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Martin-Broto J, Hindi N, Cruz J, Martinez-Trufero J, Valverde C, De Sande LM, Sala A, Bellido L, De Juan A, Rubió-Casadevall J, Diaz-Beveridge R, Cubedo R, Tendero O, Salinas D, Gracia I, Ramos R, Baguè S, Gutierrez A, Duran-Moreno J, Lopez-Pousa A. Relevance of Reference Centers in Sarcoma Care and Quality Item Evaluation: Results from the Prospective Registry of the Spanish Group for Research in Sarcoma (GEIS). Oncologist 2018; 24:e338-e346. [PMID: 30409793 DOI: 10.1634/theoncologist.2018-0121] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 02/28/2018] [Accepted: 08/28/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Reference centers (RCs) are a key point for improving the survival of patients with soft-tissue sarcomas (STS). The aim of this study was to evaluate selected items in the management of patients with STS, comparing results between RC and local hospitals (LHs). MATERIALS AND METHODS Diagnostic and therapeutic data from patients diagnosed between January 2004 and December 2011 were collected. Correlation with outcome was performed. RESULTS A total of 622 sarcomas were analyzed, with a median follow-up of 40 months. Imaging of primary tumor preoperatively (yes vs. no) correlated with a higher probability of free surgical margins (77.4% versus 53.7%; p = .006). The provenance of the biopsy (RC vs. LH) significantly affected relapse-free survival (RFS; 3-year RFS 66% vs. 46%, respectively; p = .019). Likewise, 3-year RFS was significantly worse in cases with infiltrated (55.6%) or unknown (43.4%) microscopic surgical margins compared with free margins (63.6%; p < .001). Patients managed by RCs had a better 3-year overall survival compared with those managed by LHs (82% vs. 70.4%, respectively; p = .003). Perioperative chemotherapy in high-risk STS, more frequently administered in RCs than in LHs, resulted in significantly better 3-year RFS (66% vs. 44%; p = .011). In addition, patients with stage IV disease treated in RCs survived significantly longer compared with those in LHs (30.4 months vs. 18.5 months; p = .036). CONCLUSION Our series indicate that selected quality-of-care items were accomplished better by RCs over LHs, all with significant prognostic value in patients with STS. Early referral to an RC should be mandatory if the aim is to improve the survival of patients with STS. IMPLICATIONS FOR PRACTICE This prospective study in patients diagnosed with soft-tissue sarcoma shows the prognostic impact of reference centers in the management of these patients. The magnitude of this impact encompasses all steps of the process, from the initial management (performing diagnostic biopsy) to the advanced disease setting. This is the first prospective evidence showing improvement in outcomes of patients with metastatic disease when they are managed in centers with expertise. This study provides extra data supporting referral of patients with sarcoma to reference centers.
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Affiliation(s)
- Javier Martin-Broto
- Biomedicine Institute of Seville (IBIS), Lab 215, CSIC, University of Seville, Seville, Spain
- Medical Oncology Department, Virgen del Rocio University Hospital, Seville, Spain
| | - Nadia Hindi
- Biomedicine Institute of Seville (IBIS), Lab 215, CSIC, University of Seville, Seville, Spain
- Medical Oncology Department, Virgen del Rocio University Hospital, Seville, Spain
| | - Josefina Cruz
- Medical Oncology Department, Hospital Universitario de Canarias, Tenerife, Spain
| | | | - Claudia Valverde
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Angeles Sala
- Medical Oncology Department, Hospital de Basurto, Bilbao, Spain
| | - Lorena Bellido
- Medical Oncology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Ana De Juan
- Medical Oncology Department, Hospitalario Universitario Marqués de Valdecilla, Santander, Spain
| | - Jordi Rubió-Casadevall
- Medical Oncology Department, Hospital Josep Trueta, Instituto Catalán de Oncología, Girona, Spain
| | | | - Ricardo Cubedo
- Medical Oncology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Oscar Tendero
- Department of Orthopedic Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Diego Salinas
- Department of Orthopedic Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Isidro Gracia
- Department of Orthopedic Surgery, Hospital Universitari Sant Pau, Barcelona, Spain
| | - Rafael Ramos
- Department of Pathology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Silvia Baguè
- Department of Pathology, Hospital Universitari Sant Pau, Barcelona, Spain
| | - Antonio Gutierrez
- Department of Hematology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - José Duran-Moreno
- Department of Medical Oncology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Antonio Lopez-Pousa
- Department of Medical Oncology, Hospital Universitari Sant Pau, Barcelona, Spain
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Garcia Garcia Y, De Juan A, Mendiola C, Barretina-Ginesta MP, Prat A, Santaballa A, Bover I, Gil-Martin M, Manzano A, Rubio MJ, Romeo M, Arqueros C, Garcia Martinez E, Gonzalez Martin A. Phase II randomized trial of neoadjuvant (NA) chemotherapy (CT) with or without bevacizumab (Bev) in advanced epithelial ovarian cancer (EOC) (GEICO 1205/NOVA TRIAL). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.5508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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
5508 Background: First line carboplatin(C)-paclitaxel(P) and Bev has proved to be an active combination after primary debulking surgery and improve overall survival in sub-optimal resected advanced EOC patients (pts). However, the role of Bev in the NA setting has not been well defined yet. Methods: We performed a phase II randomized open label multicentric study in pts with high grade serous or endometrioid EOC, FIGO stage III-IV, ECOG 0-2, considered unresectable in whom NA CT and interval debulking surgery (IDS) were planned. Main exclusion criteria were intestinal occlusion and contraindication for Bev. Pts were randomized to 4 courses of triweekly C AUC 6 and P 175 mg/m2 iv alone or with at least 3 courses of Bev 15 mg/kg i.v. every 3w in experimental arm. The primary endpoint was complete macroscopic response (CMR) rate at IDS. Secondary objectives were safety, surgical feasibility, optimal surgery rate (OSR), RECIST 1.1 and CA-125 GCIG response rate. Sample collection for translational research was taken at diagnosis and IDS. After surgery pts in both arms completed 3 additional cycles of CT and Bev, followed by maintenance Bev up to 15 mo. Results: Sixty-eight out of seventy-one evaluable pts. Clinical pts characteristics were well balanced, median age 60.0 y.o and a 33.8% stage IV. No differences in CMR were found at IDS (2/33 Control and 2/35 Bev). Bev arm was favoured in rate of surgical feasibility (66.7 vs 88.6%, p = 0.029), while no differences were found in OSR (63.6 vs 65.7%, p = 0.858) and in number of pts considered unresectable at time of IDS (2 vs 0). Median time from IDS to restarting Bev was 7.1 w. Median PFS was 20.3 mo in both arms, 20.13 mo in control arm and 20.36 mo in Bev arm, HR: 1.14 (IC 95%, 0.656 - 1.994). There were lower rates of serious adverse events (grade 3-4) in Bev arm (69.7 vs 42.9%, p = 0.026). 8 pts presented AE of special interest in Bev arm (3G2 proteinuria, 1G2/1G3 hypertension, 1G3 entero-vaginal fistulae, 1G3 entero-cutaneous fistulae, 1G3 deep venous thrombosis, 1G2 bleeding, 1G1 surgical dehiscence). Conclusions: NACT with Bevacizumab was feasible and improved the surgical outcomes at IDS in pts initially considered unresectable. Clinical trial information: 2012-003883-31.
