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Serra-Aracil X, Pericay C. Reply to the Letter to the Editor 'The role of chemoradiotherapy in organ preservation for rectal cancer' by L. Xie, Q. Chen, and J. Zhu. Ann Oncol 2023; 34:440-442. [PMID: 37061250 DOI: 10.1016/j.annonc.2022.12.011] [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] [Received: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 04/17/2023] Open
Affiliation(s)
- X Serra-Aracil
- Coloproctology Unit, Parc Tauli University Hospital, Sabadell, Institut d'investigació i innovació Parc Tauli I3PT, Department of Surgery, Universitat Autònoma de Barcelona, Barcelona.
| | - C Pericay
- Medical Oncology Department, Mutua de Terrassa University Hospital, Terrassa, Barcelona, Spain
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Serra-Aracil X, Pericay C, Badia-Closa J, Golda T, Biondo S, Hernández P, Targarona E, Borda-Arrizabalaga N, Reina A, Delgado S, Vallribera F, Caro A, Gallego-Plazas J, Pascual M, Álvarez-Laso C, Guadalajara-Labajo HG, Mora-Lopez L. Short-term outcomes of chemoradiotherapy and local excision versus total mesorectal excision in T2-T3ab,N0,M0 rectal cancer: a multicentre randomised, controlled, phase III trial (the TAU-TEM study). Ann Oncol 2023; 34:78-90. [PMID: 36220461 DOI: 10.1016/j.annonc.2022.09.160] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The standard treatment of T2-T3ab,N0,M0 rectal cancers is total mesorectal excision (TME) due to the high recurrence rates recorded with local excision. Initial reports of the combination of pre-operative chemoradiotherapy (CRT) and transanal endoscopic microsurgery (TEM) have shown reductions in local recurrence. The TAU-TEM study aims to demonstrate the non-inferiority of local recurrence and the improvement in morbidity achieved with CRT-TEM compared with TME. Here we describe morbidity rates and pathological outcomes. PATIENTS AND METHODS This was a prospective, multicentre, randomised controlled non-inferiority trial including patients with rectal adenocarcinoma staged as T2-T3ab,N0,M0. Patients were randomised to the CRT-TEM or the TME group. Patients included, tolerance of CRT and its adverse effects, surgical complications (Clavien-Dindo and Comprehensive Complication Index classifications) and pathological results (complete response in the CRT-TEM group) were recorded in both groups. Patients attended follow-up controls for local and systemic relapse. TRIAL REGISTRATION NCT01308190. RESULTS From July 2010 to October 2021, 173 patients from 17 Spanish hospitals were included (CRT-TEM: 86, TME: 87). Eleven were excluded after randomisation (CRT-TEM: 5, TME: 6). Modified intention-to-treat analysis thus included 81 patients in each group. There was no mortality after CRT. In the CRT-TEM group, one patient abandoned CRT, 1/81 (1.2%). The CRT-related morbidity rate was 29.6% (24/81). Post-operative morbidity was 17/82 (20.7%) in the CRT-TEM group and 41/81 (50.6%) in the TME group (P < 0.001, 95% confidence interval 42.9% to 16.7%). One patient died in each group (1.2%). Of the 81 patients in the CRT-TEM group who received the allocated treatment, 67 (82.7%) underwent organ preservation. Pathological complete response in the CRT-TEM group was 44.3% (35/79). In the TME group, pN1 were found in 17/81 (21%). CONCLUSION CRT-TEM treatment obtains high pathological complete response rates (44.3%) and a high CRT compliance rate (98.8%). Post-operative complications and hospitalisation rates were significantly lower than those in the TME group. We await the results of the follow-up regarding cancer outcomes and quality of life.
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Affiliation(s)
- X Serra-Aracil
- Coloproctology Unit, Parc Tauli University Hospital, Sabadell, Institut d'investigació i innovació Parc Tauli I3PT, Department of Surgery, Universitat Autònoma de Barcelona, Barcelona.
| | - C Pericay
- Medical Oncology Department, Parc Tauli University Hospital, Sabadell, Institut d'investigació i innovació Parc Tauli I3PT, Barcelona
| | - J Badia-Closa
- Coloproctology Unit, Parc Tauli University Hospital, Sabadell, Institut d'investigació i innovació Parc Tauli I3PT, Department of Surgery, Universitat Autònoma de Barcelona, Barcelona
| | - T Golda
- Colorectal Unit, General and Digestive Surgery Department, Bellvitge University Hospital, Barcelona
| | - S Biondo
- Colorectal Unit, General and Digestive Surgery Department, Bellvitge University Hospital, Barcelona
| | - P Hernández
- Colorectal Unit, General and Digestive Surgery Department, Santa Creu i Sant Pau University Hospital, Barcelona
| | - E Targarona
- Colorectal Unit, General and Digestive Surgery Department, Santa Creu i Sant Pau University Hospital, Barcelona
| | - N Borda-Arrizabalaga
- Servicio de Cirugía General y Digestiva, Hospital Universitario Donostia, Donostia, Gipuzkoa
| | - A Reina
- Unidad de Cirugía Colorrectal, Unidad de Gestión Clínica Cirugía y Area de Gestión Norte de Almería, Complejo Hospitalario Torrecárdenas, Almería
| | - S Delgado
- Colorectal Unit, General and Digestive Surgery Department, Mutua de Terrassa University Hospital, Terrassa, Barcelona
| | - F Vallribera
- Colorectal Unit, General and Digestive Surgery Department, Vall d'Hebron University Hospital, Departamento de Cirugía, Universitat Autònoma de Barcelona, Barcelona
| | - A Caro
- Colorectal Unit, General and Digestive Surgery Department, Joan XXIII University Hospital, Tarragona
| | - J Gallego-Plazas
- Medical Oncology, Hospital General Universitario de Elche (Alicante), Alicante
| | - M Pascual
- Colorectal Unit, General and Digestive Surgery Department, Del Mar University Hospital, Barcelona
| | - C Álvarez-Laso
- Colorectal Unit, General and Digestive Surgery Department, Hospital Universitario de Cabueñes, Gijón
| | - H G Guadalajara-Labajo
- Colorectal Unit, General and Digestive Surgery Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - L Mora-Lopez
- Coloproctology Unit, Parc Tauli University Hospital, Sabadell, Institut d'investigació i innovació Parc Tauli I3PT, Department of Surgery, Universitat Autònoma de Barcelona, Barcelona
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Fonseca PJ, La Salvia A, Capdevila J, Castaño A, Benavent M, Alonso-Orduna V, Alonso T, Canovas MS, Custodio A, Centeno RG, Llanos M, Crespo G, Lopez de Sa A, Teule A, Fernández LO, Torres I, Plazas JG, Pericay C, Villabona C, López C. 1159MO Survival and prognostic factors analysis of 535 grade 3 gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN): Data from the Spanish Taskforce of Neuroendocrine Tumours Registry (R-GETNE). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Martínez Vila C, Oliveres Montero de Novoa H, Martínez-Bauer E, Serra-Aracil X, Mora L, Casalots-Casado A, Macías-Declara I, Pericay C. A real world analysis of recurrence risk factors for early colorectal cancer T1 treated with standard endoscopic resection. Int J Colorectal Dis 2020; 35:921-927. [PMID: 32146501 DOI: 10.1007/s00384-020-03553-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND STUDY AIM Currently, endoscopic resection of early colorectal cancer defined as carcinoma with limited invasion of the mucosa (Tis) and submucosa (T1) is possible. However, lymph node spreading increases to 16.2% of cases when tumor invades the submucosa. We analyzed the previously identified factors for lymph node dissemination and recurrence, in our population. PATIENTS AND METHODS We analyzed retrospectively all patients with T1 tumors, treated at our center with endoscopic resection and some with additional surgery between January 2006 and January 2018. Statistical analysis was performed using IBM SPSS Statistics 25.0. RESULTS One hundred fifty-nine patients were treated with endoscopic resection, 56.6% with additional surgery. The mean age was 68.74 years and 69. 9% were male. All patients who underwent additional surgery presented negative margins and 8.8% presented positive lymph nodes. In a mean follow-up of 23.36 months, 13 patients had relapsed. The risk of relapse did not differ between patients treated with additional surgery from those who only underwent endoscopic resection (p = 0.506). On the other hand, lymph node dissemination (p = 0.007) and a positive endoscopic margin (p = 0.01) were independent risk factors for relapse. There was a positive association between lymph node dissemination and lymphatic (p = 0.07), vascular (p = 0.007), and perineural (p = 0.001) invasion and also with degree of histological differentiation (p = 0.001). CONCLUSION In our study, lymphatic, vascular, and perineural invasion and also the degree of histological differentiation were associated with lymph node dissemination. However, the only independent risk factors for long-term recurrence were a positive margin and lymph node dissemination.
