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Cura Y, Sánchez-Martín A, Márquez-Pete N, González-Flores E, Martínez-Martínez F, Pérez-Ramírez C, Jiménez-Morales A. Role of Single-Nucleotide Polymorphisms in Genes Implicated in Capecitabine Pharmacodynamics on the Effectiveness of Adjuvant Therapy in Colorectal Cancer. Int J Mol Sci 2023; 25:104. [PMID: 38203276 PMCID: PMC10778960 DOI: 10.3390/ijms25010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
Colorectal cancer (CRC) is a highly prevalent form of neoplasm worldwide. Capecitabine, an oral antimetabolite, is widely used for CRC treatment; however, there exists substantial variation in individual therapy response. This may be due to genetic variations in genes involved in capecitabine pharmacodynamics (PD). In this study, we investigated the role of single-nucleotide polymorphisms (SNPs) related to capecitabine's PD on disease-free survival (DFS) in CRC patients under adjuvant treatment. Thirteen SNPs in the TYMS, ENOSF1, MTHFR, ERCC1/2, and XRCC1/3 genes were genotyped in 142 CRC patients using real-time PCR with predesigned TaqMan® probes. A significant association was found between favorable DFS and the ENOSF1 rs2612091-T allele (p = 0.010; HR = 0.34; 95% CI = 0.14-0.83), as well as with the TYMS/ENOSF1 region ACT haplotype (p = 0.012; HR = 0.37; 95% CI = 0.17-0.80). Other factors such as low histological grade (p = 0.009; HR = 0.34; 95% CI = 0.14-0.79) and a family history of cancer (p = 0.040; HR = 0.48; 95% CI = 0.23-0.99) were also linked to improved DFS. Therefore, the SNP ENOSF1 rs2612091 could be considered as a predictive genetic biomarker for survival in CRC patients receiving capecitabine-based adjuvant regimens.
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Affiliation(s)
- Yasmin Cura
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (Y.C.)
| | - Almudena Sánchez-Martín
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (Y.C.)
| | - Noelia Márquez-Pete
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (Y.C.)
| | - Encarnación González-Flores
- Medical Oncology, University Hospital Virgen de las Nieves, 18014 Granada, Spain
- Biomedical Research Institute—ibs.Granada, 18012 Granada, Spain
| | | | - Cristina Pérez-Ramírez
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, 18016 Granada, Spain
| | - Alberto Jiménez-Morales
- Pharmacy Service, Pharmacogenetics Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain; (Y.C.)
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Cura Y, Sánchez-Martín A, Márquez-Pete N, González-Flores E, Martínez-Martínez F, Pérez-Ramírez C, Jiménez-Morales A. Association of Single-Nucleotide Polymorphisms in Capecitabine Bioactivation Pathway with Adjuvant Therapy Safety in Colorectal Cancer Patients. Pharmaceutics 2023; 15:2548. [PMID: 38004528 PMCID: PMC10675271 DOI: 10.3390/pharmaceutics15112548] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is part of the standard treatment of colorectal cancer (CRC). Severe adverse dose limiting reactions that impair treatment safety and lead to treatment suspension remain a relevant concern. Single-nucleotide polymorphisms (SNPs) in genes involved in the activation of capecitabine may alter the bioavailability of 5-FU and thereby affect therapy outcomes. The aim of this study was to evaluate the association of these SNPs with severe toxicity and treatment suspension in patients with CRC treated with capecitabine-based therapy. An ambispective cohort study was conducted, including 161 patients with CRC. SNPs were analyzed using real-time PCR with TaqMan® probes. Toxicity was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events v.5.0. CES1 rs71647871-A was associated with a severe hand-foot syndrome (p = 0.030; OR = 11.92; 95% CI = 1.46-73.47; GG vs. A). CDA rs1048977-CC (p = 0.030; OR = 2.30; 95% CI 1.09-5.00; T vs. CC) and capecitabine monotherapy (p = 0.003; OR = 3.13; 95% CI 1.49-6.81) were associated with treatment suspension due to toxicity. SNPs CES1 rs71647871 and CDA rs1048977 may act as potential predictive biomarkers of safety in patients with CRC under capecitabine-based adjuvant therapy.
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Affiliation(s)
- Yasmin Cura
- Pharmacy Service, Pharmacogenetics Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Almudena Sánchez-Martín
- Pharmacy Service, Pharmacogenetics Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Noelia Márquez-Pete
- Pharmacy Service, Pharmacogenetics Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | - Encarnación González-Flores
- Medical Oncology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
- Biosanitary Research Institute, Ibs.Granada, 18012 Granada, Spain
| | | | - Cristina Pérez-Ramírez
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, 18016 Granada, Spain
| | - Alberto Jiménez-Morales
- Pharmacy Service, Pharmacogenetics Unit, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
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Fernández-Ramírez A, Olivas-Martinez A, Ruiz-Manriquez J, Kauffman-Ortega E, Moctezuma-Velázquez C, Marquez-Guillen E, Contreras AG, Vilatobá M, González-Flores E, Cruz-Martínez R, Flores-García NC, García-Juárez I. Posttransplantation diabetes mellitus after liver transplant and the impact of family history of diabetes in a Mexican cohort. Rev Gastroenterol Mex (Engl Ed) 2023:S2255-534X(23)00112-3. [PMID: 37858455 DOI: 10.1016/j.rgmxen.2023.06.002] [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] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/08/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION AND AIMS Posttransplantation diabetes mellitus (PTDM) is a serious long-term complication that has a negative impact on graft and patient survival. The purpose of the present study was to describe the incidence of PTDM in a Mexican cohort and evaluate its association with a previous family history of diabetes (FHD). METHODS A retrospective single-center cohort study was conducted on patients undergoing liver transplantation (LT). The primary outcome was time from LT to PTDM. The diagnosis of PTDM was established using the ADA criteria. A mediation analysis that used adjusted Cox regression models and considered pretransplant prediabetes a mediator was performed, to determine the total effect and direct effect of FHD on PTDM. RESULTS A total of 152 patients were included, with a median follow-up time of 41 months; 19.2% (n = 29) had pretransplant diabetes. During the follow-up time, 15% of patients developed PTDM (n = 23), with an incidence rate of 4.71 cases/100 person-years. PTDM was significantly higher in patients with FHD, compared with those with no FHD (8.72 cases/100 person-years vs 2.04 cases/100 person-years, respectively; p = 0.001). The adjusted hazard ratio of PTDM for FHD was 4.14 (95% CI 1.60-10.7), p = 0.005) and 3.48 (95% CI 1.35-9.01, p = 0.010), when further controlled for pretransplant prediabetes. CONCLUSION The occurrence of PTDM was similar to that reported in most international studies. As with type 2 diabetes, family history plays an important role in the development of PTDM, even after accounting for pretransplant prediabetes. Patients with FHD should undergo a stricter metabolic program.
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Affiliation(s)
- A Fernández-Ramírez
- Departamento de Medicina Interna, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - A Olivas-Martinez
- Departamento de Bioestadística, Universidad de Washington, Seattle, WA, United States
| | - J Ruiz-Manriquez
- Unidad de Hepatología y Trasplante Hepático, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - E Kauffman-Ortega
- Unidad de Hepatología y Trasplante Hepático, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C Moctezuma-Velázquez
- Unidad de Hepatología y Trasplante Hepático, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - E Marquez-Guillen
- Unidad de Hepatología y Trasplante Hepático, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - A G Contreras
- Departamento de Cirugía y Trasplante, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - M Vilatobá
- Departamento de Cirugía y Trasplante, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - E González-Flores
- Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - R Cruz-Martínez
- Departamento de Cirugía y Trasplante, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - N C Flores-García
- Unidad de Hepatología y Trasplante Hepático, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - I García-Juárez
- Unidad de Hepatología y Trasplante Hepático, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Tristán AI, González-Flores E, Salmerón ADM, Abreu AC, Caba O, Jiménez-Luna C, Melguizo C, Prados J, Fernández I. Serum nuclear magnetic resonance metabolomics analysis of human metastatic colorectal cancer: Biomarkers and pathway analysis. NMR Biomed 2023:e4935. [PMID: 36945883 DOI: 10.1002/nbm.4935] [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] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
We describe the use of nuclear magnetic resonance metabolomics to analyze blood serum samples from healthy individuals (n = 26) and those with metastatic colorectal cancer (CRC; n = 57). The assessment, employing both linear and nonlinear multivariate data analysis techniques, revealed specific metabolite changes associated with metastatic CRC, including increased levels of lactate, glutamate, and pyruvate, and decreased levels of certain amino acids and total fatty acids. Biomarker ratios such as glutamate-to-glutamine and pyruvate-to-alanine were also found to be related to CRC. The study also found that glutamate was linked to progression-free survival and that both glutamate and 3-hydroxybutyrate were risk factors for metastatic CRC. Additionally, gas chromatography coupled to flame-ionization detection was utilized to analyze the fatty acid profile and pathway analysis was performed on the profiled metabolites to understand the metabolic processes involved in CRC. A correlation was also found between the presence of certain metabolites in the blood of CRC patients and certain clinical features.
