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Toledano-Fonseca M, Gómez-España MA, Élez E, Grávalos C, García-Alfonso P, Rodríguez R, Losa F, Alés Díaz I, Graña B, Valladares-Ayerbes M, García-Ortiz MV, Polo E, Salgado M, Rivera F, Safont MJ, Salud A, Ruiz-Casado A, Tabernero JM, Riesco MC, Rodríguez-Ariza A, Aranda E. A signature of circulating microRNAs predicts the response to treatment with FOLFIRI plus aflibercept in metastatic colorectal cancer patients. Biomed Pharmacother 2023; 159:114272. [PMID: 36706629 DOI: 10.1016/j.biopha.2023.114272] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
The benefit of adding the antiangiogenic drug aflibercept to FOLFIRI regime in metastatic colorectal cancer (CRC) patients resistant to or progressive on an oxaliplatin-based therapy has been previously demonstrated. However, the absence of validated biomarkers to predict greater outcomes is a major challenge encountered when using antiangiogenic therapies. In this study we investigated profiles of circulating microRNAs (miRNAs) to build predictive models of response to treatment and survival. Plasma was obtained from 98 metastatic CRC patients enrolled in a clinical phase II trial before receiving FOLFIRI plus aflibercept treatment, and the circulating levels of 754 individual miRNAs were quantified using real-time PCR. A distinct signature of circulating miRNAs differentiated responder from non-responder patients. Remarkably, most of these miRNAs were found to target genes that are involved in angiogenic processes. Accordingly, some of these miRNAs had predictive value and entered in predictive models of response to therapy, progression of disease, and survival of patients treated with FOLFIRI plus aflibercept. Among these miRNAs, circulating levels of hsa-miR-33b-5p efficiently discriminated between responder and non-responder patients and predicted the risk of disease progression. Moreover, the combination of circulating VEGF-A and miR-33b-5p levels improved clinical stratification of metastatic CRC patients who were to receive FOLFIRI plus aflibercept treatment. In conclusion, our study supports circulating miRNAs as valuable biomarkers for predicting better outcomes in metastatic CRC patients treated with FOLFIRI plus aflibercept.
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Affiliation(s)
- M Toledano-Fonseca
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Cancer Network Biomedical Research Center (CIBERONC), Instituto de Salud Carlos III, E28029 Madrid, Spain.
| | - M A Gómez-España
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Department of Medical Oncology, Reina Sofía University Hospital, E14004 Córdoba, Spain.
| | - E Élez
- Department of Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain.
| | - C Grávalos
- Department of Medical Oncology, H. Universitario 12 de Octubre, Instituto de Investigación i+12, Avenida de Córdoba, S/N, 28041 Madrid, Spain.
| | - P García-Alfonso
- Department of Medical Oncology, H. Gregorio Marañón, Calle del Doctor Esquerdo, 46, 28007 Madrid, Spain.
| | - R Rodríguez
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Department of Medical Oncology, Reina Sofía University Hospital, E14004 Córdoba, Spain.
| | - F Losa
- Department of Medical Oncology, ICO-CSI. H. Sant Joan Despí - Moisés Broggi, Carrer d'Oriol Martorell, 12, 08970 Sant Joan Despí, Barcelona, Spain.
| | - I Alés Díaz
- Department of Medical Oncology, Unidad de Gestión Clínica Intercentros de Oncología Médica. Hospitales Universitarios Regional y Virgen de la Victoria. IBIMA, Campus de Teatinos, S/N, 29010 Málaga, Spain.
| | - B Graña
- Department of Medical Oncology, C. H. Universitario, Lugar, Xubias de Arriba, 84, 15006 A Coruña, Spain.
| | - M Valladares-Ayerbes
- Department of Medical Oncology, H. Virgen del Rocío, IBIS, Av. Manuel Siurot s/n, 41013 Sevilla, Spain.
| | - M V García-Ortiz
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Cancer Network Biomedical Research Center (CIBERONC), Instituto de Salud Carlos III, E28029 Madrid, Spain.
| | - E Polo
- Department of Medical Oncology, H. Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain.