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Affiliation(s)
- C Martínez Vila
- Department of Medical Oncology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - H Oliveres Montero de Novoa
- Department of Medical Oncology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - E Martínez-Bauer
- Department of Digestology-Endoscopy, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - X Serra-Aracil
- Department of Surgery, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - L Mora
- Department of Surgery, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - A Casalots-Casado
- Department of Pathology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - I Macías-Declara
- Department of Medical Oncology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - C Pericay
- Department of Medical Oncology, Corporació Sanitària Parc Taulí Sabadell, Parc del Taulí 1, 08208, Sabadell, Barcelona, Spain.
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Velasco AG, Macarulla T, Sánchez CB, Martín M, García C, Pericay C, Merino S, Visa L, Martín T, Pedraza M, Carnero B, Guardeño R, Pellín L, Vilanova D, Laquente B. Quality of life of patients with metastatic pancreatic adenocarcinoma initiating first‐line chemotherapy in routine practice. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pericay C, Gallego J, Montes AF, Oliveres H, Asensio-Martínez H, Garcia-Gómez J, Fernandez-Plana J, Marín-Alcalá M, Ballester-Espinosa M, Salgado M, Declara IM, Gómez-González L, Iglesias-Rey L, Cirera L. Real world data in colorectal cancer: A retrospective analysis of overall survival in metastatic colorectal cancer patients between 2011-2015 treated in Spain, preliminary results (RWD-ACROSS study). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Serra-Aracil X, Pericay C, Golda T, Mora L, Targarona E, Delgado S, Reina A, Vallribera F, Enriquez-Navascues JM, Serra-Pla S, Garcia-Pacheco JC. Non-inferiority multicenter prospective randomized controlled study of rectal cancer T 2-T 3s (superficial) N 0, M 0 undergoing neoadjuvant treatment and local excision (TEM) vs total mesorectal excision (TME). Int J Colorectal Dis 2018; 33:241-249. [PMID: 29234923 DOI: 10.1007/s00384-017-2942-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival. The TAU-TEM study aims to demonstrate the non-inferiority of the oncological outcomes and the improvement in morbidity and quality of life achieved with TEM compared with TME. METHODS Prospective, multicenter, randomized controlled non-inferiority trial includes patients with rectal adenocarcinoma less than 10 cm from the anal verge and up to 4 cm in size, staged as T2 or T3-superficial N0-M0. Patients will be randomized to two areas: CRT plus TEM or radical surgery (TME). Postoperative morbidity and mortality will be recorded and patients will complete the quality of life questionnaires before the start of treatment, after CRT in the CRT/TEM arm, and 6 months after surgery in both arms. The estimated sample size for the study is 173 patients. Patients will attend follow-up controls for local and systemic relapse. CONCLUSIONS This study aims to demonstrate the preservation of the rectum after preoperative CRT and TEM in rectal cancer stages T2-3s, N0, M0 and to determine the ability of this strategy to avoid the need for radical surgery (TME). TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01308190. Número de registro del Comité de Etica e Investigación Clínica (CEIC) del Hospital universitario Parc Taulí: TAU-TEM-2009-01.
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Affiliation(s)
- X Serra-Aracil
- Coloproctology Unit, General and Digestive Surgery Department, Parc Tauli University Hospital, Universitat Autònoma de Barcelona, Parc Tauli s/n. 08208, Sabadell, Spain.
| | - C Pericay
- Medical Oncology Department, Parc Tauli University Hospital, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - T Golda
- Coloproctology Unit, General and Digestive Surgery Department, Bellvitge University Hospital, Barcelona, Spain
| | - L Mora
- Coloproctology Unit, General and Digestive Surgery Department, Parc Tauli University Hospital, Universitat Autònoma de Barcelona, Parc Tauli s/n. 08208, Sabadell, Spain
| | - E Targarona
- General and Digestive Surgery Department, Santa Creu and Sant Pau University Hospital, Barcelona, Spain
| | - S Delgado
- General and Digestive Surgery Department, Clinic University Hospital, Barcelona, Spain
| | - A Reina
- Coloproctology Unit, General and Digestive Surgery Department, Torrecardenas University Hospital, Almeria, Spain
| | - F Vallribera
- Coloproctology Unit, General and Digestive Surgery Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - S Serra-Pla
- Coloproctology Unit, General and Digestive Surgery Department, Parc Tauli University Hospital, Universitat Autònoma de Barcelona, Parc Tauli s/n. 08208, Sabadell, Spain
| | - J C Garcia-Pacheco
- Coloproctology Unit, General and Digestive Surgery Department, Parc Tauli University Hospital, Universitat Autònoma de Barcelona, Parc Tauli s/n. 08208, Sabadell, Spain
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Carmona-Bayonas A, Jiménez-Fonseca P, Custodio A, Sánchez Cánovas M, Hernández R, Pericay C, Echavarria I, Lacalle A, Visa L, Rodríguez Palomo A, Mangas M, Cano JM, Buxo E, Álvarez-Manceñido F, García T, Lorenzo JE, Ferrer-Cardona M, Viudez A, Azkarate A, Ramchandani A, Arias D, Longo F, López C, Sánchez Bayona R, Limón ML, Díaz-Serrano A, Fernández Montes A, Sala P, Cerdá P, Rivera F, Gallego J. Anthracycline-based triplets do not improve the efficacy of platinum-fluoropyrimidine doublets in first-line treatment of advanced gastric cancer: real-world data from the AGAMEMON National Cancer Registry. Gastric Cancer 2018; 21:96-105. [PMID: 28393278 DOI: 10.1007/s10120-017-0718-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/03/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although anthracycline-based triplets are one of the most widely used schedules to treat advanced gastric cancer (AGC), the benefit of including epirubicin in these therapeutic combinations remains unknown. This study aims to evaluate both the efficacy and tolerance of triplets with epirubicin vs. doublets with platinum-fluoropyrimidine in a national AGC registry. METHODS Patients with AGC treated with polychemotherapy without trastuzumab at 28 hospitals in Spain between 2008 and 2016 were included. The effect of anthracycline-based triplets against doublets was evaluated by propensity score matching (PSM) and Cox proportional hazards (PH) regression. RESULT A total of 1002 patients were included (doublets, n = 653; anthracycline-based triplets, n = 349). The multivariable Cox PH regression failed to detect significantly increased OS in favor of triplets with anthracyclines: HR 0.90 (95% CI, 0.78-1.05), p = 0.20035. After PSM, the sample contained 325 pairs with similar baseline characteristics. This method was also unable to reveal an increase in OS: 10.5 (95% CI, 9.7-12.3) vs. 9.9 (95% CI, 9.2-11.4) months, HR 0.91 (CI 95%, 0.76-1.083), and (log-rank test, p = 0.226). Response rates (42.1 vs. 33.1%, p = 0.12) and PFS (HR 0.95, CI 95%, 0.80-1.13, log-rank test, p = 0.873) were not significantly higher with epirubicin-based regimens. The triplets were associated with greater grade 3-4 hematological toxicity, and increased hospitalization due to toxicity by 68%. The addition of epirubicin is viable, but 23.7% discontinued treatment because of adverse effects or patient decision. CONCLUSION Anthracyclines added to platinum-fluoropyrimidine doublets did not improve the response rate or survival outcomes in patients with AGC but entailed greater toxicity.