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Affiliation(s)
| | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | | | - Aleix Prat
- Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Marta Gil-Martin
- Institut Català D'Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Margarita Romeo
- Medical Oncology Department, Catalan Institute of Oncology- IDIBGi, Badalona, Spain
| | - Cristina Arqueros
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Elena Garcia Martinez
- Department of Hematology and Medical Oncology, Hospital G. Universitario Morales Meseguer, IMIB-Arrixaca, Universidad Catolica San Antonio, Murcia, Spain
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3
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Romero I, Leskella S, Redondo A, Gutierrez-Pecharroman A, Santaballa A, Cristobal Lana EM, Calvo E, Rosa-Rosa JM, Oaknin A, Bover I, Herrero A, Sanchez-Heras AB, Churruca CM, De Juan A, Mendiola C, Romeo M, Ojeda B, Lopez-Guerrero JA, Palacios J, Poveda A. CD8 + TILs in early stage epithelial ovarian cancer: A GEICO study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.5543] [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
5543 Background: The extent of tumor infiltrating lymphocytes (TILs) has emerged as a potential clinical useful biomarker in epithelial ovarian cancer (OC); however differences in TILs among OC histological types have not been extensively analysed. Methods: From a prospective early stage (I-II) GEICO registry of 1151 cases, 573 were sent for central pathology review. Complete analysis for classification of OC correctly identified 488 cases. Histological typing was performed according to morphological features and the expression of WT1, p53, p16, estrogen receptor (ER), progesterone receptor, and napsin A. The expression of mismatch repair (MMR) proteins MLH1, PMS2, MSH2 and MSH6 was performed in all tumors. The absolute number of stromal and intraepithelial CD8+ TILs per 0.6 mm2 TMA core was quantified and correlated with pathological features. Results: The series included 127 high-grade serous carcinomas (HGSC) (26%), 22 low-grade serous carcinomas (LGSOC) (4.5%), 165 endometrioid carcinomas (EC) (33.8%), 124 clear cell carcinomas (CCC) (2.4%), and 50 mucinous carcinomas (MC) (10.2%). The mean of intraepithelial CD8+ TILs was higher in HGSG (48.7) than in all other histological types (LGSG: 16.3; EC: 27.1; MC: 7.0; and CCC 10.3; p<0.0001). In the stromal component, the mean of CD8+TILs was also higher in HGSG (31.1) than in EC, MC and CCC (15.8, 8.0 and 12.7, respectively; p<0.0001). The mean of intraepithelial CD8+ TILs was significantly higher in RE-positive (71.9) than in RE-negative (34.8) HGSC ( p=0.002). In the complete series, 33 (6.6%) OCs showed absent expression of at least 1 MMR protein, and the mean of intraepithelial CD8+ TILs was significantly higher in these OCs (57.0) than in those with preserved expression of all MMR proteins (23.6; p=0.0035). MMR protein deficiency was observed in 27 (16%) ECs, and these tumours had significantly higher mean of both intraepithelial (60.4 vs. 20.7 p=0.003) and stromal CD8+ TILs (26.6 vs. 13.8, p= 0.046). No significant differences in TILs were observed among EC of different histological grades. Conclusions: The extent of CD8+TILs significantly correlates with the histological type and MMR status in OCs, being HGSCs and EC with MMR deficiency those OCs with higher CD8+TILs.
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Affiliation(s)
- Ignacio Romero
- Clinical Area of Gynecologic Oncology, Instituto Valenciano de Oncología (IVO), Valencia, Spain
| | - Susanna Leskella
- Pathology Department, Hospital Universitario Ramón y Cajal, IRyCIS, Madrid, Spain
| | | | | | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Elisa Calvo
- Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | - Ana Oaknin
- Vall d’Hebron University Hospital Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | | | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | - Margarita Romeo
- Medical Oncology Department, Catalan Institute of Oncology- IDIBGi, Badalona, Spain
| | | | | | - José Palacios
- Pathology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
| | - Andres Poveda
- Clinical Area of Gynecologic Oncology, Instituto Valenciano de Oncología (IVO), Valencia, Spain
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4
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Martinez-Trufero J, Hindi N, Cruz J, Alvarez Alvarez RM, Diaz Beveridge RP, Valverde Morales CM, Gutierrez A, Bernad IP, Lopez-Pousa A, Vaz Salgado MÁ, Lavernia J, Cano JM, Sevilla I, Rubió-Casadevall J, De Juan A, Carrasco JA, Hernandez Leon N, Agra Pujol C, Ferrando Lamana L, Martin Broto J. Correlation between a new growth modulation index (GMI)-based Geistra score and efficacy outcomes in patients (PTS) with advanced soft tissue sarcomas (ASTS) treated with trabectedin (T): A Spanish group for research on sarcomas (GEIS-38 study). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.11070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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
11070 Background: The GMI is a marker of drug activity and represents an intra-patient comparison of successive time to progression (TTP), defined as the TTP ratio between the second (or later) line (TTPn) of therapy divided by the prior line (TTPn−1). Defining a clinical profile of pts with GMI >1.33 could help to identify pts who can gain greater benefit from T. Methods: We retrospectively evaluated the concordance between the GMI and the efficacy outcomes and clinical profiles of 198 pts with ASTS treated with trabectedin 1.5 mg/m² (24-h infusion q3w) as a 2nd or further-line treatment from Jan 2007 to Jun 2016. Results: After a median follow-up of 58 months (m; range: 18-172) median overall survival from ASTS diagnosis (MOS) and from T (MT-OS) were 27.5 m (23-32.1) and 10.8 m (8.9-12.7), respectively, while median TTP from T (MT-TTP) and T-1 were 3.4 m (2.8-4) and 3.5 m (2.8-4.2). Overall, 106 pts (53%) had a GMI <1; 22 (11%) a GMI=1-1.33 and 70 pts (35%) a GMI >1.33. A high GMI (<1.33 vs >1.33) correlated with favorable efficacy outcomes: MT-OS: 23 vs 36 m (p<0.001), MT-TTP 2.3 vs 8.2 m (p<0.001) and clinical benefit (objective response + stable disease) 23% vs 68% (p=0.001). The multivariate analysis identified L-type sarcoma (Odds ratio: 1.99, 95% CI 1.06-3.71), metastatic free interval (MFI) from initial diagnosis > 8.1 m (2.24, 95%CI 1.19-4.18) and Karnofsky >80 (2.3, 95%CI 1.00-5.28) as factors independently associated to GMI> 1.33. Based on these 3 variables we defined a new GEISTRA score assigning 1 point for each adversely affected variable: non L-Sarcoma, MFI<8.1m or Karnofsky <80. This score showed a strong correlation with MT-TTP (p<0.001) and MT-OS (p<0.001). Conclusions: Based on the high GMI we defined a new GEISTRA score, which is strongly associated with favorable efficacy outcomes in pts with ASTS treated with T. Thus, GEISTRA score could be a potentially useful predictable clinical tool for T benefit. [Table: see text]
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Affiliation(s)
| | - Nadia Hindi
- Virgen del Rocio University Hospital, Institute of Biomedicine Research (IBIS), Seville, Spain
| | - Josefina Cruz
- Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | | | | | | | | | | | | | | | | | | | - Isabel Sevilla
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | | | | | | | - Javier Martin Broto
- Virgen del Rocio University Hospital, Institute of Biomedicine Research (IBIS), Seville, Spain
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5
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Gudmundsson J, Thorleifsson G, Sigurdsson JK, Stefansdottir L, Jonasson JG, Gudjonsson SA, Gudbjartsson DF, Masson G, Johannsdottir H, Halldorsson GH, Stacey SN, Helgason H, Sulem P, Senter L, He H, Liyanarachchi S, Ringel MD, Aguillo E, Panadero A, Prats E, Garcia-Castaño A, De Juan A, Rivera F, Xu L, Kiemeney LA, Eyjolfsson GI, Sigurdardottir O, Olafsson I, Kristvinsson H, Netea-Maier RT, Jonsson T, Mayordomo JI, Plantinga TS, Hjartarson H, Hrafnkelsson J, Sturgis EM, Thorsteinsdottir U, Rafnar T, de la Chapelle A, Stefansson K. A genome-wide association study yields five novel thyroid cancer risk loci. Nat Commun 2017; 8:14517. [PMID: 28195142 PMCID: PMC5316879 DOI: 10.1038/ncomms14517] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [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] [Received: 08/08/2016] [Accepted: 01/06/2017] [Indexed: 12/13/2022] Open
Abstract
The great majority of thyroid cancers are of the non-medullary type. Here we report findings from a genome-wide association study of non-medullary thyroid cancer, including in total 3,001 patients and 287,550 controls from five study groups of European descent. Our results yield five novel loci (all with Pcombined<3 × 10−8): 1q42.2 (rs12129938 in PCNXL2), 3q26.2 (rs6793295 a missense mutation in LRCC34 near TERC), 5q22.1 (rs73227498 between NREP and EPB41L4A), 10q24.33 (rs7902587 near OBFC1), and two independently associated variants at 15q22.33 (rs2289261 and rs56062135; both in SMAD3). We also confirm recently published association results from a Chinese study of a variant on 5p15.33 (rs2736100 near the TERT gene) and present a stronger association result for a moderately correlated variant (rs10069690; OR=1.20, P=3.2 × 10−7) based on our study of individuals of European ancestry. In combination, these results raise several opportunities for future studies of the pathogenesis of thyroid cancer. Non-medullary thyroid cancers include papillary and follicular subtypes, and are the most common type of thyroid cancer. Here, the authors extend previous work by performing a large genome-wide association study and find five novel loci associated with this disease.