| | - M Salgado
- Department of Medical Oncology, C. H. Universitario de Ourense, Calle Ramón Puga Noguerol, 54, 32005 Orense, Spain.
| | - F Rivera
- Department of Medical Oncology, H. Universitario Marqués de Valdecilla, IDIVAL, Avenida de Valdecilla, 25, 39008 Santander, Spain.
| | - M J Safont
- Department of Medical Oncology, H. General Universitario, CIBERONC, Universidad de Valencia, Avenida de les Tres Creus, 2, 46014 Valencia, Spain.
| | - A Salud
- Department of Medical Oncology, H. Universitario Arnau de Vilanova, Avenida Alcalde Rovira Roure, 80, 25198 Lérida, Spain.
| | - A Ruiz-Casado
- Department of Medical Oncology, H. Puerta de Hierro Majadahonda, Calle Joaquín Rodrigo, 1, 28222 Majadahonda, Spain.
| | - J M Tabernero
- Department of Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain.
| | - M C Riesco
- Department of Medical Oncology, H. Universitario 12 de Octubre, Instituto de Investigación i+12, Avenida de Córdoba, S/N, 28041 Madrid, Spain.
| | - A Rodríguez-Ariza
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Cancer Network Biomedical Research Center (CIBERONC), Instituto de Salud Carlos III, E28029 Madrid, Spain; Department of Medical Oncology, Reina Sofía University Hospital, E14004 Córdoba, Spain.
| | - E Aranda
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC), E14004 Córdoba, Spain; Cancer Network Biomedical Research Center (CIBERONC), Instituto de Salud Carlos III, E28029 Madrid, Spain; Department of Medical Oncology, Reina Sofía University Hospital, E14004 Córdoba, Spain; Department of Medicine, Faculty of Medicine, University of Córdoba, E14004 Córdoba, Spain.
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Ruiz-Casado A, Hijos M, Ruiz R, Romero J. Orbital metastasis from oesophageal cancer. When the ophtalmologist meets gastrointestinal specialists. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:594-595. [PMID: 35879175 DOI: 10.1016/j.oftale.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Affiliation(s)
- A Ruiz-Casado
- Departamento de Oncología Médica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
| | - M Hijos
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - R Ruiz
- Departamento de Radiología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - J Romero
- Departamento de Radioterapia, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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Romero-Elias M, Alvarez-Bustos A, Garcia Gonzalez D, Franco F, Aguado R, Gutierrez Sanz L, Sanchez Ruiz A, Cebolla H, Gonzalez-Cutre D, Ruiz-Casado A. 1568P Physical condition in patients with a recent diagnosis of colorectal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Rodriguez-Ariza A, Gomez España M, Elez Fernandez M, Gravalos Castro M, García Alfonso P, Losa F, Ales Diaz I, Grana Suarez B, Gallego I, García-Ortiz M, Polo Marques E, Salgado Fernandez M, Rivera Herrero F, Safont Aguileria M, Salud Salvia M, Ruiz-Casado A, Tabernero J, Riesco Martinez M, Toledano-Fonseca M, Ara Aguilar E. 342P A signature of circulating microRNAs predicts the response to treatment with FOLFIRI plus aflibercept in metastatic colorectal cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.480] [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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5
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Ruiz-Casado A, Franco F, Romero-Elias M, Fiuxa C, Gutiérrez Sanz L, Alvarez-Bustos A, Sanchez Ruiz A, Garcia Gonzalez D, Gonzalez-Cutre D, Cebolla H. 1564P Cancer-related fatigue in colorectal cancer patients at the time of diagnosis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gomez OH, Soto VH, Machado I, Mendez M, Cuatrecasas M, Horndler C, Vermeulen L, Hoorn ST, Mendiola M, Martín-Richard M, Ruiz-Casado A, Galvez E, Aparicio J, García IS, Leno R, Fernández-Martos C, Alonso-Orduna V, Montes AF, Maurel J, Feliu J. 474P Prognostic and predictive role of Consensus Molecular Subtypes (CMS) determined by immunohistochemistry in metastatic colorectal cancer (mCRC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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7
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Seguí E, Alonso-Orduna V, Sesma A, Martin-Richard M, Salud A, Fernández-Montes A, Fernández-Martos C, Ruiz-Casado A, Gallego J, Aparicio J, Gálvez E, Manzano H, Alcaide-Garcia J, Gallego R, Falco E, Esposito F, Oliveres H, Torres F, Feliu J, Maurel J. 471P Identification and validation of a new prognostic score in metastatic colorectal cancer (mCRC): GEMCAD score. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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8
