1
|
Castilla M, Pérez S, Guevara R, Alemany J, Campos M, Pla M, Ortega C, Falo C, Benítez A, Bajen M, Pérez L, Valdivielso A, Martínez E, Plana ML, Pérez H, Petit A, Soler T, Taco C, Ponce J, García A. P085 Target axillary disecction in cN2 breast cancer patients after neoadjuvant chemotherapy. Preliminary results. Breast 2023. [DOI: 10.1016/s0960-9776(23)00202-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
|
2
|
Vethencourt A, Trinidad E, Gómez Aleza C, Pernas Simon S, Petit A, Soler T, Urruticoechea A, Gumà Martinez A, García-Tejedor A, Pla M, Capó C, Gil MG, Stradella A, Fernádez A, Recalde Penabad S, Cejuela M, Vazquez S, Iserte A, Falo C, Gonzalez-Suarez E. 14P Immunomodulatory effect of denosumab in early breast cancer: Preliminary results of a randomized window-opportunity clinical trial D-Biomark. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.028] [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] Open
|
3
|
Recalde S, Quiroga V, del Barco S, Falo C, Dorca J, Margeli M, Stradella A, Soler T, Te García IR, Viñas G, Fernandez A, Vázquez RV, Vethencourt A, Marin MR, Gil-Gil M. Influence of age on the indication of adjuvant chemotherapy in early breast cancer using Oncotype DX. An analysis of 240 patients treated in the Institut Catala d’Oncologia (ICO) hospitals. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.034] [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
|
4
|
Falo C, Fernández S, Garrigós E, Casado ACV, Vázquez S, Stradella A, Recalde S, Pla M, Campos M, Gumà A, Ortega R, Petit A, Soler T, Perez J, Fernandez E, Bergamino M, Simon SP, Gil M, Ponce J, Tejedor AG. Residual cancer burden as a prognostic factor in a large series of neoadjuvant chemotherapy. Subgroup analysis per molecular surrogated subtypes. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.065] [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
|
5
|
Ferrer M, Dorcas J, Quiroga V, Margelí M, del Barco S, Stradella A, Petit A, Falo C, Viñas G, Romeo M, Villanueva R, Cirauqui B, Vázquez S, Fernández A, Recalde S, Vethencourt A, Soler T, Pérez-Martín X, Gil-Gil M. Abstract P5-15-09: Impact of oncotype dx genetic signature used in early breast cancer. Clinical and economic analisys of a 110 patient cohort treated in the Catalan Oncologic Institute (ICO), Spain. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-15-09] [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
Benefit from adjuvant chemotherapy (CT) is doubtful in a high percentage of patients with early breast cancer. The 21-gene recurrence-score (RS) assay (Oncotype DX, Genomic Health) is one gene-expression assay that provide prognostic and predictive information in hormone-receptor (RH) positive breast cancer. The results of the TAILORx study have confirmed that the majority of patients with tumors RH + and HER2 negative can avoid CT without increasing their risk of relapse. From 2012 to 2015 we used Mammaprint (MMP), in our institution and 60% of cases could avoided CT (communicated in SABCS 2015). Since 2017 we use RS for this purpose.
Primary Objective
To analyze the impact of using RS to change the indication of adjuvant CT.
Secondary Objectives
To analyze the association between different clinical pathological factors and the RS value, and calculate the difference between the cost of all RS test and the cost in direct expense of the treatment with CT of all patients who could avoid it thanks to the RS
Material and methods
We analyzed all RS test performed in the three ICO centers during 2017. We sent 112 tumor samples; in 2 samples adequated RNA for RS was not obtained. We compared the adjuvant treatment initially planned according to institutional treatment protocol with the treatment given after RS. We compared the direct economic costs of CT with the costs of the diagnostic test, and performed a logistic regression analysis of some pathological factors and RS value.
Results
The RS could be determined in 110 of 112 cases, in which there was indication of adjuvant CT. Only 14 patients received CT (12,72%) with the RS value, so CT was avoided in 96 patients (87,28%).
The clinical-pathological characteristics of the series are summarized in the table 1. Of the risk factors analyzed, only grade 3 (p 0.001) and PR <20% (p<0.002) showed a statistically significant relationship with a higher probability of RS> 25. No association was found between age, nodal status, tumor diameter, Ki67, Infiltrating Ductal Carcinoma vs neither Infiltrating Lobular Carcinoma nor Lympho-Vascular invasion.
The cost of the genetic studies was 180000€ (1636€ each). The cost of each CT schedule (EC x 4 followed by paclitaxel x 12) was 7214€ and the total cost of 96 cases 692590€. Direct costs savings estimated from the reduction in CT treatment were 512590€
Conclusion: Our series shows that RS avoided unnecessary CT in 87% of cases and was more cost-effective than a previous series with MMP. G3 and RP <20 were the only pathological factors associated with an increased risk of RS> 25.
Table 1.Patients characteristics and clinical-pathological details from the analyzed tumorsPatient characteristicsAge, mean (range)53,76 (19 – 75)≥50y72 (65.5%)<50y38 (34.5%)HistologyInfiltrating ductal carcinoma88 (80%)Infiltrating lobular carcinoma20 (18,2%)Others2 (1,8%)TNMTumor diameter (mm), mean (range)19,25 (1 – 160)pN058 (52,7%)pN1mic21 (19%)pN131 (28,3%)Hormone receptorsRE 2-100%110 (100%)RP <20%22 (20%)RP ≥20%88 (80%)Ki67 median, mean (range)20, 21 (2-75)Lymphovascular invasionyes9 (8%)no101 (92%)Adjuvant treatmentCT14 (12,72%)Hormonotherapy96 (87,28%)
Citation Format: Ferrer M, Dorcas J, Quiroga V, Margelí M, del Barco S, Stradella A, Petit A, Falo C, Viñas G, Romeo M, Villanueva R, Cirauqui B, Vázquez S, Fernández A, Recalde S, Vethencourt A, Soler T, Pérez-Martín X, Gil-Gil M. Impact of oncotype dx genetic signature used in early breast cancer. Clinical and economic analisys of a 110 patient cohort treated in the Catalan Oncologic Institute (ICO), Spain [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-15-09.