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Affiliation(s)
- Ana Isabel Tristán
- Department of Chemistry and Physics, Research Centre CIAIMBITAL, University of Almería, Almería, Spain
| | - Encarnación González-Flores
- Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
- Medical Oncology Service, Virgen de las Nieves Hospital, Granada, Spain
| | - Ana Del Mar Salmerón
- Department of Chemistry and Physics, Research Centre CIAIMBITAL, University of Almería, Almería, Spain
| | - Ana Cristina Abreu
- Department of Chemistry and Physics, Research Centre CIAIMBITAL, University of Almería, Almería, Spain
| | - Octavio Caba
- Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, Spain
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Cristina Jiménez-Luna
- Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, Spain
| | - Consolación Melguizo
- Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, Spain
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain
| | - José Prados
- Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, Spain
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Ignacio Fernández
- Department of Chemistry and Physics, Research Centre CIAIMBITAL, University of Almería, Almería, Spain
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Cura Y, Pérez-Ramírez C, Sánchez-Martín A, Membrive-Jimenez C, Valverde-Merino MI, González-Flores E, Morales AJ. Influence of Single-Nucleotide Polymorphisms on Clinical Outcomes of Capecitabine-Based Chemotherapy in Colorectal Cancer Patients: A Systematic Review. Cancers (Basel) 2023; 15:cancers15061821. [PMID: 36980706 PMCID: PMC10046456 DOI: 10.3390/cancers15061821] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
The aim of this systematic review was to provide a comprehensive overview of the literature published in the last decade on the association of single-nucleotide polymorphisms in genes involved in the pharmacodynamic and pharmacokinetic pathways of capecitabine with treatment outcomes among colorectal cancer patients. A systematic search of the literature published in the last 10 years was carried out in two databases (Medline and Scopus) using keywords related to the objective. Quality assessment of the studies included was performed using an assessment tool derived from the Strengthening the Reporting of Genetic Association (STREGA) statement. Thirteen studies were included in this systematic review. Genes involved in bioactivation, metabolism, transport, mechanism of action of capecitabine, DNA repair, and folate cycle were associated with toxicity. Meanwhile, genes related to DNA repair were associated with therapy effectiveness. This systematic review reveals that several SNPs other than the four DPYD variants that are screened in clinical practice could have an impact on treatment outcomes. These findings suggest the identification of future predictive biomarkers of effectiveness and toxicity in colorectal cancer patients treated with capecitabine. However, the evidence is sparse and requires further validation.
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Affiliation(s)
- Yasmin Cura
- Pharmacy Service, Pharmacogenetics Unit, Hospital Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18004 Granada, Spain
| | - Cristina Pérez-Ramírez
- Department of Biochemistry and Molecular Biology II, José Mataix Institute of Nutrition and Food Technology, Center for Biomedical Research, Universidad de Granada, Avda. del Conocimiento s/n, 18016 Granada, Spain
- Correspondence:
| | - Almudena Sánchez-Martín
- Pharmacy Service, Pharmacogenetics Unit, Hospital Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18004 Granada, Spain
| | - Cristina Membrive-Jimenez
- Pharmacy Service, Pharmacogenetics Unit, Hospital Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18004 Granada, Spain
| | - María Isabel Valverde-Merino
- Pharmaceutical Care Research Group, Facultad de Farmacia, Universidad de Granada, Campus de la Cartuja, 18071 Granada, Spain
| | - Encarnación González-Flores
- Medical Oncology, Hospital Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18004 Granada, Spain
- Biosanitary Research Institute of Granada, Ibs.Granada, Avda. de Madrid, 15, 18012 Granada, Spain
| | - Alberto Jiménez Morales
- Pharmacy Service, Pharmacogenetics Unit, Hospital Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18004 Granada, Spain
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Valladares M, Safont Aguileria M, González-Flores E, García Alfonso P, López Muñoz A, Aranda Aguilar E, Falco Ferrer E, Rodriguez-Salas N, Cirera L, Llanos-Munoz M, Aparicio J, Pimentel P, Castillo Trujillo A, Salgado Fernandez M, Salud Salvia M, Vidal Tocino R, Massuti Sureda B, Garcia-Carbonero R, Vicente Conesa M, Lloansi Vila A. 382P Sequential RAS mutation status evaluation in circulating free DNA (cfDNA) in RAS wild type (wt) metastatic colorectal cancer (mCRC) patients (pt) starting first-line (1L) treatment with panitumumab (P) and chemotherapy (CT). PERSEIDA (Idylla Cohort) study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Benavides M, Gómez-España A, García-Alfonso P, González CG, Viéitez JM, Rivera F, Safont MJ, Abad A, Sastre J, Valladares-Ayerbes M, Carrato A, González-Flores E, Robles L, Salud A, Alonso-Orduña V, Montagut C, Asensio E, Díaz-Rubio E, Aranda E. Upfront primary tumour resection and survival in synchronous metastatic colorectal cancer according to primary tumour location and RAS status: Pooled analysis of the Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD). Eur J Surg Oncol 2021; 48:1123-1132. [PMID: 34872775 DOI: 10.1016/j.ejso.2021.11.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/14/2021] [Accepted: 11/17/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Retrospective studies and meta-analyses suggest that upfront primary tumour resection (UPTR) confers a survival benefit in patients with asymptomatic unresectable metastatic colorectal cancer (mCRC) undergoing chemotherapy, however a consensus of its role in routine clinical practice in the current era of targeted therapies is lacking. This retrospective study aimed to analyse the survival benefit of UPTR in terms of tumour location and mutational status, in patients with synchronous mCRC receiving chemotherapy and targeted therapy. PATIENTS AND METHODS Survival was analysed in a pooled cohort of synchronous mCRC patients treated with a first-line anti-VEGF or anti-EGFR inhibitor in seven trials of the Spanish TTD group, according to UPTR, tumour-sidedness and mutational profiling. RESULTS Of 1334 eligible patients, 642 (48%) had undergone UPTR. UPTR was associated with significantly longer overall survival (OS; 25.0 vs 20.3 months; HR 1.30, 95%CI 1.15-1.48; p < 0.0001). UPTR was associated with significant OS benefit in both left-sided (HR 1.38, 95%CI 1.13-1.69; p = 0.002) and right-sided (HR 1.39, 95%CI 1.00-1.94; p = 0.049) tumours, RASwt (HR 1.29, 95%CI 1.05-1.60; p = 0.016) and BRAFwt (HR 1.49, 95%CI 1.21-1.84; p = 0.0002) tumours, and treatment with anti-EGFRs (HR 1.47, 95%CI 1.13-1.92; p = 0.004) and anti-VEGFs (HR 1.25, 95%CI 1.08-1.44; p = 0.003). Multivariate analysis identified number of metastatic sites, RAS status, primary tumour location and UPTR as independent prognostic factors for OS. CONCLUSION Considering the selection bias inherent to this study, our results support UPTR before first-line anti-EGFR or anti-VEGF targeted therapy in right and left-sided asymptomatic unresectable synchronous mCRC patients. RAS/BRAF mutational status may also influence UPTR function.
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Affiliation(s)
- Manuel Benavides
- UGC Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, Málaga, Spain.