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Affiliation(s)
| | | | | | | | - Jon G Jonasson
- Landspitali-University Hospital, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland.,The Icelandic Cancer Registry, 105 Reykjavik, Iceland
| | | | | | | | | | | | | | - Hannes Helgason
- deCODE genetics/AMGEN, 101 Reykjavik, Iceland.,School of Engineering and Natural Sciences, University of Iceland, 101 Reykjavik, Iceland
| | | | - Leigha Senter
- Division of Human Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio 43210, USA
| | - Huiling He
- Department of Cancer Biology and Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio 43210, USA
| | - Sandya Liyanarachchi
- Department of Cancer Biology and Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio 43210, USA
| | - Matthew D Ringel
- Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University, Columbus, Ohio 43210, USA
| | - Esperanza Aguillo
- Division of Endocrinology, University Hospital, 50009 Zaragoza, Spain
| | - Angeles Panadero
- Division of Medical Oncology, Ciudad de Coria Hospital, 10800 Coria, Spain
| | - Enrique Prats
- Division of Nuclear Medicine, University Hospital, 50009 Zaragoza, Spain
| | - Almudena Garcia-Castaño
- Division of Medical Oncology, Marques de Valdecilla University Hospital, 39008 Santander, Spain
| | - Ana De Juan
- Division of Medical Oncology, Marques de Valdecilla University Hospital, 39008 Santander, Spain
| | - Fernando Rivera
- Division of Medical Oncology, Marques de Valdecilla University Hospital, 39008 Santander, Spain
| | - Li Xu
- Department of Head &Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Lambertus A Kiemeney
- Radboud University Medical Centre, Radboud Institute for Health Sciences, 6500HB Nijmegen, The Netherlands
| | | | - Olof Sigurdardottir
- Department of Clinical Biochemistry, Akureyri Hospital, 600 Akureyri, Iceland
| | | | | | - Romana T Netea-Maier
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Radboud Institute for Health Sciences, 6500HB Nijmegen, The Netherlands
| | - Thorvaldur Jonsson
- Landspitali-University Hospital, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | | | - Theo S Plantinga
- Department of Pathology, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, 6500HB Nijmegen, The Netherlands
| | | | | | - Erich M Sturgis
- Department of Head &Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Unnur Thorsteinsdottir
- deCODE genetics/AMGEN, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | | | - Albert de la Chapelle
- Department of Cancer Biology and Genetics, Ohio State University Comprehensive Cancer Center, Columbus, Ohio 43210, USA
| | - Kari Stefansson
- deCODE genetics/AMGEN, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
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6
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Martin Broto J, Fernandez-Serra A, Lopez-Pousa A, Gutierrez A, De Las Penas R, Martinez-Trufero J, Cruz J, Alvarez RM, Cubedo R, Redondo A, Carrasco JA, Lopez-Martin JA, Sala MÁ, Sevilla I, Balana C, Vaz Salgado MÁ, De Juan A, Poveda A, Hindi N, Lopez-Guerrero JA. CUL4A and ERCC1 genesas predictive factors for trabectedin efficacy in advanced soft tissue sarcomas (STS): A Spanish Group for Sarcoma Research (GEIS) study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.11048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Josefina Cruz
- Hospital Universitario de Canarias, Santa Cruz De Tenerife, Spain
| | | | | | | | | | | | | | - Isabel Sevilla
- Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Carmen Balana
- Institut Catala Oncologia. Hospital Germans Trias I Pujol, Badalona/Barcelona, Spain
| | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | - Andres Poveda
- Clinical Area Gynecologic Oncology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Nadia Hindi
- Universitary Hospital Virgen del Rocio, Sevilla, Spain
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7
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Martin-Broto J, Pousa AL, de Las Peñas R, García Del Muro X, Gutierrez A, Martinez-Trufero J, Cruz J, Alvarez R, Cubedo R, Redondo A, Maurel J, Carrasco JA, López-Martin JA, Sala Á, Meana JA, Ramos R, Martinez-Serra J, Lopez-Guerrero JA, Sevilla I, Balaña C, Vaz Á, De Juan A, Alemany R, Poveda A. Randomized Phase II Study of Trabectedin and Doxorubicin Compared With Doxorubicin Alone as First-Line Treatment in Patients With Advanced Soft Tissue Sarcomas: A Spanish Group for Research on Sarcoma Study. J Clin Oncol 2016; 34:2294-302. [PMID: 27185843 DOI: 10.1200/jco.2015.65.3329] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Doxorubicin and trabectedin are considered active drugs in soft tissue sarcoma (STS). The combination of both drugs was hypothesized to be advantageous and safe on the basis of preclinical evidence and a previous phase I trial, respectively. The aim of this study was to compare the clinical outcome of trabectedin plus doxorubicin with doxorubicin as first-line treatment of advanced STS patients. PATIENTS AND METHODS In this open-label randomized phase II trial, the main end point was progression-free survival (PFS). Trabectedin 1.1 mg/m(2) in a 3-hour infusion plus doxorubicin 60 mg/m(2) as the experimental arm and doxorubicin 75 mg/m(2) as the control arm were administered for up to six cycles. Translational research was planned to correlate the expression of apoptotic and DNA repair genes with clinical outcome. RESULTS In 115 randomly assigned patients, the median PFS was 5.5 months in the control arm and 5.7 months in the experimental arm (hazard ratio, 1.16; 95% CI, 0.79 to 1.71; P = .45) in the intent-to-treat analysis. The trial was stopped for futility after the interim analysis, because the results in the experimental arm showed the risk reduction for the main end point to be < 9.64%. The proportion of patients with grade 3 or 4 thrombocytopenia, asthenia, and liver toxicity was significantly higher in the experimental arm. FAS and p53 were shown to be prognostic factors for PFS (7.0 months if FAS+ and p53-; 3.4 months if FAS+/p53+ or FAS-/p53-; and 0.7 months if FAS- and p53+; P < .001) and for overall survival. CONCLUSION Trabectedin plus doxorubicin did not show superiority over doxorubicin alone as first-line treatment of advanced STS. The prognostic role of apoptotic key genes, FAS and p53, was shown to be robust enough to continue this research line.