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Franco F, Camara JC, Martín-Valadés JI, López-Alfonso A, Marrupe D, Gutiérrez-Abad D, Martínez-Amores B, León A, Juez I, Pérez M, Royuela A, Ruiz-Casado A. Clinical outcomes of FOLFIRINOX and gemcitabine-nab paclitaxel for metastatic pancreatic cancer in the real world setting. Clin Transl Oncol 2020; 23:812-819. [PMID: 32857340 DOI: 10.1007/s12094-020-02473-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES The incidence of pancreatic cancer is increasing in developed countries. The incorporation of new therapies, to the first-line treatment of patients with good performance status led to better survival in clinical trials. However, there is a wide variability in their use and some concerns about the treatment of elderly patients who were not included in the clinical trials. METHODS This is a retrospective multicenter study. Data from consecutive patients diagnosed with metastatic pancreatic cancer (mPC) treated with FOLFIRINOX (FFX) or gemcitabine plus nab-paclitaxel (GnP) were analysed to evaluate efficacy (overall survival-OS) and toxicity. RESULTS A total of 119 patients were included. 49.6% were treated with FFX and 50.4% with GNP in first-line. The median OS was 12 months with no statistically significant differences between both regimens (12.7 m for FFX vs 10.2 m for GnP). Elevated Ca 19.9 levels and neutrophil-lymphocyte ratio (NLR) increased the risk of death. Patients who received both regimens in first/second line had a median OS longer than 15 months whichever the sequence. 32 patients (27%) were older than 70-y. 54% patients received a second-line treatment, 56% in the FFX group and 44% in the GnP group. The median OS for patients older than 70 was 9.5 m versus 12.3 m for patients younger than 70. Progression of the disease was the cause of death in 67.6% of the patients. CONCLUSIONS In our setting, the use of FFX and GnP for treating mPC is quite similar, but superiority could not be demonstrated for any of the schemes in the first line. OS was determined by basal levels of Ca 19.9 and NLR. Patients receiving both regimens in first/second line whichever the sequence, exhibited the best survival rates. In our series, elderly patients had poorer survival rates.
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Affiliation(s)
- F Franco
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.
| | - J C Camara
- Department of Medical Oncology, Fundación Hospital Alcorcón, Alcorcón, Spain
| | | | - A López-Alfonso
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - D Marrupe
- Department of Medical Oncology, Hospital Universitario de Móstoles, Móstoles, Spain
| | - D Gutiérrez-Abad
- Department of Medical Oncology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - B Martínez-Amores
- Department of Medical Oncology, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
| | - A León
- Department of Medical Oncology, Fundación Jiménez Díaz, Madrid, Spain
| | - I Juez
- Department of Medical Oncology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - M Pérez
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - A Royuela
- Department of Biostatistics, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - A Ruiz-Casado
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
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9
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Chau I, Fakih M, García-Alfonso P, Linke Z, Ruiz-Casado A, Marques EP, Picard P, Celanovic M, Cartwright T. Safety and effectiveness of aflibercept + FOLFIRI for the treatment of patients with metastatic colorectal cancer (mCRC): OZONE secondary analyses. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Fernandez MEE, Gómez-España M, Grávalos C, García-Alfonso P, Rodríguez B, Losa F, Ales-Diaz I, Suarez BG, Toledano M, Valladares-Ayerbes M, Marques EP, Fernandez MS, de Castro EM, Raga MG, Salvia MAS, Ruiz-Casado A, Rodríguez-Ariza A, Aguilar EA. POLAF study: Efficacy and safety of FOLFIRI/aflibercept in a phase II trial in patients with metastatic colorectal cancer: Results of plasmatic prognostic and predictive markers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.062] [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: 11/12/2022] Open
