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Lopez-Tarruella S, Del Monte-Millán M, Roche-Molina M, Jerez Y, Echavarria Diaz-Guardamino I, Herrero López B, Gamez Casado S, Marquez-Rodas I, Alvarez E, Cebollero M, Massarrah T, Ocaña I, Arias A, García-Sáenz JÁ, Moreno Anton F, Olier Garate C, Moreno Muñoz D, Marrupe D, Lara Álvarez MÁ, Enrech S, Bueno Muiño C, Martín M. Correlation between breast cancer subtypes determined by immunohistochemistry and n-COUNTER PAM50 assay: a real-world study. Breast Cancer Res Treat 2024; 203:163-172. [PMID: 37773555 PMCID: PMC10771357 DOI: 10.1007/s10549-023-07094-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/13/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Molecular subtyping based on gene expression profiling (i.e., PAM50 assay) aids in determining the prognosis and treatment of breast cancer (BC), particularly in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative tumors, where luminal A and B subtypes have different prognoses and treatments. Several surrogate classifications have been proposed for distinguishing between the luminal A and B subtypes. This study determines the accuracy of local immunohistochemistry (IHC) techniques for classifying HR-positive/HER2-negative (HR+/HER2-) tumors according to intrinsic subtypes using the nCOUNTER PAM50 assay as reference and the HR status definition according the ASCO/CAP recommendations. METHODS Molecular subtypes resulting from nCOUNTER PAM50 performed in our laboratory between 2014 and 2020 were correlated with three different proxy surrogates proposed in the literature based on ER, PR, HER2, and Ki67 expression with different cut-off values. Concordance was measured using the level of agreement and kappa statistics. RESULTS From 1049 samples with the nCOUNTER test, 679 and 350 were luminal A and B subtypes, respectively. Only a poor-to-fair correlation was observed between the three proxy surrogates and real genomic subtypes as determined by nCOUNTER PAM50. Moreover, 5-11% and 18-36% of the nCOUNTER PAM50 luminal B and A tumors were classified as luminal A and B, respectively, by these surrogates. CONCLUSION The concordance between luminal subtypes determined by three different IHC-based classifiers and the nCOUNTER PAM50 assay was suboptimal. Thus, a significant proportion of luminal A and B tumors as determined by the surrogate classifiers could be undertreated or over-treated.
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Affiliation(s)
- Sara Lopez-Tarruella
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañon (IiSGM), CIBERONC, Geicam, Universidad Complutense, 28007, Madrid, Spain
| | - María Del Monte-Millán
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CiberOnc, Madrid, Spain
| | - Marta Roche-Molina
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Yolanda Jerez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CiberOnc, Madrid, Spain
| | - Isabel Echavarria Diaz-Guardamino
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CiberOnc, Madrid, Spain
| | - Blanca Herrero López
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Salvador Gamez Casado
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Iván Marquez-Rodas
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CiberOnc, Madrid, Spain
| | - Enrique Alvarez
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - María Cebollero
- Pathology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Tatiana Massarrah
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CiberOnc, Madrid, Spain
| | - Inmaculada Ocaña
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Ainhoa Arias
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - José Ángel García-Sáenz
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - Fernando Moreno Anton
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - Clara Olier Garate
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Alcorcon, Spain
| | - Diana Moreno Muñoz
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Alcorcon, Spain
| | - David Marrupe
- Department of Oncologia, Hospital Universitario de Móstoles, Mostoles, Spain
| | - Miguel Ángel Lara Álvarez
- Medical Oncology Department, Hospital Universitario Infanta Leonor, Universidad Complutense, Madrid, Spain
| | - Santos Enrech
- Medical Oncology Department, Hospital Universitario de Getafe, Madrid, Spain
| | - Coralia Bueno Muiño
- Medical Oncology Department, Hospital Infanta Cristina (Parla), Fundación de Investigación Biomédica del H.U. Puerta de Hierro, Majadahonda, 28009, Madrid, Spain
| | - Miguel Martín
- Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañon (IiSGM), CIBERONC, Geicam, Universidad Complutense, 28007, Madrid, Spain.