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Affiliation(s)
- Javier Martin-Broto
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain.
| | - Antonio López Pousa
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Ramón de Las Peñas
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Xavier García Del Muro
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Antonio Gutierrez
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Javier Martinez-Trufero
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Josefina Cruz
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Rosa Alvarez
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Ricardo Cubedo
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Andrés Redondo
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Joan Maurel
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Juan A Carrasco
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - José A López-Martin
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Ángeles Sala
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - José Andrés Meana
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Rafael Ramos
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Jordi Martinez-Serra
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - José A Lopez-Guerrero
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Isabel Sevilla
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Carmen Balaña
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Ángeles Vaz
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Ana De Juan
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Regina Alemany
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
| | - Andrés Poveda
- Javier Martin-Broto, Virgen del Rocio Hospital and Biomedicine Institute, Sevilla; Antonio López Pousa, Sant Pau Hospital; Xavier García del Muro, Institut Català d'Oncologia; and Joan Maurel, CIBERehd, IDIBAPS, Hospital Clinic, Barcelona; Ramón de las Peñas, Provincial Hospital, Castellón; Antonio Gutierrez, Rafael Ramos, and Jordi Martinez-Serra, Son Espases Hospital; and Regina Alemany, Balearic Islands University, Palma de Mallorca; Javier Martinez-Trufero, Miguel Servet Hospital, Zaragoza; Josefina Cruz, University Hospital Canarias, Tenerife; Rosa Alvarez, Gregorio Marañón Hospital; Ricardo Cubedo, Puerta de Hierro Hospital; Andrés Redondo, La Paz University Hospital; José A. López-Martin, 12 de Octubre Hospital; and Ángeles Vaz, Ramón y Cajal Hospital, Madrid; Juan A. Carrasco, Xeral Cies Hospital, Vigo; Ángeles Sala and Ana De Juan, Basurto Hospital, Bilbao; José Andrés Meana, University General Hospital, Alicante; José A. Lopez-Guerrero and Andrés Poveda, Valencian Oncologic Institute, Valencia; Isabel Sevilla, Virgen de la Victoria Hospital, Málaga; and Carmen Balaña, Insitut Català d'Oncologia, Badalona, Spain
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8
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García Y, De Juan A, Mendiola C, Barretina-Ginesta P, Vidal L, Santaballa A, Bover I, Gil-Martin M, Manzano A, Rubio MJ, Romeo M, Gomez de Liaño A, García-Martínez E, Gonzalez-Martin A. Phase II randomized trial of neoadjuvant (NA) chemotherapy (CT) with or without bevacizumab (Bev) in advanced epithelial ovarian cancer (EOC) (GEICO 1205/NOVA TRIAL). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yolanda García
- Corporació Sanitaria Universitaria Parc Taulí, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | - Pilar Barretina-Ginesta
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Universitari Josep Trueta, Girona, Spain
| | - Laura Vidal
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Isabel Bover
- GEICO and Hospital Son Llàtzer, Palma De Mallorca, Spain
| | - Marta Gil-Martin
- Early Clinical Research Unit, Institut Català d'Oncologia, Barcelona, Spain
| | | | | | - Margarita Romeo
- Servicio de Oncologia Médica, Institut Català d'Oncologia (Hospital Germans Trias i Pujol), Badalona, Spain
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9
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Romero I, Churruca CM, Redondo A, Santaballa A, Calvo E, Ojeda B, Del Campo JM, Laínez N, García-Martínez E, Romeo M, Bover I, Mendiola C, Caballero C, Martinez J, Herrero A, Sánchez AB, De Juan A, Hernando Polo S, Lopez-Guerrero JA, Poveda A. Early stage ovarian cancer clinical behavior according to FIGO 2014 Staging changes with a focus on IC subtype: data from prospective GEICO registry. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Elisa Calvo
- Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | | | - Nuria Laínez
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - Margarita Romeo
- Servicio de Oncologia Médica, Institut Català d'Oncologia (Hospital Germans Trias i Pujol), Badalona, Spain
| | - Isabel Bover
- GEICO and Hospital Son Llàtzer, Palma De Mallorca, Spain
| | | | | | | | | | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | | | - Andres Poveda
- Area Clinica de Oncologia Ginecológica, Fundacion Instituto Valenciano de Oncología, Valencia, Spain
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10
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Rubió-Casadevall J, Martinez-Trufero J, Garcia-Albeniz X, Calabuig S, Lopez-Pousa A, Del Muro JG, Fra J, Redondo A, Lainez N, Poveda A, Valverde C, De Juan A, Sevilla I, Casado A, Andres R, Cruz J, Martin-Broto J, Maurel J. Role of surgery in patients with recurrent, metastatic, or unresectable locally advanced gastrointestinal stromal tumors sensitive to imatinib: a retrospective analysis of the Spanish Group for Research on Sarcoma (GEIS). Ann Surg Oncol 2015; 22:2948-57. [PMID: 25608769 DOI: 10.1245/s10434-014-4360-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Recurrent, metastatic, and locally advanced gastrointestinal stromal tumors (GISTs) can be treated successfully with imatinib mesylate. Surgery for residual disease has been suggested for nonrefractory metastatic GISTs to reduce the probability of resistant recurrent clones, although no randomized Phase III trial has been performed to answer the question about its benefit. We carried out an analysis of the outcome of patients with recurrent unresectable locally advanced or metastatic imatinib-sensitive priamary GIST in 14 institutions in Spain. We compared two cohorts: treated or not treated with surgery after partial response or stabilization by imatinib. PATIENTS AND METHODS Data were obtained from the online GIST registry of the Spanish Group for Research in Sarcomas. Selected patients were then divided into two groups: group A, treated initially only with imatinib, and group B, treated additionally with metastasectomy. Baseline characteristics between groups were compared, and univariate and multivariate analysis for progression-free survival and overall survival (OS) were performed. RESULTS Analysis was undertaken in 171 patients considered nonrefractory to imatinib. The median follow-up time was 56.6 months. Focusing on OS, the Eastern Cooperative Oncology Group performance status different than 0, extent of disease limited to one metastatic organ, and comparison between groups A or B achieved statistical difference in the multivariate analysis. Median survival was 59.9 months in group A and 87.6 months in group B. CONCLUSIONS Based in its benefit in OS, our study supports surgery of metastatic disease in GIST patients who respond to imatinib therapy.
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Affiliation(s)
- Jordi Rubió-Casadevall
- Department of Medical Oncology, Institut Català d'Oncologia de Girona, Hospital Josep Trueta, Girona, Spain,
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11
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Freire J, Domínguez-Hormaetxe S, Pereda S, De Juan A, Vega A, Simón L, Gómez-Román J. Collagen, type XI, alpha 1: An accurate marker for differential diagnosis of breast carcinoma invasiveness in core needle biopsies. Pathol Res Pract 2014; 210:879-84. [DOI: 10.1016/j.prp.2014.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 05/06/2014] [Accepted: 07/22/2014] [Indexed: 12/01/2022]
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12
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Rafnar T, Sulem P, Thorleifsson G, Vermeulen SH, Helgason H, Saemundsdottir J, Gudjonsson SA, Sigurdsson A, Stacey SN, Gudmundsson J, Johannsdottir H, Alexiusdottir K, Petursdottir V, Nikulasson S, Geirsson G, Jonsson T, Aben KKH, Grotenhuis AJ, Verhaegh GW, Dudek AM, Witjes JA, van der Heijden AG, Vrieling A, Galesloot TE, De Juan A, Panadero A, Rivera F, Hurst C, Bishop DT, Sak SC, Choudhury A, Teo MTW, Arici C, Carta A, Toninelli E, de Verdier P, Rudnai P, Gurzau E, Koppova K, van der Keur KA, Lurkin I, Goossens M, Kellen E, Guarrera S, Russo A, Critelli R, Sacerdote C, Vineis P, Krucker C, Zeegers MP, Gerullis H, Ovsiannikov D, Volkert F, Hengstler JG, Selinski S, Magnusson OT, Masson G, Kong A, Gudbjartsson D, Lindblom A, Zwarthoff E, Porru S, Golka K, Buntinx F, Matullo G, Kumar R, Mayordomo JI, Steineck DG, Kiltie AE, Jonsson E, Radvanyi F, Knowles MA, Thorsteinsdottir U, Kiemeney LA, Stefansson K. Genome-wide association study yields variants at 20p12.2 that associate with urinary bladder cancer. Hum Mol Genet 2014; 23:5545-57. [PMID: 24861552 DOI: 10.1093/hmg/ddu264] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [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] [Indexed: 01/04/2023] Open
Abstract
Genome-wide association studies (GWAS) of urinary bladder cancer (UBC) have yielded common variants at 12 loci that associate with risk of the disease. We report here the results of a GWAS of UBC including 1670 UBC cases and 90 180 controls, followed by replication analysis in additional 5266 UBC cases and 10 456 controls. We tested a dataset containing 34.2 million variants, generated by imputation based on whole-genome sequencing of 2230 Icelanders. Several correlated variants at 20p12, represented by rs62185668, show genome-wide significant association with UBC after combining discovery and replication results (OR = 1.19, P = 1.5 × 10(-11) for rs62185668-A, minor allele frequency = 23.6%). The variants are located in a non-coding region approximately 300 kb upstream from the JAG1 gene, an important component of the Notch signaling pathways that may be oncogenic or tumor suppressive in several forms of cancer. Our results add to the growing number of UBC risk variants discovered through GWAS.
