1
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Escobar-Álvarez Y, de Castro-Carpeño J, Feyjoo M, Martín-Algarra S. Evaluation of patient quality care in Spain in prevention of nausea and vomiting induced by chemotherapy. J Healthc Qual Res 2021; 36:142-149. [PMID: 33744239 DOI: 10.1016/j.jhqr.2021.01.001] [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: 07/27/2020] [Revised: 12/24/2020] [Accepted: 01/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To characterise current management of chemotherapy-induced nausea and vomiting in Spain, as well as professional adherence to antiemetic guidelines. MATERIALS AND METHODS Retrospective observational study. A multicenter has been designed including 360 patient case files from 18 hospitals. The involvement of pharmacists and nurses was studied, and also indicators of structure, process, and selected outcomes previously recruited from antiemetic guidelines. RESULTS We found 94.4% of hospitals used a written protocol for managing chemotherapy-induced nausea and vomiting and only 44.4% had educational programs for patients regarding this. Patients were prescribed antiemetic prophylactic treatment for delayed emesis in varying degree between highly and moderately emetogenic chemotherapy (77.8% and 58.9%, respectively). Dexamethasone was the most prescribed antiemetic drug for patients receiving highly and moderately emetogenic chemotherapy (98.3% and 90%, respectively), followed by ondansetron (68.9% and 95%, respectively). Nursing was more involved than pharmacy units in evaluating emetic risk factors in patients (64.7% vs 21.4%), and tracking symptom onset (88.2% vs 57.1%) and adherence to treatment (94.1% vs 28.6%). Pharmacy units were more involved than nursing in choosing the antiemetic treatment (78.6% vs 47%). CONCLUSIONS Although antiemetic guidelines were used by all hospitals, there were differences in management of chemotherapy-induced nausea and vomiting. Increased education directed towards patients and oncology professionals is needed to improve adherence.
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Affiliation(s)
- Y Escobar-Álvarez
- Servicio de Oncología Médica, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | - M Feyjoo
- Servicio de Oncología Médica, Hospital Universitario Sanitas La Moraleja, Madrid, Spain.
| | - S Martín-Algarra
- Servicio de Oncología Médica, Clínica Universidad de Navarra, Pamplona, Spain
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2
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Sanmamed MF, Perez-Gracia JL, Schalper KA, Fusco JP, Gonzalez A, Rodriguez-Ruiz ME, Oñate C, Perez G, Alfaro C, Martín-Algarra S, Andueza MP, Gurpide A, Morgado M, Wang J, Bacchiocchi A, Halaban R, Kluger H, Chen L, Sznol M, Melero I. Changes in serum interleukin-8 (IL-8) levels reflect and predict response to anti-PD-1 treatment in melanoma and non-small-cell lung cancer patients. Ann Oncol 2018; 28:1988-1995. [PMID: 28595336 DOI: 10.1093/annonc/mdx190] [Citation(s) in RCA: 295] [Impact Index Per Article: 49.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Surrogate biomarkers of efficacy are needed for anti-PD1/PD-L1 therapy, given the existence of delayed responses and pseudo-progressions. We evaluated changes in serum IL-8 levels as a biomarker of response to anti-PD-1 blockade in melanoma and non-small-cell lung cancer (NSCLC) patients. Patients and methods Metastatic melanoma and NSCLC patients treated with nivolumab or pembrolizumab alone or nivolumab plus ipilimumab were studied. Serum was collected at baseline; at 2-4 weeks after the first dose; and at the time-points of response evaluation. Serum IL-8 levels were determined by sandwich ELISA. Changes in serum IL-8 levels were compared with the Wilcoxon test and their strength of association with response was assessed with the Mann-Whitney test. Accuracy of changes in IL-8 levels to predict response was estimated using receiver operation characteristics curves. Results Twenty-nine melanoma patients treated with nivolumab or pembrolizumab were studied. In responding patients, serum IL-8 levels significantly decreased between baseline and best response (P <0.001), and significantly increased upon progression (P = 0.004). In non-responders, IL-8 levels significantly increased between baseline and progression (P = 0.013). Early changes in serum IL-8 levels (2-4 weeks after treatment initiation) were strongly associated with response (P <0.001). These observations were validated in 19 NSCLC patients treated with nivolumab or pembrolizumab (P = 0.001), and in 15 melanoma patients treated with nivolumab plus ipilimumab (P <0.001). Early decreases in serum IL-8 levels were associated with longer overall survival in melanoma (P = 0.001) and NSCLC (P = 0.015) patients. Serum IL-8 levels also correctly reflected true response in three cancer patients presenting pseudoprogression. Conclusions Changes in serum IL-8 levels could be used to monitor and predict clinical benefit from immune checkpoint blockade in melanoma and NSCLC patients.