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López-Gómez V, Yarza R, Muñoz-González H, Revilla E, Enrech S, González-Valle O, Tolosa P, Ciruelos E. Ribociclib-Related Stevens-Johnson Syndrome: Oncologic Awareness, Case Report, and Literature Review. J Breast Cancer 2019; 22:661-666. [PMID: 31897340 PMCID: PMC6933037 DOI: 10.4048/jbc.2019.22.e44] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 06/14/2019] [Accepted: 08/12/2019] [Indexed: 12/19/2022] Open
Abstract
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis belong to a severe dermatopathic spectrum that includes frequently fatal mucocutaneous manifestations consisting of whole epidermal necrosis and sloughing with bullous transformation, blistering, and further skin detachment. Notably, cancer patients are at higher risk of developing SJS than the general population as a consequence of both the nature of neoplastic disease and frequent exposure to anticancer drugs. Ribociclib is a newly approved cycline-dependent kinase inhibitor that has been recently associated with a single case of SJS. We hereby present a case of ribociclib-related SJS. Early detection of threatening skin lesions is crucial to permit the immediate discontinuation of ribociclib given the predictable and unacceptable risk level. In cases of established SJS, early aggressive support should be initiated, ribociclib should be abruptly discontinued, and specific treatment based on actual evidence should be started.
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Affiliation(s)
- Victoria López-Gómez
- Department of Clinical Oncology, University Hospital 12 de Octubre, Madrid, Spain
| | - Ramón Yarza
- Department of Clinical Oncology, University Hospital 12 de Octubre, Madrid, Spain
| | | | - Enrique Revilla
- Department of Pathology, University Hospital 12 de Octubre, Madrid, Spain
| | - Santos Enrech
- Department of Clinical Oncology, Getafe Hospital, Madrid, Spain
| | | | - Pablo Tolosa
- Department of Clinical Oncology, University Hospital 12 de Octubre, Madrid, Spain.,Division of Gyneco-Oncology, Breast Cancer Unit, University Hospital 12 de Octubre, Madrid, Spain
| | - Eva Ciruelos
- Department of Clinical Oncology, University Hospital 12 de Octubre, Madrid, Spain.,Division of Gyneco-Oncology, Breast Cancer Unit, University Hospital 12 de Octubre, Madrid, Spain
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3
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Ciruelos E, Apellániz-Ruiz M, Cantos B, Martinez-Jáñez N, Bueno-Muiño C, Echarri MJ, Enrech S, Guerra JA, Manso L, Pascual T, Dominguez C, Gonzalo JF, Sanz JL, Rodriguez-Antona C, Sepúlveda JM. A Pilot, Phase II, Randomized, Open-Label Clinical Trial Comparing the Neurotoxicity of Three Dose Regimens of Nab-Paclitaxel to That of Solvent-Based Paclitaxel as the First-Line Treatment for Patients with Human Epidermal Growth Factor Receptor Type 2-Negative Metastatic Breast Cancer. Oncologist 2019; 24:e1024-e1033. [PMID: 31023863 DOI: 10.1634/theoncologist.2017-0664] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 12/19/2017] [Accepted: 03/28/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study aimed to characterize the neurotoxicity of three different regimens of nab-paclitaxel compared with a standard regimen of solvent-based (sb) paclitaxel for the first-line treatment of HER2-negative metastatic breast cancer based on the Total Neurotoxicity Score (TNS), a tool specifically developed to assess chemotherapy-induced neurotoxicity. MATERIALS AND METHODS This was a randomized, open-label study testing 4-week cycles of 80 mg/m2 sb-paclitaxel (PACL80/w) on days 1, 8, and 15; 100 mg/m2 nab-paclitaxel on days 1, 8, and 15 (NAB100/w); 150 mg/m2 nab-paclitaxel on days 1, 8, and 15 (NAB150/w); and 150 mg/m2 nab-paclitaxel on days 1 and 15 (NAB150/2w). In addition to the TNS, neuropathy was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE). Tumor response and quality of life were also evaluated. RESULTS Neurotoxicity, as evaluated by the TNS, did not significantly differ between the sb-paclitaxel group and any of the nab-paclitaxel groups. The frequency of (any grade) polyneuropathy, as measured by the NCI-CTCAE, was lower in the PACL80/w (n = 7, 50%) and NAB150/2w (n = 10, 62.5%) groups than in the NAB100/w (n = 13, 81.3%) or NAB150/w (n = 11, 78.6%) group. Although the differences were not statistically significant, compared with the other groups, in the NAB150/w group, the time to occurrence of grade ≥2 polyneuropathy was shorter, and the median time to recovery from grade ≥2 polyneuropathy was longer. Dose delays and reductions due to neurotoxicity and impact of neurotoxicity on the patients' experience of symptoms and functional limitations was greater with NAB150/w. Among the seven polymorphisms selected for genotyping, the variant alleles of EPHA5-rs7349683, EPHA6-rs301927, and EPHA8-rs209709 were associated with an increased risk of paclitaxel-induced neuropathy. CONCLUSION The results of this exploratory study showed that, regardless of the dose, nab-paclitaxel did not differ from sb-paclitaxel in terms of neurotoxicity as evaluated with the TNS. However, results from NCI-CTCAE, dose delays and reductions, and functional tools consistently indicate that NAB150/w regimen is associated with a greater risk of chemotherapy-induced neuropathy. Thus, our results question the superiority of the TNS over NCI-CTCAE for evaluating chemotherapy-induced neuropathy and guiding treatment decisions in this context. The selection of