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Affiliation(s)
| | | | | | | | - Hannes Helgason
- deCODE Genetics/AMGEN, Reykjavik 101, Iceland School of Engineering and Natural Sciences and
| | | | | | | | | | | | | | | | | | | | | | - Thorvaldur Jonsson
- Faculty of Medicine, University of Iceland, Reykjavik 101, Iceland Department of Surgery, Landspitali-University Hospital, Reykjavik 101, Iceland
| | - Katja K H Aben
- Department for Health Evidence Comprehensive Cancer Center The Netherlands, Utrecht, The Netherlands
| | | | - Gerald W Verhaegh
- Department of Urology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | - Aleksandra M Dudek
- Department of Urology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | - J Alfred Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | | | | | | | - Ana De Juan
- Division of Medical Oncolology, Marques de Valdecilla University Hospital, Santander 39008, Spain
| | - Angeles Panadero
- Division of Medical Oncolology, Ciudad de Coria Hospital, Coria 10800, Spain
| | - Fernando Rivera
- Division of Medical Oncolology, Marques de Valdecilla University Hospital, Santander 39008, Spain
| | - Carolyn Hurst
- Section of Experimental Oncology, Leeds Institute of Cancer and Pathology, St. James's University Hospital, Leeds LS9 7TF, UK
| | - D Timothy Bishop
- Section of Epidemiology & Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds LS2 9JT, UK
| | - Sei C Sak
- Mid Yorkshire NHS Trust, Pinderfields Hospital, Wakefield WF1 4DG, UK
| | | | - Mark T W Teo
- Section of Experimental Oncology, Leeds Institute of Cancer and Pathology, St. James's University Hospital, Leeds LS9 7TF, UK
| | - Cecilia Arici
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, Brescia 1-25125, Italy
| | - Angela Carta
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, Brescia 1-25125, Italy
| | - Elena Toninelli
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, Brescia 1-25125, Italy
| | - Petra de Verdier
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm S171 76, Sweden
| | - Peter Rudnai
- Department of Environmental Epidemiology, National Institute of Environmental Health, Budapest H-1450, Hungary
| | - Eugene Gurzau
- Health Department, Environmental Health Center, Babes Bolyai University, Cluj-Napoca 3400, Romania
| | - Kvetoslava Koppova
- Department of Environmental Health, Regional Authority of Public Health, Banska Bystrica 975 56, Slovakia
| | | | - Irene Lurkin
- Department of Pathology, Erasmus MC, Rotterdam 3000 CA, The Netherlands
| | - Mieke Goossens
- Department of General Practice, Catholic University of Leuven, Leuven 3000, Belgium
| | - Eliane Kellen
- Leuven University Centre for Cancer Prevention (LUCK), Leuven 3000, Belgium
| | | | - Alessia Russo
- Human Genetics Foundation, HuGeF, Torino I-10126, Italy Department of Medical Sciences and
| | - Rossana Critelli
- Human Genetics Foundation, HuGeF, Torino I-10126, Italy Department of Medical Sciences and
| | - Carlotta Sacerdote
- Human Genetics Foundation, HuGeF, Torino I-10126, Italy Unit of Cancer Epidemiology, University of Torino, Torino 10126, Italy Centre for Cancer Epidemiology and Prevention (CPO Piemonte), Torino 10126, Italy
| | - Paolo Vineis
- Human Genetics Foundation, HuGeF, Torino I-10126, Italy Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Clémentine Krucker
- CNRS, UMR 144, Oncologie Moléculaire, Institut Curie, Paris 75248 Cedex 05, France Institut Curie, Centre de Recherche, Paris 75248 Cedex 05, France
| | - Maurice P Zeegers
- Department of Epidemiology & Complex Genetics NUTRIM/Faculty of Health, Medicine and Life Sciences Maastricht University, Maastricht 6200 MD, The Netherlands
| | - Holger Gerullis
- Department of Urology, Lukasklinik Neuss, Preussenstr. 64, Neuss 41464, Germany
| | - Daniel Ovsiannikov
- Department of Urology, St.-Josefs-Hospital Dortmund-Hörde, Dortmund 44263, Germany
| | - Frank Volkert
- Department of Urology, Evangelisches Krankenhaus Paul Gerhardt Foundation, Lutherstadt Wittenberg 06886, Germany
| | - Jan G Hengstler
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund 44139, Germany
| | - Silvia Selinski
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund 44139, Germany
| | | | | | - Augustine Kong
- deCODE Genetics/AMGEN, Reykjavik 101, Iceland School of Engineering and Natural Sciences and
| | - Daniel Gudbjartsson
- deCODE Genetics/AMGEN, Reykjavik 101, Iceland School of Engineering and Natural Sciences and
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm S171 76, Sweden
| | - Ellen Zwarthoff
- Department of Pathology, Erasmus MC, Rotterdam 3000 CA, The Netherlands
| | - Stefano Porru
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, Brescia 1-25125, Italy
| | - Klaus Golka
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund 44139, Germany
| | - Frank Buntinx
- Department of General Practice, Catholic University of Leuven, Leuven 3000, Belgium Research School Care & Department of General Practice, Maastricht University, Maastricht 6200 MD, The Netherlands
| | - Giuseppe Matullo
- Human Genetics Foundation, HuGeF, Torino I-10126, Italy Department of Medical Sciences and
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg D-69120, Germany
| | - José I Mayordomo
- Division of Medical Oncology, University of Zaragoza, Zaragoza 50009, Spain
| | - D Gunnar Steineck
- Department of Oncology and Pathology, Karolinska Hospital, Stockholm S171 76, Sweden Department of Oncology, Sahlgrenska University Hospital, Goteborg S-413 45, Sweden
| | - Anne E Kiltie
- Gray Institute for Radiation Oncology and Biology, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK
| | | | - François Radvanyi
- CNRS, UMR 144, Oncologie Moléculaire, Institut Curie, Paris 75248 Cedex 05, France Institut Curie, Centre de Recherche, Paris 75248 Cedex 05, France
| | - Margaret A Knowles
- Section of Experimental Oncology, Leeds Institute of Cancer and Pathology, St. James's University Hospital, Leeds LS9 7TF, UK
| | - Unnur Thorsteinsdottir
- deCODE Genetics/AMGEN, Reykjavik 101, Iceland Faculty of Medicine, University of Iceland, Reykjavik 101, Iceland
| | - Lambertus A Kiemeney
- Department for Health Evidence Department of Urology, Radboud University Medical Center, Nijmegen 6500 HB, The Netherlands
| | - Kari Stefansson
- deCODE Genetics/AMGEN, Reykjavik 101, Iceland Faculty of Medicine, University of Iceland, Reykjavik 101, Iceland
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13
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Romero I, Oaknin A, Arranz JA, García-Martínez E, Herrero A, Casado A, De Juan A, Guerra E, Hernando Polo S, Santaballa A, Poveda A, Gonzalez-Martin A. Phase II trial of intraperitoneal (IP) administration of catumaxomab (C) as consolidation therapy for patients (pts) with relapsed epithelial ovarian cancer (OC) in second or third complete remission: GEICO 1001 study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.5528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ignacio Romero
- Area Clinica Oncologia Ginecológica. Instituto Valenciano de Oncologia, Valencia, Spain
| | - Ana Oaknin
- GEICO and Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | | | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | - Eva Guerra
- Hospital Universitario Ramon y Cajal, Madrid, Spain
| | | | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Andres Poveda
- Area Clínica Oncología Ginecológica. Instituto Valenciano de Oncologia, Valencia, Spain
| | - Antonio Gonzalez-Martin
- GEICO and Medical Oncology Service, Centro Oncológico M. D. Anderson International Spain, Madrid, Spain
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14
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Pollán M, Castello A, Ruiz A, Casas A, Baena-Cañada JM, Lope V, Antolín S, Ramos Vazquez M, Munoz-Mateu M, Lluch A, De Juan A, Jara-Sanchez C, Jimeno MA, Rosado P, Diaz Pena E, Guillem V, Carrasco EM, Perez-Gomez B, Vioque J, Martin M. Breast cancer risk among women following lifestyle recommendations: A case-control study in Spain. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Marina Pollán
- National Center of Epidemiology, Instituto Salud Carlos III, Madrid, Spain
| | - Adela Castello
- Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo Ruiz
- Instituto Valenciano de Oncología, Valencia, Spain
| | - Ana Casas
- Hospital Universitario Virgen Del Rocio, Sevilla, Spain
| | | | | | - Silvia Antolín
- Medical Oncology, Complejo Hospitalario Universitario a Coruña, A Coruña, Spain
| | | | | | - Ana Lluch
- Hospital Clínico de Valencia - INCLIVA Health Research Institute, University of Valencia., Valencia, Spain
| | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | | | | | | | | | | | - Beatriz Perez-Gomez
- Cancer Epidemiology Unit, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Jesus Vioque
- Department of Public Health, Universidad Miguel Hernandez, Sant Joan D'Alacant, Spain
| | - Miguel Martin
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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15
