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Palafox M, Monserrat L, Bellet M, Villacampa G, Gonzalez-Perez A, Oliveira M, Brasó-Maristany F, Ibrahimi N, Kannan S, Mina L, Herrera-Abreu MT, Òdena A, Sánchez-Guixé M, Capelán M, Azaro A, Bruna A, Rodríguez O, Guzmán M, Grueso J, Viaplana C, Hernández J, Su F, Lin K, Clarke RB, Caldas C, Arribas J, Michiels S, García-Sanz A, Turner NC, Prat A, Nuciforo P, Dienstmann R, Verma CS, Lopez-Bigas N, Scaltriti M, Arnedos M, Saura C, Serra V. Author Correction: High p16 expression and heterozygous RB1 loss are biomarkers for CDK4/6 inhibitor resistance in ER + breast cancer. Nat Commun 2022; 13:6928. [PMID: 36376284 PMCID: PMC9663725 DOI: 10.1038/s41467-022-34580-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Marta Palafox
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Laia Monserrat
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Meritxell Bellet
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Guillermo Villacampa
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Abel Gonzalez-Perez
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain
- Research Program on Biomedical Informatics, Universitat Pompeu Fabra, Barcelona, Spain
| | - Mafalda Oliveira
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Fara Brasó-Maristany
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Nusaibah Ibrahimi
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, Villejuif, France
| | | | - Leonardo Mina
- Medica Scientia Innovation Research (MedSIR), Barcelona, Spain
| | | | - Andreu Òdena
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Mònica Sánchez-Guixé
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Marta Capelán
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Analía Azaro
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Alejandra Bruna
- Preclinical Modelling of Pediatric Cancer Evolution Group, The Institute of Cancer Research, London, UK
| | - Olga Rodríguez
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Marta Guzmán
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Judit Grueso
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Cristina Viaplana
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Javier Hernández
- Translational Molecular Pathology, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
| | - Faye Su
- Novartis Pharmaceuticals, East Hanover, NJ, USA
| | - Kui Lin
- Genentech, Inc., South San Francisco, California, USA
| | - Robert B Clarke
- Breast Biology Group, Manchester Breast Centre, Manchester, UK
| | | | - Joaquín Arribas
- CIBERONC, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Growth Factors Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Stefan Michiels
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, Villejuif, France
| | | | | | - Aleix Prat
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
- SOLTI Breast Cancer Research Group, Barcelona, Spain
- Department of Oncology, IOB Institute of Oncology, Barcelona, Spain
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Chandra S Verma
- Bioinformatics Institute (A*STAR), Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Nuria Lopez-Bigas
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain
- Research Program on Biomedical Informatics, Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Maurizio Scaltriti
- Departments of Pathology and Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Monica Arnedos
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
- Inserm Unit U981, Villejuif, France
| | - Cristina Saura
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Violeta Serra
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
- CIBERONC, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
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Palafox M, Monserrat L, Bellet M, Villacampa G, Gonzalez-Perez A, Oliveira M, Brasó-Maristany F, Ibrahimi N, Kannan S, Mina L, Herrera-Abreu MT, Òdena A, Sánchez-Guixé M, Capelán M, Azaro A, Bruna A, Rodríguez O, Guzmán M, Grueso J, Viaplana C, Hernández J, Su F, Lin K, Clarke RB, Caldas C, Arribas J, Michiels S, García-Sanz A, Turner NC, Prat A, Nuciforo P, Dienstmann R, Verma CS, Lopez-Bigas N, Scaltriti M, Arnedos M, Saura C, Serra V. High p16 expression and heterozygous RB1 loss are biomarkers for CDK4/6 inhibitor resistance in ER + breast cancer. Nat Commun 2022; 13:5258. [PMID: 36071033 PMCID: PMC9452562 DOI: 10.1038/s41467-022-32828-6] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/17/2022] [Indexed: 12/27/2022] Open
Abstract
CDK4/6 inhibitors combined with endocrine therapy have demonstrated higher antitumor activity than endocrine therapy alone for the treatment of advanced estrogen receptor-positive breast cancer. Some of these tumors are de novo resistant to CDK4/6 inhibitors and others develop acquired resistance. Here, we show that p16 overexpression is associated with reduced antitumor activity of CDK4/6 inhibitors in patient-derived xenografts (n = 37) and estrogen receptor-positive breast cancer cell lines, as well as reduced response of early and advanced breast cancer patients to CDK4/6 inhibitors (n = 89). We also identified heterozygous RB1 loss as biomarker of acquired resistance and poor clinical outcome. Combination of the CDK4/6 inhibitor ribociclib with the PI3K inhibitor alpelisib showed antitumor activity in estrogen receptor-positive non-basal-like breast cancer patient-derived xenografts, independently of PIK3CA, ESR1 or RB1 mutation, also in drug de-escalation experiments or omitting endocrine therapy. Our results offer insights into predicting primary/acquired resistance to CDK4/6 inhibitors and post-progression therapeutic strategies.