the nab-paclitaxel regimen should be individualized based on the clinical context and potentially supported by pharmacogenetic analysis. Registry: EudraCT, 2012-002361-36; NCT01763710 IMPLICATIONS FOR PRACTICE: The results of this study call into question the superiority of the Total Neurotoxicity Score over the National Cancer Institute Common Terminology Criteria for Adverse Events for evaluating chemotherapy-induced neuropathy and guiding treatment decisions in this context and suggest that a regimen of 150 mg/m2 nab-paclitaxel administered on days 1, 8, and 15 is associated with a greater risk of chemotherapy-induced neuropathy and hematological toxicity compared with other lower-dose nab-paclitaxel regimens or a standard regimen of solvent-based paclitaxel. The selection of the nab-paclitaxel regimen should be individualized based on the clinical context and could benefit from pharmacogenetics analysis.
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Affiliation(s)
- Eva Ciruelos
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Oncosur Study Group, Madrid, Spain
| | - María Apellániz-Ruiz
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - Blanca Cantos
- Oncosur Study Group, Madrid, Spain
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Noelia Martinez-Jáñez
- Oncosur Study Group, Madrid, Spain
- Medical Oncology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Coralia Bueno-Muiño
- Oncosur Study Group, Madrid, Spain
- Medical Oncology Department, Hospital Infanta Cristina, Parla, Spain
| | - Maria-Jose Echarri
- Oncosur Study Group, Madrid, Spain
- Medical Oncology Department, Hospital Severo Ochoa, Leganes, Spain
| | - Santos Enrech
- Oncosur Study Group, Madrid, Spain
- Medical Oncology Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Juan-Antonio Guerra
- Oncosur Study Group, Madrid, Spain
- Medical Oncology Department, Hospital de Fuenlabrada, Fuenlabrada, Spain
| | - Luis Manso
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Oncosur Study Group, Madrid, Spain
| | - Tomas Pascual
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Oncosur Study Group, Madrid, Spain
| | - Cristina Dominguez
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Oncosur Study Group, Madrid, Spain
| | - Juan-Francisco Gonzalo
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Oncosur Study Group, Madrid, Spain
| | - Juan-Luis Sanz
- Clinical Research Department, Apoyo a la Investigación Clínica en España (APICES), Madrid, Spain
| | - Cristina Rodriguez-Antona
- Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Center (CNIO), Madrid, Spain
- Neurology Division, Neuromuscular Unit, ISCIII Center for Biomedical Research on Rare Diseases (CIBERER), Madrid, Spain
| | - Juan-Manuel Sepúlveda
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Oncosur Study Group, Madrid, Spain
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Ciruelos E, Martinez N, Cantos B, Echarri MJ, Enrech S, Bueno C, Guerra JA, Manso L, Pascual T, Mendiola C, Dominguez C, Gonzalo JF, Rodriguez de Antona C, Apellaniz-Ruiz M, Sanz JL, Sepúlveda JM. Phase II randomized study of nab-paclitaxel versus conventional paclitaxel as first-line therapy of metastatic HER2-negative breast cancer for neurotoxicity characterization: An Oncosur Study Group study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1029] [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)
- Eva Ciruelos
- Hospital Universitario 12 De Octubre, Madrid, Spain
| | | | - Blanca Cantos
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | | | | | | | - Luis Manso
- Medical Oncology Department. Hospital 12 de Octubre, Madrid, Spain
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5
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Manso L, Moreno F, Márquez R, Castelo B, Arcediano A, Arroyo M, Ballesteros AI, Calvo I, Echarri MJ, Enrech S, Gómez A, González Del Val R, López-Miranda E, Martín-Angulo M, Martínez-Jañez N, Olier C, Zamora P. Use of bevacizumab as a first-line treatment for metastatic breast cancer. ACTA ACUST UNITED AC 2015; 22:e51-60. [PMID: 25908921 DOI: 10.3747/co.22.2210] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE During clinical practice, it can be challenging, given the lack of response biomarkers, to identify the patients with metastatic breast cancer (mbca) who would benefit most from the addition of bevacizumab to first-line standard chemotherapy. The aim of the present review was to summarize the relevant scientific evidence and to discuss the experience of a group of experts in using bevacizumab to treat mbca. METHODS A panel of 17 Spanish oncology experts met to discuss the literature and their experience in the use of bevacizumab as first-line treatment for mbca. During the meeting, discussions focused on three main issues: the profile of the patients who could benefit most from bevacizumab, the optimal bevacizumab treatment duration, and the safety profile of bevacizumab. RESULTS The subset of mbca patients who would benefit the most from the addition of bevacizumab to first-line standard chemotherapy are those with clinically defined aggressive disease. Treatment with bevacizumab should be maintained until disease progression or the appearance of unacceptable toxicity. In the mbca setting, the toxicity profile of bevacizumab is well known and can be managed in clinical practice after adequate training. CONCLUSIONS This expert group recommends administering bevacizumab as first-line treatment in patients with clinically aggressive disease.