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Affiliation(s)
- A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, IMIB, Avenida Marqués de los Vélez, 30008, Murcia, Spain.
| | - P Jiménez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - M Sánchez Cánovas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, IMIB, Avenida Marqués de los Vélez, 30008, Murcia, Spain
| | - R Hernández
- Medical Oncology Department, Hospital Universitario de Canarias, Tenerife, Spain
| | - C Pericay
- Medical Oncology Department, Corporació Sanitària Parc Taulí , Sabadell, Spain
| | - I Echavarria
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - A Lacalle
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - L Visa
- Medical Oncology Department, Hospital Universitario Del Mar, Barcelona, Spain
| | - A Rodríguez Palomo
- Pharmacy Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - M Mangas
- Medical Oncology Department, Hospital Galdakao-Usansolo, Galdakao-Usansolo, Spain
| | - J M Cano
- Medical Oncology Department, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - E Buxo
- Medical Oncology Department, Hospital Universitario Clinic, Barcelona, Spain
| | - F Álvarez-Manceñido
- Pharmacy Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - T García
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, IMIB, Avenida Marqués de los Vélez, 30008, Murcia, Spain
| | - J E Lorenzo
- Medical Oncology Department, Hospital Universitario de Canarias, Tenerife, Spain
| | - M Ferrer-Cardona
- Medical Oncology Department, Corporació Sanitària Parc Taulí , Sabadell, Spain
| | - A Viudez
- Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - A Azkarate
- Medical Oncology Department, Hospital Universitario Son Espases, Mallorca, Spain
| | - A Ramchandani
- Medical Oncology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - D Arias
- Medical Oncology Department, Complejo Hospitalario de Orense, Orense, Spain
| | - F Longo
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - C López
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - R Sánchez Bayona
- Medical Oncology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - M L Limón
- Medical Oncology Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - A Díaz-Serrano
- Medical Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - A Fernández Montes
- Medical Oncology Department, Complejo Hospitalario de Orense, Orense, Spain
| | - P Sala
- Medical Oncology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - P Cerdá
- Medical Oncology Department, Clínica Tecknon de Barcelona, Barcelona, Spain
| | - F Rivera
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - J Gallego
- Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain
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Patel UB, Brown G, Machado I, Santos-Cores J, Pericay C, Ballesteros E, Salud A, Isabel-Gil M, Montagut C, Maurel J, Ramón-Ayuso J, Martin N, Estevan R, Fernandez-Martos C. MRI assessment and outcomes in patients receiving neoadjuvant chemotherapy only for primary rectal cancer: long-term results from the GEMCAD 0801 trial. Ann Oncol 2017; 28:344-353. [PMID: 28426108 DOI: 10.1093/annonc/mdw616] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Primary chemotherapy has been tested as a possible approach for patients with high risk features but predicted clear mesorectal margins on preoperative MRI assessment. This study investigates the prognostic relevance of baseline and post-treatment MRI and pathology staging in rectal cancer patients undergoing primary chemotherapy. Patients and methods Forty-six patients with T3 tumour > =2 mm from the mesorectal fascia were prospectively treated with Neoadjuvant Capecitabine, Oxaliplatin and Bevacizumab prior to surgery between 2009 and 2011. The baseline and post-treatment MRI: T, Nodal and Extra-mural venous invasion (EMVI) status were recorded as well as post-treatment MRI Tumour regression grade (TRG) and modified-RECIST assessment of tumour length. The post-treatment pathology (yp) assessments of T3 substage, N, EMVI and TRG status were also recorded. Three-year disease-free survival (DFS) and cumulative incidence of recurrence were estimated by using the Kaplan-Meier product-limit method, and Cox proportional hazards models were used to determine associations between staging and response on MRI and pathology with survival outcomes. Results About 46 patients underwent neoadjuvant chemotherapy alone for high risk margin safe primary rectal cancer. The median follow-up was 41 months, 5 patients died and 11 patients experienced relapse (2 local, 8 distant and 1 both). In total 23/46 patients were identified with MRI features of EMVI at baseline. mrEMVI positive status carried independent prognostic significance for DFS (P = 0.0097) with a hazard ratio of 31.33 (95% CI: 2.3-425.4). The histopathologic factor that was of independent prognostic importance was a final ypT downstage of ypT3a or less, hazard ratio: 14.0 (95% CI: 1.5-132.5). Conclusions mrEMVI is an independent prognostic factor at baseline for poor outcomes in rectal cancer treated with neoadjuvant chemotherapy while ≤ypT3a is associated with an improvement in DFS. Future preoperative therapy evaluation in rectal cancer patients will need to stratify treatment according to baseline EMVI status as a crucial risk factor for recurrence in patients with predicted CRM clear rectal cancer.
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Affiliation(s)
- U B Patel
- Radiology Department, London North-West Healthcare NHS Trust, London
| | - G Brown
- Radiology Department, The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - I Machado
- Department of Pathology, Valencia Institute of Oncology, Valencia, Spain
| | - J Santos-Cores
- Department of Radiology, Fundacion InstitutoValenciano de Oncologia, Valencia, Spain
| | - C Pericay
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - E Ballesteros
- Department of Radiology, Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
| | - A Salud
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - M Isabel-Gil
- Department of Radiology, Hospital Universitari Arnau de Vilanova, Lleida
| | - C Montagut
- Department of Medical Oncology Department, Hospital del Mar, Barcelona
| | - J Maurel
- Department of Medical Oncology, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona, Spain
| | - J Ramón-Ayuso
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona
| | - N Martin
- Department of Pivotal, Madrid, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | - R Estevan
- Department of Surgery, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | - C Fernandez-Martos
- Department of Medical Oncology, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
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Vera R, Gómez M, Ayuso J, Figueras J, Garcia-Alfonso P, Martinez V, Lacasta A, Ruiz A, Safont M, Aparicio J, Campos J, Cámara J, Martin M, Montagut C, Pericay C, Viéitez J, Falcó E, Jorge M, Marín Vera M, Salgado Fernandez M. Correlation between RECIST-criteria, morphologic response by CT and pathologic regression in hepatic metastasis secondary to colorectal cancer: The AVAMET study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Benavides M, Abad A, Carrato A, Gravalos C, Fernández-Montes A, Falcó E, González-Flores E, Garcia Garcia T, Martin-Valades J, Gallego Plazas J, Valladares-Ayerbes M, García-Girón C, Dueñas R, García-Tapiador A, Pericay C, Losa F, Viudez A, García-Teijido P, Diaz Rubio E, Aranda Aguilar E. Benefits of upfront primary tumour resection (UPTR) according to sidedness in mCRC: Retrospective analyses of TTD MACRO-2 and PLANET randomised trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gravalos C, Capdevila J, Layos L, Pericay C, Martínez-Villacampa M, López López C, Losa F, Safont M, Gómez-España A, Alonso V, Escudero P, Gallego J, García-Paredes B, Palacios A, Biondo S, Salazar R, Aranda Aguilar E. Phase II randomized trial of capecitabine + radiation therapy with/without bevacizumab as preoperative treatment for patients with resectable locally advanced rectal adenocarcinoma: Final results of 3 and 5-year disease free survival, distant relapse free survival and overall survival. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Custodio A, Carmona-Bayonas A, Jiménez-Fonseca P, Sánchez ML, Viudez A, Hernández R, Cano JM, Echavarria I, Pericay C, Mangas M, Visa L, Buxo E, García T, Rodríguez Palomo A, Álvarez Manceñido F, Lacalle A, Macias I, Azkarate A, Ramchandani A, Fernández Montes A, López C, Longo F, Sánchez Bayona R, Limón ML, Díaz-Serrano A, Hurtado A, Madero R, Gómez C, Gallego J. Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab. Br J Cancer 2017; 116:1526-1535. [PMID: 28463962 PMCID: PMC5518851 DOI: 10.1038/bjc.2017.122] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [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: 01/04/2017] [Revised: 03/14/2017] [Accepted: 04/10/2017] [Indexed: 12/20/2022] Open
Abstract
Background: To develop and validate a nomogram and web-based calculator to predict overall survival (OS) in Caucasian-advanced oesophagogastric adenocarcinoma (AOA) patients undergoing first-line combination chemotherapy. Methods: Nine hundred twenty-four AOA patients treated at 28 Spanish teaching hospitals from January 2008 to September 2014 were used as derivation cohort. The result of an adjusted-Cox proportional hazards regression was represented as a nomogram and web-based calculator. The model was validated in 502 prospectively recruited patients treated between October 2014 and December 2016. Harrell's c-index was used to evaluate discrimination. Results: The nomogram includes seven predictors associated with OS: HER2-positive tumours treated with trastuzumab, Eastern Cooperative Oncology Group performance status, number of metastatic sites, bone metastases, ascites, histological grade, and neutrophil-to-lymphocyte ratio. Median OS was 5.8 (95% confidence interval (CI), 4.5–6.6), 9.4 (95% CI, 8.5–10.6), and 14 months (95% CI, 11.8–16) for high-, intermediate-, and low-risk groups, respectively (P<0.001), in the derivation set and 4.6 (95% CI, 3.3–8.1), 12.7 (95% CI, 11.3–14.3), and 18.3 months (95% CI, 14.6–24.2) for high-, intermediate-, and low-risk groups, respectively (P<0.001), in the validation set. The nomogram is well-calibrated and reveals acceptable discriminatory capacity, with optimism-corrected c-indices of 0.618 (95% CI, 0.591–0.631) and 0.673 (95% CI, 0.636–0.709) in derivation and validation groups, respectively. The AGAMENON nomogram outperformed the Royal Marsden Hospital (c-index=0.583; P=0.00046) and Japan Clinical Oncology Group prognostic indices (c-index=0.611; P=0.03351). Conclusions: We developed and validated a straightforward model to predict survival in Caucasian AOA patients initiating first-line polychemotherapy. This model can contribute to inform clinical decision-making and optimise clinical trial design.
