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Martínez-Jañez N, Ezquerra MB, Manso Sanchez LM, Carrasco FH, Torres AA, Morales S, Ortega PT, Gil VLO, Sampedro T, Conejero RA, Calvo-Martinez L, Galve-Calvo E, López R, de la Pena FA, Lopez-Tarruella S, de Araguiz BAHF, Ruiz LB, Cardenas TM, Chacon JI, Antón FM. First-line therapy with palbociclib in patients with advanced HR +/HER2 - breast cancer: The real-life study PALBOSPAIN. Breast Cancer Res Treat 2024:10.1007/s10549-024-07287-w. [PMID: 38561577 DOI: 10.1007/s10549-024-07287-w] [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: 11/08/2023] [Accepted: 02/07/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE To evaluate the efficacy and safety of first-line therapy with palbociclib in a Spanish cohort treated after palbociclib approval. METHODS PALBOSPAIN is an observational, retrospective, multicenter study evaluating real-world patterns and outcomes with 1 L palbociclib in men and women (any menopausal status) with advanced HR+/HER2- BC diagnosed between November 2017 and November 2019. The primary endpoint was real-world progression-free survival (rw-PFS). Secondary endpoints included overall survival (OS), the real-world response rate (rw-RR), the clinical benefit rate, palbociclib dose reduction, and safety. RESULTS A total of 762 patients were included. The median rw-PFS and OS were 24 months (95% CI 21-27) and 42 months (40-not estimable [NE]) in the whole population, respectively. By cohort, the median rw-PFS and OS were as follows: 28 (95% CI 23-39) and 44 (95% CI 38-NE) months in patients with de novo metastatic disease, 13 (95% CI 11-17) and 36 months (95% CI 31-41) in patients who experienced relapse < 12 months after the end of ET, and 31 months (95% CI 26-37) and not reached (NR) in patients who experienced relapse > 12 months after the end of ET. rw-PFS and OS were longer in patients with oligometastasis and only one metastatic site and those with non-visceral disease. The most frequent hematologic toxicity was neutropenia (72%; grade ≥ 3: 52.5%), and the most common non-hematologic adverse event was asthenia (38%). CONCLUSION These findings, consistent with those from clinical trials, support use of palbociclib plus ET as 1 L for advanced BC in the real-world setting, including pre-menopausal women and men. TRIAL REGISTRATION NUMBER NCT04874025 (PALBOSPAIN). Date of registration: 04/30/2021 retrospectively registered.
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Affiliation(s)
- N Martínez-Jañez
- Medical Oncology Department, Ramon y Cajal University Hospital, Hospital Ramón y Cajal, Ctra. de Colmenar Viejo km. 9,100, Madrid, 28034, Spain
| | - M Bellet Ezquerra
- Oncology Department, Vall d'Hebron Institute of Oncology (VHIO)-Cellex Center, Barcelona, Spain
| | - L M Manso Sanchez
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Henao Carrasco
- Oncology, Hospital Universitario Virgen Macarena, Seville, Spain
| | - A Anton Torres
- Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - S Morales
- Medical Oncology Department, Hospital Arnau de Vilanova - Lleida, Alpicat, Spain
| | - P Tolosa Ortega
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - V L Obadia Gil
- Breast Cancer Unit, ICO - Institut Català d'Oncologia l'Hospitalet (Hospital Duran i Reynals) L'Hospitalet De, Llobregat, Spain
| | - T Sampedro
- Medical Oncology Department, Hospital Universitario de Cabuenes, Gijón, Spain
| | - R Andrés Conejero
- Medical Oncology Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - L Calvo-Martinez
- Medical Oncology Department, CHUAC - Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - E Galve-Calvo
- Medical Oncology Department, Hospital Universitario de Basurto, Bilbao, Spain
| | - R López
- Servicio de Oncología Médica y Grupo de Oncología Médica Traslacional, Hospital Clínico Universitario e Instituto de Investigación Sanitaria-CIBERONC, Santiago de Compostela, Spain
| | - F Ayala de la Pena
- Medical Oncology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - S Lopez-Tarruella
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERONC, Geicam, Universidad Complutense, Madrid, Spain
| | | | - L Boronat Ruiz
- Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - T Martos Cardenas
- Medical Oncology Department, Hospital del Mar - Parc de Salut Mar, Barcelona, Spain
| | - J I Chacon
- Medical Oncology Department, Hospital Virgen de la Salud, Toledo, Spain
| | - F Moreno Antón
- Medical Oncology Department, Hospital Clínico Universitario San Carlos, Madrid, Spain.
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Antacli JC, Di Mauro R, Rimondino GN, Alurralde G, Schloss IR, González GA, Morales S, Ottero A, Vodopivez C. Microplastic pollution in waters of the Antarctic coastal environment of Potter Cove (25 de Mayo Island/King George Island, South Shetlands). Sci Total Environ 2024; 915:170155. [PMID: 38228241 DOI: 10.1016/j.scitotenv.2024.170155] [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] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/21/2023] [Accepted: 01/12/2024] [Indexed: 01/18/2024]
Abstract
Plastic pollution in the Southern Ocean around Antarctica is a growing concern, but many areas in this vast region remain unexplored. This study provides the first comprehensive analysis of marine microplastic (MPs) concentrations in Potter Cove, located near the Argentinian Carlini research station on 25 de Mayo/King George Island, Antarctica. Water samples were collected at 14 sites within the cove, representing various influences from the station's activities. Two sampling methods were used: a 5 L Niskin bottle and an in-situ filtering device called Microfilter, allowing for large water volumes to be filtered. MPs were found in 100 % of the samples. Microfilter samples ranged from 0.02 to 2.14 MPs/L, with a mean concentration of 0.44 ± 0.44 MPs/L. Niskin bottle samples showed concentrations from 0.40 to 55.67 MPs/L, with a mean concentration of 19.03 ± 18.21 MPs/L. The dominant types of MPs were anthropogenic black, transparent, and pink microfibers (MFs) measuring between 0.11 and 3.6 mm (Microfilter) and 0.06 to 7.96 mm (Niskin bottle), with a median length of 0.01 mm for both methods. Transparent and black irregular microfragments (MFRs) with diameters from 0.10 to 5.08 mm and a median diameter of 0.49 mm were also prevalent. FTIR-spectroscopy revealed the presence of 14 types of polymers. Cellulose-based materials and polyethylene terephthalate were the most abundant in MFs, while polyurethanes and styrene-based copolymers dominated in MFRs. MPs were more abundant near the Carlini station. Compared to other coastal Antarctic areas, the MPs in the cove were relatively abundant and mostly smaller than 1 mm. Local activities on the island were identified as the primary source of MPs in the cove, and the cyclonic water circulation likely affects the distribution of small-sized particles. To protect the ecosystem, reducing plastic usage, improving waste management, regulating MPs debris, and enhancing wastewater practices are essential.
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Affiliation(s)
- J C Antacli
- Universidad Nacional de Córdoba, Facultad de Ciencias Exactas, Físicas y Naturales, Ecología Marina, Av. Vélez Sarsfield 299, 5000 Córdoba, Argentina; Instituto de Diversidad y Ecología Animal (IDEA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina.
| | - R Di Mauro
- Gabinete de Zooplancton, Instituto Nacional de Investigación y Desarrollo Pesquero (INIDEP), Paseo Victoria Ocampo N° 1, B7602HSA Mar del Plata, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - G N Rimondino
- Instituto de Investigaciones en Fisicoquímica de Córdoba (INFIQC), CONICET, Departamento de Físico-Química, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - G Alurralde
- Department of Environmental Science, Stockholm University, 10691 Stockholm, Sweden; Baltic Marine Environment Protection Commission HELCOM, Helsinki FI-00160, Finland
| | - I R Schloss
- Instituto Antártico Argentino, 25 de Mayo 1143, San Martín, Buenos Aires, Argentina; Centro Austral de Investigaciones Científicas (CADIC, CONICET), Bernardo Houssay 200, Ushuaia, Tierra del Fuego, Argentina; Universidad Nacional de Tierra del Fuego, Ushuaia, Tierra del Fuego, Argentina
| | - G A González
- Universidad Nacional de Córdoba, Facultad de Ciencias Exactas, Físicas y Naturales, Ecología Marina, Av. Vélez Sarsfield 299, 5000 Córdoba, Argentina; Instituto de Diversidad y Ecología Animal (IDEA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - S Morales
- Universidad Nacional de Córdoba, Facultad de Ciencias Exactas, Físicas y Naturales, Ecología Marina, Av. Vélez Sarsfield 299, 5000 Córdoba, Argentina
| | - A Ottero
- Universidad Nacional de Córdoba, Facultad de Ciencias Exactas, Físicas y Naturales, Ecología Marina, Av. Vélez Sarsfield 299, 5000 Córdoba, Argentina
| | - C Vodopivez
- Instituto Antártico Argentino, 25 de Mayo 1143, San Martín, Buenos Aires, Argentina
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Samame J, Costanzo M, Gasol A, Ostinelli A, Rua O, Motta R, Failoc V, Falcón S, Morales S. P260 Real World Data Analysis of Palbociclib plus endocrine therapy in first-line in ibero-american premenopausal women with Luminal Advanced Breast Cancer. Breast 2023. [DOI: 10.1016/s0960-9776(23)00378-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
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Isler JR, Pini N, Lucchini M, Shuffrey LC, Morales S, Bowers ME, Leach SC, Sania A, Wang L, Condon C, Nugent JD, Elliott AJ, Friedrich C, Andrew R, Fox NA, Myers MM, Fifer WP. Longitudinal characterization of EEG power spectra during eyes open and eyes closed conditions in children. Psychophysiology 2023; 60:e14158. [PMID: 35968705 PMCID: PMC9729391 DOI: 10.1111/psyp.14158] [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: 07/27/2021] [Revised: 05/18/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
This study is the first to examine spectrum-wide (1 to 250 Hz) differences in electroencephalogram (EEG) power between eyes open (EO) and eyes closed (EC) resting state conditions in 486 children. The results extend the findings of previous studies by characterizing EEG power differences from 30 to 250 Hz between EO and EC across childhood. Developmental changes in EEG power showed spatial and frequency band differences as a function of age and EO/EC condition. A 64-electrode system was used to record EEG at 4, 5, 7, 9, and 11 years of age. Specific findings were: (1) the alpha peak shifts from 8 Hz at 4 years to 9 Hz at 11 years, (2) EC results in increased EEG power (compared to EO) at lower frequencies but decreased EEG power at higher frequencies for all ages, (3) the EEG power difference between EO and EC changes from positive to negative within a narrow frequency band which shifts toward higher frequencies with age, from 9 to 12 Hz at 4 years to 32 Hz at 11 years, (4) at all ages EC is characterized by an increase in lower frequency EEG power most prominently over posterior regions, (5) at all ages, during EC, decreases in EEG power above 30 Hz are mostly over anterior regions of the scalp. This report demonstrates that the simple challenge of opening and closing the eyes offers the potential to provide quantitative biomarkers of phenotypic variation in brain maturation by employing a brief, minimally invasive protocol throughout childhood.
