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Peters S, Angevin E, Alonso-Gordoa T, Rohrberg K, Melero I, Mellado B, Perez-Gracia JL, Tabernero J, Adessi C, Boetsch C, Watson C, Dal Porto J, Dejardin D, Del Nagro C, Nicolini V, Evers S, Klein C, Leutgeb B, Pisa P, Rossmann E, Saro J, Umana P, Charo J, Teichgräber V, Steeghs N. Obinutuzumab Pretreatment as a Novel Approach to Mitigate Formation of Anti-Drug Antibodies Against Cergutuzumab Amunaleukin in Patients with Solid Tumors. Clin Cancer Res 2024; 30:1630-1641. [PMID: 38319672 DOI: 10.1158/1078-0432.ccr-23-2658] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/11/2023] [Accepted: 02/02/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE The immunocytokine cergutuzumab amunaleukin (CEA-IL2v) showed manageable safety and favorable pharmacodynamics in phase I/Ib trials in patients with advanced/metastatic carcinoembryonic antigen-positive (CEA+) solid tumors, but this was accompanied by a high incidence of anti-drug antibodies (ADA). We examined B-cell depletion with obinutuzumab as a potential mitigation strategy. EXPERIMENTAL DESIGN Preclinical data comparing B-cell depletion with rituximab versus obinutuzumab are summarized. Substudies of phase I/Ib trials investigated the effect of obinutuzumab pretreatment on ADA development, safety, pharmacodynamics, and antitumor activity of CEA-IL2v ± atezolizumab in patients with advanced/metastatic or unresectable CEA+ solid tumors who had progressed on standard of care. RESULTS Preclinical data showed superior B-cell depletion with obinutuzumab versus rituximab. In clinical studies, patients received CEA-IL2v monotherapy with (n = 16) or without (n = 6) obinutuzumab pretreatment (monotherapy study), or CEA-IL2v + atezolizumab + obinutuzumab pretreatment (n = 5; combination study). In the monotherapy study, after four cycles (every 2 weeks treatment), 0/15 evaluable patients administered obinutuzumab pretreatment had ADAs versus 4/6 patients without obinutuzumab. Obinutuzumab pretreatment with CEA-IL2v monotherapy showed no new safety signals and pharmacodynamic data suggested minimal impact on T cells and natural killer cells. Conversely, increased liver toxicity was observed in the combination study (CEA-IL2v + atezolizumab + obinutuzumab pretreatment). CONCLUSIONS These preliminary findings suggest that obinutuzumab pretreatment before CEA-IL2v administration in patients with CEA+ solid tumors may be a feasible and potent ADA mitigation strategy, with an acceptable safety profile, supporting broader investigation of obinutuzumab pretreatment for ADA mitigation in other settings.
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Affiliation(s)
- Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University, Lausanne, Switzerland
| | - Eric Angevin
- Drug Development Department (DITEP), Institut Gustave Roussy, Villejuif, France
| | | | - Kristoffer Rohrberg
- Phase 1 Unit, Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ignacio Melero
- Oncology and Immunology Department, Clinica Universidad de Navarra and CIBERONC, Pamplona, Spain
| | - Begoña Mellado
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Jose-Luis Perez-Gracia
- Oncology and Immunology Department, Clinica Universidad de Navarra and CIBERONC, Pamplona, Spain
| | - Josep Tabernero
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), UVic-UCC, IOB-Quiron, Barcelona, Spain
| | - Celine Adessi
- F. Hoffmann-La Roche Ltd, Research & Early Development Oncology, Basel, Switzerland
| | - Christophe Boetsch
- F. Hoffmann-La Roche Ltd, Research & Early Development Oncology, Basel, Switzerland
| | - Carl Watson
- A4P Consulting Ltd, Sandwich, United Kingdom
| | | | - David Dejardin
- Product Development, Data Science, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Christopher Del Nagro
- Research & Early Development Oncology, F. Hoffmann-La Roche Ltd, Zurich, Switzerland
| | - Valeria Nicolini
- F. Hoffmann-La Roche Ltd, Research & Early Development Oncology, Basel, Switzerland
| | - Stefan Evers
- F. Hoffmann-La Roche Ltd, Research & Early Development Oncology, Basel, Switzerland
| | - Christian Klein
- Research & Early Development Oncology, F. Hoffmann-La Roche Ltd, Zurich, Switzerland
| | - Barbara Leutgeb
- Product Development Oncology F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Pavel Pisa
- Research & Early Development Oncology, F. Hoffmann-La Roche Ltd, Zurich, Switzerland
| | - Eva Rossmann
- Product Development, Safety Science, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - José Saro
- Research & Early Development Oncology, F. Hoffmann-La Roche Ltd, Zurich, Switzerland
| | - Pablo Umana
- Research & Early Development Oncology, F. Hoffmann-La Roche Ltd, Zurich, Switzerland
| | - Jehad Charo
- Research & Early Development Oncology, F. Hoffmann-La Roche Ltd, Zurich, Switzerland
| | - Volker Teichgräber
- F. Hoffmann-La Roche Ltd, Research & Early Development Oncology, Basel, Switzerland
| | - Neeltje Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
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Agarwal N, Castellano D, Alonso-Gordoa T, Arranz Arija JA, Colomba E, Gravis G, Mourey L, Oudard S, Fléchon A, Gonzalez M, Maroto PM, Schweizer MT, Gallardo E, Johnston E, Balar A, Haddad N, Appiah AK, Nacerddine K, Piulats JM. A Signal-finding Study of Abemaciclib in Heavily Pretreated Patients with Metastatic Castration-Resistant Prostate Cancer: Results from CYCLONE 1. Clin Cancer Res 2024:741928. [PMID: 38512117 DOI: 10.1158/1078-0432.ccr-23-3436] [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: 11/06/2023] [Revised: 01/23/2024] [Accepted: 03/19/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors radically changed the treatment paradigm for breast cancer. Similar to estrogen receptor in breast cancer, androgen receptor signaling activates cyclin D-CDK4/6, driving proliferation and resistance to hormonal manipulation in prostate cancer. This study was designed to detect signals of clinical activity for abemaciclib in treatment-refractory metastatic castration-resistant prostate cancer (mCRPC). METHODS Eligible patients had progressive mCRPC, measurable disease, and previously received ≥1 novel hormonal agent(s) and 2 lines of taxane chemotherapy. Abemaciclib 200 mg BID was administered on a continuous dosing schedule. Primary endpoint was objective response rate (ORR) without concurrent bone progression. This study was designed to detect a minimum ORR of 12.5%. RESULTS At trial entry, forty (90.9%) of 44 patients had objective radiographic disease progression, four (9.1%) had prostate-specific antigen (PSA)-only progression, and 20 (46.5%) had visceral metastases (of these, 60% had liver metastases). Efficacy analyses are as follows: ORR without concurrent bone progression: 6.8%; disease control rate: 45.5%; median time to PSA progression: 6.5 months (95% CI: 3.2, NA); median radiographic PFS; 2.7 months (95% CI: 1.9, 3.7); and median OS: 8.4 months (95% CI: 5.6, 12.7). Most frequent grade ≥3 TEAEs were neutropenia (25.0%), anemia, and fatigue (11.4% each). No grade 4 or 5 AEs were related to abemaciclib. CONCLUSION Abemaciclib monotherapy was well tolerated and showed clinical activity in this heavily pretreated population, nearly half with visceral metastases. This study is considered preliminary proof-of-concept and designates CDK4/6 as a valid therapeutic target in prostate cancer.
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Affiliation(s)
- Neeraj Agarwal
- Huntsman Cancer Institute, Salt lake City, UT, United States
| | | | | | | | | | | | - Loic Mourey
- IUCT-Oncopole Claudius Regaud, Toulouse, France
| | - Stephane Oudard
- Hopital Européen Georges Pompidou, Paris, Ile de France, France
| | | | | | | | | | - Enrique Gallardo
- Institute of Research and Innovation Parc Tauli, Sabadell, Spain
| | | | - Arjun Balar
- Perlmutter Cancer Center, NYU Langone Medical Center, United States
| | | | | | | | - Josep M Piulats
- Institut Català d'Oncologia-IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
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3
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Patel SP, Alonso-Gordoa T, Banerjee S, Wang D, Naidoo J, Standifer NE, Palmer DC, Cheng LY, Kourtesis P, Ascierto ML, Das M, Diamond JR, Hellmann MD, Carneiro BA. Phase 1/2 study of monalizumab plus durvalumab in patients with advanced solid tumors. J Immunother Cancer 2024; 12:e007340. [PMID: 38309722 PMCID: PMC10840023 DOI: 10.1136/jitc-2023-007340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND The combination of monalizumab (anti-NKG2A/CD94) and durvalumab (anti-programmed death ligand-1) may promote antitumor immunity by targeting innate and adaptive immunity. This phase 1/2 study of monalizumab and durvalumab evaluated safety, antitumor activity, and pharmacodynamics in patients with advanced solid tumors. MAIN BODY Immunotherapy-naïve patients aged ≥18 years with advanced disease, Eastern Cooperative Oncology Group performance status of 0-1, and 1-3 prior lines of systemic therapy in the recurrent/metastatic setting were enrolled. In part 1 (dose escalation), patients received durvalumab 1500 mg every 4 weeks (Q4W) with increasing doses of monalizumab Q2W/Q4W (n=15). Dose expansion in part 1 included patients with cervical cancer (n=15; durvalumab 1500 mg Q4W and monalizumab 750 mg Q2W) or metastatic microsatellite stable (MSS)-colorectal cancer (CRC) (n=15; durvalumab 1500 mg Q4W and monalizumab 750 mg Q4W). In part 2 (dose expansion), patients with MSS-CRC (n=40), non-small cell lung cancer (NSCLC; n=20), MSS-endometrial cancer (n=40), or ovarian cancer (n=40) received durvalumab 1500 mg Q4W and monalizumab 750 mg Q2W. The primary endpoint was safety. Secondary endpoints included antitumor activity per Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST v1.1). Exploratory analyses included assessment of T-cell and natural killer (NK) cell activation and proliferation in peripheral blood and the tumor microenvironment (TME). The study enrolled 185 patients (part 1, 45; part 2, 140). No dose-limiting toxicities were observed and the maximum tolerated dose was not reached. In part 2, the most common treatment-related adverse events were fatigue (12.1%), asthenia (9.3%), diarrhea (9.3%), pruritus (7.9%), and pyrexia (7.1%). In the expansion cohorts, response rates were 0% (cervical), 7.7% (MSS-CRC), 10% (NSCLC), 5.4% (ovarian), and 0% (MSS-endometrial). Sustained NK cell activation, CD8+ T-cell proliferation, increased serum levels of CXCL10 (C-X-C motif chemokine ligand 10) and CXCL11, and increased tumor infiltration of CD8+ and granzyme B+ cells were observed. CONCLUSIONS Although efficacy was modest, monalizumab plus durvalumab was well tolerated and encouraging immune activation was observed in the peripheral blood and TME. TRIAL REGISTRATION NUMBER NCT02671435.
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Affiliation(s)
- Sandip P Patel
- University of California San Diego, Moores Cancer Center, San Diego, California, USA
| | | | - Susana Banerjee
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK
| | - Ding Wang
- Henry Ford Health System, Detroit, Michigan, USA
| | - Jarushka Naidoo
- Johns Hopkins Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
- Johns Hopkins Medicine The Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
| | - Nathan E Standifer
- BioPharmaceuticals Research and Development, AstraZeneca, South San Francisco, California, USA
| | - Doug C Palmer
- Oncology Research and Development, AstraZeneca, Gaithersburg, Maryland, USA
| | - Lin-Yang Cheng
- Oncology Research and Development, AstraZeneca, Gaithersburg, Maryland, USA
| | | | - Maria L Ascierto
- Oncology Research and Development, AstraZeneca, Gaithersburg, Maryland, USA
| | - Mayukh Das
- Oncology Research and Development, AstraZeneca, Gaithersburg, Maryland, USA
| | | | | | - Benedito A Carneiro
- Legorreta Cancer Center at Brown University, Lifespan Cancer Institute, Providence, Rhode Island, USA
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4
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Grünwald V, Powles T, Kopyltsov E, Kozlov V, Alonso-Gordoa T, Eto M, Hutson T, Motzer R, Winquist E, Maroto P, Keam B, Procopio G, Wong S, Melichar B, Rolland F, Oya M, Rodriguez-Lopez K, Saito K, McKenzie J, Porta C. Survival by Depth of Response and Efficacy by International Metastatic Renal Cell Carcinoma Database Consortium Subgroup with Lenvatinib Plus Pembrolizumab Versus Sunitinib in Advanced Renal Cell Carcinoma: Analysis of the Phase 3 Randomized CLEAR Study. Eur Urol Oncol 2023; 6:437-446. [PMID: 36720658 PMCID: PMC10875602 DOI: 10.1016/j.euo.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/03/2022] [Accepted: 01/14/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND The extent of tumor shrinkage has been deemed a predictor of survival for advanced/metastatic renal cell carcinoma (RCC), a disease with historically poor survival. OBJECTIVE To perform an exploratory analysis of overall survival (OS) by tumor response by 6 mo, and to assess the efficacy and survival outcomes in specific subgroups. DESIGN, SETTING, AND PARTICIPANTS CLEAR was an open-label, multicenter, randomized, phase 3 trial of first-line treatment of advanced clear cell RCC. INTERVENTION Patients were randomized 1:1:1 to lenvatinib 20 mg orally daily with pembrolizumab 200 mg intravenously once every 3 wk, lenvatinib plus everolimus (not included in this analysis), or sunitinib 50 mg orally daily for 4 wk on treatment/2 wk of no treatment. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Landmark analyses were conducted to assess the association of OS with tumor shrinkage and progressive disease status by 6 mo. Progression-free survival, duration of response, and objective response rate (ORR) were analyzed by the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk subgroup and by the presence of target kidney lesions. Efficacy was assessed by an independent review committee as per Response Evaluation Criteria in Solid Tumors version 1.1. RESULTS AND LIMITATIONS Landmark analyses by tumor shrinkage showed that patients enrolled to lenvatinib plus pembrolizumab arm with a confirmed complete response or >75% target-lesion reduction by 6 mo had a 24-mo OS probability of ≥91.7%. A landmark analysis by disease progression showed that patients with no progression by 6 mo had lower probabilities of death in both arms. Patients with an IMDC risk classification of intermediate/poor had longer median progression-free survival (22.1 vs 5.9 mo) and a higher ORR (72.4% vs 28.8%) with lenvatinib plus pembrolizumab versus sunitinib. Similarly, results favored lenvatinib plus pembrolizumab in IMDC-favorable patients and those with/without target kidney lesions. Limitations of the study are that results were exploratory and not powered/stratified. CONCLUSIONS Lenvatinib plus pembrolizumab showed improved efficacy versus sunitinib for patients with advanced RCC; landmark analyses showed that tumor response by 6 mo correlated with longer OS. PATIENT SUMMARY In this report of the CLEAR trial, we explored the survival of patients with advanced renal cell carcinoma by assessing how well they initially responded to treatment. We also explored how certain groups of patients responded to treatment overall. Patients were assigned to cycles of either lenvatinib 20 mg daily plus pembrolizumab 200 mg every 3 wk or sunitinib 50 mg daily for 4 wk (followed by a 2-wk break). Patients who either had a "complete response" or had their tumors shrunk by >75% within 6 mo after starting treatment with lenvatinib plus pembrolizumab had better survival than those with less tumor reduction by 6 mo. Additionally, patients who had more severe disease (as per the International Metastatic Renal Cell Carcinoma Database Consortium) at the start of study treatment survived for longer without disease progression with lenvatinib plus pembrolizumab than with sunitinib.