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Affiliation(s)
- M F Sanmamed
- Department of Immunobiology, Yale University School of Medicine, New Haven, USA
| | - J L Perez-Gracia
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,CIBERONC (Centro de Investigación Biomedica en Red de Cáncer)
| | - K A Schalper
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.,Comprehensive Cancer Center Section of Medical Oncology, Yale University School of Medicine, New Haven, CT, USA
| | - J P Fusco
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - A Gonzalez
- CIBERONC (Centro de Investigación Biomedica en Red de Cáncer).,Department of Biochemistry, Clínica Universidad de Navarra, Pamplona, Spain
| | - M E Rodriguez-Ruiz
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Oncología (CIBERONC), Spain
| | - C Oñate
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - G Perez
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - C Alfaro
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,CIBERONC (Centro de Investigación Biomedica en Red de Cáncer)
| | - S Martín-Algarra
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - M P Andueza
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - A Gurpide
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - M Morgado
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - J Wang
- Department of Immunobiology, Yale University School of Medicine, New Haven, USA
| | - A Bacchiocchi
- Department of Dermatology, Yale University School of Medicine, New Haven, USA
| | - R Halaban
- Department of Dermatology, Yale University School of Medicine, New Haven, USA
| | - H Kluger
- Comprehensive Cancer Center Section of Medical Oncology, Yale University School of Medicine, New Haven, CT, USA
| | - L Chen
- Department of Immunobiology, Yale University School of Medicine, New Haven, USA
| | - M Sznol
- Comprehensive Cancer Center Section of Medical Oncology, Yale University School of Medicine, New Haven, CT, USA
| | - I Melero
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,Department of Biochemistry, Clínica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Oncología (CIBERONC), Spain
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3
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Iriarte AR, Martín-Algarra S, Merino LC, Abreu DR, Espinosa E, Berrocal A, Castro RL, Curiel T, Luna P, Lorenzo A, Piulats J. Phase II multi-centre, non randomized, open label study of nivolumab in combination with ipilimumab as first line in adults patients with metastatic uveal melanoma. GEM 14-02. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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4
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Sanmamed M, Perez-Gracia J, Fusco J, Oñate C, Perez G, Alfaro C, Martín-Algarra S, González A, Rodriguez-Ruiz M, Andueza M, Wang J, Bacchiocchi A, Halaban R, Kluger H, Sznol M, Melero I. Changes in serum IL8 levels reflect and predict response to anti-PD-1 treatment in melanoma and non-small cell lung cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw378.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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5
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Martín-Algarra S, de la Cruz-Merino L, Soriano V, Manzano JL, Espinosa E. Clinical use of ipilimumab for metastatic melanoma in Spain: towards a more consistent approach. Clin Transl Oncol 2016; 18:1044-50. [PMID: 26801342 DOI: 10.1007/s12094-016-1484-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Ipilimumab has been approved in patients with advanced melanoma by different regulatory bodies worldwide, but its use in clinical practice is not fully consistent among oncologists. We have surveyed a representative sample of Spanish medical oncologists on issues related to the use of ipilimumab. MATERIALS AND METHODS The survey was based on the Delphi method, where experts respond anonymously to two rounds of a questionnaire. Questionnaire consisted of 42 statements divided among the following eight categories: Pathology and Diagnosis; Patterns of Response; Parameters affecting Treatment Selection; Patient Profile; Sequencing of Treatment; Definition of Long-Term Survivors; Quality of Life; Concept of Immuno-oncology. The experts were asked to rate each statement on a scale of 1-9, where 1 meant "completely disagree" and 9 meant "completely agree". RESULTS Thirty-three oncologists responded to both rounds of the survey (62.3 % of total surveyed). On issues related to pathology and diagnosis, patterns of response, and immuno-oncology, the specialists reached a high level of consensus. There was also a high level of agreement, albeit without consensus on assessment of BRAF mutations before deciding on treatment with ipilimumab. However, there was a lower level of agreement on sequencing treatment with BRAF inhibitors and ipilimumab, on predictive factors, on the use of corticosteroids, and on patient quality of life. CONCLUSIONS The disparity in many of these topics suggests that oncologists need more information on certain aspects of ipilimumab treatment. We need to define generally accepted algorithms of treatment, especially with regard to issues that were shown to be controversial or unclear.
