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Barrenetxea G, Celis R, Barrenetxea J, Martínez E, De Las Heras M, Gómez O, Aguirre O. Intraovarian platelet-rich plasma injection and IVF outcomes in patients with poor ovarian response: a double-blind randomized controlled trial. Hum Reprod 2024; 39:760-769. [PMID: 38423539 DOI: 10.1093/humrep/deae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/03/2024] [Indexed: 03/02/2024] Open
Abstract
STUDY QUESTION Does platelet-rich plasma (PRP) intraovarian injection increase the number of retrieved oocytes in successive ovarian punctions among patients with poor ovarian reserve (POR)? SUMMARY ANSWER The injection of PRP increases the number of retrieved oocytes without increasing the quality of developed blastocysts. WHAT IS KNOWN ALREADY Management of women with reduced ovarian response to stimulation is one of the significant challenges in reproductive medicine. Recently, PRP treatment has been proposed as an adjunct in assisted reproduction technology, with controversial results. STUDY DESIGN, SIZE, DURATION This placebo-controlled, double-blind, randomized trial included 60 patients with POR stratified according to the POSEIDON classification groups 3 and 4. It was conducted to explore the efficacy and safety of intraovarian PRP injection. Patients were proposed to undergo three consecutive ovarian stimulations to accumulate oocytes and were randomized to receive either PRP or placebo during their first oocyte retrieval. Randomization was performed using computer-generated randomization codes. Double blinding was ensured so that neither the participant nor the investigators knew of the treatment allotted. All patients underwent three ovarian stimulations and egg retrieval procedures. ICSI was performed after a third ovarian puncture. The primary endpoint was the number of mature oocytes retrieved after PRP or placebo injection in successive ovarian punctures. PARTICIPANTS/MATERIALS, SETTING, METHODS Sixty women (30-42 years) fulfilling inclusion criteria were randomized in equal proportions to the treatment or control groups. MAIN RESULTS AND THE ROLE OF CHANCE The baseline demographic and clinical characteristics [age, BMI, anti-Müllerian hormone (AMH) levels] were comparable between the groups. Regarding the primary endpoint, the cumulative number (mean ± SEM) of retrieved mature oocytes was slightly higher in the treatment group: 10.45 ± 0.41 versus 8.91 ± 0.39 in the control group, respectively (95% CI of the difference 0.42-2.66; P = 0,008). The number of mature oocytes obtained among all patients increased in successive egg retrievals: 2.61 ± 0.33 (mean ± SEM) in punction 1 (P1), 3.85 ± 0.42 in P2, and 4.73 ± 0.44 in P3. However, the increase was higher among patients receiving the assessed PRP treatment. In P2, the number of retrieved mature oocytes was 4.18 ± 0.58 versus 3.27 ± 0.61 in controls (95% CI of the difference: -0.30 to 2.12; P = 0.138) and in P3, 5.27 ± 0.73 versus 4.15 ± 0.45 (95% CI of the difference: 0.12-2.12; P = 0.029). The mean ± SEM number of developed and biopsied blastocysts was 2.43 ± 0.60 in the control group and 1.90 ± 0.32 in the treatment group, respectively (P = 0.449). The mean number of euploid blastocysts was 0.81 ± 0.24 and 0.81 ± 0.25 in the control and treatment groups, respectively (P = 1.000). The percentages of patients with euploid blastocysts were 53.33% (16 out of 30) and 43.33% (13 out of 30) for patients in the control and treatment groups, respectively (Fisher's exact test P = 0.606). The overall pregnancy rate per ITT was 43% (26 out of 60 patients). However, the percentage of clinical pregnancies was higher in the control group (18 out of 30, 60%) than in the treatment group (8 out of 30, 27%) (P = 0.018). There was also a trend toward poorer outcomes in the treatment group when considering full-term pregnancies (P = 0.170). There were no differences between control and treatment groups regarding type of delivery, and sex of newborns. LIMITATIONS, REASONS FOR CAUTION The mechanism of the potential beneficial effect of PRP injection on the number of retrieved oocytes is unknown. Either delivered platelet factors or a mechanical effect could be implicated. Further studies will be needed to confirm or refute the data presented in this trial and to specify the exact mechanism of action, if any, of PRP preparations. WIDER IMPLICATIONS OF THE FINDINGS The increasing number of women with a poor response to ovarian stimulation supports the exploration of new areas of research to know the potential benefits of therapies capable of increasing the number of oocytes available for fertilization and improving the quality of developed blastocysts. An increase in the retrieved oocytes in both arms of the trial suggests that, beyond the release of growth factor from platelets, a mechanical effect can play a role. However, neither improvement in euploid blastocyst development nor pregnancy rates have been demonstrated. STUDY FUNDING/COMPETING INTEREST(S) This trial was supported by Basque Government and included in HAZITEK program, framed in the new Euskadi 2030 Science and Technology Plan (PCTI 2030). These aids are co-financed by the European Regional Development Fund (FEDER). The study funders had no role in the study design, implementation, analysis, manuscript preparation, or decision to submit this article for publication. No competing interests are declared by all the authors. TRIAL REGISTRATION NUMBER Clinical Trial Number EudraCT 2020-000247-32. TRIAL REGISTRATION DATE 3 November 2020. DATE OF FIRST PATIENT’S ENROLLMENT 16 January 2021.
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Affiliation(s)
- G Barrenetxea
- Reproducción Bilbao Assisted Reproduction Center, Bilbao, Spain
- Departamento de Especialidades Médico-Quirúrgicas, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Leioa, Spain
| | - R Celis
- Reproducción Bilbao Assisted Reproduction Center, Bilbao, Spain
| | - J Barrenetxea
- Reproducción Bilbao Assisted Reproduction Center, Bilbao, Spain
- Osakidetza/Servicio Vasco de Salud, Hospital de Urduliz Alfredo Espinosa, Urduliz, Spain
| | - E Martínez
- Reproducción Bilbao Assisted Reproduction Center, Bilbao, Spain
| | - M De Las Heras
- Reproducción Bilbao Assisted Reproduction Center, Bilbao, Spain
| | - O Gómez
- Reproducción Bilbao Assisted Reproduction Center, Bilbao, Spain
| | - O Aguirre
- Reproducción Bilbao Assisted Reproduction Center, Bilbao, Spain
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Borregón M, Sánchez D, Martínez E. Screening and treatment of latent tuberculosis in patients with solid tumors and systemic cancer therapy. Clin Transl Oncol 2024:10.1007/s12094-024-03433-4. [PMID: 38514601 DOI: 10.1007/s12094-024-03433-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/01/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Tuberculosis is one of the infectious diseases with greater morbidity and mortality worldwide. Cancer causes an important immunosuppression with increased risk of infections. There is an enlarged bidirectional incidence between tuberculosis and cancer, mainly due to latent tuberculosis. GUIDELINES REVIEW There is great discrepancy between recommendations for screening and prophylaxis of latent tuberculosis in patients with solid tumors and systemic cancer therapy among different medical societies and guidelines. Most infectious diseases guidelines recommend it, while most oncology guidelines do not. DISCUSSION Patients with solid tumours generally have a limited life expectancy and a state of intermittent immunosuppression, resulting in a lower risk of tuberculosis reactivation than other risky populations. There is a lack of prospective and retrospective studies analysing the benefit of screening and prophylaxis in this population. The first step is to study the incidence of active tuberculosis in this population to estimate the real magnitude of the problem.
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Affiliation(s)
- Miguel Borregón
- Servicio de Oncología Médica del Hospital General Universitario de Elche, Carrer Almazara, 11, 03203, Elche, Alicante, Spain.
| | - David Sánchez
- Servicio de Oncología Médica del Hospital General Universitario de Elche, Carrer Almazara, 11, 03203, Elche, Alicante, Spain
| | - Elia Martínez
- Servicio de Oncología Médica del Hospital Universitario de Fuenlabrada, Madrid, Spain
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Sánchez Cánovas M, Fernández Garay D, Gómez Martínez F, Brozos Vázquez E, Lobo de Mena M, García Adrián S, Pacheco-Barcía V, Cacho Lavin D, Martínez de Castro E, Martín Fernández de Soignie AM, Martínez E, Rúperez Blanco AB, García Escobar I, Salvador Coloma C, Blaya Boluda N, Guirao García ME, Gambín Arroniz M, Muñoz Martín AJ. Validation of the CoVID-TE model as a tool to predict thrombosis, bleeding, and mortality in the oncology patient with Sars-Cov-2 infection: a study by the SEOM cancer and thrombosis group. Clin Transl Oncol 2024; 26:171-177. [PMID: 37301805 PMCID: PMC10257483 DOI: 10.1007/s12094-023-03233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE The CoVID-TE model was developed with the aim of predicting venous thrombotic events (VTE) in cancer patients with Sars-Cov-2 infection. Moreover, it was capable of predicting hemorrhage and mortality 30 days following infection diagnosis. The model is pending validation. METHODS/PATIENTS Multicenter retrospective study (10 centers). Adult patients with active oncologic disease/ antineoplastic therapy with Sars-Cov-2 infection hospitalized between March 1, 2020 and March 1. 2022 were recruited. The primary endpoint was to study the association between the risk categories of the CoVID-TE model and the occurrence of thrombosis using the Chi-Square test. Secondary endpoints were to demonstrate the association between these categories and the occurrence of post-diagnostic Sars-Cov-2 bleeding/ death events. The Kaplan-Meier method was also used to compare mortality by stratification. RESULTS 263 patients were enrolled. 59.3% were men with a median age of 67 years. 73.8% had stage IV disease and lung cancer was the most prevalent tumor (24%). A total of 86.7% had an ECOG 0-2 and 77.9% were receiving active antineoplastic therapy. After a median follow-up of 6.83 months, the incidence of VTE, bleeding, and death 90 days after Sars-Cov-2 diagnosis in the low-risk group was 3.9% (95% CI 1.9-7.9), 4.5% (95% CI 2.3-8.6), and 52.5% (95% CI 45.2-59.7), respectively. For the high-risk group it was 6% (95% CI 2.6-13.2), 9.6% (95% CI 5.0-17.9), and 58.0% (95% CI 45.3-66.1). The Chi-square test for trends detected no statistically significant association between these variables (p > 0.05). Median survival in the low-risk group was 10.15 months (95% CI 3.84-16.46), while in the high-risk group it was 3.68 months (95% CI 0.0-7.79). The differences detected were not statistically significant (p = 0.375). CONCLUSIONS The data from our series does not validate of the CoVID-TE as a model to predict thrombosis, hemorrhage, or mortality in cancer patients with Sars-Cov-2 infection.
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Affiliation(s)
- Manuel Sánchez Cánovas
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain.
- Hematology and Medical Oncology Service, Hospital Universitario José María Morales Meseguer, Murcia, Spain.
| | - David Fernández Garay
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Complejo Hospital Costa del Sol, Marbella, Spain
| | - Francisco Gómez Martínez
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Hematology and Medical Oncology Service, Hospital Universitario José María Morales Meseguer, Murcia, Spain
| | - Elena Brozos Vázquez
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Miriam Lobo de Mena
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital General Universitario de Valencia, Valencia, Spain
| | - Silvia García Adrián
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital Universitario de Móstoles, Madrid, Spain
| | - Vilma Pacheco-Barcía
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital Universitario de Torrejón, Madrid, Spain
| | - Diego Cacho Lavin
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación IDIVAL, Santander, Spain
| | - Eva Martínez de Castro
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación IDIVAL, Santander, Spain
| | | | - Elia Martínez
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital de Fuenlabrada, Madrid, Spain
| | - Ana Belén Rúperez Blanco
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital Universitario de Toledo, Toledo, Spain
| | - Ignacio García Escobar
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital Universitario de Toledo, Toledo, Spain
| | - Carmen Salvador Coloma
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital Lluis Alcanyis de Xativa, Valencia, Spain
| | - Noel Blaya Boluda
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Hematology and Medical Oncology Service, Hospital Universitario José María Morales Meseguer, Murcia, Spain
| | - María Esperanza Guirao García
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Hematology and Medical Oncology Service, Hospital Universitario José María Morales Meseguer, Murcia, Spain
| | | | - Andrés J Muñoz Martín
- SEOM Cancer and Thrombosis Research Group (SEOM), Madrid, Spain
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
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Masiá M, Padilla S, Estañ G, Portu J, Silva A, Rivero A, González-Cordón A, García-Fraile L, Martínez O, Bernal E, Galera C, Martínez VB, Macias J, Montero M, García-Rosado D, Vivancos-Gallego MJ, Llenas-García J, Torralba M, García JA, Agulló V, Fernández-González M, Gutiérrez F, Martínez E. Correction: Impact of an enhanced screening program on the detection of non-AIDS neoplasias in patients with human immunodeficiency virus infection. Trials 2023; 24:614. [PMID: 37759269 PMCID: PMC10523741 DOI: 10.1186/s13063-023-07655-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Affiliation(s)
- M Masiá
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain
| | - S Padilla
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain
| | - G Estañ
- Hospital General Universitario de Elche, Elche, Spain
| | - J Portu
- Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - A Silva
- Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - A Rivero
- Hospital Universitario Reina Sofía de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) and Universidad de Córdoba, Córdoba, Spain
| | - A González-Cordón
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - O Martínez
- Hospital General Universitario Santa Lucía de Cartagena, Murcia, Spain
| | - E Bernal
- Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | - C Galera
- Hospital Virgen de La Arrixaca, Murcia, Spain
| | | | - J Macias
- Hospital Universitario de Valme, Seville, Spain
| | | | - D García-Rosado
- Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - M J Vivancos-Gallego
- Hospital Ramon y Cajal and Ramon y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | | | - M Torralba
- Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - J A García
- Hospital General Universitario de Elche, Elche, Spain
| | - V Agulló
- Hospital General Universitario de Elche, Elche, Spain
| | | | - F Gutiérrez
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain.