Collapse
Affiliation(s)
- M Ferrer
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Dorcas
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - V Quiroga
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Margelí
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - S del Barco
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Stradella
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Petit
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - C Falo
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - G Viñas
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Romeo
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - R Villanueva
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - B Cirauqui
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Vázquez
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Fernández
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Recalde
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Vethencourt
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - T Soler
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - X Pérez-Martín
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Gil-Gil
- Hospital Duran I Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Josep Trueta. ICO Girona, Girona, Spain; Hospital Germans Trias I Pujol. ICO Badalona, Badalona, Barcelona, Spain; Hospital de Bellvitge. Hospitalet de Llobregat, L'Hospitalet de Llobregat, Barcelona, Spain; Statistical. Clinical Research Unit. Hospital Duran i Reynals. ICO Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
6
|
Fernandez-Gonzalez S, Falo Zamora C, Nuñez D, Vethencourt A, Pla MJ, Soler T, Guma A, Perez X, Gil M, Ponce J, Garcia A. Abstract P6-09-04: Predictive factors for considering to avoid axillar lymphadenectomy in selected node positive breast cancer patients after neoadjuvant chemotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-09-04] [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:
To perform a systematic axillar lymphadenectomy (ALND) in clinical node positive (N+) patients after neoadjuvant chemotherapy (NACT) is currently under discussion. We aimed to study which factors are related to a pathological complete axillar response (ypN0) after NACT in order to select which patients could benefit from a sentinel lymph node biopsy without interfering with survival.
Material and methods
N+ patients who underwent ALND after NACT between June 2008 and December 2016 were retrospectively analyzed. Clinical features, molecular and histological factors, recurrence and specific mortality rates were compared between patients achieving a complete pathological axillary response vs not (ypN0 vs ypN+).
Results
345 N+ patients were reviewed. After NACT, 137 (39.6%) become ypN0[CF1] , 9 (2.6%) ypN1 mic, 113 (32.7%) ypN1, 60 (17.3%) ypN2 and 22 (6.4%) N3. Univariate analysis results regarding the predictive factors for ypN0 are detailed in [table 1]. Multivariate analyses showed molecular subtype (TN and Her2+) and clinical response as independent predictors of ypN0 [table 2]. After a mean follow-up of 58 months, overall survival was statistically superior in ypN0 vs ypN1 (p= 0.001).
Table 1.Predictive factors for ypN0 YpN0 (n = 137)YpN+ (n = 208)pAge (mean, years)58.3 ± 13.2758.59 ± 12.340.799BMI (mean)27.8±5.4927.8±5.360.973Dosis of QT (median)(%) 0.575IIA6 (31.6)13 (68.4) IIB71 (39.3)110 (60.8) IIIA28 (36.8)48 (63.2) IIIB24 (43.6)31 (56.4) IIIC7 (58.3)5 (41.7) Radiological image(%) 0.930Nodule77 (38.1)125 (61.9) Non-mass distortion10 (43.5)13 (56.5) Radiological size (median)32 (0-115)29 (0-130)0.246Suspicious a-LN by US(%) 0.486130 (30.9)37 (24.3) 25 (5.2)14 (9.2) >257 (58.8)91 (59.9) Histological subtype(%) 0.093Invasive Ductal Carcinoma133 (40.9)192 (59.1) Invasive Lobular Carcinoma2 (20)8 (80) Others2 (22.2)7 (78.8) Nottingham grade(%) <0.001G11 (6.2)15 (93.8) G244 (28.6)110 (71.4) G386 (53.4)75 (46.6) Molecular-like subtype(%) <0.001Luminal A-like2 (5.3)36 (94.7) Luminal B-like (Her2 -)21(18.1)95 (81.9) Luminal B-like (Her2 +)40 (63.5)23 (36.5) HER-2 enriched (non luminal)43 (74.1)15 (25.9) Triple Negative31 (44.9)38 (55.1) Vascular invasion19 (42.2)26 (57.8)0.889Clinical Response(%) <0.001Complete61 (75.3)20 (24.7) Partial69 (31.8)148 (68.2) No response6 (20.7)23 (79.3) Progression1 (10)9 (90) Percentage are given per row.
Table 2.Multivariate analysis logistic regression of clinical predictive factors of ypN0. OR95% Confidence Intervalp valueMolecular subtype No-luminal vs Luminal7,7483,913-15,343<0,001Clinical response Response vs not response6,8491,834-25,5710,04OR: Odd ratio. No-luminal includes: luminal B (HER2 +), HER2 Henriched and triple negative. Luminal includes: Luminal A and Luminal B (HER2 -).
Conclusions
A remarkable percentage of N+ became ypN0 after NATC. Molecular subtype and complete clinical response were independent predictive factors of ypN0. We propose to offer the benefit of a targeted axillary procedure in those patients.
Citation Format: Fernandez-Gonzalez S, Falo Zamora C, Nuñez D, Vethencourt A, Pla MJ, Soler T, Guma A, Perez X, Gil M, Ponce J, Garcia A. Predictive factors for considering to avoid axillar lymphadenectomy in selected node positive breast cancer patients after neoadjuvant 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 P6-09-04.
Collapse
Affiliation(s)
- S Fernandez-Gonzalez
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - C Falo Zamora
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - D Nuñez
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Vethencourt
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - MJ Pla
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - T Soler
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Guma
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - X Perez
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Gil
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Ponce
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Garcia
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
7
|
Garcia-Tejedor A, Guma A, Soler T, Valdivieso A, Petit A, Contreras N, Chappuis CG, Falo C, Pernas S, Anselem A, Fernandez-Montoli E, Pla MJ, Burdio F, Ponce J. Abstract P3-13-07: Is radiofrequency ablation better than lumpectomy for margin status in breast cancer? Results of a randomized clinical trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-13-07] [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
PURPOSE: To study the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation (RFA) as local treatment for breast cancer and to intraoperatively evaluate the margin status after RFA in comparison with lumpectomy.
MATERIAL and METHODS: Preliminary in vitro RF ablation experimentation with two mastectomy specimens was performed to test the electrode, practice the ultrasound technique and evaluate the macroscopic and microscopic effects of RF. Then, aprospective, randomized open-label phase II clinical trial (NCT02281812) was conducted in a single institution from 2013-2017. Forty subjects, mean age 64 (range 46-86), with ductal infiltrating carcinoma of the breast ≤2 cm were randomly assigned to RFA plus lumpectomy or lumpectomy alone. Margin status, tumor cell viability (TCV) after RFA (by nicotinamide adenine dinucleotide (NADH) and Cytokeratin 18 (CK18) staining), adverse events and local recurrences were evaluated by univariable and multivariable analyses (SPSS statistical software).
RESULTS: In the experimental design with mastectomies, the only procedural complication was a skin burn at the entrance site of the electrodes. We learned that the tip of the electrodes should cut cross the tumor by at least 10mm.
The clinical trial includes two groups: study group (n=20) and control group (n=20). NADH and CK18 staining demonstrated absence of TCV after RFA with at least one of the two techniques. The percentage of intraoperatively affected surgical margins was higher in the control group although local adverse effects after surgery was higher in the RFA treatment arm. Three study subjects presented local infection (two had partial irradiation of the breast) and none in the control group. Median follow up was 25 months (range 1–83). No recurrence or second surgery was required during the study period.