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Affiliation(s)
- J. R. Isler
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - N. Pini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032 USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
| | - M. Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032 USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
| | - L. C. Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032 USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
| | - S. Morales
- Department of Psychology, University of Southern California, Los Angeles, CA 90089 USA
| | - M. E. Bowers
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20742 USA
| | - S. C. Leach
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20742 USA
| | - A. Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032 USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
| | - L. Wang
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
- Data Science Institute, Columbia University, New York, NY 10027 USA
| | - C. Condon
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
| | - J. D. Nugent
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
| | | | - C. Friedrich
- Avera Research Institute, Sioux Falls, SD 57108 USA
| | - R. Andrew
- Avera Research Institute, Sioux Falls, SD 57108 USA
| | - N. A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD 20742 USA
| | - M. M. Myers
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032 USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032 USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
| | - W. P. Fifer
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032 USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032 USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032 USA
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Uriarte-Gaspari L, Acuña A, Morales S, Fernández-Theoduloz G, Paz V, Pérez A, Cabana Á, Gradin V. Who do I want in my team: Social avoidance of high qualified partners in depression and social anxiety. Journal of Affective Disorders Reports 2022. [DOI: 10.1016/j.jadr.2022.100402] [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: 10/15/2022] Open
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Bellido-Luque J, Licardie E, Sanchez-Matamoros I, García Reyes A, Bellido Luque A, Nogales Muñoz A, Tejada Gomez A, Morales S. V-017 TOTALLY ENDOSCOPIC APPROACH TO MODIFIED SUGARBAKER PARASTOMAL HERNIA REPAIR BY TRANSVERSUS ABDOMINIS RELEASE (ETEP-PAULí). ADVANTAGES OF RETROMUSCULAR/PREPERITONEAL MESH PLACEMENT. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.269] [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: 11/12/2022]
Abstract
Abstract
Several studies published have shown that TAR is an effective technique for reconstructing midline hernias and lateral hernias. In 2016, Pauli et al. described a novel technique for parastomal hernioplasty using open TAR combined with a modified Sugarbaker repair.A 56-year-old woman operated on 5 years earlier due to rectum adenocarcinoma by laparoscopic resection. A parastomal hernia was diagnosed. CT revealed a 5 cm wide parastomal hernia associated with an umbilical hernia.Patient is placed in the supine position. Identification by ultrasound of the lateral junction of right rectus sheaths. incision on subcostal region 1 cm medial to said juntion. An incision is made on the anterior lamina and retromuscular space is created with a dissection balloon. With the placement of two 11–5 trocars, the medial aspect of the posterior rectus sheath muscle is incised at the epigastric level and the Crossover is carried out. Left retromuscular dissection is performed. The hernia content is reduced. the left arcuate ligament is identified and the transverse abdominis muscle is released.
Anterior defect closure with barded suture. An horizontal peritoneal incision is performed with the aim of lateralizing the colonic stump, the peritoneum and posterior aspect of the rectum sheath are closed.Placement of PPL mesh of 25×30 cms covering the dissected space.Patient was discharged on postoperative day 2. No complications or hernia recurrence were identified.
Conclusions
This technique offers some advantages; Coated mesh is unnecessary,The retromuscular positioning permits the integration on both sides.However several drawbacks; lack of long-term outcomes and technically challenge.
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Affiliation(s)
- J Bellido-Luque
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
| | - E Licardie
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
| | - I Sanchez-Matamoros
- Gastrointestinal Surgical Department, virgen Macarena universitary Hospital , Seville , Spain
| | - A García Reyes
- Gastrointestinal Surgical Department, virgen Macarena universitary Hospital , Seville , Spain
| | - A Bellido Luque
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
| | - A Nogales Muñoz
- Gastrointestinal Surgical Department, virgen Macarena universitary Hospital , Seville , Spain
| | - A Tejada Gomez
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
| | - S Morales
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
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Bellido-Luque J, Licardie E, Gomez Rosado JC, Sanchez-Matamoros I, Nogales Muñoz A, Tejada Gomez A, Bellido Luque A, Morales S. P-097 MINIMALLY INVASIVE REPAIR IN SEVERE RECTUS DIASTASIS WITH MIDLINE HERNIA ASSOCIATED IN MALES SHOWS HIGH RECURRENCE IN MID-TERM FOLLOW-UP. CASE-CONTROL STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.195] [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: 11/13/2022]
Abstract
Abstract
Aim
Endoscopic plication could develop excessive midline tension that could increase recurrence rate in patients with severe rectus diastasis (SRD). New minimally invasive endoscopic repair (FESSA technique)(FT) was proposed to corrects both pathologies. Aim: assess clinical results, postoperative pain, functional recovery and recurrence of FT compared to endoscopic anterior rectus sheaths plication and mesh (ARSP).
Patients and Methods
male patients with ventral/incisional hernia and SRD were included. 2017–2019 patient underwent to ARSP. 2019–2020 patients underwent to FT. data: Defect and diastasis width and length. Surgical results: Operation time, Intraoperative complications, Hospital stay,Postoperative complications,Pain on 1th/7th/30th days, Functional recovery, Hernia recurrence. Statistic variables were compared using nonparametric tests.
Results
53 patients were included. 28 patients underwent FT and 25 to ARSP. operative time: 70 +/-9 min in FT, 55+/- 7 min in ARSP with significant differences.Hospital stay:1.4+/- 0,5 days for FT and 2,08+/-0,5 for ARSP with significant differences. one postoperative subcutaneous hematoma, requiring surgical removal (2%) in ARSP. Pain at postoperative day 1:21+/2 in FT and 25 +/-2 in ARSP without differences. Pain after 7 and 30 days,significant improvement were shown in favor of FT. functional recovery at 1 month: 17,8 +/-2,4 in FT and 27,8 +/-3,3 in ARSP with significant improvement in FT. recurrence after 24 months: 1 patient in FT (3.6%) and 9 patient in ARSP(36.0%) with significant differences.
Conclusions
Minimally invasive endoscopic Anterior rectus sheaths plication with mesh in SRD and midline hernias, shows higher recurrence rate, postoperative pain and worse functional recovery due to probably excessive midline tension.
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Affiliation(s)
- J Bellido-Luque
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
| | - E Licardie
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
| | - J C Gomez Rosado
- Gastrointestinal Surgical Department, virgen Macarena universitary Hospital , Seville , Spain
| | - I Sanchez-Matamoros
- Gastrointestinal Surgical Department, virgen Macarena universitary Hospital , Seville , Spain
| | - A Nogales Muñoz
- Gastrointestinal Surgical Department, virgen Macarena universitary Hospital , Seville , Spain
| | - A Tejada Gomez
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
| | - A Bellido Luque
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
| | - S Morales
- Gastrointestinal Surgical Department , Quironsalud Sagrado Corazón, Seville , Spain
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Montoya VHG, Cardona LG, Morales S, Ospina JA, Rueda X. Lymphomatoid papulosis associated with rosacea-like primary cutaneous B cell lymphoma, a rare association. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00618-9] [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: 11/03/2022]
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Lopez KL, Monachino AD, Morales S, Leach SC, Bowers ME, Gabard-Durnam LJ. HAPPILEE: HAPPE In Low Electrode Electroencephalography, a standardized pre-processing software for lower density recordings. Neuroimage 2022; 260:119390. [PMID: 35817295 PMCID: PMC9395507 DOI: 10.1016/j.neuroimage.2022.119390] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/03/2022] [Accepted: 06/13/2022] [Indexed: 11/04/2022] Open
Abstract
Lower-density Electroencephalography (EEG) recordings (from 1 to approximately 32 electrodes) are widely-used in research and clinical practice and enable scalable brain function measurement across a variety of settings and populations. Though a number of automated pipelines have recently been proposed to standardize and optimize EEG pre-processing for high-density systems with state-of-the-art methods, few solutions have emerged that are compatible with lower-density systems. However, lower-density data often include long recording times and/or large sample sizes that would benefit from similar standardization and automation with contemporary methods. To address this need, we propose the HAPPE In Low Electrode Electroencephalography (HAPPILEE) pipeline as a standardized, automated pipeline optimized for EEG recordings with lower density channel layouts of any size. HAPPILEE processes task-free (e.g., resting-state) and task-related EEG (including event-related potential data by interfacing with the HAPPE+ER pipeline), from raw files through a series of processing steps including filtering, line noise reduction, bad channel detection, artifact correction from continuous data, segmentation, and bad segment rejection that have all been optimized for lower density data. HAPPILEE also includes post-processing reports of data and pipeline quality metrics to facilitate the evaluation and reporting of data quality and processing-related changes to the data in a standardized manner. Here the HAPPILEE steps and their optimization with both recorded and simulated EEG data are described. HAPPILEE's performance is then compared relative to other artifact correction and rejection strategies. The HAPPILEE pipeline is freely available as part of HAPPE 2.0 software under the terms of the GNU General Public License at: https://github.com/PINE-Lab/HAPPE.
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Affiliation(s)
- K L Lopez
- Northeastern University, 360 Huntington Ave, Boston, MA, United States
| | - A D Monachino
- Northeastern University, 360 Huntington Ave, Boston, MA, United States
| | - S Morales
- University of Maryland, College Park, MD, United States
| | - S C Leach
- University of Maryland, College Park, MD, United States
| | - M E Bowers
- University of Maryland, College Park, MD, United States
| | - L J Gabard-Durnam
- Northeastern University, 360 Huntington Ave, Boston, MA, United States.
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Errazuriz A, Avello D, Morales S, Pino R. Adverse childhood experiences and suicidal ideation among immigrants in Santiago, Chile. Eur Psychiatry 2021. [PMCID: PMC9475980 DOI: 10.1192/j.eurpsy.2021.1087] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionUnderstanding suicidal ideation and its association with childhood adversity is crucial for preventing suicide. Although the “healthy immigrant effect”, whereby immigrants are healthier than the native-born population, has been well documented across studies, little research has examined the presence of such effect on lifetime suicidal ideation (LSI) and its association to early adversity.ObjectivesThe aim of this study was to compare the prevalence of LSI between the immigrant and native-born population in Chile and explore the association between childhood adversity and suicidal ideation in immigrants.MethodsData from two cross-sectional health surveys: the Santiago Immigrant Wellbeing Study (STRING, n=1,091; 2019) and the Chilean National Health Survey (ENS2016, n=3,432) were used. Each study used multistage probability sampling and estimates were weighted to approximate the distribution of demographic variables in each population. Outcomes included LSI measured by WHO-CIDI and an adapted version of the Adverse Childhood Experience Questionnaire. Multivariate logistic regression was employed.Resultsindicated that immigrants were less likely to report LSI compared with the native-born population. Moreover, male and female immigrants had lower risk of having SI than native-born counterparts. After controlling for socioeconomic status, social support, and health conditions, childhood adversities predicted an increased risk of LSI in immigrants. No gender differences were found in the effects of childhood adversity on suicidal thoughts.ConclusionsFindings confirm the presence of a healthy immigrant effect in LSI and support a life course perspective, highlighting the importance of assessing early life disadvantages to understand suicidal ideation among immigrants.
