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de la Cruz-Merino L, Gion M, Cruz J, Alonso-Romero JL, Quiroga V, Moreno F, Andrés R, Santisteban M, Ramos M, Holgado E, Cortés J, López-Miranda E, Cortés A, Henao F, Palazón-Carrión N, Rodriguez LM, Ceballos I, Soto A, Puertes A, Casas M, Benito S, Chiesa M, Bezares S, Caballero R, Jiménez-Cortegana C, Sánchez-Margalet V, Rojo F. Pembrolizumab in combination with gemcitabine for patients with HER2-negative advanced breast cancer: GEICAM/2015-04 (PANGEA-Breast) study. BMC Cancer 2022; 22:1258. [PMID: 36463104 PMCID: PMC9719636 DOI: 10.1186/s12885-022-10363-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND We evaluated a new chemoimmunotherapy combination based on the anti-PD1 monoclonal antibody pembrolizumab and the pyrimidine antimetabolite gemcitabine in HER2- advanced breast cancer (ABC) patients previously treated in the advanced setting, in order to explore a potential synergism that could eventually obtain long term benefit in these patients. METHODS HER2-negative ABC patients received 21-day cycles of pembrolizumab 200 mg (day 1) and gemcitabine (days 1 and 8). A run-in-phase (6 + 6 design) was planned with two dose levels (DL) of gemcitabine (1,250 mg/m2 [DL0]; 1,000 mg/m2 [DL1]) to determine the recommended phase II dose (RP2D). The primary objective was objective response rate (ORR). Tumor infiltrating lymphocytes (TILs) density and PD-L1 expression in tumors and myeloid-derived suppressor cells (MDSCs) levels in peripheral blood were analyzed. RESULTS Fourteen patients were treated with DL0, resulting in RP2D. Thirty-six patients were evaluated during the first stage of Simon's design. Recruitment was stopped as statistical assumptions were not met. The median age was 52; 21 (58%) patients had triple-negative disease, 28 (78%) visceral involvement, and 27 (75%) ≥ 2 metastatic locations. Progression disease was observed in 29 patients. ORR was 15% (95% CI, 5-32). Eight patients were treated ≥ 6 months before progression. Fourteen patients reported grade ≥ 3 treatment-related adverse events. Due to the small sample size, we did not find any clear association between immune tumor biomarkers and treatment efficacy that could identify a subgroup with higher probability of response or better survival. However, patients that experienced a clinical benefit showed decreased MDSCs levels in peripheral blood along the treatment. CONCLUSION Pembrolizumab 200 mg and gemcitabine 1,250 mg/m2 were considered as RP2D. The objective of ORR was not met; however, 22% patients were on treatment for ≥ 6 months. ABC patients that could benefit of chemoimmunotherapy strategies must be carefully selected by robust and validated biomarkers. In our heavily pretreated population, TILs, PD-L1 expression and MDSCs levels could not identify a subgroup of patients for whom the combination of gemcitabine and pembrolizumab would induce long term benefit. TRIAL REGISTRATION ClinicalTrials.gov and EudraCT (NCT03025880 and 2016-001,779-54, respectively). Registration dates: 20/01/2017 and 18/11/2016, respectively.
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Affiliation(s)
- L. de la Cruz-Merino
- grid.411375.50000 0004 1768 164XDepartment of Medical Oncology, Medicine Department, Virgen Macarena University Hospital, University of Seville, Dr. Fedriani St, No. 3, Seville, 41009 Spain ,grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - M. Gion
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411347.40000 0000 9248 5770Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J. Cruz
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - JL. Alonso-Romero
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411372.20000 0001 0534 3000Department of Medical Oncology, Hospital Clínico Universitario Virgen de La Arrixaca-IMIB, Murcia, Spain
| | - V. Quiroga
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.418701.b0000 0001 2097 8389Department of Medical Oncology, Badalona Applied Research Group in Oncology (B-ARGO Group), Catalan Institute of Oncology, Badalona, Spain
| | - F. Moreno
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411068.a0000 0001 0671 5785Department of Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - R. Andrés
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411050.10000 0004 1767 4212Department of Medical Oncology, Hospital Clínico Universitario Lozano Blesa, Saragossa, Spain
| | - M. Santisteban
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411730.00000 0001 2191 685XDepartment of Medical Oncology, Clínica Universidad de Navarra, Navarra, Spain ,grid.508840.10000 0004 7662 6114IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M. Ramos
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.418394.3Department of Medical Oncology, Centro Oncológico de Galicia, A Coruña, Spain
| | - E. Holgado
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.414808.10000 0004 1772 3571Department of Medical Oncology, Hospital La Luz, Quironsalud, Madrid, Spain
| | - J. Cortés
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,International Breast Cancer Center (IBCC), Quiron Group, Barcelona and Madrid, Spain ,grid.411083.f0000 0001 0675 8654Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain ,grid.119375.80000000121738416Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - E. López-Miranda
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411347.40000 0000 9248 5770Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A. Cortés
- grid.411347.40000 0000 9248 5770Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - F. Henao
- grid.411375.50000 0004 1768 164XDepartment of Medical Oncology, Medicine Department, Virgen Macarena University Hospital, University of Seville, Dr. Fedriani St, No. 3, Seville, 41009 Spain ,grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - N. Palazón-Carrión
- grid.411375.50000 0004 1768 164XDepartment of Medical Oncology, Medicine Department, Virgen Macarena University Hospital, University of Seville, Dr. Fedriani St, No. 3, Seville, 41009 Spain ,grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - L. M. Rodriguez
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - I. Ceballos
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - A. Soto