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Affiliation(s)
- Viktor Grünwald
- Interdisciplinary Genitourinary Oncology, Clinic for Urology, Clinic for Medical Oncology, University Hospital Essen, Essen, Germany.
| | | | - Evgeny Kopyltsov
- State Institution of Healthcare "Regional Clinical Oncology Dispensary", Omsk, Russia
| | - Vadim Kozlov
- State Budgetary Health Care Institution "Novosibirsk Regional Clinical Oncology Dispensary", Novosibirsk, Russia
| | | | | | | | - Robert Motzer
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eric Winquist
- University of Western Ontario, London, Ontario, Canada
| | - Pablo Maroto
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Bhumsuk Keam
- Seoul National University Hospital, Seoul, Republic of Korea
| | | | | | - Bohuslav Melichar
- Palacký University Medical School and Teaching Hospital, Olomouc, Czech Republic
| | - Frederic Rolland
- Centre René Gauducheau Centre de Lutte Contre Le Cancer Nantes, Saint-Herblain, France
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5
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Gómez-Vecino A, Corchado-Cobos R, Blanco-Gómez A, García-Sancha N, Castillo-Lluva S, Martín-García A, Mendiburu-Eliçabe M, Prieto C, Ruiz-Pinto S, Pita G, Velasco-Ruiz A, Patino-Alonso C, Galindo-Villardón P, Vera-Pedrosa ML, Jalife J, Mao JH, Macías de Plasencia G, Castellanos-Martín A, Sáez-Freire MDM, Fraile-Martín S, Rodrigues-Teixeira T, García-Macías C, Galvis-Jiménez JM, García-Sánchez A, Isidoro-García M, Fuentes M, García-Cenador MB, García-Criado FJ, García-Hernández JL, Hernández-García MÁ, Cruz-Hernández JJ, Rodríguez-Sánchez CA, García-Sancho AM, Pérez-López E, Pérez-Martínez A, Gutiérrez-Larraya F, Cartón AJ, García-Sáenz JÁ, Patiño-García A, Martín M, Alonso-Gordoa T, Vulsteke C, Croes L, Hatse S, Van Brussel T, Lambrechts D, Wildiers H, Chang H, Holgado-Madruga M, González-Neira A, Sánchez PL, Pérez Losada J. Intermediate Molecular Phenotypes to Identify Genetic Markers of Anthracycline-Induced Cardiotoxicity Risk. Cells 2023; 12:1956. [PMID: 37566035 PMCID: PMC10417374 DOI: 10.3390/cells12151956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023] Open
Abstract
Cardiotoxicity due to anthracyclines (CDA) affects cancer patients, but we cannot predict who may suffer from this complication. CDA is a complex trait with a polygenic component that is mainly unidentified. We propose that levels of intermediate molecular phenotypes (IMPs) in the myocardium associated with histopathological damage could explain CDA susceptibility, so variants of genes encoding these IMPs could identify patients susceptible to this complication. Thus, a genetically heterogeneous cohort of mice (n = 165) generated by backcrossing were treated with doxorubicin and docetaxel. We quantified heart fibrosis using an Ariol slide scanner and intramyocardial levels of IMPs using multiplex bead arrays and QPCR. We identified quantitative trait loci linked to IMPs (ipQTLs) and cdaQTLs via linkage analysis. In three cancer patient cohorts, CDA was quantified using echocardiography or Cardiac Magnetic Resonance. CDA behaves as a complex trait in the mouse cohort. IMP levels in the myocardium were associated with CDA. ipQTLs integrated into genetic models with cdaQTLs account for more CDA phenotypic variation than that explained by cda-QTLs alone. Allelic forms of genes encoding IMPs associated with CDA in mice, including AKT1, MAPK14, MAPK8, STAT3, CAS3, and TP53, are genetic determinants of CDA in patients. Two genetic risk scores for pediatric patients (n = 71) and women with breast cancer (n = 420) were generated using machine-learning Least Absolute Shrinkage and Selection Operator (LASSO) regression. Thus, IMPs associated with heart damage identify genetic markers of CDA risk, thereby allowing more personalized patient management.
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Affiliation(s)
- Aurora Gómez-Vecino
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
| | - Roberto Corchado-Cobos
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
| | - Adrián Blanco-Gómez
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
| | - Natalia García-Sancha
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
| | - Sonia Castillo-Lluva
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Químicas, Universidad Complutense, 28040 Madrid, Spain;
- Instituto de Investigaciones Sanitarias San Carlos (IdISSC), 24040 Madrid, Spain
| | - Ana Martín-García
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Servicio de Cardiología, Hospital Universitario de Salamanca, Universidad de Salamanca (CIBER.CV), 37007 Salamanca, Spain
| | - Marina Mendiburu-Eliçabe
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
| | - Carlos Prieto
- Servicio de Bioinformática, Nucleus, Universidad de Salamanca, 37007 Salamanca, Spain;
| | - Sara Ruiz-Pinto
- Human Genotyping Unit-CeGen, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (S.R.-P.); (G.P.); (A.V.-R.)
| | - Guillermo Pita
- Human Genotyping Unit-CeGen, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (S.R.-P.); (G.P.); (A.V.-R.)
| | - Alejandro Velasco-Ruiz
- Human Genotyping Unit-CeGen, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (S.R.-P.); (G.P.); (A.V.-R.)
| | - Carmen Patino-Alonso
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Departamento de Estadística, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Purificación Galindo-Villardón
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Departamento de Estadística, Universidad de Salamanca, 37007 Salamanca, Spain
- Escuela Superior Politécnica del Litoral, ESPOL, Centro de Estudios e Investigaciones Estadísticas, Campus Gustavo Galindo, Km. 30.5 Via Perimetral, Guayaquil P.O. Box 09-01-5863, Ecuador
| | | | - José Jalife
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, 28029 Madrid, Spain; (M.L.V.-P.); (J.J.)
| | - Jian-Hua Mao
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA;
- Berkeley Biomedical Data Science Center, Lawrence Berkeley National Laboratory, Berkeley, CA 92720, USA
| | - Guillermo Macías de Plasencia
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Servicio de Cardiología, Hospital Universitario de Salamanca, Universidad de Salamanca (CIBER.CV), 37007 Salamanca, Spain
| | - Andrés Castellanos-Martín
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
| | - María del Mar Sáez-Freire
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
| | - Susana Fraile-Martín
- Servicio de Patología Molecular Comparada, Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca, 37007 Salamanca, Spain; (S.F.-M.); (T.R.-T.); (C.G.-M.)
| | - Telmo Rodrigues-Teixeira
- Servicio de Patología Molecular Comparada, Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca, 37007 Salamanca, Spain; (S.F.-M.); (T.R.-T.); (C.G.-M.)
| | - Carmen García-Macías
- Servicio de Patología Molecular Comparada, Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca, 37007 Salamanca, Spain; (S.F.-M.); (T.R.-T.); (C.G.-M.)
| | - Julie Milena Galvis-Jiménez
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Instituto Nacional de Cancerología de Colombia, Bogotá 111511-110411001, Colombia
| | - Asunción García-Sánchez
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Servicio de Bioquímica Clínica, Hospital Universitario de Salamanca, 37007 Salamanca, Spain
| | - María Isidoro-García
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Servicio de Bioquímica Clínica, Hospital Universitario de Salamanca, 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Manuel Fuentes
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
- Unidad de Proteómica y Servicio General de Citometría de Flujo, Nucleus, Universidad de Salamanca, 37007 Salamanca, Spain
| | - María Begoña García-Cenador
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Departamento de Cirugía, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Francisco Javier García-Criado
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Departamento de Cirugía, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Juan Luis García-Hernández
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
| | | | - Juan Jesús Cruz-Hernández
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
- Servicio de Oncología, Hospital Universitario de Salamanca, 37007 Salamanca, Spain
| | - César Augusto Rodríguez-Sánchez
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
- Servicio de Oncología, Hospital Universitario de Salamanca, 37007 Salamanca, Spain
| | - Alejandro Martín García-Sancho
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Servicio de Hematología, Hospital Universitario de Salamanca, CIBERONC, 37007 Salamanca, Spain;
| | - Estefanía Pérez-López
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Servicio de Hematología, Hospital Universitario de Salamanca, CIBERONC, 37007 Salamanca, Spain;
| | - Antonio Pérez-Martínez
- Department of Paediatric Hemato-Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Federico Gutiérrez-Larraya
- Department of Paediatric Cardiology, Hospital Universitario La Paz, 28046 Madrid, Spain; (F.G.-L.); (A.J.C.)
| | - Antonio J. Cartón
- Department of Paediatric Cardiology, Hospital Universitario La Paz, 28046 Madrid, Spain; (F.G.-L.); (A.J.C.)
| | - José Ángel García-Sáenz
- Medical Oncology Service, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - Ana Patiño-García
- Department of Pediatrics, Solid Tumor Program, Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, IdisNA, 31008 Pamplona, Spain;
| | - Miguel Martín
- Department of Medicine, Gregorio Marañón Health Research Institute (IISGM), Centro de Investigación Biomédica en Red Oncológica (CIBERONC), Universidad Complutense, 28007 Madrid, Spain;
| | - Teresa Alonso-Gordoa
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | - Christof Vulsteke
- Department of Molecular Imaging, Pathology, Radiotherapy and Oncology (MIPRO), Center for Oncological Research (CORE), Antwerp University, 2610 Antwerp, Belgium; (C.V.); (L.C.)
- Department of Oncology, Integrated Cancer Center in Ghent, AZ Maria Middelares, 9000 Ghent, Belgium
| | - Lieselot Croes
- Department of Molecular Imaging, Pathology, Radiotherapy and Oncology (MIPRO), Center for Oncological Research (CORE), Antwerp University, 2610 Antwerp, Belgium; (C.V.); (L.C.)
- Department of Oncology, Integrated Cancer Center in Ghent, AZ Maria Middelares, 9000 Ghent, Belgium
| | - Sigrid Hatse
- Laboratory of Experimental Oncology (LEO), Department of Oncology, Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Katholieke Universiteit (KU) Leuven, 3000 Leuven, Belgium;
| | - Thomas Van Brussel
- VIB Center for Cancer Biology, VIB, 3000 Leuven, Belgium; (T.V.B.); (D.L.)
- Laboratory of Translational Genetics, Department of Human Genetics, Katholieke Universiteit (KU) Leuven, 3000 Leuven, Belgium
| | - Diether Lambrechts
- VIB Center for Cancer Biology, VIB, 3000 Leuven, Belgium; (T.V.B.); (D.L.)
- Laboratory of Translational Genetics, Department of Human Genetics, Katholieke Universiteit (KU) Leuven, 3000 Leuven, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology and Multidisciplinary Breast Unit, Leuven Cancer Institute, and Laboratory of Experimental Oncology (LEO), Department of Oncology, Leuven Cancer Institute and University Hospital Leuven, Katholieke Universiteit (KU) Leuven, 3000 Leuven, Belgium;
| | - Hang Chang
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA;
- Berkeley Biomedical Data Science Center, Lawrence Berkeley National Laboratory, Berkeley, CA 92720, USA
| | - Marina Holgado-Madruga
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
- Departamento de Fisiología y Farmacología, Universidad de Salamanca, 37007 Salamanca, Spain
- Instituto de Neurociencias de Castilla y León (INCyL), 37007 Salamanca, Spain
| | - Anna González-Neira
- Human Genotyping Unit-CeGen, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (S.R.-P.); (G.P.); (A.V.-R.)
| | - Pedro L. Sánchez
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Servicio de Cardiología, Hospital Universitario de Salamanca, Universidad de Salamanca (CIBER.CV), 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Jesús Pérez Losada
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC-CIC), Universidad de Salamanca/CSIC, 37007 Salamanca, Spain; (A.G.-V.); (R.C.-C.); (A.B.-G.); (N.G.-S.); (M.M.-E.); (A.C.-M.); (M.d.M.S.-F.); (J.M.G.-J.); (M.F.); (J.L.G.-H.); (J.J.C.-H.); (C.A.R.-S.); (A.M.G.-S.); (E.P.-L.)
- Instituto de Investigación Biosanitaria de Salamanca (IBSAL), 37007 Salamanca, Spain; (A.M.-G.); (C.P.-A.); (P.G.-V.); (G.M.d.P.); (A.G.-S.); (M.I.-G.); (M.B.G.-C.); (F.J.G.-C.)
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Capdevila J, Hernando J, Teule A, Lopez C, Garcia-Carbonero R, Benavent M, Custodio A, Garcia-Alvarez A, Cubillo A, Alonso V, Carmona-Bayonas A, Alonso-Gordoa T, Crespo G, Jimenez-Fonseca P, Blanco M, Viudez A, La Casta A, Sevilla I, Segura A, Llanos M, Landolfi S, Nuciforo P, Manzano JL. Durvalumab plus tremelimumab for the treatment of advanced neuroendocrine neoplasms of gastroenteropancreatic and lung origin. Nat Commun 2023; 14:2973. [PMID: 37221181 DOI: 10.1038/s41467-023-38611-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
Single immune checkpoint blockade in advanced neuroendocrine neoplasms (NENs) shows limited efficacy; dual checkpoint blockade may improve treatment activity. Dune (NCT03095274) is a non-randomized controlled multicohort phase II clinical trial evaluating durvalumab plus tremelimumab activity and safety in advanced NENs. This study included 123 patients presenting between 2017 and 2019 with typical/atypical lung carcinoids (Cohort 1), G1/2 gastrointestinal (Cohort 2), G1/2 pancreatic (Cohort 3) and G3 gastroenteropancreatic (GEP) (Cohort 4) NENs; who progressed to standard therapies. Patients received 1500 mg durvalumab and 75 mg tremelimumab for up to 13 and 4 cycles (every 4 weeks), respectively. The primary objective was the 9-month clinical benefit rate (CBR) for cohorts 1-3 and 9-month overall survival (OS) rate for Cohort 4. Secondary endpoints included objective response rate, duration of response, progression-free survival according to irRECIST, overall survival, and safety. Correlation of PD-L1 expression with efficacy was exploratory. The 9-month CBR was 25.9%/35.5%/25% for Cohorts 1, 2, and 3 respectively. The 9-month OS rate for Cohort 4 was 36.1%, surpassing the futility threshold. Benefit in Cohort 4 was observed regardless of differentiation and Ki67 levels. PD-L1 combined scores did not correlate with treatment activity. Safety profile was consistent with that of prior studies. In conclusion, durvalumab plus tremelimumab is safe in NENs and shows modest survival benefit in G3 GEP-NENs; with one-third of these patients experiencing a prolonged OS.
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Affiliation(s)
- J Capdevila
- Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain.
- Medical Oncology Department, IOB-Quiron-Teknon, Barcelona, Spain.
| | - J Hernando
- Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Teule
- Medical Oncology Department, Institut Català d'Oncologia (ICO) - IDIBELL L'Hospitalet del Llobregat, L'Hospitalet de Llobregat, Spain
| | - C Lopez
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - R Garcia-Carbonero
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Imas12, UCM, CNIO, Madrid, Spain
| | - M Benavent
- Medical Oncology Department, University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Garcia-Alvarez
- Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Cubillo
- Medical Oncology Department, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - V Alonso
- Medical Oncology Department, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - T Alonso-Gordoa
- Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - G Crespo
- Medical Oncology Department, Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - P Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - M Blanco
- Medical Oncology Department, Hospital Universitario Gregorio Marañon, Madrid, Spain
| | - A Viudez
- Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
| | - A La Casta
- Medical Oncology Department, Hospital Universitario Donostia, San Sebastián, Spain
| | - I Sevilla
- Medical Oncology Department, Investigación Clínica y Traslacional en Cáncer/Instituto de Investigaciones Biomédicas de Málaga (IBIMA)/Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Málaga, Spain
| | - A Segura
- Medical Oncology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M Llanos
- Medical Oncology Department, Hospital Universitario de Canarias, San Cristobal de la Laguna, Spain
| | - S Landolfi
- Pathology Department, Vall Hebron University Hospital, CIBERONC, Barcelona, Spain
| | - P Nuciforo
- Molecular Oncology Group. Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - J L Manzano
- Medical Oncology Department, Institut Català d'Oncologia (ICO) - Badalona, Hospital Germans Trias i Pujol, Badalona, Spain
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Fernandez-Perez MP, Perez-Navarro E, Alonso-Gordoa T, Conteduca V, Font A, Vázquez-Estévez S, González-Del-Alba A, Wetterskog D, Antonarakis ES, Mellado B, Fernandez-Calvo O, Méndez-Vidal MJ, Climent MA, Duran I, Gallardo E, Rodriguez Sanchez A, Santander C, Sáez MI, Puente J, Tudela J, Martínez A, López-Andreo MJ, Padilla J, Lozano R, Hervas D, Luo J, de Giorgi U, Castellano D, Attard G, Grande E, Gonzalez-Billalabeitia E. A correlative biomarker study and integrative prognostic model in chemotherapy-naïve metastatic castration-resistant prostate cancer treated with enzalutamide. Prostate 2023; 83:376-384. [PMID: 36564933 PMCID: PMC10107622 DOI: 10.1002/pros.24469] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/06/2022] [Accepted: 11/20/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND There is a considerable need to incorporate biomarkers of resistance to new antiandrogen agents in the management of castration-resistant prostate cancer (CRPC). METHODS We conducted a phase II trial of enzalutamide in first-line chemo-naïve asymptomatic or minimally symptomatic mCRPC and analyzed the prognostic value of TMPRSS2-ERG and other biomarkers, including circulating tumor cells (CTCs), androgen receptor splice variant (AR-V7) in CTCs and plasma Androgen Receptor copy number gain (AR-gain). These biomarkers were correlated with treatment response and survival outcomes and developed a clinical-molecular prognostic model using penalized cox-proportional hazard model. This model was validated in an independent cohort. RESULTS Ninety-eight patients were included. TMPRSS2-ERG fusion gene was detected in 32 patients with no differences observed in efficacy outcomes. CTC detection was associated with worse outcome and AR-V7 in CTCs was associated with increased rate of progression as best response. Plasma AR gain was strongly associated with an adverse outcome, with worse median prostate specific antigen (PSA)-PFS (4.2 vs. 14.7 m; p < 0.0001), rad-PFS (4.5 vs. 27.6 m; p < 0.0001), and OS (12.7 vs. 38.1 m; p < 0.0001). The clinical prognostic model developed in PREVAIL was validated (C-Index 0.70) and the addition of plasma AR (C-Index 0.79; p < 0.001) increased its prognostic ability. We generated a parsimonious model including alkaline phosphatase (ALP); PSA and AR gain (C-index 0.78) that was validated in an independent cohort. CONCLUSIONS TMPRSS2-ERG detection did not correlate with differential activity of enzalutamide in first-line mCRPC. However, we observed that CTCs and plasma AR gain were the most relevant biomarkers.