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Affiliation(s)
- S Martín-Algarra
- Department of Oncology, Clínica Universidad de Navarra. Instituto de Investigación Sanitaria de Navarra (IDISNA), Av. Pío XII, 36, 31008, Pamplona, Navarra, España, Spain.
| | | | - V Soriano
- Department of Oncology, Instituto Valenciano Oncología, Valencia, Spain
| | - J L Manzano
- Department of Oncology, Hospital Germans Trias i Pujol. ICO-Badalona, Barcelona, Spain
| | - E Espinosa
- Department of Oncology, Hospital La Paz, Madrid, Spain
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6
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Sereno M, Merino M, López-Gómez M, Gómez-Raposo C, Zambrana Tébar F, Moreno Rubio J, Espinós J, Martín-Algarra S, Casado Sáenz E. MYH polyposis syndrome: clinical findings, genetics issues and management. Clin Transl Oncol 2014; 16:675-9. [DOI: 10.1007/s12094-014-1171-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 02/21/2014] [Indexed: 12/15/2022]
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7
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Martín-Algarra S, Fernández-Figueras MT, López-Martín JA, Santos-Briz A, Arance A, Lozano MD, Berrocal A, Ríos-Martín JJ, Espinosa E, Rodríguez-Peralto JL. Guidelines for biomarker testing in metastatic melanoma: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology. Clin Transl Oncol 2013; 16:362-73. [DOI: 10.1007/s12094-013-1090-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 07/16/2013] [Indexed: 12/19/2022]
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8
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Domínguez-Prado I, Rodríguez-Fraile M, Alcalde JM, de Abajo J, Martín-Algarra S, García-Velloso MJ. [Identification of the lymph node drainage and selective sentinel lymph node biopsy in a patient with amelanotic melanoma of the uvula]. ACTA ACUST UNITED AC 2011; 30:325-6. [PMID: 21524825 DOI: 10.1016/j.remn.2011.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 03/01/2011] [Indexed: 11/28/2022]
Affiliation(s)
- I Domínguez-Prado
- Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, Navarra, España.
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9
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González-Cao M, Viteri S, Díaz-Lagares A, González A, Redondo P, Nieto Y, Espinós J, Chopitea A, Ponz M, Martín-Algarra S. Preliminary results of the combination of bevacizumab and weekly Paclitaxel in advanced melanoma. Oncology 2008; 74:12-6. [PMID: 18536525 DOI: 10.1159/000138351] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Accepted: 12/16/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pretreated advanced melanoma is a poor prognosis scenario with few, if any, active therapeutic options. The antibody against vascular endothelial growth factor, bevacizumab, has demonstrated increased activity in combination with chemotherapy in many tumors. We intended to evaluate the activity of the combination of weekly paclitaxel and bevacizumab in previously treated metastatic melanoma. PATIENTS AND METHODS Patients with previously treated metastatic melanoma received paclitaxel 70 mg/m(2) weekly and bevacizumab 10 mg/kg biweekly for 5 consecutive weeks every 6 weeks. RESULTS Twelve patients were treated. Two patients (16.6%) achieved a partial response and 7 patients (58.3%) stable disease. Responses were seen in soft tissue, lung and brain metastases. Median disease-free and overall survival times were 3.7 and 7.8 months, respectively. Treatment was well tolerated. Main toxicities were grade 3 asymptomatic lymphopenia in 6 patients, grade 3 leucopenia in 2 patients, and grade 3 thrombocytopenia in 1 patient. CONCLUSIONS Our preliminary results suggest that the combination of bevacizumab and weekly paclitaxel is active and safe in patients with metastatic melanoma, warranting further investigation.
