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Hardy-Werbin M, Maiques JM, Busto M, Cirera I, Aguirre A, Garcia-Gisbert N, Zuccarino F, Carbullanca S, Del Carpio LA, Ramal D, Gayete Á, Martínez-Roldan J, Marquez-Colome A, Bellosillo B, Gibert J. MultiCOVID: a multi modal deep learning approach for COVID-19 diagnosis. Sci Rep 2023; 13:18761. [PMID: 37907750 PMCID: PMC10618492 DOI: 10.1038/s41598-023-46126-8] [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: 02/10/2023] [Accepted: 10/27/2023] [Indexed: 11/02/2023] Open
Abstract
The rapid spread of the severe acute respiratory syndrome coronavirus 2 led to a global overextension of healthcare. Both Chest X-rays (CXR) and blood test have been demonstrated to have predictive value on Coronavirus Disease 2019 (COVID-19) diagnosis on different prevalence scenarios. With the objective of improving and accelerating the diagnosis of COVID-19, a multi modal prediction algorithm (MultiCOVID) based on CXR and blood test was developed, to discriminate between COVID-19, Heart Failure and Non-COVID Pneumonia and healthy (Control) patients. This retrospective single-center study includes CXR and blood test obtained between January 2017 and May 2020. Multi modal prediction models were generated using opensource DL algorithms. Performance of the MultiCOVID algorithm was compared with interpretations from five experienced thoracic radiologists on 300 random test images using the McNemar-Bowker test. A total of 8578 samples from 6123 patients (mean age 66 ± 18 years of standard deviation, 3523 men) were evaluated across datasets. For the entire test set, the overall accuracy of MultiCOVID was 84%, with a mean AUC of 0.92 (0.89-0.94). For 300 random test images, overall accuracy of MultiCOVID was significantly higher (69.6%) compared with individual radiologists (range, 43.7-58.7%) and the consensus of all five radiologists (59.3%, P < .001). Overall, we have developed a multimodal deep learning algorithm, MultiCOVID, that discriminates among COVID-19, heart failure, non-COVID pneumonia and healthy patients using both CXR and blood test with a significantly better performance than experienced thoracic radiologists.
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Affiliation(s)
- Max Hardy-Werbin
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Emergency Department, Hospital del Mar, Barcelona, Spain
| | | | - Marcos Busto
- Radiology Department, Hospital del Mar, Barcelona, Spain
| | - Isabel Cirera
- Emergency Department, Hospital del Mar, Barcelona, Spain
| | - Alfons Aguirre
- Emergency Department, Hospital del Mar, Barcelona, Spain
| | - Nieves Garcia-Gisbert
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | | | | | - Didac Ramal
- Radiology Department, Hospital del Mar, Barcelona, Spain
| | - Ángel Gayete
- Radiology Department, Hospital del Mar, Barcelona, Spain
| | - Jordi Martínez-Roldan
- Innovation and Digital Transformation Department, Hospital del Mar, Barcelona, Spain
| | | | - Beatriz Bellosillo
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Joan Gibert
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
- Pathology Department, Hospital del Mar, Barcelona, Spain.