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Affiliation(s)
- María P Fernandez-Perez
- Department of Haematology and Medical Oncology, Hospital Universitario Morales Meseguer, IMIB, Murcia, Spain
| | - Enrique Perez-Navarro
- Department of Medical Oncology, Instituto de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Vicenza Conteduca
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) "Dino Amadori" IRCCS, Meldola, Italy
| | - Albert Font
- Department of Medical Oncology, Catalan Institute of Oncology, Badalona Applied Research Group in Oncology (BARGO), Badalona, Spain
| | | | | | - Daniel Wetterskog
- University College London Cancer Institute, Paul O'Gorman Building, London, UK
| | - Emmanuel S Antonarakis
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Begona Mellado
- Department of Medical Oncology, IDIBAPS, Hospital Clinic, Universidad de Barcelona, Barcelona, Spain
| | - Ovidio Fernandez-Calvo
- Department of Medical Oncology, Complejo Hospitalario Universitario Ourense, Orense, Spain
| | - María J Méndez-Vidal
- Department of Medical Oncology, Hospital Universitario Reina Sofía (HURS), Maimonides Institute for biomedical research of Córdoba (IMIBIC), Córdoba, Spain
| | - Miguel A Climent
- Servicio de Oncología Médica, Instituto Valenciano de Oncología, Valencia, Spain
| | - Ignacio Duran
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Enrique Gallardo
- Department of Medical Oncology, Servicio de Oncología Médica, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | | | - Carmen Santander
- Department of Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Maria I Sáez
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain
| | - Javier Puente
- Department of Medical Oncology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - Julian Tudela
- Department of Pathology, Hospital Morales Meseguer, Murcia, Spain
| | | | | | - José Padilla
- Department of Haematology and Medical Oncology, Hospital Universitario Morales Meseguer, IMIB, Murcia, Spain
| | - Rebeca Lozano
- Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre, Madrid, Spain
- Genitourinary Translational Research Group, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - David Hervas
- Data Science Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Jun Luo
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ugo de Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) "Dino Amadori" IRCCS, Meldola, Italy
| | - Daniel Castellano
- Department of Medical Oncology, Instituto de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Gerhardt Attard
- University College London Cancer Institute, Paul O'Gorman Building, London, UK
| | | | - Enrique Gonzalez-Billalabeitia
- Department of Haematology and Medical Oncology, Hospital Universitario Morales Meseguer, IMIB, Murcia, Spain
- Department of Medical Oncology, Instituto de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain
- Universidad Católica San Antonio de Murcia-UCAM, Murcia, Spain
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8
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de Velasco G, Alonso-Gordoa T, Rodríguez-Vida A, Anguera G, Campayo M, Pinto Á, Ortega EM, Gallardo E, Núñez NF, García-Carbonero I, Reig O, Méndez-Vidal MJ, Fernández-Calvo O, Cassinello NV, Torregrosa D, López-Martín A, Rosero A, Valiente PG, de España CG, Climent MA, Santasusana MD, Sánchez ÁR, González IC, Afonso R, García Del Muro X, Casinello J, Fernández-Parra EM, García Sánchez L, Afonso J, Polo SH, Asensio Ú. Long-term Clinical Outcomes of a Spanish Cohort of Metastatic Renal Cell Carcinoma Patients with a Complete Response to Sunitinib. Clin Genitourin Cancer 2022; 21:e166-e174. [PMID: 36610891 DOI: 10.1016/j.clgc.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The long-term clinical outcomes of patients with metastatic renal cell carcinoma (mRCC) and a complete response (CR) to the tyrosine kinase inhibitor (TKI) sunitinib are poorly known. The characteristics of these patients could reveal previously undetected associations with clinical variables. PATIENTS AND METHODS This observational, retrospective study (ATILA) used data from a registry of patients with mRCC who had received first-line sunitinib and had achieved CR from 2007 to 2018 in Spain. RESULTS Sixty-two patients with CR were included; 48 patients (77.4%) received sunitinib in monotherapy and 14 (22.6%) combined with or followed by local treatment. Median age was 58.5 years (range, 32-81). Most patients (79.0%) had clear cell histology and had undergone previous nephrectomy (90.3%). The majority (70.2%) had an intermediate IMDC prognosis, 23% favorable and 7.0% poor. The median time on treatment with sunitinib was 28.2 months (IQR, 16.7-41.0) and the median time to CR was 10.9 months (IQR, 7.2-19.3). After a median follow-up of 8 years (range, 3-13 years), the median PFS was not reached. The overall median duration of complete response was 64.1 months (IQR, 32.2-99.4). The tolerance and safety profile of sunitinib was consistent with previous reports. CONCLUSION Durable CR to sunitinib was observed in patients regardless the prognosis group, metastasis site or histology type, with 75% of patients remaining in CR after 10 years. CLINICALTRIALS gov: NCT03916458.
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Affiliation(s)
| | - Teresa Alonso-Gordoa
- Department of Medical Oncology and Department of Genitourinary, Germ cell and Endocrine Tumors, Ramón y Cajal University Hospital and Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Alejo Rodríguez-Vida
- Department of Medical Oncology, Hospital del Mar-CIBERONC, IMIM Research Institute, Barcelona, Spain
| | - Georgia Anguera
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Marc Campayo
- Department of Medical Oncology, Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain
| | - Álvaro Pinto
- Department of Medical Oncology, University Hospital La Paz, Madrid, Spain
| | | | - Enrique Gallardo
- Department of Medical Oncology, University Hospital Parc Taulí, Institut d'Investigació i Innovació Parc Taulí, Sabadell, Spain
| | | | | | - Oscar Reig
- Department of Medical Oncology, Hospital Clínic and Translational Genomics and Targeted Therapeutics in Solid Tumors Group (IDIBAPS), Barcelona, Spain
| | - María José Méndez-Vidal
- Department of Medical Oncology, University Hospital Reina Sofía, Maimónides Institute for Biomedical research of Córdoba (IMIBIC), Córdoba, Spain
| | | | - Natalia Vidal Cassinello
- Department of Medical Oncology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - Dolores Torregrosa
- Department of Medical Oncology, University Hospital Dr. Peset, Valencia, Spain
| | - Ana López-Martín
- Medical Oncology Department, University Hospital Severo Ochoa, Madrid, Spain
| | - Adriana Rosero
- Department of Medical Oncology, University Hospital Infanta Cristina, Parla, Madrid, Spain
| | - Patricia G Valiente
- Department of Medical Oncology, University Hospital Marqués de Valdecilla, Santander, Spain
| | | | - Miguel A Climent
- Department of Medical Oncology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | | | | | - Isabel Chirivella González
- Department of Medical Oncology, Hospital Clínico Universitario, INCLIVA, University of Valencia, Valencia, Spain
| | - Ruth Afonso
- Department of Medical Oncology, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Xavier García Del Muro
- Genitourinary Cancer and Sarcoma Unit, Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - Javier Casinello
- Department of Medical Oncology, University Hospital of Guadalajara, Guadalajara, Spain
| | | | | | - Javier Afonso
- Department of Medical Oncology, University Hospital of Ferrol, A Coruña, Spain
| | - Susana Hernando Polo
- Department of Medical Oncology, University Hospital Fundación Alcorcón, Madrid, Spain
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9
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Molina-Cerrillo J, Santoni M, Ruiz Á, Massari F, Pozas J, Ortego I, Gómez V, Grande E, Alonso-Gordoa T. Epigenetics in advanced renal cell carcinoma: Potential new targets. Crit Rev Oncol Hematol 2022; 180:103857. [DOI: 10.1016/j.critrevonc.2022.103857] [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] [Received: 07/14/2022] [Revised: 10/06/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
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10
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Cortellini A, Dettorre GM, Dafni U, Aguilar-Company J, Castelo-Branco L, Lambertini M, Gennatas S, Angelis V, Sita-Lumsden A, Rogado J, Pedrazzoli P, Viñal D, Prat A, Rossi M, Berardi R, Alonso-Gordoa T, Grisanti S, Dimopoulou G, Queirolo P, Pradervand S, Bertuzzi A, Bower M, Arnold D, Salazar R, Tucci M, Harrington KJ, Mazzoni F, Mukherjee U, Tsourti Z, Michielin O, Pommeret F, Brunet J, Vincenzi B, Tonini G, Patriarca A, Biello F, Krengli M, Tabernero J, Pentheroudakis G, Gennari A, Peters S, Romano E, Pinato DJ. Immune checkpoint inhibitor therapy and outcomes from SARS-CoV-2 infection in patients with cancer: a joint analysis of OnCovid and ESMO-CoCARE registries. J Immunother Cancer 2022; 10:jitc-2022-005732. [PMID: 36450384 PMCID: PMC9716413 DOI: 10.1136/jitc-2022-005732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND As management and prevention strategies against COVID-19 evolve, it is still uncertain whether prior exposure to immune checkpoint inhibitors (ICIs) affects COVID-19 severity in patients with cancer. METHODS In a joint analysis of ICI recipients from OnCovid (NCT04393974) and European Society for Medical Oncology (ESMO) CoCARE registries, we assessed severity and mortality from SARS-CoV-2 in vaccinated and unvaccinated patients with cancer and explored whether prior immune-related adverse events (irAEs) influenced outcome from COVID-19. FINDINGS The study population consisted of 240 patients diagnosed with COVID-19 between January 2020 and February 2022 exposed to ICI within 3 months prior to COVID-19 diagnosis, with a 30-day case fatality rate (CFR30) of 23.6% (95% CI 17.8 to 30.7%). Overall, 42 (17.5%) were fully vaccinated prior to COVID-19 and experienced decreased CFR30 (4.8% vs 28.1%, p=0.0009), hospitalization rate (27.5% vs 63.2%, p<0.0001), requirement of oxygen therapy (15.8% vs 41.5%, p=0.0030), COVID-19 complication rate (11.9% vs 34.6%, p=0.0040), with a reduced need for COVID-19-specific therapy (26.3% vs 57.9%, p=0.0004) compared with unvaccinated patients. Inverse probability of treatment weighting (IPTW)-fitted multivariable analysis, following a clustered-robust correction for the data source (OnCovid vs ESMO CoCARE), confirmed that vaccinated patients experienced a decreased risk of death at 30 days (adjusted OR, aOR 0.08, 95% CI 0.01 to 0.69).Overall, 38 patients (15.8%) experienced at least one irAE of any grade at any time prior to COVID-19, at a median time of 3.2 months (range 0.13-48.7) from COVID-19 diagnosis. IrAEs occurred independently of baseline characteristics except for primary tumor (p=0.0373) and were associated with a significantly decreased CFR30 (10.8% vs 26.0%, p=0.0462) additionally confirmed by the IPTW-fitted multivariable analysis (aOR 0.47, 95% CI 0.33 to 0.67). Patients who experienced irAEs also presented a higher median absolute lymphocyte count at COVID-19 (1.4 vs 0.8 109 cells/L, p=0.0098). CONCLUSION Anti-SARS-CoV-2 vaccination reduces morbidity and mortality from COVID-19 in ICI recipients. History of irAEs might identify patients with pre-existing protection from COVID-19, warranting further investigation of adaptive immune determinants of protection from SARS-CoV-2.
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Affiliation(s)
- Alessio Cortellini
- Department of Surgery & Cancer, Hammersmith Hospital Campus, Imperial College London, London, UK,Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128, Roma, Italy
| | - Gino M Dettorre
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Urania Dafni
- Laboratory of Biostatistics, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Juan Aguilar-Company
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain,Infectious Disease, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Luis Castelo-Branco
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland,NOVA National School of Publich Health, NOVA University, Lisbon, Portugal
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genova, Italy,Medical Oncology Department, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Spyridon Gennatas
- Medical Oncology Department, The Royal Marsden Hospital and NHS Foundation Trust, London, UK
| | - Vasileios Angelis
- Medical Oncology Department, The Royal Marsden Hospital and NHS Foundation Trust, London, UK
| | - Ailsa Sita-Lumsden
- Medical Oncology, Guy's and St Thomas' NHS Foundation Trust (GSTT), London, UK
| | - Jacobo Rogado
- Medical Oncology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Paolo Pedrazzoli
- Medical Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy,Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - David Viñal
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Aleix Prat
- Department of Medical Oncology, Hospital Clinic de Barcelona, Barcelona, Spain,Translational Genomics and Targeted Therapies in Solid Tumors, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Maura Rossi
- Oncology Department, ASO ‘SS Antonio Biagio e Cesare Arrigo’, Alessandria, Italy
| | - Rossana Berardi
- Medical Oncology, AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Ancona, Italy
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Georgia Dimopoulou
- Laboratory of Biostatistics, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Paola Queirolo
- Melanoma Sarcoma and Rare Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Sylvain Pradervand
- Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, UK
| | - Dirk Arnold
- Oncology, Haematology, Palliative Care Department, Asklepios Klinik Altona e Asklepios Kliniken, Hamburg, Germany
| | - Ramon Salazar
- Department of Medical Oncology, ICO L’Hospitalet, Oncobell Program (IDIBELL), CIBERONC, Hospitalet de Llobregat, Barcelona, Spain
| | - Marco Tucci
- Section of Medical Oncology, Department of Interdisciplinary Medicine (DIM), University of Bari 'Aldo Moro', Bari, Italy,IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Kevin J Harrington
- Division of Radiotherapy and Imaging, The Royal Marsden Hospital and The Institute of Cancer Research NIHR Biomedical Research Centre, London, UK
| | | | - Uma Mukherjee
- Medical Oncology, Barts Health NHS Trust, London, UK
| | - Zoi Tsourti
- Frontier Science Foundation-Hellas, Athens, Greece
| | - Olivier Michielin
- Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Fanny Pommeret
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, 114 rue Edouard Vaillant, Villejuif, France
| | - Joan Brunet
- Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Josep Trueta, Girona, Spain
| | - Bruno Vincenzi
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128, Roma, Italy
| | - Giuseppe Tonini
- Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128, Roma, Italy
| | - Andrea Patriarca
- Division of Haematology, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore della Carità, Novara, Italy
| | - Federica Biello
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore della Carità, Novara, Italy
| | - Marco Krengli
- Division of Radiotherapy, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore Della Carita, Novara, Italy
| | - Josep Tabernero
- Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - George Pentheroudakis
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland
| | - Alessandra Gennari
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore della Carità, Novara, Italy
| | - Solange Peters
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland,Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Emanuela Romano
- Center for Cancer Immunotherapy, Department of Oncology, PSL Research University, Institut Curie, Paris, France
| | - David J Pinato
- Department of Surgery & Cancer, Hammersmith Hospital Campus, Imperial College London, London, UK,Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale and Azienda Ospedaliera Maggiore della Carità, Novara, Italy
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11
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Araujo-Castro M, Redondo López S, Pascual-Corrales E, Polo López R, Alonso-Gordoa T, Molina-Cerrillo J, Moreno Mata N, Caballero Silva U, Barberá Durbán R. Surgical and non-surgical management of thoracic and cervical paraganglioma. Ann Endocrinol (Paris) 2022:S0003-4266(22)00857-5. [PMID: 36334803 DOI: 10.1016/j.ando.2022.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 12/24/2022]
Abstract
Thoracic and cervical paragangliomas (PGLs) are rare neuroendocrine tumors arising from chromaffin cells of the neural crest progenitors located outside the adrenal gland. We describe our current protocol as a multidisciplinary team for the management of cervical and thoracic PGLs. Surgery is generally considered the treatment of choice as it offers the best chance for cure. For resection of thoracic PGLs, video-assisted thoracoscopic surgery (VATS) is the main surgical approach, while open thoracotomy is preferred in case of tumors > 6cm, lacking confirmation of a plane of separation with adjacent structures, or with technical difficulties during VATS. In cervical PGLs, the surgical approach should be individualized according to location, mainly based on the Glasscock-Jackson and the Fisch-Mattox classifications. Surgery is the treatment of choice for most cervical and thoracic PGLs, but radiotherapy or observation could be more suitable options in unresectable cervical and thoracic PGLs or when resection has been incomplete.