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Affiliation(s)
- Marta Palafox
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Laia Monserrat
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Meritxell Bellet
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Guillermo Villacampa
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Abel Gonzalez-Perez
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain
- Research Program on Biomedical Informatics, Universitat Pompeu Fabra, Barcelona, Spain
| | - Mafalda Oliveira
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Fara Brasó-Maristany
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Nusaibah Ibrahimi
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, Villejuif, France
| | | | - Leonardo Mina
- Medica Scientia Innovation Research (MedSIR), Barcelona, Spain
| | | | - Andreu Òdena
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Mònica Sánchez-Guixé
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Marta Capelán
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Analía Azaro
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Alejandra Bruna
- Preclinical Modelling of Pediatric Cancer Evolution Group, The Institute of Cancer Research, London, UK
| | - Olga Rodríguez
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Marta Guzmán
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Judit Grueso
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Cristina Viaplana
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Javier Hernández
- Translational Molecular Pathology, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
| | - Faye Su
- Novartis Pharmaceuticals, East Hanover, NJ, USA
| | - Kui Lin
- Genentech, Inc., South San Francisco, California, USA
| | - Robert B Clarke
- Breast Biology Group, Manchester Breast Centre, Manchester, UK
| | | | - Joaquín Arribas
- CIBERONC, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Growth Factors Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Stefan Michiels
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France
- Oncostat U1018, Inserm, University Paris-Saclay, Villejuif, France
| | | | | | - Aleix Prat
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
- SOLTI Breast Cancer Research Group, Barcelona, Spain
- Department of Oncology, IOB Institute of Oncology, Barcelona, Spain
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Chandra S Verma
- Bioinformatics Institute (A*STAR), Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Nuria Lopez-Bigas
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain
- Research Program on Biomedical Informatics, Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Maurizio Scaltriti
- Departments of Pathology and Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Monica Arnedos
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
- Inserm Unit U981, Villejuif, France
| | - Cristina Saura
- Breast Cancer and Melanoma Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Violeta Serra
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
- CIBERONC, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
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Brasó-Maristany F, Palafox M, Monserrat L, Bellet M, Oliveira M, Capelán M, Galván P, Martínez D, Chic N, Viaplana C, Dienstmann R, Nuciforo P, Saura Manich C, Prat A, Serra V. 16P Understanding the biologic determinants of ribociclib efficacy in breast cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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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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Palafox M, Mina L, Malfettone A, Monserrat L, Rodriguez M, Rodríguez O, Guzmán M, Grueso J, Scaltriti M, Miquel T, Saura C, Capelán M, Gil-Gil M, Llombart Cussac A, Cortés J, Perez Garcia J, Del Campo M, Bellet Ezquerra M, Serra V. 1933MO TransFAL: Establishment of clinical trial-matched luminal breast cancer patient-derived xenografts (PDX) for translational studies. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1326] [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: 10/23/2022] Open