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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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12
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Martin M, Zielinski C, Ruiz-Borrego M, Carrasco E, Turner N, Ciruelos EM, Muñoz M, Bermejo B, Margeli M, Anton A, Kahan Z, Csöszi T, Casas MI, Murillo L, Morales S, Alba E, Gal-Yam E, Guerrero-Zotano A, Calvo L, de la Haba-Rodriguez J, Ramos M, Alvarez I, Garcia-Palomo A, Huang Bartlett C, Koehler M, Caballero R, Corsaro M, Huang X, Garcia-Sáenz JA, Chacón JI, Swift C, Thallinger C, Gil-Gil M. Palbociclib in combination with endocrine therapy versus capecitabine in hormonal receptor-positive, human epidermal growth factor 2-negative, aromatase inhibitor-resistant metastatic breast cancer: a phase III randomised controlled trial-PEARL. Ann Oncol 2020; 32:488-499. [PMID: 33385521 DOI: 10.1016/j.annonc.2020.12.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [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: 09/01/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Palbociclib plus endocrine therapy (ET) is the standard treatment of hormone receptor-positive and human epidermal growth factor receptor 2-negative, metastatic breast cancer (MBC). However, its efficacy has not been compared with that of chemotherapy in a phase III trial. PATIENTS AND METHODS PEARL is a multicentre, phase III randomised study in which patients with aromatase inhibitor (AI)-resistant MBC were included in two consecutive cohorts. In cohort 1, patients were randomised 1 : 1 to palbociclib plus exemestane or capecitabine. On discovering new evidence about estrogen receptor-1 (ESR1) mutations inducing resistance to AIs, the trial was amended to include cohort 2, in which patients were randomised 1 : 1 between palbociclib plus fulvestrant and capecitabine. The stratification criteria were disease site, prior sensitivity to ET, prior chemotherapy for MBC, and country of origin. Co-primary endpoints were progression-free survival (PFS) in cohort 2 and in wild-type ESR1 patients (cohort 1 + cohort 2). ESR1 hotspot mutations were analysed in baseline circulating tumour DNA. RESULTS From March 2014 to July 2018, 296 and 305 patients were included in cohort 1 and cohort 2, respectively. Palbociclib plus ET was not superior to capecitabine in both cohort 2 [median PFS: 7.5 versus 10.0 months; adjusted hazard ratio (aHR): 1.13; 95% confidence interval (CI): 0.85-1.50] and wild-type ESR1 patients (median PFS: 8.0 versus 10.6 months; aHR: 1.11; 95% CI: 0.87-1.41). The most frequent grade 3-4 toxicities with palbociclib plus exemestane, palbociclib plus fulvestrant and capecitabine, respectively, were neutropenia (57.4%, 55.7% and 5.5%), hand/foot syndrome (0%, 0% and 23.5%), and diarrhoea (1.3%, 1.3% and 7.6%). Palbociclib plus ET offered better quality of life (aHR for time to deterioration of global health status: 0.67; 95% CI: 0.53-0.85). CONCLUSIONS There was no statistical superiority of palbociclib plus ET over capecitabine with respect to PFS in MBC patients resistant to AIs. Palbociclib plus ET showed a better safety profile and improved quality of life.
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Affiliation(s)
- M Martin
- Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Medicine Department, Universidad Complutense, Madrid, Spain; Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain.
| | - C Zielinski
- Medical Oncology, Central European Cancer Center, Wiener Privatklinik Hospital, Vienna, Austria; CECOG Central European Cooperative Oncology Group, Vienna, Austria
| | - M Ruiz-Borrego
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - E Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - N Turner
- Institute of Cancer Research and Royal Marsden, London, UK
| | - E M Ciruelos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain; Medical Oncology, HM Hospitales Madrid, Madrid, Spain; SOLTI Group on Breast Cancer Research, Barcelona, Spain
| | - M Muñoz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clinic de Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors (IDIBAPS), Barcelona, Spain
| | - B Bermejo
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Biomedical Research Institute INCLIVA, Valencia, Spain
| | - M Margeli
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; B-ARGO Group, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - A Anton
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Z Kahan
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - T Csöszi
- Department of Oncology, Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rendelőintezet, Szolnok, Hungary
| | - M I Casas
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - L Murillo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico de Zaragoza Lozano Blesa, Zaragoza, Spain
| | - S Morales
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - E Alba
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; UGCI Medical Oncology, Hospitales Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - E Gal-Yam
- Department of Oncology, Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
| | - A Guerrero-Zotano
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Instituto Valenciano de Oncología, Valencia, Spain
| | - L Calvo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Complejo Hospitalario A Coruña, Coruña, Spain
| | - J de la Haba-Rodriguez
- Oncology Biomedical Research National Network (CIBERONC-ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Reina Sofia, Córdoba; Instituto Maimonides de Investigación Biomédica (IMIBIC); Universidad de Córdoba, Córdoba, Spain
| | - M Ramos
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Centro Oncológico de Galicia, A Coruña, Coruña, Spain
| | - I Alvarez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Universitario Donostia-Biodonostia, San Sebastián, Spain
| | - A Garcia-Palomo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital de León, León, Spain
| | | | - M Koehler
- Pfizer, USA; Repare Therapeutics, Cambridge, USA
| | - R Caballero
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | | | - J A Garcia-Sáenz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - J I Chacón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Medical Oncology, Hospital Virgen de la Salud, Toledo, Spain
| | - C Swift
- Ralph Lauren Centre for Breast Cancer Research, Royal Marsden, London, UK
| | - C Thallinger
- CECOG Central European Cooperative Oncology Group, Vienna, Austria; Department of Oncology, Medical University of Vienna, Department of Oncology, Vienna, Austria
| | - M Gil-Gil
- GEICAM Spanish Breast Cancer Group, Madrid, Spain; Institut Català d'Oncologia (ICO) & IDIBELL, L'Hospitalet, Barcelona, Spain
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Hervé L, Kraemer DCA, Cioni O, Mandula O, Menneteau M, Morales S, Allier C. Alternation of inverse problem approach and deep learning for lens-free microscopy image reconstruction. Sci Rep 2020; 10:20207. [PMID: 33214618 PMCID: PMC7678858 DOI: 10.1038/s41598-020-76411-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/29/2020] [Accepted: 10/06/2020] [Indexed: 11/29/2022] Open
Abstract
A lens-free microscope is a simple imaging device performing in-line holographic measurements. In the absence of focusing optics, a reconstruction algorithm is used to retrieve the sample image by solving the inverse problem. This is usually performed by optimization algorithms relying on gradient computation. However the presence of local minima leads to unsatisfactory convergence when phase wrapping errors occur. This is particularly the case in large optical thickness samples, for example cells in suspension and cells undergoing mitosis. To date, the occurrence of phase wrapping errors in the holographic reconstruction limits the application of lens-free microscopy in live cell imaging. To overcome this issue, we propose a novel approach in which the reconstruction alternates between two approaches, an inverse problem optimization and deep learning. The computation starts with a first reconstruction guess of the cell sample image. The result is then fed into a neural network, which is trained to correct phase wrapping errors. The neural network prediction is next used as the initialization of a second and last reconstruction step, which corrects to a certain extent the neural network prediction errors. We demonstrate the applicability of this approach in solving the phase wrapping problem occurring with cells in suspension at large densities. This is a challenging sample that typically cannot be reconstructed without phase wrapping errors, when using inverse problem optimization alone.
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Affiliation(s)
- L Hervé
- Univ. Grenoble Alpes, CEA, LETI, DTBS, 38000, Grenoble, France
| | - D C A Kraemer
- Univ. Grenoble Alpes, CEA, LETI, DTBS, 38000, Grenoble, France
| | - O Cioni
- Univ. Grenoble Alpes, CEA, LETI, DTBS, 38000, Grenoble, France
| | - O Mandula
- Univ. Grenoble Alpes, CEA, LETI, DTBS, 38000, Grenoble, France
| | - M Menneteau
- Univ. Grenoble Alpes, CEA, LETI, DTBS, 38000, Grenoble, France
| | - S Morales
- Univ. Grenoble Alpes, CEA, LETI, DTBS, 38000, Grenoble, France
| | - C Allier
- Univ. Grenoble Alpes, CEA, LETI, DTBS, 38000, Grenoble, France.
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14
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Morales S, Gasol Cudos A, Rodriguez Galindo A, Serrate Lopez A, Velasco Sanchez A, Melé Olivé J, Canosa Morales C. 228P Pathologic response to neoadjuvant antiher2 therapy in HER2 equivocal overexpression with FISH amplification. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.349] [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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15
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Gasol Cudos A, Morales S, Rodriguez Galindo A, Velasco Sanchez A, Serrate Lopez A, Mele Olive J, Canosa Morales C. 230P Pathologic response to neoadjuvant therapy in HER2 positive/oestrogen receptor positive breast cancer patients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.351] [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] Open
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16
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Ocaña A, Chacón JILM, Calvo L, Antón A, Mansutti M, Alba E, Lluch A, Lahuerta A, Bisagni G, Bermejo B, Semiglazov V, Thill M, Chan A, Morales S, Albanell J, Herranz J, Trias Bes IT, Valagussa P, Chiesa M, Gianni L. Association of derived neutrophil-to-lymphocyte ratio (dNLR) with pathological complete response (pCR) after neoadjuvant chemotherapy (CT). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.094] [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: 11/13/2022] Open
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17
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Ortega JC, Adaniel C, Morales S, Gasol A, Veas J, Rodriguez A, Blanco AC, Salud A. EP1.01-92 Effectiveness of Second-Line Treatment with Nintedanib + Docetaxel (ND) in Patients with Metastatic Lung Adenocarcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Alés-Martínez J, Morales S, Fernández Abad M, Sánchez-Rovira P, Salvador Bofill F, Lahuerta A, García-Sáenz J, Garau Llinas I, Díaz Redondo T, Ferrer N, Carañana V, López R, Alonso Soler S, Bermejo B, de la Haba J, Zamora P, Balmana J, López-Miranda E, Cortés J, Llombart Cussac A. Effectiveness of olaparib plus trastuzumab in HER2[+], BRCA–mutated (BRCAm) or homologous recombination deficient (HRD) advanced breast cancer (ABC) patients (pts). The OPHELIA study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz242.079] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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19
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Martín M, Loibl S, Hyslop T, De la Haba-Rodríguez J, Aktas B, Cirrincione CT, Mehta K, Barry WT, Morales S, Carey LA, Garcia-Saenz JA, Partridge A, Martinez-Jañez N, Hahn O, Winer E, Guerrero-Zotano A, Hudis C, Casas M, Rodriguez-Martin C, Furlanetto J, Carrasco E, Dickler MN. Evaluating the addition of bevacizumab to endocrine therapy as first-line treatment for hormone receptor-positive metastatic breast cancer: a pooled analysis from the LEA (GEICAM/2006-11_GBG51) and CALGB 40503 (Alliance) trials. Eur J Cancer 2019; 117:91-98. [PMID: 31276981 DOI: 10.1016/j.ejca.2019.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 03/05/2019] [Revised: 05/20/2019] [Accepted: 06/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Randomised trials comparing the efficacy of standard endocrine therapy (ET) versus experimental ET + bevacizumab (Bev) in 1st line hormone receptor-positive patients with metastatic breast cancer have thus far shown conflicting results. PATIENTS AND METHODS We pooled data from two similar phase III randomised trials of ET ± Bev (LEA and Cancer and Leukemia Group B 40503) to increase precision in estimating treatment effect. Primary end-point was progression-free survival (PFS). Secondary end-points were overall survival (OS), objective response rate (ORR), clinical benefit rate (CBR) and safety. Exploratory analyses were performed within subgroups defined by patients with recurrent disease, de novo disease, prior endocrine sensitivity or resistance and reported grades III-IV hypertension and proteinuria. RESULTS The pooled sample consisted of 749 patients randomised to ET or ET + Bev. Median PFS was 14.3 months for ET versus 19 months for ET + Bev (unadjusted hazard ratio [HR] 0.77; 95% confidence interval [CI] 0.66-0.91; p < 0.01). ORR and CBR with ET and ET + Bev were 40 versus 61% (p < 0.01) and 64 versus 77% (p < 0.01), respectively. There was no difference in OS (HR 0.96; 95% CI 0.77-1.18; p = 0.68). PFS was superior for ET + Bev for endocrine-sensitive patients (HR 0.68; 95% CI 0.53-0.89; p = 0.004). Grade III-IV hypertension (2.2 versus 20.1%), proteinuria (0 versus 9.3%), cardiovascular (0.5 versus 4.2%) and liver events (0 versus 2.9%) were significantly higher for ET + Bev (all p < 0.01). Hypertension and proteinuria were not predictors of efficacy (interaction test p = 0.33). CONCLUSION The addition of Bev to ET increased PFS overall and in endocrine-sensitive patients but not OS at the expense of significant additional toxicity. TRIALS REGISTRATION ClinicalTrial.Gov NCT00545077 and NCT00601900.