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Affiliation(s)
- Marta Araujo-Castro
- Neuroendocrinology Division, Department of Endocrinology & Nutrition & IRYCIS, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, Madrid, Spain.
| | - Sandra Redondo López
- Department of Vascular Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Eider Pascual-Corrales
- Neuroendocrinology Division, Department of Endocrinology & Nutrition & IRYCIS, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, Madrid, Spain
| | - Rubén Polo López
- Department of Otorhinolaryngology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Teresa Alonso-Gordoa
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal & IRYCIS, Madrid, Spain
| | - Javier Molina-Cerrillo
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal & IRYCIS, Madrid, Spain
| | - Nicolás Moreno Mata
- Department of Thoracic Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Usue Caballero Silva
- Department of Thoracic Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Rafael Barberá Durbán
- Department of Otorhinolaryngology, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Araujo-Castro M, Pascual-Corrales E, Lorca Álvaro J, Mínguez Ojeda C, Pian H, Ruz-Caracuel I, Sanjuanbenito Dehesa A, Serrano Romero A, Alonso-Gordoa T, Molina-Cerrillo J, Gómez Dos Santos V. Manejo quirúrgico y posquirúrgico de paragangliomas abdominales y feocromocitomas. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2022.05.008] [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: 11/07/2022]
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Araujo-Castro M, Pascual-Corrales E, Alonso-Gordoa T, Molina-Cerrillo J, Martínez Lorca A. Papel de las pruebas de imagen con radionúclidos en el diagnóstico y tratamiento de los feocromocitomas y paragangliomas. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.09.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Araujo-Castro M, Pascual-Corrales E, Alonso-Gordoa T, Molina-Cerrillo J, Martínez Lorca A. Role of imaging test with radionuclides in the diagnosis and treatment of pheochromocytomas and paragangliomas. ENDOCRINOL DIAB NUTR 2022; 69:614-628. [PMID: 36402734 DOI: 10.1016/j.endien.2022.11.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/29/2021] [Indexed: 06/16/2023]
Abstract
Radionuclide imaging tests with [123I] Metaiodobenzylguanidine (MIBG), [18F] -fluorodeoxyglucose, [18F]-fluorodopa, or 68Ga-DOTA(0)-Tyr(3)-octreotate are useful for the diagnosis, staging and follow-up of pheochromocytomas (PHEOs) and paragangliomas (PGLs) (PPGLs). In addition to their ability to detect and localize the disease, they allow a better molecular characterization of the tumours, which is useful for planning targeted therapy with iodine-131 (131I) -labelled MIBG or with peptide receptor radionuclide therapy (PRRT) with [177Lu]-labelled DOTATATE or other related agents in patients with metastatic disease. In this review we detail the main characteristics of the radiopharmaceuticals used in the functional study of PPGLs and the role of nuclear medicine tests for initial evaluation, staging, selection of patients for targeted molecular therapy, and radiation therapy planning. It also offers a series of practical recommendations regarding the functional imaging according to the different clinical and genetic scenarios in which PPGLs occur, and on the indications and efficacy of therapy with [131I]-MIBG and 177Lu-DOTATATE.
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Affiliation(s)
- Marta Araujo-Castro
- Unidad de Neuroendocrinología, Servicio de Endocrinología y Nutrición, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain; Universidad de Alcalá, Departamento de Ciencias de la Salud, Madrid, Spain.
| | - Eider Pascual-Corrales
- Unidad de Neuroendocrinología, Servicio de Endocrinología y Nutrición, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Teresa Alonso-Gordoa
- Servicio de Oncología Médica, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Javier Molina-Cerrillo
- Servicio de Oncología Médica, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Alberto Martínez Lorca
- Servicio de Medicina Nuclear, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain.
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Pozas J, Alonso-Gordoa T, Román MS, Santoni M, Thirlwell C, Grande E, Molina-Cerrillo J. Novel therapeutic approaches in GEP-NETs based on genetic and epigenetic alterations. Biochim Biophys Acta Rev Cancer 2022; 1877:188804. [PMID: 36152904 DOI: 10.1016/j.bbcan.2022.188804] [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: 08/19/2022] [Revised: 09/17/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022]
Abstract
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are heterogeneous malignancies with distinct prognosis based on primary tumor localization, grade, stage and functionality. Surgery remains the only curative option in localized tumors, but systemic therapy is the mainstay of treatment for patients with advanced disease. For decades, the therapeutic landscape of GEP-NETs was limited to chemotherapy regimens with low response rates. The arrival of novel agents such as somatostatin analogues, peptide receptor radionuclide therapy, tyrosine kinase inhibitors or mTOR-targeted drugs, has changed the therapeutic paradigm of GEP-NETs. However, the efficacy of these agents is limited in time and there is scarce knowledge of optimal treatment sequencing. In recent years, massive parallel sequencing techniques have started to unravel the genomic intricacies of these tumors, allowing us to better understand the mechanisms of resistance to current treatments and to develop new targeted agents that will hopefully start an era for personalized treatment in NETs. In this review we aim to summarize the most relevant genomic aberrations and signaling pathways underlying GEP-NET tumorigenesis and potential therapeutic strategies derived from them.
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Affiliation(s)
- Javier Pozas
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Medicine School, Alcalá University, Madrid, Spain
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Medicine School, Alcalá University, Madrid, Spain
| | - Maria San Román
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Medicine School, Alcalá University, Madrid, Spain
| | | | | | - Enrique Grande
- Medical Oncology Ddepartment. MD Anderson Cancer Center Madrid, 28033 Madrid, Spain
| | - Javier Molina-Cerrillo
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Medicine School, Alcalá University, Madrid, Spain.
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Climent MA, Font A, Durán I, Puente J, José Méndez-Vidal M, Sáez MI, Santander Lobera C, Ángel Arranz Arija J, González-Del-Alba A, Sánchez-Hernandez A, Juan Fita MJ, Esteban E, Alonso-Gordoa T, Mellado Gonzalez B, Maroto P, Lázaro-Quintela M, Cassinello-Espinosa J, Pérez-Valderrama B, Garcias C, Castellano D. A phase II randomised trial of abiraterone acetate plus prednisone in combination with docetaxel or docetaxel plus prednisone after disease progression to abiraterone acetate plus prednisone in patients with metastatic castration-resistant prostate cancer: The ABIDO-SOGUG trial. Eur J Cancer 2022; 175:110-119. [PMID: 36099670 DOI: 10.1016/j.ejca.2022.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/22/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to compare the efficacy and safety of maintaining or withdrawing abiraterone acetate plus prednisone (AAP) in patients with metastatic castration-resistant prostate cancer who had experienced cancer progression to this treatment and were beginning a docetaxel-based therapy. PATIENTS AND METHODS Phase II, randomised, open-label study conducted in patients with metastatic castration-resistant prostate cancer who were asymptomatic or mildly symptomatic. After open-label treatment with AAP, patients who had experienced cancer progression to AAP were randomised to 75 mg/m2 of docetaxel plus AAP or to receive 75 mg/m2 of docetaxel plus 10 mg of prednisone orally daily. The primary outcome was the radiographic progression-free survival rate at 12 months as evaluated by the investigators in all randomised patients. RESULTS A total of 148 patients were included in open-label treatment with AAP, and of them, 94 patients were randomised to receive either docetaxel plus AAP (intervention group; n = 47) or docetaxel plus prednisone (control group; n = 47). The 12-month radiographic progression-free survival rates did not differ between the intervention group (34.9%; 95% CI 20.7-49.2) and the control group (33.9%; 95% CI 19.5-48.3). There were no significant differences in the time to radiographic progression and the overall survival between the intervention and control groups. Grade 3-5 neutropenia with the combination of docetaxel plus prednisone and AA was more frequent than with docetaxel plus prednisone (59.6% versus 27.7%). CONCLUSION Our results indicate that the therapeutic strategy of maintaining AAP added to docetaxel in chemotherapy-naïve patients who have experienced cancer progression to AAP treatment should not be further evaluated and should be avoided in clinical practice. CLINICAL TRIALS NCT02036060 https://clinicaltrials.gov/ct2/show/NCT02036060.
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Affiliation(s)
- Miguel A Climent
- Medical Oncology, Fundación Instituto Valenciano de Oncología (IVO), Valencia, Spain.
| | - Albert Font
- Medical Oncology, Instituto Catalá d'Oncologia (ICO), Badalona, Spain.
| | - Ignacio Durán
- Medical Oncology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
| | - Javier Puente
- Medical Oncology, Hospital Clínico San Carlos, Madrid, Spain.
| | - María José Méndez-Vidal
- Medical Oncology, Maimonides Institute for Biomedical Research of Córdoba (IMIBIC) Hospital Universitario Reina Sofia (HURS), Córdoba, Spain.
| | - María Isabel Sáez
- UGCI Oncología Médica, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga, Spain.
| | | | | | | | | | - Maria Jose Juan Fita
- Medical Oncology, Fundación Instituto Valenciano de Oncología (IVO), Valencia, Spain.
| | - Emilio Esteban
- Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | | | - Begoña Mellado Gonzalez
- Medical Oncology, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - Pablo Maroto
- Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | | | | | | | - Carmen Garcias
- Medical Oncology, Hospital Universitario Son Espases, Palma de Mallorca, Spain.
| | - Daniel Castellano
- Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain.
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Capdevila Castillon J, Plana M, Castelo B, Iglesias L, Hernando J, Yaya Tur R, Baste N, Carmona-Bayonas A, Ruiz S, Trigo J, Lorenzo-Lorenzo I, Grande E, Lorente D, Ugidos L, Marquina G, García-Alvarez A, Taberna M, Villamayor J, Molina-Cerrillo J, Alonso-Gordoa T. 1645O Durvalumab (D) plus tremelimumab (T) for the treatment of patients with progressive, refractory advanced thyroid carcinoma: The DUTHY (GETNE-T1812) trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1725] [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: 11/01/2022] Open
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18
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Carles J, Alonso-Gordoa T, Mellado B, Méndez-Vidal MJ, Vázquez S, González-Del-Alba A, Piulats JM, Borrega P, Gallardo E, Morales-Barrera R, Paredes P, Reig O, Garcías de España C, Collado R, Bonfill T, Suárez C, Sampayo-Cordero M, Malfettone A, Garde J. Radium-223 for patients with metastatic castration-resistant prostate cancer with asymptomatic bone metastases progressing on first-line abiraterone acetate or enzalutamide: A single-arm phase II trial. Eur J Cancer 2022; 173:317-326. [PMID: 35981452 DOI: 10.1016/j.ejca.2022.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The paper aims to evaluate the efficacy and safety of 223Ra in patients who progressed after first-line androgen deprivation therapy. PATIENTS AND METHODS EXCAAPE (NCT03002220) was a multicentre, single-arm, open-label, non-controlled phase IIa trial in 52 patients with metastatic castration-resistant prostate cancer and asymptomatic bone metastases who have progressed on abiraterone acetate or enzalutamide, up to six doses of 223Ra (55 kBq/kg of body weight per month). The primary end-point was radiographic progression-free survival (rPFS). Secondary end-points included rPFS based on androgen receptor splice variant 7 (AR-V7) expression in circulating tumour cells (CTCs), overall survival, and safety. RESULTS Median rPFS was 5.5 months (95% CI 5.3-5.5). Median rPFS of patients with AR-V7(-) CTCs was longer than that of patients with AR-V7(+) CTCs (5.5 versus 2.2 months, respectively; P = 0.056). Median overall survival was 14.8 months (95% CI 11.2-not reached) and was significantly greater for AR-V7(-) patients than for AR-V7(+) patients (14.8 months versus 3.5 months, respectively; P < 0.01). 223Ra was well tolerated; anaemia and thrombocytopenia were the most common grade 3/4 adverse events (5.8% and 11.5%, respectively). CONCLUSIONS 223Ra seems to be a reasonable treatment for patients with metastatic castration-resistant prostate cancer and asymptomatic bone metastases progressing on novel hormonal therapy and had an acceptable safety profile.
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Affiliation(s)
- Joan Carles
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Universitat Autónoma de Barcelona, Barcelona, Spain.
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Begoña Mellado
- Medical Oncology Department, Hospital Clínic Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors Lab, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - María J Méndez-Vidal
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Córdoba, Spain; Reina Sofía University Hospital (HURS), Córdoba, Spain
| | | | | | | | | | - Enrique Gallardo
- Parc Taulí University Hospital, Parc Taulí Institute of Research and Innovation I3PT, Barcelona, Spain
| | - Rafael Morales-Barrera
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Pilar Paredes
- Medical Oncology Department, Hospital Clínic Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors Lab, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Oscar Reig
- Medical Oncology Department, Hospital Clínic Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapeutics in Solid Tumors Lab, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | | | - Cristina Suárez
- Universitat Autónoma de Barcelona, Barcelona, Spain; Parc Taulí University Hospital, Parc Taulí Institute of Research and Innovation I3PT, Barcelona, Spain
| | | | | | - Javier Garde
- Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain
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Riesco Martinez M, Capdevila Castillon J, Alonso V, Jimenez-Fonseca P, Teule A, Grande E, Sevilla I, Benavent M, Alonso-Gordoa T, Custodio A, Antón Pascual B, Hernando J, Polo E, Castillo Trujillo O, Garcia-Carbonero R. 496MO Final overall survival results from the NICE-NEC trial (GETNE-T1913): A phase II study of nivolumab and platinum-doublet chemotherapy (CT) in untreated advanced G3 neuroendocrine neoplasms (NENs) of gastroenteropancreatic (GEP) or unknown (UK) origin. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.624] [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
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20
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Araujo-Castro M, Pascual-Corrales E, Lorca Álvaro J, Mínguez Ojeda C, Pian H, Ruz-Caracuel I, Sanjuanbenito Dehesa A, Serrano Romero AB, Alonso-Gordoa T, Molina-Cerrillo J, Gómez Dos Santos V. Surgical and postsurgical management of abdominal paragangliomas and pheochromocytomas. Actas Urológicas Españolas (English Edition) 2022; 47:68-77. [PMID: 37078847 DOI: 10.1016/j.acuroe.2022.08.008] [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] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe our current protocol for surgical and postsurgical management of abdominal paragangliomas (PGLs) and pheochromocytomas, with a special focus on multidisciplinary management in centres with experience. METHODS The physicians involved in the management of patients with abdominal PGLs and pheochromocytomas of our hospital reviewed systematically current knowledge on the surgical management of abdominal PGLs and pheochromocytomas. RESULTS Currently, surgery is considered the treatment of choice for abdominal PGLs and pheochromocytomas. The choice of surgical approach is determined based on the location of the lesion, size, patient́s body habitus and the likelihood of malignancy. Laparoscopic surgery is usually considered the gold standard approach for pheochromocytomas, but open access should be considered in invasive and/or potentially malignant tumours >8-10 cm and for abdominal PGLs. Postsurgical management of pheochromocytomas and PGLs includes close hemodynamic monitoring and treatment of postsurgical complications, the pathological study of the surgical specimen, reassessment of hormonal and/or radiological status and planning of follow-up based on the risk of recurrence and malignancy. CONCLUSION Surgery represents the treatment of choice of most abdominal PGLs and pheochromocytomas. Optimal postsurgical evaluation, including hemodynamic, pathological, hormonal, and radiological evaluation, should be performed by a multidisciplinary team specializing in PGL/pheochromocytoma management.
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Affiliation(s)
- M Araujo-Castro
- Departamento de Endocrinología y Nutrición, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - E Pascual-Corrales
- Departamento de Endocrinología y Nutrición, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Lorca Álvaro
- Departamento de Urología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - C Mínguez Ojeda
- Departamento de Urología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - H Pian
- Departamento de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - I Ruz-Caracuel
- Departamento de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A Sanjuanbenito Dehesa
- Departamento de General y Cirugía Digestiva, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A B Serrano Romero
- Departamento de Anestesia, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - T Alonso-Gordoa
- Departamento Médico Oncológico, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Molina-Cerrillo
- Departamento Médico Oncológico, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - V Gómez Dos Santos
- Departamento de Urología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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21
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Pozas J, Albarrán-Fernández V, González-Campo L, Olmedo-García ME, Corral de la Fuente E, Corral-Corral I, Carrasco Á, Alonso-Gordoa T, Molina-Cerrillo J, Lage-Alfranca Y, Gómez-Rueda A, Garrido P. Anti-Zic4 paraneoplastic cerebellar degeneration in a patient with EGFR-mutated NSCLC: a case report. Transl Lung Cancer Res 2022; 11:1497-1502. [PMID: 35958343 PMCID: PMC9359961 DOI: 10.21037/tlcr-21-989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/06/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Javier Pozas
- Department of Medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain
| | | | | | | | - Elena Corral de la Fuente
- Early Phase Clinical Drug Development in Oncology, South Texas Accelerated Research Therapeutics (START), Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain
| | | | - Ángela Carrasco
- Department of Immunology, Ramón y Cajal University Hospital, Madrid, Spain
| | - Teresa Alonso-Gordoa
- Department of Medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain
| | | | | | - Ana Gómez-Rueda
- Department of Medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain
| | - Pilar Garrido
- Department of Medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain
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22
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Molina-Cerrillo J, Ortego I, Pinto A, Alonso-Gordoa T, Massari F, Aurilio G, Buti S, Santoni M, Grande E. Does timing of Immune checkpoint inhibitors (ICIs) administration in first line Metastatic Renal Cell Carcinoma (mRCC) have impact in survival outcomes? J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e16512] [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
e16512 Background: Recent data in metastatic melanoma patients shows that time-of-day infusion of ICIs may directly impact on the efficacy based on the dependence of the adaptive immune system on circadian rhythm. ICIs either as single agents or in combinations, are now considered the backbone systemic treatment of mRCC pts. There is a strong biological rational showing that “Clock genes”, particularly PER2, TIMELESS and TIPIN have an altered expression in RCC compared with normal tissue. We conducted a retrospective analysis in pts with mRCC receiving ICIs-based therapies in order to determinate whether timing of ICIs administration has an impact on survival outcomes. Methods: This is a multicenter and retrospective study performed in 3 academic institutions in Spain and 3 in Italy to describe the outcome of all pts who received ICIs-ICIs or ICIs-TKI treatment for the first line setting of mRCC in daily standarc practice related to the timing of administration. We selected 16.30h as the time-limit and identified the pts receiving more than 20% of the treatment infusion after that time. Pts were treated and evaluated according to institutional local guidelines. Pts characteristics, efficacy and treatment-related toxicities were gathered. A Cox regression analysis was conducted to explore the association of baseline variables. Results: From 2019, 61 pts received either Nivolumab/Ipilimumab (N = 46, 75.4%) or pembrolizumab/axitinib (N = 15, 24,6%) for the upfront mRCC treatment. 52 (85.2%) pts (17 ICI+TKI and 25 ICI+ICI) received less than 20% of the ICIs combination treatment infusion after 16.30h compared with 9 (14.8%) pts (3 ICI+TKI and 6 ICI+ICI) who received more than 20% of the treatment infusion after 16.30h. Median follow up was 14.6 months (m). Pts who received most treatment before 16.30h had a significantly longer median PFS compared with those pts with the latest administration (12.3 vs 5.6m; HR 2.28: 95%CI 1.1-5.15; p = 0.048). Overall Survival (OS) data were immature but showed a tend to a better survival for those patients with earlier infusion administration (HR 2.33 p = 0.16). Corticosteroids concomitant administration or immune-related adverse events did not seem to have an impact on these results. Conclusions: Consistently to the melanoma findings, we also identified a potential survival impact from timing of IO administration in mRCC pts receiving ICIs-based combinations in first line treatment. Despite these promising results, there are study limitations such as number of patients and heterogeneous treatment groups. Larger prospective and randomized data are needed to assess the robustness of this hypothesis in the clinic.