- grid.411372.20000 0001 0534 3000Department of Medical Oncology, Hospital Clínico Universitario Virgen de La Arrixaca-IMIB, Murcia, Spain
| | - A. Puertes
- grid.411372.20000 0001 0534 3000Department of Medical Oncology, Hospital Clínico Universitario Virgen de La Arrixaca-IMIB, Murcia, Spain
| | - M. Casas
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - S. Benito
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - M. Chiesa
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - S. Bezares
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - R. Caballero
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain
| | - C. Jiménez-Cortegana
- grid.411375.50000 0004 1768 164XMedical Biochemistry and Molecular Biology and Immunology Department, Virgen Macarena University Hospital, University of Seville, Seville, Spain
| | - V. Sánchez-Margalet
- grid.411375.50000 0004 1768 164XMedical Biochemistry and Molecular Biology and Immunology Department, Virgen Macarena University Hospital, University of Seville, Seville, Spain
| | - F. Rojo
- grid.430580.aGEICAM Spanish Breast Cancer Group, San Sebastián de los Reyes, Madrid, Spain ,grid.419651.e0000 0000 9538 1950Pathology Department, IIS-Fundación Jiménez Díaz, Madrid, Spain ,CIBERONC-ISCIII, Madrid, Spain
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Stott D, Santos FD, Rodgers A, Holgado E, Pandya P. Antenatal findings and early postnatal outcomes in pregnancies with trisomy 21: A 10‐year retrospective review at a tertiary centre. Prenat Diagn 2022; 42:1273-1280. [DOI: 10.1002/pd.6215] [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: 02/14/2022] [Revised: 05/30/2022] [Accepted: 06/27/2022] [Indexed: 11/07/2022]
Affiliation(s)
- D Stott
- University College Hospital Department of Obstetrics and Gynaecology Elizabeth Garrett Anderson Wing 25 Grafton Way LondonWC1E 6DB United Kingdom
| | - F Dos Santos
- Obstetrics and Gynaecology, Health Education England University College Hospital – Department of Obstetrics and Gynaecology Elizabeth Garrett Anderson Wing 25 Grafton Way LondonWC1E 6DB United Kingdom
| | - A Rodgers
- Neonatology, University College Hospital – Department of Neonatology, Elizabeth Garrett Anderson Wing, 25 Grafton Way LondonWC1E 6DB United Kingdom
| | - E Holgado
- Health Services Laboratories The Halo Building1 Mabledon Place LondonWC1H 9AX United Kingdom
| | - P Pandya
- University College Hospital – Fetal Medicine Unit Elizabeth Garrett Anderson Wing, 25 Grafton Way LondonWC1E 6DB United Kingdom
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Yusof MM, Cescon D, Rugo H, Im SA, Gallardo C, Lipatov O, Barrios C, Holgado E, Iwata H, Masuda N, Gokmen E, Loi S, Guo Z, Jensen E, Aktan G, Karantza V, Schmid P, Cortes J. 43O Phase III KEYNOTE-355 study of pembrolizumab (pembro) vs placebo (pbo) + chemotherapy (chemo) for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (TNBC): Results for patients (Pts) enrolled in Asia. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.063] [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] Open
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Merino LDC, Cruz J, Alonso J, Garcia VQ, Anton FM, Andres R, Santiesteban M, Vazquez MR, Cortes MG, Cortés J, Carrion NP, Lenza IC, Soto A, Casas M, Benito S, Montes SB, Holgado E. Results from a Phase II Trial of Pembrolizumab (P) Plus Gemcitabine (GEM) in patients (PTS) with HER2-Negative Advanced Breast Cancer (ABC): GEICAM/2015-04 (PANGEA-Breast) study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz451.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vokes EE, Ready N, Felip E, Horn L, Burgio MA, Antonia SJ, Arén Frontera O, Gettinger S, Holgado E, Spigel D, Waterhouse D, Domine M, Garassino M, Chow LQM, Blumenschein G, Barlesi F, Coudert B, Gainor J, Arrieta O, Brahmer J, Butts C, Steins M, Geese WJ, Li A, Healey D, Crinò L. Nivolumab versus docetaxel in previously treated advanced non-small-cell lung cancer (CheckMate 017 and CheckMate 057): 3-year update and outcomes in patients with liver metastases. Ann Oncol 2019; 29:959-965. [PMID: 29408986 DOI: 10.1093/annonc/mdy041] [Citation(s) in RCA: 303] [Impact Index Per Article: 60.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Long-term data with immune checkpoint inhibitors in non-small-cell lung cancer (NSCLC) are limited. Two phase III trials demonstrated improved overall survival (OS) and a favorable safety profile with the anti-programmed death-1 antibody nivolumab versus docetaxel in patients with previously treated advanced squamous (CheckMate 017) and nonsquamous (CheckMate 057) NSCLC. We report results from ≥3 years' follow-up, including subgroup analyses of patients with liver metastases, who historically have poorer prognosis among patients with NSCLC. Patients and methods Patients were randomized 1 : 1 to nivolumab (3 mg/kg every 2 weeks) or docetaxel (75 mg/m2 every 3 weeks) until progression or discontinuation. The primary end point of each study was OS. Patients with baseline liver metastases were pooled across studies by treatment for subgroup analyses. Results After 40.3 months' minimum follow-up in CheckMate 017 and 057, nivolumab continued to show an OS benefit versus docetaxel: estimated 3-year OS rates were 17% [95% confidence interval (CI), 14% to 21%] versus 8% (95% CI, 6% to 11%) in the pooled population with squamous or nonsquamous NSCLC. Nivolumab was generally well tolerated, with no new safety concerns identified. Of 854 randomized patients across both studies, 193 had baseline liver metastases. Nivolumab resulted in improved OS compared with docetaxel in patients with liver metastases (hazard ratio, 0.68; 95% CI, 0.50-0.91), consistent with findings from the overall pooled study population (hazard ratio, 0.70; 95% CI, 0.61-0.81). Rates of treatment-related hepatic adverse events (primarily grade 1-2 liver enzyme elevations) were slightly higher in nivolumab-treated patients with liver metastases (10%) than in the overall pooled population (6%). Conclusions After 3 years' minimum follow-up, nivolumab continued to demonstrate an OS benefit versus docetaxel in patients with advanced NSCLC. Similarly, nivolumab demonstrated an OS benefit versus docetaxel in patients with liver metastases, and remained well tolerated. Clinical trial registration CheckMate 017: NCT01642004; CheckMate 057: NCT01673867.