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11
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Ruiz-Casado A, Gutiérrez L, Sánchez A, Manso M. Lengua geográfica inducida por inhibidores de la angiogénesis. Rev Clin Esp 2018; 218:501-502. [DOI: 10.1016/j.rce.2018.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 07/18/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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12
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Ramos J, Álvarez-Bustos A, Soriano M, Nuñez B, Ros J, Osorio P, Gutierrez L, Gómez R, Hidalgo F, Leon A, Mendez M, González C, Sanchez A, Martínez S, Pagola I, Brea L, Fiuza-Luces C, Lucia A, Ruiz-Casado A. Ideal cardiovascular health (ICVH) in patients with a recent diagnosis of colorectal cancer (CRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Gonzaga-López A, Muñoz-Rodriguez J, Ruiz-Casado A. Necrotising fasciitis in a patient treated with FOLFIRI-aflibercept for colorectal cancer: a case report. Ann R Coll Surg Engl 2017; 99:e225-e226. [PMID: 28768426 PMCID: PMC5696931 DOI: 10.1308/rcsann.2017.0143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Anti-angiogenics have become an important part of the treatment of several types of tumours such as ovarian, breast, lung and colorectal cancer. Necrotising fasciitis has been reported with bevacizumab but no cases have been reported with aflibercept, ramucirumab or regorafenib in patients with colorectal cancer. Necrotising fasciitis is a rare complication affecting one in 5000 bevacizumab users. We report the case of a 64-year-old man with stage IV rectosigmoid cancer under treatment with folinic acid, fluorouracil and irinotecan (FOLFIRI) and aflibercept, who developed a Fournier’s gangrene.
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Affiliation(s)
| | | | - A Ruiz-Casado
- Medical oncologist at Puerta de Hierro Majadahonda University Hospital
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14
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Ramos J, Cantos B, Maximiano C, Cebolla H, Fiuza-Luces C, Gutierrez L, Osorio P, Cerrato J, Sanchez J, Nuñez B, Garate A, Pagola I, Alejo L, Lucia A, Ruiz-Casado A. Cancer-related fatigue in breast cancer survivors: more evidence for a physiological substrate. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.64] [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: 11/12/2022] Open
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15
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Ruiz-Casado A, Alejo LB, Santos-Lozano A, Soria A, Ortega MJ, Pagola I, Fiuza-Luces C, Palomo I, Garatachea N, Cebolla H, Lucia A. Validity of the Physical Activity Questionnaires IPAQ-SF and GPAQ for Cancer Survivors: Insights from a Spanish Cohort. Int J Sports Med 2016; 37:979-985. [PMID: 27557405 DOI: 10.1055/s-0042-103967] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Regular physical activity (PA) decreases mortality risk in survivors of breast and colorectal cancer. Such impacts of exercise have prompted initiatives designed both to promote and adequately monitor PA in cancer survivors. This study examines the validity of 2 widely used self-report methods for PA determination, the International Physical Activity Questionnaire short version (IPAQ-SF) and Global Physical Activity Questionnaire (GPAQ). Both instruments were compared with the triaxial accelerometry (Actigraph) method as an objective reference standard. Study participants were 204 cancer survivors (both sexes, aged 18-79 years). Compared with accelerometry, both questionnaires significantly overestimated PA levels (across all intensities) and underestimated physical inactivity levels. No differences were detected between the 2 questionnaires except for a shorter inactivity time estimated by GPAQ (p=0.001). The Bland and Altman method confirmed that both questionnaires overestimated all PA levels. Receiver operating characteristic (ROC) analysis classified IPAQ and GPAQ as fair and poor predictors, respectively, of the proportions of survivors fulfilling international PA recommendations (≥150 min·week-1 of moderate-vigorous PA). IPAQ-SF showed a higher sensitivity but lower specificity than GPAQ. Our data do not support the use of IPAQ-SF or GPAQ to determine PA or inactivity levels in cancer survivors.