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Affiliation(s)
| | | | - Alvaro Pinto
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | | | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gaetano Aurilio
- Medical Oncology Division of Urogenital and Head and Neck Tumors, European Institute of Oncology, Milan, Italy
| | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Matteo Santoni
- Medical Oncology Unit, Macerata General Hospital, Macerata, Italy
| | - Enrique Grande
- Medical Oncology Department, MD Anderson Cancer Center Madrid, Madrid, Spain
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23
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Castelo-Branco L, Tsourti Z, Gennatas S, Rogado J, Sekacheva M, Viñal D, Lee R, Croitoru A, Vitorino M, Khallaf S, Šušnjar S, Soewoto W, Cardeña A, Djerouni M, Rossi M, Alonso-Gordoa T, Ngelangel C, Whisenant JG, Choueiri TK, Dimopoulou G, Pradervand S, Arnold D, Harrington K, Michielin O, Dafni U, Pentheroudakis G, Peters S, Romano E. COVID-19 in patients with cancer: first report of the ESMO international, registry-based, cohort study (ESMO-CoCARE). ESMO Open 2022; 7:100499. [PMID: 35644101 PMCID: PMC9080222 DOI: 10.1016/j.esmoop.2022.100499] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND ESMO COVID-19 and CAncer REgistry (ESMO-CoCARE) is an international collaborative registry-based, cohort study gathering real-world data from Europe, Asia/Oceania and Africa on the natural history, management and outcomes of patients with cancer infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). PATIENTS AND METHODS ESMO-CoCARE captures information on patients with solid/haematological malignancies, diagnosed with coronavirus disease 2019 (COVID-19). Data collected since June 2020 include demographics, comorbidities, laboratory measurements, cancer characteristics, COVID-19 clinical features, management and outcome. Parameters influencing COVID-19 severity/recovery were investigated as well as factors associated with overall survival (OS) upon SARS-CoV-2 infection. RESULTS This analysis includes 1626 patients from 20 countries (87% from 24 European, 7% from 5 North African, 6% from 8 Asian/Oceanian centres), with COVID-19 diagnosis from January 2020 to May 2021. Median age was 64 years, with 52% of female, 57% of cancer stage III/IV and 65% receiving active cancer treatment. Nearly 64% patients required hospitalization due to COVID-19 diagnosis, with 11% receiving intensive care. In multivariable analysis, male sex, older age, Eastern Cooperative Oncology Group (ECOG) performance status ≥2, body mass index (BMI) <25 kg/m2, presence of comorbidities, symptomatic disease, as well as haematological malignancies, active/progressive cancer, neutrophil-to-lymphocyte ratio (NLR) ≥6 and OnCovid Inflammatory Score ≤40 were associated with COVID-19 severity (i.e. severe/moderate disease requiring hospitalization). About 98% of patients with mild COVID-19 recovered, as opposed to 71% with severe/moderate disease. Advanced cancer stage was an additional adverse prognostic factor for recovery. At data cut-off, and with median follow-up of 3 months, the COVID-19-related death rate was 24.5% (297/1212), with 380 deaths recorded in total. Almost all factors associated with COVID-19 severity, except for BMI and NLR, were also predictive of inferior OS, along with smoking and non-Asian ethnicity. CONCLUSIONS Selected patient and cancer characteristics related to sex, ethnicity, poor fitness, comorbidities, inflammation and active malignancy predict for severe/moderate disease and adverse outcomes from COVID-19 in patients with cancer.
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Affiliation(s)
- L Castelo-Branco
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland; NOVA National School of Public Health, NOVA University, Lisbon, Portugal
| | - Z Tsourti
- Frontier Science Foundation-Hellas, Athens, Greece
| | - S Gennatas
- Medical Oncology Department, The Royal Marsden Hospital - NHS Foundation Trust, London, UK
| | - J Rogado
- Medical Oncology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - M Sekacheva
- World-Class Research Center 'Digital Biodesign and Personalized Healthcare', Sechenov First Moscow State Medical University, Moscow, Russia
| | - D Viñal
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - R Lee
- Medical Oncology Department, The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - A Croitoru
- Medical Oncology Department, Fundeni Clinical Institute, Bucharest, Romania
| | - M Vitorino
- Servico Oncologia, Hospital Prof. Dr Fernando Fonseca EPE (Hospital Amadora/Sintra), Amadora, Portugal
| | - S Khallaf
- Medical Oncology Department, South Egypt Cancer Institute (SECI), Assiut University, Assiut, Egypt
| | - S Šušnjar
- Department of Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - W Soewoto
- Department of Surgery, Oncology Division, Sebelas Maret University, Surakarta, Indonesia
| | - A Cardeña
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - M Djerouni
- Oncology Department, Dr Saadane Hospital, Biskra, Algeria
| | - M Rossi
- Oncology Deparment, ASO 'SS. Antonio, Biagio e Cesare Arrigo', Alessandria, Italy
| | - T Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - C Ngelangel
- Asian Cancer Institute - Asian Hospital and Medical Center, Metro Manila, the Philippines
| | - J G Whisenant
- Vanderbilt University Medical Center, Nashville, USA
| | - T K Choueiri
- The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, USA; Harvard Medical School, Boston, USA
| | - G Dimopoulou
- Frontier Science Foundation-Hellas, Athens, Greece
| | - S Pradervand
- Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - D Arnold
- Oncology, Haematology, Palliative Care Department, Asklepios Klinik Altona - Asklepios Kliniken, Hamburg, Germany
| | - K Harrington
- Division of Radiotherapy and Imaging, The Royal Marsden/The Institute of Cancer Research NIHR Biomedical Research Centre, London, UK
| | - O Michielin
- Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - U Dafni
- Laboratory of Biostatistics, School of Health Sciences, National and Kapodistrian University of Athens, Athens Frontier Science Foundation-Hellas, Athens, Greece
| | - G Pentheroudakis
- Scientific and Medical Division, ESMO (European Society for Medical Oncology), Lugano, Switzerland
| | - S Peters
- Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - E Romano
- Center for Cancer Immunotherapy, Department of Oncology, PSL Research University, Institut Curie, Paris, France.
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Ortego I, Molina-Cerrillo J, Pinto A, Santoni M, Alonso-Gordoa T, Lopez Criado MP, Gonzalez-Morales A, Grande E. Time-of-day infusion of immunotherapy in metastatic urothelial cancer (mUC): Should it be considered to improve survival outcomes? J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e16541] [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
e16541 Background: Immune-checkpoint inhibitors (ICIs) are key in the current management of mUC pts. Recent data in melanoma revealed a link in between the circadian rhythm of the immune-system and expected activity with ICIs (Quian et al, Lancet Oncol 2021). In preclinical models naïve CD4 and CD8 T cells in blood have shown to approach nadir levels around 4 P.M., and therefore, to lower adaptative immune responses after that time. We aimed to correlate the activity of single agent ICIs for the systemic treatment of mUC pts depending on the time of administration. Methods: This is a multicenter and retrospective study performed in 3 academic institutions in Spain and 1 in Italy of patients with mUC who initiated treatment with anti-PD1 or anti-PDL1 as 1st or subsequent line. ICIs were administered and managed according to product labelling. Time cut-off as adaptive immune-modulation for ICIs administration was considered after 4:30 PM. We divided pts into those who received at least 20% of their infusions after 4:30 PM and those who received fewer than 20% after that time. Other data such as patient characteristics and adverse-events related to the treatment were also collected. We carried out a survival analysis by a Cox regression model. Results: From 2016, 92 pts were treated with single agent ICIs for mUC. Most of the pts (n = 62; 67.4%) received less than 20% of the doses after 4:30 PM, while a lower proportion (n = 26; 28.3%) received at least 20% of the doses after that time. Median follow-up time of immunotherapy was 8.6 months. 35 (38.0%) and 57 (62.0%) pts received ICIs as 1st and subsequent lines of treatment respectively. There were no differences in the proportion of pts in 1st vs subsequent lines and time of administration, nor other well prognostic baseline factors like PD-L1 expression, or Bajorin or Bellmunt’s scoring. A significant benefit in both PFS (11.38 vs 3.58 months; HR 2.66: 95%CI 1.53-4.63; p = 0.001) and in OS (14.04 vs 6.80 months; HR 2.62: 95%CI 1.48-4.63: p = 0.001) benefited to pts who received less than 20% of the doses after 4:30 PM. Response rate also favored (59.3% vs 16.0%) the earlier administration of the treatments. Neither corticosteroids concomitant use nor immune-related toxicity appeared to impact on these outcomes. Conclusions: Time of the day administration of ICIs may influence the efficacy of ICIs in mUC pts. Although the small size of the sample and the short median follow-up is something to be considered, this data are promising and consistent with the previous studies. Prospective confirmation is needed.
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Affiliation(s)
| | | | - Alvaro Pinto
- Department of Medical Oncology, La Paz University Hospital, Madrid, Spain
| | - Matteo Santoni
- Medical Oncology Unit, Macerata General Hospital, Macerata, Italy
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Román-Gil MS, Pozas J, Rosero-Rodríguez D, Chamorro-Pérez J, Ruiz-Granados Á, Caracuel IR, Grande E, Molina-Cerrillo J, Alonso-Gordoa T. Resistance to RET targeted therapy in Thyroid Cancer: Molecular basis and overcoming strategies. Cancer Treat Rev 2022; 105:102372. [DOI: 10.1016/j.ctrv.2022.102372] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 12/07/2022]
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Araujo-Castro M, Pascual-Corrales E, Molina-Cerrillo J, Moreno Mata N, Alonso-Gordoa T. Bronchial Carcinoids: From Molecular Background to Treatment Approach. Cancers (Basel) 2022; 14:cancers14030520. [PMID: 35158788 PMCID: PMC8833538 DOI: 10.3390/cancers14030520] [Citation(s) in RCA: 6] [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: 12/16/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Bronchial carcinoids (BCs) are uncommon and usually slow growing neuroendocrine epithelial malignancies that represent less than 2% of all lung cancers. Differences in the extent of molecular alterations between neuroendocrine carcinomas and BCs may underline the differences in the aggressiveness of these lesions. Moreover, although atypical BCs and typical BCs have similar set of mutations, some differential molecular and genetic alterations have been described between these two entities. A better understanding of the genetic and molecular background of BCs would allow a better selection of medical treatments in these patients. Regarding treatment, most BCs can be cured by surgery; however, inoperable tumors are mostly insensitive to chemotherapy and radiotherapy. In advanced BCs, the only drug that has a positive phase III clinical trial in BCs is everolimus. Somatostatin analogues constitute the gold standard for symptomatic relief. Peptide receptor radionuclide therapy has been associated with longer progression free. The efficacy of other treatments such as antiangiogenic agents and immunotherapy is still not established. Abstract A better understanding of the genetic and molecular background of bronchial carcinoids (BCs) would allow a better estimation of the risk of disease progression and the personalization of treatment in cases of advanced disease. Molecular studies confirmed that lungs neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs) are different entities; thus, no progression of NET to NEC is expected. In BCs, MEN1 gene mutations and deletions and decreased gene expression have been associated with a poor prognosis. ATRX mutation has also been linked to a shorter disease-specific survival. In terms of therapeutic targets, PI3K/AKT/mTOR pathway mutations have been described in 13% of typical carcinoids (TCs) and 39% of atypical carcinoids (ACs), representing a targetable mutation with kinase inhibitors. Regarding treatment, surgical resection is usually curative in localized BCs and adjuvant treatment is not routinely recommended. Multiple options for systemic therapy exist for patients with advanced BCs, although limited by a heterogeneity in the scientific evidence behind their use recommendation. These options include somatostatin analogues, everolimus, peptide receptor radionuclide therapy, chemotherapy, radiotherapy, antiangiogenic agents, and immunotherapy. In this article, we provide a comprehensive review about the molecular and genetic background of BCs, and about the treatment of local and metastatic disease, as well as the main paraneoplastic syndromes that have been associated with this tumor.
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Affiliation(s)
- Marta Araujo-Castro
- Neuroendocrinology Unit, Endocrinology and Nutrition Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
- Instituto de Investigación Biomédica Ramón y Cajal (IRICYS), 28034 Madrid, Spain;
- Universidad de Alcalá, 28801 Madrid, Spain
- Correspondence: (M.A.-C.); (J.M.-C.)
| | - Eider Pascual-Corrales
- Neuroendocrinology Unit, Endocrinology and Nutrition Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
- Instituto de Investigación Biomédica Ramón y Cajal (IRICYS), 28034 Madrid, Spain;
| | - Javier Molina-Cerrillo
- Instituto de Investigación Biomédica Ramón y Cajal (IRICYS), 28034 Madrid, Spain;
- Universidad de Alcalá, 28801 Madrid, Spain
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
- Correspondence: (M.A.-C.); (J.M.-C.)
| | - Nicolás Moreno Mata
- Thoracic Surgery Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | - Teresa Alonso-Gordoa
- Instituto de Investigación Biomédica Ramón y Cajal (IRICYS), 28034 Madrid, Spain;
- Universidad de Alcalá, 28801 Madrid, Spain
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
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Bernardini A, Dueñas M, Martín-Soberon MC, Rubio C, Suarez-Cabrera C, Ruiz-Palomares R, Munera-Maravilla E, Lázaro S, Lodewijk I, Rueda D, Gómez-Sánchez D, Alonso-Gordoa T, Puente J, Pinto Á, González-Peramato P, Aguado C, Herrera M, López F, Martinez VMG, Morales L, Castellano D, Paramio JM, de Velasco G. Genomic Landscape of Vinflunine Response in Metastatic Urothelial Cancer. Cancers (Basel) 2022; 14:cancers14020378. [PMID: 35053540 PMCID: PMC8773703 DOI: 10.3390/cancers14020378] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/30/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Few metastatic urothelial cancer patients achieve durable clinical benefit with vinflunine. Predictive biomarkers to help to identify better treatment strategies are extremely needed. The objective of this study was to identify molecular differences between extreme responders to vinflunine in urothelial cancer. Genomic and immune markers are potentially useful identifying patients that may achieve greater benefit with vinflunine. Abstract Background and Aims: Metastatic urothelial carcinoma (mUC) remains an incurable disease with limited treatment options after platinum-based chemotherapy and immune checkpoint blockade (ICB). Vinflunine has shown a modest increase in overall survival and remains a therapeutic option for chemo- and immunotherapy refractory tumours. However, biomarkers that could identify responding patients to vinflunine and possible alternative therapies after failure to treatment are still missing. In this study, we aimed to identify potential genomic biomarkers of vinflunine response in mUC patient samples and potential management alternatives. Methods: Formalin-fixed paraffin-embedded samples of mUC patients (n = 23) from three university hospitals in Spain were used for genomic targeted-sequencing and transcriptome (using the Immune Profile panel by NanoString) analyses. Patients who received vinflunine after platinum-based chemotherapy failure were classified in non-responders (NR: progressive disease ≤ 3 months; n= 11) or responders (R: response ≥ 6 months; n = 12). Results: Genomic characterization revealed that the most common alteration, TP53 mutations, had comparable frequency in R (6/12; 50%) and NR (4/11; 36%). Non-synonymous mutations in KTM2C (4/12; 33.3%), PIK3CA (3/12; 25%) and ARID2 (3/12; 25%) were predominantly associated with response. No significant difference was observed in tumour mutational burden (TMB) between R and NR patients. The NR tumours showed increased expression of diverse immune-related genes and pathways, including various interferon gamma-related genes. We also identified increased MAGEA4 expression as a potential biomarker of non-responding tumours to vinflunine treatment. Conclusions: Our data may help to identify potential genomic biomarkers of response to vinflunine. Moreover, tumours refractory to vinflunine showed immune signatures potentially associated with response to ICB. Extensive validation studies, including longitudinal series, are needed to corroborate these findings.