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Affiliation(s)
- A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid 28046, Spain
| | - A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Av Marqués de los Vélez, s/n, Murcia 30008, Spain
| | - P Jiménez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, Av. Roma, s/n, Oviedo 33011, Spain
| | - M L Sánchez
- Medical Oncology Department, MD Anderson Cancer Center, Calle de Arturo Soria, 270, Madrid 28033, Spain
| | - A Viudez
- Medical Oncology Department, Complejo Hospitalario de Navarra, Calle de Irunlarrea, 3, Pamplona 31008, Spain
| | - R Hernández
- Medical Oncology Department, Hospital Universitario de Canarias, Carretera de Ofra, s/n, San Cristóbal de La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - J M Cano
- Medical Oncology Department, Hospital General Universitario de Ciudad Real, Calle Obispo Rafael Torija, s/n, Ciudad Real 13005, Spain
| | - I Echavarria
- Medical Oncology Department, Hospital Universitario Gregorio Marañón, Calle del Dr Esquerdo, 46, Madrid 28007, Spain
| | - C Pericay
- Medical Oncology Department, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona 08208, Spain
| | - M Mangas
- Medical Oncology Department, Hospital Galdakao-Usansolo, Barrio Labeaga, s/n, Usansolo, Bizkaia 48960, Spain
| | - L Visa
- Medical Oncology Department, Hospital Universitario del Mar, Passeig Marítim, 25-29, Barcelona 08003, Spain
| | - E Buxo
- Medical Oncology Department, Hospital Universitario Clínic i Provincial de Barcelona, Carrer de Villarroel, 170, Barcelona08036, Spain
| | - T García
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Av Marqués de los Vélez, s/n, Murcia 30008, Spain
| | - A Rodríguez Palomo
- Pharmacy Department, Hospital Universitario Central de Asturias, Av. Roma, s/n, Oviedo 33011, Spain
| | - F Álvarez Manceñido
- Medical Oncology Department, Hospital Universitario Central de Asturias, Av. Roma, s/n, Oviedo 33011, Spain
| | - A Lacalle
- Medical Oncology Department, Complejo Hospitalario de Navarra, Calle de Irunlarrea, 3, Pamplona 31008, Spain
| | - I Macias
- Medical Oncology Department, Corporació Sanitària Parc Taulí, Parc Taulí, 1, Sabadell, Barcelona 08208, Spain
| | - A Azkarate
- Medical Oncology Department, Hospital Universitario Son Espases, Carrer de Valldemossa, 79, Palma, Islas Baleares 07120, Spain
| | - A Ramchandani
- Medical Oncology Department, Hospital Universitario Insular de Gran Canaria, Av Marítima Sur, s/n, Las Palmas de Gran Canaria 35001, Spain
| | - A Fernández Montes
- Medical Oncology Department, Complejo Hospitalario Universitario de Ourense, Calle Ramon Puga Noguerol, 54, Ourense 32005, Spain
| | - C López
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Av. Valdecilla, 25, Santander 39008, Spain
| | - F Longo
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Ctra. Colmenar Viejo, km. 9,100, Madrid 28034, Spain
| | - R Sánchez Bayona
- Medical Oncology Department, Clínica Universidad de Navarra, Av. de Pío XII, 36, Pamplona, Navarra 31008, Spain
| | - M L Limón
- Medical Oncology Department, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, s/n, Sevilla 41013, Spain
| | - A Díaz-Serrano
- Medical Oncology Department, Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n, Madrid 28041, Spain
| | - A Hurtado
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Calle Budapest, 1, Alcorcón, Madrid 28922, Spain
| | - R Madero
- Biostatistics Unit, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid 28046, Spain
| | - C Gómez
- Medical Oncology Department, Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n, Madrid 28041, Spain
| | - J Gallego
- Medical Oncology Department, Hospital General Universitario de Elche, Camí de l'Almazara, 11, Elche, Alicante 03203, Spain
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Font R, Espinas J, Layos L, Martinez Villacampa M, Capdevila J, Tobeña M, Pisa A, Pericay C, Lezcano C, Fort E, Cardona I, Berga N, Solà J, Borras J. Adherence to capecitabine in preoperative treatment of stage II and III rectal cancer: do we need to worry? Ann Oncol 2017; 28:831-835. [DOI: 10.1093/annonc/mdx006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Maurel J, Martos CF, Richard MM, Alonso V, Méndez CM, Salud A, Pericay C, Aparicio J, Gallego J, Carmona A, Casado E, Manzano H, Horndler C, Rubini M, Cuatrecasas M, García-Albéniz X, Feliu J. PULSE, a phase 2 study of mFOLFOX6-panitumumab (P) with biomarker stratification as first-line chemotherapy (CT), in patients (pts) with KRAS (exon 2) metastatic colorectal cancer (mCRC). A GEMCAD 09-03 study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Martin-Richard M, Custodio A, García-Girón C, Grávalos C, Gomez C, Jimenez-Fonseca P, Manzano JL, Pericay C, Rivera F, Carrato A. Erratum to: SEOM guidelines for the treatment of gastric cancer 2015. Clin Transl Oncol 2016; 18:426. [PMID: 26867938 PMCID: PMC4969810 DOI: 10.1007/s12094-016-1491-3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- M Martin-Richard
- Medical Oncology Department, Hospital de la Santa Creu I, Sant Pau, 167, 08025, Barcelona, Spain.
| | - A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - C García-Girón
- Medical Oncology Department, Hospital Universitario de Burgos, Burgos, Spain
| | - C Grávalos
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C Gomez
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - J L Manzano
- Medical Oncology Department, Hospital Universitari Germans Trias I Pujol de Badalona, Barcelona, Spain
| | - C Pericay
- Medical Oncology Department, Hospital de Sabadell-Consorcio Sanitario Parc Taulì, Barcelona, Spain
| | - F Rivera
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A Carrato
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Longo-Muñoz F, Argiles G, Tabernero J, Cervantes A, Gravalos C, Pericay C, Gil-Calle S, Mizuguchi H, Carrato-Mena A, Limón ML, Garcia-Carbonero R. Efficacy of trifluridine and tipiracil (TAS-102) versus placebo, with supportive care, in a randomized, controlled trial of patients with metastatic colorectal cancer from Spain: results of a subgroup analysis of the phase 3 RECOURSE trial. Clin Transl Oncol 2016; 19:227-235. [PMID: 27443414 PMCID: PMC5239803 DOI: 10.1007/s12094-016-1528-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/20/2016] [Indexed: 11/28/2022]
Abstract
Purpose TAS-102 is a combination of the thymidine-based nucleoside analog trifluridine and the thymidine phosphorylase inhibitor tipiracil. Efficacy and safety of TAS-102 in patients with metastatic colorectal cancer (mCRC) refractory or intolerant to standard therapies were evaluated in the phase 3 RECOURSE trial. Results of RECOURSE demonstrated significant improvement in overall survival (OS) and progression-free survival (PFS) with TAS-102 versus placebo [hazard ratio (HR) = 0.68 and 0.48 for OS and PFS, respectively; both P < 0.001]. The current analysis evaluates efficacy and safety of TAS-102 in the RECOURSE Spanish subgroup. Methods Primary and key secondary endpoints were evaluated in a post hoc analysis of the RECOURSE Spanish subgroup, using univariate and multivariate analyses. Safety and tolerability were reported with descriptive statistics. Results The RECOURSE Spanish subgroup included 112 patients (mean age 61 years, 62 % male). Median OS was 6.8 months in the TAS-102 group (n = 80) versus 4.6 months in the placebo group (n = 32) [HR = 0.47; 95 % confidence interval (CI): 0.28–0.78; P = 0.0032). Median PFS was 2.0 months in the TAS-102 group and 1.7 months in the placebo group (HR = 0.47; 95 % CI: 0.30–0.74; P = 0.001). Eighty (100 %) TAS-102 versus 31 (96.9 %) placebo patients had adverse events (AEs). The most common drug-related ≥Grade 3 AE was neutropenia (40 % TAS-102 versus 0 % placebo). There was 1 (1.3 %) case of febrile neutropenia in the TAS-102 group versus none in the placebo group. Conclusions In the RECOURSE Spanish subgroup, TAS-102 was associated with significantly improved OS and PFS versus placebo, consistent with the overall RECOURSE population. No new safety signals were identified. ClinicalTrials.gov study number NCT01607957
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Affiliation(s)
- F Longo-Muñoz
- Hospital Universitario Ramón y Cajal, Servicio Oncología Médica, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Carretera de Colmenar Viejo Km 9.100, Madrid, Spain, 28034
| | - G Argiles
- Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), P. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - J Tabernero
- Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), P. Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - A Cervantes
- Biomedical Research Institute INCLIVA, University of Valencia, Av. Menéndez Pelayo 4 accesorio, 46010, Valencia, Spain
| | - C Gravalos
- Hospital Universitario Doce de Octubre, Servicio Oncología Médica, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Avenida Cordoba km 5.4, Madrid, Spain, 28041
| | - C Pericay
- Hospital Universitario de Sabadell, Corporació Sanitària Parc Tauli, Parc Taulí, 1, 08208, Sabadell, Spain
| | - S Gil-Calle
- Hospital Carlos Haya, Av. de Carlos Haya, s/n, 29010, Málaga, Spain
| | - H Mizuguchi
- Taiho Oncology Inc, 202 Carnegie Center, Suite 100, Princeton, NJ, 08540, USA
| | - A Carrato-Mena
- Hospital Universitario Ramón y Cajal, Servicio Oncología Médica, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Carretera de Colmenar Viejo Km 9.100, Madrid, Spain, 28034
| | - M L Limón
- Hospital Universitario Virgen del Rocío, Sº Oncologia Medica, Manuel Siurot, 41013, Seville, Spain
| | - R Garcia-Carbonero
- Hospital Universitario Doce de Octubre, Servicio Oncología Médica, (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Avenida Cordoba km 5.4, Madrid, Spain, 28041.