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Ojeda B, Churruca CM, Romero I, Redondo A, Calvo E, Santaballa A, del Campo JM, Sebio A, Laínez N, Bover I, Romeo M, Caballero C, García-Martínez E, Martinez J, Herrero A, Sánchez AB, De Juan A, Hernando Polo S, Ruiz N, Poveda A. Early-stage ovarian cancer: Clinical outcome and analysis of prognostic factors—Results from a prospective registry of GEICO (Spanish Group for Ovarian Cancer Research). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.5582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Belen Ojeda
- GEICO and Hospital de la Santa Creu i Sant Pau, Department of Medical Oncology, Barcelona, Spain
| | | | - Ignacio Romero
- Area Clinica Oncologia Ginecológica. Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Elisa Calvo
- Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Ana Sebio
- Hospital de la Santa Creu i Sant Pau, Medical Oncology Department, Barcelona, Spain
| | - Nuria Laínez
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Isabel Bover
- GEICO and Son Llatzer University Hospital, Mallorca, Spain
| | - Margarita Romeo
- Servicio de Oncologia Médica, Institut Català d'Oncologia (Hostal Germans Trias i Pujol), Badalona, Spain
| | | | | | | | | | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | - Nuria Ruiz
- Hospital Provincial de Castellón, Castellon, Spain
| | - Andres Poveda
- Area Clínica Oncología Ginecológica. Instituto Valenciano de Oncologia, Valencia, Spain
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16
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Freire J, Garcia-Berbel L, Dominguez-Hormaetxe S, Pereda S, De Juan A, Hens A, Fernandez Montes A, Simon L, Gomez-Roman J. Pro-COL11A1: A biomarker to predict malignant relapse of breast intraductal papillomas. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.540] [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
540 Background: Breast cancer is currently the most frequent tumor among women. Despite the huge progress achieved in its early diagnosis, there are still many unsolved clinical issues, being the diagnosis, prognosis and treatment of papillary diseases (and specifically intraductal papilloma), one of the highest challenges. Because of its unpredictable clinical behavior, treatment of intraductal papilloma has generated a great controversy. Even though considered as a benign lesion, it presents high rate of malignant recurrence. This is the reason why there are clinicians supporting a complete excision of the papillary lesion, while others support an only expectant follow up. Previous results of our group have suggested that pro-Collagen 11 alpha 1 (pro-COL11A1) expression in cancer associated fibroblasts (CAFs) correlates with an infiltrating phenotype in breast lesions. We have analyzed the correlation between the differential expression of pro-COL11A1 in intraductal papilloma and their risk of malignant recurrence. Methods: Immunohistochemistry of pro-COL11A1 (clone 1E8.33, ONCOMATRIX, Bilbao, SPAIN) was performed in formalin fixed, paraffin embedded Core Needle Biopsy samples of 51 patients with intraductal papilloma. All patients had a minimum follow-up of 5 years. Results: Twenty-three out of 51 cases showed positive staining for COL11A1. Nine patients out of the positive cases relapsed as infiltrating carcinoma, two as intraductal papilloma and the rest had not recurred after five years of follow up. Only one case out of the 28 negative cases relapsed as invasive carcinoma. There were significant differences (p=0.0013) when comparing staining of individuals with malignant recurrence versus non recurrence and benign relapse patients, with a sensitivity of 90% and specificity of 66%. Conclusions: These data suggest that COL11A1 expression in CAFs is a highly sensitive biomarker to predict malignant relapse of intraductal papilloma. The low specificity might be biased by the complete excision of this lesion as the routine treatment or by a short follow-up of the patients.
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Affiliation(s)
- Javier Freire
- Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain
| | | | | | - Saray Pereda
- Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain
| | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | - Angela Hens
- Hospital Universitario de Puerto Real, Cádiz, Spain
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Garcia del Muro X, Maurel J, Martinez Trufero J, Lavernia J, Lopez-Pousa A, De Las Penas R, Cubedo R, Fra J, Casado A, De Juan A, Jimenez Colomo L, Martin Broto J. Phase II trial of ifosfamide in combination with sorafenib in patients with advanced soft tissue sarcoma: A Spanish Group for Research on Sarcomas (GEIS) study. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.10523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
10523 Background: Recent studies suggest that VEGFR inhibition could play a role in the treatment of soft tissue sarcoma (STS). Prior studies by our group showed that the combination of ifosfamide with sorafenib resulted in preclinical additive activity and that was feasible and safe in the phase I trial. Methods: Patients (pts) with advanced STS, previously treated with doxorubicin, no prior ifosfamide, ECOG PS 0-2, and adequate hematological, renal and hepatic function, were enrolled in this multicenter phase II study, receiving sorafenib 400 mg bid po continuously and ifosfamide 2 g/m2 iv for 3 days together with mesna 400 mg/m2 every 3 weeks. The primary endpoint was progression-free rate (PFR) at 3 months. A one-sample binomial design was used (PFR P0=40%, P1=60%, α=0.10, β=0.20), requiring at least 19 of 35 pts free of progression at 3 months to be considered positive. Results: From September 09 to March 12, 35 pts were enrolled at 11 centers. Median age was 55 (18-73). PS: 0-13, 1-18; 2-4 pts. Histologic types were: LMS 12, Lipo 6, SS 5, MPNST 2, other 10 pts. . The median number of cycles administered per patient was 4. PFR at 3 months was 67%, with 23 pts being free of progression at 3 months. Median progression-free survival was 4.8 months (95% CI, 1.9-6.3) and median overall survival was 16.2 months. PR was achieved in 17% pts. Most common grade 3-4 toxicities were asthenia (25%), hand-foot syndrome (11%) and neutropenia (20%) resulting in 3 episodes of neutropenic fever. Other common toxicities (G1-4) included emesis (34%), rash (22%), diarrhea (34%), hypertension (11%) and mucositis (9%). Conclusions: The combination of ifosfamide and sorafenib is active and has acceptable toxicity in pts with doxorubicin pretreated STS. The PFR at 3 months might exceed the expected with ifosfamide alone warranting further investigation. Clinical trial information: EudraCT: 2007-002176-34.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
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Martin Broto J, Lopez-Pousa A, Ramos R, Gronchi A, Casali PG, Gutierrez A, Picci P, Ferrari S, Cruz J, Luna Fra P, Casado A, Cubedo R, Lasso R, Poveda A, De Juan A, Balana C, Calabuig S, Obrador A, Lopez-Guerrero JA. Relationship of CUL4A gene underexpression and prognosis in localized high-risk soft tissue sarcoma (STS) patients of limbs or trunk wall. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.10079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
10079 Background: Genes involved in cell cycle checkpoints and chromosome stability seem to be relevant in distant metastases appearance in STS. CUL4A is an E3 ubiquitin ligase that has been related to both p16 activation and maintenance of genomic stability. Expression of CUL4A has been scarcely described in some tumors with divergent outcome and there are no publications regarding its expression in STS patients. We previously showed that protein underexpression of CUL4A in metastatic STS was related to poor survival. Methods: The expression level of CUL4A was determined by quantitative qPCR and was retrospectively performed in a subset of 39 high-risk (grade 3, deep tumours and > than 5 cm) localized STS of limbs or trunk wall patients for which histological material and clinical data were available. Patients of this series were enrolled prospectively into a randomized clinical trial conducted by the Italian and Spanish sarcoma groups (ISG-GEIS 0101) comparing 3 vs 5 cycles of epirrubicin and ifosfamide. Differences in PFS, RFS, and OS were calculated using log-rank test Results: The median age was 51 years with a median follow-up of 52 months. The pathologic subtypes were undifferentiated pleomorphic sarcoma (35.3%), synovial sarcoma (23.5%) and mixed subtypes (41.2%). Location was distributed as inferior limbs (66.6%), upper limbs (25.5%) and trunk wall (7.9%). No relationship was seen between CUL4A expression and clinical variables (histologic types, location, size or response to neoadjuvant treatment). The expression level of CUL4A was significantly associated with events of progression, 65% vs 32%, p =0.037, for expression values under and over the median respectively. Regarding 4 y actuarial survival, there was a significant worse PFS and RFS for patients underexpressing CUL4A (p=0.041 and 0.009 respectively) and a trend towards worse OS (p=0.056). Conclusions: Expression of CUL4A gene shows a prognostic role in sarcomas within this high risk localized subset of STS patients. The outcome of this exploratory analysis is aligned with our hypothesis that genes implicated in cell cycle regulation and chromosome stability could play a relevant prognostic role in STS.