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Clavé S, Jackson JB, Salido M, Kames J, Gerding KMR, Verner EL, Kong EF, Weingartner E, Gibert J, Hardy-Werbin M, Rocha P, Riera X, Torres E, Hernandez J, Cerqueira G, Nichol D, Simmons J, Taus Á, Pijuan L, Bellosillo B, Arriola E. Comprehensive NGS profiling to enable detection of ALK gene rearrangements and MET amplifications in non-small cell lung cancer. Front Oncol 2023; 13:1225646. [PMID: 37927472 PMCID: PMC10623306 DOI: 10.3389/fonc.2023.1225646] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/28/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Next-generation sequencing (NGS) is currently widely used for biomarker studies and molecular profiling to identify concurrent alterations that can lead to the better characterization of a tumor's molecular landscape. However, further evaluation of technical aspects related to the detection of gene rearrangements and copy number alterations is warranted. Methods There were 12 ALK rearrangement-positive tumor specimens from patients with non-small cell lung cancer (NSCLC) previously detected via fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and an RNA-based NGS assay, and 26 MET high gene copy number (GCN) cases detected by FISH, selected for this retrospective study. All 38 pre-characterized cases were reassessed utilizing the PGDx™ elio™ tissue complete assay, a 505 gene targeted NGS panel, to evaluate concordance with these conventional diagnostic techniques. Results The detection of ALK rearrangements using the DNA-based NGS assay demonstrated excellent sensitivity with the added benefit of characterizing gene fusion partners and genomic breakpoints. MET copy number alterations were also detected; however, some discordances were observed likely attributed to differences in algorithm, reporting thresholds and gene copy number state. TMB was also assessed by the assay and correlated to the presence of NSCLC driver alterations and was found to be significantly lower in cases with NGS-confirmed canonical driver mutations compared with those without (p=0.0019). Discussion Overall, this study validates NGS as an accurate approach for detecting structural variants while also highlighting the need for further optimization to enable harmonization across methodologies for amplifications.
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Affiliation(s)
- Sergi Clavé
- Pathology Department, Hospital del Mar, Barcelona, Spain
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | | | - Marta Salido
- Pathology Department, Hospital del Mar, Barcelona, Spain
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Jacob Kames
- Personal Genome Diagnostics (PGDx/Labcorp), Baltimore, MD, United States
| | | | - Ellen L. Verner
- Personal Genome Diagnostics (PGDx/Labcorp), Baltimore, MD, United States
| | - Eric F. Kong
- Personal Genome Diagnostics (PGDx/Labcorp), Baltimore, MD, United States
| | | | - Joan Gibert
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Max Hardy-Werbin
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Pedro Rocha
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Xènia Riera
- Pathology Department, Hospital del Mar, Barcelona, Spain
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Erica Torres
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - James Hernandez
- Personal Genome Diagnostics (PGDx/Labcorp), Baltimore, MD, United States
| | - Gustavo Cerqueira
- Personal Genome Diagnostics (PGDx/Labcorp), Baltimore, MD, United States
| | - Donna Nichol
- Personal Genome Diagnostics (PGDx/Labcorp), Baltimore, MD, United States
| | - John Simmons
- Personal Genome Diagnostics (PGDx/Labcorp), Baltimore, MD, United States
| | - Álvaro Taus
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - Lara Pijuan
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Beatriz Bellosillo
- Pathology Department, Hospital del Mar, Barcelona, Spain
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Edurne Arriola
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
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Montero MM, Hardy-Werbin M, Gonzalez-Gallardo S, Torres E, Rueda R, Hannet I, Kirk JT, Yager TD, Navalkar K, Arenas MDM, Arietta-Aldea I, Castañeda S, Gómez-Junyent J, Gómez-Zorrilla S, Guerri-Fernandez R, Sanchez-Martinez F, López-Montesinos I, Pelegrín I, Sendra E, Sorlí L, Villar-García J, Bellosillo B, Horcajada JP. Evaluation of the host immune response assay SeptiCyte RAPID for potential triage of COVID-19 patients. Sci Rep 2023; 13:944. [PMID: 36653401 PMCID: PMC9845827 DOI: 10.1038/s41598-023-28178-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Tools for the evaluation of COVID-19 severity would help clinicians with triage decisions, especially the decision whether to admit to ICU. The aim of this study was to evaluate SeptiCyte RAPID, a host immune response assay (Immunexpress, Seattle USA) as a triaging tool for COVID-19 patients requiring hospitalization and potentially ICU care. SeptiCyte RAPID employs a host gene expression signature consisting of the ratio of expression levels of two immune related mRNAs, PLA2G7 and PLAC8, measured from whole blood samples. Blood samples from 146 adult SARS-CoV-2 (+) patients were collected within 48 h of hospital admission in PAXgene blood RNA tubes at Hospital del Mar, Barcelona, Spain, between July 28th and December 1st, 2020. Data on demographics, vital signs, clinical chemistry parameters, radiology, interventions, and SeptiCyte RAPID were collected and analyzed with bioinformatics methods. The performance of SeptiCyte RAPID for COVID-19 severity assessment and ICU admission was evaluated, relative to the comparator of retrospective clinical assessment by the Hospital del Mar clinical care team. In conclusion, SeptiCyte RAPID was able to stratify COVID-19 cases according to clinical severity: critical vs. mild (AUC = 0.93, p < 0.0001), critical vs. moderate (AUC = 0.77, p = 0.002), severe vs. mild (AUC = 0.85, p = 0.0003), severe vs. moderate (AUC = 0.63, p = 0.05). This discrimination was significantly better (by AUC or p-value) than could be achieved by CRP, lactate, creatine, IL-6, or D-dimer. Some of the critical or severe cases had "early" blood draws (before ICU admission; n = 33). For these cases, when compared to moderate and mild cases not in ICU (n = 37), SeptiCyte RAPID had AUC = 0.78 (p = 0.00012). In conclusion, SeptiCyte RAPID was able to stratify COVID-19 cases according to clinical severity as defined by the WHO COVID-19 Clinical Management Living Guidance of January 25th, 2021. Measurements taken early (before a patient is considered for ICU admission) suggest that high SeptiScores could aid in predicting the need for later ICU admission.