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Pericay C, Martínez-Lago N, Corral M, Macías Declara I, Donnay O, Juez Martel I, García-Paredes B, Méndez Méndez J, Cacho Lanvin D, González-Astorga B, Ruiz Casado A, Delgado Ureña M, Rodriguez N, Calderero Aragón V, Mata Velasco E, Barrera Ramírez J, Macarulla T. P-051 Preliminary clinical and pathologic characteristics of patients treated in second-line (2L) with 25 cycles (Cy) or more of FOLFIRI + Aflibercept (FA). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Ferrer M, Pericay C, Macías Declara I, Saigí E, Dotor E, Pisa A. P-082 Three years of metastatic gastric cancer follow up in our hospital. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Muñoz A, Ruiz Casado A, Pericay C, Ibeas Millan P, Grandez Ladrón de Guevara R, Díaz Peña E, Lopez Muñoz Ana M, González Cebrián I, Moreno Santos Ma A, Juez Martel I, Encinas García S, Alcaide García J, Machengs Bruquetas I, García Adrián S, Lobo de Mena M, Higuera O, Ghanem I, García Alfonso P, Rodriguez N. P-145 Metastases resection following FOLFIRI-aflibercept in refractory patients to first-line chemotherapy: safety and efficacy analysis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Folprecht G, Pericay C, Saunders MP, Thomas A, Lopez Lopez R, Roh JK, Chistyakov V, Höhler T, Kim JS, Hofheinz RD, Ackland SP, Swinson D, Kopp M, Udovitsa D, Hall M, Iveson T, Vogel A, Zalcberg JR. Oxaliplatin and 5-FU/folinic acid (modified FOLFOX6) with or without aflibercept in first-line treatment of patients with metastatic colorectal cancer: the AFFIRM study. Ann Oncol 2016; 27:1273-9. [PMID: 27091810 DOI: 10.1093/annonc/mdw176] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 04/10/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The combination of aflibercept with FOLFIRI has been shown to significantly prolong overall survival in patients with metastatic colorectal cancer (mCRC) after progression on oxaliplatin-based therapy. This trial evaluated the addition of aflibercept to oxaliplatin-based first-line treatment of patients with mCRC. PATIENTS AND METHODS Patients with mCRC were randomized to receive first-line therapy with mFOLFOX6 plus aflibercept (4 mg/kg) or mFOLFOX6 alone. The primary end point of this phase II study was the progression-free survival (PFS) rate at 12 months in each arm. The analysis of efficacy between the arms was a pre-planned secondary analysis. RESULTS Of 236 randomized patients, 227 and 235 patients were evaluable for the primary efficacy analysis and safety, respectively. The probabilities of being progression-free at 12 months were 25.8% [95% confidence interval (CI) 17.2-34.4] for the aflibercept/mFOLFOX6 arm and 21.2% (95% CI 12.2-30.3) for the mFOLFOX6 arm. The median PFS was 8.48 months (95% CI 7.89-9.92) for the aflibercept/mFOLFOX6 arm and 8.77 months (95% CI 7.62-9.27) for the mFOLFOX6 arm; the hazard ratio of aflibercept/mFOLFOX6 versus mFOLFOX6 was 1.00 (95% CI 0.74-1.36). The response rates were 49.1% (95% CI 39.7-58.6) and 45.9% (95% CI 36.4-55.7) for patients treated with and without aflibercept, respectively. The most frequent treatment-emergent grade 3/4 adverse events (AEs) excluding laboratory abnormalities reported for aflibercept/mFOLFOX6 versus mFOLFOX6 were neuropathy (16.8% versus 17.2%) and diarrhea (13.4% versus 5.2%). Neutropenia grade 3/4 occurred in 36.1% versus 29.3%. The most common vascular endothelial growth factor inhibition class-effect grade 3/4 AEs for aflibercept/mFOLFOX6 versus mFOLFOX6 were hypertension (35.3% versus 1.7%), proteinuria (9.2% versus 0%), deep vein thrombosis (5.9% versus 0.9%) and pulmonary embolism (5.9% versus 5.2%). CONCLUSION No difference in PFS rate was observed between treatment groups. Adding aflibercept to first-line mFOLFOX6 did not increase efficacy but was associated with higher toxicity. CLINICAL TRIAL NUMBER NCT00851084, www.clinicaltrials.gov, EudraCT 2008-004178-41.
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Affiliation(s)
- G Folprecht
- Medical Department I, University Cancer Center, University Hospital Carl Gustav Carus, Dresden, Germany
| | - C Pericay
- Hospital de Sabadell, Corporació Sanitaria Parc Taulí-Institut Universitari, Sabadell, Spain
| | - M P Saunders
- Department of Radiotherapy and Oncology, The Christie NHS Foundation Trust, Manchester
| | - A Thomas
- Department of Cancer Studies, University of Leicester, Leicester, UK
| | - R Lopez Lopez
- Department of Medical Oncology, Hospital Clinico Universitario e Instituto de Investigación, Santiago de Compostela, Spain
| | - J K Roh
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - T Höhler
- Department I of Internal Medicine, Prosper Hospital, Recklinghausen, Germany
| | - J-S Kim
- Department of Oncology and Hematology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - R-D Hofheinz
- Department III of Internal Medicine, University Hospital, Mannheim, Germany
| | - S P Ackland
- Department of Medical Oncology, Calvary Mater Hospital, Newcastle Hunter Medical Research Institute and University of Newcastle, Callaghan, Australia
| | - D Swinson
- Department of Oncology, St James' Hospital, Leeds, UK
| | - M Kopp
- Samara Regional Oncology Dispensary, Samara
| | - D Udovitsa
- Oncological Dispensary #2, Sochi, Russia
| | - M Hall
- Cancer Services Division, Mount Vernon Cancer Centre, Middlesex
| | - T Iveson
- Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Vogel
- Clinic of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - J R Zalcberg
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Martin-Richard M, Custodio A, García-Girón C, Grávalos C, Gomez C, Jimenez-Fonseca P, Manzano JL, Pericay C, Rivera F, Carrato A. Seom guidelines for the treatment of gastric cancer 2015. Clin Transl Oncol 2015; 17:996-1004. [PMID: 26691658 PMCID: PMC4689778 DOI: 10.1007/s12094-015-1456-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 11/13/2015] [Indexed: 02/06/2023]
Abstract
Gastric cancer is the fourth cause of death by cancer in Spain and a significant medical problem. Molecular biology results evidence that gastroesophageal junction tumors and gastric cancer should be considered as two independent entities with a different prognosis and treatment approach. Endoscopic resection in very early tumors is feasible. Neoadjuvant and adjuvant therapy in locally advanced resectable tumor increase overall survival and should be considered standard treatments. In stage IV tumors, platinum–fluoropyrimidine-based schedule, with trastuzumab in HER2-overexpressed tumors, is the first-line treatment. Different therapies in second line have demonstrated in randomized studies their clear benefit in survival improvement.