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Affiliation(s)
| | | | - Rafael Ramos
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | | | | | | | | | - Josefina Cruz
- Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Pablo Luna Fra
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | | | | | - Andres Poveda
- Area Clínica Oncología Ginecológica. Instituto Valenciano de Oncologia, Valencia, Spain
| | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | - Carmen Balana
- Institut Catala d'Oncologia Badalona, Barcelona, Spain
| | - Silvia Calabuig
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Antonia Obrador
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
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Lopez-Vega JM, Calvo EG, Plazaola A, Morales S, Hernando B, Gomez RMS, Alvarez I, Anton A, Illarramendi JJ, De Juan A, Martinez P, Lahuerta A, Llombart Cussac A, Garcia Gonzalez M, Lao J, Boni V, Puertolas T, Sherer S, Sabariz L, Garcia-Foncillas J. Activation of angiogenic pathway in the prediction of pathologic response to bevacizumab-based neoadjuvant therapy in breast cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.10595] [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
10595 Background: To evaluate potential biomarkers of pathological response to bevacizumab-based neoadjuvant therapy in untreated breast cancers (BC) patients recruited in a phase II, multicenter clinical trial. Methods: Patients received a single infusion of bevacizumab (15 mg/ kg) (C1) 3 weeks prior to the beginning of neoadjuvant chemotherapy (NAC) consisting in 4 cycles of docetaxel (60 mg/mq), doxorubicin (50 mg/mq) and bevacizumab (15 mg/ kg) every 21 days (C2-C5) following by surgery. Biomarker expression was assessed by immunohistochemistry (Ki67, CD31, CD31/Ki67, VEGFR2, pVEGFR2 [Y951]) before and after bevacizumab infusion (C1). Gene expression was analyzed using Affimetrix Human Gene ST 1.0. Results: This analysis was performed on 73 patients (49 yr, range 29-70). Twenty (27%) patients obtained best response (G4-G5) whether 50 (68%) were considered as no responder (G1-G2-G3). Response was associated with negative estrogen receptors expression (p=0.02) and high Ki67 basal and after C1 expression (p=0.009 and p=0.01). Six (54%) of the triple negative tumors were responders (p=0.05). Interestingly, change in pVEGFR2 [Y951] staining induced by bevacizumab administration was found significantly associated with response (p=0.0). Decrease in the phosphorilation status of VEGFR2 (Y951) >70% yielded a receiver operating characteristic (ROC) curve area of 0.681 (95% CI: 0.536 - 0.825) with 84% sensitivity and 95% specificity. The positive and negative predictive values for this marker were 60% and 64%, respectively. The change in phosphorilation status of VEGFR2p remains a significant predictor biomarker of response in multivariate analysis (OR=0.9, IC%95 0.96-0.99, p=0.04) after adjusting for clinical-pathological characteristics. Conclusions: These findings suggest the role of the phosphorilation status of VEGFR2 as predictive biomarkers of pathological response to bevacizumab in neoadjuvant setting in breast cancer.
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Affiliation(s)
| | | | | | - Serafin Morales
- Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | | | | | | | - Antonio Anton
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | | | | | | | - Juan Lao
- Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Teresa Puertolas
- Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Garcia-Foncillas J, Martinez P, Lahuerta A, Llombart Cussac A, Garcia Gonzalez M, Gomez RMS, Alvarez I, Anton A, Illarramendi JJ, De Juan A, Calvo EG, Plazaola A, Morales S, Hernando B, Lao J, Boni V, Puertolas T, Sherer S, Palacios G, Lopez-Vega JM. Dynamic contrast-enhanced MRI versus 18F-misonidazol-PET/CT to predict pathologic response in bevacizumab-based neoadjuvant therapy in breast cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.10512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
10512 Background: To investigate the role of DCE-MRI versus 18F-Misonidazole (FMISO) positron emission tomography (PET/CT) in the prediction of pathological response to bevacizumab-based neodajuvant therapy. Methods: 73 chemotherapy naïve, stage II and III breast cancer (BC) patients (pts) were enrolled in a phase II, single-arm, multicenter, open-label and prospective clinical trial. Pts received single infusion of bevacizumab (15 mg/ kg) (C1) 3 weeks prior to the beginning of neoadjuvant chemotherapy (NAC) consisting of 4 cycles of docetaxel (60 mg/mq), doxorubicin (50 mg/mq) and bevacizumab (15 mg/ kg) every 21 days (C2-C5), followed by surgery. Tumor proliferation, hypoxia and perfusion were evaluated respectively using 18F-Fluorothymidine (FLT) and 18F-Misonidazole (FMISO) positron emission tomography (PET/CT) and dynamic contrast enhancement magnetic resonance (DCE-MR). Serial imaging studies were performed in parallel at several time points including baseline (BL) and 14-21 days after bevacizumab alone (C1). Results: After only one administration of bev, tumor proliferation and perfusion assessed using FLT-PET and DCE-MRI significantly decrease (-26% and -46%, p<0.001) but these changes were not found to be associated with final response. Most important, changes in tumor hypoxia induced by bevacizumab was significantly associated with pathological response (p= 0.004) and was an independent predictor of response in multivariate analysis (RR=0.95, IC 95% 0.92-0.99, p=0.02). Decrease in FMISO uptake >10% yielded a ROC curve area of 0.7 (95% CI: 0.56 - 0.85) with high specificity (94%). Conclusions: Our findings suggest a significant value of early changes in tumor hypoxia assessed by FMISO-PET as a biomarker of pathological response in bevacizumab-based neoadjuvant therapy in breast cancer.