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Affiliation(s)
- L Manso
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Moreno
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - R Márquez
- MD Anderson Cancer Center, Madrid, Spain
| | - B Castelo
- Hospital Universitario La Paz, Madrid, Spain
| | - A Arcediano
- Hospital General Universitario de Guadalajara, Guadalajara, Mexico
| | - M Arroyo
- Hospital Príncipe de Asturias, Alcalá de Henares, Spain
| | | | - I Calvo
- Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - M J Echarri
- Hospital Universitario Severo Ochoa, Leganés, Spain
| | - S Enrech
- Hospital Universitario de Getafe, Getafe, Spain
| | - A Gómez
- Hospital Universitario de Salamanca, Salamanca, Spain
| | | | | | | | | | - C Olier
- Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - P Zamora
- Hospital Universitario La Paz, Madrid, Spain
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6
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Manso L, Perez-Carrion R, Chacon Lopez-Muniz JI, Garcia Palomo A, Galve Calvo E, Llorente RM, Cassinello J, Catalan G, Llorca C, Torregrosa MD, Alvarez I, Gallegos Sancho I, Blanco E, Oruezabal M, Mielgo Rubio X, Garcia Lopez MJ, Hernando B, Enrech S, Lara MA, Cortes-Funes H. Observational cross-sectional study to evaluate the prognostic factors influencing the selection of bevacizumab combined with chemotherapy in patients with HER2-negative metastatic breast cancer in routine clinical practice. ONCOSUR-AVALOX study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e11074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e11074 Background: Combining bevacizumab (BEV) with chemotherapy (CT) improves survival in HER2-negative metastatic breast cancer (MBC). We investigated the influence of age, ECOG, hormonal status, number of sites and location of metastases and patient decision on the selection of BEV combined with CT in MBC. Methods: Observational cross-sectional multicenter study in pts with HER2-negative MBC who have received first-line CT with BEV. Results: From November 2010 to November 2011, 124 pts were included: median age 51 (45-64) yr; ECOG: 0=50%; 60% pre-menopausic; 23% triple-negative (TN); 77% hormone receptor-positive (HR+). Metastatic disease: ≥3 sites=42% (TN: 32%; HR+: 45%); location: 44% bone, 35% lung, 30% liver. Most frequent BEV-based combinations were paclitaxel/BEV (53%) and docetaxel/BEV (14.5%); median no. of CT cycles: 6 (5-8). A disease-free survival (DFS) ≥12 months was achieved by 73%; TN: 68%; HR+: 76%. Overall response rate (ORR) was 58%: 51% partial response (PR), 7% complete response (CR); 28% stable disease (SD) and 10% disease progression. TN: ORR 44% (40% PR), clinical benefit 80% (36% SD); HR+: ORR 62% (54% PR), clinical benefit 87% (25% SD). 58% presented at least one toxicity, mainly grade 1-2; 26% BEV-related: only 3 (2.4%) grade 3 toxicities; no grade 4. Receiving adjuvant hormonal therapy was associated to DFS ≥12 months (p<0.05). ER+ tumors (OR: 0.215; 95% CI: 0.08-0.56; p=0.002) and one metastatic site, vs. ≥3 sites (OR: 0.309; 95% CI: 0.12-0.83; p=0,020) were independent factors associated with the selection of paclitaxel-BEV therapy in the overall population (TN or HR+). Metastases in the liver were significantly related to paclitaxel-BEV administration (p<0.01). Conclusions: Our findings suggest that first-line CT with BEV is an active and tolerable treatment option for pts with TN and HR+ MBC. ER+ tumors and a single metastatic site were identified as independent factors for the selection of a paclitaxel-BEV therapy. The presence of metastases in the liver was significantly associated to the administration of a paclitaxel-BEV regimen.
