 in cohorts 1 and 2, respectively). No complete responses were observed. Overall disease control index was 75%. Conclusions: The combination of gemcitabine, erlotinib and bevacizumab is well tolerated. MTD has not been reached. Encouraging clinical activity in advanced pancreatic cancer has been observed. Phase I is still ongoing. Toxicity data for all the p will be presented. No significant financial relationships to disclose.
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Affiliation(s)
- C. Gomez-Martin
- 12 Octubre University Hospital, Madrid, Spain; Hospital de Alcorcon, Madrid, Spain; Roche Farma, Madrid, Spain; John Hopkins University, Baltimore, MD
| | - J. C. Camara
- 12 Octubre University Hospital, Madrid, Spain; Hospital de Alcorcon, Madrid, Spain; Roche Farma, Madrid, Spain; John Hopkins University, Baltimore, MD
| | - H. Cortes
- 12 Octubre University Hospital, Madrid, Spain; Hospital de Alcorcon, Madrid, Spain; Roche Farma, Madrid, Spain; John Hopkins University, Baltimore, MD
| | - C. Jara
- 12 Octubre University Hospital, Madrid, Spain; Hospital de Alcorcon, Madrid, Spain; Roche Farma, Madrid, Spain; John Hopkins University, Baltimore, MD
| | - C. Gravalos
- 12 Octubre University Hospital, Madrid, Spain; Hospital de Alcorcon, Madrid, Spain; Roche Farma, Madrid, Spain; John Hopkins University, Baltimore, MD
| | - B. Rubio
- 12 Octubre University Hospital, Madrid, Spain; Hospital de Alcorcon, Madrid, Spain; Roche Farma, Madrid, Spain; John Hopkins University, Baltimore, MD
| | - M. L. Amador
- 12 Octubre University Hospital, Madrid, Spain; Hospital de Alcorcon, Madrid, Spain; Roche Farma, Madrid, Spain; John Hopkins University, Baltimore, MD
| | - M. Hidalgo
- 12 Octubre University Hospital, Madrid, Spain; Hospital de Alcorcon, Madrid, Spain; Roche Farma, Madrid, Spain; John Hopkins University, Baltimore, MD
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Gomez-Martin C, Lazaro M, Vazquez L, Carrasco J, Jorge M, Lopez C, Castellanos J. P-487 Biweekly gemcitabinelcarboplatin in poor PS patients with non. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80980-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gomez-Martin C, Solá C, Hornedo J, Perea S, Lumbreras C, Valentí V, Arcediano A, Rodriguez M, Salazar R, Cortés-Funes H, Hidalgo M. Rifampin does not improve the efficacy of quinolone antibacterial prophylaxis in neutropenic cancer patients: results of a randomized clinical trial. J Clin Oncol 2000; 18:2126-34. [PMID: 10811678 DOI: 10.1200/jco.2000.18.10.2126] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine whether the addition of rifampin to a quinolone-based antibacterial prophylactic regimen in patients undergoing high-dose chemotherapy (HDC) with peripheral-blood stem-cell transplantation (PBSCT) decreases the incidence of neutropenia and fever, Gram-positive bacteremia, and infection-related morbidity. PATIENTS AND METHODS Patients with solid tumors undergoing HDC with PBSCT were randomized to receive prophylactic antibiotics with either ciprofloxacin 500 mg orally every 8 hours or the same ciprofloxacin regimen with rifampin 300 mg orally every 12 hours. Prophylaxis was started 48 hours before stem-cell reinfusion. Patients were monitored to document the occurrence of neutropenia and fever, incidence and cause of bacterial infection, time to onset and duration of fever, requirement for intravenous antimicrobials, and length of hospital admission. RESULTS Sixty-five patients were randomized to receive ciprofloxacin and 65 to receive ciprofloxacin plus rifampin, and from these groups, 62 and 61 were assessable, respectively. The proportion of patients who developed neutropenia and fever was 87% in the group treated with ciprofloxacin and 78% in the group treated with ciprofloxacin and rifampin (P =.25). Although there was a trend toward a reduction in the overall incidence of bacteremia (12 v 4 patients), and Gram-positive bacteremia (8 v 2 patients) with the addition of rifampin, none of these comparisons was statistically significant (P =.05 and P =.09, respectively). CONCLUSION The results of this study, which demonstrate that rifampin does not improve ciprofloxacin antibacterial prophylaxis in cancer patients undergoing HDC with PBSCT support but that it does increase the occurrence of undesirable side effects, do not support the routine use of rifampin in this setting.
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Affiliation(s)
- C Gomez-Martin
- Division of Medical Oncology, Microbiology, and Infectious Disease, Hospital Universitario "12 de Octubre," Madrid, Spain
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