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LoRusso P, García-Corbacho J, Braiteh FS, Gonçalves A, Ricci F, Iwata H, Capelán M, Sablin MP, Prat A, Hardebeck MC, Puig M, Huang DCL, Hsu M, Yee D. Abstract CT165: An open label, multi-cohort, phase Ib study of xentuzumab and abemaciclib: Preliminary results from the advanced non-small cell lung cancer (NSCLC) cohort. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-ct165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Insulin-like growth factor (IGF) signaling and the cyclin D-cyclin-dependent kinase (CDK) 4 & 6-retinoblastoma pathway are implicated in cancer progression and treatment resistance. Activation of the IGF receptor results in upregulation of cyclin D1 and progression through the cell cycle. Dual inhibition of IGF and CDK 4 & 6 should lead to decreased cell proliferation through disruption of cell-cycle progression. This phase Ib trial assessed safety and preliminary efficacy of xentuzumab, an IGF-ligand neutralizing antibody, in combination with abemaciclib, a CDK 4 & 6 inhibitor. In a dose-finding cohort in patients (pts) with solid tumors, the recommended phase II dose was determined as xentuzumab 1000 mg weekly intravenously plus abemaciclib 150 mg every 12 hours (Q12h) orally. Here, we present data from an expansion cohort in pts with NSCLC. Methods: Eligible pts had stage IV NSCLC with measurable disease which had progressed after platinum-based chemotherapy and immunotherapy, and had either received 1-2 prior chemotherapies for advanced/metastatic disease or were judged ineligible for further standard second-line chemotherapy. Prior CDK 4 & 6 inhibitor therapy was not permitted. Pts received xentuzumab 1000 mg weekly plus abemaciclib 150 mg Q12h until disease progression or intolerability of study medication. The primary endpoint was objective response defined as best overall response of complete response or partial response (PR) per RECIST 1.1. Secondary endpoints included progression-free survival (PFS). Results: 25 pts with NSCLC were treated (17 male [68%], median age 64 years [range 53-76]). 4 pts remained on treatment at time of analysis. Median treatment exposure was 1.6 months (range 0.5-19.7). Of 19 pts evaluable for response, 1 had a best overall response of PR (65% target lesion shrinkage), 9 had stable disease (duration ≥24 weeks in 3 pts) and 9 had progressive disease. Median PFS was 2.1 months (95% CI 1.2-5.3). All pts experienced adverse events (AEs) and 23 experienced treatment-related AEs (TRAEs), most commonly diarrhea (n=15; 60%), nausea (n=10; 40%) and platelet count decreased (n=8; 32%). The most common grade ≥3 TRAEs were thrombocytopenia (n=4; 16%) and neutropenia (n=3; 12%). No AEs of hyperglycemia or blood glucose increased were reported. Serious AEs were experienced by 13 pts (52%). 2 pts had fatal serious AEs due to disease progression and respiratory failure. Conclusion: The combination of xentuzumab and abemaciclib showed preliminary efficacy in pts with NSCLC who had progressed on chemotherapy and an immune checkpoint inhibitor. One PR was reported. The combination had a manageable safety profile.
Citation Format: Patricia LoRusso, Javier García-Corbacho, Fadi S. Braiteh, Anthony Gonçalves, Francesco Ricci, Hiroji Iwata, Marta Capelán, Marie Paule Sablin, Aleix Prat, Molly Catherine Hardebeck, Marta Puig, Dennis Chin-Lun Huang, Mingchi Hsu, Douglas Yee. An open label, multi-cohort, phase Ib study of xentuzumab and abemaciclib: Preliminary results from the advanced non-small cell lung cancer (NSCLC) cohort [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT165.