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Affiliation(s)
- M González-Cao
- Department of Oncology, University Clinic of Navarra, Navarra University, Pamplona, Spain
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10
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Duart-Clemente J, San-Julián M, Martínez-Monge R, Martín-Algarra S. Soft Tissue Sarcoma: Can a Rescue Procedure be Performed when the First Surgery was Unsuccessful? Rev Esp Cir Ortop Traumatol (Engl Ed) 2008. [DOI: 10.1016/s1988-8856(08)70064-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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11
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Pérez-Gracia JL, López-Picazo JM, Martín-Algarra S, Viteri S, García-Foncillas J, Gúrpide A. [Small-cell lung cancer]. Rev Med Univ Navarra 2007; 51:7-13. [PMID: 17886708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Small cell lung cancer is one of the most aggressive solid tumors because of its rapid growth and early tendency to spread to distant organs. Nonetheless, it is also one of the most sensitive tumors to chemotherapy and radiotherapy, which can give patients with limited disease a chance to become long-term survivors. These characteristics have made this tumor a clinical model to explore various treatment strategies, including concomitant chemotherapy and radiotherapy, alternant chemotherapy, high-dose chemotherapy with hematologic support, or use of whole-brain prophylactic radiotherapy. In addition, in recent years, small cell lung cancer has been used as a platform to develop some new targeted therapy agents or immunotherapeutic approaches.
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Affiliation(s)
- J L Pérez-Gracia
- Departamento de Oncología, Cínica Universítaria, Facultad de Medicina, Universidad de Navarra, Pamplona.
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12
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De La Cámara J, Rodriguez J, Rotellar F, Viudez A, García-Foncillas J, Pardo F, Gíl-Bazo I, Chopitea A, Martín-Algarra S. Triplet therapy with oxaliplatin, irinotecan, 5-fluorouracil and folinic acid within a combined modality approach in patients with liver metastases from colorectal cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3593] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. De La Cámara
- Clínica Universitaria.University of Navarra, Pamplona, Spain
| | - J. Rodriguez
- Clínica Universitaria.University of Navarra, Pamplona, Spain
| | - F. Rotellar
- Clínica Universitaria.University of Navarra, Pamplona, Spain
| | - A. Viudez
- Clínica Universitaria.University of Navarra, Pamplona, Spain
| | | | - F. Pardo
- Clínica Universitaria.University of Navarra, Pamplona, Spain
| | - I. Gíl-Bazo
- Clínica Universitaria.University of Navarra, Pamplona, Spain
| | - A. Chopitea
- Clínica Universitaria.University of Navarra, Pamplona, Spain
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13
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Rodriguez J, Viudez A, Salgado E, García-Foncillas J, De La Cámara J, Espinós J, Garrán C, Chopitea A, Fernández-Hidalgo O, Martín-Algarra S. Irinotecan and mitomycin C (MMC) as salvage therapy for patients with metastatic colorectal cancer previously treated with fluoropyrimidine, irinotecan and/or oxaliplatin based chemotherapy. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. Rodriguez
- Clínica Universitaria. University of Navarra, Pamplona, Spain
| | - A. Viudez
- Clínica Universitaria. University of Navarra, Pamplona, Spain
| | - E. Salgado
- Clínica Universitaria. University of Navarra, Pamplona, Spain
| | | | - J. De La Cámara
- Clínica Universitaria. University of Navarra, Pamplona, Spain
| | - J. Espinós
- Clínica Universitaria. University of Navarra, Pamplona, Spain
| | - C. Garrán
- Clínica Universitaria. University of Navarra, Pamplona, Spain
| | - A. Chopitea
- Clínica Universitaria. University of Navarra, Pamplona, Spain
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14
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Santisteban M, Viudez A, Salgado E, Garrán C, Navarro V, De La Cámara J, Fernández-Hidalgo O, García-Velloso MJ, Martín-Algarra S. Role of 18F-fluorodeoxyglucose positron emission tomography in mucocutaneous malignant melanoma. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - A. Viudez
- Clínica Universitaria, Pamplona, Spain
| | | | - C. Garrán
- Clínica Universitaria, Pamplona, Spain
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15