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Affiliation(s)
- Maria Milagro Montero
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra Barcelona, 08002, Barcelona, Spain.,CIBER of Infectious Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Max Hardy-Werbin
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Emergency Department, Hospital del Mar, Barcelona, Spain
| | | | - Erica Torres
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Rebeca Rueda
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | | | | | | | | | - Maria Del Mar Arenas
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Itziar Arietta-Aldea
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Silvia Castañeda
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Joan Gómez-Junyent
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Silvia Gómez-Zorrilla
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra Barcelona, 08002, Barcelona, Spain.,CIBER of Infectious Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Roberto Guerri-Fernandez
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra Barcelona, 08002, Barcelona, Spain.,CIBER of Infectious Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Francisca Sanchez-Martinez
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra Barcelona, 08002, Barcelona, Spain
| | - Immaculada López-Montesinos
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Ivan Pelegrín
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Elena Sendra
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Luisa Sorlí
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra Barcelona, 08002, Barcelona, Spain.,CIBER of Infectious Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Judith Villar-García
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra Barcelona, 08002, Barcelona, Spain
| | - Beatriz Bellosillo
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,Pathology Department, Hospital del Mar, Barcelona, Spain.
| | - Juan Pablo Horcajada
- Infectious Disease Department, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra Barcelona, 08002, Barcelona, Spain.,CIBER of Infectious Diseases, Institute of Health Carlos III, Madrid, Spain
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Rios Hoyo A, Hardy-Werbin M, Monzonís X, Monge Escartin I, Moliner L, Navarro N, Taus Á, Durán X, Conde D, Arriola E. 975P Impact of body mass index on the efficacy of immune checkpoint inhibitors in cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1359] [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: 11/26/2022] Open
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Rios Hoyo A, Hardy-Werbin M, Navarro N, Moliner L, Durán X, Taus Á, González Gallardo S, del Rey Vergara R, Campos MG, Arriola E. 1660P Changes in the pattern of diagnosis and treatment of patients with SCLC in the last 20 years. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.244] [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: 11/30/2022] Open
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Del Rev-Vergara R, Galindo-Campos M, Hardy-Werbin M, Moliner L, Ríos-Hoyo A, Martínez C, Carpes M, González-Gallardo S, Taus Á, Rovira A, Arriola E. 53P Antitumoral effects of the Met inhibitor savolitinib in combination with durvalumab in a syngeneic small cell lung cancer mouse model. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01895-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Taus Á, Camacho L, Rocha P, Hernández A, Longarón R, Clavé S, Fernández-Ibarrondo L, Salido M, Hardy-Werbin M, Fernández-Rodríguez C, Albanell J, Bellosillo B, Arriola E. Plasmatic KRAS Kinetics for the Prediction of Treatment Response and Progression in Patients With KRAS-mutant Lung Adenocarcinoma. Arch Bronconeumol 2020; 57:323-329. [PMID: 32253118 DOI: 10.1016/j.arbres.2020.01.023] [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: 08/26/2019] [Revised: 01/20/2020] [Accepted: 01/26/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION KRAS is the most common driver mutation in lung cancer. ctDNA-based assessment offers advantages over tumor as a minimally invasive method able to capture tumor heterogeneity. Monitoring KRAS mutational load in ctDNA may be useful in the management of the patients. METHODS Consecutive patients diagnosed with KRAS mutant lung adenocarcinoma in the tumor biopsy were included in this study. Plasma samples were obtained at different time points during the course of the disease. KRAS mutations in plasma were quantified using digital PCR and correlated with mutations in