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Affiliation(s)
- E E Vokes
- Department of Medicine, University of Chicago Medicine & Biological Sciences, Chicago, USA.
| | - N Ready
- Department of Medicine, Duke University Medical Center, Durham, USA
| | - E Felip
- Lung Cancer Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - L Horn
- Thoracic Oncology Program, Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - M A Burgio
- Medical Oncology Unit, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCSS, Meldola, Italy
| | - S J Antonia
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, USA
| | - O Arén Frontera
- Oncologia Medica, Centro Internacional de Estudios Clinicos, Santiago, Chile, USA
| | - S Gettinger
- Department of Internal Medicine, Yale Comprehensive Cancer Center, New Haven, USA
| | - E Holgado
- Department of Medicine, Hospital De Madrid, Madrid, Spain
| | - D Spigel
- Research Consortium, Sarah Cannon Research Institute, Nashville, USA; Tennessee Oncology, PLLC, Nashville, USA
| | - D Waterhouse
- Department of Medical Oncology, OHC (Oncology Hematology Care), Cincinnati, USA; US Oncology, Cincinnati, USA
| | - M Domine
- Department of Medical Oncology, Fundación Jiménez Díaz, Madrid, Spain
| | - M Garassino
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Q M Chow
- Department of Medicine, University of Washington, Seattle, USA
| | - G Blumenschein
- Department of Thoracic/Head and Neck Medical Oncology, MD Anderson Cancer Center, Houston, USA
| | - F Barlesi
- Multidisciplinary Oncology & Therapeutic Innovations Departmen, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - B Coudert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - J Gainor
- Cancer Center, Massachusetts General Hospital, Boston, USA
| | - O Arrieta
- Thoracic Oncology Unit and Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - J Brahmer
- Thoracic Oncology Program, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, USA
| | - C Butts
- Department of Oncolog, Division of Medical Oncology, Cross Cancer Institute, Edmonton, Canada
| | - M Steins
- Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany
| | - W J Geese
- Immuno-Oncology, Bristol-Myers Squibb, Princeton, USA
| | - A Li
- Immuno-Oncology, Bristol-Myers Squibb, Princeton, USA
| | - D Healey
- Immuno-Oncology, Bristol-Myers Squibb, Princeton, USA
| | - L Crinò
- Medical Oncology Unit, Istituto Scientifico Romagnolo Per lo Studio e la Cura dei Tumori (IRST) IRCSS, Meldola, Italy
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Nuciforo P, Pascual T, Cortés J, Llombart-Cussac A, Fasani R, Paré L, Oliveira M, Galvan P, Martínez N, Bermejo B, Vidal M, Pernas S, López R, Muñoz M, Garau I, Manso L, Alarcón J, Martínez E, Rodrik-Outmezguine V, Brase JC, Villagrasa P, Prat A, Holgado E. A predictive model of pathologic response based on tumor cellularity and tumor-infiltrating lymphocytes (CelTIL) in HER2-positive breast cancer treated with chemo-free dual HER2 blockade. Ann Oncol 2019; 29:170-177. [PMID: 29045543 DOI: 10.1093/annonc/mdx647] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [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: 01/13/2023] Open
Abstract
Background The presence of stromal tumor-infiltrating lymphocytes (TILs) is associated with increased pathologic complete response (pCR) and improved outcomes in HER2-positive early-breast cancer (BC) treated with anti-HER2-based chemotherapy. In the absence of chemotherapy, the association of TILs with pCR following anti-HER2 therapy-only is largely unknown. Patients and methods The PAMELA neoadjuvant trial treated 151 women with HER2-positive BC with lapatinib and trastuzumab [and hormonal therapy if hormone receptor (HR)-positive] for 18 weeks. Percentage of TILs and tumor cellularity were determined at baseline (N = 148) and at day 15 (D15) of treatment (N = 134). Associations of TILs and tumor cellularity with pCR in the breast were evaluated. A combined score based on tumor cellularity and TILs (CelTIL) measured at D15 was derived in PAMELA, and validated in D15 samples from 65 patients with HER2-positive disease recruited in the LPT109096 neoadjuvant trial, where anti-HER2 therapy-only was administer for 2 weeks, then standard chemotherapy was added for 24 weeks. Results In PAMELA, baseline and D15 TILs were significantly associated with pCR in univariate analysis. In multivariable analysis, D15 TILs, but not baseline TILs, were significantly associated with pCR. At D15, TILs and tumor cellularity were found independently associated with pCR. A combined score (CelTIL) taking into account both variables was derived. CelTIL at D15 as a continuous variable was significantly associated with pCR, and patients with CelTIL-low and CelTIL-high scores had a pCR rate of 0% and 33%, respectively. In LPT109096, CelTIL at D15 was found associated with pCR both as a continuous variable and as group categories using a pre-defined cut-off (75.0% versus 33.3%). Conclusions On-treatment TILs, but not baseline TILs, are independently associated with response following anti-HER2 therapy-only. A combined score of TILs and tumor cellularity measured at D15 provides independent predictive information upon completion of neoadjuvant anti-HER2-based therapy. Clinical trial number NCT01973660.