| | - Auxiliadora Gómez-España
- Department of Medical Oncology, IMIBIC, Universidad de Córdoba, CIBERONC, Instituto de Salud Carlos III, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Pilar García-Alfonso
- Department of Medical Oncology, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina García González
- UGC Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - Jose María Viéitez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Fernando Rivera
- Department of Medical Oncology, University Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - María José Safont
- Department of Medical Oncology, Hospital General Universitario Valencia, Universidad de Valencia, CIBERONC, Valencia, Spain
| | - Albert Abad
- Department of Medical Oncology, Instituto Oncológico Dr. Rosell, Barcelona, Spain
| | - Javier Sastre
- Department of Medical Oncology, Hospital Clínico San Carlos, Instituto de Investigación Hospital Clínico San Carlos (IdISSC), University Complutense, CIBERONC, Madrid, Spain
| | | | - Alfredo Carrato
- Department of Medical Oncology, IRYCIS, CIBERONC, Alcalá University, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Luis Robles
- Department of Medical Oncology, Hospital 12 de Octubre, Madrid, Spain
| | - Antonieta Salud
- Department of Medical Oncology, Hospital de Lleida Arnau de Vilanova, Lérida, Spain
| | - Vicente Alonso-Orduña
- Department of Medical Oncology, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IISA), Zaragoza, Spain
| | - Clara Montagut
- Department of Medical Oncology, Hospital del Mar Medical Research Institute, CIBERONC, Barcelona, Spain
| | - Elena Asensio
- Department of Medical Oncology, Hospital General Universitario de Elche, Alicante, Spain
| | - Eduardo Díaz-Rubio
- Department of Medical Oncology, Hospital Clínico San Carlos, Instituto de Investigación Hospital Clínico San Carlos (IdISSC), University Complutense, CIBERONC, Madrid, Spain
| | - Enrique Aranda
- Department of Medical Oncology, IMIBIC, Universidad de Córdoba, CIBERONC, Instituto de Salud Carlos III, Hospital Universitario Reina Sofía, Córdoba, Spain
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Garcia-Carbonero R, Benavent M, Jiménez Fonseca P, Castellano D, Alonso-Gordoa T, Teulé A, Custodio A, Tafuto S, La Casta A, Spada F, López C, Ibrahim T, Silva MV, Iranzo V, García-Alfonso P, González-Flores E, Grande E, Crespo G, Carmona-Bayonas A, Capdevila J. 1097O The AXINET trial (GETNE1107): Axitinib plus octreotide LAR improves PFS by blinded central radiological assessment vs placebo plus octreotide LAR in G1-2 extrapancreatic NETs. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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9
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Benavides M, Gómez-España A, García-Alfonso P, García C, Vieitez J, Massuti Sureda B, Rivera F, Safont Aguilera M, Abad Esteve A, Granja Ortega M, Valladares-Ayerbes M, Carrato Mena A, González-Flores E, Robles L, Salud Salvia A, Alonso V, Montagut Viladot C, Asensio-Martinez E, Díaz-Rubio E, Aranda Aguilar E. 418P Upfront primary tumour resection (UPTR) and survival in synchronous metastatic colorectal cancer according to primary tumour location and RAS status: Pooled analysis of the Spanish Cooperative Group for the Treatment of Digestive Tumours (TTD). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Triviño-Ibáñez EM, Pardo Moreno P, Ciampi Dopazo JJ, Ramos-Font C, Ruiz Villaverde G, González-Flores E, Navarro Vergara PF, Rashki M, Gómez-Río M, Rodríguez-Fernández A. Biomarkers associated with survival and favourable outcome of radioembolization with yttrium-90 glass microspheres for colon cancer liver metastases: Single centre experience. Rev Esp Med Nucl Imagen Mol 2021; 41:231-238. [PMID: 34454892 DOI: 10.1016/j.remnie.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the therapeutic effectiveness and safety of transarterial radioembolization (TARE) with Yttrium-90 in patients with colorectal cancer (CRC) liver metastases and to evaluate the prognostic value of different biomarkers. MATERIAL AND METHODS This prospective longitudinal study enrolled consecutive patients with CRC liver metastases treated with TARE between November 2015 and june 2020. The therapeutic response at three and six months (RECIST1.1 criteria) and the relationship of biomarkers with therapeutic response, by calculating objective tumor response rates (ORR) and disease control (DCR), and overall survival (OS) and progression-free (PFS). RESULTS Thirty TAREs were performed in 23 patients (mean age, 61.61 ± 9.13 years; 56.5% male). At three months, the objective response rate (ORR) was 16.7% and the disease control rate (DCR) 53.3%. At six months, the disease progressed in 80%. The ORR and DCR were significantly associated with age at diagnosis (P = 0.047), previous bevacizumab treatment (P = 0.008), pre-TARE haemoglobin (P = 0.008), NLR (P = 0.040), pre-TARE albumin (P = 0.012), pre-TARE ALT (P = 0.023) and tumour-absorbed dose > 115 Gy (P = 0.033). Median overall survival (OS) was 12 months (95% CI, 4.75-19.25 months) and median progression-free survival (PFS) 3 months (95% CI, 2.41-3.59). OS was significantly associated with primary tumour resection (P = 0.019), KRAS mutation (HR: 5.15; P = 0.024), pre-TARE haemoglobin (HR: 0.50; p = 0.009), pre-TARE NLR (HR: 1.65; P = 0.005) and PLR (HR: 1.01; P = 0.042). CONCLUSION TARE prognosis and therapeutic response were predicted by different biomarkers, ranging from biochemical parameters to tumour dosimetrics.
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Affiliation(s)
- E M Triviño-Ibáñez
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain; IBS, Granada Bio-Health Research Institute, Granada, Spain.
| | - P Pardo Moreno
- Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - J J Ciampi Dopazo
- Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - C Ramos-Font
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain; IBS, Granada Bio-Health Research Institute, Granada, Spain
| | - G Ruiz Villaverde
- Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - E González-Flores
- Servicio de Oncología Médica, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - P F Navarro Vergara
- Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M Rashki
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M Gómez-Río
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain; IBS, Granada Bio-Health Research Institute, Granada, Spain
| | - A Rodríguez-Fernández
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain; IBS, Granada Bio-Health Research Institute, Granada, Spain
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11
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Aranda E, Viéitez JM, Gómez-España A, Gil Calle S, Salud-Salvia A, Graña B, Garcia-Alfonso P, Rivera F, Quintero-Aldana GA, Reina-Zoilo JJ, González-Flores E, Salgado Fernández M, Guillén-Ponce C, Garcia-Carbonero R, Safont MJ, La Casta Munoa A, García-Paredes B, López López R, Sastre J, Díaz-Rubio E. FOLFOXIRI plus bevacizumab versus FOLFOX plus bevacizumab for patients with metastatic colorectal cancer and ≥3 circulating tumour cells: the randomised phase III VISNÚ-1 trial. ESMO Open 2021; 5:e000944. [PMID: 33148620 PMCID: PMC7640586 DOI: 10.1136/esmoopen-2020-000944] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE 5-Fluorouracil/leucovorin, oxaliplatin, irinotecan (FOLFOXIRI) plus bevacizumab is more effective than doublets plus bevacizumab as first-line therapy for metastatic colorectal cancer, but is not widely used because of concerns about toxicity and lack of predictive biomarkers. This study was designed to explore the role of circulating tumour cell (CTC) count as a biomarker to select patients for therapy with FOLFOXIRI-bevacizumab. PATIENTS AND METHODS VISNÚ-1 was a multicentre, open-label, randomised, phase III study in patients with previously untreated, unresectable, metastatic colorectal carcinoma and ≥3 CTC/7.5 mL blood. Patients received bevacizumab 5 mg/kg plus FOLFOXIRI (irinotecan 165 mg/m2, oxaliplatin 85 mg/m2, leucovorin 400 mg/m2 and 5-fluorouracil 3200 mg/m2) or FOLFOX (oxaliplatin 85 mg/m2, leucovorin 400 mg/m2, 5-fluorouracil 400 mg/m2 then 2400 mg/m2) by intravenous administration every 2 weeks. The primary outcome was progression-free survival (PFS). RESULTS The intention-to-treat population comprised 349 patients (FOLFOXIRI-bevacizumab, n=172; FOLFOX-bevacizumab, n=177). Median PFS was 12.4 months (95% CI 11.2 to 14.0) with FOLFOXIRI bevacizumab and 9.3 months (95% CI 8.5 to 10.7) with FOLFOX-bevacizumab (stratified HR, 0.64; 95% CI 0.49 to 0.82; p=0.0006). Grade≥3 adverse events were more common with FOLFOXIRI-bevacizumab 85.3% vs 75.1% with FOLFOX-bevacizumab (p=0.0178). Treatment-related deaths occurred in 8 (4.7%) and 6 (3.4%) patients, respectively. CONCLUSIONS First-line FOLFOXIRI-bevacizumab significantly improved PFS compared with FOLFOX-bevacizumab in patients with metastatic colorectal cancer and ≥3 CTCs at baseline, which indicate a poor prognosis. CTC count may be a useful non-invasive biomarker to assist with the selection of patients for intensive first-line therapy.
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Affiliation(s)
- Enrique Aranda
- IMIBIC, University of Cordoba, CIBERONC, Instituto de Salud Carlos III, Hospital Universitario Reina Sofía, Medical Oncology Department, Cordoba, Spain.