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Affiliation(s)
- Alejandra Bernardini
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
| | - Marta Dueñas
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
| | - María Cruz Martín-Soberon
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Departamento de Oncología Médica, Hospital 12 de Octubre, 28040 Madrid, Spain; (M.H.); (F.L.)
| | - Carolina Rubio
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
| | - Cristian Suarez-Cabrera
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
| | - Raquel Ruiz-Palomares
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
| | - Ester Munera-Maravilla
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
| | - Sara Lázaro
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
| | - Iris Lodewijk
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
| | - Daniel Rueda
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
| | - David Gómez-Sánchez
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
| | | | - Javier Puente
- Departamento de Oncología Médica, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.P.); (C.A.)
| | - Álvaro Pinto
- Departamento de Oncología Médica, Hospital La Paz, 28046 Madrid, Spain; (Á.P.); (P.G.-P.)
| | | | - Carlos Aguado
- Departamento de Oncología Médica, Hospital Clínico San Carlos, 28040 Madrid, Spain; (J.P.); (C.A.)
| | - Mercedes Herrera
- Departamento de Oncología Médica, Hospital 12 de Octubre, 28040 Madrid, Spain; (M.H.); (F.L.)
| | - Flora López
- Departamento de Oncología Médica, Hospital 12 de Octubre, 28040 Madrid, Spain; (M.H.); (F.L.)
| | - Victor M. G. Martinez
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
| | - Lucía Morales
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
| | - Daniel Castellano
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
- Departamento de Oncología Médica, Hospital 12 de Octubre, 28040 Madrid, Spain; (M.H.); (F.L.)
| | - Jesús M. Paramio
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Unidad de Oncología Molecular, CIEMAT, 28045 Madrid, Spain;
- Centro de Investigacion en Red de Cáncer CIBERONC, 28029 Madrid, Spain
- Correspondence: (J.M.P.); (G.d.V.)
| | - Guillermo de Velasco
- Instituto de Investigación i+12, Hospital University “12 de Octubre”, 28040 Madrid, Spain; (A.B.); (M.D.); (M.C.M.-S.); (C.R.); (C.S.-C.); (R.R.-P.); (E.M.-M.); (I.L.); (D.R.); (D.G.-S.); (V.M.G.M.); (L.M.); (D.C.)
- Departamento de Oncología Médica, Hospital 12 de Octubre, 28040 Madrid, Spain; (M.H.); (F.L.)
- Correspondence: (J.M.P.); (G.d.V.)
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Molina-Cerrillo J, Alonso-Gordoa T, Carrato A, Grande E. Addendum: Hyperprogression to a dual immune blockade followed by subsequent response with cabozantinib in metastatic poor-risk clear cell renal cell carcinoma with NOTCH mutation. Oncotarget 2022; 13:1245. [PMID: 36395352 PMCID: PMC9671451 DOI: 10.18632/oncotarget.28312] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | | | - Alfredo Carrato
- Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain
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Jimenez-Fonseca P, Carmona-Bayonas A, Lamarca A, Barriuso J, Castaño A, Benavent M, Alonso V, Riesco MDC, Alonso-Gordoa T, Custodio A, Sanchez Canovas M, Hernando J, López C, La Casta A, Fernandez Montes A, Marazuela M, Crespo G, Diaz JA, Feliciangeli E, Gallego J, Llanos M, Segura A, Vilardell F, Percovich JC, Grande E, Capdevila J, Valle J, Garcia-Carbonero R. External Validity of Somatostatin Analogs Trials in Advanced Neuroendocrine Neoplasms: The GETNE-TRASGU Study. Neuroendocrinology 2022; 112:88-100. [PMID: 33508849 DOI: 10.1159/000514808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/27/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Somatostatin analogs (SSA) prolong progression-free survival (PFS) in patients with well-differentiated gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, the eligibility criteria in randomized clinical trials (RCTs) have been restricted, which contrasts with the vast heterogeneity found in NENs. METHODS We identified patients with well-differentiated (Ki-67% ≤20%), metastatic GEP-NENs treated in first line with SSA monotherapy from the Spanish R-GETNE registry. The therapeutic effect was evaluated using a Bayesian Cox model. The objective was to compare survival-based outcomes from real-world clinical practice versus RCTs. RESULTS The dataset contained 535 patients with a median age of 62 years (range: 26-89). The median Ki-67% was 4 (range: 0-20). The most common primary tumor sites were as follows: midgut, 46%; pancreas, 34%; unknown primary, 10%; and colorectal, 10%. Half of the patients received octreotide LAR (n = 266) and half, lanreotide autogel (n = 269). The median PFS was 28.0 months (95% CI: 22.1-32.0) for octreotide versus 30.1 months (95% CI: 23.1-38.0) for lanreotide. The overall hazard ratio for lanreotide versus octreotide was 0.90 (95% credible interval: 0.71-1.12). The probability of effect sizes >30% with lanreotide versus octreotide was 2 and 6% for midgut and foregut NENs, respectively. CONCLUSION Our study evaluated the external validity of RCTs examining SSAs in the real world, as well as the main effect-modifying factors (progression status, symptoms, tumor site, specific metastases, and analytical data). Our results indicate that both octreotide LAR and lanreotide autogel had a similar effect on PFS. Consequently, both represent valid alternatives in patients with well-differentiated, metastatic GEP-NENs.
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Affiliation(s)
- Paula Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Alberto Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - Angela Lamarca
- Medical Oncology Department, The Christie NHS Foundation Trust, ENETS Centre of Excellence, Manchester, United Kingdom
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Jorge Barriuso
- Medical Oncology Department, The Christie NHS Foundation Trust, ENETS Centre of Excellence, Manchester, United Kingdom
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Angel Castaño
- Pathology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Marta Benavent
- Medical Oncology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Vicente Alonso
- Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Maria Del Carmen Riesco
- Medical Oncology Department, Hospital Universitario Doce de Octubre, IIS imas12, UCM, CNIO, CIBERONC, Madrid, Spain
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Ana Custodio
- Medical Oncology Department, Hospital Universitario La Paz, CIBERONC CB16/12/00398, Madrid, Spain
| | - Manuel Sanchez Canovas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - Jorge Hernando
- Medical Oncology Department, Hospital Universitario Vall d'Hebron, Vall Hebron Institute of Oncology (VHIO), Autonomous University of Barcelona, Barcelona, Spain
| | - Carlos López
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Adelaida La Casta
- Medical Oncology Department, Hospital Universitario Donostia, San Sebastián, Spain
| | - Ana Fernandez Montes
- Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | - Mónica Marazuela
- Endocrinology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - Guillermo Crespo
- Medical Oncology Department, Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - Jose Angel Diaz
- Endocrinology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Eduardo Feliciangeli
- Medical Oncology Department, Hospital Universitario Santa Lucia, Cartagena, Spain
| | - Javier Gallego
- Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain
| | - Marta Llanos
- Medical Oncology Department, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain
| | - Angel Segura
- Medical Oncology Department, Hospital Universitario La Fe, Valencia, Spain
| | - Felip Vilardell
- Pathology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | | | - Enrique Grande
- Medical Oncology Department, MD Anderson Cancer Center Madrid, Madrid, Spain
| | - Jaume Capdevila
- Medical Oncology Department, Hospital Universitario Vall d'Hebron, Vall Hebron Institute of Oncology (VHIO), Autonomous University of Barcelona, Barcelona, Spain
| | - Juan Valle
- Medical Oncology Department, The Christie NHS Foundation Trust, ENETS Centre of Excellence, Manchester, United Kingdom
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Rocio Garcia-Carbonero
- Medical Oncology Department, Hospital Universitario Doce de Octubre, IIS imas12, UCM, CNIO, CIBERONC, Madrid, Spain
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de Velasco G, Carril-Ajuria L, Guerrero-Ramos F, Alonso-Gordoa T, Rodríguez-Moreno JF, Carretero A, Martin-Soberon M, de la Rosa-Kehrmann F, Castellano D. Addendum: A case series of advanced renal cell carcinoma patients treated with neoadjuvant cabozantinib prior to cytoreductive nephrectomy within the phase 2 CABOPRE trial. Oncotarget 2022; 13:983. [PMCID: PMC9359456 DOI: 10.18632/oncotarget.28263] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Guillermo de Velasco
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | - Lucia Carril-Ajuria
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | - Felix Guerrero-Ramos
- Urology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Comunidad de Madrid, Madrid, Spain
| | - Juan F. Rodríguez-Moreno
- Medical Oncology Department, Hospital Universitario HM Sanchinarro, Comunidad de Madrid, Madrid, Spain
| | - Alberto Carretero
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | - Maricruz Martin-Soberon
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | | | - Daniel Castellano
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
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Araujo-Castro M, Pascual-Corrales E, Nattero Chavez L, Martínez Lorca A, Alonso-Gordoa T, Molina-Cerrillo J, Lorca Álvaro J, Mínguez Ojeda C, Redondo López S, Barberá Durbán R, Polo López R, Moreno Mata N, Caballero Silva U, Pian H, Ruz-Caracuel I, Sanjuanbenito Dehesa A, Gómez Dos Santos V, Serrano Romero AB. Protocol for presurgical and anesthetic management of pheochromocytomas and sympathetic paragangliomas: a multidisciplinary approach. J Endocrinol Invest 2021; 44:2545-2555. [PMID: 34304388 DOI: 10.1007/s40618-021-01649-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/21/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To offer a practical guide for the presurgical and anesthetic management of pheochromocytomas and sympathetic paragangliomas (PGLs). METHODS This protocol was based on a comprehensive review of the literature and on our own multidisciplinary team's experience from managing pheochromocytoma and sympathetic PGLs at a referral center. RESULTS Patients with pheochromocytomas and sympathetic paragangliomas (PGLs) may develop potentially life-threatening complications, especially during surgical procedures. A complete biochemical, radiological, genetic, and cardiological assessment is recommended in the preoperative stage as it provides an evaluation of the risk of surgical complications and malignancy, allowing individualization of the presurgical treatment. Treatment with α-blockade and proper volume expansion in the preoperative stage significantly reduces the perioperative morbidity. During surgery, the anesthesiologist should look for a deep anesthetic level that inhibits the cardiovascular effects of catecholamines to minimize the risk of intraoperative complications. CONCLUSIONS An optimal presurgical evaluation of pheochromocytomas/ sympathetic PGL requires a multidisciplinary approach, including a complete hormonal, radiological, cardiac, genetic, and functioning evaluation in most cases. A proper preoperative evaluation in combination with strict blood pressure and heart rate control, and blood volume status optimization, will significantly reduce the risk of intraoperative and perioperative complications. In those patients who unfortunately develop intraoperative complications, the role of the anesthesiologist is essential since the selection of the appropriate management has a direct impact on morbimortality reduction.
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Affiliation(s)
- M Araujo-Castro
- Neuroendocrinology Division, Department of Endocrinology and Nutrition, IRYCIS, Hospital Universitario Ramón y Cajal, Colmenar Viejo street, S/N, 28034, Madrid, Spain.
| | - E Pascual-Corrales
- Neuroendocrinology Division, Department of Endocrinology and Nutrition, IRYCIS, Hospital Universitario Ramón y Cajal, Colmenar Viejo street, S/N, 28034, Madrid, Spain
| | - L Nattero Chavez
- Neuroendocrinology Division, Department of Endocrinology and Nutrition, IRYCIS, Hospital Universitario Ramón y Cajal, Colmenar Viejo street, S/N, 28034, Madrid, Spain
| | - A Martínez Lorca
- Department of Nuclear Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - T Alonso-Gordoa
- Department of Medical Oncology, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Molina-Cerrillo
- Department of Medical Oncology, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Lorca Álvaro
- Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - C Mínguez Ojeda
- Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - S Redondo López
- Department of Vascular Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Barberá Durbán
- Department of Otorhinolaryngology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Polo López
- Department of Otorhinolaryngology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - N Moreno Mata
- Department of Thoracic Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - U Caballero Silva
- Department of Thoracic Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - H Pian
- Department of Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - I Ruz-Caracuel
- Department of Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A Sanjuanbenito Dehesa
- Department of General and Digestive Surgery, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - V Gómez Dos Santos
- Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A B Serrano Romero
- Department of Anesthesia, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Garcia-Carbonero R, Benavent M, Jiménez Fonseca P, Castellano D, Alonso-Gordoa T, Teulé A, Custodio A, Tafuto S, La Casta A, Spada F, López C, Ibrahim T, Silva MV, Iranzo V, García-Alfonso P, González-Flores E, Grande E, Crespo G, Carmona-Bayonas A, Capdevila J. 1097O The AXINET trial (GETNE1107): Axitinib plus octreotide LAR improves PFS by blinded central radiological assessment vs placebo plus octreotide LAR in G1-2 extrapancreatic NETs. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Riesco-Martinez M, Capdevila J, Alonso V, Jimenez-Fonseca P, Teule A, Grande E, Sevilla I, Benavent Viñuales M, Alonso-Gordoa T, Custodio A, Hernando J, Polo E, Castillo Trujillo O, Garcia-Carbonero R. 1098O Nivolumab plus platinum-doublet chemotherapy as first-line therapy in unresectable, locally advanced or metastatic G3 neuroendocrine Neoplasms (NENs) of the gastroenteropancreatic (GEP) tract or unknown (UK) origin: Preliminary results from the phase II NICE-NEC trial (GETNE T1913). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.180] [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: 10/20/2022] Open
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McDermott D, Lee JL, Bjarnason G, Larkin J, Gafanov R, Kochenderfer M, Jensen N, Donskov F, Malik J, Poprach A, Tykodi S, Alonso-Gordoa T, Cho D, Geertsen P, Climent Duran M, Di Simone C, Liu H, Burgents J, Rodriguez-Lopez K, Atkins M. 666P Pembrolizumab (pembro) monotherapy as first-line therapy in advanced clear cell renal cell carcinoma (ccRCC): Results after a minimum of 41 months of follow-up from KEYNOTE-427 cohort A. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.062] [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: 10/20/2022] Open
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Pozas J, San Roman M, Molina-Cerrillo J, Caracuel IR, Pian H, Valderrábano P, Gómez Ramírez J, Caniego Casas T, Pizarro D, Gajate Borau P, Albarrán Fernández V, Rosero Rodríguez D, Chamorro J, Alvarez Ballesteros P, Orejana Martin I, Sanz L, Grande E, Carrato Mena A, Garrido Lopez P, Alonso-Gordoa T. 572P Potential impact of molecularly-selected treatment in patients with endocrine neoplasms at a tertiary university hospital. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.707] [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: 10/20/2022] Open
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Capdevila J, Landolfi S, Hernando J, Teule A, Garcia-Carbonero R, Custodio A, Cubillo A, Alonso-Gordoa T, Carmona-Bayonas A, Crespo G, Blanco M, Viudez A, La Casta A, Sevilla I, Segura Á, López C, Benavent Viñuales M, Nuciforo P, Manzano J. 1107P Durvalumab plus tremelimumab in patients with grade 3 neuroendocrine neoplasms of gastroenteropancreatic origin: Updated results from the multicenter phase II DUNE trial (GETNE 1601). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.189] [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: 11/16/2022] Open
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Hernando J, Manzano J, Teule A, López C, Garcia-Carbonero R, Benavent Viñuales M, Custodio A, Cubillo A, Alonso V, Alonso-Gordoa T, Carmona-Bayonas A, Crespo G, Blanco M, Jimenez-Fonseca P, Viudez A, La Casta A, Sevilla I, Llanos M, Segura Á, Capdevila J. 1099MO Durvalumab plus tremelimumab influence on response to subsequent treatments in patients with neuroendocrine neoplasms (NENs) of gastroenteropancreatic and lung origins: Results from the phase II DUNE trial (GETNE 1601). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.181] [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: 11/24/2022] Open
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De Velasco G, Alonso-Gordoa T, Rodríguez-Moreno J, Duran I, Carretero-González A, Martin-Soberon M, Gutiérrez Baños J, Guerrero-Ramos F, Dueñas M, Castellano Gauna D. 676P CABOPRE: A phase II study of cabozantinib (cabo) prior cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lopez Campos F, Lorente D, Llacer-Pérez C, Henríquez I, Peleteiro P, Gómez-Iturriaga A, Ramírez-Backhaus M, Álvarez S, Alonso-Gordoa T, Molina-Cerrillo J, Vallejo C, Hervás A, Navarro-Castellón J, Gómez J, Morillo V, Lozano R, Romero-Laorden N, García R, Hernández-Corrales A, Pelari L, Ferrer-Albiach C, Sancho S, Castro E, Olmos D. PD-0913 Local treatment to the primary tumor and PSA changes as prognostic factors in mCRPC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Grande E, Rodriguez-Antona C, López C, Alonso-Gordoa T, Benavent M, Capdevila J, Teulé A, Custodio A, Sevilla I, Hernando J, Gajate P, Molina-Cerrillo J, Díez JJ, Santos M, Lanillos J, García-Carbonero R. Sunitinib and Evofosfamide (TH-302) in Systemic Treatment-Naïve Patients with Grade 1/2 Metastatic Pancreatic Neuroendocrine Tumors: The GETNE-1408 Trial. Oncologist 2021; 26:941-949. [PMID: 34190375 DOI: 10.1002/onco.13885] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/23/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Sunitinib (SUN)-induced hypoxia within the tumor could promote the activation of the prodrug evofosfamide (EVO), locally releasing the cytotoxic DNA alkylator bromo-isophosphoramide mustard. SUNEVO, a phase II, open-label, single-arm trial, investigated the potential synergy of SUN plus EVO in advanced progressive pancreatic neuroendocrine tumors (panNETs). METHODS Systemic treatment-naïve patients with advanced or metastatic, unresectable, grade 1/2 panNETs with a Ki67 ≤20%, received EVO 340 mg/m2 on days 8, 15, and 22 every 4 weeks and sunitinib 37.5 mg/day continuously. The primary endpoint was objective response rate, measured every 8 weeks by RECIST version 1.1. RESULTS From 2015 to 2018, 17 patients were enrolled. The median age was 62.4 years, 47% had a Ki67 >10%, and 70.6% had liver metastasis. Patients received a median of five and four cycles of SUN and EVO, respectively. After a median follow-up of 15.7 months, 17.6% of patients achieved a complete (n = 1) or partial response (n = 2), and 11 patients had stable disease (64.7%). The median progression-free survival was 10.4 months (95% confidence interval, 2.6-18.0). Treatment-related adverse events (grade ≥3) were observed in 64.7% of the patients, the most frequent being neutropenia (35.3%), fatigue (17.6%), and thrombopenia (11.8%). Treatment discontinuation due to toxicity was reported in 88.2% of the patients. No correlation was found between treatment response and DAXX, ATRX, MEN1, SETD2, and PTEN gene mutations. CONCLUSION SUN plus EVO had a negative toxicity profile that should be taken into account for further clinical research in advanced panNETs. The combination showed moderate activity in terms of treatment response that did not correlate with somatic mutations. (Clinical trial identification number: NCT02402062) IMPLICATIONS FOR PRACTICE: Addition of hypoxia-activated prodrugs has been proposed as a potential mechanism to overcome tumor resistance to antiangiogenic agents. Sunitinib and evofosfamide, which were widely proposed as a potential synergistic option, showed modest efficacy in pancreatic neuroendocrine tumors (panNETs), reaching a median objective response rate of 17.6% and median progression-free survival of 10.4 months. Treatment response does not correlate with the biomarkers analyzed. The high systemic toxicity, with 88.2% of patients discontinuing the treatment, makes this therapeutic approach unfeasible and encourages future research to overcome panNETs' resistance to antiangiogenic agents with other therapies with a safer profile.