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Affiliation(s)
- P Nuciforo
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - T Pascual
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - J Cortés
- Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain.,Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Llombart-Cussac
- Department of Medical Oncology, Arnau de Vilanova University Hospital, Valencia, Spain
| | - R Fasani
- Molecular Oncology Laboratory, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - L Paré
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - M Oliveira
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - P Galvan
- Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - N Martínez
- Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain
| | - B Bermejo
- Department of Medical Oncology, Hospital Clínico de Valencia, Valencia, Spain
| | - M Vidal
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - S Pernas
- Department of Medical Oncology, Instituto Catalán de Oncología, Hospitalet, Spain
| | - R López
- Department of Medical Oncology, Complejo Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - M Muñoz
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - I Garau
- Department of Medical Oncology, Hospital de Son Llàtzer, Palma de Mallorca, Spain
| | - L Manso
- Department of Medical Oncology, Hospital 12 de Octubre, Madrid, Spain
| | - J Alarcón
- Department of Medical Oncology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - E Martínez
- Department of Medical Oncology, Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain
| | | | - J C Brase
- Novartis Oncology, Basel, Switzerland
| | - P Villagrasa
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - A Prat
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.,Translational Genomics and Targeted Therapeutics in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - E Holgado
- Department of Medical Oncology, Ramon y Cajal University Hospital, Madrid, Spain.,Department of Medical Oncology, Baselga Oncological Institute, Madrid, Spain.,Department of Medical Oncology, Baselga Oncological Institute, Barcelona, Spain
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7
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Griguolo G, Holgado E, Cortés J, Fasani R, Pascual T, Paré L, Bermejo B, Oliveira M, Morales S, Martinez N, Vidal M, Pernas S, Lopez R, Muñoz M, Galvan P, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, LLombart-Cussac A, Prat A, Nuciforo P. Abstract P6-17-08: Dynamics of tumor-infiltrating lymphocytes (TILs) during neoadjuvant dual HER2 blockade in HER2-positive (HER2+) breast cancer in the absence of chemotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-17-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: TILs in HER2+ breast cancer (BC) predict 1) prognosis in early setting, 2) complete pathological response (pCR) following neoadjuvant antiHER2-based therapy and 3) response to trastuzumab and pembrolizumab in the metastatic setting. However, less is known regarding changes in TILs during antiHER2-based treatment.
Methods: Stromal TILs where evaluated centrally using H/E slides in tumor samples from the PAMELA (NCT01973660) neoadjuvant phase II trial. Briefly, 151 women with HER2+ BC were treated with lapatinib and trastuzumab, and hormonal therapy if HR positive, for 18 weeks. TIL levels were determined at baseline (n=148), after 2 weeks of treatment (n=134) and at surgery (n=137). Expression of 560 genes, including immune-related genes (e.g. CD8A, CD4, PD1 and PDL1) was measured at the same timepoints (baseline n=151, 2-weeks n=144, surgery n=144) using the nCounter platform. Intrinsic subtyping at baseline was determined using the PAM50 gene expression predictor. Changes in TILs between 2 time-points were determined by paired t-tests. Correlation of TILs with gene expression was assessed by quantitative SAM analysis using a False Discovery Rate <1%. All statistical tests were two-sided and considered significant when p<0.05. All statistical analyses were carried out using the R software.
Results: Compared to baseline, a significant increase in TILs was observed at week 2 in HR- (p<0.001) and HER2-enriched (HER2-E) tumors (p=0.001), but not in HR+ (p=0.133) and non-HER2-E tumors (p=0.067). Within HR- and HER2-E tumors, increase in TILs at week 2 from baseline was observed regardless of pathological response at surgery (pCR and HR- [p=0.008]; RD and HR- [p=0.037]; pCR and HER2-E [p=0.010]; RD and HER2-E [p=0.056]). Compared to week 2, a significant decrease in TILs at surgery was observed in HR- (p=0.002) and HER2-E (p=0.003) tumors, but not in HR+ (p=0.616) and non-HER2-E tumors (p=0.578). Within HR- and HER2-E tumors, a significant decrease in TILs between week 2 and surgery was observed in tumors achieving pCR (p=0.004 and p=0.005), while, in tumors not achieving pCR, no significant tendency was observed (26.4% and 33.0% of tumors showed an increase and a decrease of TILs between week 2 and surgery). Nonetheless, the vast majority of residual tumors (non-pCR) at surgery had TILs above ≥5%: 34.3% 5-10%, 21.0% 10-20%, 15.2% 20-40% and 11.4% ≥40%. Finally, TILs scoring was found highly enriched (FDR<1%) for immune-related genes tracking activated CD8 T-cells (i.e. CD8A, CD3G, LAG3 and PD1). Expression of these immune genes consistently correlated with TIL levels across the 3 time-points.
Conclusions: In early HER2+ BC, a general increase in TILs is observed following 2 weeks of dual HER2 blockade. This observation is mostly observed in HR- and HER2-E subtype, but regardless of pathological response at surgery. After 2 weeks of treatment, TILs consistently decrease in patients achieving a pCR, whereas two main patterns of TILs expression are observed in patients with residual disease at surgery. Nonetheless, most residual tumors at surgery are inflamed (i.e. TILs ≥5%) and might be good candidates for clinical trials evaluating adjuvant immune checkpoint inhibitors.
Citation Format: Griguolo G, Holgado E, Cortés J, Fasani R, Pascual T, Paré L, Bermejo B, Oliveira M, Morales S, Martinez N, Vidal M, Pernas S, Lopez R, Muñoz M, Galvan P, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, LLombart-Cussac A, Prat A, Nuciforo P. Dynamics of tumor-infiltrating lymphocytes (TILs) during neoadjuvant dual HER2 blockade in HER2-positive (HER2+) breast cancer in the absence of chemotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-17-08.
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Affiliation(s)
- G Griguolo
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - E Holgado
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - J Cortés
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - R Fasani
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - T Pascual
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - L Paré
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - B Bermejo
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Oliveira
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - S Morales
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - N Martinez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Vidal
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - S Pernas
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - R Lopez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - M Muñoz
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - P Galvan
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - I Garau
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - L Manso
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - J Alarcón
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - E Martínez
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - P Villagrasa
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - A LLombart-Cussac
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - A Prat
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
| | - P Nuciforo
- Hospital Clinic de Barcelona / IDIBAPS, Barcelona, Spain; University of Padova, Padova, Italy; Hospital Universitario Ramón y Cajal, Madrid, Spain; Molecular Oncology Group, Vall d´Hebron Institute of Oncology, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Hospital Clínico Universitario de Valencia / INCLIVA / CIBERONC, Valencia, Spain; Vall d'Hebrón University Hospital, Barcelona, Spain; Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Institut Catala d'Oncologia, Hospitalet, Hospitalet del Llobregat, Spain; Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain; Hospital Universitario Arnau de Vilanova de Valencia, Valencia, Spain
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Loi S, Schmid P, Cortés J, Park YH, Muñoz-Couselo E, Kim SB, Sohn J, Im SA, Holgado E, Foukakis T, Kuemmel S, Dent R, Wang A, Aktan G, Karantza V, Salgado R. Abstract P3-10-09: Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (Pembro)+chemotherapy (Chemo) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): phase Ib KEYNOTE-173 trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Abstract
Background:Increasing quantities of stromal TILs (sTILs) are associated with higher pathologic complete response (pCR) rates with conventional chemo in early-stage TNBC. We evaluated the association between sTILs and PD-L1 expression with response to pembro+chemo as NAT for TNBC in the KEYNOTE-173 trial (NCT02622074).