| | - Jose Maria Viéitez
- Hospital Universitario Central de Asturias, Medical Oncology Department, Oviedo, Spain
| | - Auxiliadora Gómez-España
- IMIBIC, University of Cordoba, CIBERONC, Instituto de Salud Carlos III, Hospital Universitario Reina Sofía, Medical Oncology Department, Cordoba, Spain
| | - Silvia Gil Calle
- Hospital Universitario Regional y Virgen de la Victoria, Medical Oncology Department, Málaga, Spain
| | - Antonieta Salud-Salvia
- Hospital Universitario Arnau de Vilanova de Lleida, Medical Oncology Department, Lleida, Spain
| | - Begoña Graña
- University Hospital A Coruña, SERGAS, Medical Oncology Department, La Coruña, Spain
| | - Pilar Garcia-Alfonso
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Medical Oncology Department, Madrid, Spain
| | - Fernando Rivera
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Medical Oncology Department, Santander, Spain
| | | | - Juan José Reina-Zoilo
- Complejo Universitario Virgen de la Macarena, Medical Oncology Department, Seville, Spain
| | | | | | - Carmen Guillén-Ponce
- Hospital Universitario Ramón y Cajal, Medical Oncology Department, Madrid, Spain
| | - Rocio Garcia-Carbonero
- Hospital Universitario 12 de Octubre, imas12, UCM, CIBERONC, Medical Oncology Department, Madrid, Spain; Hospital Universitario Virgen del Rocío, Medical Oncology Department, Seville, Spain
| | - María José Safont
- Hospital General Universitario de Valencia, Medical Oncology Department, Valencia, Spain
| | | | - Beatriz García-Paredes
- Instituto de Investigación Hospital Clinico San Carlos (IdISSC), CIBERONC, Hospital Clínico San Carlos, Medical Oncology Department, Madrid, Spain
| | - Rafael López López
- University Hospital and Health Research Institute (IDIS), CIBERONC, Santiago de Compostela University School of Medicine, Medical Oncology Department, Santiago de Compostela, Spain
| | - Javier Sastre
- Instituto de Investigación Hospital Clinico San Carlos (IdISSC), CIBERONC, Hospital Clínico San Carlos, Medical Oncology Department, Madrid, Spain
| | - Eduardo Díaz-Rubio
- Instituto de Investigación Hospital Clinico San Carlos (IdISSC), CIBERONC, Hospital Clínico San Carlos, Medical Oncology Department, Madrid, Spain
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12
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Triviño-Ibáñez EM, Pardo Moreno P, Ciampi Dopazo JJ, Ramos-Font C, Ruiz Villaverde G, González-Flores E, Navarro Vergara PF, Rashki M, Gómez-Río M, Rodríguez-Fernández A. Biomarkers associated with survival and favourable outcome of radioembolization with yttrium-90 glass microspheres for colon cancer liver metastases: Single centre experience. Rev Esp Med Nucl Imagen Mol 2021; 41:S2253-654X(21)00129-3. [PMID: 34294586 DOI: 10.1016/j.remn.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 11/30/2022]
Abstract
OBJETIVE To determine the therapeutic effectiveness and safety of transarterial radioembolization (TARE) with Yttrium-90 in patients with colorectal cancer (CRC) liver metastases and to evaluate the prognostic value of different biomarkers. MATERIAL AND METHODS This prospective longitudinal study enrolled consecutive patients with CRC liver metastases treated with TARE between November 2015 and june 2020. The therapeutic response at three and six months (RECIST1.1 criteria) and the relationship of biomarkers with therapeutic response, by calculating objective tumor response rates (ORR) and disease control (DCR), and overall survival (OS) and progression-free (PFS). RESULTS Thirty TAREs were performed in 23 patients (mean age, 61,61±9,13 years; 56,5% male). At three months, the objective response rate (ORR) was 16,7% and the disease control rate (DCR) 53,3%. At six months, the disease progressed in 80%. The ORR and DCR were significantly associated with age at diagnosis (P=.047), previous bevacizumab treatment (P=.008), pre-TARE haemoglobin (P=.008), NLR (P=.040), pre-TARE albumin (P=.012), pre-TARE ALT (P=.023) and tumour-absorbed dose>115Gy (P=.033). Median overall survival (OS) was 12 months (95% CI, 4.75-19.25 months) and median progression-free survival (PFS) 3 months (95% CI, 2.41-3.59). OS was significantly associated with primary tumour resection (P=.019), KRAS mutation (HR: 5.15; P=.024), pre-TARE haemoglobin (HR: .50; p=.009), pre-TARE NLR (HR: 1.65; P=.005) and PLR (HR: 1.01; P=.042). CONCLUSION TARE prognosis and therapeutic response were predicted by different biomarkers, ranging from biochemical parameters to tumour dosimetrics.
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Affiliation(s)
- E M Triviño-Ibáñez
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España; IBS, Granada Bio-Health Research Institute, Granada, España.
| | - P Pardo Moreno
- Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, España
| | - J J Ciampi Dopazo
- Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, España
| | - C Ramos-Font
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España; IBS, Granada Bio-Health Research Institute, Granada, España
| | - G Ruiz Villaverde
- Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, España
| | - E González-Flores
- Servicio de Oncología Médica, Hospital Universitario Virgen de las Nieves, Granada, España
| | - P F Navarro Vergara
- Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, España
| | - M Rashki
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España
| | - M Gómez-Río
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España; IBS, Granada Bio-Health Research Institute, Granada, España
| | - A Rodríguez-Fernández
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España; IBS, Granada Bio-Health Research Institute, Granada, España
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13
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Jimenez-Luna C, González-Flores E, Ortiz R, Martínez-González LJ, Antúnez-Rodríguez A, Expósito-Ruiz M, Melguizo C, Caba O, Prados J. Circulating PTGS2, JAG1, GUCY2C and PGF mRNA in Peripheral Blood and Serum as Potential Biomarkers for Patients with Metastatic Colon Cancer. J Clin Med 2021; 10:2248. [PMID: 34067294 PMCID: PMC8196898 DOI: 10.3390/jcm10112248] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/24/2022] Open
Abstract
Genes involved in the angiogenic process have been proposed for the diagnosis and therapeutic response of metastatic colorectal cancer (CRC). This study aimed to investigate the value of PTGS2, JAG1, GUCY2C and PGF-circulating RNA as biomarkers in metastatic CRC. Blood cells and serum mRNA from 59 patients with metastatic CRC and 47 healthy controls were analyzed by digital PCR. The area under the receiver operating characteristic curve (AUC) was used to estimate the diagnostic value of each mRNA alone or mRNA combinations. A significant upregulation of the JAG1, PTGS2 and GUCY2C genes in blood cells and serum samples from metastatic CRC patients was detected. Circulating mRNA levels in the serum of all genes were significantly more abundant than in blood. The highest discrimination ability between metastatic CRC patients and healthy donors was obtained with PTGS2 (AUC of 0.984) and GUCY2C (AUC of 0.896) in serum samples. Biomarker combinations did not improve the discriminatory capacity of biomarkers separately. Analyzed biomarkers showed no correlation with overall survival or progression-free survival, but GUCY2C and GUCY2C/PTGS2 expression in serum correlated significantly with the response to antiangiogenic agents. These findings demonstrate that assessment of genes involved in the angiogenic process may be a potential non-invasive diagnostic tool for metastatic CRC and its response to antiangiogenic therapy.
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Affiliation(s)
- Cristina Jimenez-Luna
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, 18100 Granada, Spain; (C.J.-L.); (R.O.); (O.C.); (J.P.)
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012 Granada, Spain;
| | - Encarnación González-Flores
- Instituto de Investigación Biosanitaria ibs. Granada, 18012 Granada, Spain;
- Medical Oncology Service, Hospital Virgen de las Nieves, 18014 Granada, Spain
| | - Raul Ortiz
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, 18100 Granada, Spain; (C.J.-L.); (R.O.); (O.C.); (J.P.)
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012 Granada, Spain;
| | - Luis J. Martínez-González
- GENyO, Centre for Genomics and Oncological Research, Pfizer-University of Granada-Andalusian Regional Government, 18016 Granada, Spain; (L.J.M.-G.); (A.A.-R.)
| | - Alba Antúnez-Rodríguez
- GENyO, Centre for Genomics and Oncological Research, Pfizer-University of Granada-Andalusian Regional Government, 18016 Granada, Spain; (L.J.M.-G.); (A.A.-R.)
| | - Manuela Expósito-Ruiz
- Unit of Biostatistics, Department of Statistics and Operations Research, School of Medicine, University of Granada, 18071 Granada, Spain;
| | - Consolación Melguizo
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, 18100 Granada, Spain; (C.J.-L.); (R.O.); (O.C.); (J.P.)
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012 Granada, Spain;
| | - Octavio Caba
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, 18100 Granada, Spain; (C.J.-L.); (R.O.); (O.C.); (J.P.)
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012 Granada, Spain;
| | - Jose Prados
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, 18100 Granada, Spain; (C.J.-L.); (R.O.); (O.C.); (J.P.)
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, 18012 Granada, Spain;
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14
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Ciruelos EM, Montaño A, Rodríguez CA, González-Flores E, Lluch A, Garrigós L, Quiroga V, Antón A, Malón D, Chacón JI, Velasco M, Gonzalez-Cortijo L, Jolis L, Echarri MJ, Muñoz M, Pascual T, Amigo Y, Casas M, Carrasco E, Casas A. Phase III study to evaluate patient's preference of subcutaneous versus intravenous trastuzumab in HER2-positive metastatic breast cancer patients: Results from the ChangHER study (GEICAM/2012-07). Eur J Cancer Care (Engl) 2020; 29:e13253. [PMID: 32578279 DOI: 10.1111/ecc.13253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 01/08/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We compared patients' preferences for intravenous (IV-t) versus subcutaneous (SC-t) trastuzumab administration. METHODS Phase III, open-label, multicentre study in HER2-positive metastatic breast cancer. Patients were receiving IV-t for at least 4 months without progression. Randomisation was 1:1 to administer 2 cycles of SC-t with vial followed by 2 cycles with single injection device (SID) or the reverse sequence (600mg SC-t every 3 weeks for 4 cycles). PRIMARY OBJECTIVE patients' preference for IV-t versus SC-t; secondary objectives: patients' preference for vial versus SID, healthcare professional (HCP) preference and safety. RESULTS We randomised 166 patients in 26 sites. Median number of previous lines of chemotherapy and/or endocrine therapy was 1 (1-7). Median duration of prior IV-t was 1.8 years (0.3-14). Of the159 patients completing the questionnaires, 86.2% preferred SC-t, 6.9% preferred IV-t, and 6.9% had no preference. Patients preferred SID (59.2%) over vial (26.3%). Most (87.2%) HCP preferred SC-t of whom 51.3% and 28.2% preferred SID and vial respectively. Related adverse events included G1-2 injection site reactions in 18 patients (10.8%), G1 pain in 8 (4.8%), G1-2 allergic reaction in 2 (1.2%), one G3 heart failure and 1 G2 ejection fraction decrease. CONCLUSIONS SC-t is preferred with no safety impact.