| | - E Martínez
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Castilla M, Pérez S, Guevara R, Alemany J, Campos M, Pla M, Ortega C, Falo C, Benítez A, Bajen M, Pérez L, Valdivielso A, Martínez E, Plana ML, Pérez H, Petit A, Soler T, Taco C, Ponce J, García A. P085 Target axillary disecction in cN2 breast cancer patients after neoadjuvant chemotherapy. Preliminary results. Breast 2023. [DOI: 10.1016/s0960-9776(23)00202-3] [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: 03/16/2023] Open
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Orozco Cortés J, Badenes Romero Á, Garrigos G, Estellés N, Mut T, Reyes MD, Martínez E, Medina R, Peláez S, Abreu P, Esteban Á, Barrachina García MD, Cueto B, Balaguer D, la Torre Agraz I, Plancha C, Martínez R, Caballero E. Implementation of the use of SPECT-portable for evaluation of surgical margins in breast cancer with indication of ROLL: First results. Rev Esp Med Nucl Imagen Mol 2022; 42:147-155. [PMID: 36403725 DOI: 10.1016/j.remnie.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Main objective: To compare the effectiveness for checking surgical margins between SPECT-portable and mammography of the piece (RxM). SECONDARY OBJECTIVE To standardize a pre-operative protocol using SPECT-portable and to evaluate the time required in the use of this technique. MATERIAL AND METHODS Prospective longitudinal study with 36 patients (39 lesions) diagnosed with breast cancer (CM) with criteria for SNOLL/ROLL. A pre-surgical study of the tumor lesion was performed, after the eco-guided administration of 99mTc-nanocolloids of albumin/99mTc-macroaggregates of albumin, in the tumor lesion. Hybrid images (optical + SPECT) and 3D navigation images with gamma probe are obtained using freehandSPECT. In the operating room, 4-5 images are obtained with freehandSPECT, (I) on skin for tumor location, (II) after exposure of surgical bed for resection guide, (III) of the surgical bed after exeresis, (IV and V) the anterior-posterior and lateral surface of the surgical specimen. The three criteria to decide to extend the margins are: (a) residual activity (cps) at the edges of the surgical bed resection; (b) visual analysis of the uptake in the specimen; (c) a minimum distance of 10 mm from the edges of the specimen to the center of greatest uptake, plus the radius of the lesion. We study the concordance of: the depth measurement between ultrasound and freehandSPECT; the surgical margins between freehandSPECT vs. mammography of the specimen (RxM), considering anatomical pathology (AP) as the gold standard technique as reference; surgical time used with freehandSPECT and RxM. RESULTS Intraoperative localization was performed in all cases. False negative (FN: no detection margin affected) with freehandSPECT: 9 margins; with RxM: 8. True positive (TP: detection margin affected) with freehandSPECT: 5 margins, with RxM: 6. True negative (TN: consider free margin when healthy) with freehandSPECT: 213 margins; with RxM: 196. Negative predictive value (NPV: probability of negative margin on unaffected part) with freehandSPECT: 95.9%, with RxM: 96.07%. Specificity with freehandSPECT: 96.8%, with RxM: 97%. The concordance of surgical bed margins between freehandSPECT and RxM: 94.5%. Between freehandSPECT and AP: 93.1%. Between RxM and PA: 93.5%, being all statistically significant (p-value <0.000), so we can affirm that both techniques are related or dependent on the reference technique, the PA. Degree of correlation between SPECT-portable and low PA (Kappa index: 0.34, 95% CI [0.22-0.47], and between RxM and moderate PA (Kappa index: 0.42, 95% CI [0.29-0.56], p-value <0.001. Comparison of the successes and failures of both techniques (SPECT-portable and RxM) and PA: Distribution χ2: 0.023 with degree of freedom 1, with value <0.05, so we can affirm that both techniques are similar, since there are no significant statistical differences. Median total OR time: 60.25 min (30-145). Mean freehandSPECT OR time: 5 scans = 10 min. CONCLUSIONS There are no statistically significant differences in the probability to rule out affective margins that require a second surgery between both techniques (SPECT-portable and RxM) so, the technique performed with SPECT-Portable is a useful and effective procedure, which requires specific training with an optimized and multidisciplinary protocol. The time spent with SPECT-portable is feasible for daily practice.
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Affiliation(s)
- J Orozco Cortés
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain.
| | - Á Badenes Romero
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
| | - G Garrigos
- Servicio de Cirugía General, Hospital Universitario Doctor Peset, Valencia, Spain
| | - N Estellés
- Servicio de Cirugía General, Hospital Universitario Doctor Peset, Valencia, Spain
| | - T Mut
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
| | - M D Reyes
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
| | - E Martínez
- Servicio de Cirugía General, Hospital Universitario Doctor Peset, Valencia, Spain
| | - R Medina
- Servicio de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia, Spain
| | - S Peláez
- Servicio de Anatomía Patológica, Hospital Universitario Doctor Peset, Valencia, Spain
| | - P Abreu
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Á Esteban
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
| | | | - B Cueto
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
| | - D Balaguer
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
| | - I la Torre Agraz
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
| | - C Plancha
- Radiofarmacia Hospital Universitario Doctor Peset, Valencia, Spain
| | - R Martínez
- Servicio de Cirugía General, Hospital Universitario Doctor Peset, Valencia, Spain
| | - E Caballero
- Servicio de Medicina Nuclear, Hospital Universitario Doctor Peset, Valencia, Spain
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Martínez E, Osorio M, Finkielstein C, Ortíz I, Peresin MS, Castro C. 5-Fluorouracil drug delivery system based on bacterial nanocellulose for colorectal cancer treatment: Mathematical and in vitro evaluation. Int J Biol Macromol 2022; 220:802-815. [PMID: 35998853 DOI: 10.1016/j.ijbiomac.2022.08.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 12/14/2022]
Abstract
Colorectal cancer (CRC) is the third most common worldwide. Its treatment includes adjuvant chemotherapy with 5-fluorouracil (5FU) administered intravenously. 5FU is an antineoplastic drug of the fluoropyrimidines group, widely used in the treatment of solid tumors, mainly CRC. Nevertheless, it causes several adverse effects and poor effectiveness due to its short half-life. This work aimed to employ bacterial nanocellulose (BNC) as an encapsulation material for the oral administration of 5FU. First, the adsorption phenomena were analyzed by isotherms, thermodynamic parameters, and kinetic models. Then, encapsulation was carried out using spray-drying, and encapsulated 5FU desorption profiles were assessed in simulated fluids. The biological behavior was evaluated on colon cancer SW480 and SW620 cell lines. As result, it was found that at 25 °C a monolayer of 5FU was formed and the process showed to be the most spontaneous one. In the characterization of the nanocapsules, important changes were detected by the presence of 5FU. The delivery in the colon corresponded to a controlled release behavior. The in vitro assay indicated an improvement in the toxicity effect of the drug and its mechanism of action. Accordingly, BNC is a promising biomaterial for the development of a colon drug delivery platform of 5FU.
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Affiliation(s)
- E Martínez
- Grupo de Investigación sobre Nuevos Materiales (GINUMA), Universidad Pontificia Bolivariana, Colombia
| | - M Osorio
- Grupo de Investigación sobre Nuevos Materiales (GINUMA), Universidad Pontificia Bolivariana, Colombia; Grupo de investigación Biología de Sistemas, Universidad Pontificia Bolivariana, Colombia
| | - C Finkielstein
- Cancer Research Group, Virginia Polytechnic Institute and State University, United States
| | - I Ortíz
- Grupo de investigación Biología de Sistemas, Universidad Pontificia Bolivariana, Colombia
| | - Maria S Peresin
- Sustainable Bio-Based Materials Lab, Forest Products Development Center, College of Forestry and Wildlife Sciences, Auburn, AL, United States
| | - C Castro
- Grupo de Investigación sobre Nuevos Materiales (GINUMA), Universidad Pontificia Bolivariana, Colombia.
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Alonso-Llanes L, Martínez E, Batista-Leyva AJ, Toussaint R, Altshuler E. Continuous to intermittent flows in growing granular heaps. Phys Rev E 2022; 106:014904. [PMID: 35974509 DOI: 10.1103/physreve.106.014904] [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] [Received: 06/16/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
If a granular material is poured from above on a horizontal surface between two parallel, vertical plates, a sand heap grows in time. For small piles, the grains flow smoothly downhill, but after a critical pile size X_{c}, the flow becomes intermittent: sudden avalanches slide downhill from the apex to the base, followed by an "uphill front" that slowly climbs up, until a new downhill avalanche interrupts the process. By means of experiments, controlling the distance between the apex of the sandpile and the container feeding it from above, we show that X_{c} grows linearly with the input flux, but scales as the square root of the feeding height. We explain these facts from a phenomenological model based on the experimental observation that the flowing granular phase forms a "wedge" on top of the static one, differently from the case of stationary heaps. Moreover, we demonstrate that our controlled experiments allow to predict the value of X_{c} for the common situation in which the feeding height decreases as the pile increases in size.
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Affiliation(s)
- L Alonso-Llanes
- Group of Complex Systems and Statistical Physics, Physics Faculty, University of Havana, 10400 Havana, Cuba
- Université de Strasbourg, CNRS, Institut Terre et Environnement de Strasbourg, UMR7063, 67000 Strasbourg, France
| | - E Martínez
- Department of Physics, NTNU, NO-7491 Trondheim, Norway
| | - A J Batista-Leyva
- Group of Complex Systems and Statistical Physics, Physics Faculty, University of Havana, 10400 Havana, Cuba
- Instituto Superior de Tecnologías y Ciencias Aplicadas (InSTEC), University of Havana, 10400 Havana, Cuba
| | - R Toussaint
- Université de Strasbourg, CNRS, Institut Terre et Environnement de Strasbourg, UMR7063, 67000 Strasbourg, France
- SFF PoreLab, The Njord Centre, Department of Physics, University of Oslo, P.O. Box 1074 Blindern, 0316 Oslo, Norway
| | - E Altshuler
- Group of Complex Systems and Statistical Physics, Physics Faculty, University of Havana, 10400 Havana, Cuba
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Ruiz M, Martín AM, Font C, Castellón V, Salgado M, Martínez E, Rupérez A, Cárdenas A, Martin-Lozano R, González-Caraballo I, Jiménez R, Morán LO, Salas E, Soria JM. OC-01: Mortality impact of cancer-associated venous thromboembolism: final analysis from Oncothromb12-01 study. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00173-6] [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: 11/29/2022]
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10
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Salgado M, Molina R, Vázquez EB, Martínez E, Cillán E, Fullana T, Villa J, Lobo M, Masvidal M, Porta R, Campos B, Garicano F, Pampols M, Fernández I, Font C, Martínez P, Gutiérrez D, Horvath E, Costa A, Malheiro M, Arias D, for the CARTAGO study group. PO-54: Preliminary evaluation of venous thromboembolic risk in patients with colorectal cancer from the CARTAGO study. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00244-4] [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: 10/18/2022]
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11
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Bouza E, Arribas JR, Alejos B, Bernardino JI, Coiras M, Coll P, Del Romero J, Fuster MJ, Górgolas M, Gutiérrez A, Gracia D, Hernando V, Martínez-Picado J, Martínez Sesmero JM, Martínez E, Moreno S, Mothe B, Navarro ML, Podzamczer D, Pulido F, Ramos JT, Ruiz-Mateos E, Suárez García I, Palomo E. Past and future of HIV infection. A document based on expert opinion. Rev Esp Quimioter 2022; 35:131-156. [PMID: 35018404 PMCID: PMC8972691 DOI: 10.37201/req/083.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
HIV infection is now almost 40 years old. In this time, along with the catastrophe and tragedy that it has entailed, it has also represented the capacity of modern society to take on a challenge of this magnitude and to transform an almost uniformly lethal disease into a chronic illness, compatible with a practically normal personal and relationship life. This anniversary seemed an ideal moment to pause and reflect on the future of HIV infection, the challenges that remain to be addressed and the prospects for the immediate future. This reflection has to go beyond merely technical approaches, by specialized professionals, to also address social and ethical aspects. For this reason, the Health Sciences Foundation convened a group of experts in different aspects of this disease to discuss a series of questions that seemed pertinent to all those present. Each question was presented by one of the participants and discussed by the group. The document we offer is the result of this reflection.