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Affiliation(s)
| | - Javier García-Corbacho
- 2Clinical Trials Unit, Clinic Institute of Haematological and Oncological Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Fadi S. Braiteh
- 3Comprehensive Cancer Centers of Nevada, University of Nevada School of Medicine, Las Vegas, NV
| | | | - Francesco Ricci
- 5Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France
| | - Hiroji Iwata
- 6Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Marta Capelán
- 7Department of Medical Oncology, Vall d'Hebron University Hospital, and Breast Cancer Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Marie Paule Sablin
- 5Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France
| | - Aleix Prat
- 8Medical Oncology Department, Hospital Clínic, Barcelona, Spain
| | | | - Marta Puig
- 10Boehringer Ingelheim España S.A., Barcelona, Spain
| | | | - Mingchi Hsu
- 12Boehringer Ingelheim (China) Investment Co. Ltd., Shanghai, China
| | - Douglas Yee
- 13Masonic Cancer Center, University of Minnesota, Minneapolis, MN
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7
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Oliveira M, Ruiz-Pace F, Matito J, Perez-Lopez R, Suñol A, Bellet M, Escriva-de-Romani S, Zamora E, Gomez P, Garrigós L, Capelán M, Arumí M, Ortiz C, Amair-Pinedo F, Mancuso FM, Espinosa-Bravo M, Nuciforo P, Dienstmann R, Vivancos A, Saura C. Determinants of concordance in clinically relevant genes (CRG) from synchronously acquired tumor biopsies (tBx) and ctDNA in metastatic breast cancer (MBC). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.1075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1075 Background: NGS in ctDNA from MBC is feasible and results may be informative for patients’ management, especially in non-luminal tumors (Oliveira et al, ASCO 2018). We aimed to study the determinants of concordance in CRG in a cohort of 60 MBC patients undergoing tBx and ctDNA collection. Methods: MiSeq Amplicon-based NGS (59 cancer-related genes) was performed in one single metastatic lesion per patient and compared with liquid biopsies taken at the same time point at disease progression to prior treatment. The concordance in CRG ( PIK3CA, AKT1, ERBB2, ESR1, PTEN, BRAF, FGFR1, HRAS, KRAS, and PIK3R1) in tBx vs ctDNA was determined at patient and at mutation (mut) level and correlated with mutant allele fraction (MAF), total disease volume (TDV), and clinical characteristics. True positive in plasma (TPP): patient with a mut detected both in ctDNA and tBx. TDV was defined as all metastasis volume assessed by CT scan (excluding sclerotic bone metastasis), and analyzed by an experienced radiologist using the 3DSlicer semiautomatic segmentation tool (TDV = pixel size x number of pixels). Results: Concordance in CRG at patient and mut level was 72% and 55%, respectively. Concordance for ERBB2 (1/1; 100%) and PIK3CA (17/22; 77%) was higher than for ESR1 (8/20; 40%) and AKT1 (2/6; 33%). ctDNA failed to detect 14 mut present in tBx ( ESR1 n = 5, PIK3CA n = 5, AKT1 n = 3, BRAF n = 1). Concordance was 100% for non-luminal and 60% for luminal cases (P = 0.01). In univariate analysis, concordance was not associated with MAF in tBx (P = 0.15), TDV (p = 0.86), number of prior lines of therapy (P = 0.57), number of metastatic sites (P = 0.56) or presence of visceral metastasis (P = 1.0). In patients with PIK3CA mut (N = 22), those with TPP had a numerically higher TDV than those where a PIK3CA mut was not detected in ctDNA (20.9cm3 vs 5.1cm3, P = 0.28). Across all patients, in the multivariate logistic model adjusted for other factors, TDV was a determinant of TPP (OR 1.02, 95%CI 1.0-1.06; P = 0.059). For each increase of 1cm3 in TDV, there was a 2% increase in the probability of detecting a mut in ctDNA. Conclusions: Our results suggest that liquid biopsy testing for the detection of actionable CRG is clinically valid in MBC, although its yield depends on several factors – tumor subtype, analyzed gene, and possibly tumor volume – that reflect both tumor heterogeneity and tumor shedding rate. Due to the potential clinical implications, the observation that mutation detection in ctDNA may correlate with tumor volume merits further study in a larger dataset.