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Affiliation(s)
- A Ruiz-Casado
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - L B Alejo
- Universidad Europea. Instituto de Investigación i + 12, Madrid, Spain Ciencias del Deporte, European University of Madrid, Madrid, Spain
| | - A Santos-Lozano
- Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
| | - A Soria
- Department of Oncology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - M J Ortega
- Department of Oncology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - I Pagola
- Universidad Europea. Instituto de Investigación i + 12, Madrid, Spain Ciencias del Deporte, European University of Madrid, Madrid, Spain
| | - C Fiuza-Luces
- Instituto de Investigación i +12, Madrid, Spain Biomedicine, Universidad Europea de Madrid, Madrid, Spain
| | - I Palomo
- Department of Oncology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - N Garatachea
- Physiotherapy and Nursing, University of Zaragoza, Huesca, Spain, Huesca, Spain
| | - H Cebolla
- Department of Social Stratification, Universidad Nacional Educación a Distancia, Madrid, Spain
| | - A Lucia
- Universidad Europea. Instituto de Investigación i + 12, Madrid, Spain Ciencias del Deporte, European University of Madrid, Madrid, Spain
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Abstract
The mechanism of action of hypersensitivity reactions from paclitaxel has not been fully understood. It has not even been defined if they are secondary to paclitaxel, its vehicle or the premedication. Postmarketing pharmacovigilance is predominantly based on spontaneous reporting. These reports albeit biased and incomplete serve to detect previously unrecognised adverse events. We report a life threatening adverse event related to paclitaxel without any evidence of histamine release. It consisted of a cardiac arrest probably secondary to bradiarrhythmia or branch block.
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Affiliation(s)
- A Ruiz-Casado
- Medical Oncology Department, Hospital de Fuenlabrada, Madrid, Spain.
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Jimeno J, López-Martín JA, Ruiz-Casado A, Izquierdo MA, Scheuer PJ, Rinehart K. Progress in the clinical development of new marine-derived anticancer compounds. Anticancer Drugs 2004; 15:321-9. [PMID: 15057135 DOI: 10.1097/00001813-200404000-00003] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Naturally derived anticancer agents continue to be instrumental in the systemic therapeutic intervention against solid tumors and hematological malignancies. Such compounds now have a relevant role in contemporary models of combination with targeted agents, thus providing a rationale to consider nature as a valid tool to discover new innovative anticancer agents. The marine ecosystem has increasingly been the focus of interest for new discoveries in the field that are expected to be of significant therapeutic impact in cancer patients. A critical review of the integrated data generated in our marine-derived anticancer program seems to confirm such expentancies. ET-743 (Yondelis) represents the first new agent developed against advanced pretreated soft tissue sarcoma in the past 25 years, and also harbors activity in women bearing pretreated ovarian cancer and a solid potential in combination therapy. The lack of cumulative toxicities makes this compound suitable for long-lasting therapies, reversible transaminitis being the most prevalent toxicity. Aplidin has shown a positive therapeutic index in phase I trials and phase II studies are ongoing. In contrast to the lack of bone marrow toxicity, a set of translational results anticipates a potential in leukemia. Kahalalide F has also successfully completed the phase I program in solid tumors with evidence of activity in resistant tumors and phase II studies are under way. Finally, the mechanistic data generated in parallel with the clinical program confirms the potential of the marine ecosystem in the discovery of new agents acting against new cellular targets of relevance in cancer cell biology.