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Affiliation(s)
- E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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12
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Masiá M, Padilla S, Estañ G, Portu J, Silva A, Rivero A, González-Cordón A, García-Fraile L, Martínez O, Bernal E, Galera C, Boix Martínez V, Macias J, Montero M, García-Rosado D, Vivancos-Gallego MJ, Llenas-García J, Torralba M, García JA, Agulló V, Fernández-González M, Gutiérrez F, Martínez E. Impact of an enhanced screening program on the detection of non-AIDS neoplasias in patients with human immunodeficiency virus infection. Trials 2021; 22:851. [PMID: 34838115 PMCID: PMC8626748 DOI: 10.1186/s13063-021-05777-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of non-AIDS defining cancer (NADC) is higher in people living with HIV (PLWH) than in the general population, and it is already one of the leading causes of death in the HIV-infected population. It is estimated that the situation will be aggravated by the progressive aging of PLWH. Early diagnosis through intensive cancer screening may improve the ability for therapeutic interventions and could be critical in reducing mortality, but it might also increase expenditure and harms associated with adverse events. The aim of this study is to evaluate an enhanced screening program for early diagnosis of cancer in PLWH compared to standard practice. The specific objectives are (1) to compare the frequency of cancer diagnosed at an early stage, (2) to analyze safety of the enhanced program: adverse events and unnecessary interventions, (3) to analyze the cost-utility of the program, and (4) to estimate the overall and site-specific incidence of NADC in PLWH. METHODS We will conduct a multicenter, non-blinded, randomized, controlled trial, comparing two parallel arms: conventional vs enhanced screening. Data will be recorded in an electronic data collection notebook. Conventional intervention group will follow the standard of care screening in the participating centers, according to the European AIDS Clinical Society recommendations, and the enhanced intervention group will follow an expanded screening aimed to early detection of lung, liver, anal, cervical, breast, prostate, colorectal, and skin cancer. The trial will be conducted within the framework of the Spanish AIDS Research Network Cohort (CoRIS). DISCUSSION The trial will evaluate the efficacy, safety, and efficiency of an enhanced screening program for the early diagnosis of cancer in HIV patients compared to standard of care practice. The information provided will be relevant since there are currently no studies on expanded cancer screening strategies in patients with HIV, and available data estimating cost effectiveness or cost-utility of such as programs are scarce. An enhanced program for NADC screening in patients with HIV could lead to early diagnosis and improve the prognosis of these patients, with an acceptable rate of unnecessary interventions, but it is critical to demonstrate that the benefits clearly outweigh the harms, before the strategy could be implemented. TRIAL REGISTRATION ClinicalTrials.gov NCT04735445. Registered on 25 June 2019.
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Affiliation(s)
- M Masiá
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain
| | - S Padilla
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain
| | - G Estañ
- Hospital General Universitario de Elche, Elche, Spain
| | - J Portu
- Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - A Silva
- Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - A Rivero
- Hospital Universitario Reina Sofía de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) and Universidad de Córdoba, Córdoba, Spain
| | - A González-Cordón
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - O Martínez
- Hospital General Universitario Santa Lucía de Cartagena, Murcia, Spain
| | - E Bernal
- Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | - C Galera
- Hospital Virgen de la Arrixaca, Murcia, Spain
| | | | - J Macias
- Hospital Universitario de Valme, Seville, Spain
| | | | - D García-Rosado
- Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - M J Vivancos-Gallego
- Hospital Ramon y Cajal and Ramon y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | | | - M Torralba
- Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - J A García
- Hospital General Universitario de Elche, Elche, Spain
| | - V Agulló
- Hospital General Universitario de Elche, Elche, Spain
| | | | - F Gutiérrez
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain.
| | - E Martínez
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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13
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Podzamczer D, Micán R, Tiraboschi J, Portilla J, Domingo P, Llibre JM, Ribera E, Vivancos MJ, Morano L, Masiá M, Gómez C, Fanjul F, Payeras A, Inciarte A, Estrada V, Rivero A, Castro Á, Bernal E, Vinuesa D, Knobel H, Troya J, Macías J, Montero M, Sanz J, Navarro-Alcaraz A, Caicedo A, Fernández G, Martínez E, Moreno S. Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Versus Dolutegravir/Abacavir/Lamivudine in Antiretroviral-Naive Adults (SYMTRI): A Multicenter Randomized Open-Label Study (PReEC/RIS-57). Open Forum Infect Dis 2021; 9:ofab595. [PMID: 35237700 PMCID: PMC8883591 DOI: 10.1093/ofid/ofab595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) is the reference for combination therapy based on protease inhibitors due to its efficacy, tolerability, and convenience. Head-to-head randomized comparisons between D/C/F/TAF and combination therapy based on integrase inhibitors in antiretroviral-naive patients are lacking. Methods Adult (>18 years old) human immunodeficiency virus-infected antiretroviral-naive patients (HLA-B∗5701 negative and hepatitis B virus negative), with viral load (VL) ≥500 c/mL, were centrally randomized to initiate D/C/F/TAF or dolutegravir/abacavir/lamivudine (DTG/3TC/ABC) after stratifying by VL and CD4 count. Clinical and analytical assessments were performed at weeks 0, 4, 12, 24, and 48. The primary endpoint was VL <50 c/mL at week 48 in the intention-to-treat (ITT)-exposed population (US Food and Drug Administration snapshot analysis, 10% noninferiority margin). Results Between September 2018 and 2019, 316 patients were randomized and 306 patients were included in the ITT-exposed analysis (151 D/C/F/TAF and 155 DTG/3TC/ABC). Almost all (94%) participants were male and their median age was 35 years. Forty percent had a baseline VL >100 000 copies/mL, and 13% had <200 CD4 cells/μL. Median weight was 73 kg and median body mass index was 24 kg/m2. At 48 weeks, 79% (D/C/F/TAF) versus 82% (DTG/3TC/ABC) had VL <50 c/mL (difference, −2.4%; 95% confidence interval [CI], −11.3 to 6.6). Eight percent versus four percent experienced virologic failure but no resistance-associated mutations emerged. Four percent versus six percent had drug discontinuation due to adverse events. In the per-protocol analysis, 94% versus 96% of patients had VL <50 c/mL (difference, −2%; 95% CI, −8.1 to 3.5). There were no differences in CD4 cell count or weight changes. Conclusions We could not demonstrate the noninferiority of D/C/F/TAF relative to DTG/ABC/3TC as initial antiretroviral therapy, although both regimens were similarly well tolerated.
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Affiliation(s)
- D Podzamczer
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - R Micán
- Hospital La Paz, Madrid, Spain
| | - J Tiraboschi
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - J Portilla
- Hospital General Universitario de Alicante, Alicante, Spain
| | - P Domingo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J M Llibre
- Hospital Germans Trias i Pujol, Barcelona, Spain
| | - E Ribera
- Hospital Universitario de la Vall d’Hebrón, Barcelona, Spain
| | - M J Vivancos
- Hospital Universitario Ramón y Cajal, Madrid, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - L Morano
- Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - M Masiá
- Hospital General Universitario de Elche, Elche, Spain
| | - C Gómez
- Hospital Universitario Virgen de la Victoria-IBIMA, Málaga, Spain
| | - F Fanjul
- Hospital Universitario Son Espases, Palma, Spain
| | - A Payeras
- Hospital Universitario Son Llàtzer, Palma, Spain
| | | | - V Estrada
- Hospital Clínico San Carlos-IdiSSC, Madrid, Spain
| | - A Rivero
- Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Á Castro
- Complejo Hospitalario Universitario, A Coruña, Spain
| | - E Bernal
- Hospital Universitario Reina Sofía, Murcia, Spain
| | - D Vinuesa
- Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - H Knobel
- Hospital del Mar, Barcelona, Spain
| | - J Troya
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J Macías
- Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - M Montero
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - J Sanz
- Hospital Universitario de La Princesa, Madrid, Spain
| | | | - A Caicedo
- RIS Red de Investigación en SIDA, Madrid, Spain
| | - G Fernández
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - S Moreno
- Hospital Universitario Ramón y Cajal, Madrid, Universidad de Alcalá, IRYCIS, Madrid, Spain
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Herranz P, Trasobares L, Mateu A, Martínez E, Ruiz-Villaverde R, Baniandrés O, Mataix Díaz J, Jiménez-Gómez N, Serra M, Ruiz Genao DP, Rivera N, Tercedor-Sánchez J, Garcia C, Cordey M, Herrera-Acosta E. Characterization and Outcomes in Patients Treated With Apremilast in Routine Clinical Practice in Spain: Results From the APPRECIATE Study. Actas Dermosifiliogr (Engl Ed) 2021; 112:S0001-7310(21)00202-7. [PMID: 34052202 DOI: 10.1016/j.ad.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/29/2021] [Accepted: 05/09/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES It is necessary to expand the knowledge in the use of apremilast in clinical practice. The APPRECIATE study (NCT02740218) aims to describe the characteristics of patients with psoriasis treated with apremilast, to evaluate their perspectives and those of dermatologists, as well as the outcomes obtained in clinical practice in Spain. METHODS Observational, retrospective, cross-sectional, multicenter study of patients with chronic plaque psoriasis who could be contacted 6 (±1) months after apremilast initiation. The data were obtained from medical records and questionnaires from patients and physicians. RESULTS A total of 80 patients were evaluated; at apremilast onset, they showed mean (standard deviation, SD) Psoriasis Area and Severity Index (PASI) = 8.3 (5.3), mean (SD) Dermatology Life Quality Index (DLQI) = 8.9 (6.6). At six months, 58.8% (n=47) of patients continued apremilast treatment (discontinuations due to lack of efficacy [16.3%], safety/tolerability [20.0%]). In patients continuing treatment, PASI75 was achieved by 36.7% of patients; mean (95% CI) DLQI score was 2.2 (0.7-3.6) and mean (SD) Patient Benefit Index score was 2.8 (0.8). Compliance with physicians' expectations was correlated with benefits reported by patients (r=0.636). Adverse events were reported by 56.3% of patients (the most common were diarrhoea and nausea). CONCLUSIONS Patients receiving apremilast for 6 months in Spanish clinical practice, reported substantial improvements in their quality of life (mean DLQI reduced by more than 6 points) and disease severity (PASI75 achieved by over one-third of patients), despite less skin involvement than patients who enrolled in clinical trials.
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Affiliation(s)
- P Herranz
- Hospital Universitario La Paz, Madrid, España.
| | - L Trasobares
- Hospital Universitario Príncipe de Asturias, Madrid, España
| | - A Mateu
- Hospital Universitario Doctor Peset, Valencia, España
| | - E Martínez
- Hospital Lluís Alcanyís Xàtiva, Valencia, España
| | | | - O Baniandrés
- Hospital General Universitario Gregorio Marañón, Madrid, España
| | | | | | - M Serra
- Hospital Can Misses, Illes Balears, España
| | | | - N Rivera
- Hospital de Mollet, Barcelona, España
| | | | | | - M Cordey
- Amgen Inc., Amgen (Europe) GmbH, Rotkreuz, Suiza
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Llombart Cussac A, Pérez-Garcia J, Blanch S, Tolosa P, Ruiz Borrego M, Gion Cortes M, Fernádez A, Urruticoechea A, Galve E, Cueva Banuelos J, Ponce J, Alonso J, Capelán M, Martínez E, Bermejo De Las Heras B, Rojas B, Martos T, López A, Gómez-Peralta F, Cortés J. 129TiP Metformin (MF) in the prevention of hyperglycemia (HG) in patients (pts) with PIK3CA-mutated, hormone receptor (HR)[+]/HER2[–] advanced breast cancer (ABC) treated with alpelisib (ALP) plus fulvestrant (F): METALLICA. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ciruelos E, Garcia A, Cortés J, Pernas Simon S, Garate E, Melé M, Montaño Á, Martinez-Jañez N, Oliveira M, Haba-Rodríguez JDL, Vega E, Martorell AP, Bermejo De Las Heras B, Cantos Sanchez De Ibarguen B, Martínez E, Navarro EV, Pascual T, González-Farré X, Villagrasa P, Prat A. 130TiP SOLTI-1303 PATRICIA 2 randomized phase II trial of palbociclib plus trastuzumab and endocrine therapy (ET) versus treatment of physician's choice (TPC) in metastatic HER2-positive and hormone receptor-positive (HER2+/HR+) breast cancer (BC) with PAM50 luminal intrinsic subtype. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.144] [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: 11/28/2022] Open
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Barrado M, Villafranca E, Sola A, Visus I, Fuentemilla N, Santiago P, Rodríguez M, Rosas L, Barco A, Martínez E. PO-0253 Real-time intraoperative-planning reduces toxicity in LDR-brachytherapy-boost in prostate cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06412-4] [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: 10/21/2022]
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Muñoz A, Ay C, Grilz E, López S, Font C, Pachón V, Castellón V, Martínez-Marín V, Salgado M, Martínez E, Calzas J, Rupérez A, Salas E, Pabinger I, Soria J. OC-13 A clinical-genetic risk score to predict cancer-associated venous thromboembolism: a development and validation study in two independent prospective cohorts. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00155-9] [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: 10/21/2022]
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Griguolo G, Serna G, Pascual T, Fasani R, Guardia X, Chic N, Paré L, Pernas S, Muñoz M, Oliveira M, Vidal M, Llombart-Cussac A, Cortés J, Galván P, Bermejo B, Martínez N, López R, Morales S, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, Prat A, Nuciforo P. Immune microenvironment characterisation and dynamics during anti-HER2-based neoadjuvant treatment in HER2-positive breast cancer. NPJ Precis Oncol 2021; 5:23. [PMID: 33742063 PMCID: PMC7979716 DOI: 10.1038/s41698-021-00163-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
Despite their recognised role in HER2-positive (HER2+) breast cancer (BC), the composition, localisation and functional orientation of immune cells within tumour microenvironment, as well as its dynamics during anti-HER2 treatment, is largely unknown. We here investigate changes in tumour-immune contexture, as assessed by stromal tumour-infiltrating lymphocytes (sTILs) and by multiplexed spatial cellular phenotyping, during treatment with lapatinib-trastuzumab in HER2+ BC patients (PAMELA trial). Moreover, we evaluate the relationship of tumour-immune contexture with hormone receptor status, intrinsic subtype and immune-related gene expression. sTIL levels increase after 2 weeks of HER2 blockade in HR-negative disease and HER2-enriched subtype. This is linked to a concomitant increase in cell density of all four immune subpopulations (CD3+, CD4+, CD8+, Foxp3+). Moreover, immune contexture analysis showed that immune cells spatially interacting with tumour cells have the strongest association with response to anti-HER2 treatment. Subsequently, sTILs consistently decrease at the surgery in patients achieving pathologic complete response, whereas most residual tumours at surgery remain inflamed, possibly reflecting a progressive loss of function of T cells. Understanding the features of the resulting tumour immunosuppressive microenvironment has crucial implications for the design of new strategies to de-escalate or escalate systemic therapy in early-stage HER2+ BC.