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Affiliation(s)
- M Martín
- Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense Madrid, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Spain.
| | - S Loibl
- GBG (German Breast Group), Neu-Isenburg, Germany
| | - T Hyslop
- Alliance Statistics and Data Center, Duke University, Durham, NC, USA
| | - J De la Haba-Rodríguez
- Oncology Department and Research Unit, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Reina Sofía, Universidad de Córdoba Spain. Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Spain
| | - B Aktas
- University Women's Hospital Leipzig, Leipzig, Germany
| | - C T Cirrincione
- Alliance Statistics and Data Center, Duke University, Durham, NC, USA
| | - K Mehta
- GBG (German Breast Group), Neu-Isenburg, Germany
| | - W T Barry
- Alliance Statistics and Data Center, Dana-Farber/Partners Cancer Care, Boston, MA, USA
| | - S Morales
- Medical Oncology, Hospital Arnau de Vilanova de Lérida, GEICAM Spanish Breast Cancer Group, Spain
| | - L A Carey
- University of North Carolina, Chapel Hill, NC, USA
| | - J A Garcia-Saenz
- Medical Oncology, Instituto de Investigación Sanitaria del Hospital Clinico San Carlos (IdISSC) Madrid, Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, GEICAM Spanish Breast Cancer Group, Spain
| | - A Partridge
- Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - N Martinez-Jañez
- Medical Oncology. Universitary Hospital Ramon y Cajal. GEICAM, Spanish Breast Cancer Group; Madrid, Spain
| | - O Hahn
- Alliance Protocol Operations Office, University of Chicago, Chicago, IL, USA
| | - E Winer
- Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - A Guerrero-Zotano
- Medical Oncology. Valencian Institute of Oncology. GEICAM Spanish Breast Cancer Group, Valencia, Spain
| | - C Hudis
- American Society of Clinical Oncology (ASCO), Alexandria, VA, USA
| | - M Casas
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | - J Furlanetto
- GBG (German Breast Group), Neu-Isenburg, Germany
| | - E Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
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Allier C, Hervé L, Mandula O, Blandin P, Usson Y, Savatier J, Monneret S, Morales S. Quantitative phase imaging of adherent mammalian cells: a comparative study. Biomed Opt Express 2019; 10:2768-2783. [PMID: 31259050 PMCID: PMC6583341 DOI: 10.1364/boe.10.002768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 05/30/2023]
Abstract
The Quantitative phase imaging methods have several advantages when it comes to monitoring cultures of adherent mammalian cells. Because of low photo-toxicity and no need for staining, we can follow cells in a minimally invasive way over a long period of time. The ability to measure the optical path difference in a quantitative manner allows the measurement of the cell dry mass, an important metric for studying the growth kinetics of mammalian cells. Here we present and compare cell measurements obtained with three different techniques: digital holographic microscopy, lens-free microscopy and quadriwave lateral sheering interferometry. We report a linear relationship between optical volume density values measured with these different techniques and estimate the precisions of this measurement for the different individual instruments.
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Affiliation(s)
- C. Allier
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - L. Hervé
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - O. Mandula
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - P. Blandin
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - Y. Usson
- TIMC-IMAG, Uni. Grenoble Alpes, CNRS UMR 5525, France
| | - J. Savatier
- Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille,
France
| | - S. Monneret
- Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille,
France
| | - S. Morales
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
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21
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Mejia B, Morales S, Forero A, Casale M, Franco J. Surgery first approach and condilectomy for management of facial asymmetry. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Cordoba Ortega J, Salud A, Morales S, Veas J, Rodriguez A. TTF1 status in non-small cell lung cancer adenocarcinoma: A prognostic factor. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz072.014] [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: 11/13/2022] Open
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Aslam S, Pretorius V, Adler E, Lehman S, Morales S, Gaidamaka A, Furr C, Rosas F, Bishop-Lilly K, Biswas B, Sisson B, Fackler J, Trigg M, Schooley R. Novel Bacteriophage Therapy for Treatment of Ventricular Assist Device Infections. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.542] [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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Cordoba Ortega J, Salud A, Morales S, Veas J, Rodriguez A. High blood platelets levels (BPL): A prognostic factor in patients with early or locally advanced non-small cell lung cancer (NSCLC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz064.012] [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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Aapro MS, Hegg R, Ruiz Borrego M, Staroslawska E, Morales S, Cinieri S, De Freitas Junior R, Garcia Estevez L, Szombara E, Hervieu H, Groc M, Villanova GR. Abstract P1-14-01: Final results of NorBreast-231, a randomized phase II study evaluating weekly oral vinorelbine versus weekly paclitaxel as first-line chemotherapy in patients with advanced breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-14-01] [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: Single-agent chemotherapy (CT) is the standard treatment option in endocrine receptor (ER)-positive advanced breast cancer (ABC) after failure of endocrine therapy (ET) or in patients (pts) without visceral crisis. Both weekly paclitaxel (WP) and oral vinorelbine (OV) are among the recommended treatment options in this setting. The aim of this study was to evaluate the efficacy and safety profiles of OV and WP in a face to face study.
Material and methods: Pts with ER-positive, HER2-negative ABC, with an age ≥18 years and with a documented locally recurrent or metastatic involvement previously untreated by CT were eligible. Pts were randomized to receive, as first-line CT, 3 weekly-cycles of either: ARM A: weekly OV, given as a 80 mg/m2 dose (following a first cycle at 60 mg/m2, dose escalation to 80 in the absence of grade 3 or 4 toxicity at cycle 1); ARM B: WP 80 mg/m2 per week. Primary endpoint was disease control rate (DCR). Pts were stratified according to prior taxane CT and visceral metastases.
Results: 131 pts have been treated (OV: 66, WP: 65). Baseline pts characteristics (Arms OV/WP): median age 58/61 years; median number of prior ET: 2/2; prior (neo) adjuvant CT 74/72%; prior anthracycline 67/62%; prior taxane: 41/42%; >3 metastatic sites 42/48%; visceral metastases 79/79%. Median number of cycles (range): 6(1-55)/7(1-44); dose escalation of OV was performed in 75% of pts. Safety: most common non-hematological related G3/4 adverse events per pt were fatigue 8/2%, peripheral neuropathy 0/5%, nausea 3/0%, diarrhoea 3/2%, vomiting 3/0%, constipation 3/2%, alopecia (G2) 2/34%, no toxic deaths; febrile neutropenia was present in 2/0% of pts. Quality of life: over time, no major differences between both arms have been observed. Efficacy: DCR in the intent-to-treat population was [95%CI] 75.8 [63.6-85.5] /75.4 [63.1-85.2]%; overall response rate 20/40%; median progression-free survival: 5.5/6.4 months. Median overall survival was: OV 27.6/WP 22.3 months.
Conclusion: Both OV and WP reached similar DCR rates of 75%. Each regimen presented a specific tolerance profile, with, in particular, a lower incidence of alopecia and peripheral neuropathy with OV. OV and WP are valid first-line CT options for ER-positive/HER2-negative pts with ABC.
Citation Format: Aapro MS, Hegg R, Ruiz Borrego M, Staroslawska E, Morales S, Cinieri S, De Freitas Junior R, Garcia Estevez L, Szombara E, Hervieu H, Groc M, Villanova GR. Final results of NorBreast-231, a randomized phase II study evaluating weekly oral vinorelbine versus weekly paclitaxel as first-line chemotherapy in patients with advanced 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 P1-14-01.
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Affiliation(s)
- MS Aapro
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - R Hegg
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - M Ruiz Borrego
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - E Staroslawska
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - S Morales
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - S Cinieri
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - R De Freitas Junior
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - L Garcia Estevez
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - E Szombara
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - H Hervieu
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - M Groc
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
| | - GR Villanova
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Perola Byington, Sao Paulo, Brazil; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Araujo Jorge, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Medicament, Boulogne-Billancourt, France
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Velasco Sánchez A, Gasol Cudos A, Morales S, Veas Rodriguez J, Serrate López A, Mele Olivé J, Canosa Morales C. Abstract P3-08-24: Mutational characterization of HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-24] [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: Studies of mutational analysis have been widely reported in various global series of breast cancer. However, in the era of different phenotypes of breast cancer, these analyses should be more specific in order to find differences in each phenotype that could predict response to treatment. Particularly HER2 positive is a special subtype with different connotations that make the analysis of its genotype very interesting.
Methods: Cohorts of 47 consecutive samples of HER2 positive breast cancer, treated in our institution were analyzed. It was conducted a mutational study with NGS technique of the most common genes involved in breast cancer.
Results: 10 patients were metastatic at diagnostic, 17 with negative estrogen receptor expression, the median value of Ki67 was 45 (20-95) and the median initial tumor size was 33.5 mm (18-111). Inmunohistochemical expression of HER2 was +3 in 31 tumors and +2 in 15 with a median ratio by FISH of 3,2 (1,18-8,3). We also analyzed the expression of HER by PCR of mRNA in 35 samples with a median expression of 2,49 (0,26-33,15). 38 patients underwent surgical excision of the tumor with a pathologic complete response observed in 19.
We found a total of 38 significant mutations and the genes with more frequent mutations were MCPH1 (100%), HNF1 (98%), p53 (96%), somatic BRCA1 (62%), TSC1 (30%), PIK3CA (23%), ATM (21%), ALK (15%) and somatic BRCA2 (13%). Although the aim of the study was to find the most frequent mutations in this subtype, we have also analyzed possible correlations of those with pathological response or with more common variables, finding no significance in any of them.
Conclusions: In our series, we found a high percentage of mutations in MCPH1, HNF1 and p53 genes with almost 100% of mutations in p53 that are also limited in a very specific area. Also interesting is the 62% of mutations found in BRCA1 and 13% in BRCA2 that could allow more specific treatments in this subgroup. Although the study did not have the power to assess the predictive factor of these mutations, it is very suggestive that in the 7 patients with BRCA mutations, 6 achieved a complete pathological response.
Citation Format: Velasco Sánchez A, Gasol Cudos A, Morales S, Veas Rodriguez J, Serrate López A, Mele Olivé J, Canosa Morales C. Mutational characterization of 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 P3-08-24.
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Affiliation(s)
| | - A Gasol Cudos
- Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - S Morales
- Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | | | | | - J Mele Olivé
- Hospital Universitari Arnau de Vilanova, Lleida, Spain
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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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Gnant M, Martin M, Holmes FA, Jackisch C, Chia SK, Iwata H, Moy B, Martinez N, Mansi J, Morales S, Ruiz-Borrego M, von Minckwitz G, Buyse M, Delaloge S, Bhandari M, Murias Rosales A, Galeano T, Fujita T, Luczak A, Barrios CH, Saura C, Rugo HS, Chien J, Johnston SR, Spencer M, Xu F, Barnett B, Chan A, Ejlertsen B. Abstract P2-13-01: Efficacy of neratinib in hormone receptor-positive patients who initiated treatment within 1 year of completing trastuzumab-based adjuvant therapy in HER2+ early-stage breast cancer: Subgroup analyses from the phase III ExteNET trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-13-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The international, randomized, placebo-controlled phase III ExteNET trial showed that 1 year (yr) of neratinib 240 mg/day after trastuzumab-based adjuvant therapy significantly improved invasive disease-free survival (iDFS) in 2840 patients with early-stage HER2+ breast cancer at 2 yr (hazard ratio 0.67; 95% CI 0.50–0.91; p=0.009) [Chan 2016] and 5 yr (hazard ratio 0.73; 95% CI 0.57-0.92; p=0.008) [Martin 2017]. A prespecified subgroup analysis by hormone receptor (HR) status suggested enhanced efficacy with neratinib in patients with HR+ (2-yr hazard ratio 0.51; 95% CI 0.33–0.77) vs. HR– tumors (2-yr hazard ratio 0.93; 95% CI 0.60–1.43). The efficacy of neratinib was also greater in patients who initiated treatment within 1 yr of prior trastuzumab compared with those who started neratinib later. The European Medicines Agency's Committee for Medicinal Products for Human Use recently recommended neratinib for use in patients with HR+ tumors who initiate treatment within 1 yr of completing trastuzumab-based adjuvant therapy. Subgroup analyses from ExteNET examining iDFS benefits in this patient population are presented here.