Methods: sTILs were quantified using light microscopy of H&E-stained slides from pretreatment and on-treatment (during first 3 weeks of pembro monotherapy) tumor biopsies by a pathologist blind to response data. Pretreatment PD-L1 expression was assessed using the PD-L1 IHC 22C3 pharmDx assay and reported as combined positive score (CPS). Endpoints were pCR rate by ypT0 ypN0 and ypT0/Tis ypN0 and objective response rate (ORR; RECIST v1.1) after the first 4 cycles of NAT (taxane±carboplatin+pembro) by MRI. sTILs and PD-L1 CPS were evaluated as continuous variables. Association between sTILs and PD-L1 CPS with response was assessed using logistic regression and area under the reciever operating curve (AUROC) analyses, with a 1-sided alpha level of 0.10. Correlation between PD-L1 and sTILs was assessed by Spearman's rank correlation coefficient. Multivariate analysis included sTILs (pretreatment and on-treatment) and PD-L1 CPS. Likelihood ratio tests were used to evaluate the added value of factors in predicting pCR rate.
Results: Of 60 total pts, 34 had tumors evaluated for pretreatment sTILs, 52 for PD-L1 CPS, and 33 for both sTILs and CPS. On-treatment sTILs were evaluated in 31 pts. Overall pCR rates were 56.7% and 60% by ypT0 ypN0 and ypT0/Tis ypN0, respectively; ORR was 78.3%. In pts evaluated for sTILs and CPS (individually), pCR rates and ORR were comparable with overall pCR rates and ORR. There was a significant correlation between pretreatment sTILs and PD-L1 CPS (ρ=0.65, P<0.001).Higher pretreatment sTILs were significantly associated with response: ypT0 ypN0 P= 0.011; ypT0/Tis ypN0 P=0.006; ORR P=0.061. On-treatment sTILs were also significantly associated with response: ypT0 ypN0 P=0.061; ypT0/Tis ypN0 P=0.041; ORR P=0.031. Pretreatment PD-L1 CPS was significantly associated with response: ypT0 ypN0 P=0.073; ypT0/is ypN0 P=0.030; and ORR P=0.021. AUROC of pretreatment sTIL association with pCR was numerically higher than with on-treatment sTILs and PD-L1 CPS (0.69 vs 0.61 vs 0.56 for ypT0ypN0 and 0.72 vs 0.67 vs 0.62 for ypT0/Tis ypN0). Responders had higher median pretreatment sTIL levels vs nonresponders: 45% [10, 75] vs 10% [5, 20] for pCR rate by ypT0 ypN0 and 52.5% [10, 73.8] vs 10% [5, 20] for pCR rate by ypT0/Tis ypN0; 25% [5, 70] vs 10% [6.3, 27.5] for ORR. In multivariate analysis, only pretreatment sTILs were significant for both pCR endpoints (ypT0 ypN0 P=0.031; ypT0/Tis ypN0 P=0.034). Likelihood ratio tests demonstrated that for both pCR endpoints, PD-L1 CPS (P=0.683/P=0.422) and on-treatment sTILs (P=0.984/P=0.568) did not add significantly more value to pretreatment sTILs when predicting pCR.
Conclusions:Higher quantities of pretreatment sTILs and PD-L1 CPS and on-treatment sTILs were significantly associated with higher pCR rates and ORR in primary TNBC treated with pembro and NAT.
Citation Format: Loi S, Schmid P, Cortés J, Park YH, Muñoz-Couselo E, Kim S-B, Sohn J, Im S-A, Holgado E, Foukakis T, Kuemmel S, Dent R, Wang A, Aktan G, Karantza V, Salgado R. Relationship between tumor infiltrating lymphocytes (TILs) and response to pembrolizumab (Pembro)+chemotherapy (Chemo) as neoadjuvant treatment (NAT) for triple-negative breast cancer (TNBC): phase Ib KEYNOTE-173 trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-10-09.
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Affiliation(s)
- S Loi
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - P Schmid
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - J Cortés
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - YH Park
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - E Muñoz-Couselo
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S-B Kim
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - J Sohn
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S-A Im
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - E Holgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - T Foukakis
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - S Kuemmel
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - R Dent
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - A Wang
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - G Aktan
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - V Karantza
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
| | - R Salgado
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia; Centre for Experimental Medicine, Barts Cancer Institute, London, United Kingdom; Vall d'Hebron Institute of Oncology (VHIO), Madrid, Spain; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Seoul National University College of Medicine, Seoul, Republic of Korea; Ramon y Cajal University Hospital, Madrid, Spain; Karolinska University Hospital, Stockholm, Sweden; Kliniken Essen-Mitte, Essen, Germany; National Cancer Centre, Singapore, Singapore; Merck & Co., Inc., Kenilworth, NJ
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Quiroga V, Holgado E, Alonso J, Andres R, Moreno Anton F, Alamo De La Gala M, Henao F, Cirauqui Cirauqui B, Margeli M, Cortes Castan J, Gion Cortes M, Soto A, Benito S, Escudero M, Chiesa M, Caballero R, Bezares Montes S, Carrasco E, De La Cruz Merino L. Run-in-phase results from a multicenter phase II trial to evaluate pembrolizumab (P) and gemcitabine (Gem) in patients (pts) with HER2-negative advanced breast cancer (ABC): GEICAM/2015-04 PANGEA-Breast. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy487.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cortes J, Perez-Garcia J, Levy C, Gómez Pardo P, Bourgeois H, Spazzapan S, Martínez-Jañez N, Chao TC, Espié M, Nabholtz J, Gonzàlez Farré X, Beliakouski V, Román García J, Holgado E, Campone M. Open-label randomised phase III trial of vinflunine versus an alkylating agent in patients with heavily pretreated metastatic breast cancer. Ann Oncol 2018; 29:881-887. [DOI: 10.1093/annonc/mdy051] [Citation(s) in RCA: 3] [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: 11/12/2022] Open
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Nuciforo P, Holgado E, Llombart A, Fasani R, Paré L, Pascual T, Oliveira M, Martínez N, Bermejo B, Vidal M, Pernas S, López R, Muñoz M, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, Cortés J, Prat A. Abstract P2-09-14: A predictive model of pathological response following dual HER2 blockade-only based on tumor cellularity and tumor-infiltrating lymphocytes (CelTIL) in HER2-positive breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Increased number of tumor-infiltrating lymphocytes (TILs) at baseline is associated with pathological complete response (pCR) and improved outcomes in HER2-positive early breast cancer treated with anti-HER2-based chemotherapy. In the absence of chemotherapy, the association of TILs with pCR following anti-HER2 therapy-only is currently unknown.