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Affiliation(s)
- G Griguolo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
- Division of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - G Serna
- Molecular oncology group, Vall d´Hebron Institute of Oncology, Barcelona, Spain
| | - T Pascual
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - R Fasani
- Molecular oncology group, Vall d´Hebron Institute of Oncology, Barcelona, Spain
| | - X Guardia
- Molecular oncology group, Vall d´Hebron Institute of Oncology, Barcelona, Spain
| | - N Chic
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - L Paré
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - S Pernas
- Institut Catala d'Oncologia-H.U.Bellvitge-IDIBELL, Hospitalet, Barcelona, Spain
| | - M Muñoz
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Oliveira
- Medical Oncology Department, Vall d'Hebrón University Hospital, Barcelona, Spain
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - M Vidal
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Llombart-Cussac
- Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - J Cortés
- IOB Institute of Oncology, Quironsalud Group, Madrid & Barcelona, Spain
| | - P Galván
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - B Bermejo
- Hospital Clínico Universitario de Valencia/INCLIVA/CIBERONC, Valencia, Spain
| | - N Martínez
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R López
- Hospital Clínico Universitario de Santiago, IDIS, CIBERONC, Santiago de Compostela, Spain
| | - S Morales
- Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - I Garau
- Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - L Manso
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Alarcón
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - E Martínez
- Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - P Villagrasa
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - A Prat
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.
- SOLTI Breast Cancer Research Group, Barcelona, Spain.
| | - P Nuciforo
- Molecular oncology group, Vall d´Hebron Institute of Oncology, Barcelona, Spain.
- SOLTI Breast Cancer Research Group, Barcelona, Spain.
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De Salazar PM, Lu F, Hay JA, Gómez-Barroso D, Fernández-Navarro P, Martínez E, Astray-Mochales J, Amillategui R, García-Fulgueiras A, Chirlaque MD, Sánchez-Migallón A, Larrauri A, Sierra MJ, Lipsitch M, Simón F, Santillana M, Hernán MA. Near real-time surveillance of the SARS-CoV-2 epidemic with incomplete data. medRxiv 2021:2021.01.25.20230094. [PMID: 33532788 PMCID: PMC7852239 DOI: 10.1101/2021.01.25.20230094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Designing public health responses to outbreaks requires close monitoring of population-level health indicators in real-time. Thus, an accurate estimation of the epidemic curve is critical. We propose an approach to reconstruct epidemic curves in near real time. We apply this approach to characterize the early SARS-CoV-2 outbreak in two Spanish regions between March and April 2020. We address two data collection problems that affected the reliability of the available real-time epidemiological data, namely, the frequent missing information documenting when a patient first experienced symptoms, and the frequent retrospective revision of historical information (including right censoring). This is done by using a novel back-calculating procedure based on imputing patients' dates of symptom onset from reported cases, according to a dynamically-estimated "backward" reporting delay conditional distribution, and adjusting for right censoring using an existing package, NobBS , to estimate in real time (nowcast) cases by date of symptom onset. This process allows us to obtain an approximation of the time-varying reproduction number ( R t ) in real-time. At each step, we evaluate how different assumptions affect the recovered epidemiological events and compare the proposed approach to the alternative procedure of merely using curves of case counts, by report day, to characterize the time-evolution of the outbreak. Finally, we assess how these real-time estimates compare with subsequently documented epidemiological information that is considered more reliable and complete that became available later in time. Our approach may help improve accuracy, quantify uncertainty, and evaluate frequently unstated assumptions when recovering the epidemic curves from limited data obtained from public health surveillance systems in other locations.
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Affiliation(s)
- PM De Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - F Lu
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
| | - JA Hay
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - D Gómez-Barroso
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
| | - P Fernández-Navarro
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
| | - E Martínez
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - J Astray-Mochales
- Directorate-General for Public Health, Madrid General Health Authority, Spain
| | - R Amillategui
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
| | - A García-Fulgueiras
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - MD Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - A Sánchez-Migallón
- Directorate-General for Public Health, Madrid General Health Authority, Spain
| | - A Larrauri
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
- Centro Nacional de Epidemiología, Carlos III Health Institute, Madrid, Spain
| | - MJ Sierra
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - M Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
| | - F Simón
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
- Centro de Coordinación de Alertas y Emergencias Sanitarias, Ministry of Health, Madrid, Spain
| | - M Santillana
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, United States
- Machine Intelligence Lab, Boston Children’s Hospital, Boston, United States
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, United States
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, United States
| | - MA Hernán
- Department of Epidemiology and Department of Biostatistics, Harvard T.H. Chan School of Public Health; Harvard-MIT Division of Health Sciences and Technology, Boston, United States
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de Goede M, Dijkstra M, Chang L, Acharyya N, Kozyreff G, Obregón R, Martínez E, García-Blanco SM. Mode-splitting in a microring resonator for self-referenced biosensing. Opt Express 2021; 29:346-358. [PMID: 33362120 DOI: 10.1364/oe.411931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
Self-referenced biosensing based on mode-splitting on a microring resonator is experimentally demonstrated. A Bragg grating integrated on the surface of the ring provides coupling between the clockwise and counterclockwise travelling modes of the pristine ring resonator lifting their degeneracy. The amount of mode-splitting is directly related to the reflectivity of the grating and it is only affected by structurally modifying the grating. Environmental perturbations to the surroundings of the gratings, such as temperature and bulk refractive index variations, have a minor effect on the amount of mode-splitting. This principle allows the realization of a self-referenced sensing scheme based on the detection of variations of the mode-splitting induced by structural changes to the grating. In this work, a polymethyl methacrylate (PMMA) Bragg grating is integrated onto a ring resonator in Al2O3. It is shown both theoretically and experimentally that the amount of splitting of a resonance varies minimally under temperature or bulk refractive index perturbations. However, the structural change of attaching a layer of biomolecules inside the grating does affect its reflectivity and the amount of mode splitting present. This result represents the first proof-of-concept demonstration of an integrated mode-splitting biosensor insensitive to temperature and refractive index variations of the liquid matrix where the molecules to be detected are embedded. The reported results pave the road towards the realization of truly self-referenced biosensors.
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Rabadán A, Álvarez-Ortí M, Martínez E, Pardo-Giménez A, Zied D, Pardo J. Effect of replacing traditional ingredients for oils and flours from nuts and seeds on the characteristics and consumer preferences of lamb meat burgers. Lebensm Wiss Technol 2021. [DOI: 10.1016/j.lwt.2020.110307] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Khalaf D, Aragón I, Annala M, Lozano R, Taavitsainen S, Lorente D, Finch D, Romero-Laorden N, Vergidis J, Cendón Y, Oja C, Pacheco M, Zulfiqar M, Gleave M, Wyatt A, Olmos D, Chi K, Castro E, Almagro E, Arranz J, Billalabeitia E, Borrega P, Castro E, Contreras J, Domenech M, Escribano R, Fernández-Parra E, Gallardo E, García-Carbonero I, García R, Garde J, González del Alba A, González B, Hernández A, Hernando S, Jiménez P, Laínez N, Lorente D, Luque R, Martínez E, Medina A, Méndez-Vidal M, Montesa A, Morales R, Olmos David, Pérez-Gracia J, Pérez-Valderrama B, Pinto Á, Piulats J, Puente J, Querol R, Rodríguez-Vida A, Romero-Laorden N, Sáez M, Vázquez S, Vélez E, Villa-Guzmán J, Villatoro R, Zambrana C. HSD3B1 (1245A>C) germline variant and clinical outcomes in metastatic castration-resistant prostate cancer patients treated with abiraterone and enzalutamide: results from two prospective studies. Ann Oncol 2020; 31:1186-1197. [DOI: 10.1016/j.annonc.2020.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/15/2020] [Accepted: 06/03/2020] [Indexed: 12/22/2022] Open
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Luque L, Rodrigo T, García-García JM, Casals M, Millet JP, Caylà J, Orcau A, Agüero R, Alcázar J, Altet N, Altube L, Álvarez F, Anibarro L, Barrón M, Bermúdez P, Bikuña E, Blanquer R, Borderías L, Bustamante A, Calpe J, Caminero J, Cañas F, Casas F, Casas X, Cases E, Castejón N, Castrodeza R, Cebrián J, Cervera A, Ciruelos J, Delgado A, De Souza M, Díaz D, Domínguez M, Fernández B, Gallardo J, Gallego M, Clemente MG, García C, García F, Garros F, Gort A, Guerediaga A, Gullón J, Hidalgo C, Iglesias M, Jiménez G, Jiménez M, Kindelan J, Laparra J, López I, Lera R, Lloret T, Marín M, Lacasa XM, Martínez E, Martínez A, Medina J, Melero C, Milà C, Millet J, Mir I, Molina F, Morales C, Morales M, Moreno A, Moreno V, Muñoz A, Muñoz C, Muñoz J, Muñoz L, Oribe M, Parra I, Penas A, Pérez J, Rivas P, Rodríguez J, Ruiz-Manzano J, Sala J, Sandel D, Sánchez M, Sánchez M, Sánchez P, Santamaría I, Sanz F, Serrano A, Somoza M, Tabernero E, Trujillo E, Valencia E, Valiño P, Vargas A, Vidal I, Vidal R, Villanueva M, Villar A, Vizcaya M, Zabaleta M, Zubillaga G. Factors Associated With Extrapulmonary Tuberculosis in Spain and Its Distribution in Immigrant Population. Open Respiratory Archives 2020. [DOI: 10.1016/j.opresp.2020.04.004] [Citation(s) in RCA: 2] [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: 12/16/2022] Open
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Herrero Morant A, Atienza Mateo B, Loricera J, Calvo del Rio V, Martín-Varillas JL, Espinosa G, Graña J, Moriano C, Pérez Sandoval T, Martín Martínez M, Diez E, García-Armario MD, Martínez E, Castellví I, Moya Alvarado P, Sivera F, Calvo J, De la Morena I, Ortiz Sanjuán F, Román Ivorra JA, Pérez Gómez A, Olive A, Díez C, Alegre JJ, Ybáñez-García D, Martínez-Ferrer Á, Narvaez J, Figueras I, Turrión AI, Romero-Yuste S, Trénor P, Ojeda S, González-Gay MÁ, Blanco R. FRI0487 APREMILAST IN MONOTHERAPY OR COMBINED IN NON-ULCER MANIFESTATIONS OF BEHÇET’S DISEASE. NATIONAL MULTICENTER STUDY OF 34 REFRACTORY CASES OF CLINICAL PRACTICE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Apremilast (APR) has demonstrated efficacy in orogenital ulcers of Behçet´s disease (BD). Response of other clinical manifestations remains unknown.Objectives:To assess the efficacy and safety of APR in monotherapy or combined with disease-modifying anti-rheumatic drugs (DMARDs) in non-aphthous ulcers of BD.Methods:National multicenter open-label study on 34 BD patients treated with APR at maintained standard dose of 30 mg twice daily.Results:From a cohort of 51 patients with APR by refractory orogenital ulcers of BD, we selected 34 (24 women/10 men, mean age 43.8±14.3 years), cases with another clinical manifestation/s.Excluding CTs, colchicine or NSAIDs, APR was given in monotherapy (n=21) or combined with conventional and/or biologic DMARDs in 13 cases (5 methotrexate, 3 azathioprine, 3 hydroxychloroquine, 1 sulfasalazine, 1 dapsone, 2 tocilizumab, 1 IFX). Other active manifestations present at APR onset were: arthralgia/arthritis (16, true arthritis in 5), folliculitis/pseudofolliculitis (14), erythema nodosum (3), furunculosis (2), paradoxical psoriasis by TNFi (2), intestinal ileitis (2), deep venous thrombosis (2), leg ulcers (1), erythematosus and scaly skin lesions (1), fever (1), unilateral anterior uveitis (1) and neurobehçet (1).After a median follow-up of 6 [3-12] months, folliculitis and ileitis improved, neurobehçet remained stable and musculoskeletal manifestations evolved in a variable way.(TABLE)TABLE.Conclusion:In addition of orogenital ulcers, APR in monotherapy or combined, seems to be useful in skin manifestations of BDDisclosure of Interests:Alba Herrero Morant: None declared, Belen Atienza Mateo: None declared, J. Loricera: None declared, Vanesa Calvo del Rio Grant/research support from: MSD and Roche, Speakers bureau: Abbott, Lilly, Celgene, Grünenthal, UCB Pharma, José Luis Martín-Varillas Grant/research support from: AbbVie, Pfizer, Janssen and Celgene, Speakers bureau: Pfizer and Lilly, Gerard Espinosa: None declared, Jenaro Graña: None declared, Clara Moriano: None declared, Trinidad Pérez Sandoval: None declared, Manuel Martín Martínez: None declared, Elvira Diez: None declared, María Dolores García-Armario: None declared, Esperanza Martínez: None declared, Ivan Castellví Consultant of: Boehringer Ingelheim, Actelion, Kern Pharma, Speakers bureau: Boehringer Ingelheim, Actelion, Bristol-Myers Squibb, Roche, Patricia Moya Alvarado: None declared, Francisca Sivera: None declared, Jaime Calvo Grant/research support from: Lilly, UCB, Consultant of: Abbvie, Jansen, Celgene, Isabel de la Morena: None declared, Francisco Ortiz Sanjuán: None declared, José Andrés Román Ivorra: None declared, Ana Pérez Gómez: None declared, Alejandro Olive: None declared, Carolina Díez: None declared, Juan José Alegre: None declared, D Ybáñez-García Speakers bureau: Lilly, Roche, Sanofi, Ángels Martínez-Ferrer: None declared, Javier Narvaez: None declared, Ignasi Figueras: None declared, Ana Isabel Turrión: None declared, Susana Romero-Yuste: None declared, Pilar Trénor: None declared, Soledad Ojeda Speakers bureau: AMGEN, LILLY, GEBRO, Miguel Á. González-Gay Grant/research support from: AbbVie, MSD and Roche, Speakers bureau: AbbVie, MSD and Roche, Ricardo Blanco Grant/research support from: Abbvie, MSD and Roche, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD