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Affiliation(s)
- Luis Manso
- Hospital Universitario 12 de Octubre (ONCOSUR), Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Mauro Oruezabal
- Hospital Universitario Infanta Cristina (ONCOSUR), Madrid, Spain
| | | | | | | | - Santos Enrech
- Hospital Universitario de Getafe (ONCOSUR), Madrid, Spain
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Abstract
We report the case of a 32-year-old patient with a left atrium myxosarcoma, presenting with congestive heart failure. It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. These tumors present local recidives and distance metastasis, so the mean survival is about 1 year, independent of any therapeutical option.
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Affiliation(s)
- Paula Awamleh
- Cardiology Service, Hospital Universitario de Getafe, Madrid, Spain.
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Coca S, Enrech S, Moreno García V, Sáez MA, Gutiérrez C, Colmenarejo A, Hernández JM, Pérez Piqueras J. Evaluation of the antitumor activity of interleukin-12 in an experimental murine model of colorectal cancer induced by 1,2 dimethyl-hydrazine (DMH). Rev Esp Enferm Dig 2005; 97:619-28. [PMID: 16266234 DOI: 10.4321/s1130-01082005000900002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Interleukin 12 (IL-12) is a cytokine that may enhance the proliferation and cytotoxic activity of T lymphocytes and natural killer (NK) cells. A relationship between extensive intratumoral infiltration of NK cells and longer survival rates in colorectal cancer (CRC) patients was previously noted. Preliminary evidence suggests that the combined administration of IL-12 and IL-2 may produce additive immunomodulatory activity. The purpose of this study was to determine whether the systemic administration of IL-12 (+/- IL-2) may induce an immune response against CRC as induced by 1,2-dimethylhydrazine (DMH). METHODS Sixty-five 6-week-old Wistar rats were treated with weekly subcutaneous injections of DMH for 26 weeks at a dose of 20 mg/kg of body weight. Once tumoral induction was over, the animals were randomly allocated to one of three groups: I, control; II, intraperitoneal injections of IL-12; III, intraperitoneal injections of IL-12 combined with IL-2. At 30 weeks, all surviving animals were sacrificed. We studied the following parameters in each rat--number of tumors, size of tumors, and total tumoral volume. Tumor samples were studied using the monoclonal antibody CD 57 for the detection of NK cells. The extent of NK infiltration was classified as small, less than 50 NK cells/50 high-power field (HPF); moderate, 50 to 150 NK cells/50 HPF, and extensive, more than 150 NK cells/50 HPF. RESULTS Thirty-five rats died before completion of the carcinogen exposure, and 30 rats were randomized (10 each group). In group II, 2 animals died during treatment. All rats in groups I and III developed tumors, while in group II two rats (25%) were tumor-free. Moreover, only one rat in group II developed multiple neoplasms, in contrast with group I and group III, where six rats (60%) and seven rats (70%), respectively, had more than one tumor. We found statistically significant differences in the mean number of tumors found in group II when compared to group I (p = 0.028) and group III (p = 0.019). Other parameters measured, such as biggest tumor size and total tumoral volume were found to be lower in group II, although no statistical differences were found between groups. Only 10% of rats in group I showed moderated/extensive NK cell infiltration, vs. 60% of rats in group II (p = 0.077) and 70% in group III (p = 0.02). CONCLUSION The administration of DMH to rodents provides a reliable and consistent means of inducing CRC that may be suitable for the evaluation of anti-cancer therapies. Our findings suggest that IL-12 is effective against the development of experimental CRC. Its antineoplastic effect could be attributed to the stimulus of this cytokine on the intratumoral infiltration of NK cells.
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Affiliation(s)
- S Coca
- Department of Pathology, Hospital Central de la Defensa Gómez Ulla, School of Medicine, Universidad Complutense, Madrid, Spain.
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