Methods: The PAMELA (NCT01973660)neoadjuvant trial treated 151 women with HER2-positive breast cancer with lapatinib and trastuzumab (and hormonal therapy if hormone receptor-positive) for 18 weeks. Percentage of TILs and tumor cellularity were determined at baseline (n=148) and after 2 weeks of treatment (n=134). Associations of TILs and tumor cellularity with pCR in the breast were evaluated using univariate and multivariable logistic regression models. The regression coefficients were used to derive a score based on TILs and tumor cellularity measured at week 2 (CelTIL) was derived in PAMELA,and tested in week 2 samples from 65 patients with HER2+ disease recruited in the LPT109096 (NCT00524303) phase 2 neoadjuvant trial, where anti-HER2 therapy-only (trastuzumab, lapatinib or the combination) was administered for 2 weeks, followed by the addition of standard multi-agent chemotherapy for 24 weeks.
Results: In PAMELA, at baseline, TILs were significantly associated with pCR in univariate analysis but not in multivariable analysis (adjusted odds ratio [OR]=1.01, 0.98-1.03; p-value=0.620). A statistically significant increase in TILs was observed at week 2 compared to baseline (mean difference +6.9%; p-value<0.001). At week 2, TILs were significantly associated with pCR in univariate and multivariable analyses (adjusted OR=1.04, 1.01-1.06; p-value=0.009). TILs and tumor cellularity at week 2 were independently associated with pCR and a combined score (from 0 to 100) taking into account both variables was derived. CelTIL as a continuous variable was significantly associated with pCR, and patients with CelTIL-low and CelTIL-high scores (cutoff < 33.59) had a pCR rate of 0% and 33%, respectively. Independent validation of CelTIL in week 2 samples from 65 patients with HER2+ disease recruited in the LPT109096 phase 2 neoadjuvant trial will be presented at the conference.
Conclusions: A combined score of TILs and tumor cellularity at week 2 following anti-HER2 therapy-only is associated with pCR upon completion of neoadjuvant anti-HER2-based therapy.
Citation Format: Nuciforo P, Holgado E, Llombart A, Fasani R, Paré L, Pascual T, Oliveira M, Martínez N, Bermejo B, Vidal M, Pernas S, López R, Muñoz M, Garau I, Manso L, Alarcón J, Martínez E, Villagrasa P, Cortés J, Prat A. A predictive model of pathological response following dual HER2 blockade-only based on tumor cellularity and tumor-infiltrating lymphocytes (CelTIL) in HER2-positive breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-14.
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Affiliation(s)
- P Nuciforo
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - E Holgado
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - A Llombart
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - R Fasani
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - L Paré
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - T Pascual
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - M Oliveira
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - N Martínez
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - B Bermejo
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - M Vidal
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - S Pernas
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - R López
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - M Muñoz
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - I Garau
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - L Manso
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - J Alarcón
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - E Martínez
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - P Villagrasa
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - J Cortés
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - A Prat
- Vall d'Hebrón Institut d'Oncología, Barcelona, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain; Institut Català d'Oncología, Hospitalet del Llobregat, Spain; Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain; Hospital de Son Llàtzer, Palma de Mallorca, Spain; Hospital 12 de Octubre, Madrid, Spain; Hospital Universitario Son Espases, Palma de Mallorca, Spain; Hospital Provincial Centre de Castelló, Castelló de la Plana, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain
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Schmid P, Dent R, Sohn J, Park YH, Muñoz-Couselo E, Kim SB, Im SA, Holgado E, Chen E, Dang T, Aktan G, Cortés J. Abstract PD6-12: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd6-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- P Schmid
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - R Dent
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - J Sohn
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - YH Park
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Muñoz-Couselo
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - S-B Kim
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - S-A Im
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Holgado
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - E Chen
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - T Dang
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - G Aktan
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
| | - J Cortés
- Barts Cancer Institute, London, United Kingdom; National Cancer Centre, Singapore; Yonsei University College of Medicine, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea; Ramon y Cajal University Hospital, Madrid, Spain; Merck & Co., Inc., Kenilworth, NJ