Outcomes RFA group (n = 20)Control group (n=20)p valueSpecimen weight (median, gr)42 (24-80)27 (11-60)0.004Specimen volume (median, ml)369 (259-847)201 (100-602)0.004Positive margin (intraoperative)4/20 (20%)11/20 (55%)0.022Pathological size (median, mm)11.5 (5-20)10.5 (6-16)0.07Local Adverse effect8/20 (40%)1/20 (5%)0.01Breast Inflammation5/20 (25%)1/20 (5%)0.182Breast Infection3/20 (15%)0/20 (0%)0.23RFA: radiofrequency ablation. n=number of subjects
CONCLUSION: RFA seems effective in the cases considered and could be more accurate than lumpectomy in terms of obtaining more free margins. Surgical excision associated with RFA leads to a higher amount of local adverse effects, especially if combined with partial irradiation of the breast. RFA could be considered as a less invasive treatment in tumors smaller than 20 mm; however, this warrants further investigation.
Citation Format: Garcia-Tejedor A, Guma A, Soler T, Valdivieso A, Petit A, Contreras N, Chappuis CG, Falo C, Pernas S, Anselem A, Fernandez-Montoli E, Pla MJ, Burdio F, Ponce J. Is radiofrequency ablation better than lumpectomy for margin status in breast cancer? Results of a randomized clinical 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 P3-13-07.
Collapse
Affiliation(s)
- A Garcia-Tejedor
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - A Guma
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - T Soler
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - A Valdivieso
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - A Petit
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - N Contreras
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - CG Chappuis
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - C Falo
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - S Pernas
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - A Anselem
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - E Fernandez-Montoli
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - MJ Pla
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - F Burdio
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| | - J Ponce
- Hospital Universitari Bellvitge, Idibell, Hospitalet de Llobregat, Barcelona, Spain; Institut Català d'Oncología, Hospitalet de Llobregat, Barcelona, Spain; Parc de Salut-Hospital del Mar, Barcelona, Spain
| |
Collapse
|
8
|
Soler T, Dorca E, Fernandez-Calvo D, Bosch J, Petit A, Taco M, Guerra E, Zanca A, Baixeras N, Perez Tapia L, Ortega R, Perez-Sidelnikova D, Fernandez Montoli M, Tena G, Matias-Guiu X. Diagnosis of fibroepithelial lesions and Pyllodes tumors by core biopsy: Correlation with the surgical specimen. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30697-x] [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: 10/17/2022]
|
9
|
Gil-Gil M, Morilla I, Petit A, Soler T, Perez-Martin X, Guma A, Pla MJ, Ortega R, Garcia-Tejedor A, Falo C, Montal R, Perez-Casanova L, Loayza C, Pernas S. Abstract P4-08-08: Biomarkers to predict distant recurrence free survival after neoadjuvant endocrine therapy in breast cancer. A long follow up retrospective study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-08-08] [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:
Neoadjuvant endocrine therapy (NET) is gaining more acceptances for the management of estrogen receptor (ER) positive breast cancer (BC). Rate of patients achieving pathological complete response is very low and Ki67 suppression and PEPI score are the only prognostic factors associated with relapse free survival.
The aim of our study was to identify biomarkers of prediction of distant relapse risk that could help clinicians in the decision-making of systemic adjuvant treatment in patients previously treated with NET
Material & Methods:
Retrospective study of 119 postmenopausal women with ER or progesterone receptor (PR) positive BC treated with NET in ICO-HUB from 1997 to 2009. Clinical-pathological data and treatments administered were reviewed. IHC expression of ER, PR, Ki67, Androgen receptor (AR), BCL-2, Cyclin D1 (CD1), p16, p53, CD 44 and synaptophysin were analyzed in post-NET surgical formalin-fixed paraffin-embedded tumor samples through a tissue microarray. Survival was calculated by Kaplan-Meier method. Univariate and multivariate analysis of variables associated with distant relapse free survival (DRFS) was evaluated by Cox proportional hazard model.
Results:
Mean age was 74 (63-88). cT: T2 5%, T3 6.5%, T4 43.5%. cN: N0 59%, N1 25%, N2-3 16%. Stage: I 21%, II 49.5%, III 29.5%. Histological subtype: ductal 84%, lobular 6%, others 10%. Histological grade: G1 20%, G2 55%, G3 25%.
Vascular invasion 15%. NET: Aromatase Inhibitors 64%, SERM 36%. Median duration of NET 8.5 months. Clinical Response: Complete 4%, Partial 55%, Stable 37%, Progression 4%. Surgery: Lumpectomy 72%, Mastectomy 28%;Lymphadenectomy 70.5%, Sentinel lymph node biopsy 6%, No surgical approach of axilla 23.5%. Surgical specimen: ypT1 36%, ypT2 54%, ypT3 6%, ypT4 4%; ypN0 28%, ypN1 22%, ypN2 13.5%, ypN3 12% ypNx 23.5%. Surgical margins: Negative 89% Positive 11%. Median fibrosis rate 20% (0-95). PR and Ki67 showed a statistically significant decrease after NET(p<0,05) but no ER (p=0,29).
Adjuvant treatment: chemotherapy 7%, radiotherapy 76%, endocrine therapy 96%. Median follow-up: 104 months. Only 21 patients developed distance relapse. Median OS was 139 months [95% CI = 98-181]. Univariate analysis for DRFS showed statistically significant differences in cN (HR=3), histological grade 3 (HR=3.61), ypN (HR=3.62), p16 (HR=6.1) and p53 (HR=2.79). Multivariate analysis of post-NET biomarkers showed that negative nuclear p16 expression (HR=4.79)and positive p53 (HR=2.83)were independently associated with worse DRFS. In multivariate analysis of all clinico-pathological and molecular factors, histological grade 3 (HR=2.82) was the sole DRFS independent factor.
Conclusions:
Negative nuclear p16 expression and positive p53 post-NET were associated with worseDRFS. Whenall clinico-pathological and molecular factors were analysed, G3 was the sole DRFS independent factor. Patients with G3, negative p16 or positive p53 after NET could probably benefit from adjuvant chemotherapy or CDK 4-6 inhibitors treatment. In our series, we did not find usefulness in analysing ER, PR and Ki67 post-NET changes to predict DRFS.
Citation Format: Gil-Gil M, Morilla I, Petit A, Soler T, Perez-Martin X, Guma A, Pla MJ, Ortega R, Garcia-Tejedor A, Falo C, Montal R, Perez-Casanova L, Loayza C, Pernas S. Biomarkers to predict distant recurrence free survival after neoadjuvant endocrine therapy in breast cancer. A long follow up retrospective study [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 P4-08-08.