Methods: Patients with early-stage HER2+ breast cancer who completed trastuzumab-based (neo)adjuvant therapy were assigned to oral neratinib 240 mg/day or placebo for 1 yr. Randomization was stratified by HR status (determined locally before trial entry), nodal status, and trastuzumab regimen. Endocrine therapy was allowed in patients with HR+ disease. The primary endpoint, iDFS, was tested by 2-sided log-rank test and hazard ratios (95% CI) were estimated using Cox proportional hazards models. Kaplan-Meier methods were used to estimate iDFS rates. Secondary endpoints were DFS-DCIS, time to distant recurrence, distant DFS, and CNS recurrences. The primary analysis was conducted at 2 yr, and a sensitivity analysis conducted at 5 yr. Clinicaltrials.gov:NCT00878709.
Results: Of the 2840 patients (neratinib, n=1420; placebo, n=1420), 1631 (57%) had HR+ disease (neratinib, n=816; placebo, n=815). Most (93%) HR+ patients were receiving endocrine therapy at baseline. 1334 of 1631 (82%) patients with HR+ tumors were randomized to start neratinib within 1 yr of last trastuzumab dose (neratinib, n=670; placebo, n=664). iDFS benefits from neratinib in this population are shown in the table. Secondary endpoints were also improved with neratinib vs. placebo in this population. Safety data in this subset will be presented at the meeting.
Table. iDFS in patients with an interval between last trastuzumab dose and randomization of ≤1 yr
HR+ population (N=1334)ITT population (N=2297) Hazard ratiob Hazard ratiob Δ, %a(95% CI)P-valueΔ, %a(95% CI)P-value2-yr analysisc+4.50.490.002+2.90.630.006 (0.30–0.78) (0.45–0.88) 5-yr analysisd+5.10.580.002+3.20.700.006 (0.41–0.82) (0.54–0.90) aDifference in iDFS rates between neratinib vs. placebo; bNeratinib vs. placebo; cData cut-off: July 2014; dData cut-off: March 2017
Conclusions: Neratinib may have enhanced and sustained efficacy in patients with HR+ disease who initiate treatment within 1 yr of trastuzumab-based adjuvant therapy.
Citation Format: Gnant M, Martin M, Holmes F-A, Jackisch C, Chia SK, Iwata H, Moy B, Martinez N, Mansi J, Morales S, Ruiz-Borrego M, von Minckwitz G, Buyse M, Delaloge S, Bhandari M, Murias Rosales A, Galeano T, Fujita T, Luczak A, Barrios CH, Saura C, Rugo HS, Chien J, Johnston SR, Spencer M, Xu F, Barnett B, Chan A, Ejlertsen B. Efficacy of neratinib in hormone receptor-positive patients who initiated treatment within 1 year of completing trastuzumab-based adjuvant therapy in HER2+ early-stage breast cancer: Subgroup analyses from the phase III ExteNET trial [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 P2-13-01.
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Affiliation(s)
- M Gnant
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Martin
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - F-A Holmes
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - C Jackisch
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - SK Chia
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - H Iwata
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - B Moy
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - N Martinez
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - J Mansi
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - S Morales
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Ruiz-Borrego
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - G von Minckwitz
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Buyse
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - S Delaloge
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Bhandari
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - A Murias Rosales
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - T Galeano
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - T Fujita
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - A Luczak
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - CH Barrios
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - C Saura
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - HS Rugo
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - J Chien
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - SR Johnston
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - M Spencer
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - F Xu
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - B Barnett
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - A Chan
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
| | - B Ejlertsen
- Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain; Texas Oncology, Houston, TX; Sana Klinikum Offenbach, Offenbach, Germany; British Columbia Cancer Agency, Vancouver, Canada; Aichi Cancer Center Hospital, Chikusa-ku Nagoya, Japan; Massachusetts General Hospital Cancer Center, Boston, MA; Hospital Universitario Ramón y Cajal, Madrid, Spain; Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, United Kingdom; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen del Rocio, Seville, Spain; German Breast Group, Neu-Isenburg, Germany; International Drug Development Institute, San Francisco, CA; Institut Gustave Roussy, Villejuif, France; Christ Hospital of Cincinnati, Cincinnati, OH; Compejo Hospitalario Materno Insular de Las Palmas, Las Palmas, Spain; Magna Graecia University, Catan
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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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Crown J, Sablin MP, Cortés J, Bergh J, Im SA, Lu YS, Martínez N, Neven P, Lee KS, Morales S, Pérez-Fidalgo JA, Adamson D, Goncalves A, Prat A, Jerusalem G, Schlieker L, Espadero RM, Bogenrieder T, Chin-Lun Huang D, Schmid P. Abstract P6-21-01: Xentuzumab (BI 836845), an insulin-like growth factor (IGF)-neutralizing antibody (Ab), combined with exemestane and everolimus in hormone receptor-positive (HR+) locally advanced/metastatic breast cancer (LA/mBC): Randomized phase 2 results. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-21-01] [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: 11/16/2022]
Abstract
Abstract
Background:
Xentuzumab (Xen), an IGF-1/-2-neutralizing Ab, binds IGF-1 and IGF-2, inhibits their growth-promoting signaling, and suppresses AKT activation by everolimus (Ev). This Phase 1b/2 trial evaluates Xen in combination with Ev and exemestane (Ex) in HR+/HER2− LA/mBC.
Methods:
The two-arm, open-label, randomized Phase 2 part enrolled female patients (pts) with HR+/HER2− LA/mBC not amenable to curative therapy and refractory to nonsteroidal aromatase inhibitors. Pts were randomized (1:1) to: oral Ev (10 mg/d) + Ex (25 mg/d); or Xen (1000 mg/wk iv) + Ev (10 mg/d) + Ex (25 mg/d). Randomization was stratified by visceral metastases (VM; Y vs N). Treatment continued in 28-day cycles until progression, intolerable adverse events (AEs) or other reasons for discontinuation. Primary endpoint was progression-free survival (PFS), with an interim futility analysis incorporated in the study design.
Results:
Following the results of the interim analysis, the Data Monitoring Committee (DMC) advised early termination of the trial and discontinuation of Xen treatment. Thus, Xen treatment exposure time and time-to-event data for the Xen+Ev+Ex arm are limited. Of the 139 women treated (Xen+Ev+Ex 70; Ev+Ex 69), 77% had VM. Median PFS was not significantly different between arms (Xen+Ev+Ex vs Ev+Ex, 7.3 vs 5.6 months; HR [95% CI] 0.97 [0.57–1.65]; p=0.91). In a pre-specified subgroup of pts without VM, Xen+Ev+Ex showed favorable PFS vs Ev+Ex (HR 0.21 [0.05–0.98]; Pint=0.0141). Pint values <0.05 were also observed for ad hoc subgroups: measurable disease at baseline; bone-only metastases. Rates of total AEs/grade ≥3 AEs/drug-related AEs were similar between arms (Xen+Ev+Ex, 100/60/96%; Ev+Ex, 99/58/96%). The most common AEs overall were diarrhea (44 vs 33%), mucosal inflammation (39 vs 32%), rash (34 vs 33%) and stomatitis (34 vs 38%); most were grade 1/2. 6% of pts in the Xen+Ev+Ex arm discontinued Xen due to AEs. Ev/Ex discontinuations (Xen+Ev+Ex vs Ev+Ex) occurred in 13/6% vs 23/6%; 1 pt each in the Xen+Ev+Ex arm died from pneumonitis and liver injury and 1 pt each in the Ev+Ex arm died from Burkitt's lymphoma, acute kidney injury and metastases to the peritoneum.
Conclusion:
In the overall population, PFS did not improve with the addition of Xen to Ev+Ex and the trial was therefore discontinued early. Nevertheless, a favorable signal was observed in the pre-specified subgroup of pts without VM when treated with Xen+Ev+Ex, which warrants additional investigation. The safety profile was comparable between arms.
Citation Format: Crown J, Sablin M-P, Cortés J, Bergh J, Im S-A, Lu Y-S, Martínez N, Neven P, Lee KS, Morales S, Pérez-Fidalgo JA, Adamson D, Goncalves A, Prat A, Jerusalem G, Schlieker L, Espadero R-M, Bogenrieder T, Chin-Lun Huang D, Schmid P. Xentuzumab (BI 836845), an insulin-like growth factor (IGF)-neutralizing antibody (Ab), combined with exemestane and everolimus in hormone receptor-positive (HR+) locally advanced/metastatic breast cancer (LA/mBC): Randomized phase 2 results [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 P6-21-01.
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Affiliation(s)
- J Crown
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - M-P Sablin
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - J Cortés
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - J Bergh
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - S-A Im
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - Y-S Lu
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - N Martínez
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - P Neven
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - KS Lee
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - S Morales
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - JA Pérez-Fidalgo
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - D Adamson
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - A Goncalves
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - A Prat
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - G Jerusalem
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - L Schlieker
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - R-M Espadero
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - T Bogenrieder
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - D Chin-Lun Huang
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
| | - P Schmid
- St Vincent's University Hospital, Dublin, Ireland; Institut Curie, Paris, France; Ramon y Cajal University Hospital, Madrid, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; National University Hospital, Seoul, Republic of Korea; National Taiwan University Hospital, Taipei, Taiwan; UZ Leuven, Campus Gasthuisberg, Lueven, Belgium; National Cancer Center, Goyang, Republic of Korea; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain; Ninewells Hospital, Tayside Cancer Centre, Dundee, United Kingdom; Institut Paoli Calmettes, Marseille, France; Hospital Clínic de Barcelona Servicio de Oncología Médica, Barcelona, Spain; Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium; External Statistician on Behalf of Boehringer Ingelheim Pharma GmbH & Co. KG, Staburo GmbH & Co. KG
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Herve L, Cioni O, Blandin P, Navarro F, Menneteau M, Bordy T, Morales S, Allier C. Multispectral total-variation reconstruction applied to lens-free microscopy. Biomed Opt Express 2018; 9:5828-5836. [PMID: 30460165 PMCID: PMC6238925 DOI: 10.1364/boe.9.005828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/27/2018] [Accepted: 09/26/2018] [Indexed: 05/05/2023]
Abstract
Lens-free microscopy multispectral acquisitions are processed with an inverse problem approach: a multispectral total variation criterion is defined and minimized with the conjugate gradients method. Reconstruction results show that the method is efficient to recover the phase image of densely packed cells.