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Herrero Morant A, Atienza Mateo B, Loricera J, Calvo del Rio V, Martín-Varillas JL, Graña J, Espinosa G, Moriano C, Pérez Sandoval T, Martín Martínez M, Diez E, García-Armario MD, Martínez E, Castellví I, Moya Alvarado P, Sivera F, Calvo J, De la Morena I, Ortiz Sanjuán F, Román Ivorra JA, Pérez Gómez A, Heredia S, Olive A, Prior Á, Díez C, Alegre-Sancho JJ, Ybáñez-García D, Martínez-Ferrer Á, Narváez J, Figueras I, Turrión AI, Romero-Yuste S, Trénor P, Ojeda S, González-Gay MÁ, Blanco R. THU0307 RESPONSE OF BEHÇET’S REFRACTORY ORAL AND/OR GENITAL ULCERS TO APREMILAST IN COMBINATION VS MONOTHERAPY. NATIONAL MULTICENTER STUDY OF 51 CASES OF CLINICAL PRACTICE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Apremilast (APR) has demonstrated efficacy in the treatment of oral and/or genital aphthous ulcers in Behçet´s disease (BD). Combination of APR to other disease-modifying anti-rheumatic drugs (DMARDs) has not been assessed.Objectives:To compare the efficacy and safety of APR in monotherapy or combined with DMARDs in refractory BD.Methods:National multicenter open-label study on 51 BD patients with oral and/or genital ulcers refractory to conventional treatment.Results:We included 51 patients (35 women/16 men), mean age 44.7±13.2 years. Before APR, all patients had received several systemic conventional drugs. The main clinical symptoms for starting APR were oral (n=19) and genital (2) aphthous ulcers or both (30).Excluding corticosteroids, colchicine or NSAIDs, APR was given at standard dose of 30 mg twice daily in monotherapy (n=31), or combined with conventional DMARDs in 16 cases (6 azathioprine, 5 methotrexate, 4 hydroxychloroquine, 4 sulfasalazine, 1 dapsone) or with biologic DMARDs in 4 (2 tocilizumab, 1 adalimumab, 1 infliximab). There were not found statistically significant differences in demographic features, previous therapy, clinical manifestations or reported adverse effects.After a median follow-up of 6 [3-12] months, most of the patients experienced improvement of the orogenital ulcers in both groups (89.8% in the first 2 weeks), without statistically significant differences.(TABLE)Conclusion:APR leads to a rapid and maintained improvement in most patients with refractory BD orogenital ulcers. APR seems as effective and safe in monotherapy as combined.TABLE:Week 1-2Week 4Month 6Month 12Month 24Outcome of oral and/or genital ulcers n, (%)Cn=19Mn=30Cn=19Mn=26Cn=12Mn=17Cn=7Mn=6Cn=1Mn=1 Complete resolution8 (42.1)11 (36.7)12 (63.2)20 (77)7 (58.4)14 (82.4)3 (42.8)3 (50)1 (100)1 (100) Partial resolution9 (47.4)16 (53.4)7 (36.8)3 (11.5)5 (41.6)2 (11.7)4 (57.2)3 (50)00 No response2 (10.5)3 (9.9)03 (11.5)01 (5.9)0000p value0.90.10.10.80.7Abbreviations: C= combined; M= monotherapy; n= available data.Disclosure of Interests:Alba Herrero Morant: None declared, Belen Atienza Mateo: None declared, J. Loricera: None declared, Vanesa Calvo del Rio Grant/research support from: MSD and Roche, Speakers bureau: Abbott, Lilly, Celgene, Grünenthal, UCB Pharma, José Luis Martín-Varillas Grant/research support from: AbbVie, Pfizer, Janssen and Celgene, Speakers bureau: Pfizer and Lilly, Jenaro Graña: None declared, Gerard Espinosa: None declared, Clara Moriano: None declared, Trinidad Pérez Sandoval: None declared, Manuel Martín Martínez: None declared, Elvira Diez: None declared, María Dolores García-Armario: None declared, Esperanza Martínez: None declared, Ivan Castellví Consultant of: Boehringer Ingelheim, Actelion, Kern Pharma, Speakers bureau: Boehringer Ingelheim, Actelion, Bristol-Myers Squibb, Roche, Patricia Moya Alvarado: None declared, Francisca Sivera: None declared, Jaime Calvo Grant/research support from: Lilly, UCB, Consultant of: Abbvie, Jansen, Celgene, Isabel de la Morena: None declared, Francisco Ortiz Sanjuán: None declared, José Andrés Román Ivorra: None declared, Ana Pérez Gómez: None declared, Sergi Heredia: None declared, Alejandro Olive: None declared, Águeda Prior: None declared, Carolina Díez: None declared, Juanjo J Alegre-Sancho Consultant of: UCB, Roche, Sanofi, Boehringer, Celltrion, Paid instructor for: GSK, Speakers bureau: MSD, GSK, Lilly, Sanofi, Roche, UCB, Actelion, Pfizer, Abbvie, Novartis, D Ybáñez-García Speakers bureau: Lilly, Roche, Sanofi, Ángels Martínez-Ferrer: None declared, J. Narváez: None declared, Ignasi Figueras: None declared, Ana Isabel Turrión: None declared, Susana Romero-Yuste: None declared, Pilar Trénor: None declared, Soledad Ojeda Speakers bureau: AMGEN, LILLY, GEBRO, Miguel Á. González-Gay Grant/research support from: AbbVie, MSD and Roche, Speakers bureau: AbbVie, MSD and Roche, Ricardo Blanco Grant/research support from: Abbvie, MSD and Roche, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD
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Ciruelos E, Villagrasa P, Oliveira M, Pernas Simon S, Cortés J, Vazquez S, Martínez N, Perelló A, Bermejo De Las Heras B, Martínez E, Garau Llinas I, Mele Olive M, Montaño A, Vega E, Cantos B, Echarri M, Pascual T, Celiz P, González-Farré X, Prat A. 180TiP Palbociclib, trastuzumab and endocrine therapy (ET) versus treatment of physician's choice (TPC) in metastatic HER2-positive and hormone receptor-positive (HER2+/HR+) breast cancer (BC) with PAM50 luminal intrinsic subtype (SOLTI-1303 PATRICIA II): A randomized phase II trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Perello R, Vergara A, Monclus E, Jimenez S, Montero M, Saubi N, Moreno A, Eto Y, Inciarte A, Mallolas J, Martínez E, Marcos MA. Cytomegalovirus infection in HIV-infected patients in the era of combination antiretroviral therapy. BMC Infect Dis 2019; 19:1030. [PMID: 31801482 PMCID: PMC6894188 DOI: 10.1186/s12879-019-4643-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/20/2019] [Indexed: 12/20/2022] Open
Abstract
Background Cytomegalovirus infection dramatically decreased with the introduction of antiretroviral therapy. Whether incidence, clinical characteristics and prognosis of cytomegalovirus in HIV infected patients, has changed over time is. scarcely known. Methods Retrospective single-center study. Patients included in this study were all HIV infected patients that went to our center for any disease, and were diagnosed with cytomegalovirus, during the period 2004–2015. epidemiological, clinical and laboratory patients variables were collected in a clinical database. Clinical characteristics, incidence of cytomegalovirus and predictors of mortality during the study were assessed. Results were considered statistically significant when p < 0.05. All statistical analyses were calculated by SPSS version 20.0 (Chicago, IL,USA). Results Fifty-six cases of cytomegalovirus infection, in HIV infected patients were identified during the study period (incidence rate-1.7 cases per 1000 persons/year). The most frequent presentation was systemic illness in 43% of cases. Of note,no patients presented with ophthalmic manifestations. The 30-days mortality was 18%. Predictors of mortality were, in the univariate analysis, admission to the intensive care unit OR 32.4 (3.65–287.06) p = 0.0001, and mechanic ventilation 84 OR (8.27–853.12) p = 0.0001, and ART OR 4.1 (0.97–17.31) p = 0.044. These variables were assessed by multivariate analysis, and only mechanical ventilation was statistically significant (p < 0.05) Conclusion Incidence of cytomegalovirus infection was higher than described in the antiretroviral therapy era. Clinical presentation has changed. Mechanic ventilation predicted mortality.
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Affiliation(s)
- R Perello
- Servicio de Urgencias, Hospital Clínic, Barcelona, Spain.
| | - A Vergara
- Servicio de Microbiología, CDB, Hospital Clínic, Barcelona, Spain
| | - E Monclus
- Servicio de Urgencias, Hospital Clínic, Barcelona, Spain
| | - S Jimenez
- Servicio de Urgencias, Hospital Clínic, Barcelona, Spain
| | - M Montero
- Servicio de Urgencias, Hospital Clínic, Barcelona, Spain
| | - N Saubi
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - A Moreno
- Servicio de Microbiología, CDB, Hospital Clínic, Barcelona, Spain
| | - Y Eto
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - A Inciarte
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - J Mallolas
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - E Martínez
- Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - M A Marcos
- Servicio de Microbiología, CDB, Hospital Clínic, Barcelona, Spain
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Ocampo A, Domingo P, Fernández P, Diz J, Barberá JR, Sepúlveda MA, Salgado X, Rodriguez M, Santos J, Yzusqui M, Mayorga MI, Lorenzo JF, Bahamonde A, Bachiller P, Martínez E, Rozas N, Torres C, Muñoz A, Casado A, Podzamczer D. Lipid changes and tolerability in a cohort of adult HIV-infected patients who switched to rilpivirine/emtricitabine/tenofovir due to intolerance to previous combination ART: the PRO-STR study. J Antimicrob Chemother 2019; 73:2171-2176. [PMID: 29788066 DOI: 10.1093/jac/dky175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 04/16/2018] [Indexed: 01/15/2023] Open
Abstract
Objectives To analyse lipid changes and tolerability in a cohort of HIV-infected patients who switched their antiretroviral regimens to rilpivirine/emtricitabine/tenofovir (RPV/FTC/TDF) in a real-world setting. Methods PRO-STR is a 48 week prospective observational post-authorization study in 25 hospitals. Patients with a viral load <1000 copies/mL, receiving at least 12 months of combination ART (cART), with constant posology for at least the prior 3 months, were categorized according to previous treatment [NNRTI or ritonavir-boosted PI (PI/r)]. Analytical tests were performed at the baseline visit, between week 16 and week 32, and at week 48. Results A total of 303 patients were included (mean age 46.6 years; male 74.0%; previous treatment 74.7% NNRTI and 25.3% PI/r). Both groups exhibited significantly reduced lipid profiles, except for HDL cholesterol, for which a non-significant increase was observed. [NNRTI patients: total cholesterol (baseline: 195.5 ± 38.4 mg/dL; week 48: 171.0 ± 35.5 mg/dL), total cholesterol/HDL ratio (baseline: 4.2 ± 1.2; week 48: 4.0 ± 1.2), HDL (baseline: 49.1 ± 12.0 mg/dL; week 48: 49.2 ± 45.8 mg/dL), LDL (baseline: 119.2 ± 30.2 mg/dL; week 48: 114.2 ± 110.7 mg/dL), and triglycerides (baseline: 136.6 ± 86.8 mg/dL; week 48: 113.4 ± 67.8 mg/dL); PI/r patients: total cholesterol (baseline: 203.2 ± 48.8 mg/dL; week 48: 173.4 ± 36.9 mg/dL), total cholesterol/HDL ratio (baseline: 4.7 ± 1.6; week 48: 4.0 ± 1.2), HDL (baseline: 46.4 ± 12.5 mg/dL; week 48: 52.1 ± 54.4 mg/dL), LDL (baseline: 127.0 ± 36.3 mg/dL; week 48: 111.4 ± 35.8 mg/dL), and triglycerides (baseline: 167.6 ± 107.7 mg/dL; week 48: 122.7 ± 72.1 mg/dL)]. The most common intolerances were neuropsychiatric in the NNRTI patients and gastrointestinal and metabolic in the PI/r patients, and these intolerances were significantly reduced in both groups at week 48 [NNRTI: neuropsychiatric (baseline: 81.3%; week 48: 0.0%); PI/r: gastrointestinal (baseline: 48.7%; week 48: 0.0%) and metabolic (baseline: 42.1%; week 48: 0.0%)]. Conclusions RPV/FTC/TDF improved the lipid profiles and reduced the intolerances after switching from NNRTI or PI-based regimens, in a cohort of HIV-infected patients.