Collapse
Affiliation(s)
- M Gil-Gil
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - I Morilla
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - A Petit
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - T Soler
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - X Perez-Martin
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - A Guma
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - MJ Pla
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - R Ortega
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - A Garcia-Tejedor
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - C Falo
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - R Montal
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - L Perez-Casanova
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - C Loayza
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| | - S Pernas
- Institut Català d'Oncologia, Medical Oncology (ICO) - Hospital Universitari de Bellvitge (HUB). Breast Cancer Unit, L'Hospitalet, Barcelona, Spain; Hospital Clinic, Barcelona, Spain
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Mateo F, Arenas EJ, Aguilar H, Serra-Musach J, de Garibay GR, Boni J, Maicas M, Du S, Iorio F, Herranz-Ors C, Islam A, Prado X, Llorente A, Petit A, Vidal A, Català I, Soler T, Venturas G, Rojo-Sebastian A, Serra H, Cuadras D, Blanco I, Lozano J, Canals F, Sieuwerts AM, de Weerd V, Look MP, Puertas S, García N, Perkins AS, Bonifaci N, Skowron M, Gómez-Baldó L, Hernández V, Martínez-Aranda A, Martínez-Iniesta M, Serrat X, Cerón J, Brunet J, Barretina MP, Gil M, Falo C, Fernández A, Morilla I, Pernas S, Plà MJ, Andreu X, Seguí MA, Ballester R, Castellà E, Nellist M, Morales S, Valls J, Velasco A, Matias-Guiu X, Figueras A, Sánchez-Mut JV, Sánchez-Céspedes M, Cordero A, Gómez-Miragaya J, Palomero L, Gómez A, Gajewski TF, Cohen EEW, Jesiotr M, Bodnar L, Quintela-Fandino M, López-Bigas N, Valdés-Mas R, Puente XS, Viñals F, Casanovas O, Graupera M, Hernández-Losa J, Ramón Y Cajal S, García-Alonso L, Saez-Rodriguez J, Esteller M, Sierra A, Martín-Martín N, Matheu A, Carracedo A, González-Suárez E, Nanjundan M, Cortés J, Lázaro C, Odero MD, Martens JWM, Moreno-Bueno G, Barcellos-Hoff MH, Villanueva A, Gomis RR, Pujana MA. Stem cell-like transcriptional reprogramming mediates metastatic resistance to mTOR inhibition. Oncogene 2016; 36:2737-2749. [PMID: 27991928 PMCID: PMC5442428 DOI: 10.1038/onc.2016.427] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 03/10/2016] [Revised: 08/31/2016] [Accepted: 10/10/2016] [Indexed: 01/16/2023]
Abstract
Inhibitors of the mechanistic target of rapamycin (mTOR) are currently used to treat advanced metastatic breast cancer. However, whether an aggressive phenotype is sustained through adaptation or resistance to mTOR inhibition remains unknown. Here, complementary studies in human tumors, cancer models and cell lines reveal transcriptional reprogramming that supports metastasis in response to mTOR inhibition. This cancer feature is driven by EVI1 and SOX9. EVI1 functionally cooperates with and positively regulates SOX9, and promotes the transcriptional upregulation of key mTOR pathway components (REHB and RAPTOR) and of lung metastasis mediators (FSCN1 and SPARC). The expression of EVI1 and SOX9 is associated with stem cell-like and metastasis signatures, and their depletion impairs the metastatic potential of breast cancer cells. These results establish the mechanistic link between resistance to mTOR inhibition and cancer metastatic potential, thus enhancing our understanding of mTOR targeting failure.
Collapse
Affiliation(s)
- F Mateo
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - E J Arenas
- Oncology Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - H Aguilar
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - J Serra-Musach
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - G Ruiz de Garibay
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - J Boni
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - M Maicas
- Centre for Applied Medical Research (CIMA) and Department of Biochemistry and Genetics, University of Navarra, Pamplona, Spain
| | - S Du
- Department of Radiation Oncology, New York University School of Medicine, New York, NY, USA
| | - F Iorio
- European Molecular Biology Laboratory-European Bioinformatics Institute (EMBL-EBI), Wellcome Trust Genome Campus, Cambridge, UK.,Cancer Genome Project, Wellcome Trust Sanger Institute, Hinxton, UK
| | - C Herranz-Ors
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Islam
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - X Prado
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Llorente
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Petit
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Vidal
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - I Català
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - T Soler
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - G Venturas
- Department of Pathology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Rojo-Sebastian
- Department of Pathology, MD Anderson Cancer Center, Madrid, Spain
| | - H Serra
- Angiogenesis Research Group, ProCURE, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - D Cuadras
- Statistics Unit, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - I Blanco
- Hereditary Cancer Programme, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - J Lozano
- Department of Molecular Biology and Biochemistry, Málaga University, and Molecular Oncology Laboratory, Mediterranean Institute for the Advance of Biotechnology and Health Research (IBIMA), University Hospital Virgen de la Victoria, Málaga, Spain
| | - F Canals
- ProteoRed-Instituto de Salud Carlos III, Proteomic Laboratory, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Spain
| | - A M Sieuwerts
- Department of Medical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Cancer Genomics Centre, Rotterdam, The Netherlands
| | - V de Weerd
- Department of Medical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Cancer Genomics Centre, Rotterdam, The Netherlands
| | - M P Look
- Department of Medical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Cancer Genomics Centre, Rotterdam, The Netherlands
| | - S Puertas
- Chemoresistance and Predictive Factors Laboratory, ProCURE, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - N García
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - A S Perkins
- University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY, USA
| | - N Bonifaci
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - M Skowron
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - L Gómez-Baldó
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - V Hernández
- Biological Clues of the Invasive and Metastatic Phenotype Laboratory, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Martínez-Aranda
- Biological Clues of the Invasive and Metastatic Phenotype Laboratory, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - M Martínez-Iniesta
- Chemoresistance and Predictive Factors Laboratory, ProCURE, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - X Serrat
- Cancer and Human Molecular Genetics, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - J Cerón
- Cancer and Human Molecular Genetics, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - J Brunet
- Hereditary Cancer Programme, ICO, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - M P Barretina
- Department of Medical Oncology, ICO, IDIBGI, Girona, Spain
| | - M Gil
- Department of Medical Oncology, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - C Falo
- Department of Medical Oncology, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Fernández
- Department of Medical Oncology, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - I Morilla
- Department of Medical Oncology, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - S Pernas
- Department of Medical Oncology, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - M J Plà
- Department of Gynecology, University Hospital of Bellvitge, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - X Andreu
- Department of Pathology, Parc Taulí Hospital Consortium, Sabadell, Barcelona, Spain
| | - M A Seguí
- Medical Oncology Service, Parc Taulí Hospital Consortium, Sabadell, Barcelona, Spain
| | - R Ballester
- Department of Radiation Oncology, University Hospital Germans Trias i Pujol, ICO, Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
| | - E Castellà
- Department of Pathology, University Hospital Germans Trias i Pujol, ICO, IGTP, Badalona, Barcelona, Spain
| | - M Nellist
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - S Morales
- Hospital Arnau de Vilanova, University of Lleida, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain