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Affiliation(s)
- Enrique Grande
- Medical Oncology Department, MD Anderson Cancer Center Madrid, Madrid, Spain
| | - Cristina Rodriguez-Antona
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Centre, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain
| | - Carlos López
- Medical Oncology, Hospital Universitario Marqués de Valdecilla, Instituto de investigación sanitaria Valdecilla (IDIVAL), Santander, Spain
| | | | - Marta Benavent
- Medical Oncology Department, Hospital Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - Jaume Capdevila
- Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology, Barcelona, Spain
| | - Alex Teulé
- Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet del Llobregat, Spain
| | - Ana Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Isabel Sevilla
- Investigación Clínica y Traslacional en Cáncer/Instituto de Investigaciones Biomédicas de Málaga (IBIMA)/Hospitales Universitarios Regional y Virgen de la Victoria, Málaga, Spain
| | - Jorge Hernando
- Medical Oncology Department, Vall Hebron University Hospital, Vall Hebron Institute of Oncology, Barcelona, Spain
| | - Pablo Gajate
- Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Juan José Díez
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Madrid, Spain
| | - María Santos
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Centre, Madrid, Spain
| | - Javier Lanillos
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Centre, Madrid, Spain
| | - Rocío García-Carbonero
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación 12 de Octubre (i+12), Universidad Complutense de Madrid (UCM), Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
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de Mestier L, Lamarca A, Hernando J, Zandee W, Alonso-Gordoa T, Perrier M, Walenkamp AM, Chakrabarty B, Landolfi S, Van Velthuysen MLF, Kats-Ugurlu G, Caminoa A, Ronot M, Manoharan P, Garcia-Alvarez A, Brabander T, García Gómez-Muriel MI, Cadiot G, Couvelard A, Capdevila J, Pavel ME, Cros J. Treatment outcomes of advanced digestive well-differentiated grade 3 NETs. Endocr Relat Cancer 2021; 28:549-561. [PMID: 34061764 DOI: 10.1530/erc-21-0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 11/08/2022]
Abstract
There is no standardized treatment for grade 3 neuroendocrine tumors (G3 NETs). We aimed to describe the treatments received in patients with advanced G3 NETs and compare their efficacy. Patients with advanced digestive G3 NETs treated between 2010 and 2018 in seven expert centers were retrospectively studied. Pathological samples were centrally reviewed, and radiological data were locally reviewed. We analyzed RECIST-defined objective response (OR), tumor growth rate (TGR) and progression-free survival (PFS) obtained with first- (L1) or second-line (L2) treatments. We included 74 patients with advanced G3 NETs, mostly from the duodenal or pancreatic origin (71.6%), with median Ki-67 of 30%. The 126 treatments (L1 = 74; L2 = 52) included alkylating-based (n = 32), etoposide-platinum (n = 22) or adenocarcinoma-like (n = 20) chemotherapy, somatostatin analogs (n = 21), targeted therapies (n = 22) and liver-directed therapies (n = 7). Alkylating-based chemotherapy achieved the highest OR rate (37.9%) compared to other treatments (multivariable OR 4.22, 95% CI (1.5-12.2); P = 0.008). Adenocarcinoma-like and alkylating-based chemotherapies showed the highest reductions in 3-month TGR (P < 0.001 and P = 0.008, respectively). The longest median PFS was obtained with adenocarcinoma-like chemotherapy (16.5 months (9.0-24.0)) and targeted therapies (12.0 months (8.2-15.8)), while the shortest PFS was observed with somatostatin analogs (6.2 months (3.8-8.5)) and etoposide-platinum chemotherapy (7.2 months (5.2-9.1)). Etoposide-platinum CT achieved shorter PFS than adenocarcinoma-like (multivariable HR 3.69 (1.61-8.44), P = 0.002) and alkylating-based chemotherapies (multivariable HR 1.95 (1.01-3.78), P = 0.049). Overall, adenocarcinoma-like and alkylating-based chemotherapies may be the most effective treatments for patients with advanced G3 NETs regarding OR and PFS. Etoposide-platinum chemotherapy has poor efficacy in this setting.
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Affiliation(s)
- Louis de Mestier
- Université de Paris, Department of Gastroenterology-Pancreatology, Beaujon University Hospital (APHP), Clichy, France
| | - Angela Lamarca
- Division of Cancer Sciences, Department of Medical Oncology, The Christie NHS Foundation, University of Manchester, Manchester, United Kingdom
| | - Jorge Hernando
- Department of Medical Oncology, Vall d'Hebron University Hospital and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Wouter Zandee
- Department of Internal Medicine, Sector Endocrinology, Erasmus University Medical Center and Erasmus MC Cancer Institute, Rotterdam, The Netherlands
- Division of Endocrinology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Teresa Alonso-Gordoa
- Department of Medical Oncology, Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Marine Perrier
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Reims, France
| | - Annemiek Me Walenkamp
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Stefania Landolfi
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Marie-Louise F Van Velthuysen
- Department of Pathology, Erasmus University Medical Center and Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Gursah Kats-Ugurlu
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alejandra Caminoa
- Department of Pathology, University Hospital Ramon y Cajal, Madrid, Spain
| | - Maxime Ronot
- Université de Paris, Department of Radiology, Beaujon University Hospital (APHP), Clichy, France
| | - Prakash Manoharan
- Department of Radiology and Nuclear Medicine, The Christie, Manchester, United Kingdom
| | - Alejandro Garcia-Alvarez
- Department of Medical Oncology, Vall d'Hebron University Hospital and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Tessa Brabander
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Guillaume Cadiot
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Reims, France
| | - Anne Couvelard
- Université de Paris, Department of Pathology, Beaujon/Bichat University Hospital (APHP), Clichy/Paris, France
| | - Jaume Capdevila
- Department of Medical Oncology, Vall d'Hebron University Hospital and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Marianne E Pavel
- Department of Endocrinology, Erlangen University Hospital, Erlangen, Germany
| | - Jérôme Cros
- Université de Paris, Department of Pathology, Beaujon/Bichat University Hospital (APHP), Clichy/Paris, France
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López-Campos F, Lorente D, Llacer Perez C, Ramirez-Backhaus M, Peleteiro P, Gomez-Iturriaga A, Henriquez-López I, Lozano R, Romero N, Alonso-Gordoa T, Molina-Cerrillo J, Navarro-Castellón J, Castaño A, Pelari L, Hernández-Corrales A, Morillo V, García R, Ferrer Albiach C, Castro E, Olmos D. Evaluation of PSA progression after initiation of enzalutamide or abiraterone: Real-world data on metastatic castration-resistant prostate cancer (mCRPC). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.5024] [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
5024 Background: PSA value is widely used for the monitoring of treatment outcome in mCRPC in the clinical real-world setting. Early PSA changes are not considered in the definition of PSAProg due to the potential for spurious “flare” reactions. We aimed to evaluate the significance of an early PSA increase in mCRPC patients (pts) treated with enzalutamide or abiraterone (Enz/Abi). Methods: We retrospectively evaluated Enz/Abi-treated mCRPC pts from 11 hospitals between 2011-2020. Early PSAProg was defined as a 25% increase in PSA from baseline at 4 (PSAProg4) or 8 (PSAProg8) weeks after treatment initiation. PSA progression at 12 weeks (PSAProg12) was confirmed by a second reading. Uni- and multivariable (MV) Cox regression models were conducted to explore the association of PSAProg and overall survival (OS) in chemotherapy naïve patients treated with Abi or Enz. Interaction tests were conducted to explore differences in the impact of PSA progression on OS in Abi or Enz-treated pts. Results: We analyzed 511 chemotherapy-naïve mCRPC pts treated with Abi (N=391; 76.5%) or Enz (N=120; 23.5%). Median follow-up: 30.2 months. OS was longer in Enz-treated pts (38.1 vs 29m; HR 1.4; p=0.027). 59 (15.1%), 70 (17.9%) and 48 (12.3%) of Abi-treated and 9 (7.5%), 11 (9.2%) and 10 (8.3%) of Enz-treated pts experienced PSAProg4, PSAProg8 and PSAProg12, respectively, although differences were not statistically significant. PSAProg was associated with worse OS at all 3 timepoints only in Abi-treated pts. In Enz-treated pts, PSAProg4 had a large impact on OS, not observed in PSAProg8 or PSAProg12. We observed no significant interaction between agent (Enz/Abi) and PSA progression (Table). Conclusions: PSA progression at 4 weeks after Enz/Abi is significantly associated with shorter OS and may help identify pts not benefitting from Abi/Enz before clinical or radiographic progression. PSA pattern progression and its association with OS might differ depending on the drug used (Enz/Abi). Prospective validation studies are needed.[Table: see text]
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Affiliation(s)
| | - David Lorente
- Medical Oncology Department, Hospital Provincial de Castellón, Castellón De La Plana, Spain
| | | | | | - Paula Peleteiro
- Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | - Rebeca Lozano
- Spanish National Cancer Research Centre, Prostate Cancer Clinical Research Unit, Madrid, Spain
| | - Nuria Romero
- Medical Oncology Department, Hospital Universitario La Princesa,, Madrid, Spain
| | | | | | | | - Ana Castaño
- Radiation Oncology Department Hospital Universitario La Paz, Madrid, Spain
| | - Lira Pelari
- Radiation Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Virginia Morillo
- Radiation Oncology Department, Hospital Provincial de Castellón, Castellón, Spain
| | - Raquel García
- Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Elena Castro
- Hospitales Virgen de la Victoria y Regional de Málaga, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - David Olmos
- Spanish National Cancer Research Center (CNIO), Madrid, Spain
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Araujo-Castro M, Pascual-Corrales E, Molina-Cerrillo J, Alonso-Gordoa T. Immunotherapy in Adrenocortical Carcinoma: Predictors of Response, Efficacy, Safety, and Mechanisms of Resistance. Biomedicines 2021; 9:biomedicines9030304. [PMID: 33809752 PMCID: PMC8002272 DOI: 10.3390/biomedicines9030304] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/02/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022] Open
Abstract
Adrenocortical carcinoma (ACC) is a rare endocrine malignancy with limited treatment options in the advanced stages. Immunotherapy offers hope for altering the orthodox management of cancer, and its role in advanced ACC has been investigated in different studies. With the aim clarifying the role of immunotherapy in ACC we performed a comprehensive review about this topic focusing on the predictors of response, efficacy, safety, and the mechanisms of resistance. Five clinical trials with four immune checkpoint inhibitors (pembrolizumab, avelumab, nivolumab, and ipilimumab) have investigated the role of immunotherapy in advanced ACC. Despite, the different primary endpoints used in these studies, the reported rates of overall response rate and progression free survival were generally poor. Three main potential markers of response to immunotherapy in ACC have been described: Expression of PD-1 and PD-L1, microsatellite instability and tumor mutational burden. However, none of them has been validated in prospective studies. Several mechanisms of ACC immunoevasion may be responsible of immunotherapy failure, and a greater knowledge of these mechanisms might lead to the development of new strategies to overcome the immunotherapy resistance. In conclusion, although currently the role of immunotherapy is limited, the identification of immunological markers of response and the implementation of strategies to avoid immunotherapy resistance could improve the efficacy of this therapy.
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Affiliation(s)
- Marta Araujo-Castro
- Neuroendocrinology Unit, Endocrinology and Nutrition Department, Ramón y Cajal Health Research Institute (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
- Correspondence:
| | - Eider Pascual-Corrales
- Neuroendocrinology Unit, Endocrinology and Nutrition Department, Ramón y Cajal Health Research Institute (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | - Javier Molina-Cerrillo
- Medical Oncology Department, Ramón y Cajal Health Research Institute (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (J.M.-C.); (T.A.-G.)
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Ramón y Cajal Health Research Institute (IRYCIS), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (J.M.-C.); (T.A.-G.)
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Lamarca A, Cives M, de Mestier L, Crona J, Spada F, Öberg K, Pavel M, Alonso-Gordoa T. Advanced small-bowel well-differentiated neuroendocrine tumours: An international survey of practice on 3 rd-line treatment. World J Gastroenterol 2021; 27:976-989. [PMID: 33776367 PMCID: PMC7968134 DOI: 10.3748/wjg.v27.i10.976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/12/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Somatostatin analogues are an established first-line therapy for well differentiated small bowel neuroendocrine tumours (Wd-SBNETs), while and peptide receptor radionuclide therapy (PRRT) is frequently used as a second-line therapy. Adequate treatment selection of third-line treatment remains challenging due to the limited prospective data currently available on the best therapeutic sequence.
AIM To understand current practice and rationale for decision-making by physicians in the 3rd-line setting by building an online survey.
METHODS Weighted average (WA) of likelihood of usage between responders (1 very unlikely; 4 very likely) was used to reflect the relevance of factors explored.
RESULTS Replies from representatives of 28 centers were received (5/8/2020-21/9/2020); medical oncologist (53.6%), gastroenterologist (17.9%); United Kingdom (21.4%), Spain (17.9%), Italy (14.3%). Majority from European Neuroendocrine Tumor Society (ENETS) Centres of Excellence (57.1%), who followed ENETS guidelines (82.1%). Generally speaking, 3rd-line treatment for Wd-SBNETs was: everolimus (EVE) (66.7%), PRRT (18.5%), liver embolization (LE) (7.4%) and interferon-alpha (IFN) (3.7%); chemotherapy (0%); decision was based on clinical trial data (59.3%), or personal experience (22.2%). EVE was most likely used if Ki-67 < 10% (WA 3.27/4) or age < 70 years (WA 3.23/4), in the 3rd-line setting (WA 3.23/4); regardless of presence/absence of carcinoid syndrome (CS), rate of progression or extent of disease. Chemotherapy was mainly utilised only if rapid progression (within 6 mo) (WA 3.35/4), Ki-67 10%-20% (WA 2.77/4), negative somatostatin receptor imaging (WA 2.65/4) or high tumour burden (WA 2.77/4); temozolomide or streptozocin was used with capecitabine or 5-fluorouracil (5-FU) (57.7%), FOLFOX (5-FU combined with oxaliplatin) (23.1%). LE was selected if presence of CS (WA 3.24/4) or Ki-67 < 10% (WA 2.8/4), after progression to other treatments (WA 2.8/4). IFN was rarely used (WA 1.3/4).
CONCLUSION Everolimus was the most frequently used therapeutic option in the third-line setting. The most important factors for decision-making included Ki-67, rate of progression, functionality and tumour burden; since this decision is based on multiple factors, it highlights the need for a multidisciplinary assessment.