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Affiliation(s)
- L Herve
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - O Cioni
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - P Blandin
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - F Navarro
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSMB, F-38000 Grenoble, France
| | - M Menneteau
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSMB, F-38000 Grenoble, France
| | - T Bordy
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - S Morales
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
| | - C Allier
- Univ. Grenoble Alpes, CEA, LETI, DTBS-LSIV, F-38000 Grenoble, France
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Blancas I, Aguirre E, Morales S, Gonzálvez ML, Servitja S, Díaz N, Del Barco S, Barnadas A, Margelí M, García Carbonero I, Llombart A. Real-world data on the efficacy and safety of weekly oral vinorelbine in breast cancer patients previously treated with anthracycline or taxane-based regimens. Clin Transl Oncol 2018; 21:459-466. [PMID: 30293232 DOI: 10.1007/s12094-018-1946-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/05/2018] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of oral weekly vinorelbine 60 mg/m2 for metastatic breast cancer (MBC) in patients previously treated with anthracyclines or taxanes in routine clinical practice. MATERIALS AND METHODS Fifty-five patients were enrolled in a prospective multicentre study conducted in Spain. Women ≥ 18 years of age with locally advanced breast cancer who were not candidates for surgical treatment with a radical intention or patients with stage IV disease, and who had received a prior taxane or anthracycline regimen were eligible for participation. RESULTS Median age was 67 years. Median progression-free survival was 3.7 months (95% CI 2.5-4.9), median overall survival 10 months (95% CI 6.6-13.5), and overall response rate and clinical benefit rate were 29.1% and 49.1%, respectively. Main grade 3 and 4 toxicities were neutropenia 9.1%, febrile neutropenia 3.6% and constipation 3.6%. In total, 86% of the patients received complete treatment without delays or dose reduction. Moreover, HER2-positive patients who received oral vinorelbine concomitantly with trastuzumab showed better response (complete response: HER2-positive 14.3% vs. HER2-negative 0%; partial response: HER2-positive 42.9% vs. HER2-negative 25.6%; p = 0.008), better disease control rate (HER2-positive 100% vs. HER2-negative 46.2%; p = 0.011), and better values for the remaining analysed variables than HER2-negative patients. CONCLUSION Our study provides real-world data on the use of oral weekly vinorelbine, which proves an effective and well-tolerated regimen for MBC patients previously treated with taxanes or anthracyclines. Patients with HER2-positive disease could also benefit from this treatment in combination with trastuzumab.
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Affiliation(s)
- I Blancas
- Department of Medical Oncology, University Hospital San Cecilio, Av. De la Investigación s/n, 18016, Granada, Spain.
| | - E Aguirre
- Department of Medical Oncology, University Hospital Arnau de Vilanova, Lleida, Spain
| | - S Morales
- Department of Medical Oncology, University Hospital Arnau de Vilanova, Lleida, Spain
| | - M L Gonzálvez
- Department of Medical Oncology, University Hospital Arrixaca, Murcia, Spain
| | - S Servitja
- Department of Medical Oncology, Hospital Del Mar, Barcelona, Spain
| | - N Díaz
- Department of Medical Oncology, University Hospital San Juan de Alicante, Alicante, Spain
| | - S Del Barco
- Department of Medical Oncology, Institut Català d'Oncologia, Girona, Spain
| | - A Barnadas
- Department of Medical Oncology, University Hospital Sant Pau, Barcelona, Spain
| | - M Margelí
- Department of Medical Oncology, Institut Català d'Oncologia, Badalona, Spain
| | - I García Carbonero
- Department of Medical Oncology, Virgen de La Salud Hospital, Toledo, Spain
| | - A Llombart
- Department of Medical Oncology, Arnau de Vilanova Hospital, Valencia, Spain
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Marzal A, Møller AP, Espinoza K, Morales S, Luján-Vega C, Cárdenas-Callirgos JM, Mendo L, Álvarez-Barrientos A, González-Blázquez M, García-Longoria L, de Lope F, Mendoza C, Iannacone J, Magallanes S. Variation in malaria infection and immune defence in invasive and endemic house sparrows. Anim Conserv 2018. [DOI: 10.1111/acv.12423] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- A. Marzal
- Department of Anatomy, Cellular Biology and Zoology; University of Extremadura; Badajoz Spain
| | - A. P. Møller
- Ecologie Systématique Evolution; Université Paris-Sud; CNRS; AgroParisTech; Université Paris-Saclay; Orsay Cedex France
| | - K. Espinoza
- Department of Veterinary Medicine; Universidad Científica del Sur; Villa Peru
| | - S. Morales
- Department of Veterinary Medicine; Universidad Científica del Sur; Villa Peru
- Department of Animal and Public Health; Faculty of Veterinary Medicine; Universidad Nacional Mayor de San Marcos; San Borja Peru
| | - C. Luján-Vega
- Global Health Initiative; Wabash College; Crawfordsville Indiana USA
- Pharmacology and Toxicology Graduate Group; University of California; Davis USA
| | | | - L. Mendo
- Área de Gestión de fauna Silvestre; Autoridad Regional Ambiental; Gobierno Regional de San Martín; Tarapoto Perú
| | - A. Álvarez-Barrientos
- Servicio de Técnicas Aplicadas a las Biociencias; Universidad de Extremadura; Badajoz Spain
| | - M. González-Blázquez
- Department of Anatomy, Cellular Biology and Zoology; University of Extremadura; Badajoz Spain
| | - L. García-Longoria
- Department of Anatomy, Cellular Biology and Zoology; University of Extremadura; Badajoz Spain
| | - F. de Lope
- Department of Anatomy, Cellular Biology and Zoology; University of Extremadura; Badajoz Spain
| | - C. Mendoza
- Laboratorio de Análisis Clínico Moraleslab SAC; Morales San Martín Perú
| | - J. Iannacone
- Laboratorio de Ecología y Biodiversidad Animal; Universidad Nacional Federico Villarreal; El Agustino; Lima Perú
- Laboratorio de Parasitología; Universidad Ricardo Palma; Santiago de Surco; Lima Perú
| | - S. Magallanes
- Department of Anatomy, Cellular Biology and Zoology; University of Extremadura; Badajoz Spain
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Brugha R, Martin I, Morales S, Lehman S, Alton E, Davies J. P035 Differential gene expression by Pseudomonas aeruginosa in response to bacteriophage infection. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30332-1] [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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Morales S, Velasco A, Gasol A, Córdoba F, Vidal J, Serrate A, Valls J, Samame JC, Gisbert R, Moral D, Llombart-Cussac A, Salud A, Matias-Guiu X. Circulating tumor cells (CTCs) and cytokeratin 19 (CK19) mRNA as prognostic factors in heavily pretreated patients with metastatic breast cancer. Cancer Treat Res Commun 2018; 16:13-17. [PMID: 31298997 DOI: 10.1016/j.ctarc.2018.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 01/09/2018] [Accepted: 04/03/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Circulating tumor cell (CTC) count and cytokeratin 19 (CK19) mRNA expression have a prognostic value for patients with metastatic breast cancer (MBC), but their clinical utility remains controversial. We studied CTC count and CK19 mRNA expression in the peripheral blood samples from heavily pretreated patients with MBC and their correlations with prognosis and response to the subsequent line of therapy. METHODS This prospective observational study included 67 consecutive patients with MBC who were on progression to systemic therapy, and criteria for a new line of systemic treatment were proposed outside a clinical trial. CTC counts and CK19 mRNA expression were measured by the CellSearch® and RT-PCR methods, respectively, before and after the first cycle of treatment. Progression-free survival (PFS) was defined as the time elapsed between the initiation of the treatment and either the date of clinical or radiological tumor progression or death from any cause or the last follow-up. Cox proportional hazards regression model was used to assess the univariate prognostic value of CTC and CK19 mRNA expression on PFS and Kaplan-Meier estimates. A multivariate Cox model was also used to additionally account for phenotype and visceral disease. RESULTS The mean age was 60 (range 35-86) years, and the average number of previous treatments was 3 (range 1-10); 42 patients (62.6%) were ER+ and 38 patients (56.7%) had visceral disease. The median PFS rate was 8 months (95% CI: 3.7-8.2). Univariate analyses showed a significant effect of the initial value of CK19 mRNA expression (HR = 2.00; 95% CI: 1.05-3.8; p = 0.03) and for the second value of CTC (HR = 2.18; 95% CI: 1.22-3.9; p = 0.009) but did not reach statistical significance for the initial value of CTC and the second value of CK19 mRNA expression. The estimated PFS rates at 6 and 12 months were 75% and 31% for patients with a low initial value of CK19 mRNA expression and 36% and 10% for those with a high initial value of CK19 mRNA expression, respectively (p: 0.022). Further, the estimated PFS rates at 6 and 12 months were 86% and 65% for patients with a low second value of CTC and 76% and 47% for those with a high second value of CTC, respectively (p: 0.004). In the multivariate analysis adjusted for phenotype, visceral disease, and the last treatment performed, only the effect of the second value of CTC remained significant (HR = 2.7, p = 0.004). CONCLUSIONS CK19 mRNA expression and CTC count appeared clinically meaningful in pretreated patients with MBC, even when adjusted for phenotype and visceral disease involvement. These results support the use of CK19 and CTC as relevant biomarkers for predicting clinical response in MBC.
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Affiliation(s)
- S Morales
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain.
| | - A Velasco
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - A Gasol
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - F Córdoba
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - J Vidal
- Hospital Arnau de Vilanova de Valencia, Spain
| | - A Serrate
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - J Valls
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - J C Samame
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - R Gisbert
- Hospital Arnau de Vilanova de Valencia, Spain
| | - D Moral
- Hospital Arnau de Vilanova de Valencia, Spain
| | | | - A Salud
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
| | - X Matias-Guiu
- Hospital Arnau de Vilanova de Lleida, Spain; Institut de recerca biomedica lleida, Spain
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Abstract
Adrenal cortical insufficiency secondary to destruction of the cortex by a metastatic tumor is a rare condition. Addison's disease is usually caused by an autoimmune process or by a tuberculous infection. We report a case of adrenal Insufficiency as the first clinical manifestation of a metastatic prostate carcinoma that occurred simultaneously with an active pulmonary infection by M. tuberculosis.
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Affiliation(s)
- M Navarro
- Department of Internal Medicine, Granollers Hospital, Barcelona, Spain
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Aslam S, Yung G, Dan J, Reed S, LeFebvre M, Logan C, Taplitz R, Law N, Golts E, Afshar K, Lehman S, Morales S, Furr C, Rosas F, Gaidamaka A, Bilinsky I, Grint P, Biswas B, Duplessis C, Hamilton T, Schooley R. Bacteriophage Treatment in a Lung Transplant Recipient. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.376] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Pascual T, Martín M, Pare L, Alba E, Rodríguez-Lescure A, Perrone G, Cortés J, Morales S, Lluch A, Urruticoechea A, Galván P, Rodríguez A, Chic N, Righi D, Cejalvo J, Tonini G, Adamo B, Vidal M, Muñoz M, Prat A. NOLUS: a predictive model to identify Basal-like and HER2-enriched intrinsic subtypes based on estrogen receptor (ER), progesterone receptor (PR) and Ki67 immunohistochemistry (IHC) in hormone receptor-positive/HER2-negative (HR+/HER2–) breast cancer (BC). Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30638-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ruiz Borrego M, Hegg R, Staroslawska E, Morales S, Cinieri S, De Freitas Junior R, Garcia Estevez L, Szombara E, Hervieu H, Groc M, Villanova G, Aapro M. NorBreast-231 trial: a randomized phase II study evaluating weekly oral vinorelbine versus weekly paclitaxel in estrogen receptor positive, HER2-negative patients with advanced breast cancer. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30523-9] [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: 11/28/2022]
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Gil-Gil M, Bellet M, Morales S, Barnadas A, Manso L, Morilla Ruiz I, Azaro A, Ciruelos Gil E, Garcia Martínez E, Marínez N, Melé M, Soler T, Villagrasa P, Pernas S. Abstract P6-15-06: SOLTI-0702 CAPRICE: Final results of a phase II study of pegylated liposomal doxorubicin plus cyclophosphamide followed by paclitaxel as neoadjuvant chemotherapy in elderly or cardiotoxicity-prone patients with high-risk breast cancer: 5-year overall survival disease free survival and late cardiac safety. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-15-06] [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:
Anthracycline and taxane-based chemotherapy is the standard treatment for high-risk breast cancer. However, conventional anthracyclines are not commonly used in elderly patients or those patients prone to cardiotoxicity and there is a potential risk leaving them undertreated. Pegylated liposomal doxorubicin (PLD) has comparable efficacy, but significantly less cardiotoxicity than conventional anthracyclines. We conducted a phase II trial to assess the efficacy and safety of a neoadjuvant chemotherapy (NC) based on PLD and paclitaxel (PTX) in this group of patients. The pathological complete response, breast conservative surgery (BCS) and safety data at a 35-month follow-up were published (Gil-Gil et al. Breast Cancer Res Treat 2015). Here we present the final analysis of 5-year overall survival (OS) and 5-year disease-free survival (DFS) and cardiac safety after 60 months of follow-up.