| | - J Valls
- Hospital Arnau de Vilanova, University of Lleida, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain
| | - A Velasco
- Hospital Arnau de Vilanova, University of Lleida, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain
| | - X Matias-Guiu
- Hospital Arnau de Vilanova, University of Lleida, Biomedical Research Institute of Lleida (IRB Lleida), Lleida, Spain
| | - A Figueras
- Angiogenesis Research Group, ProCURE, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - J V Sánchez-Mut
- Cancer Epigenetics and Biology Program (PEBC), IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - M Sánchez-Céspedes
- Cancer Epigenetics and Biology Program (PEBC), IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Cordero
- Cancer Epigenetics and Biology Program (PEBC), IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - J Gómez-Miragaya
- Cancer Epigenetics and Biology Program (PEBC), IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - L Palomero
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Gómez
- Cancer Epigenetics and Biology Program (PEBC), IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - T F Gajewski
- Departments of Pathology and Medicine, University of Chicago, Chicago, IL, USA
| | - E E W Cohen
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - M Jesiotr
- Department of Pathology, Military Institute of Medicine, Warsaw, Poland
| | - L Bodnar
- Department of Oncology, Military Institute of Medicine, Warsaw, Poland
| | - M Quintela-Fandino
- Breast Cancer Clinical Research Unit, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - N López-Bigas
- Department of Experimental and Health Sciences, Barcelona Biomedical Research Park, Pompeu Fabra University (UPF), Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - R Valdés-Mas
- Department of Biochemistry and Molecular Biology, University Institute of Oncology of Asturias, University of Oviedo, Oviedo, Spain
| | - X S Puente
- Department of Biochemistry and Molecular Biology, University Institute of Oncology of Asturias, University of Oviedo, Oviedo, Spain
| | - F Viñals
- Angiogenesis Research Group, ProCURE, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - O Casanovas
- Angiogenesis Research Group, ProCURE, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - M Graupera
- Angiogenesis Research Group, ProCURE, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - J Hernández-Losa
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - S Ramón Y Cajal
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - L García-Alonso
- European Molecular Biology Laboratory-European Bioinformatics Institute (EMBL-EBI), Wellcome Trust Genome Campus, Cambridge, UK
| | - J Saez-Rodriguez
- European Molecular Biology Laboratory-European Bioinformatics Institute (EMBL-EBI), Wellcome Trust Genome Campus, Cambridge, UK
| | - M Esteller
- Cancer Epigenetics and Biology Program (PEBC), IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.,Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - A Sierra
- Molecular and Translational Oncology Laboratory, Biomedical Research Center CELLEX-CRBC, Biomedical Research Institute 'August Pi i Sunyer' (IDIBAPS), and Systems Biology Department, Faculty of Science and Technology, University of Vic, Central University of Catalonia, Barcelona, Spain
| | - N Martín-Martín
- Center for Cooperative Research in Biosciences (CIC bioGUNE), Derio, Spain
| | - A Matheu
- Neuro-Oncology Section, Oncology Department, Biodonostia Research Institute, San Sebastian, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - A Carracedo
- Center for Cooperative Research in Biosciences (CIC bioGUNE), Derio, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Spain.,Department of Biochemistry and Molecular Biology, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - E González-Suárez
- Cancer Epigenetics and Biology Program (PEBC), IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - M Nanjundan
- Department of Cell Biology, Microbiology, and Molecular Biology, University of South Florida, Tampa, FL, USA
| | - J Cortés
- Department of Medical Oncology, VHIO, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Lázaro
- Hereditary Cancer Programme, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - M D Odero
- Centre for Applied Medical Research (CIMA) and Department of Biochemistry and Genetics, University of Navarra, Pamplona, Spain
| | - J W M Martens
- Department of Medical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Cancer Genomics Centre, Rotterdam, The Netherlands
| | - G Moreno-Bueno
- Department of Biochemistry, Autonomous University of Madrid (UAM), Biomedical Research Institute 'Alberto Sols' (Spanish National Research Council (CSIC)-UAM), Translational Research Laboratory, Hospital La Paz Institute for Health Research (IdiPAZ), and MD Anderson International Foundation, Madrid, Spain
| | - M H Barcellos-Hoff
- Department of Radiation Oncology, New York University School of Medicine, New York, NY, USA
| | - A Villanueva
- Chemoresistance and Predictive Factors Laboratory, ProCURE, ICO, IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - R R Gomis
- Oncology Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - M A Pujana
- Breast Cancer and Systems Biology Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Barcelona, Spain
| |
Collapse
|
12
|
Bukiet F, Soler T, Guivarch M, Camps J, Tassery H, Cuisinier F, Candoni N. Factors affecting the viscosity of sodium hypochlorite and their effect on irrigant flow. Int Endod J 2013; 46:954-61. [PMID: 23480363 DOI: 10.1111/iej.12086] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 02/09/2013] [Indexed: 11/30/2022]
Affiliation(s)
- F. Bukiet
- Laboratoire biologie santé et Nanosciences; UFR Odontologie de Montpellier 1; Montpellier; France
| | - T. Soler
- Laboratoire Interface Matrice Extracellulaire Biomatériaux; UFR Odontologie de Marseille, Aix Marseille Université a; Marseille; France
| | - M. Guivarch
- Laboratoire Interface Matrice Extracellulaire Biomatériaux; UFR Odontologie de Marseille, Aix Marseille Université a; Marseille; France
| | - J. Camps
- Laboratoire Interface Matrice Extracellulaire Biomatériaux; UFR Odontologie de Marseille, Aix Marseille Université a; Marseille; France
| | - H. Tassery
- Laboratoire biologie santé et Nanosciences; UFR Odontologie de Montpellier 1; Montpellier; France
| | - F. Cuisinier
- Laboratoire biologie santé et Nanosciences; UFR Odontologie de Montpellier 1; Montpellier; France
| | - N. Candoni
- CNRS, Centre Interdisciplinaire de Nanosciences de Marseille; Aix Marseille Université, Campus de Luminy; a Marseille; France
| |
Collapse
|
13
|
Gómez-Diez S, Mas Vidal A, Soler T, Vázquez-López F, Pérez Oliva N. [Vitamin A deficiency and bowel-associated dermatosis-arthritis syndrome secondary to biliopancreatic diversion for obesity]. Actas Dermosifiliogr 2010; 101:900-902. [PMID: 21159272] [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: 05/30/2023] Open
|
14
|
Bajén MT, Benítez AM, Domènech A, Ricart Y, Mora J, Notta P, Ramal D, Urruticoechea A, Soler T, Martín-Comin J. [Positive sentinel node risk in relation to oestrogen receptors in breast cancer in premenopausal and postmenopausal women]. ACTA ACUST UNITED AC 2010; 29:289-92. [PMID: 20828880 DOI: 10.1016/j.remn.2010.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 07/16/2010] [Accepted: 07/20/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The influence of the relationship between pre- and post-menopausal stage of patients with breast cancer (BC) and the risk of sentinel lymph node (SLN) metastasis as well as the influence of oestrogen receptor (ER) status within each one of these groups were analyzed. METHODS A BC database with 1,388 patients was analysed. Three age groups were studied: A, elderly postmenopausal, 200 patients, ≥ 70 years old; B, younger postmenopausal, 89 patients, 55-69 years old; C, premenopausal, 85 patients, <55 years old. In each group 2 subgroups were analyzed: positive ER and negative ER tumours. Data analysed: SLN-positive patients, non-sentinel node (NSN)-positive patients, non-surgical detections (NSD) and non disease-free (NDF) patients after a follow-up of 52 months. STATISTICAL ANALYSIS chi-squared test, significance: P ≤ 0.05. RESULTS SLN metastasis was significantly (P<0.025) more common in premenopausal than in postmenopausal patients, and within those, mainly in negative ER tumours. Positive-NSN increases slightly in premenopausal patients (exclusively in negative ER tumours). NDF patients are similar in the 3 groups and in all of them it is much more frequent in negative ER tumours. CONCLUSION SLN metastasis varies significantly according to hormonal state and not according to age, being more frequent in premenopausal patients and mainly in ER negative tumours.