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Affiliation(s)
- M Martin-Richard
- Medical Oncology Department, Hospital de la Santa Creu I Sant Pau, 167, 08025, Barcelona, Spain.
| | - A Custodio
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - C García-Girón
- Medical Oncology Department, Hospital Universitario de Burgos, Burgos, Spain
| | - C Grávalos
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C Gomez
- Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Jimenez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - J L Manzano
- Medical Oncology Department, Hospital Universitari Germans Trias I Pujol de Badalona, Barcelona, Spain
| | - C Pericay
- Medical Oncology Department, Hospital de Sabadell-Consorcio Sanitario Parc Taulì, Barcelona, Spain
| | - F Rivera
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A Carrato
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Pericay C, Serra-Aracil X, Ocaña-Rojas J, Mora-López L, Dotor E, Casalots A, Pisa A, Saigí E. Further evidence for preoperative chemoradiotherapy and transanal endoscopic surgery (TEM) in T2-3s,N0,M0 rectal cancer. Clin Transl Oncol 2015; 18:666-71. [DOI: 10.1007/s12094-015-1415-7] [Citation(s) in RCA: 8] [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: 05/12/2015] [Accepted: 09/23/2015] [Indexed: 12/21/2022]
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Garcia RV, Gomez M, Ayuso J, Figueras J, Alfonso PG, Martinez V, Lacasta A, Ruiz A, Safont M, Aparicio J, Campos J, Camara J, Martin-Richard M, Montagut C, Pericay C, Vieitez J, Falco E, Jorge M, Marin M, Salgado M. 2051 Relation between RAS mutations and radiologic (RECIST and morphologic) and pathologic response, in hepatic metastasis secondary to colorectal cancer: The AVAMET study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30974-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sotelo L, Sastre J, García-Paredes B, Cabezas-Camarero S, Vieitez J, Alonso V, Grávalos C, Escudero P, Vera R, Aranda E, García-Alfonso P, Gallego-Plazas J, Lopez C, Pericay C, Arrivi A, Vicente P, Ballesteros P, Elez E, Lopez-Ladron A, Diaz-Rubio E. 2033 Stage III colorectal cancer (CRC) in Spain: A retrospective analysis from 35 centres. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30956-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abad A, Massuti B, Gravalos C, Escudero P, Guillen-Ponce C, Manzano J, Ortiz M, Safont M, Gallego J, Sastre J, Pericay C, Duenas R, Rivera F, Losa F, Valladares-Ayerbes M, Gonzalez E, Robles L, Aranda E, Carrato A. 2128 Early tumour shrinkage (ETS) and depth of response (DpR) with first-line panitumumab (P) plus FOLFOX4 (P-FOLFOX4) or FOLFIRI (P-FOLFIRI) in patients (pts) with wild-type (WT) RAS colorectal cancer (CRC) and liver-limited disease (LLD). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31050-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fernandez-Martos C, Garcia-Albeniz X, Pericay C, Maurel J, Aparicio J, Montagut C, Safont M, Salud A, Vera R, Massuti B, Escudero P, Alonso V, Bosch C, Martin M, Minsky B. Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trial. Ann Oncol 2015; 26:1722-8. [DOI: 10.1093/annonc/mdv223] [Citation(s) in RCA: 205] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/02/2015] [Indexed: 12/17/2022] Open
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Sotelo MJ, Sastre J, Maestro ML, Veganzones S, Viéitez JM, Alonso V, Grávalos C, Escudero P, Vera R, Aranda E, García-Alfonso P, Gallego-Plazas J, Lopez C, Pericay C, Arrivi A, Vicente P, Ballesteros P, Elez E, López-Ladrón A, Díaz-Rubio E. Role of circulating tumor cells as prognostic marker in resected stage III colorectal cancer. Ann Oncol 2014; 26:535-41. [PMID: 25515656 DOI: 10.1093/annonc/mdu568] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prognostic role of circulating tumor cells (CTC) in early colorectal cancer (CRC) has not been determined yet. We evaluated the potential prognostic value of CTC in stage III CRC patients. PATIENTS AND METHODS Prospective multicenter study of 519 patients with stage III CRC recruited between January 2009 and June 2010. CTC were enumerated with the CellSearch System after primary tumor resection and before the start of adjuvant therapy. A total of 472 patients were included in the analysis. RESULTS CTC ≥1, ≥2, ≥3 and ≥5 were detected in 166 (35%), 93 (20%), 57 (12%) and 34 (7%) patients, respectively. Median follow-up was 40 months. In the overall population, CTC ≥1 (disease-free survival (DFS): HR 0.97, P = 0.85; overall survival (OS): HR 1.03, P = 0.89), ≥2 (DFS: HR 1.07, P = 0.76; OS: HR 1.02, P = 0.95), ≥3 (DFS: HR 0.96, P = 0.87; OS: HR 0.74, P = 0.41) and ≥5 (DFS: HR 0.72, P = 0.39; OS: HR 0.48, P = 0.21) were not associated with worse DFS and OS. No clinicopathological characteristics were significantly associated with the presence of CTC. In patients with disease relapse, the proportion with CTC ≥1 was not significantly different between those with single versus multiple metastatic locations (37.9% versus 31.4%, P = 0.761). In the multivariate analysis, CTC ≥1 was not an independent prognostic factor for DFS (HR 0.97, P = 0.87) and OS (HR 0.96, P = 0.89). CONCLUSION CTC detection was not associated with worse DFS and OS in patients with stage III CRC. Given the scarcity of CTC in these patients, it is likely that CTC determined by CellSearch system does not have a prognostic role in this setting. However, a longer follow-up is needed.
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Affiliation(s)
| | | | - M L Maestro
- Department of Clinical Analysis, Hospital Universitario Clínico San Carlos, Madrid
| | - S Veganzones
- Department of Clinical Analysis, Hospital Universitario Clínico San Carlos, Madrid
| | - J M Viéitez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo
| | - V Alonso
- Department of Medical Oncology, Hospital Universitario Miguel Servet, Zaragoza
| | - C Grávalos
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid
| | - P Escudero
- Department of Medical Oncology, Hospital Clínico Lozano Blesa, Zaragoza
| | - R Vera
- Department of Medical Oncology, Complejo Hospitalario de Navarra, Pamplona
| | - E Aranda
- Department of Medical Oncology, Hospital Reina Sofía, Universidad de Córdoba, Maimonides Institute of Biomedical Research (IMIBIC), Córdoba
| | - P García-Alfonso
- Department of Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid
| | - J Gallego-Plazas
- Department of Medical Oncology, Hospital Universitario de Elche, Elche
| | - C Lopez
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander
| | - C Pericay
- Department of Medical Oncology, Corporació Sanitària Universitària Parc Taulí, Sabadell
| | - A Arrivi
- Department of Medical Oncology, Hospital Son Llatzer, Palma de Mallorca
| | - P Vicente
- Department of Medical Oncology, Hospital de Granollers, Granollers
| | - P Ballesteros
- Department of Medical Oncology, Hospital Universitario Virgen de las Nieves, Granada
| | - E Elez
- Department of Medical Oncology, Hospital Vall d́Hebrón, Barcelona
| | - A López-Ladrón
- Department of Medical Oncology, Hospital Universitario de Valme, Sevilla, Spain
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Sastre J, Argilés G, Benavides M, Feliú J, García-Alfonso P, García-Carbonero R, Grávalos C, Guillén-Ponce C, Martínez-Villacampa M, Pericay C. Clinical management of regorafenib in the treatment of patients with advanced colorectal cancer. Clin Transl Oncol 2014; 16:942-53. [PMID: 25223744 PMCID: PMC4194027 DOI: 10.1007/s12094-014-1212-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 08/01/2014] [Indexed: 12/19/2022]
Abstract
Colorectal cancer is one of the most common tumors worldwide and at least 50 % of patients with this disease develop metastases. In this setting, additional treatment options are needed for patients presenting disease progression after exhausting all standard therapies. Regorafenib is an orally administered multikinase inhibitor which has been shown to provide survival benefits to patients with metastatic colorectal cancer (mCRC). Although most adverse events (AEs) associated with regorafenib may resolve within the first 8 weeks of treatment, some of them may require dose reduction or treatment interruption. Overall, while remaining aware of the safety profile of regorafenib and how to manage the most common toxicities related to its use, this drug should be considered a new standard of care for patients with pretreated mCRC. This review addresses practical aspects of its use, such as dosing, patient monitoring, and management of the most common regorafenib-related AEs.