Methods:
Fifty patients with stage II (48%) and III (52%) breast cancer (seven cases were T4d) and with at least one risk factor for developing cardiotoxicity were included. NC schedule: PLD 35 mg/m2 plus cyclophosphamide 600 mg/m2 every 4 weeks for four cycles, followed by 80 mg/m2 weekly PTX for 12. Median age was 73 years old (84% were older than 65 years). Forty-eight (96%) of tumors were triple negative (TN). Secondary objectives included 5-year DFS, 5year OS and cardiac safety measured by a decrease in left ventricular ejection fraction (LVEF), electrocardiogram (ECG) anda cardiac questionnaire performed every 3 months during the first year, every 6 months year 2-3 and every 12 months year 4-5 of follow-up.
Results: Forty-eight patients (96%) completed the 4 cycles of PLD plus CPM, while only 26 patients (52%) could complete the 12 weeks of PTX. Forty-six patients (92%) underwent surgery. After surgery: 27 patients received radiotherapy, 2 letrozole and 1 trastuzumab. The 5-year OS was 56% (95% CI 41.2-68.4) and the 5-year DFS was 54.4% [95% CI: 38.3-67.9].No significant decrease in LVEF was seen (mean baseline LVEF was 66.6 (52-86) and mean LVEF after 60 months was 66 (54.5-73). Four patients (8%) developed cardiotoxicity (in 2 cases G3). There were 5 non-cancer deaths (10%): 3 during treatment (all in patients > 80 years: a sudden death one month after surgery, a haemorrhagic stroke 30 days after completing chemotherapy and a non-neutropenic pneumonia); and 2 during follow-up (1 Amyotrophic Lateral Sclerosis and 1 intestinal ischemia).
Conclusions:
PLD followed by PTX as NC was feasible in a fragile population of patients who were not candidates for conventional doxorubicin. The 5 year DFS and 5 year OS in elderly patients with bulky TN tumors were similar tothe reported in the literature. This regimen could be an option for the neoadjuvant treatment of cardiotoxicity-prone patients or elderly patients who present high-risk breast cancer.
Citation Format: Gil-Gil M, Bellet M, Morales S, Barnadas A, Manso L, Morilla Ruiz I, Azaro A, Ciruelos Gil E, Garcia Martínez E, Marínez N, Melé M, Soler T, Villagrasa P, Pernas S. SOLTI-0702 CAPRICE: Final results of a phase II study of pegylated liposomal doxorubicin plus cyclophosphamide followed by paclitaxel as neoadjuvant chemotherapy in elderly or cardiotoxicity-prone patients with high-risk breast cancer: 5-year overall survival disease free survival and late cardiac safety [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 P6-15-06.
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Affiliation(s)
- M Gil-Gil
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - M Bellet
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - S Morales
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - A Barnadas
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - L Manso
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - I Morilla Ruiz
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - A Azaro
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - E Ciruelos Gil
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - E Garcia Martínez
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - N Marínez
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - M Melé
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - T Soler
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - P Villagrasa
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
| | - S Pernas
- Institut Català d'Oncologia, IDIBELL, L' Hospitalet, Spain; Hospital Vall d´Hebron, Barcelona, Spain; Hospital Arnau de Vilanova, Leida, Spain; Hospital de Sant Pau, Barcelona, Spain; Hospital. 12 de Octubre, Madrid, Spain; Hospital. JM Morales Messeguer, Murcia, Spain; Hospital Ramón y Cajal, Madrid, Spain; Hospital Sant Joan, Reus, Spain; Hospital Universitari de Bellvitge, Barcelona, Spain; SOLTI, Barcelona, Spain
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Aapro M, Ruiz Borrego M, Staroslawska E, Morales S, Cinieri S, De Freitas Junior R, Garcia Estevez L, Szombara E, Hervieu H, Groc M, Villanova G, Hegg R. Abstract P6-14-03: Randomized phase II study evaluating weekly oral vinorelbine versus weekly paclitaxel in estrogen receptor positive, HER2-negative patients with advanced breast cancer (NorBreast-231 trial). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-14-03] [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
Rationale: Quality of Life is of prime importance in Advanced Breast Cancer (ABC), a mostly non-curable disease. Both paclitaxel (P) and vinorelbine as single-agent chemotherapy (CT) are recommended treatment options in the management of ABC non-responsive to hormone therapy (HT) and with no visceral crisis. These agents are active with a good tolerance profile. The benefits and safety of oral vinorelbine (OV) and weekly P have however never been evaluated in a face to face trial.
Methods: Main eligibility criteria included: age ≥18 years, documented locally recurrent or metastatic involvement previously untreated by CT, estrogen receptor positive disease previously treated by at least one HT, HER2-negative status, Karnofsky PS ≥70 and presence of at least one measurable lesion. Study treatment (until progression): Arm A, OV 80 mg/m2 weekly (following a first cycle at 60 mg/m2 and dose escalation to 80 in the absence of grade 3 or 4 toxicity); Arm B: paclitaxel 80 mg/m2 weekly. One cycle was defined as three weeks of treatment. Patients were stratified according to prior taxane (yes/no) and visceral metastases (yes/no). Primary endpoint was disease control rate (DCR), defined as confirmed complete response/partial response/stable disease of a minimum duration of 6 weeks.
Results: 131 pts have been randomized (OV 66; P 65). Baseline patient characteristics (Arms A/B): median age 58/61 years; median number of previous HT 2/2; prior (neo)adjuvant CT 74/72%; prior anthracycline 64/62%; prior taxane 39/42%; >3 metastatic sites 42/48%; visceral metastases 80/78%. Safety: the most common non-haematological related G3/4 adverse events (≥3% patients) were: fatigue 7.6/1.5%, peripheral neuropathy 0/4.6%, nausea 3/0%, diarrhoea 3/1.5%, vomiting 3/0%, constipation 3/1.5%; alopecia (G2) was present in 1.5/33.8%; no toxic deaths observed. Efficacy: DCR in the intent-to-treat population was [95%CI] 75.8 [63.6-85.5]/75.4 [63.1-85.2] %; overall response was 20/40%; stable disease was 56/35% respectively. Treatment exposure, other efficacy / safety parameters and quality of life results will be presented during the meeting.
Conclusion: Both OV and P reached similar DCR rates of 75%. As expected, each regimen presented a specific tolerance profile, with, in particular, a lower incidence of alopecia and peripheral neuropathy with OV.
Citation Format: Aapro M, Ruiz Borrego M, Staroslawska E, Morales S, Cinieri S, De Freitas Junior R, Garcia Estevez L, Szombara E, Hervieu H, Groc M, Villanova G, Hegg R. Randomized phase II study evaluating weekly oral vinorelbine versus weekly paclitaxel in estrogen receptor positive, HER2-negative patients with advanced breast cancer (NorBreast-231 trial) [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 P6-14-03.
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Affiliation(s)
- M Aapro
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - M Ruiz Borrego
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - E Staroslawska
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - S Morales
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - S Cinieri
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - R De Freitas Junior
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - L Garcia Estevez
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - E Szombara
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - H Hervieu
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - M Groc
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - G Villanova
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
| | - R Hegg
- Breast Center, Genolier Cancer Center, Genolier, Switzerland; Hospital Virgen del Rocio, Seville, Spain; Oncology Center, Lublin, Poland; Hospital Arnau de Vilanova, Lleida, Spain; Ospedale A. Perrino, Brindisi, Italy; Hospital Universitario Jorge Araujo, Goiania, Brazil; Hospital San Chinarro, Madrid, Spain; Marie Curie Oncology Center, Warsaw, Poland; Pierre Fabre Médicament, Boulogne-Billancourt, France; Hospital Perola Byington, Sao Paulo, Brazil
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Villagrasa Gonzalez P, Prat A, Oliveira M, de la Pena L, Gonzalez X, Cortes Castan J, Rios J, Vázquez J, Martínez Jañez N, Perelló Martorell A, Garau I, Martinez de Dueñas E, Morales S, Melé M, Bermejo De Las Heras B, Ciruelos E. SOLTI-1303 PATRICIA: A phase II study of palbociclib and trastuzumab (with or without letrozole in ER+) in previously trastuzumab-pretreated, postmenopausal patients with HER2-positive metastatic breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.084] [Citation(s) in RCA: 3] [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: 11/12/2022] Open
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von Minckwitz G, Ponomarova O, Morales S, Zhang N, Hanes V. Efficacy and safety of biosimilar ABP 980 compared with trastuzumab in HER2 positive early breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.002] [Citation(s) in RCA: 3] [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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Santasusagna S, Navarro A, Moreno I, Ibeas R, Martinez F, Castellano J, Muñoz C, Canals J, Morales S, Hernandez R, Moreno J, Monzo M. Exosomal ECM1 protein expression in plasma from the tumor-draining vein (mesenteric vein) and time to relapse in colon cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.103] [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: 11/13/2022] Open
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Morales S, Gasol Cudos A, Novell Alvarez A, Vilardell Villellas F, Panades Siurana M, Canosa Morales C, Mele Olive J, Iglesias Martinez E. Vitamin D as a prognostic factor in triple negative early breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.050] [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: 11/13/2022] Open
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Navarro A, Santasusagna S, Vinolas Segarra N, Castellano J, Moises J, Morales S, Canals J, Muñoz C, Ramírez J, Marrades R, Molins L, Monzo M. HOXA-related long non-coding RNAs impact prognosis in early stage NSCLC patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx381.010] [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: 11/13/2022] Open
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Morales S, Corsi MC, Fourcault W, Bertrand F, Cauffet G, Gobbo C, Alcouffe F, Lenouvel F, Le Prado M, Berger F, Vanzetto G, Labyt E. Magnetocardiography measurements with 4He vector optically pumped magnetometers at room temperature. Phys Med Biol 2017; 62:7267-7279. [PMID: 28257003 DOI: 10.1088/1361-6560/aa6459] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this paper, we present a proof of concept study which demonstrates for the first time the possibility of recording magnetocardiography (MCG) signals with 4He vector optically pumped magnetometers (OPM) operated in a gradiometer mode. Resulting from a compromise between sensitivity, size and operability in a clinical environment, the developed magnetometers are based on the parametric resonance of helium in a zero magnetic field. Sensors are operated at room temperature and provide a tri-axis vector measurement of the magnetic field. Measured sensitivity is around 210 f T (√Hz)-1 in the bandwidth (2 Hz; 300 Hz). MCG signals from a phantom and two healthy subjects are successfully recorded. Human MCG data obtained with the OPMs are compared to reference electrocardiogram recordings: similar heart rates, shapes of the main patterns of the cardiac cycle (P/T waves, QRS complex) and QRS widths are obtained with both techniques.