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Affiliation(s)
- A Ocampo
- Xeral de Vigo Hospital, Pontevedra, Spain
| | - P Domingo
- de la Santa Creu y Sant Pau Hospital, Barcelona, Spain
| | | | - J Diz
- de Montecelo Hospital, A Coruña, Spain
| | - J R Barberá
- La Mancha Centro Hospital, Ciudad Real, Spain
| | | | - X Salgado
- University de Girona Dr Josep Trueta Hospital, Girona, Spain
| | | | - J Santos
- Virgen de la Victoria Hospital, Málaga, Spain
| | - M Yzusqui
- Nuestra Señora del Prado Hospital, Toledo, Spain
| | | | | | | | - P Bachiller
- University del Río Hortega Hospital, Valladolid, Spain
| | - E Martínez
- University de Albacete Hospital, Albacete, Spain
| | - N Rozas
- University de Bellvitge, Barcelona Hospital, Barcelona, Spain
| | - C Torres
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - A Muñoz
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - A Casado
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - D Podzamczer
- University de Bellvitge, Barcelona Hospital, Barcelona, Spain
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Llombart Cussac A, Medioni J, Colleoni M, Ettl J, Schmid P, Macpherson I, Gligorov J, Albanell J, Bellet Ezquerra M, Fernández A, Ruiz Borrego M, Gavilá-Gregori J, Wheatley D, Zamora P, Martínez E, Sampayo M, Riva F, Malfettone A, Pérez-García J, Cortés J. Palbociclib rechallenge in hormone receptor (HR)[+]/HER2[-] advanced breast cancer (ABC). PALMIRA trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.082] [Citation(s) in RCA: 2] [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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Martínez E, Perriot R, Kober EM, Bowlan P, Powell M, McGrane S, Cawkwell MJ. Parallel replica dynamics simulations of reactions in shock compressed liquid benzene. J Chem Phys 2019; 150:244108. [PMID: 31255087 DOI: 10.1063/1.5092209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The study of the long-term evolution of slow chemical reactions is challenging because quantum-based reactive molecular dynamics simulation times are typically limited to hundreds of picoseconds. Here, the extended Lagrangian Born-Oppenheimer molecular dynamics formalism is used in conjunction with parallel replica dynamics to obtain an accurate tool to describe the long-term chemical dynamics of shock-compressed benzene. Langevin dynamics has been employed at different temperatures to calculate the first reaction times in liquid benzene at pressures and temperatures consistent with its unreacted Hugoniot. Our coupled engine runs for times on the order of nanoseconds (one to two orders of magnitude longer than traditional techniques) and is capable of detecting reactions that are characterized by rates significantly slower than we could study before. At lower pressures and temperatures, we mainly observe Diels-Alder metastable reactions, whereas at higher pressures and temperatures we observe stable polymerization reactions.
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Affiliation(s)
- E Martínez
- Theoretical Division, T-1, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Perriot
- Theoretical Division, T-1, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - E M Kober
- Theoretical Division, T-1, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - P Bowlan
- Physical Chemistry and Applied Spectroscopy, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Powell
- Shock and Detonation Physics, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S McGrane
- Shock and Detonation Physics, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M J Cawkwell
- Theoretical Division, T-1, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
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de Goede M, Dijkstra M, Obregón R, Ramón-Azcón J, Martínez E, Padilla L, Mitjans F, Garcia-Blanco SM. Al 2O 3 microring resonators for the detection of a cancer biomarker in undiluted urine. Opt Express 2019; 27:18508-18521. [PMID: 31252793 DOI: 10.1364/oe.27.018508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/20/2019] [Indexed: 06/09/2023]
Abstract
Concentrations down to 3 nM of the rhS100A4 protein, associated with human tumor development, have been detected in undiluted urine using an integrated sensor based on microring resonators in the emerging Al2O3 photonic platform. The fabricated microrings were designed for operation in the C-band (λ = 1565 nm) and exhibited a high-quality factor in air of 3.2 × 105. The bulk refractive index sensitivity of the devices was ~100 nm/RIU (for TM polarization) with a limit of detection of ~10-6 RIU. A surface functionalization protocol was developed to allow for the selective binding of the monoclonal antibodies designed to capture the target biomarker to the surface of the Al2O3 microrings. The detection of rhS100A4 proteins at clinically relevant concentrations in urine is a big milestone towards the use of biosensors for the screening and early diagnosis of different cancers. Biosensors based on this microring technology can lead to portable, multiplexed and easy-to-use point of care devices.
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Garcia-Arellano A, Martínez-González MA, Ramallal R, Salas-Salvadó J, Hébert JR, Corella D, Shivappa N, Forga L, Schröder H, Muñoz-Bravo C, Estruch R, Fiol M, Lapetra J, Serra-Majem L, Ros E, Rekondo J, Toledo E, Razquin C, Ruiz-Canela M, Alonso A, Barrio Lopez M, Basterra-Gortari F, Benito Corchon S, Bes-Rastrollo M, Beunza J, Carlos S, Cervantes S, de Irala J, de la Rosa P, de la Fuente C, Donat-Vargas C, Donazar M, Fernandez Montero A, Gea A, Goni-Ochandorena E, Guillen-Grima F, Lahortiga F, Llorca J, Lopez del Burgo C, Mari-Sanchıs A, Marti A, Mendonça R, Nuñez-Cordoba J, Pimenta A, Rico A, Ruiz Zambrana A, Sayon-Orea C, Toledo-Atucha J, Vazquez Ruiz Z, Zazpe Garcıa I, Sánchez- Tainta A, Buil-Cosiales P, Díez-Espino J, Sanjulian B, Martínez J, Marti A, Serrano-Martínez M, Basterra-Gortari F, Extremera-Urabayen J, Garcia-Pérez L, Arroyo-Azpa C, Barcena A, Oreja-Arrayago C, Lasanta-Sáez M, Cia-Lecumberri P, Elcarte-Lopez T, Artal-Moneva F, Esparza-López J, Figuerido-Garmendia E, Tabar-Sarrias J, Fernández- Urzainqui L, Ariz-Arnedo M, Cabeza-Beunza J, Pascual-Pascual P, Martínez-Mazo M, Arina-Vergara E, Macua-Martínez T, Pascual Pascual P, Garcés Ducar M, Martí Massó R, Villanueva Moreno R, Parra-Osés A, Serra-Mir M, Pérez-Heras A, Viñas C, Casas R, Medina-Remon A, Villanueva P, Baena J, García M, Oller M, Amat J, Duaso I, García Y, Iglesias C, Simón C, Quinzavos L, Parra L, Liroz M, Benavent J, Clos J, Pla I, Amorós M, Bonet M, Martín M, Sánchez M, Altirriba J, Manzano E, Altés A, Cofán M, Valls-Pedret C, Sala-Vila A, Doménech M, Bulló M, Basora-Gallisa J, González R, Molina C, Mena G, Martínez P, Ibarrola N, Sorlí J, García Roselló J, Martin F, Tort N, Isach A, Babio N, Salas-Huetos A, Becerra-Tomás N, Rosique- Esteban N, Hernandez P, Canudas S, Papandreou C, Ferreira C, Cabre M, Mestres G, Paris F, Llauradó M, Pedret R, Basells J, Vizcaino J, Segarra R, Giardina S, Guasch-Ferré M, Díaz-López A, Fernández-Ballart J, Balanza R, Tello S, Vila J, de la Torre R, Muñoz-Aguayo D, Elosua R, Marrugat J, Schröder H, Molina N, Maestre E, Rovira A, Castañer O, Farré M, Sorli J, Carrasco P, Ortega-Azorín C, Asensio E, Osma R, Barragán R, Francés F, Guillén M, González J, Sáiz C, Portolés O, Giménez F, Coltell O, Fernández-Carrión R, Guillem-Sáiz P, González-Monje I, Quiles L, Pascual V, Riera C, Pages M, Godoy D, Carratalá-Calvo A, Sánchez-Navarro S, Valero-Barceló C, Salaverria I, Hierro TD, Algorta J, Francisco S, Alonso A, San Vicente J, Casi A, Sanz E, Felipe I, Rekondo J, Loma-Osorio A, Fernandez-Crehuet J, Garcia-Rodriguez A, Wärnberg J, Benitez Pont R, Bianchi Alba M, Navajas R, Gómez-Huelgas R, Martínez-González J, Velasco García V, de Diego Salas J, Baca Osorio A, Gil Zarzosa J, Sánchez Luque J, Vargas López E, Romaguera D, García-Valdueza M, Proenza A, Prieto R, Frontera G, Munuera S, Vivó M, Bestard F, Munar J, Coll L, Fiol F, Ginard M, Jover A, García J, Santos-Lozano J, Ortega-Calvo M, Leal M, Martínez E, Mellado L, Miró-Moriano L, Domínguez-Espinaco C, Vaquero- Diaz S, Iglesias P, Román P, Corchado Y, Lozano-Rodríguez J, Lamuela-Raventós R, López- Sabater M, Castellote-Bargalló A, Quifer-Rada P, Tresserra-Rimbau A, Alvarez-Pérez J, Díez Benítez E, Bautista Castaño I, Maldonado Díaz I, Sanchez-Villegas A, Férnandez- Rodríguez M, Sarmiendo de la Fe F, Simón García C, Falcón Sanabria I, Macías Gutiérrez B, Santana Santana A, de la Cruz E, Galera A, Pintó-Salas X, Trias F, Sarasa I, Rodríguez M, Corbella X, Corbella E, Goday A, Muñoz M, Cabezas C, Vinyoles E, Rovira M, Garcia L, Baby P, Ramos A, Mengual L, Roura P, Yuste M, Guarner A, Rovira A, Santamaria M, Mata M, de Juan C, Brau A, Fernandez M, Gutierrez E, Murillo C, Garcia J, Tafalla M, Bobe I, Díaz A, Araque M, Solis E, Cervello T, Montull I, Tur J, Portillo M, Sáez G. Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies. Clin Nutr 2019; 38:1221-1231. [PMID: 30651193 DOI: 10.1016/j.clnu.2018.05.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 04/24/2018] [Accepted: 05/02/2018] [Indexed: 12/22/2022]
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Nuciforo P, Pascual T, Cortés J, Llombart-Cussac A, Fasani R, Paré L, Oliveira M, Galvan P, Martínez N, Bermejo B, Vidal M, Pernas S, López R, Muñoz M, Garau I, Manso L, Alarcón J, Martínez E, Rodrik-Outmezguine V, Brase JC, Villagrasa P, Prat A, Holgado E. A predictive model of pathologic response based on tumor cellularity and tumor-infiltrating lymphocytes (CelTIL) in HER2-positive breast cancer treated with chemo-free dual HER2 blockade. Ann Oncol 2019; 29:170-177. [PMID: 29045543 DOI: 10.1093/annonc/mdx647] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background The presence of stromal tumor-infiltrating lymphocytes (TILs) is associated with increased pathologic complete response (pCR) and improved outcomes in HER2-positive early-breast cancer (BC) treated with anti-HER2-based chemotherapy. In the absence of chemotherapy, the association of TILs with pCR following anti-HER2 therapy-only is largely unknown. Patients and methods The PAMELA neoadjuvant trial treated 151 women with HER2-positive BC with lapatinib and trastuzumab [and hormonal therapy if hormone receptor (HR)-positive] for 18 weeks. Percentage of TILs and tumor cellularity were determined at baseline (N = 148) and at day 15 (D15) of treatment (N = 134). Associations of TILs and tumor cellularity with pCR in the breast were evaluated. A combined score based on tumor cellularity and TILs (CelTIL) measured at D15 was derived in PAMELA, and validated in D15 samples from 65 patients with HER2-positive disease recruited in the LPT109096 neoadjuvant trial, where anti-HER2 therapy-only was administer for 2 weeks, then standard chemotherapy was added for 24 weeks. Results In PAMELA, baseline and D15 TILs were significantly associated with pCR in univariate analysis. In multivariable analysis, D15 TILs, but not baseline TILs, were significantly associated with pCR. At D15, TILs and tumor cellularity were found independently associated with pCR. A combined score (CelTIL) taking into account both variables was derived. CelTIL at D15 as a continuous variable was significantly associated with pCR, and patients with CelTIL-low and CelTIL-high scores had a pCR rate of 0% and 33%, respectively. In LPT109096, CelTIL at D15 was found associated with pCR both as a continuous variable and as group categories using a pre-defined cut-off (75.0% versus 33.3%). Conclusions On-treatment TILs, but not baseline TILs, are independently associated with response following anti-HER2 therapy-only. A combined score of TILs and tumor cellularity measured at D15 provides independent predictive information upon completion of neoadjuvant anti-HER2-based therapy. Clinical trial number NCT01973660.
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Affiliation(s)
- P Nuciforo
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - T Pascual
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - J Cortés
- Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain.,Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Llombart-Cussac
- Department of Medical Oncology, Arnau de Vilanova University Hospital, Valencia, Spain
| | - R Fasani
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - L Paré
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - M Oliveira
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - P Galvan
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - N Martínez
- Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain
| | - B Bermejo
- Department of Medical Oncology, Hospital Clínico de Valencia, Valencia, Spain
| | - M Vidal
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - S Pernas
- Department of Medical Oncology, Instituto Catalán de Oncología, Hospitalet, Spain
| | - R López
- Department of Medical Oncology, Complejo Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - M Muñoz
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - I Garau
- Department of Medical Oncology, Hospital de Son Llàtzer, Palma de Mallorca, Spain
| | - L Manso
- Department of Medical Oncology, Hospital 12 de Octubre, Madrid, Spain
| | - J Alarcón
- Department of Medical Oncology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - E Martínez
- Department of Medical Oncology, Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain
| | | | - J C Brase
- Novartis Oncology, Basel, Switzerland
| | - P Villagrasa
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - A Prat
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - E Holgado
- Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain.,Department of Medical Oncology, Baselga Oncological Institute, Madrid, Spain.,Department of Medical Oncology, Baselga Oncological Institute, Barcelona, Spain
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Linares I, Berenguer M, Martínez E, Laplana M, Cañas R, Comas S, Pérez-Montero H, Ventura M, Guedea F. PO-1072 INTRABEAM: precision hypo-fractionated radiotherapy with a systemic immune response. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31492-6] [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: 10/26/2022]
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Brasó-Maristany F, Griguolo G, Llombart-Cussac A, Pascual T, Paré L, Bermejo B, Oliveira M, Morales S, Martinez N, Vidal M, Pernas S, Lopez R, Muñoz M, Galvan P, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, Cortés J, Prat A. Abstract P6-17-07: Gene signatures and subtype changes during HER2 dual blockade in PAM50 HER2-enriched HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-17-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: HER2-positive (HER2+) breast cancer (BC) is composed of 4 molecular subtypes: Luminal A and B, HER2-enriched (HER2-E) and Basal-like. Among them, the HER2-E is highly sensitive to anti-HER2 treatment. However, ˜60% of HER2-E tumors do not achieve a pathological complete response (pCR) following neoadjuvant dual HER2 blockade without chemotherapy. Here, we aimed to better understand the molecular changes of the HER2-E subtype during anti-HER2 treatment.