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Crinò L, Horn L, Felip E, Frontera OA, Burgio M, Waterhouse D, Blumenschein G, Barlesi F, Garassino M, Holgado E, Antonia S, Spigel D, Gainor J, Gettinger S, Geese W, Li A, Healey D, Ready N. P3.07-012 Nivolumab Versus Docetaxel in Patients With Previously Treated Advanced Non-Small Cell Lung Cancer and Liver Metastases. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Calvo E, Moreno V, Flynn M, Holgado E, Olmedo ME, Lopez Criado MP, Kahatt C, Lopez-Vilariño JA, Siguero M, Fernandez-Teruel C, Cullell-Young M, Soto Matos-Pita A, Forster M. Antitumor activity of lurbinectedin (PM01183) and doxorubicin in relapsed small-cell lung cancer: results from a phase I study. Ann Oncol 2017; 28:2559-2566. [PMID: 28961837 PMCID: PMC5834091 DOI: 10.1093/annonc/mdx357] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [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] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Lurbinectedin (PM01183) has synergistic antitumor activity when combined with doxorubicin in mice with xenografted tumors. This phase I trial determined the recommended dose (RD) of doxorubicin (bolus) and PM01183 (1-h intravenous infusion) on day 1 every 3 weeks (q3wk), and obtained preliminary evidence of antitumor activity for this combination in small-cell lung cancer (SCLC). PATIENTS AND METHODS Patients with advanced solid tumors received doxorubicin and PM01183 following a standard dose escalation design and expansion at the RD. Twenty-seven patients had relapsed SCLC: 12 with sensitive disease (platinum-free interval ≥90 days) and 15 with resistant disease (platinum-free interval <90 days). RESULTS Doxorubicin 50 mg/m2 and PM01183 4.0 mg flat dose was the RD. In relapsed SCLC, treatment tolerance at the RD was manageable. Transient and reversible myelosuppression (including neutropenia, thrombocytopenia, and febrile neutropenia) was the main toxicity, managed with dose adjustment and colony-stimulating factors. Fatigue (79%), nausea/vomiting (58%), decreased appetite (53%), mucositis (53%), alopecia (42%), diarrhea/constipation (42%), and asymptomatic creatinine (68%) and transaminase increases (alanine aminotransferase 42%; aspartate aminotransferase 32%) were common, and mostly mild or moderate. Complete (n = 2, 8%) and partial response (n = 13, 50%) occurred in relapsed SCLC, mostly at the RD. Response rates at second line were 91.7% in sensitive disease [median progression-free survival (PFS)=5.8 months] and 33.3% in resistant disease (median PFS = 3.5 months). At third line, response rate was 20.0% (median PFS = 1.2 months), all in resistant disease. CONCLUSION Doxorubicin 50 mg/m2 and PM01183 4.0 mg flat dose on day 1 q3wk has shown remarkable activity, mainly in second line, with manageable tolerance in relapsed SCLC, leading to further evaluation of this combination within an ongoing phase III trial.
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Affiliation(s)
- E Calvo
- START Madrid - Oncology, HM CIOCC, Hospital Madrid Norte Sanchinarro, Madrid
| | - V Moreno
- START Madrid - Oncology, FJD (Hospital Fundación Jiménez Díaz), Madrid, Spain
| | - M Flynn
- Department of Oncology, University College of London Hospital and UCL Cancer Institute, London, UK
| | - E Holgado
- START Madrid - Oncology, HM CIOCC, Hospital Madrid Norte Sanchinarro, Madrid
| | - M E Olmedo
- Department of Oncology, Hospital Ramon y Cajal, Madrid
| | | | - C Kahatt
- Clinical R&D, Pharma Mar, S.A., Colmenar Viejo, Madrid, Spain
| | | | - M Siguero
- Clinical R&D, Pharma Mar, S.A., Colmenar Viejo, Madrid, Spain
| | | | - M Cullell-Young
- Clinical R&D, Pharma Mar, S.A., Colmenar Viejo, Madrid, Spain
| | | | - M Forster
- Department of Oncology, University College of London Hospital and UCL Cancer Institute, London, UK;.
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Nuciforo P, Prat A, Llombart A, Fasani R, Paré L, Pascual T, Oliveira M, Martínez Jañez N, Bermejo De Las Heras B, Vidal M, Pernas Simon S, López R, Muñoz M, Garau I, Manso L, Alarcon Company J, Martinez de Dueñas E, Villagrasa Gonzalez P, Cortes Castan J, Holgado E. Tumor-infiltrating lymphocytes (TILs) in HER2-positive (HER2+) early breast cancer treated with neoadjuvant lapatinib and trastuzumab without chemotherapy in the PAMELA Trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.006] [Citation(s) in RCA: 3] [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: 11/14/2022] Open
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Felip Font E, Gettinger S, Burgio M, Antonia S, Holgado E, Spigel D, Arrieta O, Domine Gomez M, Aren Frontera O, Brahmer J, Chow L, Crinò L, Butts C, Coudert B, Horn L, Steins M, Geese W, Li A, Healey D, Vokes E. Three-year follow-up from CheckMate 017/057: Nivolumab versus docetaxel in patients with previously treated advanced non-small cell lung cancer (NSCLC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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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17
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Quintela-Fandino M, Manso L, Mouron S, Lopez-Acosta JF, García-Saenz JA, Holgado E, Pascual-Martinez T, Medicna L, Guerra J, Gonzalez-Cortijo L, Mañes S. Abstract OT3-01-02: CNIO-BR-008 trial: Reversion of T-cell exhaustion caused by chronic treatment with hypoxia-inducing antiangiogenic treatment by durvalumab in HER2-negative breast cancer: A pilot proof-of-concept trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot3-01-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The role of immune checkpoints in tumor progression is less relevant in breast cancer than in other malignancies. However, in preclinical experimentation we found a niche for immune checkpoint inhibitors. In an immunocompetent model of HER2-negative breast cancer (MMTV-PyMT) we observed that antiangiogenic agents may induce either a tumor normoxic or hypoxic adaptation. Normoxic adaptation leads to a therapeutically exploitable dependence on mitochondrial metabolism (Cell Rep 2016; 15: 1-14). Hypoxic adaptation (usually caused by monoclonal antibody type antiangiogenics) induces an increase in PGE2 and PGA synthesis, followed by a switch of the tryptophan metabolism from 5HIAA to kinurenine that culminates in differentiation of naive T-cells to Tregs and expression of PD-L1 in the hypoxic areas. The exhausted T-cell response observed in this model can be restored with PD-L1 inhibitors. We sought to prove the relevance of T-cell exhaustion an its reversibility by the anti-PD-L1 antibody durvalumab in patients receiving chronic bevacizumab (Bev).
Trial design
Single-arm, prospective, multicentric, phase II open-label trial. Patients receiving Bev maintenance after a chemotherapy+Bev regimen administered in the first line of metastatic disease that experience disease progression (PD) during maintenance will be candidates. The treatment will start by adding durvalumab (10 mg/kg q2w) to the ongoing Bev (15 mg/kg q3 w). Patients will undergo serial tumor biopsies, tumor-cfDNA sequencing (baseline and progression), and immunophenotyping (baseline and q4w). RECIST/I-RECIST and NCI CTC AE V4.03 criteria will be used for assessing disease response and toxicity.