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Affiliation(s)
- Eva M Ciruelos
- Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain.,SOLTI Breast Cancer Research Group, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Alvaro Montaño
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - César A Rodríguez
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Encarnación González-Flores
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Ana Lluch
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain.,Centro de Investigación Biomédica en Red de Oncología, CIBERONC-ISCIII, Madrid, Spain
| | - Laia Garrigós
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital del Mar, Barcelona, Spain.,Oncology Department, Hospital Valle de Hebrón, Barcelona, Spain
| | - Vanesa Quiroga
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Badalona-Applied Research Group in Oncology: B-ARGO Group, Catalan Institut of Oncology, Barcelona, Spain
| | - Antonio Antón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Diego Malón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Jose I Chacón
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Virgen de la Salud, Toledo, Spain
| | - Montserrat Velasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital de Mataró (Consorci Sanitari del Maresme), Barcelona, Spain
| | - Lucía Gonzalez-Cortijo
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Quirón de Madrid, Madrid, Spain
| | - Laura Jolis
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital General de Granollers, Barcelona, Spain
| | - María J Echarri
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Severo Ochoa, Madrid, Spain
| | - Montse Muñoz
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Clinic i Provincial, Barcelona, Spain
| | - Tomás Pascual
- Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain.,Oncology Department, Hospital Clinic i Provincial, Barcelona, Spain
| | | | | | - Eva Carrasco
- GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Ana Casas
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Oncology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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15
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Martín-Blázquez A, Díaz C, González-Flores E, Franco-Rivas D, Jiménez-Luna C, Melguizo C, Prados J, Genilloud O, Vicente F, Caba O, Pérez Del Palacio J. Untargeted LC-HRMS-based metabolomics to identify novel biomarkers of metastatic colorectal cancer. Sci Rep 2019; 9:20198. [PMID: 31882610 PMCID: PMC6934557 DOI: 10.1038/s41598-019-55952-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/28/2019] [Indexed: 12/13/2022] Open
Abstract
Colorectal cancer is one of the main causes of cancer death worldwide, and novel biomarkers are urgently needed for its early diagnosis and treatment. The utilization of metabolomics to identify and quantify metabolites in body fluids may allow the detection of changes in their concentrations that could serve as diagnostic markers for colorectal cancer and may also represent new therapeutic targets. Metabolomics generates a pathophysiological ‘fingerprint’ that is unique to each individual. The purpose of our study was to identify a differential metabolomic signature for metastatic colorectal cancer. Serum samples from 60 healthy controls and 65 patients with metastatic colorectal cancer were studied by liquid chromatography coupled to high-resolution mass spectrometry in an untargeted metabolomic approach. Multivariate analysis revealed a separation between patients with metastatic colorectal cancer and healthy controls, who significantly differed in serum concentrations of one endocannabinoid, two glycerophospholipids, and two sphingolipids. These findings demonstrate that metabolomics using liquid-chromatography coupled to high-resolution mass spectrometry offers a potent diagnostic tool for metastatic colorectal cancer.
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Affiliation(s)
- Ariadna Martín-Blázquez
- Fundación MEDINA, Centro de Excelencia en Investigación de Medicamentos Innovadores en Andalucía, Granada, Spain
| | - Caridad Díaz
- Fundación MEDINA, Centro de Excelencia en Investigación de Medicamentos Innovadores en Andalucía, Granada, Spain
| | | | - Daniel Franco-Rivas
- Fundación MEDINA, Centro de Excelencia en Investigación de Medicamentos Innovadores en Andalucía, Granada, Spain
| | - Cristina Jiménez-Luna
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, Spain
| | - Consolación Melguizo
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, Spain.,Biosanitary Institute of Granada (ibs. GRANADA), SAS-Universidad de Granada, Granada, Spain.,Department of Anatomy and Embryology, University of Granada, Granada, Spain
| | - José Prados
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, Spain. .,Biosanitary Institute of Granada (ibs. GRANADA), SAS-Universidad de Granada, Granada, Spain. .,Department of Anatomy and Embryology, University of Granada, Granada, Spain.
| | - Olga Genilloud
- Fundación MEDINA, Centro de Excelencia en Investigación de Medicamentos Innovadores en Andalucía, Granada, Spain
| | - Francisca Vicente
- Fundación MEDINA, Centro de Excelencia en Investigación de Medicamentos Innovadores en Andalucía, Granada, Spain
| | - Octavio Caba
- Institute of Biopathology and Regenerative Medicine (IBIMER), Center of Biomedical Research (CIBM), University of Granada, Granada, Spain.,Biosanitary Institute of Granada (ibs. GRANADA), SAS-Universidad de Granada, Granada, Spain.,Department of Anatomy and Embryology, University of Granada, Granada, Spain
| | - José Pérez Del Palacio
- Fundación MEDINA, Centro de Excelencia en Investigación de Medicamentos Innovadores en Andalucía, Granada, Spain
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Vera R, Aparicio J, Carballo F, Esteva M, González-Flores E, Santianes J, Santolaya F, Fernández-Cebrián JM. Correction to: Recommendations for follow‑up of colorectal cancer survivors. Clin Transl Oncol 2019; 21:1440. [DOI: 10.1007/s12094-019-02088-w] [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: 10/27/2022]
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17
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Vera R, González-Flores E, Rubio C, Urbano J, Valero Camps M, Ciampi-Dopazo JJ, Orcajo Rincón J, Morillo Macías V, Gomez Braco MA, Suarez-Artacho G. Multidisciplinary management of liver metastases in patients with colorectal cancer: a consensus of SEOM, AEC, SEOR, SERVEI, and SEMNIM. Clin Transl Oncol 2019; 22:647-662. [PMID: 31359336 DOI: 10.1007/s12094-019-02182-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/08/2019] [Indexed: 12/12/2022]
Abstract
Colorectal cancer (CRC) has the second-highest tumor incidence and is a leading cause of death by cancer. Nearly 20% of patients with CRC will have metastases at the time of diagnosis, and more than 50% of patients with CRC develop metastatic disease during the course of their disease. A group of experts from the Spanish Society of Medical Oncology, the Spanish Association of Surgeons, the Spanish Society of Radiation Oncology, the Spanish Society of Vascular and Interventional Radiology, and the Spanish Society of Nuclear Medicine and Molecular Imaging met to discuss and provide a multidisciplinary consensus on the management of liver metastases in patients with CRC. The group defined the different scenarios in which the disease can present: fit or unfit patients with resectable liver metastases, patients with potential resectable liver metastases, and patients with unresectable liver metastases. Within each scenario, the different strategies and therapeutic approaches are discussed.
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Affiliation(s)
- R Vera
- Medical Oncology, Complejo Hospitalario de Navarra, Calle Irunlarrea, 3, 31008, Pamplona, Navarra, Spain.