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Affiliation(s)
- Mafalda Oliveira
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Fiorella Ruiz-Pace
- Oncology Data Science (ODysSey) Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Judit Matito
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Raquel Perez-Lopez
- Radiomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Suñol
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Meritxell Bellet
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Santiago Escriva-de-Romani
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Esther Zamora
- Medical Oncology Department, Vall d'Hebron University Hospital. Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Patricia Gomez
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Laia Garrigós
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Marta Capelán
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Miriam Arumí
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Carolina Ortiz
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Fabiola Amair-Pinedo
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Francesco M Mancuso
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Martin Espinosa-Bravo
- Breast Surgical Unit, Breast Cancer Center, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Lab and Molecular Pathology Lab, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Cristina Saura
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Casas A, Gonzàlez X, Capelán M, Morales J, Fabián M, Ciruelos E, Gabriele G. Abstract P5-13-05: Overcoming barriers to achieve a successful breast cancer patient recruitment: Professionals' views. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-13-05] [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
Accurate recruitment in performing clinical trials is crucial to avoid delays in the availability of potential beneficial treatments for patients. However, optimal strategies to improve it remain elusive and highly variable. The aim of this study was to identify the factors affecting recruitment from a multi-professional approach.
Methods: A convergent mixed method study was used, including key informant in-depth interviews (n=13), 5 focus groups (n=40) and a 209-item Likert-scale survey for the measurement of a whole array of variables of interest (i.e. job attitudes, job satisfaction, job stressors and social status). A purposive sample of professionals from thirty-three clinical trial sites in Spain were targeted. Qualitative data were analyzed alongside quantitative data to document patterns and modifiers of recruitment performance. Audio material was recorded, transcribed verbatim and analyzed using the framework method.
Findings: Pattern observed in qualitative data was confirmed in quantitative analysis. A total of 32 key barriers to successful patient recruitment were identified and clustered in three categories. The most commonly reported barriers and facilitators regarding a multifactorial approach were: System/organization: Counting on experienced recruiters and having a strong team-workforce awareness (92,3%); automated recruitment software, scientific culture, recruiting philosophy, adequate workload demands (88%); high stimuli and interprofessional trust (84%). However, lack of time devoted to clinical research in favor of assistance demands, excessive workload and bureaucratic tasks were the most salient stressors to fulfill professional research and recruitment responsibilities (54%). Working team conditions: Insufficient workforce support as well as high employee turnover contributed to emotional exhaustion and depersonalization and to a lower personal accomplishment (15%). Interpersonal relations affected not only motivation and performance but professionalism satisfaction with outcomes. Professional recruiter characteristics: Professionals with a high level of expertise and academic specialization (>5 years), greater active involvement in relevant clinical trials just as interprofessional prestige and recognition showed a greater satisfaction. Consequently, they were prompted to intensify their efforts to fulfill recruitment. The more effective clinical research settings were those better aligned with attributes for becoming high recruiters and with better multi-professional articulation. Suggestions to improve recruitment included providing professionals with devoted time for research, setting up collaborative research agreements, building a clinical research network, collaborative tumor registries, clinical trials data sharing resources, multidisciplinary functional units and committees, flexible staffing models and empowering oncologists/managers leadership.
Conclusions: This study provided useful understanding of how to maximize patient recruitment at clinical research sites. Strong team-workforce and adequate workload were the most important identified factors for achieving it. Results will be used to inform professionals and stakeholders of the next steps needed and to engage them to fulfill accurate recruitment.
Citation Format: Casas A, Gonzàlez X, Capelán M, Morales J, Fabián M, Ciruelos E, Gabriele G. Overcoming barriers to achieve a successful breast cancer patient recruitment: Professionals' views [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 P5-13-05.