Collapse
Affiliation(s)
- M T Bajén
- Servicio de Medicina Nuclear, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Naskar S, Biswas S, Mishra D, Adhikary B, Falvello L, Soler T, Schwalbe C, Chattopadhyay S. Studies on the relative stabilities of Mn(II) and Mn(III) in complexes with N4O2 donor environments: crystal structures of [Mn(pybzhz)2] and [Mn(Ophsal)(imzH)2] ClO4 (pybzhz=N-(benzoyl)-N′-(picolinylidene) hydrazine, Ophsal=N,N′-o-phenylenebis(salicylideneimine), imzH=imidazole). Inorganica Chim Acta 2004. [DOI: 10.1016/j.ica.2004.06.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
16
|
Soler T, Pujol M, Peña-Casanova J, Hernández G, Sol JM, Aguilar M, Blesa R. Adaptation and standardization of the geriatric evaluation of relative's rating instrument (GERRI) for Spain. Neurologia 2002; 17:193-9. [PMID: 11940407] [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: 02/24/2023] Open
Abstract
BACKGROUND The Geriatric Evaluation of Relative's Rating Instrument (GERRI) is a scale that evaluates the frequencies of alterations in behavior and functional capacity over a two-week period prior to exploration. The scale depends on the observations done by a relative o first caregiver of the studied subject. AIM To adapt and standardize the GERRI for the use in the Spanish population as a part of a general project to standardized cognitive and functional tests. METHOD The scale was administered to 444 subjects: 249 controls, 85 mild memory-cognitive disorders without dementia subjects (DWD) and 110 patients with Alzheimer-type dementia (ATD). An across-sectional statistical study was conducted in our samples stratified by age, gender and education. We evaluated the reliability of repeatability of the test, the internal reliability and the age, sex and education effects on the score of the different subscales. We also took into account the diagnostical validity in the Alzheimer disease and finally we correlated this test results with Mini mental test. RESULTS The demographic variables age and schooling were found to affect the GERRI subscales differently. Gender did not reach significance. Internal consistency for the GERRI-Social, -Mood and -Cognitive were 0.8620, 0.7647 and 0.9259, respectively. CONCLUSION The Spanish version of the GERRI may be applied to Spanish clinical series because of its reliable internal consistency and reproducibility.
Collapse
Affiliation(s)
- T Soler
- Institut Clínic de Malalties del Sistema Nerviós, IDIBAPS-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Facultad de Medicina, Universitat de Barcelona, Spain
| | | | | | | | | | | | | |
Collapse
|
17
|
Sais G, Admella C, Soler T. Spontaneous regression in primary cutaneous neuroendocrine (Merkel cell) carcinoma: a rare immune phenomenon? J Eur Acad Dermatol Venereol 2002; 16:82-3. [PMID: 11952300 DOI: 10.1046/j.1468-3083.2002.374_2.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
18
|
Affiliation(s)
- M Yus
- Departamento de Química Orgánica, Facultad de Ciencias, Universidad de Alicante, Apdo. 99, 03080 Alicante, Spain.
| | | | | |
Collapse
|
19
|
Guachalla J, Soler T, Barahona R, Meneses M, Sabbagh E, Czishke C, Orlandi L, Fau C, Salas F, Rosas R, Lemus J. The value of fiberbronchoscopy (FBC) in staging of lung cancer. Lung Cancer 2000. [DOI: 10.1016/s0169-5002(00)80912-5] [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: 12/01/2022]
|
20
|
Guachalla J, Czischke C, Lemus J, Barrera A, Soler T, Barahona R, Meneses M, Orlandi L, Rodriguez P, Pavlov D, Prats R, Fau C, Rosas R, Salas F. Lung Cancer in Chile. The importance of registering lung cancer patients for surgical treatment. Lung Cancer 2000. [DOI: 10.1016/s0169-5002(00)80519-x] [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]
|
21
|
Soler T, Arbo G, Cáceres N. [Pulmonary thromboembolism associated with antiphospholipid syndrome and systemic lupus erythematosus]. Rev Med Chil 2000; 128:899-903. [PMID: 11129552] [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: 02/18/2023]
Abstract
The association between systemic lupus erythematosus and antiphospholipid syndrome can cause several complications. We report a 45 years old woman, treated with steroids for a systemic lupus erythematosus. She presented with a clinical picture of a lupus pneumonitis and, subsequently, with the picture of a pulmonary thromboembolism. The diagnosis was confirmed by helicoidal computed axial tomography. The patient was treated with anticoagulants, with a favourable outcome.