| | | | - C Rubio
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J Urbano
- Vascular and Interventional Radiology, Vithas Hospitals Group, Madrid, Spain
| | - M Valero Camps
- Nuclear Medicine, Clínica Rotger (Quiron Salud), Palma de Mallorca, Spain
| | - J J Ciampi-Dopazo
- Interventional Radiology Unit, Complejo Hospitalario de Toledo, Toledo, Spain
| | - J Orcajo Rincón
- Nuclear Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - V Morillo Macías
- Radiation Oncology, Hospital Provincial de Castellón, Castellón, Spain
| | - M A Gomez Braco
- Hepatobiliary and Liver Transplantation Unit, University Hospital Virgen del Rocío, Sevilla, Spain
| | - G Suarez-Artacho
- Hepatobiliary and Liver Transplantation Unit, University Hospital Virgen del Rocío, Sevilla, Spain
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18
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Carnerero Córdoba L, González Cebrián I, Rodríguez González C, González-Flores E, Conde V, Delgado Ureña M, Jurado García J, González-Astorga B. Clinical significance of BRAF mutations in colorectal cancer: A retrospective study of one institution in a real-life population. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Ruiz-Vozmediano J, Gutiérrez-Martínez À, Postigo-Martin P, Cruz-Fernández M, González-Flores E, Cantarero-Villanueva I. Efficacy of a therapeutic exercise program on autonomic nervous system function, cardiac function and functional capacity in colorectal cancer survivors: a randomized controlled pilot study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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González-Flores E, Serrano R, Sevilla I, Viúdez A, Barriuso J, Benavent M, Capdevila J, Jimenez-Fonseca P, López C, Garcia-Carbonero R. SEOM clinical guidelines for the diagnosis and treatment of gastroenteropancreatic and bronchial neuroendocrine neoplasms (NENs) (2018). Clin Transl Oncol 2019; 21:55-63. [PMID: 30535553 PMCID: PMC6339660 DOI: 10.1007/s12094-018-1980-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 11/07/2018] [Indexed: 12/13/2022]
Abstract
NENs are a heterogeneous family of tumors of challenging diagnosis and clinical management. Their incidence and prevalence continue to rise across all sites, stages and grades. Although improved diagnostic techniques have led to earlier detection and stage migration, the improved prognosis documented over time for advanced gastrointestinal and pancreatic neuroendocrine tumors also reflect improvements in therapy. The aim of this guideline is to update practical recommendations for the diagnosis and treatment of gastroenteropancreatic and lung NENs. Diagnostic procedures, histological classification and therapeutic options are briefly discussed, including surgery, liver-directed therapy, peptide receptor radionuclide therapy, and systemic hormonal, cytotoxic or targeted therapy, and treatment algorithms are provided.
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Affiliation(s)
- E. González-Flores
- Department of Medical Oncology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - R. Serrano
- Department of Medical Oncology, Hospital Reina Sofía, Córdoba, IMIBIC, CIBERONC, Córdoba, Spain
| | - I. Sevilla
- Department of Medical Oncology, Instituto de Investigaciones Biomédicas de Málaga (IBIMA)/Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Málaga, Spain
| | - A. Viúdez
- Department of Medical Oncology, Complejo Hospitalario de Navarra (CHN), OncobionaTras Unit, Navarrabiomed, IdiSNA, Pamplona, Spain
| | - J. Barriuso
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - M. Benavent
- Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina, Seville, Spain
| | - J. Capdevila
- Department of Medical Oncology, Vall Hebron University Hospital, Vall Hebron Institute of Oncology (VIHO), Barcelona, Spain
| | - P. Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - C. López
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - R. Garcia-Carbonero
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, IIS imas12, UCM, CNIO, CIBERONC, Av. de Córdoba, s/n, 28041 Madrid, Spain
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21
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Gómez-España MA, Gallego J, González-Flores E, Maurel J, Páez D, Sastre J, Aparicio J, Benavides M, Feliu J, Vera R. SEOM clinical guidelines for diagnosis and treatment of metastatic colorectal cancer (2018). Clin Transl Oncol 2018; 21:46-54. [PMID: 30565083 PMCID: PMC6339676 DOI: 10.1007/s12094-018-02002-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/22/2022]
Abstract
Colorectal cancer (CRC) is the second cause of cancer death in Spain, the objective of this guide published by the Spanish Society of Medical Oncology is to develop a consensus for the diagnosis and management of metastatic disease. The optimal treatment strategy for patients with metastatic CRC should be discussed in a multidisciplinary expert team to select the most appropriate treatment, and integrate systemic treatment and other options such as surgery and ablative techniques depending on the characteristics of the tumour, the patient and the location of the disease and metastases.
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Affiliation(s)
- M A Gómez-España
- Servicio de Oncología Médica, H. Universitario Reina Sofía, IMIBIC, CIBERONC, Av. Menéndez Pidal, s/n, 14004, Córdoba, Spain.
| | - J Gallego
- Servicio de Oncología Médica, Hospital General Universitario, Elche, Spain
| | - E González-Flores
- Servicio de Oncología Médica, H. U. Virgen de las Nieves, Granada, Spain
| | - J Maurel
- Servicio de Oncología Médica, Hospital Clinic, Barcelona, Spain
| | - D Páez
- Servicio de Oncología Médica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Sastre
- Servicio de Oncología Médica, Hospital Clínico San Carlos, IdISSC, CIBERONC, Madrid, Spain
| | - J Aparicio
- Servicio de Oncología Médica, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - M Benavides
- Servicio de Oncología Médica, H.U. Regional y Virgen de la Victoria, Málaga, Spain
| | - J Feliu
- Servicio de Oncología Médica, H. U. La Paz, UAM, CIBERONC, Madrid, Spain
| | - R Vera
- Servicio de Oncología Médica, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
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Mata Velasco E, González-Flores E, Juez Martel I, Alonso V, Iranzo Gomez P, Martinez Lago N, Lopez C, Cabrera Romero J, Safont Aguilera M, Ruiz Casado A, Salgado Fernandez M, González Astorga B, Escudero P, Rivera Herrero F, Pericay Pijaume C, Vera R. In the pathway to response: Is aflibercept an optimal treatment for RASwt mCRC patients after progression to 1st line containing anti-EGFR? Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Díaz-Castellanos MA, Gómez de Las Heras KV, Díaz-Redondo T, González-Flores E, Albiñana V, Botella LM. Case Report: Propranolol increases the therapeutic response to temozolomide in a patient with metastatic paraganglioma. F1000Res 2017. [PMID: 29527294 PMCID: PMC5824325 DOI: 10.12688/f1000research.13185.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
This case report presents the clinical evolution and management of a patient with a hereditary paraganglioma syndrome. This disease is characterized by rare tumors of neural crest origin that are symmetrically distributed along the paravertebral axis from the base of the skull and neck to the pelvis. In addition, these patients may develop renal cancer, gastrointestinal stromal tumors, pituitary adenomas, and bone metastasis in some cases. To date no successful therapeutic treatment has been reported. Total resection with postoperative radiotherapy and chemotherapy have been advocated, especially for the multiple metastasis. Here we show how the combination of high doses of the beta blocker propranolol (3 mg/Kg/day) and the DNA intercalating agent, temozolomide, has been successful in the treatment of a SDHA metastatic paraganglioma.
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Affiliation(s)
| | | | - Tamara Díaz-Redondo
- Servicio de Oncología, Hospital Universitario Carlos Haya, Málaga, 29010, Spain
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24
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Benavides M, Abad A, Carrato A, Gravalos C, Fernández-Montes A, Falcó E, González-Flores E, Garcia Garcia T, Martin-Valades J, Gallego Plazas J, Valladares-Ayerbes M, García-Girón C, Dueñas R, García-Tapiador A, Pericay C, Losa F, Viudez A, García-Teijido P, Diaz Rubio E, Aranda Aguilar E. Benefits of upfront primary tumour resection (UPTR) according to sidedness in mCRC: Retrospective analyses of TTD MACRO-2 and PLANET randomised trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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González-Astorga B, González Cebrián I, Delgado Ureña Ma T, Conde V, Sánchez-Toro C, García-García J, González-Flores E. Analysis retrospective from efficacy with TAS-102 in patients with metastatic colorectal cancer refractory: Experience at two hospitals. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.328] [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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26
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González-Flores E, González-Astorga B, Delgado Ureña Ma T, González Cebrián I, Sánchez-Toro C, García-García J, Conde V. Experience with aflibercept as a second line chemotherapy in metastatic colorectal cancer: Safety and efficacy in a real-life population. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.314] [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: 11/13/2022] Open
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27
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Ciruelos EM, Montaño Á, Rodríguez CA, González-Flores E, Lluch A, Garrigós L, Quiroga V, Antón A, Malón D, Chacón JI, Velasco M, Gonzalez-Cortijo L, Jolis L, Pascual T, Amigo Y, Casas M, Cámara MC, Carrasco E, Casas A. Abstract P4-21-16: Phase III trial to evaluate patient´s preference for subcutaneous versus intravenous trastuzumab administration in patients with HER2 positive advanced breast cancer (ABC) under IV trastuzumab (IV-t) treatment for at least 4 months. ChangHER-SC study (GEICAM/2012-07). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-21-16] [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: Patients with HER2-positive ABC, receive anti-HER2 treatment for several months or even years. IV-t is administered weekly or 3-weekly, mandating patients to visit the hospital on a regular basis to receive infusions. This has inconveniences for patients and increase treatment costs. Subcutaneous administration could improve convenience of trastuzumab therapy. This study was designed to evaluate patient's preference for IV-t or SC trastuzumab (SC-t) in ABC patients.
Methods:This is a phase III, open label, multicenter study inpatients with HER2 positive ABC, receiving IV-t for at least 4 months and without evidence of disease progression. Patients received 600 mg of SC-t, either from a vial or from a single injection device (SID), every 3 weeks for 4 cycles. Before starting SC-t, patients received an additional IV-t cycle. Patients were randomized 1:1 to arm A, receiving 2 cycles of SC-t with vial followed by 2 cycles with SID or arm B, receiving the opposite sequence. After cycle 4, patients decided to continue with IV-t or SC-t till disease progression. Stratification criteria were the associated therapy (Chemotherapy, Hormone-therapy or none) and its administration route (IV, oral or none). Patients completed a questionnaire of experiences and preferences at three time points: before starting SC-t, after cycle 2 and after cycle 4. Health Care Professionals completed a satisfaction questionnaire every 5 patients. The primary objective was to evaluate patient´s preference for IV-t or SC-t (after cycle 2) and, secondary objectives were, to evaluate patient´s preference between the two SC-t administrations (vial or SID) after cycle 4, Health Care Professional satisfaction, associated costs of the administration options (Time and Motion pharmacoeconomic study) and safety.