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Gil-Bazo I, Rodríguez J, Catalán V, Navarro V, Chopitea A, Espinós J, Gúrpide A, Santisteban M, García-Foncillas J, Martín-Algarra S. Vascular endothelial growth factor and von Willebrand factor levels: Clinical outcome in stage IV colorectal cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Vicent S, López-Picazo JM, Toledo G, Lozano MD, Torre W, Garcia-Corchón C, Quero C, Soria JC, Martín-Algarra S, Manzano RG, Montuenga LM. ERK1/2 is activated in non-small-cell lung cancer and associated with advanced tumours. Br J Cancer 2004; 90:1047-52. [PMID: 14997206 PMCID: PMC2409626 DOI: 10.1038/sj.bjc.6601644] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Activation of the ERK1/2 pathway is involved in malignant transformation both in vitro and in vivo. Little is known about the role of activated ERK1/2 in non-small cell lung cancer (NSCLC). The purpose of this study was to characterise the extent of the activation of ERK1/2 by immunohistochemistry in patients with NSCLC, and to determine the relationship of ERK1/2 activation with clinicopathological variables. Specimens from 111 patients with NSCLC (stages I-IV) were stained for P-ERK. Staining for epidermal growth factor receptor (EGFR) and Ki-67 was also performed. In all, 34% of the tumour specimens showed activation for ERK1/2, while normal lung epithelial tissue was consistently negative. There was a strong statistical correlation between nuclear and cytoplasmic P-ERK staining and advanced stages (P<0.05 and P<0.001, respectively), metastatic hilar or mediastinal lymph nodes (P<0.01, P<0.001), and higher T stages (P<0.01, P<0.001). We did not find correlation of nuclear or cytoplasmic P-ERK staining with either EGFR expression or Ki-67 expression. Total ERK1/2 expression was evaluated with a specific ERK1/2 antibody and showed that P-ERK staining was not due to ERK overexpression but rather to hyperactivation of ERK1/2. Patients with a positive P-ERK cytoplasmic staining had a significant lower survival (P<0.05). However, multivariate analysis did not show significant survival difference. Our study indicates that nuclear and cytoplasmic ERK1/2 activation positively correlates with stage, T and lymph node metastases, and thus, is associated with advanced and aggressive NSCLC tumours.
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Affiliation(s)
- S Vicent
- Carcinogenesis Unit, Division of Oncology, Centre for Applied Medical Research (CIMA), University of Navarra, Pamplona 31008, Spain
- Department of Histology and Pathology, University of Navarra, Pamplona 31008, Spain
| | - J M López-Picazo
- Department of Oncology, University Hospital, University of Navarra, Pamplona 31008, Spain
| | - G Toledo
- Department of Pathology, University Hospital, University of Navarra, Pamplona 31008, Spain
| | - M D Lozano
- Department of Pathology, University Hospital, University of Navarra, Pamplona 31008, Spain
| | - W Torre
- Department of Thoracic Surgery, University Hospital, University of Navarra, Pamplona 31008, Spain
| | - C Garcia-Corchón
- Department of Histology and Pathology, University of Navarra, Pamplona 31008, Spain
| | - C Quero
- Department of Oncology, University Hospital, University of Navarra, Pamplona 31008, Spain
| | - J-C Soria
- Department of Medical Oncology, Lung Unit, Institut Gustave Roussy, F-94805 Villejuif, France
| | - S Martín-Algarra
- Department of Oncology, University Hospital, University of Navarra, Pamplona 31008, Spain
| | - R G Manzano
- Carcinogenesis Unit, Division of Oncology, Centre for Applied Medical Research (CIMA), University of Navarra, Pamplona 31008, Spain
| | - L M Montuenga
- Carcinogenesis Unit, Division of Oncology, Centre for Applied Medical Research (CIMA), University of Navarra, Pamplona 31008, Spain
- Department of Histology and Pathology, University of Navarra, Pamplona 31008, Spain
- Department of Histology and Pathology, University of Navarra, C/Irunlarrea, Pamplona 31080, Spain. E-mail:
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17
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Gil-Bazo I, Catalán V, Páramo J, Quero C, Escrivá de Romaní S, Pérez-Ochoa A, Arbea L, Navarro V, de la Cámara J, Garrán C, Espinós J, Rocha E, García-Foncillas J, Martín-Algarra S. [Von Willebrand factor as an intermediate between hemostasis and angiogenesis of tumor origin]. Rev Med Univ Navarra 2003; 47:22-8. [PMID: 14727571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Cancer patients often show an imbalance condition between coagulation system and fibrinolysis which causes a prothrombotic state. Different molecular factors like von Willebrand factor (vWf), presenting higher plasmatic rates in these patients, play an important role in this situation. During active angiogenesis taking place in tumor growth, the vascular endothelial growth factor (VEGF) and the fibroblast growth factor (FGF-2) contribute to the proliferation and differentiation of endothelial tissue, the main vWf producer, promoting increased rates of vWf in the serum of neoplastic patients. Recently vWf's contribution to tumor cells and platelet adhesion has been described. In this process, the discovery of platelet, endothelial and tumor cell membrane integrins and their implication in cellular adhesion has represented a major step in demonstrating how blood clotting and platelet aggregation are mediated by tumor cell and platelet linkage. Migration properties acquired by tumor cells as a result of this binding have been also pointed out. Clinical trials show higher rates of plasmatic vWf in cancer patients the more advanced clinical and radiological stage they present (metastasic versus localized). Moreover, higher pre-surgical serum vWf rates in patients can be used to predict poorer survival after resection surgery. vWf high molecular weight multimers have been also related to a cleavage protease deficiency in the serum of the oncologic population. The promising results of antiaggregation/anticoagulation therapies in these patients permit us to envisage new therapeutic targets.