Collapse
Affiliation(s)
- T Soler
- Servicio de Medicina, Instituto Nacional del Tórax, Hospital del Salvador
| | | | | |
Collapse
|
22
|
Soler T, Latorre A, Sabater B, Silva FJ. Molecular characterization of the leucine plasmid from Buchnera aphidicola, primary endosymbiont of the aphid Acyrthosiphon pisum. Curr Microbiol 2000; 40:264-8. [PMID: 10688696 DOI: 10.1007/s002849910052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 10/28/2022]
Abstract
The complete sequence of the leucine plasmid of Buchnera aphidicola from the aphid Acyrthosiphon pisum (pLeu-BAp) is reported. Its gene organization was concordant with those of other leucine plasmids of Buchnera from aphids of the Aphidini and Macrosiphini tribes. Three inverted repeats are present in pLeu-BAp. Two of them are also present in pLeu from the family Aphididae: (i) SIR1, located downstream the leucine operon, resembles a rho-independent terminator of transcription, and (ii) LIR1, located upstream of the leucine operon, is suggested to be involved in transcription termination or messenger stability. The third, located near the putative ATGC repeats involved in the origin of replication, is specific in aphids of the Macrosiphini tribe. Phylogenetic analyses based on sequences of leuA, leuB, leuC, leuD, repA1 and ORF1 showed a closer relationship between Buchnera (A. pisum) and Buchnera (Diuraphis noxia). However, tree topologies indicate that the split between both aphid species took place soon after the formation of the Macrosiphini lineage.
Collapse
Affiliation(s)
- T Soler
- Institut Cavanilles de Biodiversitat i Biologia Evolutiva and Departament de Genètica, Universitat de València, Apartat 22085, 46071 València, Spain
| | | | | | | |
Collapse
|
23
|
Abstract
The diagnosis of spondylolysis is a major cause of concern for patients and their families, especially when the patients are young athletes with promising futures in their sports. In this study, 3152 case histories of high-level athletes were evaluated to determine which sports had a higher prevalence of spondylolysis. The overall percentage of spondylolysis among athletes in this study (8.02%) was not very much higher than that among the general population, which varies between 3% and 7%. However, when each sport was considered separately we found much higher values for some sports, with the highest percentages occurring in throwing sports (26.67%), artistic gymnastics (16.96%), and rowing (16.88%). The analysis of the biomechanical movements involved in the sports with greater prevalence of spondylolysis has led us to include the element of torsion against resistance as another possible causative factor for spondylolysis that should be added to the already known causative mechanisms, lumbar hyperextension and rotation. We have divided the sports into three risk groups according to the prevalence of spondylolysis shown and the characteristics of the sample, and we recommend systematic radiological examination of the lumbar spine in athletes considered to be at greater risk of developing spondylolysis.
Collapse
Affiliation(s)
- T Soler
- Department of Sports Orthopedics, National Center of Sports Medicine, C.A.R.I.C.D. Consejo Superior De Deportes, Madrid, Spain
| | | |
Collapse
|
24
|
Alvarez-Cuesta C, Molinos L, Cascante JA, Soler T, Pérez-Oliva N. Cutaneous granulomas in a patient with common variable immunodeficiency. Acta Derm Venereol 1999; 79:334. [PMID: 10430004 DOI: 10.1080/000155599750010869] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
|
25
|
Bianchi A, Suñol J, Hidalgo LA, Diloy R, Castellví JM, Gorgas F, Soler T, Muns R, Gubern JM. Upper digestive tract dyspepsia and early gastric cancer. Rev Esp Enferm Dig 1998; 90:639-45. [PMID: 9780800] [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: 02/09/2023]
Abstract
AIM The study of the frequency and evolution of upper digestive tract dyspepsia in a group of patients operated for early gastric cancer (EGC) and to perform a strategy of diagnosis for the patients with long term upper digestive tract dyspepsia. METHODS Clinical data of 35 patients operated for EGC were retrospectively evaluated. The frequency, characteristics and evolution time of upper digestive tract dyspepsia, main when it began more than 6 months before surgery, were analyzed. Radiologic and endoscopic exams carried out for diagnosis were also evaluated. Histological diagnosis of surgical specimens were considered, looking for the presence of chronic atrophic gastritis, intestinal metaplasia, and peptic gastric ulcer. RESULTS Long-term upper digestive tract dyspepsia was present in 27 patients (mean evolution time of 43.4 months). Clinical changes of previous symptoms that suggested gastric carcinoma were not found in 15 patients. Concurrent peptic gastric carcinoma were not found in 15 patients. Concurrent peptic gastric ulcer along with EGC was diagnosed by histology in 11 patients, and chronic atrophic gastritis and intestinal metaplasia were both present in the non-tumoral gastric mucosa in all cases. CONCLUSIONS 1) Unspecific upper digestive tract dyspepsia is frequently found in patients with EGC. 2) Endoscopy should be the first exam performed in patients with upper digestive tract dyspepsia. 3) The patients with gastric ulcer, chronic atrophic gastritis or intestinal metaplasia must be submitted to sequential endoscopic follow-up.
Collapse
Affiliation(s)
- A Bianchi
- General Surgery Department, Consorci Sanitari de Mataró, Barcelona, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
UNLABELLED Lipoma arborescens (LA) is a rare, poorly understood intraarticular lesion, with few cases reported in the imaging literature. Our purpose was to describe on MR the different morphologic appearances of LA of the knee and to investigate the incidence of associated anomalies. METHOD The medical records and MR findings of 12 patients with proven LA in 13 knee joints were retrospectively reviewed with particular emphasis on the shape of the lesion, location, signal intensity, and past clinical history. RESULTS We found three common morphological patterns of presentation: multiple villous lipomatous synovial proliferations (n = 6), isolated frond-like fat subsynovial mass (n = 2), and mixed pattern (n = 5). Multiple villous lipomatous synovial proliferations and mixed pattern were usually associated with a history of trauma and/or chronic inflammatory diseases. However, the least frequent isolated frond-like fat subsynovial mass appears to originate without antecedent. The durations of symptoms were 1-7 months (multiple villous lipomatous synovial proliferations), 1-20 years (mixed pattern) and 6-7 years (isolated frond-like subsynovial fat mass). CONCLUSION Our study suggest that LA can present with a variety of morphological appearances on MR that may depend on the previous clinical history and duration of the disease.
Collapse
Affiliation(s)
- T Soler
- Department of Radiology, Hospital Juan Canalejo, La Coruña, Spain
| | | | | | | |
Collapse
|
27
|
Vázquez-López F, Rippe ML, Soler T, Rodríguez A, Arribas JM, Pérez-Oliva N. Erythema nodosum and acute Q fever: report of a case with granulomatous hepatitis and immunological abnormalities. Acta Derm Venereol 1997; 77:73-4. [PMID: 9059687 DOI: 10.2340/00015555777374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
|
28
|
Hidalgo L, Villanueva A, Soler T, Matías Guiu X, Capellá G. [Molecular changes in adenocarcinoma of the small intestine associated with Peutz-Jeghers syndrome]. Rev Esp Enferm Dig 1996; 88:137-40. [PMID: 8664070] [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: 02/01/2023]
Abstract
The presence of molecular alterations in the c-K-ras and p53 genes in a small bowel adenocarcinoma arising in a case of Peutz-Jeghers syndrome is reported. The absence of mutations at codon 12 and 13 of the c-K-ras gene in the hamartoma and carcinoma indicates that this oncogene does not contribute to its development. On the other hand, p53 protein overexpression was detected in a small proportion (5-10%) of adenocarcinoma cells. Our findings suggest that p53 inactivation occur in late stages of tumour progression.