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Affiliation(s)
- J Sastre
- Medical Oncology Department, Clinic San Carlos University Hospital (Center Affiliated with the Red Tematica de Investigacion Cooperativa en Cancer, Instituto Carlos III, Spanish Ministry of Science and Innovation), Calle Profesor Martín Lagos, s/n, 28040, Madrid, Spain,
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Abad A, Sureda BM, Grávalos C, Escudero P, Guillen-Ponce C, Gómez A, Safont M, Plazas JG, Sastre J, Pericay C, Dueñas R, López C, Losa F, Valladares-Ayerbes M, Flores EG, Díaz LR, Layos L, Carrato A, Aranda E. Ras Analysis of the Planet Study: Phase Ii Trial of Panitumumab (P) Plus Folfox4 or Folfiri in Subjects with Wild-Type (Wt) Kras Colorectal Cancer (Crc) and Liver-Limited Disease (Lld). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Lezama MS, Sastre J, Veganzones S, De Orden V, Viéitez J, Alonso V, Grávalos C, Escudero P, Vera R, Aranda E, Alfonso PG, Plazas JG, López C, Pericay C, Arrivi A, Lazcano MV, Ballesteros P, Elez E, López-Ladrón A, Díaz-Rubio E. Role of Circulating Tumor Cells (Ctc) in Stage III Colorectal Cancer (Crc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Martin-Richard M, Gallego R, Pericay C, Garcia Foncillas J, Queralt B, Casado E, Barriuso J, Iranzo V, Juez I, Visa L, Saigi E, Barnadas A, Garcia-Albeniz X, Maurel J. Multicenter phase II study of oxaliplatin and sorafenib in advanced gastric adenocarcinoma after failure of cisplatin and fluoropyrimidine treatment. A GEMCAD study. Invest New Drugs 2014; 31:1573-9. [PMID: 24077981 DOI: 10.1007/s10637-013-0020-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 08/23/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cisplatin and fluoropyrimidine (CF) are standard first- line treatment in advanced gastric cancer, but no second-line treatment has yet been established. We present a phase II study in which we evaluated the efficacy and toxicity of the combination of Sorafenib (S), and Oxaliplatin as second-line therapy. METHODS Patients with progressive gastric adenocarcinoma after CF- first-line, ECOG 0-2, and measurable disease were included. The primary objective was PFS. Treatment doses were Oxaliplatin 130 mg/m²/3 weeks and Sorafenib 800 mg/bid/d. RESULTS We included 40 patients. CR was 2.5% and SD was 47.2%. Grade 3-4 toxic effects were neutropenia (9.8%), thrombocytopenia (7.3%), neurotoxicity (4.9%) and diarrhea (4.9%). Median PFS was 3 months (95%CI: 2.3-4.1) and median OS was 6.5 months (95% CI: 5.2-9.6). Time to progression (TTP) to first line therapy was a prognosis factor. Median OS was 9.7 months when time-to-progression during first-line chemotherapy was >6 months and 5.6 m when it was <6 months (p = 0.04). CONCLUSIONS Time-to-progression under a CF-based first-line therapy determines subgroups of GC patients with different prognosis. The combination of Oxaliplatin-Sorafenib in advanced GC patients previously treated with CF appears safe, but our results do not support the implementation of a phase III trial.
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Pericay C, Frías C, Abad A, Lamas MJ, Echave M, Oyagüez I, Rubio M, Giménez E, Naoshy S, Joulain F. [Cost-effectiveness analysis of aflibercept in combination with FOLFIRI in the treatment of patients with metastatic colorectal cancer]. Farm Hosp 2014; 38:317-27. [PMID: 25137165 DOI: 10.7399/fh.2014.38.4.7631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To estimate the incremental cost per life-year gained (LYG) of aflibercept in combination with FOLFIRI as second-line treatment in metastatic colorectal cancer (mCRC) patients previously treated with oxaliplatin. METHODS Based on clinical trial VELOUR results, a three-state Markov model (stable disease, progression and death) with 2-week cycle duration was designed. Transition to health state «progression» implied the interruption of second-line treatment and administration of a third-line treatment (post-second line chemotherapy). Cost estimation included disease management cost (pharmaceutical, adverse event management, administration costs, etc.). Both cost and outcomes were discounted (3% annually). Sensitivity analyses (SA) were performed to test model robustness. RESULTS Administration of aflibercept + FOLFIRI as second-line treatment provided 1.78 LYG (21 life-months gained). With FOLFIRI 1.43 LYG (17 months) were obtained. The cost of the clinical management of aflibercept + FOLFIRI implied an additional investment of Euros 13,564 compared with FOLFIRI for a lifetime horizon, being total costs for aflibercept + FOLFIRI of Euros 38,346, compared to Euros 24,782 with FOLFIRI. In the cost-effectiveness analysis Euros 38,931/LYG was obtained with aflibercept in combination with FOLFIRI versus FOLFIRI. CONCLUSION Aflibercept in combination with FOLFIRI increased overall survival versus FOLFIRI, so it is an effective strategy in the treatment of patients with mCRC. Aflibercept in combination with FOLFIRI is an efficient strategy for second-line mCRC treatment from the National Health System perspective.
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Affiliation(s)
- C Pericay
- Servicio de Farmacia. Corporació Sanitária Parc Taulí. Barcelona..
| | - C Frías
- Servicio de Oncología. Instituto Catalán de Oncología. Barcelona..
| | - A Abad
- Servicio de Farmacia. Complejo Hospitalario Universitario de Santiago de Compostela..
| | - M J Lamas
- Pharmacoeconomics & Outcomes Research Iberia. Madrid..
| | - M Echave
- Servicio de Oncología. Corporació Sanitária Parc Taulí. Barcelona..
| | - I Oyagüez
- Pharmacoeconomics & Outcomes Research Iberia. Madrid..
| | - M Rubio
- Departamento de Health Economics. Sanofi..
| | - E Giménez
- Departamento de Health Economics. Sanofi..
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Abad A, Massutí B, Grávalos C, Escudero P, Guillén-Ponce C, Layos L, Gomez M, Safont M, Gallego J, Sastre J, Pericay C, Dueñas R, López-López C, Losa F, Valladares M, González-Flores E, Yuste A, Robles L, Sáenz A, Cano T, Carrato A, Aranda E. Panitumumab Plus FOLFOX4 or Panitumumab Plus Folfiri in Subjects with Wild-Type KRAS (EXON 2) Colorectal Cancer and Multiple or Unresectable Liver-Limited Metastases: Data from the Randomized, Phase II Planet Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu164.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pousa AL, Paz-Ares L, Pericay C, Del Muro XG, Flor M. Phase I Trial of Sunitinib Plus Imatinib in Patients with Metastatic or Unresectable Gastrointestinal Stromal Tumors (GIST). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33282-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Aranda E, Manzano JL, Rivera F, Galán M, Valladares-Ayerbes M, Pericay C, Safont MJ, Mendez MJ, Irigoyen A, Arrivi A, Sastre J, Díaz-Rubio E. Phase II open-label study of erlotinib in combination with gemcitabine in unresectable and/or metastatic adenocarcinoma of the pancreas: relationship between skin rash and survival (Pantar study). Ann Oncol 2011; 23:1919-25. [PMID: 22156621 DOI: 10.1093/annonc/mdr560] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Skin rash is an adverse event which might be associated with longer survival in patients treated with epidermal growth factor receptor tyrosine kinase inhibitors. The aim of this nonrandomised phase II clinical trial is to prospectively evaluate the relationship between skin rash and overall survival (OS) in advanced/metastatic pancreatic cancer treated with erlotinib plus gemcitabine. PATIENTS AND METHODS Patients were given gemcitabine (1000 mg/m2/week, 3 weeks every 4 weeks) plus erlotinib (100 mg/day orally continuously) until disease progression/unacceptable toxicity. The primary end point was OS. RESULTS A total of 153 eligible patients were enrolled (grade≥2 rash, 25%; grade<2 rash, 75%). OS was longer in patients with grade≥2 rash versus grade<2 (11 versus 5 months; P<0.001). Progression-free survival was longer in patients with grade≥2 rash versus grade<2 (6 versus 3 months; P<0.001) and shorter in those without rash versus grade 1 (2 versus 4 months; P=0.005) or grade≥2 (2 versus 6 months; P<0.001). Patients with grade≥2 rash showed higher rates of overall response (21% versus 7%; P<0.05) and disease control (84% versus 43%; P<0.05) versus grade<2. CONCLUSIONS This study prospectively confirms the relationship between rash and longer OS in unresectable locally advanced/metastatic pancreatic cancer treated with erlotinib plus gemcitabine.