Results: From September-13 to July-15, 166 patients were randomized (81 arm A, 85 arm B) in 26 Spanish sites from GEICAM. Median age was 60 years (35-93), 88% of patients were postmenopausal and 123 and 42 had an ECOG PS of 0 and 1, respectively. The median duration of prior IV-t for ABC was 1.8 years (range: 0.3-14). Patients received a median of 2 previous lines of Chemotherapy and/or Hormone-therapy (range: 1-9). Twenty patients were receiving pertuzumab at inclusion. According to patient questionnaires completed after cycle 2, 137 patients preferred the SC-t (66 arm A, 71 arm B), 11 the IV-t (6 arm A, 5 arm B), 11 didn't have a preference (4 arm A, 7 arm B), and 7 didn't answer (3 progressed, 2 withdrew participation before cycle 2 and 2 unknown reason). Three of the 11 patients choosing IV-t were receiving IV treatment as accompanying therapy; after cycle 4 five of these 11 patients finally continued with SC-t, 5 with IV-t and 1 progressed. From the 11 patients without any preference 7 received SC-t, 2 receive IV-t and 2 progressed; from the 137 patients preferring SC-t, 125 actually received it, 3 received IV-t and 9 progressed.
Conclusions: Our study shows that 82.5% of patients preferred the SC-t over the IV-t. Treatment choice was not influenced by the accompanying therapy.
Citation Format: Ciruelos EM, Montaño Á, Rodríguez CA, González-Flores E, Lluch A, Garrigós L, Quiroga V, Antón A, Malón D, Chacón JI, Velasco M, Gonzalez-Cortijo L, Jolis L, Pascual T, Amigo Y, Casas M, Cámara MC, Carrasco E, Casas A. Phase III trial to evaluate patient´s preference for subcutaneous versus intravenous trastuzumab administration in patients with HER2 positive advanced breast cancer (ABC) under IV trastuzumab (IV-t) treatment for at least 4 months. ChangHER-SC study (GEICAM/2012-07) [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 P4-21-16.
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Affiliation(s)
- EM Ciruelos
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - Á Montaño
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - CA Rodríguez
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - E González-Flores
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - A Lluch
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - L Garrigós
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - V Quiroga
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - A Antón
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - D Malón
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - JI Chacón
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - M Velasco
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - L Gonzalez-Cortijo
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - L Jolis
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - T Pascual
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - Y Amigo
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - M Casas
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - MC Cámara
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - E Carrasco
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
| | - A Casas
- Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Hospital Universitario de Salamanca-IBSAL, Zaragoza, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain; Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Universitat de València, Valencia, Spain; Hospital del Mar, Barcelona, Spain; Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Universitario de Fuenlabrada, Madrid, Spain; Hospital Virgen de la Salud, Toledo, Spain; Hospital de Mataró (Consorci Sanitari del Maresme), Mataró, Barcelona, Spain; Hospital Universitario Quirón de Madrid, Madrid, Spain; Hospital General de Granollers, Granollers, Barcelona, Spain; GEICAM, Spanish Breast Cancer Group, Madrid, Spain
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González-Flores E, González-Astorga B, Delgado Ureña M T, Conde V, Sánchez-Toro C, Legeren Alvarez M, Villaescusa A, Gálvez Montosa F, García-García J. P-142 Experience with Aflibercept as a second line chemotherapy in metastatic colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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García-Carbonero R, Vera R, Rivera F, Parlorio E, Pagés M, González-Flores E, Fernández-Martos C, Corral MÁ, Bouzas R, Matute F. SEOM/SERAM consensus statement on radiological diagnosis, response assessment and follow-up in colorectal cancer. Clin Transl Oncol 2016; 19:135-148. [DOI: 10.1007/s12094-016-1518-9] [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] [Received: 02/23/2016] [Accepted: 04/30/2016] [Indexed: 12/31/2022]
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Martinez-Galán J, González-Rivas C, Conde V, Ruiz-Vozmediano J, Castillo L, Ochoa L, Amezcua V, García-García J, Ortega J, González-Flores E, Delgado J. P-124 Clinical outcome and impact of lymph node level assessment in biliary tract cancers. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.124] [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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González-Astorga B, González-Flores E, Delgado Ureña M, García-García J, Conde V, Sánchez-Toro C, Villaescusa A. P-266 Aflibercept as a second line chemotherapy in metastatic colorectal cancer. One centre experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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González-Rivas C, Castillo L, González-Flores E, Ruiz-Vozmediano J, Ochoa L, Amezcua V, Martinez-Galán J, García-García J, Sanchez-Toro C, Delgado J. P-028 Role of somatostatin analogues in the treatment of neuroendocrine tumors (NETs), experience of Virgen de las Nieves University Hospital. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.28] [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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Conde V, González-Rivas C, Martinez-Galán J, Ochoa L, García-García J, Ruiz-Vozmediano J, González-Flores E, Castillo L, Amezcua V, Delgado J. P-089 Treatment of metastatic gastric cancer with docetaxel-irinotecan combination: Virgen de las Nieves University Hospital experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.89] [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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Abad A, Massutí B, Grávalos C, Escudero P, Guillén-Ponce C, Layos L, Gomez M, Safont M, Gallego J, Sastre J, Pericay C, Dueñas R, López-López C, Losa F, Valladares M, González-Flores E, Yuste A, Robles L, Sáenz A, Cano T, Carrato A, Aranda E. Panitumumab Plus FOLFOX4 or Panitumumab Plus Folfiri in Subjects with Wild-Type KRAS (EXON 2) Colorectal Cancer and Multiple or Unresectable Liver-Limited Metastases: Data from the Randomized, Phase II Planet Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu164.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Grávalos C, Salvador J, Albanell J, Barnadas A, Borrega P, García-Mata J, Garrido P, González-Flores E, Isla D, Lomas M, Rodríguez-Lescure Á, Cruz JJ, Alba E. Functions and workload of medical oncologists in Spain. Clin Transl Oncol 2013; 14:423-9. [PMID: 22634530 DOI: 10.1007/s12094-012-0819-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The functions and workload of medical oncologists are becoming increasingly relevant as cancer is a priority health issue in our country. Taking into account the specific characteristics and complexity of caring for cancer patients, the time of physicians attached to Medical Oncology could be distributed as follows: 70% for consultation (including participation in tumour committees and multidisciplinary units), 15% for research and 15% for training, teaching and clinical sessions. The time distribution for Heads of Services or Heads of Units is different, since it must also include their clinical management tasks, team coordination, and relations with other services and institutions. The average time, calculated in minutes, spent on each activity per patient is as follows: first visit and "second visit or results visit" 60-90 min; successive visits at the day hospital 15 min; successive visits of patients for follow-up or checkups 20 min; visits with family members 15-20 min; telephone or e-mail consultations 5-10 min; hospitalisation 20 min; and interconsultation 30-60 min. Also, participation in multidisciplinary committees takes up 60-120 min of an oncologist's time each week. When new technologies such as electronic medical records, e-mail and other software are used, these times increase with a correction factor that is still to be defined and which could vary according to the centre. Finally, the ratio recommended by SEOM is one medical oncologist for every 83 new patients a year.
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Affiliation(s)
- Cristina Grávalos
- Servicio de Oncología Médica, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n - km 5,400, ES-28041 Madrid, Spain.