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Ruiz-Casado A, Sessa C, Provencio M, Casali P, Paz-Ares L, López-Brea M, Nieto A, López-Martín J, Izquierdo M, Jimeno J. 573 Safety profile for yondelis (ET-743) 1.3 mg/m2 over 3 hours (h). EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90605-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Alberola V, Camps C, Provencio M, Isla D, Rosell R, Vadell C, Bover I, Ruiz-Casado A, Azagra P, Jiménez U, González-Larriba JL, Diz P, Cardenal F, Artal A, Carrato A, Morales S, Sanchez JJ, de las Peñas R, Felip E, López-Vivanco G. Cisplatin plus gemcitabine versus a cisplatin-based triplet versus nonplatinum sequential doublets in advanced non-small-cell lung cancer: a Spanish Lung Cancer Group phase III randomized trial. J Clin Oncol 2003; 21:3207-13. [PMID: 12947054 DOI: 10.1200/jco.2003.12.038] [Citation(s) in RCA: 152] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To compare the survival benefit obtained with cisplatin plus gemcitabine, a cisplatin-based triplet, and nonplatinum sequential doublets in advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Stage IIIB to IV NSCLC patients were randomly assigned to receive cisplatin 100 mg/m2 day 1 plus gemcitabine 1,250 mg/m2 days 1 and 8, every 3 weeks for six cycles (CG); cisplatin 100 mg/m2 day 1 plus gemcitabine 1,000 mg/m2 and vinorelbine 25 mg/m2 days 1 and 8, every 3 weeks for six cycles (CGV); or gemcitabine 1,000 mg/m2 plus vinorelbine 30 mg/m2 days 1 and 8, every 3 weeks for three cycles, followed by vinorelbine 30 mg/m2 days 1 and 8 plus ifosfamide 3 g/m2 day 1, every 3 weeks for three cycles (GV-VI). RESULTS Five hundred fifty-seven patients were assigned to treatment (182 CG, 188 CGV, 187 GV-VI). Response rates were significantly inferior for the nonplatinum sequential doublet (CG, 42%; CGV, 41%; GV-VI, 27%; CG v GV-VI, P =.003). No differences in median survival or time to progression were observed. Toxicity was higher for the triplet: grade 3 to 4 neutropenia (GC, 32%; CGV, 57%; GV-VI, 27%; P <.05); neutropenic fever (CG, 4%; CGV, 19%; GV-VI, 5%; P <.0001); grade 3 to 4 thrombocytopenia (CG, 19%; CGV, 23%; GV-VI, 3%; P =.0001); and grade 3 to 4 emesis (GC, 22%; GCV, 32%; GV-VI, 6%; P <.0001). CONCLUSION On the basis of these results, CG remains a standard regimen for first-line treatment of advanced NSCLC.
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Affiliation(s)
- V Alberola
- Hospital Arnau de Vilanova, San Clemente 12, 46015 Valencia, Spain.
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Pérez-Gracia JL, Colomer R, Ruiz-Casado A, Arcediano A, Tornamira MV, Gómez-Martin C, Valentin V, Mendiola C, Cortés-Funes H, Hornedo J. High-dose mitoxantrone and cyclophosphamide without stem cell support in high-risk and advanced solid tumors: a phase I trial. Bone Marrow Transplant 2001; 27:117-23. [PMID: 11281378 DOI: 10.1038/sj.bmt.1702751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This phase I study was designed to develop a high-dose combination of two cycles of mitoxantrone and cyclophosphamide in patients with solid tumors, as an alternative to single-cycle high-dose regimens that use only alkylating agents. Treatment was delivered with granulocyte colony-stimulating factor (G-CSF), but without stem cell support, in order to avoid potential tumor cell reinfusion. Thirty-one patients with advanced solid tumors received two cycles of high-dose mitoxantrone (20-30 mg/m2) plus high-dose cyclophosphamide (3000-4000 mg/m2). All patients received G-CSF until hematologic recovery. Dose-escalation was performed when less than 50% of cycles per level had dose-limiting toxicity (DLT). The maximum tolerated dose (MTD) achieved was mitoxantrone 25 mg/m2 and cyclophosphamide 4000 mg/m2. Main dose-limiting toxicities (DLTs) were hematological: grade IV neutropenia lasting more than 7 days and thrombopenia below 20 x 10(9)/l requiring more than one platelet transfusion. Non-hematological DLT consisted predominantly of grade III emesis and asthenia. Follow-up after each cycle was performed in an outpatient setting and there were no toxic deaths. In conclusion, the administration of two cycles of high-dose mitoxantrone and cyclophosphamide with G-CSF support is safe and feasible. MTD was mitoxantrone 25 mg/m2 and cyclophosphamide 4000 mg/m2. Evaluation of this regimen is being done in a phase II trial.
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Affiliation(s)
- J L Pérez-Gracia
- Division of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
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