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Affiliation(s)
- E Aranda
- Department of Oncology, Hospital Universitario Reina Sofía, Córdoba, Spain.
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Fernandez-Martos C, Pericay C, Salud A, Massuti B, Alonso V, Safont MJ, Vera R, Escudero MP, Maurel J, Aparicio J. Three-year outcomes of GCR-3: A phase II randomized trial comparing conventional preoperative chemoradiation (CRT) followed by surgery and postoperative adjuvant chemotherapy (CT) with induction CT followed by CRT and surgery in locally advanced rectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3552] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pisa A, Pericay C, Dotor E, Alfaro J, Orellana R, Pujal M, Amador MA, Garcia Borobia F, Mato R, Saigí E. The effect of time to adjuvant chemotherapy on survival in nonmetastatic resectable pancreatic adenocarcinoma: A retrospective analysis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pericay C, Losa F, Pisa A, Alfaro J, Cirera L, Salud A, Falco E, Dotor E, Vicente P, Casado E, Oliva JC, Saigí E. Phase II study with docetaxel (D), cisplatin (C), and continuous capecitabine (CAP) combination (TCX) in advanced gastric cancer: Preliminary data. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Maurel J, Garcia-Albeniz X, Méndez Méndez C, Martin-Richard M, Pericay C, Vera R, Aparicio J, Rubini M, Cuatrecasas M. PULSE: An open-label, phase II study assessing double positivity (phospho-insulin-growth factor receptor-1 [pIGF-IR] and matrilysin [MMP7]) expression as a predictive marker of resistance in previously untreated metastatic colorectal cancer (mCRC) wild-type KRAS patients (pts) treated with panitumumab plus mFOLFOX6—A GEMCAD study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Martin-Richard M, Alonso V, Marmol M, Castellano DE, Fonseca E, Velasco A, Garcia JL, Rivera F, Galan A, Quindos M, Maetsu I, Martinez de Prado P, Sastre J, Llanos M, Pericay C, Segura A, Arenas J, Pineda E, Maisonobe P, Massuti B. Evaluation of the efficacy and the safety of lanreotide autogel 120 mg on tumor growth stabilization in patients with progressive neuroendocrine tumors (NETs) who are not eligible to surgery or chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pisa A, Moya I, Pericay C, Dotor E, Alfaro J, Alvarado A, Navarro S, Orellana R, Pampols M, Saigí E. Role of chemoradiotherapy alone in the management of unfit patients with nonmetastatic locally advanced squamous cell carcinoma of the esophagus. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.138] [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
138 Background: Surgery is considered the best treatment for patients (pts) with non-metastatic locally advanced squamous cell carcinoma of the esophagus who have responded to neoadjuvant chemoradiotherapy (CRT) in terms of locoregional control. However, in these pts PFS and OS have not been proved superior to those achieved by CRT alone. Besides, the addition of surgery to CRT increases treatment-related morbidity and mortality. Unfit pts are usually declined for surgical procedures and included in definitive CRT programs. The aim of this study was to define the role of non-surgical strategies (CRT, CT or RT) in unfit pts considered non-optimal for surgical procedures. Methods: We retrospectively reviewed 90 pts with squamous cell carcinoma of the esophagus who had been diagnosed and treated at our institution from January 2004 to December 2009. Fifty-one pts were non-metastatic among which 19 underwent surgery and 32 a non-surgical procedure (CRT, CT, RT or BSC). Our aim was to identify OS, PFS, RR, data on comorbidity and toxicity in these 32 pts. Results: Thirty out of the 32 pts were men with a median age of 62 years (range 41-90). Comorbidity was detected in 17 pts (53%) as means of respiratory disorders (21.9%), cardiopathy (12.5%), hepatopathy (21.9%), synchronic tumors (25%) and metachronic tumors (25%). Seventeen pts received CRT, 7 received CT, 1 received RT and 7 received BSC alone (53%, 22%, 3% and 22% respectively). Grade 3 and 4 toxicities were observed in 15 pts (46.9%) as means of mucositis (18.8%), oesophagitis (15.6%), diarrhoea (12.5%) and neutropaenia (12.5%). One patient in the CRT group died of toxicity. RR was 43.8% (70.6% for CRT, 14.3% for CT alone). Median follow-up was 17.2 months. Median PFS was 11.3 ± 6.12 months (17.9 for CRT, 5.1 for CT alone). Median OS was 15.6 ± 7.6 months (6.9 for CT alone). Conclusions: Our experience with CRT alone in unfit pts with locally advanced squamous cell carcinoma of the oesophagus supports its use with a median PFS of 17.9 months and controllable toxicity. Data on median OS are lacking due to pending long-term follow-up. No significant financial relationships to disclose.
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Affiliation(s)
- A. Pisa
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - I. Moya
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - C. Pericay
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - E. Dotor
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - J. Alfaro
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - A. Alvarado
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - S. Navarro
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - R. Orellana
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - M. Pampols
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
| | - E. Saigí
- Corporació Sanitària Parc Taulí, Sabadell, Spain; Hospital de Sabadell, Corporació Sanitària Parc Taulí, Sabadell, Spain; Consorci Sanitari de Terrassa, Institut Oncològic del Vallás, Terrassa, Spain; Hospital General de Catalunya, Sant Cugat, Spain
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Manzano J, Rivera F, Galan M, Valladares M, Pericay C, Mendez MJ, Safont M, Irigoyen A, Arrivi A, Sastre J. A phase II, open label study to evaluate the relationship between skin rash and survival in patients with unresectable and/or metastatic pancreatic cancer treated with erlotinib combined with gemcitabine. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Carrera G, Garcia-Albeniz X, Alonso-Espinaco V, Pericay C, Alonso V, Escudero MP, Fernandez-Martos C, Gallego R, Castellvi-Bel S, Maurel J. MMP-7 serum levels as predictor or prognostic of cetuximab benefit in the treatment of advanced colorectal cancer: Results from a HCB-05 prospective trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Moya I, Dalmau E, Seguí M, García Y, Bonfill T, Pericay C, Fernández L, Querol R, Pampols M, Saigí E. Efficacy and safety of intrapericardial bleomycin for malignant pericardial effusion. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Fernandez-Martos C, Safont M, Feliu J, Pericay C, Gallen M, Vera R, Maurel J, Aparicio J, Escudero MP, Brown G. Induction chemotherapy with or without chemoradiation in intermediate-risk rectal cancer patients defined by magnetic resonance imaging (MRI): A GEMCAD study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Muñoz A, Pericay C, Llorente B, Alonso V, Dueñas R, Roca J, Rivera F, Falco E, Alvarez I, Salud A. Phase II study of bevacizumab (B) plus oxaliplatin (Ox) plus capecitabine (C) followed by bevacizumab (B) plus erlotinib (E) as first-line treatment in metastatic colorectal cancer (mCRC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Querol R, Pericay C, Pisa A, Dotor E, Perendreu J, Falcó J, Moya I, Pampols M, Seguí M, Saigí E. Long-term follow-up of treatment of acute malignant colorectal obstruction with self-expanding metallic stent as a preoperative brigde to surgery. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pisa A, Pericay C, Losa F, Nogué M, Alfaro J, Dotor E, Bonfill T, Querol R, MoyaHorno I, Saigí E. 6532 Prospective study of docetaxel in combination with cisplatin and an oral fluoropyrimidine in patients with gastric and esohagogastric junction adenocarcinoma. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71254-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Pericay C, Querol R, Moya-Horno I, Pisa A, Dotor E, Casalots A, Bombardó J, Bonfill T, Saigí E. 6116 Epidermal growth factor receptor (EGFR) expression in stage II-III colon carcinoma (CC) – nine years of follow-up. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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