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Affiliation(s)
- Angela Lamarca
- Department of Medical Oncology, European Neuroendocrine Tumor Society Centre of Excellence, The Christie NHS Foundation Trust, University of Manchester, Manchester M20 4BX, United Kingdom
| | - Mauro Cives
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari 70121, Italy
| | - Louis de Mestier
- Department of Gastroenterology and Pancreatology, European Neuroendocrine Tumor Society Center of Excellence, Paris-Diderot University, Clichy 75006, France
| | - Joakim Crona
- Department of Medical Sciences, Uppsala University, Uppsala SE-751 85, Sweden
| | - Francesca Spada
- Gastrointestinal Medical Oncology and Neuroendocrine Tumors Unit, European Institute of Oncology, Milan 20141, Italy
| | - Kjell Öberg
- Department of Endocrine Oncology, Uppsala University Hospital, Uppsala SE-751 85, Sweden
| | - Marianne Pavel
- Department of Endocrinology, Universitatsklinikum Erlangen, Erlangen 91054, Germany
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, The Ramón y Cajal Health Research Institute, Alcalá University, University Hospital Ramon y Cajal, Madrid 28034, Spain
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McDermott DF, Lee JL, Bjarnason GA, Larkin JMG, Gafanov RA, Kochenderfer MD, Jensen NV, Donskov F, Malik J, Poprach A, Tykodi SS, Alonso-Gordoa T, Cho DC, Geertsen PF, Climent Duran MA, DiSimone C, Silverman RK, Perini RF, Schloss C, Atkins MB. Open-Label, Single-Arm Phase II Study of Pembrolizumab Monotherapy as First-Line Therapy in Patients With Advanced Clear Cell Renal Cell Carcinoma. J Clin Oncol 2021; 39:1020-1028. [PMID: 33529051 PMCID: PMC8078336 DOI: 10.1200/jco.20.02363] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [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] [Indexed: 12/25/2022] Open
Abstract
Pembrolizumab, a programmed death 1 inhibitor, demonstrated promising single-agent activity in untreated patients with various cancer types. The phase II KEYNOTE-427 study evaluated efficacy and safety of single-agent pembrolizumab in treatment-naive patients with advanced clear cell renal cell carcinoma (ccRCC; cohort A) and advanced non-ccRCC (cohort B). Results of cohort A are reported.
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Affiliation(s)
| | - Jae-Lyun Lee
- Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | | - Jahangeer Malik
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - Alexandr Poprach
- Masaryk Memorial Cancer Institute and Masaryk University, Brno, Czech Republic
| | - Scott S Tykodi
- University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Daniel C Cho
- Perlmutter Cancer Center at NYU Langone Medical Center, New York, NY
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Molina-Cerrillo J, Marquet-Palomanes J, Alonso-Gordoa T, López-Jiménez J, Grande E. May Ibrutinib Have Activity in Respiratory Complications by SARS-CoV-2? Clinical Experience in a Patient with Chronic Lymphocytic Leukemia. Healthcare (Basel) 2021; 9:78. [PMID: 33467441 PMCID: PMC7830068 DOI: 10.3390/healthcare9010078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/08/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/22/2023] Open
Abstract
COVID-19 is affecting many countries all around the world. Unfortunately, no treatment has already been approved for the management of patients infected by SARS-CoV-2. It seems that SARS-CoV-2 can induce the activation of an exaggerated immune response against itself according to different mechanisms that are not really well known. Inflammatory interleukins, such as IL-6 among others, play a central role in this uncontrolled immune response. There is a strong rational under ibrutinib use in in the treatment of immune-based diseases, such a as GVHD or RA. Ibrutinib achieves a reduction in the production of TNFα, IL1, IL-6 and Monocyte chemo-attractant protein-1 (MCP-1) by neutrophils and macrophages, that are key players in keeping the inflammatory process. We present our clinical experience about ibrutinib use in ARDS secondary to SARS-CoV-2 in a patient with chronic lymphocytic leukemia (CLL).
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Affiliation(s)
- Javier Molina-Cerrillo
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain
- The Ramón y Cajal Health Research Institute (IRYCIS), CIBERONC, 28034 Madrid, Spain; (J.M.-P.); (J.L.-J.)
- Medical School, Alcalá University, 28805 Madrid, Spain
| | - Juan Marquet-Palomanes
- The Ramón y Cajal Health Research Institute (IRYCIS), CIBERONC, 28034 Madrid, Spain; (J.M.-P.); (J.L.-J.)
- Hematology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain
- The Ramón y Cajal Health Research Institute (IRYCIS), CIBERONC, 28034 Madrid, Spain; (J.M.-P.); (J.L.-J.)
- Medical School, Alcalá University, 28805 Madrid, Spain
| | - Javier López-Jiménez
- The Ramón y Cajal Health Research Institute (IRYCIS), CIBERONC, 28034 Madrid, Spain; (J.M.-P.); (J.L.-J.)
- Medical School, Alcalá University, 28805 Madrid, Spain
- Hematology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain
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Torres-Jiménez J, Albarrán-Fernández V, Pozas J, Román-Gil MS, Esteban-Villarrubia J, Carrato A, Rosero A, Grande E, Alonso-Gordoa T, Molina-Cerrillo J. Novel Tyrosine Kinase Targets in Urothelial Carcinoma. Int J Mol Sci 2021; 22:E747. [PMID: 33451055 PMCID: PMC7828553 DOI: 10.3390/ijms22020747] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 01/03/2023] Open
Abstract
Urothelial carcinoma represents one of the most prevalent types of cancer worldwide, and its incidence is expected to grow. Although the treatment of the advanced disease was based on chemotherapy for decades, the developments of different therapies, such as immune checkpoint inhibitors, antibody drug conjugates and tyrosine kinase inhibitors, are revolutionizing the therapeutic landscape of this tumor. This development coincides with the increasing knowledge of the pathogenesis and genetic alterations in urothelial carcinoma, from the non-muscle invasive setting to the metastatic one. The purpose of this article is to provide a comprehensive review of the different tyrosine kinase targets and their roles in the therapeutic scene of urothelial carcinoma.
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Affiliation(s)
- Javier Torres-Jiménez
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain; (J.T.-J.); (V.A.-F.); (J.P.); (M.S.R.-G.); (J.E.-V.)
| | - Víctor Albarrán-Fernández
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain; (J.T.-J.); (V.A.-F.); (J.P.); (M.S.R.-G.); (J.E.-V.)
| | - Javier Pozas
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain; (J.T.-J.); (V.A.-F.); (J.P.); (M.S.R.-G.); (J.E.-V.)
| | - María San Román-Gil
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain; (J.T.-J.); (V.A.-F.); (J.P.); (M.S.R.-G.); (J.E.-V.)
| | - Jorge Esteban-Villarrubia
- Medical Oncology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain; (J.T.-J.); (V.A.-F.); (J.P.); (M.S.R.-G.); (J.E.-V.)
| | - Alfredo Carrato
- Medical Oncology Department, Ramón y Cajal Health Research Institute (IRYCIS), CIBERONC, Alcalá University, University Hospital Ramon y Cajal, 28034 Madrid, Spain;
| | - Adriana Rosero
- Medical Oncology Department, Infanta Cristina Hospital, 28607 Madrid, Spain;
| | - Enrique Grande
- Department of Medical Oncology, MD Anderson Cancer Center, 28033 Madrid, Spain
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Ramón y Cajal Health Research Institute (IRYCIS), CIBERONC, Alcalá University, University Hospital Ramon y Cajal, 28034 Madrid, Spain;
| | - Javier Molina-Cerrillo
- Medical Oncology Department, Ramón y Cajal Health Research Institute (IRYCIS), CIBERONC, Alcalá University, University Hospital Ramon y Cajal, 28034 Madrid, Spain;
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48
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de Velasco G, Carril-Ajuria L, Guerrero-Ramos F, Alonso-Gordoa T, Rodríguez-Moreno JF, Carretero A, Martin-Soberon M, de la Rosa-Kehrmann F, Castellano D. A case series of advanced renal cell carcinoma patients treated with neoadjuvant cabozantinib prior to cytoreductive nephrectomy within the phase 2 CABOPRE trial. Oncotarget 2020; 11:4457-4462. [PMID: 33315988 PMCID: PMC7720770 DOI: 10.18632/oncotarget.27807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/27/2020] [Indexed: 11/25/2022] Open
Abstract
Cytoreductive nephrectomy has long been used to improve disease control in metastastic Renal Cell Carcinoma (mRCC). However, based on the results of the CARMENA and SURTIME trials, cytoreductive nephrectomy is no longer the standard of care in patients requiring upfront systemic treatment and it should be avoided in most poor-risk patients. Nevertheless, it should still be considered in patients responding to systemic therapy and good-risk patients not requiring systemic treatment. This case series of the phase 2 CABOPRE trial suggests neoadjuvant cabozantinib may be able to induce rapid and significant responses in some intermediate-risk advanced renal cell carcinoma patients facilitating resectability.
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Affiliation(s)
- Guillermo de Velasco
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | - Lucia Carril-Ajuria
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | - Felix Guerrero-Ramos
- Urology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Comunidad de Madrid, Madrid, Spain
| | - Juan F Rodríguez-Moreno
- Medical Oncology Department, Hospital Universitario HM Sanchinarro, Comunidad de Madrid, Madrid, Spain
| | - Alberto Carretero
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | - Maricruz Martin-Soberon
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
| | | | - Daniel Castellano
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Comunidad de Madrid, Madrid, Spain
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49
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Sotelo M, Alonso-Gordoa T, Gajate P, Gallardo E, Morales-Barrera R, Pérez-Gracia JL, Puente J, Sánchez P, Castellano D, Durán I. Atezolizumab in locally advanced or metastatic urothelial cancer: a pooled analysis from the Spanish patients of the IMvigor 210 cohort 2 and 211 studies. Clin Transl Oncol 2020; 23:882-891. [PMID: 32897497 PMCID: PMC7979625 DOI: 10.1007/s12094-020-02482-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/18/2020] [Indexed: 12/28/2022]
Abstract
Background The studies IMvigor 210 cohort 2 and IMvigor211 evaluated the efficacy of atezolizumab in patients with locally advanced or metastatic urothelial cancer (mUC) upon progression to platinum-based chemotherapy worldwide. Yet, the real impact of this drug in specific geographical regions is unknown.
Materials and methods We combined individual-level data from the 131 patients recruited in Spain from IMvigor210 cohort 2 and IMvigor211 in a pooled analysis. Efficacy and safety outcomes were assessed in the overall study population and according to PD-L1 expression on tumour-infiltrating immune cells. Results Full data were available for 127 patients; 74 (58%) received atezolizumab and 53 (42%) chemotherapy. Atezolizumab patients had a numerically superior median overall survival although not reaching statistical significance (9.2 months vs 7.7 months). No statistically significant differences between arms were observed in overall response rates (20.3% vs 37.0%) or progression-free survival (2.1 months vs 5.3 months). Nonetheless, median duration of response was superior for the immunotherapy arm (non-reached vs 6.4 months; p = 0.005). Additionally, among the responders, the 12-month survival rates seemed to favour atezolizumab (66.7% vs 19.9%). When efficacy was analyzed based on PD-L1 expression status, no significant differences were found. Treatment-related adverse events of any grade occurred more frequently in the chemotherapy arm [46/57 (81%) vs 44/74 (59%)]. Conclusion Patients who achieved an objective response on atezolizumab presented a longer median duration of response and numerically superior 12 month survival rates when compared with chemotherapy responders along with a more favorable safety profile. PD-L1 expression did not discriminate patients who might benefit from atezolizumab.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- B7-H1 Antigen/metabolism
- Carcinoma, Transitional Cell/drug therapy
- Carcinoma, Transitional Cell/metabolism
- Carcinoma, Transitional Cell/mortality
- Carcinoma, Transitional Cell/secondary
- Cohort Studies
- Female
- Humans
- Lymphocytes, Tumor-Infiltrating/metabolism
- Male
- Middle Aged
- Progression-Free Survival
- Spain
- Survival Rate
- Treatment Outcome
- Ureteral Neoplasms/drug therapy
- Ureteral Neoplasms/metabolism
- Ureteral Neoplasms/mortality
- Ureteral Neoplasms/pathology
- Urethral Neoplasms/drug therapy
- Urethral Neoplasms/metabolism
- Urethral Neoplasms/mortality
- Urethral Neoplasms/pathology
- Urinary Bladder Neoplasms/drug therapy
- Urinary Bladder Neoplasms/metabolism
- Urinary Bladder Neoplasms/mortality
- Urinary Bladder Neoplasms/pathology
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Affiliation(s)
- M Sotelo
- Marqués de Valdecilla University Hospital, Edificio Sur. Despacho 277, Avda Valdecilla s/n, 39005, Santander, Spain
| | | | - P Gajate
- Ramon y Cajal University Hospital, Madrid, Spain
| | - E Gallardo
- Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | | | | | - J Puente
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - P Sánchez
- Medical Department, Roche Farma S.A., Madrid, Spain
| | - D Castellano
- Doce de Octubre University Hospital, Madrid, Spain
| | - I Durán
- Marqués de Valdecilla University Hospital, Edificio Sur. Despacho 277, Avda Valdecilla s/n, 39005, Santander, Spain.
- Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.
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50
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San Román Gil M, Pozas J, Molina-Cerrillo J, Gómez J, Pian H, Pozas M, Carrato A, Grande E, Alonso-Gordoa T. Current and Future Role of Tyrosine Kinases Inhibition in Thyroid Cancer: From Biology to Therapy. Int J Mol Sci 2020; 21:E4951. [PMID: 32668761 PMCID: PMC7403957 DOI: 10.3390/ijms21144951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 12/16/2022] Open
Abstract
Thyroid cancer represents a heterogenous disease whose incidence has increased in the last decades. Although three main different subtypes have been described, molecular characterization is progressively being included in the diagnostic and therapeutic algorithm of these patients. In fact, thyroid cancer is a landmark in the oncological approach to solid tumors as it harbors key genetic alterations driving tumor progression that have been demonstrated to be potential actionable targets. Within this promising and rapid changing scenario, current efforts are directed to improve tumor characterization for an accurate guidance in the therapeutic management. In this sense, it is strongly recommended to perform tissue genotyping to patients that are going to be considered for systemic therapy in order to select the adequate treatment, according to recent clinical trials data. Overall, the aim of this article is to provide a comprehensive review on the molecular biology of thyroid cancer focusing on the key role of tyrosine kinases. Additionally, from a clinical point of view, we provide a thorough perspective, current and future, in the treatment landscape of this tumor.
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MESH Headings
- Adenocarcinoma, Follicular/enzymology
- Adenocarcinoma, Follicular/genetics
- Adenocarcinoma, Follicular/therapy
- Adenoma, Oxyphilic/enzymology
- Adenoma, Oxyphilic/genetics
- Adenoma, Oxyphilic/therapy
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Antineoplastic Agents, Immunological/therapeutic use
- Carcinoma, Medullary/enzymology
- Carcinoma, Medullary/genetics
- Carcinoma, Medullary/therapy
- Carcinoma, Papillary/enzymology
- Carcinoma, Papillary/genetics
- Carcinoma, Papillary/therapy
- Clinical Trials as Topic
- Combined Modality Therapy
- Disease Management
- Forecasting
- Genes, Neoplasm
- Humans
- Immune Checkpoint Inhibitors/therapeutic use
- Immunoconjugates/therapeutic use
- Immunotherapy
- Iodine Radioisotopes/therapeutic use
- Molecular Targeted Therapy
- Multicenter Studies as Topic
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/genetics
- Oncogene Proteins, Fusion/antagonists & inhibitors
- Oncogene Proteins, Fusion/genetics
- Protein Kinase Inhibitors/pharmacology
- Protein Kinase Inhibitors/therapeutic use
- Protein-Tyrosine Kinases/antagonists & inhibitors
- Protein-Tyrosine Kinases/genetics
- Randomized Controlled Trials as Topic
- Thyroid Neoplasms/enzymology
- Thyroid Neoplasms/genetics
- Thyroid Neoplasms/therapy
- Tumor Microenvironment/immunology
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Affiliation(s)
- María San Román Gil
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.S.R.G.); (J.P.); (M.P.); (A.C.); (T.A.-G.)
| | - Javier Pozas
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.S.R.G.); (J.P.); (M.P.); (A.C.); (T.A.-G.)
| | - Javier Molina-Cerrillo
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.S.R.G.); (J.P.); (M.P.); (A.C.); (T.A.-G.)
- The Ramon y Cajal Health Research Institute (IRYCIS), CIBERONC, 28034 Madrid, Spain
- Medicine School, Alcalá University, 28805 Madrid, Spain; (J.G.); (H.P.)
| | - Joaquín Gómez
- Medicine School, Alcalá University, 28805 Madrid, Spain; (J.G.); (H.P.)
- General Surgery Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Héctor Pian
- Medicine School, Alcalá University, 28805 Madrid, Spain; (J.G.); (H.P.)
- Pathology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Miguel Pozas
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.S.R.G.); (J.P.); (M.P.); (A.C.); (T.A.-G.)
| | - Alfredo Carrato
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.S.R.G.); (J.P.); (M.P.); (A.C.); (T.A.-G.)
- The Ramon y Cajal Health Research Institute (IRYCIS), CIBERONC, 28034 Madrid, Spain
- Medicine School, Alcalá University, 28805 Madrid, Spain; (J.G.); (H.P.)
| | - Enrique Grande
- Medical Oncology Department, MD Anderson Cancer Center, 28033 Madrid, Spain;
| | - Teresa Alonso-Gordoa
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.S.R.G.); (J.P.); (M.P.); (A.C.); (T.A.-G.)
- The Ramon y Cajal Health Research Institute (IRYCIS), CIBERONC, 28034 Madrid, Spain
- Medicine School, Alcalá University, 28805 Madrid, Spain; (J.G.); (H.P.)
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