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Affiliation(s)
- I Gil-Bazo
- Departamento de Oncología Médica, Clínica Universitaria, Facultad de Medicina, Universidad de Navarra.
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García-Rayo S, Pérez-Calvo J, Martín-Algarra S, Martínez-Monge R, Fernández-Hidalgo O, Subirá L, Martínez-Aguillo M, Rebollo J, Azinovic I, Brugarolas A. Erratum: Multiple cycles of dose-intensive chemotherapy with repeated stem cell support as induction treatment in metastatic breast cancer: a feasibility study. Bone Marrow Transplant 2002. [DOI: 10.1038/sj.bmt.1703347] [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: 11/09/2022]
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Pérez-Calvo J, Martínez-Aguillo M, García-Rayo S, Ramón y Cajal T, Santisteban M, Ordóñez JM, Inogés S, Subirá ML, Martín-Algarra S, Brugarolas A. Factors determining the actual received dose intensity in a program of multicyclic dose-intensive alternating chemotherapy with sequential stem cell support. Acta Haematol 2001; 105:137-42. [PMID: 11463986 DOI: 10.1159/000046555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Dose intensity has been related to clinical outcome in several solid tumors. We studied the influence of clinical and cellular parameters on dose intensity received in a series of 53 patients with metastatic breast cancer or advanced ovarian cancer. They received courses of cisplatin 120 mg/m(2) plus etoposide 600 mg/m(2) alternating every 14 days with ifosfamide 8 g/m(2) plus paclitaxel 200--350 mg/m(2). Blood stem cell support was administered after every course except for the first one. Patients with excellent mobilization underwent immunomagnetic selection of CD34+ cells. We found a significant inverse correlation between the CD34+ cell dose infused and the delay for the administration of the next cycle. A CD34+ cell dose between 1.5 and 5 x 10(6)/kg per cycle was found to be feasible and was followed by a median delay of 1 day (not different from doses above 5 x 10(6)/kg). Three factors independently predicted the actually received dose intensity in a multiple regression model (R(2) = 0.4): previous autologous transplantation, eligibility for immunomagnetic selection (excellent response to mobilization) and median CD34+ cell dose received along the treatment.
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Affiliation(s)
- J Pérez-Calvo
- Department of Oncology and Cell Therapy Area, Clínica Universitaria de Navarra, Pamplona, Spain.
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García-Rayo S, Pérez-Calvo J, Martín-Algarra S, Martínez-Monge R, Fernández-Hidalgo O, Subirá L, Martínez-Aguillo M, Rebollo J, Azinovic I, Brugarolas A. Multiple cycles of dose-intensive chemotherapy with repeated stem cell support as induction treatment in metastatic breast cancer: a feasibility study. Bone Marrow Transplant 2001; 28:235-42. [PMID: 11535990 DOI: 10.1038/sj.bmt.1703125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2000] [Accepted: 05/24/2001] [Indexed: 11/08/2022]
Abstract
The purpose of this trial was to study feasibility and tolerance of a dose-intensive multicyclic alternating induction chemotherapy with repeated stem cell support in a series of 43 metastatic breast cancer patients. Anthracycline-naive patients (n = 21) received cyclophosphamide 2.5 g/m(2) plus doxorubicin 80 mg/m(2) alternating every 14 days with paclitaxel 200-350 mg/m(2) plus cisplatin 120 mg/m(2). Patients who had previously received anthracyclines (n = 22) received cisplatin 120 mg/m(2) plus etoposide 600 mg/m(2) alternating with paclitaxel 200-350 mg/m(2) plus ifosfamide 8 g/m(2). Peripheral blood stem cells were infused after every course except the first, with a median CD34(+) dose of 2.1 x 10(6)/kg per cycle. Positive selection of CD34(+) cells was performed in good mobilizers. The median number of cycles administered was six (4-8), and the time interval between them was 17 days. Median summation dose intensities (SDI) actually administered for the CA-TP and PE-TI protocol were 4.95 and 4.69, respectively (87% of scheduled SDI). There were 15 complete (35%) and 21 partial responses (49%), for an overall response rate of 84% (95% CI, 73%-95%). Infection or neutropenic fever occurred in 50% of the cycles. There was one treatment-related death. After a median follow-up of 26 months, the median event-free-survival was 12 months (95% CI: 10-14) and overall survival was 31 months. These high dose-intensity induction treatments seem to be feasible with sequential stem cell support.