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Affiliation(s)
- A Casas
- Hospital Virgen del Rocío, Sevilla, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Institut Oncològic Dr. Rosell, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; Hospital Vall d'Hebron, Barcelona, Spain; Hospital 12 de Octubre, Madrid, Spain; Pompeu Fabra University, Barcelona, Spain; FocusHealth Research Institute, Barcelona, Spain
| | - X Gonzàlez
- Hospital Virgen del Rocío, Sevilla, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Institut Oncològic Dr. Rosell, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; Hospital Vall d'Hebron, Barcelona, Spain; Hospital 12 de Octubre, Madrid, Spain; Pompeu Fabra University, Barcelona, Spain; FocusHealth Research Institute, Barcelona, Spain
| | - M Capelán
- Hospital Virgen del Rocío, Sevilla, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Institut Oncològic Dr. Rosell, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; Hospital Vall d'Hebron, Barcelona, Spain; Hospital 12 de Octubre, Madrid, Spain; Pompeu Fabra University, Barcelona, Spain; FocusHealth Research Institute, Barcelona, Spain
| | - J Morales
- Hospital Virgen del Rocío, Sevilla, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Institut Oncològic Dr. Rosell, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; Hospital Vall d'Hebron, Barcelona, Spain; Hospital 12 de Octubre, Madrid, Spain; Pompeu Fabra University, Barcelona, Spain; FocusHealth Research Institute, Barcelona, Spain
| | - M Fabián
- Hospital Virgen del Rocío, Sevilla, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Institut Oncològic Dr. Rosell, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; Hospital Vall d'Hebron, Barcelona, Spain; Hospital 12 de Octubre, Madrid, Spain; Pompeu Fabra University, Barcelona, Spain; FocusHealth Research Institute, Barcelona, Spain
| | - E Ciruelos
- Hospital Virgen del Rocío, Sevilla, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Institut Oncològic Dr. Rosell, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; Hospital Vall d'Hebron, Barcelona, Spain; Hospital 12 de Octubre, Madrid, Spain; Pompeu Fabra University, Barcelona, Spain; FocusHealth Research Institute, Barcelona, Spain
| | - G Gabriele
- Hospital Virgen del Rocío, Sevilla, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Institut Oncològic Dr. Rosell, Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; Hospital Vall d'Hebron, Barcelona, Spain; Hospital 12 de Octubre, Madrid, Spain; Pompeu Fabra University, Barcelona, Spain; FocusHealth Research Institute, Barcelona, Spain
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9
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Oliveira M, Bellet M, Suñol A, Ruiz-Pace F, Gomez P, Escrivá S, Garrigós L, Zamora E, Capelán M, Azaro A, Arumí M, Ortiz C, Matito J, Fasani R, Mancuso FM, Espinosa M, Nuciforo P, Dienstmann R, Vivancos A, Saura C. Concordance of genomic alterations (GA) in synchronous tumor biopsies (tBx) and circulating tumor (ct) DNA from metastatic breast cancer (MBC) patients (pts). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mafalda Oliveira
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Meritxell Bellet
- Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Suñol
- Breast Cancer Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Fiorella Ruiz-Pace
- Oncology Data Science (ODysSey) Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Patricia Gomez
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Santiago Escrivá
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Laia Garrigós
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Esther Zamora
- Medical Oncology Department, Vall d'Hebron University Hospital. Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Marta Capelán
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Analía Azaro
- Medical Oncology Department, Vall d’Hebron University Hospital; Molecular Therapeutics Research Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Miriam Arumí
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Carolina Ortiz
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Judit Matito
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Roberta Fasani
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Francesco M Mancuso
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Martin Espinosa
- Breast Surgical Unit, Breast Cancer Center, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Rodrigo Dienstmann
- Oncology Data Science (ODysSey) Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Cristina Saura
- Medical Oncology Department, Breast Cancer Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Fonseca PJ, Esteban E, de Vicente P, Luque M, Llorente B, Capelán M, Berros JP, Crespo G, Lacave ÁJ. Impact of erythropoietin on the reduction of blood transfusions and on survival of lung cancer patients receiving first-line chemotherapy. Clin Transl Oncol 2008; 10:426-32. [DOI: 10.1007/s12094-008-0226-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Crespo G, Sierra M, Losa R, Villanueva N, Fra J, Fonseca PJ, Fernández Y, Capelán M, Berros JP, Lacave AJ. A phase I study of pegylated liposomal doxorubicin + gemcitabine in a fixed dose-rate infusion for the treatment of patients with recurrent ovarian cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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