Collapse
Affiliation(s)
- L Hidalgo
- Servicio de Cirugía General, Consorci Sanitari de Mataró
| | | | | | | | | |
Collapse
|
29
|
Bianchi A, Mallofre C, Soler T, Diloy R, García A, Suñol J, Barja J, Hidalgo L, Ubach M. [Changes in the cellular proliferation of the healthy mucosa in patients with colorectal cancer]. Rev Esp Enferm Dig 1994; 85:431-4. [PMID: 8068420] [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: 01/28/2023]
Abstract
AIM To analyze differences in the proliferative pattern of normal mucosa between patients with colorectal cancer and healthy subjects. PATIENTS AND METHODS By using flow cytometry we examined the proliferative pattern (Proliferative Index and S-Phase) in samples of normal mucosa from 34 patients operated on for colorectal cancer at our hospital and from 14 healthy subjects as a control group. RESULTS All examined samples were diploid. The Proliferative Index and S-Phase in the Cancer Group were significantly higher than in the Control Group (16.7 +/- 5.9 vs 11.4 +/- 4, p < 0.003, and 11.9 +/- 3.9 us 6.6 +/- 3 p < 0.0004). CONCLUSIONS These findings provide evidence for an altered proliferative pattern in the healthy colonic mucosa of patients with colorectal cancer.
Collapse
Affiliation(s)
- A Bianchi
- Servicio de Cirugía General, Consorci Sanitari de Mataró
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Cequier A, Mauri J, Soler T, Ferrer I, Sabate X, Esplugas E. Cyclic changes in pulmonary wedge v waves in dilated cardiomyopathy. Eur Heart J 1993; 14:993-6. [PMID: 8375426 DOI: 10.1093/eurheartj/14.7.993] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Right and left cardiac catheterization was performed in a 29-year-old male with dilated cardiomyopathy. During the procedure, prominent v waves appeared spontaneously in the pulmonary capillary wedge pressure recording with a simultaneous decrease in left ventricular systolic pressure. Left ventricular angiography showed moderate to severe mitral regurgitation and an ejection fraction of 22%. The right ventricular endomyocardial biopsy revealed histological findings consistent with dilated cardiomyopathy. Cardiac catheterization was repeated 9 months later, after a period of clinical improvement and a reduction in the right and left ventricular filling pressures was documented. The cyclic swings in the pulmonary capillary wedge pressure and in the left ventricular systolic pressure were not observed. Left ventriculography showed mild mitral regurgitation with an ejection fraction of 37%. Right ventricular endomyocardial biopsy documented a reduction in myofibrillar and nuclear hypertrophy. Thus, cyclic changes in pulmonary wedge v waves may be observed in dilated cardiomyopathy. This finding is consistent with cyclic variations in the degree of mitral regurgitation. Disappearance of this factor seems to be related to improvement in left ventricular contractility.
Collapse
Affiliation(s)
- A Cequier
- Division of Cardiology, Hospital of Bellvitge, University of Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
31
|
Gómez Díez S, Asensi Alvarez JM, Soler T, Fernández Pérez JC. [Skin lymphocytoma caused by Borrelia?]. Med Clin (Barc) 1993; 100:78. [PMID: 8429722] [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: 01/30/2023]
|
32
|
Abstract
Studies in vitro have suggested that nonionic low osmolar contrast agents produce an increase in thrombogenicity. To determine the incidence of thrombi related to the use of nonionic low osmolar contrast media during coronary angioplasty, a double-blind randomized study was performed in 100 patients. Medication before angioplasty included oral aspirin (250 mg/day) in all cases. At the beginning of the procedure, aspirin (250 mg) and heparin (10,000 U) were intravenously administered. During the procedure patients were randomly assigned to receive either an ionic low osmolar contrast agent ioxaglate (n = 50), or a nonionic low osmolar contrast media iohexol (n = 50). The presence of thrombus was evaluated on the angiogram and on the guidewire immediately after its retrieval from the patients. Clinical, angiographic and procedural variables were similar in the 2 randomized groups. Angiographic evidence of thrombus was observed in 1 patient (2%) assigned to ioxaglate and in 11 patients (22%) assigned to iohexol (p less than 0.005). One patient (2%) from the ioxaglate group and 6 patients (12%) from the iohexol group showed thrombotic residues on the guidewire (p = not significant). Three patients had acute myocardial infarction, 1 patient (2%) receiving ioxaglate and 2 patients (4%) iohexol (p = not significant). There were no deaths. Thus, compared with an ionic low osmolar contrast media ioxaglate, the nonionic low osmolar contrast agent iohexol increases the incidence of thrombus during coronary angioplasty.
Collapse
Affiliation(s)
- E Esplugas
- Cardiac Catheterization Laboratory, Hospital of Bellvitge, University of Barcelona, Spain
| | | | | | | | | | | | | |
Collapse
|
33
|
Aguila Artal AF, Maños Pujol M, Gil Garcés E, Soler T, Oncíns R, Juan Prada A, Maños Gonzalbo M. [Neuroendocrine carcinoma of the larynx. Apropos of two cases. Preliminary note]. Acta Otorrinolaringol Esp 1988; 39:407-9. [PMID: 2856108] [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: 01/03/2023]
|
34
|
Galofré E, Soler T, Martínez JM, Ferrer I. [Neuropathological findings in patients subjected to orthotopic liver transplantation]. Neurologia 1988; 3:77-9. [PMID: 3273507] [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: 01/05/2023] Open
|
35
|
Carrera M, Griñó JM, Castelao AM, Galofré E, Soler T, Margarit J. [Postmortem study of renal lesions in 4 recipients of liver transplants treated with cyclosporin A]. Med Clin (Barc) 1987; 89:866-9. [PMID: 3329277] [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: 01/05/2023]
|
36
|
Esplugas E, Jara F, Sabaté X, Cequier A, Soler T, Mauri J, Ferrer I. [Right ventricular endomyocardial biopsy. Description of the percutaneous femoral vein technic]. Rev Esp Cardiol 1987; 40:410-4. [PMID: 3454988] [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: 01/05/2023]
|
37
|
Abstract
The distribution and organization of nerve cells in a microcerebellum and cerebellar stalk, developed within the matrix of a mature ovarian teratoma, were analyzed with respect to recent data on cerebellar histogenesis. It is postulated that a neuroectodermal germinal locus with proliferation capability similar to that found in the alar plates of the normal embryonic rhombencephalon was responsible for the formation of this highly organized neural tissue.
Collapse
|