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Affiliation(s)
- S García-Rayo
- Oncology Department, Clínica Universitaria de Navarra, Pamplona, Spain
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Pérez-Calvo J, Santisteban M, López-Picazo JM, Martín-Algarra S. Pulmonary embolism after local urokinase instillation in a Hickman catheter. Bone Marrow Transplant 2001; 28:112-3. [PMID: 11498757 DOI: 10.1038/sj.bmt.1703091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pérez-Calvo J, Fernández-Hidalgo O, Subirá ML, Martín-Algarra S, Salgado E, Brugarolas A. Mobilization of hematopoietic progenitor cells with a combination of docetaxel, adriamycin, 5-fluorouracil and filgrastim in breast cancer patients. Haematologica 2001; 86:100-1. [PMID: 11146579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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Fernández-Hidalgo OA, Vanaclocha V, Vieitez JM, Aristu JJ, Rebollo J, Gúrpide A, Aramendía JM, Moreno-Palanques R, Martín-Algarra S, Subirá ML, Brugarolas A. High-dose BCNU and autologous progenitor cell transplantation given with intra-arterial cisplatinum and simultaneous radiotherapy in the treatment of high-grade gliomas: benefit for selected patients. Bone Marrow Transplant 1996; 18:143-9. [PMID: 8832007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A phase II study of postoperative high-dose carmustine (HDBCNU), intracarotid cisplatin (CDDP), and radical radiotherapy in patients with high-grade glioma was performed. Patients underwent 4-6 consecutive days of blood hematopoietic progenitor cell (HPC) apheresis without prior mobilization. Chemotherapy included intracarotid CDDP, 60 mg/m2, and BCNU, 900 mg/m2. HPC were infused 48 h after HDBCNU. Whole brain irradiation, up to 50 Gy, was started on the 8th day after HPC infusion. With a median follow-up time of 44 months, median overall survival was 15.5 months. Eight patients (23.5%) are alive free of disease 2-6 years after treatment (seven out of 25 patients with glioblastoma multiforme and one out of nine patients with anaplastic astrocytoma). Survival was influenced by young age, good performance and complete surgical resection. Two patients (5.8%) died of therapy-related complications. Acute hematological toxicity of HDBCNU was moderate, with a full recovery on day 26. No acute pulmonary or hepatic toxicity was found. Late severe neurological toxicity was observed in one third of patients surviving beyond 2 years. We conclude that HDBCNU, 900 mg/m2, intracarotid CDDP and radical radiotherapy appear to benefit some patients with high-grade gliomas, and phase III studies should preferentially select young patients with resectable tumors.
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Affiliation(s)
- O A Fernández-Hidalgo
- Department of Oncology, Facultad de Medicina, Universidad de Navarra, Pamplona, Spain
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Rebollo J, Martín-Algarra S, Bilbao I, Zubieta JL, Calvo FA, de Castro P, Pastor MA, Viteri C, Martínez Lage JM. [Treatment of supratentorial glioma with intracarotid cisplatin and intravenous carmustine]. Neurologia 1990; 5:228-32. [PMID: 1963067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We report the results of intracarotid (IC) cisplatinum and intravenous carmustine (BCNU) in 26 patients with supratentorial malignant glioma and recurrent low grade glioma. A response rate of 53.84% (95% confidence interval 33.3%-73.4%) was found. The median survival for the whole group was 11 months (range 3-70), with 35% of patients surviving for 2 years. At the present time, 5 patients are still alive, with a median follow up of 68 months (range 56-70). Neurological toxicity has been low and transient, being attributable to the technical degree of care in catheter positioning, cisplatin dosage and the technique of drug administration into the carotid artery.
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Affiliation(s)
- J Rebollo
- Departamentos de Oncología Médica, Clínica Universitaria de Navarra, Pamplona
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