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Affiliation(s)
- Jesus Garcia-Foncillas
- Oncology Department, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | | | | | | | - Antonio Anton
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Ana De Juan
- Hospital Marques de Valdecilla, Santander, Spain
| | | | | | - Serafin Morales
- Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | | | - Juan Lao
- Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Teresa Puertolas
- Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza, Spain
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García-Del-Muro X, López-Pousa A, Maurel J, Martín J, Martínez-Trufero J, Casado A, Gómez-España A, Fra J, Cruz J, Poveda A, Meana A, Pericay C, Cubedo R, Rubió J, De Juan A, Laínez N, Carrasco JA, de Andrés R, Buesa JM. Randomized phase II study comparing gemcitabine plus dacarbazine versus dacarbazine alone in patients with previously treated soft tissue sarcoma: a Spanish Group for Research on Sarcomas study. J Clin Oncol 2011; 29:2528-33. [PMID: 21606430 DOI: 10.1200/jco.2010.33.6107] [Citation(s) in RCA: 192] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To assess the activity and toxicity of the combination of gemcitabine plus dacarbazine (DTIC) in patients with advanced soft tissue sarcoma (STS) in a randomized, multicenter, phase II study using DTIC alone as a control arm. PATIENTS AND METHODS Patients with previously treated advanced STS were randomly assigned to receive either fixed-dose rate gemcitabine (10 mg/m2/min) at 1800 mg/m2 followed by DTIC at 500 mg/m2 every 2 weeks, or DTIC alone at 1200 mg/m2 every 3 weeks. The primary end point of the study was progression-free rate (PFR) at 3 months. RESULTS From November 2005 to September 2008, 113 patients were included. PFR at 3 months was 56% for gemcitabine plus DTIC versus 37% for DTIC alone (P = .001). Median progression-free survival was 4.2 months versus 2 months (hazard ratio [HR], 0.58; 95% CI, 0.39 to 0.86; P = .005), and median overall survival was 16.8 months versus 8.2 months (HR, 0.56; 95% CI, 0.36 to 0.90; P = .014); both favored the arm of gemcitabine plus DTIC. Gemcitabine plus DTIC was also associated with a higher objective response or higher stable disease rate than was DTIC alone (49% v 25%; P = .009). Severe toxicities were uncommon, and treatment discontinuation for toxicity was rare. Granulocytopenia was the more common serious adverse event, but febrile neutropenia was uncommon. Asthenia, emesis, and stomatitis were the most frequent nonhematologic effects. CONCLUSION The combination of gemcitabine and DTIC is active and well tolerated in patients with STS, providing in this phase II randomized trial superior progression-free survival and overall survival than DTIC alone. This regimen constitutes a valuable therapeutic alternative for these patients.
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Affiliation(s)
- Xavier García-Del-Muro
- Sarcoma Multidisciplinary Unit, Institut Català d'Oncologia L'Hospitalet, Avda Gran Via Km 2.7. 08907 L'Hospitalet. Barcelona, Spain.
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22
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Benito P, García J, De Juan A, Alcazar JA, Elena E, Cano M. Reconstruction of a perianal defect by means of a bilateral V-Y advancement flap based on the perforating arteries of the gluteus maximus shaped over a cicatricial area. J Plast Reconstr Aesthet Surg 2009; 62:412-4. [DOI: 10.1016/j.bjps.2008.05.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 05/07/2008] [Accepted: 05/23/2008] [Indexed: 11/30/2022]
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Arranz López JL, García L, Elena E, Benito P, De Juan A. Unilateral dichotomy of nipple (intraareolar polythelia) and areola: report of a case and surgical correction. Aesthetic Plast Surg 2006; 30:494-6. [PMID: 16786204 DOI: 10.1007/s00266-005-0188-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
An unusual case of intraareolar polythelia with two nipples is presented. The dichotomy affected not only the nipple, but also the areola. No other breast malformation existed. Surgical correction was performed by transposition flaps sutured to one another in the center of the areola. The anatomic and functional results were satisfactory.
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Affiliation(s)
- José L Arranz López
- Department of Plastic Surgery, Hospital Universitario de Salamanca, Salamanca, Spain.
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24
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Martín J, Poveda A, Llombart-Bosch A, Ramos R, López-Guerrero JA, García del Muro J, Maurel J, Calabuig S, Gutierrez A, González de Sande JL, Martínez J, De Juan A, Laínez N, Losa F, Alija V, Escudero P, Casado A, García P, García P, Blanco R, Buesa JM. Deletions affecting codons 557-558 of the c-KIT gene indicate a poor prognosis in patients with completely resected gastrointestinal stromal tumors: a study by the Spanish Group for Sarcoma Research (GEIS). J Clin Oncol 2005; 23:6190-8. [PMID: 16135486 DOI: 10.1200/jco.2005.19.554] [Citation(s) in RCA: 292] [Impact Index Per Article: 15.4] [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: 12/15/2022] Open
Abstract
PURPOSE To explore the prognostic value of mutations in c-KIT and PDGFR-alpha genes with respect to relapse-free survival (RFS) in patients with gastrointestinal stromal tumors (GIST). We have investigated the prognostic relevance of the type and position of the mutations, in addition to other clinicopathologic factors, in a large series of patients with GIST. METHODS For this study, 162 patients were selected according to the following criteria: completely resected tumors with negative margins attended between 1994 and 2001; no metastasis at diagnosis; tumor larger than 2 cm, c-KIT-positive immunostaining; and no other primary tumors. RESULTS The median follow-up was 42 months for patients free of recurrence. Mutations were detected in 96 tumors (60%): 82 cases involving c-KIT and 14 cases involving PDFGR-alpha. Univariate analysis demonstrated the following as poor prognostic factors for RFS: tumors larger than 10 cm (P < .0001); mitotic count higher than 10 mitoses per 50 high-power fields (P < .0001); high risk index (P < .0001); intestinal GIST location (P = .0041); high cellularity (P < .0001); tumor necrosis (P < .0001); deletions affecting exon 11 (P = .0007); and deletions affecting codons 557 to 558 (P < .0001). After the multivariate analysis, only the high risk index (relative risk [RR], 12.36), high cellularity (RR, 3.97), and deletions affecting codons 557 to 558 of c-KIT (RR, 2.57) corresponded to independent prognostic factors for RFS in GIST patients. CONCLUSION Deletions affecting codons 557 to 558 are relevant for the prognosis of RFS in GIST patients. This critical genetic alteration should be considered to be a new prognostic stratification variable for randomized trials exploring imatinib mesylate in the adjuvant setting in GIST patients.
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Affiliation(s)
- Javier Martín
- Department of Oncology, Hospital Universitario de Son Dureta, C/Andrea Doria 55, 07014 Palma de Mallorca (Baleares), Spain.
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Real PJ, Sierra A, De Juan A, Segovia JC, Lopez-Vega JM, Fernandez-Luna JL. Resistance to chemotherapy via Stat3-dependent overexpression of Bcl-2 in metastatic breast cancer cells. Oncogene 2002; 21:7611-8. [PMID: 12400004 DOI: 10.1038/sj.onc.1206004] [Citation(s) in RCA: 231] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2002] [Revised: 08/05/2002] [Accepted: 08/30/2002] [Indexed: 11/09/2022]
Abstract
Disruption of apoptosis may allow metastatic cell survival and confer resistance to chemotherapeutic drugs. We have analysed the molecular pathways that activate these survival genes in specific sites of metastasis. Estrogen receptor-negative breast cancer cell line MDA-MB435 and two metastatic sublines derived from lung (435L) and brain (435B) were analysed for the expression of members of the Bcl-2 family of apoptosis regulators. The levels of Bcl-2 were higher in the metastatic sublines than in parental cells, which correlated with the activation of Stat3, but not with the expression and/or activation of known bcl-2 transcription factors (CREB and WT1). In the brain subline, both expression of Bcl-2 and Stat3 activation were induced by epidermal growth factor and abrogated after treatment with kinase inhibitors specific for epidermal growth factor receptor or Jak2. Furthermore, transfection of 435B with a dominant-negative Stat3 markedly reduced the expression of Bcl-2 protein, whereas transient expression of a constitutively active Stat3 increased Bcl-2 in parental 435 cells. In addition, blockade of Stat3 activation by treatment with epidermal growth factor receptor and Jak2 kinase inhibitors or transfection with a dominant negative Stat3, sensitizes 435B cells to chemotherapy-induced apoptosis. Our data suggest that an increased activation of the Stat3-Bcl-2 pathway in estrogen receptor-negative metastatic breast cancer cell lines confer a survival advantage to these cells and contribute to their chemoresistance.
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Affiliation(s)
- Pedro J Real
- Unidad de Genetica Molecular, Hospital Universitario Marques de Valdecilla, 39008 Santander, Spain
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