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Conde-Herrero V, González-Flores E, González-Astorga B, Soberino-García J, Martinez-Galán J, González-Rivas C, De Ávila RLM, Ruiz-Vozmediano J, Castillo-Portellano L, De Pérez JRL. Experience of a Single Center in Treatment of Epidermoid Carcinoma of the Anal Canal. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.129] [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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González-Vicente A, González-Astorga B, García-García J, Conde-Herrero V, Ruiz-Vozmediano J, González-Flores E, Castillo-Portellano L, Martinez-Galán J, González-Rivas C, Soberino-García J, Ortega-Dominguez JA, De Pérez JRL. A Retrospective Analysis of Adjuvant Chemotherapy in Elderly Patients. Experience of Our Institution. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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González-Vicente A, González-Flores E, González-Rivas C, González-Astorga B, Soberino-García J, Conde-Herrero V, Ruiz-Vozmediano J, García-García J, Castillo-Portellano L, Martinez-Galán J, Ortega-Dominguez JA, Luque-Caro R, De Pérez JRL. Differences in Management and Survival Depending on the Grade of Differentiation in Neuroendocrine Tumors (Nets). Updating of Our Institution'S Experience. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.133] [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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González-Astorga B, González-Flores E, Conde-Herrero V, García-García J, Soberino-García J, González-Rivas C, Ruiz-Vozmediano J, Castillo-Portellano L, De Pérez JRL. Efficacy of Bevacizumab Associated to Different Regimen of Chemotherapy in the Treatment of Metastatic Colorectal Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ruiz-Vozmediano J, González-Flores E, González-Astorga B, Conde-Herrero V, Soberino-García J, González-Rivas C, Castillo-Portellano L, García-García J, Carmen ST, De Pérez JRL. Retrospective Analysis in Adjuvant Treatment of Locally Advanced Rectal Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Conde-Herrero V, González-Astorga B, González-Vicente A, González-Flores E, Soberino-García J, García-García J, González-Rivas C, Ortega JA, Ruiz-Vozmediano J, De Pérez JRL. Outcomes According to Kras Mutational Status in Treatment with Chemotherapy Plus Bevacizumab in Metastatic Colorectal Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.246] [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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Ruiz-Vozmediano J, González-Flores E, Conde-Herrero V, González-Astorga B, González-Vicente A, García-García J, Linares I, De Pérez JRL, Castillo-Portellano L, González-Rivas C. Capecitabine and Radiotherapy as Preoperative Treatment in Patients with Stage Ii-Iii Rectal Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.179] [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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González-Flores E, González-Astorga B, Conde-Herrero V, García-García J, Soberino-García J, González-Rivas C, Ruiz-Vozmediano J, Castillo-Portellano L, Luque-Caro R, De Pérez JRL. Pet/Ct in the Evaluation of Response to Treatment with Bevacizumab and Chemotherapy in Patients with Advanced Colorectal Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.255] [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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González-Flores E, Ruiz J, Gonzalez-Astorga B, Conde V, Garcia JG, Gonzalez-Vicente A, Soberino J, Gonzalez C, Raquel LC, Sanchez-Toro C, Martinez-Galan J, Delgado JR. PD-0007 18F-Fdg Positron Emission Tomography (FDG-PET) and Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(19)66501-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sastre J, Aranda E, Massutí B, Tabernero J, Chaves M, Abad A, Carrato A, Reina JJ, Queralt B, Gómez-España A, González-Flores E, Rivera F, Losa F, García T, Sanchez-Rovira P, Maestu I, Díaz-Rubio E. Elderly patients with advanced colorectal cancer derive similar benefit without excessive toxicity after first-line chemotherapy with oxaliplatin-based combinations: comparative outcomes from the 03-TTD-01 phase III study. Crit Rev Oncol Hematol 2008; 70:134-44. [PMID: 19111473 DOI: 10.1016/j.critrevonc.2008.11.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 08/20/2008] [Accepted: 11/05/2008] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Healthy elderly patients with metastatic colorectal cancer may benefit from chemotherapy as much as the younger population. This analysis compares the outcomes of first-line oxaliplatin plus fluoropyrimidines in elderly versus young patients. PATIENTS AND METHODS 348 patients were randomized to capecitabine 1000 mg/(m2 12 h), days 1-14 plus oxaliplatin 130 mg/m2 day 1, every 3 weeks or weekly infusional 5-FU 2250 mg/m2 over 48 h plus bimonthly oxaliplatin 85 mg/m2. We evaluated response rate, time to progression, overall survival and toxicity according to age. RESULTS ORR for elderly and young patients were 34.9% and 44.7%, respectively (p=0.081). Median TTP did not differ between the two groups: 8.3 months for patients > or =70 years and 9.6 months for those <70 years (p=0.114). Median OS was 16.8 months and 20.5 months for the > or =70 and <70 years groups, respectively (p=0.74). With XELOX, mild paresthesia and an increase in transaminase levels were more frequent for young patients, whereas grade 3/4 diarrhea was higher in those > or =70 years (25% vs. 8%, p=0.005). For FUOX, only paresthesia was significantly lower in patients > or =70 years (53% vs. 71%, p=0.032). CONCLUSION Elderly patients with MCRC benefit from first-line oxaliplatin-fluoropyrimidine combinations as much as younger patients, without increased toxicity.
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Affiliation(s)
- Javier Sastre
- Servicio de Oncologia Medica, Hospital Clínico San Carlos, 28040 Madrid, Spain.
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Bayo-Calero JL, Mayordomo JI, Sánchez-Rovira P, Pérez-Carrión R, Illaramendi JJ, García-Bueno JM, González-Flores E, Crespo C, Ramos-Vázquez M, García-Palomo A, Ruiz-Borrego M, de la Haba J, Gómez-Bernal A, Yubero-Esteban A. A phase II study of weekly vinorelbine and trastuzumab in patients with HER2-positive metastatic breast cancer. Clin Breast Cancer 2008; 8:264-8. [PMID: 18650157 DOI: 10.3816/cbc.2008.n.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Trastuzumab combined with cytotoxic agents presents encouraging results in metastatic breast cancer (MBC), but cardiac toxicity limits some combinations. The synergism shown with trastuzumab and the favorable tolerability profile of vinorelbine provided the rationale for investigating this combination. PATIENTS AND METHODS Patients with HER2-positive MBC who had received <2 lines of chemotherapy for metastatic disease were included. Vinorelbine (25 mg/m2 on day 2, then weekly on day 1) and trastuzumab (4 mg/kg on day 1, then 2 mg/kg weekly) were administered for a maximum of 6 cycles (1 cycle=3 weeks). RESULTS A total of 52 patients were enrolled. The median age was 50 years (range, 26-79 years). Ninety percent of the patients had received adjuvant chemotherapy, 42% received a first line of chemotherapy for MBC, and 69% had disease at visceral sites. The overall response rate was 58% (95% CI, 43%-71%). The median time to progression and overall survival were 7 months (95% CI, 5-9 months) and 26 months (95% CI, 20-32 months), respectively. Grade 4 neutropenia was present in 3 courses; neutropenic fever was not reported. The main grade 3 nonhematologic toxicities were asthenia, neuropathy, diarrhea, alopecia, and nausea/vomiting. No patients experienced serious cardiac toxicity. CONCLUSION These results confirm that weekly vinorelbine/trastuzumab is an active and safe regimen in patients with HER2-positive MBC with an unfavorable prognosis.
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Pericay C, Valladares M, Benavides M, Massutí B, Aparicio J, Dueñas R, González-Flores E, Carrato A, Marcuello E, Aranda E. Oxaliplatin in combination with 5-fluorouracil (FU) in a 48-hour continuous infusion (CI) as first-line chemotherapy for elderly patients (pts) with metastatic colorectal cancer (mCRC). TTD phase II trial. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4057] [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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Díaz-Rubio E, Tabernero J, Gómez-España A, Massutí B, Sastre J, Chaves M, Abad A, Carrato A, Queralt B, Reina JJ, Maurel J, González-Flores E, Aparicio J, Rivera F, Losa F, Aranda E. Phase III study of capecitabine plus oxaliplatin compared with continuous-infusion fluorouracil plus oxaliplatin as first-line therapy in metastatic colorectal cancer: final report of the Spanish Cooperative Group for the Treatment of Digestive Tumors Trial. J Clin Oncol 2007; 25:4224-30. [PMID: 17548839 DOI: 10.1200/jco.2006.09.8467] [Citation(s) in RCA: 213] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this phase III trial was to compare the efficacy and safety of capecitabine plus oxaliplatin (XELOX) versus Spanish-based continuous-infusion high-dose fluorouracil (FU) plus oxaliplatin (FUOX) regimens as first-line therapy for metastatic colorectal cancer (MCRC). PATIENTS AND METHODS A total of 348 patients were randomly assigned to receive XELOX (oral capecitabine 1,000 mg/m2 bid for 14 days plus oxaliplatin 130 mg/m2 on day 1 every 3 weeks) or FUOX (continuous-infusion FU 2,250 mg/m2 during 48 hours on days 1, 8, 15, 22, 29, and 36 plus oxaliplatin 85 mg/m2 on days 1, 15, and 29 every 6 weeks). RESULTS There were no significant differences in efficacy between XELOX and FUOX arms, which showed, respectively, median time to tumor progression (TTP; 8.9 v 9.5 months; P = .153); median overall survival (18.1 v 20.8 months; P = .145); and confirmed response rate (RR; 37% v 46%; P = .539). The safety profile of the two regimens was similar, although there were lower rates of grade 3/4 diarrhea (14% v 24%) and grade 1/2 stomatitis (28% v 43%), and higher rates of grade 1/2 hyperbilirubinemia (37% v 21%) and grade 1/2 hand-foot syndrome (14% v 5%) with XELOX versus FUOX, respectively. CONCLUSION This randomized study shows a similar TTP of XELOX compared with FUOX in the first-line treatment of MCRC, although there was a trend for slightly lower RR and survival. XELOX can be considered as an alternative to FUOX.
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Affiliation(s)
- Eduardo Díaz-Rubio
- Department of Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain.
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