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Affiliation(s)
- S Morales
- CEA, LETI, MINATEC Campus, F-38054 Grenoble, France
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Martin I, Davies J, Morales S, Alton E. WS07.4 Combined killing effects of lytic bacteriophages and antibiotics in biofilm-grown Pseudomonas aeruginosa from CF airway cultures. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30197-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gavilá J, Perez-Garcia J, Calvo I, Ciruelos E, Muñoz M, Virizuela JA, Ruiz I, Andrés R, Morales S, Perelló A, Sánchez P, Garcia-Saenz JA, Quero Guillen JC, González-Santiago S, Garau Llinas I, González-Martín A, Cantos Sánchez de Ibargüen B, Zaragoza K, de la Peña L, Llombart-Cussac A, Oliveira M. Abstract P4-21-05: Neoadjuvant non-pegylated liposomal doxorubicin plus paclitaxel, trastuzumab and pertuzumab in patients with HER2+ breast cancer – Final results of the SOLTI OPTI-HER HEART study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-21-05] [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
INTRODUCTION
Targeting HER2 by dual blockade with trastuzumab (T) and pertuzumab (P) in a taxane-based regimen is an active neoadjuvant treatment (NAT) of HER2+ early breast cancer (EBC). Addition of an anthracycline could further enhance this response, but potential cardiac toxicity is a concern. The Opti-HER HEART trial (NCT01669239) aims to optimize neoadjuvant treatment while minimizing cardiac risk, by combining T+P with a taxane and non-pegylated liposomal doxorubicin (NPLD).
MATERIAL AND METHODS
Phase II open-label, single-arm study of six 21-day cycles of NPLD (50mg/m2 D1), paclitaxel (80mg/m2 D1,8,15), T (4mg/kg C1D1, followed by 2mg/kg weekly), and P (840mg C1D1, followed by 420mg C2-6D1) as NAT for patients (pts) with stage II-IIIB HER2+ BC. Primary objective was to evaluate cardiac safety of the combination, measured by the incidence of type A (symptomatic congestive heart failure ) or type B [asymptomatic reduction of Left Ventricular Ejection Fraction (LVEF) value: ≥10% absolute decrease and LVEF<50%, LVEF<40% or any absolute decrease ≥20%] events, during NAT. Eighty-three pts were required to reject with 80% confidence the null hypothesis that the combination increases the incidence of cardiac events above the historical control of 18% (3% type A; 15% type B).
RESULTS
Between June 2013 and January 2015, 83 pts with HER2+ EBC (stage II 78%, stage III 22%) and adequate cardiac function (LVEF≥55%) were enrolled. Mean age was 50 years, N+ 47%, hormone receptor (HR) positive 71% and median baseline LVEF 66%. Eighty-five percent of pts completed 6 cycles of NAT, whereas 15% discontinued NAT due to toxicity. Adverse events (AEs) leading to dose adjustments/temporary interruptions and discontinuation of at least 1 drug occurred in 70% and 21% of pts, respectively. Primary objective was met with an incidence of cardiac events during NAT of 4% (95%CI 1-10, 3pts, all type B). Cardiac events until study completion (1 year) were 8% (all type B). All (but 2 cases with no follow-up data) were reversible and only 1 pt presented an asymptomatic LVEF<40%. Neutropenia (45%) was the most frequent hematological toxicity (G3/4 34%; febrile neutropenia 6%), less frequent in the 71% of pts that received primary G-CSF prophylaxis (G3/4 25% vs. 67%). Common non-hematological toxicities were diarrhea (74%; G3 7%), asthenia (78%; G3 11%) and neurotoxicity (52%; G3/4 10%). Pathological complete response (pCR) in breast+axilla (ypT0/is ypN0) was 60% (87% in HR-) and 69% in breast (91% in HR-).
TOTALHR-HR+% ypT0/is (95% CI)69 (58-79)91 (72-99)61 (47-74)% ypT0/is ypN0 (95% CI)60 (46-71)87 (66-97)50 (36-64)
CONCLUSIONS
The neoadjuvant combination of T+P, paclitaxel and NPLD does not increase the risk for cardiac events in HER2+ BC pts. Since cardiac toxicities may present later, long-term cardiac monitoring is essential. Efficacy in terms of pCR was remarkable, being higher to historical values of combinations with dual anti-HER2 blockade and one of the highest reported among HR-HER2+ BC. This regimen administered with primary G-CSF prophylaxis and cardiac function monitoring may be an effective and secure option for early and locally advanced HER2+ pts with good cardiac function.
Citation Format: Gavilá J, Perez-Garcia J, Calvo I, Ciruelos E, Muñoz M, Virizuela JA, Ruiz I, Andrés R, Morales S, Perelló A, Sánchez P, Garcia-Saenz JA, Quero Guillen JC, González-Santiago S, Garau Llinas I, González-Martín A, Cantos Sánchez de Ibargüen B, Zaragoza K, de la Peña L, Llombart-Cussac A, Oliveira M. Neoadjuvant non-pegylated liposomal doxorubicin plus paclitaxel, trastuzumab and pertuzumab in patients with HER2+ breast cancer – Final results of the SOLTI OPTI-HER HEART study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-05.
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Affiliation(s)
- J Gavilá
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - J Perez-Garcia
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - I Calvo
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - E Ciruelos
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - M Muñoz
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - JA Virizuela
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - I Ruiz
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - R Andrés
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - S Morales
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - A Perelló
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - P Sánchez
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - JA Garcia-Saenz
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - JC Quero Guillen
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - S González-Santiago
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - I Garau Llinas
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - A González-Martín
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - B Cantos Sánchez de Ibargüen
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - K Zaragoza
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - L de la Peña
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - A Llombart-Cussac
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - M Oliveira
- SOLTI Breast Cancer Research, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncológico Clara Campal, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona; Hospital Arnau de Vilanova de Valencia, Valencia, Spain; Hospital Virgen de la Macarena, Sevilla, Spain; Hospital Sant Joan de Reus, Reus, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain; Hospital Universitari Son Espases, Palma de Mallorca, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Hospital Universitario Clínico San Carlos, Madrid; Hospital Quirón Sagrado Corazón, Sevilla, Spain; Complejo Hospitalario San Pedro de Alcántara, Cáceres, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain
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Prat Aparicio A, Cortes Castan J, Pare L, Galvan P, Bermejo B, Martínez N, Vidal M, Pernas S, López R, Muñoz M, Nuciforo P, Fasani R, Morales S, Oliveira M, de La Peña L, Peláez A, Llombart A. Abstract S3-03: PAM50 intrinsic subtype as a predictor of pathological complete response following neoadjuvant dual HER2 blockade without chemotherapy in HER2-positive breast cancer: First results of the PAMELA clinical trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-s3-03] [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: Prior neoadjuvant studies in HER2+ breast cancer have shown that dual HER2 blockade without chemotherapy achieves pathological complete responses (pCR) rates of 6-36% (TBCRC006/TBCRC023/NeoSphere). However, a major challenge today is how to select prospectively patients who will derive the maximum benefit from dual anti-HER2 therapies without chemotherapy. In this context, we and others have previously shown that HER2+ disease is biologically heterogeneous and composed of all the intrinsic molecular subtypes (Luminal A, Luminal B, HER2-enriched [HER2-E] and Basal-like). Among them, the HER2-E subtype shows the highest activation of the EGFR/HER2 pathway.
Methods: PAMELA (NCT01973660) is a non-randomized, open-label, multicentric, prospective translational research study in stage I-IIIA HER2+ breast cancer designed to evaluate the ability of the PAM50 intrinsic subtypes to predict pCR in the breast (pCRB; in situ allowed) following 18 weeks of neoadjuvant lapatinib and trastuzumab). Patients with HR+ disease received letrozole (if postmenopausal) or tamoxifen (if pre-menopausal). The primary objective was to compare the pCRB rates of the HER2-E versus the non-HER2-E subtypes in the intent-to-treat population. The study was planned with a power of 95% at a significance level of 0.05 to detect an absolute relative difference in pCRB rates between the two groups of 27% (i.e. 35% in HER2E and 8% in non-HER2-E). Day-15 formalin-fixed, paraffin-embedded tissue samples were prospectively collected and gene expression profiled using the nCounter platform. The intrinsic subtypes were identified using the research-based PAM50 predictor (Parker JCO 2009).
Results: A total of 151 patients were recruited (n=77 HR+ and n=74 HR-). Patient characteristics were: mean age (55 years), mean tumor size (2.84 cm), negative axilla (63.5%) and postmenopausal (60.2%). At baseline, intrinsic subtype distribution was: HER2-E (n=101, 66.9%), Luminal A (n=22; 14.6%), Luminal B (n=16; 10.6%), Basal-like (n=9; 6%) and Normal-Like (n=3; 2%). The overall pCRB was 30.5% (46/151), 18.2% in HR+ disease and 43.2% in HR- disease. Five patients (3.3%) presented progressive disease. Rates of pCRB in HER2-E and non-HER2-E subtypes were 40.6% and 10.0% (p<0.0001), respectively. HER2-E subtype predicted pCRB independently of HR status. Within HR+ disease, pCRB rates were 31.6% in HER2-E subtype and 5.3% in non-HER2-E subtype (p=0.006). Within HR- disease, pCRB rates were 46.0% in HER2-E subtype and 27.3% in non-HER2-E subtypes (p=0.331). At Day-15, the majority of tumors became Normal-like (48.9%) or Luminal A (27.5%). Rates of pCRB were 46.9% in Normal-like tumors and 11.9% in non-Normal-like tumors when evaluated at day-15 (p<0.0001).
Conclusions: The PAMELA trial met its primary endpoint. PAM50 HER2-E subtype identifies patients with HER2+ disease likely to derive a large benefit from dual anti-HER2 therapies +/- endocrine therapy, especially in HER2+/HR+ disease. In addition, early changes in gene expression indicative of a reduction of tumor cellularity are predictive of pathological complete response at surgery.
Citation Format: Prat Aparicio A, Cortes Castan J, Pare L, Galvan P, Bermejo B, Martínez N, Vidal M, Pernas S, López R, Muñoz M, Nuciforo P, Fasani R, Morales S, Oliveira M, de La Peña L, Peláez A, Llombart A. PAM50 intrinsic subtype as a predictor of pathological complete response following neoadjuvant dual HER2 blockade without chemotherapy in HER2-positive breast cancer: First results of the PAMELA clinical trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr S3-03.
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Affiliation(s)
- A Prat Aparicio
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - J Cortes Castan
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - L Pare
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - P Galvan
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - B Bermejo
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - N Martínez
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Vidal
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - S Pernas
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - R López
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Muñoz
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - P Nuciforo
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - R Fasani
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - S Morales
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Oliveira
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - L de La Peña
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - A Peláez
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
| | - A Llombart
- Hospital Clinic de Barcelona, Barcelona, Spain; Hospital Ramón y Cajal, Madrid, Spain; Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Vall d'Hebron Instituto de Oncología (VHIO), Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain; Complejo Universitario de Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain; Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain; Hospital Universitari Vall d' Hebron, Barcelona, Spain; SOLTI, Breast Cancer Research Group, Barcelona, Spain; Hospital Arnau de Vilanova de Valencia, Valencia, Spain
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