Elegibility criteria
Women >18 year old diagnosed of HER2-negative advanced breast cancer; 2) have received chemotherapy plus Bev for the first line treatment and experienced PR, CR or SD, 3) followed by maintenance with three-weekly Bev in monotherapy for at least 6 weeks before diagnosis of PD. 4) Concurrent hormonal therapy is allowed for ER+ patients, but reception of previous immunotherapy is precluded. 5) Adequate organ function defined according to standard parameters.
Specific aims
Primary:
1) To determine the relative percentages of innate and adaptive immune cell subpopulations and ascertain the status of T-cell function and polarization by multiparametric flow cytometry in patients with acquired resistance against Bev
2) To assess the reversibility of the abnormalities evidenced in (1) by durvalumab
3) To determine the disease control rate of the combination, and its relationship with (1) and (2)
Secondary:
4) To determine potential tumor neoantigens generated by chronic tumor hypoxia secondary to the antiangiogenic treatment.
Statistical methods
The sample size is calculated on the basis of the expected change in the Treg percentage in peripheral blood (10%), with an alpha and beta errors of 5% and 20% respectively. The minimum number of patients necessary to observe a 10% decrease is 25. Changes in lymphocytes will be compared with intra-subject measurements and Z-scores.
Accrual: 2 of 25 (target accrual) patients have been recruited.
Contact info: mquintela@cnio.es.
Citation Format: Quintela-Fandino M, Manso L, Mouron S, Lopez-Acosta JF, García-Saenz JA, Holgado E, Pascual-Martinez T, Medicna L, Guerra J, Gonzalez-Cortijo L, Mañes S. CNIO-BR-008 trial: Reversion of T-cell exhaustion caused by chronic treatment with hypoxia-inducing antiangiogenic treatment by durvalumab in HER2-negative breast cancer: A pilot proof-of-concept trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT3-01-02.
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Affiliation(s)
- M Quintela-Fandino
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - L Manso
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - S Mouron
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - JF Lopez-Acosta
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - JA García-Saenz
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - E Holgado
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - T Pascual-Martinez
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - L Medicna
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - J Guerra
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - L Gonzalez-Cortijo
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
| | - S Mañes
- CNIO - Spanish National Cancer Research Center, Madrid, Spain; H12O -Hospital 12 de Octubre, Madrid, Spain; HSCC - Hospital Clinico San Carlos, Madrid, Spain; HRYC - Hospital Ramon y Cajal, Madrid, Spain; HLP - Hospital La Princesa, Madrid, Spain; HUF - Hospital Universitario Fuenlabrada, Madrid, Spain; HQ - Hospital Quiron, Madrid, Spain; CNB - Centro Nacional de Biotecnología, Madrid, Spain
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Horn L, Brahmer J, Reck M, Borghaei H, Spigel D, Steins M, Ready N, Chow L, Vokes E, Felip E, Holgado E, Barlesi F, Kohlhäufl M, Burgio M, Fayette J, Gettinger S, Harbison C, Li A, Finckenstein F, Paz-Ares L. 417O Phase 3, randomized trial (CheckMate 057) of nivolumab vs docetaxel in advanced non-squamous (non-SQ) non-small cell lung cancer (NSCLC): subgroup analyses and patient reported outcomes (PROs). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv532.01] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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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Horn L, Brahmer J, Reck M, Borghaei H, Spigel D, Steins M, Ready N, Chow L, Vokes E, Felip E, Holgado E, Barlesi F, Kohlhäufl M, Burgio M, Fayette J, Gettinger S, Harbison C, Li A, Finckenstein F, Paz-Ares L. 3010 Phase, randomized trial (CheckMate 057) of nivolumab (NIVO) vs docetaxel (DOC) in advanced non-squamous (non-SQ) non-small cell lung cancer (NSCLC): Subgroup analyses and patient reported outcomes (PROs). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31655-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Soria JC, Boni V, Gazzah A, Holgado E, Even C, Ould-Kaci M, Nazabadioko S, Xue W, Calvo E. A Phase Ib dose escalation study of afatinib in combination with standard-dose cetuximab in patients with advanced solid tumours. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv081.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Calvo E, Boni V, Heist R, Matulonis U, Janne P, Hamid O, Holgado E, Ordoñez J, Nunez J, Ugrenovic M, Lin W, O'keeffe B, Lackner M, Spoerke J, Ware J, Pinder-Schenck M. Phase 1B Study of Oral Dual-Pi3K/Mtor Inhibitor Gdc-0980 in Combination with Carboplatin (Carbo)/Paclitaxel (Pac) ± Bevacizumab (Bev) and Cisplatin (Cis)/Pemetrexed (Pem) in Patients (Pts) with Advanced Solid Tumors and Nsclc. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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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Coronado C, Rodriguez-Antolin A, Sepulveda J, Diaz Padilla I, Holgado E, Garcia Escobar I, Castellano DE. Efficacy of low-dose ketoconazole in hormone refractory prostate cancer patients (HRPC): A single institution experience. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16117] [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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Castellano DE, Sepulveda J, Diaz Padilla I, Coronado C, Holgado E, Garcia Escobar I, DelaRosa F, Villacampa F, Cortes-Funes H. Sunitinib therapy for patients with advanced renal cell carcinoma (aRCC): Analysis for safety and activity on single institution experience—Prolonged overall survival. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16119] [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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Echarri M, Grávalos C, Cámara J, Ruiz A, Garcia-Garcia L, Hernández M, Holgado E, Gómez C, Garcia G, Cortes-Funes H. Bevacizumab in combination with continuous administration of capecitabine plus biweekly oxaliplatin: Preliminary results from the XELOX-AV trial. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15074] [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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Carvajal A, García Roldán JL, Holgado E, Velasco A. [Consumption of drugs in a sample of rural physicians in the province of Valladolid]. Med Clin (Barc) 1984; 83:444-6. [PMID: 6503415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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