Methods: Gene expression was evaluated in 101 patients with HER2-E tumors from the PAMELA neoadjuvant phase II trial (Lancet Oncol 2017). Briefly, women with HER2+ BC were treated with lapatinib and trastuzumab (and hormonal therapy if hormone receptor [HR]-positive) for 18 weeks. The median time between the last dose of treatment and surgery was 35 days (range=213; interquartile range=16). Expression of the PAM50 genes and 6 PAM50 signatures (Luminal A, Luminal B, HER2-E, Basal-like, normal-like and the PAM50 proliferation score) were determined using the nCounter platform at baseline (n=101), after 2 weeks of treatment (n=96) and in residual tumors (non-pCR) at surgery (n=57). Same analyses were done in 2 HER2+/HER2-E cell line models (BT474 [HR+] and SKBR3 [HR-]) following in vitro treatment with trastuzumab in combination with lapatinib. Biological changes between 2 time-points were determined by paired t-tests with a false discovery rate (FDR) <5%.
Results: After 2 weeks of treatment, 85.7% and 94.6% of the 56 genes/signatures were found differentially expressed (FDR<5%) in HER2-E/HR+ (n=35) and HER2-E/HR- (n=61) tumors, respectively. The two gene lists were highly correlated (correlation coefficient=0.93). Overall, a significant relative increase in Luminal A and normal-like signature scores, and a relative decrease in proliferation, HER2-E and Luminal B signature scores, were observed between baseline and week 2. Interestingly, a PAM50 subtype switch to Luminal A was observed in 31.6% and 4.8% of HER2-E/HR+ and HER2-E/HR- tumors. In BT474 and SKBR3, all genes/signatures were also found differentially expressed (FDR<5%) following 72h of dual HER2 blockade. The in vitro findings recapitulated the in vivo findings in 80-86% of the genes/signatures. Similar to tumors, a switch to a Luminal A subtype following dual HER2 blockade was observed in BT474 but not in SKBR3. Finally, 92.9% of the 56 genes/signatures were found differentially expressed (FDR<5%) in residual tumors at surgery compared to week 2. Contrary to the findings in the first 2 weeks of treatment, a general rebound effect in gene expression was observed between week 2 and surgery. Similarly, a rebound effect was observed in 60% of the genes/signatures in BT474 after removing anti-HER2 therapy for 72h, leading to a subtype switch from Luminal A back to HER2-E.
Conclusions: Dual HER2 blockade in the HER2-E subtype induces large biological changes that lead to a more low-proliferative Luminal A phenotype both in tumors and in vitro models, especially in HER2-E/HR+ disease. These phenotypic changes are reversible upon stopping anti-HER2 treatment. This finding supports the use of maintenance anti-HER2 treatment +/- endocrine therapy (if HR+) in advanced HER2+ BC.
Citation Format: Brasó-Maristany F, Griguolo G, Llombart-Cussac A, Pascual T, Paré L, Bermejo B, Oliveira M, Morales S, Martinez N, Vidal M, Pernas S, Lopez R, Muñoz M, Galvan P, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, Cortés J, Prat A. Gene signatures and subtype changes during HER2 dual blockade in PAM50 HER2-enriched HER2-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-17-07.
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Affiliation(s)
- F Brasó-Maristany
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - G Griguolo
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - A Llombart-Cussac
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - T Pascual
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - L Paré
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - B Bermejo
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - M Oliveira
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - S Morales
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - N Martinez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - M Vidal
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - S Pernas
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - R Lopez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - M Muñoz
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - P Galvan
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - I Garau
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - L Manso
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - J Alarcón
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - E Martínez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - P Villagrasa
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - J Cortés
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
| | - A Prat
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago / CIBERONC, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain
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Griguolo G, Holgado E, Cortés J, Fasani R, Pascual T, Paré L, Bermejo B, Oliveira M, Morales S, Martinez N, Vidal M, Pernas S, Lopez R, Muñoz M, Galvan P, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, LLombart-Cussac A, Prat A, Nuciforo P. Abstract P6-17-08: Dynamics of tumor-infiltrating lymphocytes (TILs) during neoadjuvant dual HER2 blockade in HER2-positive (HER2+) breast cancer in the absence of chemotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-17-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: TILs in HER2+ breast cancer (BC) predict 1) prognosis in early setting, 2) complete pathological response (pCR) following neoadjuvant antiHER2-based therapy and 3) response to trastuzumab and pembrolizumab in the metastatic setting. However, less is known regarding changes in TILs during antiHER2-based treatment.
Methods: Stromal TILs where evaluated centrally using H/E slides in tumor samples from the PAMELA (NCT01973660) neoadjuvant phase II trial. Briefly, 151 women with HER2+ BC were treated with lapatinib and trastuzumab, and hormonal therapy if HR positive, for 18 weeks. TIL levels were determined at baseline (n=148), after 2 weeks of treatment (n=134) and at surgery (n=137). Expression of 560 genes, including immune-related genes (e.g. CD8A, CD4, PD1 and PDL1) was measured at the same timepoints (baseline n=151, 2-weeks n=144, surgery n=144) using the nCounter platform. Intrinsic subtyping at baseline was determined using the PAM50 gene expression predictor. Changes in TILs between 2 time-points were determined by paired t-tests. Correlation of TILs with gene expression was assessed by quantitative SAM analysis using a False Discovery Rate <1%. All statistical tests were two-sided and considered significant when p<0.05. All statistical analyses were carried out using the R software.
Results: Compared to baseline, a significant increase in TILs was observed at week 2 in HR- (p<0.001) and HER2-enriched (HER2-E) tumors (p=0.001), but not in HR+ (p=0.133) and non-HER2-E tumors (p=0.067). Within HR- and HER2-E tumors, increase in TILs at week 2 from baseline was observed regardless of pathological response at surgery (pCR and HR- [p=0.008]; RD and HR- [p=0.037]; pCR and HER2-E [p=0.010]; RD and HER2-E [p=0.056]). Compared to week 2, a significant decrease in TILs at surgery was observed in HR- (p=0.002) and HER2-E (p=0.003) tumors, but not in HR+ (p=0.616) and non-HER2-E tumors (p=0.578). Within HR- and HER2-E tumors, a significant decrease in TILs between week 2 and surgery was observed in tumors achieving pCR (p=0.004 and p=0.005), while, in tumors not achieving pCR, no significant tendency was observed (26.4% and 33.0% of tumors showed an increase and a decrease of TILs between week 2 and surgery). Nonetheless, the vast majority of residual tumors (non-pCR) at surgery had TILs above ≥5%: 34.3% 5-10%, 21.0% 10-20%, 15.2% 20-40% and 11.4% ≥40%. Finally, TILs scoring was found highly enriched (FDR<1%) for immune-related genes tracking activated CD8 T-cells (i.e. CD8A, CD3G, LAG3 and PD1). Expression of these immune genes consistently correlated with TIL levels across the 3 time-points.
Conclusions: In early HER2+ BC, a general increase in TILs is observed following 2 weeks of dual HER2 blockade. This observation is mostly observed in HR- and HER2-E subtype, but regardless of pathological response at surgery. After 2 weeks of treatment, TILs consistently decrease in patients achieving a pCR, whereas two main patterns of TILs expression are observed in patients with residual disease at surgery. Nonetheless, most residual tumors at surgery are inflamed (i.e. TILs ≥5%) and might be good candidates for clinical trials evaluating adjuvant immune checkpoint inhibitors.
Citation Format: Griguolo G, Holgado E, Cortés J, Fasani R, Pascual T, Paré L, Bermejo B, Oliveira M, Morales S, Martinez N, Vidal M, Pernas S, Lopez R, Muñoz M, Galvan P, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, LLombart-Cussac A, Prat A, Nuciforo P. Dynamics of tumor-infiltrating lymphocytes (TILs) during neoadjuvant dual HER2 blockade in HER2-positive (HER2+) breast cancer in the absence of chemotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-17-08.
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Affiliation(s)
- G Griguolo
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - E Holgado
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - J Cortés
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - R Fasani
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - T Pascual
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - L Paré
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - B Bermejo
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Oliveira
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - S Morales
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - N Martinez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Vidal
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - S Pernas
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - R Lopez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Muñoz
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - P Galvan
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - I Garau
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - L Manso
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - J Alarcón
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - E Martínez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - P Villagrasa
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - A LLombart-Cussac
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - A Prat
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - P Nuciforo
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
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Ruiz-Alcalá V, Onrubia X, García-Vitoria C, Baldó J, Martínez E, Seller JM. Locating the cricothyroid membrane in males: Influence of the morphological characteristics of the neck. ACTA ACUST UNITED AC 2018; 66:144-148. [PMID: 30558801 DOI: 10.1016/j.redar.2018.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/29/2018] [Accepted: 10/31/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Cricothyrotomy is a recommended technique to restore oxygenation in most of guidelines for difficult airway management. A correct location of the cricothyroid membrane (CTM) is fundamental for a proper performance of the technique. Several studies have shown poor accuracy with the identification the CTM by palpation, resulting in a high failure rate of the technique. OBJECTIVE The aim of this study was to determine the impact of the patient's neck morphology on the accurate location of the CTM and on the time employed. MATERIALS AND METHOD Observational study in which anaesthesiologists and intensivists voluntarily participated in a simulation that consisted of a «cannot intubate, cannot oxygenate» scenario, where they had to locate the CTM, as soon as possible, in 2 selected male patients with different morphological characteristics of the neck. The time was measured from the beginning of CTM palpation to locating it with a marker. RESULTS AND CONCLUSIONS A higher body mass index and a higher neck circumference correlated with a 70% location failure rate and with a longer time as compared with a standard model.
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Affiliation(s)
- V Ruiz-Alcalá
- Servicio Anestesiología-Reanimación, Hospital Universitari Dr. Peset, València, España.
| | - X Onrubia
- Servicio Anestesiología-Reanimación, Hospital Universitari Dr. Peset, València, España
| | - C García-Vitoria
- Servicio Anestesiología-Reanimación, Hospital Universitari Dr. Peset, València, España
| | - J Baldó
- Servicio Anestesiología-Reanimación, Hospital Universitari Dr. Peset, València, España
| | - E Martínez
- Servicio Anestesiología-Reanimación, Hospital Universitari Dr. Peset, València, España
| | - J M Seller
- Servicio Anestesiología-Reanimación, Hospital Universitari Dr. Peset, València, España
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Blancas I, Fontanillas M, Conde V, Lao J, Martínez E, Sotelo MJ, Jaen A, Bayo JL, Carabantes F, Illarramendi JJ, Gordon MM, Cruz J, García-Palomo A, Mendiola C, Pérez-Ruiz E, Bofill JS, Baena-Cañada JM, Jáñez NM, Esquerdo G, Ruiz-Borrego M. Correction to: Efficacy of fulvestrant in the treatment of postmenopausal women with endocrine-resistant advanced breast cancer in routine clinical practice. Clin Transl Oncol 2018; 20:1631-1632. [DOI: 10.1007/s12094-018-1956-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Higuera Gomez O, Calderón C, Ghanem I, Carmona-Bayonas A, Jara C, Hernández R, Castelo B, Muñoz M, Beato C, García S, Martínez E, Mut M, Ramchandani Vaswani A, Mangas M, Donnay O, García-García M, Soriano M, Carrión R, Iglesias Gomez C, Jimenez Fonseca P. Cognitive functions, coping strategies and psychological distress in patients with resected non-advanced cancer receiving chemotherapy: NEOcoping study data. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy296.005] [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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González-Cordón A, Doménech M, Camafort M, Martínez-Rebollar M, Torres B, Laguno M, Rojas J, Loncà M, Blanco JL, Mallolas J, Gatell JM, de Lazzari E, Martínez E. Subclinical cardiovascular disease in patients starting contemporary protease inhibitors. HIV Med 2018; 19:497-503. [PMID: 29745457 DOI: 10.1111/hiv.12619] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the study was to assess changes in and factors associated with anatomical [carotid artery intima-media thickness (CIMT)] and functional (arterial stiffness) markers of subclinical cardiovascular disease progression in antiretroviral-naïve patients starting triple combination antiretroviral therapy containing contemporary protease inhibitors. METHODS This was a planned substudy of the ATADAR (Metabolic Effects of Atazanavir/Ritonavir Versus Darunavir/Ritonavir in Combination With Tenofovir/Emtricitabine in naïve HIV-1 Infected Patients) clinical trial (ClinicalTrials.gov identifier NCT01274780). ATADAR is a multicentre, randomized, open-label clinical trial comparing the effects of ritonavir-boosted atazanavir and darunavir, both with tenofovir/emtricitabine, in antiretroviral-naïve HIV-infected patients. Common CIMT and aortic augmentation index (AIx@75) were measured at baseline and after 12 months of follow-up. Antiretroviral treatment, traditional cardiovascular risk factors and HIV-related factors were assessed as potential predictors of CIMT and Aix@75 changes using linear regression analysis. RESULTS Thirty-three patients were included in this pilot study. While CIMT significantly increased in the pooled population [median (interquartile range (IQR)) 68 (-13, 128) μm; P = 0.0511], AIx@75 did not [median (IQR) 1 (-6, 5)%; P = 0.8964]. Patients on darunavir showed a trend to faster CIMT progression than those on atazanavir [median change (IQR) 117 (-2, 143) vs. -6 (-58, 89) μm, respectively; P = 0.0917]. However, after adjustment in the multivariate analysis, a higher baseline Framingham score was the only factor associated with CIMT progression (coefficient 16.02; 95% confidence interval -1.04, 33.08; P = 0.064). AIx@75 change was not associated with any baseline factor. CONCLUSIONS CIMT was a more sensitive marker of subclinical vascular disease progression than arterial stiffness in antiretroviral-naïve patients starting antiretroviral therapy with contemporary protease inhibitors. Classical risk factors but not antiretroviral therapy were associated with faster CIMT progression.
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Affiliation(s)
- A González-Cordón
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - M Doménech
- Cardiovascular, Nutrition and Aging Group, Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M Camafort
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBEROBN, Instituto de Salud Carlos III, Madrid, Spain
| | - M Martínez-Rebollar
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - B Torres
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - M Laguno
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - J Rojas
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - M Loncà
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - J L Blanco
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - J Mallolas
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - J M Gatell
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - E de Lazzari
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - E Martínez
- Infectious Diseases Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
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Andicoechea A, Vizoso F, Alexandre E, Cuesta E, Díez MC, Riera L, García-Muñiz J, Martínez E, Ruibal A. Preoperative Carbohydrate Antigen 195 (CA195) and CEA Serum Levels as Prognostic Factors in Patients with Colorectal Cancer. Int J Biol Markers 2018. [DOI: 10.1177/172460089801300307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We evaluated in 214 patients with primary colorectal cancer the prognostic value of the preoperative serum levels of CEA and CA195. For CEA these levels were above the cutoff of 6 ng/ml in 31.3% of patients, whereas for CA195 they were higher than 12 U/ml in 35.9% of patients. The simultaneous use of both antigens increased the sensitivity to 49%, which was significantly higher than that of CEA (p<0.001) and CA195 (p<0.01) taken singly. The mean preoperative CEA levels were significantly (p<0.001) correlated with Dukes’ stage only, while there was a significant correlation between preoperative serum levels of CA195 and Dukes’ stage (p<0.001), grade of differentiation (p<0.01) and tumor location (p<0.05). The results indicated that high preoperative serum levels of CEA and CA195 were associated with a shorter overall survival (p<0.0001). In addition, separate Cox multivariate analysis showed that preoperative CA195 was, after Dukes’ stage, the strongest factor to predict overall survival (p<0.0001).
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Affiliation(s)
| | - F. Vizoso
- Servicio de Cirugía General, Hospital de Jove, Gijón
| | - E. Alexandre
- Servicio de Cirugía General, Hospital de Jove, Gijón
| | - E. Cuesta
- Servicio de Cirugía General, Hospital de Jove, Gijón
| | - M. Cruz Díez
- Servicio de Cirugía General, Hospital de Jove, Gijón
| | - L. Riera
- Servicio de Cirugía General, Centro Médico de Asturias, Oviedo
| | | | - E. Martínez
- Servicio de Cirugía General, Hospital Central de Asturias, Oviedo
| | - A. Ruibal
- Servicio de Medicina Nuclear, Hospital Central de Asturias, Oviedo - Spain
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Latorre-Biel JI, Jiménez E, Pérez M, Leiva F, Martínez E, Blanco J. Simulation Model of a Production Facility of Agaricus bisporus Mycelium for Decision-Making Support. International Journal of Food Engineering 2018. [DOI: 10.1515/ijfe-2017-0159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractSustainability and efficiency are key factors in agro-food industry, since the success of companies in this sector relies on the achievement of these objectives. Decision-making support may contribute decisively to this task. A model for a production facility of mycelium of the mushroom variety ofAgaricus bisporusis described. This model has been developed using the paradigm of the Petri nets and can be integrated in a decision support tool for performing structural analysis with the purpose of identifying certain features, such as feasible deadlocks. A complementary and promising possibility consists of using the model for performance evaluation by simulation of the behavior of the system in combination with the outcome of a life cycle assessment. This approach allows developing a what-if analysis or an optimization process to seek for good or quasi-optimal decisions taking into account financial, as well as environmental issues, among other possibilities.
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Nuciforo P, Holgado E, Llombart A, Fasani R, Paré L, Pascual T, Oliveira M, Martínez N, Bermejo B, Vidal M, Pernas S, López R, Muñoz M, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, Cortés J, Prat A. Abstract P2-09-14: A predictive model of pathological response following dual HER2 blockade-only based on tumor cellularity and tumor-infiltrating lymphocytes (CelTIL) in HER2-positive breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Increased number of tumor-infiltrating lymphocytes (TILs) at baseline is associated with pathological complete response (pCR) and improved outcomes in HER2-positive early breast cancer treated with anti-HER2-based chemotherapy. In the absence of chemotherapy, the association of TILs with pCR following anti-HER2 therapy-only is currently unknown.
Methods: The PAMELA (NCT01973660)neoadjuvant trial treated 151 women with HER2-positive breast cancer with lapatinib and trastuzumab (and hormonal therapy if hormone receptor-positive) for 18 weeks. Percentage of TILs and tumor cellularity were determined at baseline (n=148) and after 2 weeks of treatment (n=134). Associations of TILs and tumor cellularity with pCR in the breast were evaluated using univariate and multivariable logistic regression models. The regression coefficients were used to derive a score based on TILs and tumor cellularity measured at week 2 (CelTIL) was derived in PAMELA,and tested in week 2 samples from 65 patients with HER2+ disease recruited in the LPT109096 (NCT00524303) phase 2 neoadjuvant trial, where anti-HER2 therapy-only (trastuzumab, lapatinib or the combination) was administered for 2 weeks, followed by the addition of standard multi-agent chemotherapy for 24 weeks.
Results: In PAMELA, at baseline, TILs were significantly associated with pCR in univariate analysis but not in multivariable analysis (adjusted odds ratio [OR]=1.01, 0.98-1.03; p-value=0.620). A statistically significant increase in TILs was observed at week 2 compared to baseline (mean difference +6.9%; p-value<0.001). At week 2, TILs were significantly associated with pCR in univariate and multivariable analyses (adjusted OR=1.04, 1.01-1.06; p-value=0.009). TILs and tumor cellularity at week 2 were independently associated with pCR and a combined score (from 0 to 100) taking into account both variables was derived. CelTIL as a continuous variable was significantly associated with pCR, and patients with CelTIL-low and CelTIL-high scores (cutoff < 33.59) had a pCR rate of 0% and 33%, respectively. Independent validation of CelTIL in week 2 samples from 65 patients with HER2+ disease recruited in the LPT109096 phase 2 neoadjuvant trial will be presented at the conference.
Conclusions: A combined score of TILs and tumor cellularity at week 2 following anti-HER2 therapy-only is associated with pCR upon completion of neoadjuvant anti-HER2-based therapy.
Citation Format: Nuciforo P, Holgado E, Llombart A, Fasani R, Paré L, Pascual T, Oliveira M, Martínez N, Bermejo B, Vidal M, Pernas S, López R, Muñoz M, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, Cortés J, Prat A. A predictive model of pathological response following dual HER2 blockade-only based on tumor cellularity and tumor-infiltrating lymphocytes (CelTIL) in HER2-positive breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-14.
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Affiliation(s)
- P Nuciforo
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - E Holgado
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - A Llombart
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - R Fasani
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - L Paré
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - T Pascual
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - M Oliveira
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - N Martínez
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - B Bermejo
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - M Vidal
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - S Pernas
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - R López
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - M Muñoz
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - I Garau
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - L Manso
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - J Alarcón
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - E Martínez
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - P Villagrasa
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - J Cortés
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - A Prat
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
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Martínez E, Rodríguez JA, Bautista M, Rangel-Vargas E, Santos EM. Use of 2-Naphthalenethiol for Derivatization and Determination of Acrylamide in Potato Crisps by High-Performance Liquid Chromatographic with Fluorescence Detection. FOOD ANAL METHOD 2018. [DOI: 10.1007/s12161-018-1150-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pinto-Bravo P, Ferreira-Dias G, Rebordão MR, Amaral A, Fernandes C, Cuello C, Parrilla I, Martínez E, Roberto da Costa RP, Skarzynski DJ. Is mare endometrosis linked to oviduct fibrosis? PFERDEHEILKUNDE 2018. [DOI: 10.21836/pem20180107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Blancas I, Fontanillas M, Conde V, Lao J, Martínez E, Sotelo MJ, Jaen A, Bayo JL, Carabantes F, Illarramendi JJ, Gordon MM, Cruz J, García-Palomo A, Mendiola C, Pérez-Ruiz E, Bofill JS, Baena-Cañada JM, Jáñez NM, Esquerdo G, Ruiz-Borrego M. Efficacy of fulvestrant in the treatment of postmenopausal women with endocrine-resistant advanced breast cancer in routine clinical practice. Clin Transl Oncol 2017; 20:862-869. [PMID: 29178019 DOI: 10.1007/s12094-017-1797-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/05/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This study aimed to describe the efficacy of fulvestrant 500 mg in postmenopausal women with estrogen receptor (ER)-positive advanced/metastatic breast cancer who had disease progression after receiving anti-estrogen therapy in clinical practice, getting real-world data. MATERIALS AND METHODS Multicenter, retrospective, observational study conducted in Spain. Postmenopausal women with locally advanced/metastatic ER-positive breast cancer who received treatment with fulvestrant 500 mg after progression with a previous anti-estrogen therapy were eligible. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), clinical benefit rate (CBR), duration of clinical benefit (DoCB), and safety profile. RESULTS A total of 263 women were evaluated (median age, 65.8 years). At a median follow-up of 21.5 months, median PFS and OS were 10.6 and 43.2 months, respectively. PFS according to 1st, 2nd, 3rd, and ≥ 4th lines were 11.5, 10.6, 9.9, and 8.5 months, respectively (p = 0.0245). PFS in patients with visceral involvement was 10 months vs 10.6 months in patients without visceral involvement (p = 0.6604), 9.6 months in patients with high Ki67 vs 10 months in patients with low Ki67 (p = 0.7224), and 10.2 months in HER2+ patients vs 10.3 months in HER2- patients (p = 0.6809). The CBR was 56.5% and the DoCB was 18.4 months. The most frequently adverse events were injection site pain (10.3%) and musculoskeletal disorders (7.6%). CONCLUSIONS Fulvestrant 500 mg administered in clinical practice was shown to be effective (PFS, 10.6 months; CBR, 56.5%) and well tolerated, in accordance with previous trials.
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Affiliation(s)
- I Blancas
- Hospital Universitario Clínico San Cecilio, Complejo Hospitalario Universitario, C/Dr. Oloriz, 16, 18012, Granada, Spain.
| | - M Fontanillas
- Hospital Clinic de Barcelona, illarroel, 170, 08036, Barcelona, Spain
| | - V Conde
- Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas, S/N, 18014, Granada, Spain
| | - J Lao
- Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009, Zaragoza, Spain
| | - E Martínez
- Hospital Provincial de Castellón, Av. del Dr. Clarà, 19, 12002, Castelló de la Plana, Spain
| | - M J Sotelo
- Hospital Universitario Clínico San Carlos, C/del Profesor Martín Lagos, s/n, 28040, Madrid, Spain
| | - A Jaen
- Hospital de Jaén, Avda. del Ejército Español, nº 10, 23007, Jaén, Spain
| | - J L Bayo
- Hospital Juan Ramón Jiménez, Ronda Exterior Norte s/n, 21005, Huelva, Spain
| | - F Carabantes
- Hospital Universitario Carlos Haya, Av. de Carlos Haya, s/n, 29010, Málaga, Spain
| | - J J Illarramendi
- Complejo Universitario Hospital de Navarra, Calle Irunlarrea, 3, 31008, Pamplona, Spain
| | - M M Gordon
- Hospital de Jerez, Ronda de Circunvalación s/n, 11407, Cádiz, Spain
| | - J Cruz
- Hospital Universitario de Canarias, Carretera de Ofra, s/n, 38320, Santa Cruz de Tenerife, Spain
| | - A García-Palomo
- Complejo Universitario Asistencial de León, C/Altos de Nava, s/n, León, Spain
| | - C Mendiola
- Hospital Universitario, 12 de Octubre, Avenida de Córdoba, s/n, 28041, Madrid, Spain
| | - E Pérez-Ruiz
- Hospital Costa del Sol, Autovia A-7, Km 187, 29603, Marbella, Spain
| | - J S Bofill
- Hospital Nuestra Señora De Valme, Av. de Bellavista, s/n, 41014, Seville, Spain
| | - J M Baena-Cañada
- Hospital Universitario Puerta del Mar, Av. Ana de Viya, 21, 11009, Cádiz, Spain
| | - N M Jáñez
- Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, km. 9,100, 28034, Madrid, Spain
| | - G Esquerdo
- Clínica Benidorm, Av. Alfonso Puchades, 03501, Benidorm, Spain
| | - M Ruiz-Borrego
- Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, s/n, 41013, Seville, Spain
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Farré N, Acosta E, Balart J, Sancho G, Majercakova K, Carrasco P, Fernández A, Camacho M, Majem M, Giménez A, Martínez E, Trujillo J, Torrego A, Pajares V, Craven-Bartle J. P3.14-014 Lung Stereotactic Body Radiotherapy (SBRT): Patient's Outcome and Prognostic Factors. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1787] [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: 10/18/2022]
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Melia MR, Del Carpio Huerta L, Joaquín AB, Palacios GA, Sullivan I, Perez AC, Farré N, Torrego A, Pajares V, Martínez E, Trujillo J, De Quinana C, Tarruella MM. P2.01-072 Local Management of Oligometastases in Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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