tumor and with radiological response and progression. RESULTS Two hundred and forty-five plasma samples from 56 patients were analyzed. The rate of detection of KRAS mutations in plasma in our previously characterized KRAS-mutant cases was 82% overall, reaching 96% in cases with more than 1 metastatic location. The dynamics of KRAS mutational load predicted response in 93% and progression in 63% of cases, 33 and 50 days respectively in advance of radiological evaluation. Progression-free survival for patients in whom ctDNA was not detectable in plasma after treatment initiation was significantly longer than for those in whom ctDNA remained detectable (7.7 versus 3.2 months; HR: 0.44, p=0.004). CONCLUSIONS The detection of KRAS mutations in ctDNA showed a good correlation with that in tumor biopsy and, in most cases, predicted tumor response and progression to chemotherapy in advance of radiographic evaluation. The liquid biopsies for ctDNA-based molecular analyses are a reliable tool for KRAS testing in clinical practice.
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Affiliation(s)
- Álvaro Taus
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain; Departamento de Medicina, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Laura Camacho
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Pedro Rocha
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Ainhoa Hernández
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Raquel Longarón
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Sergi Clavé
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | | | - Marta Salido
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Max Hardy-Werbin
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Joan Albanell
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Beatriz Bellosillo
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Edurne Arriola
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
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Gibert J, Clavé S, Hardy-Werbin M, Taus Á, Rocha P, Longarón R, Piquer G, Chaib I, Carcereny E, Morán T, Salido M, Dalmases A, Bellosillo B, Arriola E. Concomitant genomic alterations in KRAS mutant advanced lung adenocarcinoma. Lung Cancer 2019; 140:42-45. [PMID: 31862576 DOI: 10.1016/j.lungcan.2019.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 09/20/2019] [Revised: 11/29/2019] [Accepted: 12/03/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES KRAS mutations are one of the most prevalent alterations in non-small cell lung cancer. However, patients with this driver alteration present heterogeneous clinical outcomes. In this study, we have explored the potential clinical impact of coexisting alterations in this subset of patients. MATERIALS AND METHODS Samples from a cohort of 69 lung adenocarcinoma patients homogenously treated with platinum doublet as first-line therapy were evaluated using targeted next generation sequencing (NGS). Mutations and copy number alterations were assessed in 37 advanced KRAS-mutant (KRASm) and in 32 KRAS wild-type (KRASwt). RESULTS TP53 was the most frequent additional alteration found in both cohorts. Interestingly, TP53 mutations were more frequent in KRASwt than in KRASm patients (80 % vs. 34 %; p < 0.05) as well as STK11 mutations (17 % vs 8 %, p=NS). FGFR3 mutations were only found concomitantly with KRASm (11 %). No genomic co-alteration had an impact on overall survival within the KRASm patients treated with chemotherapy. CONCLUSIONS KRAS mutated lung adenocarcinoma is a heterogeneous entity and comprehensive characterization of co-alterations using NGS may lead to more accurate patient stratification.
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Affiliation(s)
- Joan Gibert
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Sergi Clavé
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Max Hardy-Werbin
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Álvaro Taus
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain
| | - Pedro Rocha
- Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain
| | - Raquel Longarón
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Gabriel Piquer
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Imane Chaib
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Enric Carcereny
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Marta Salido
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Alba Dalmases
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Beatriz Bellosillo
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Edurne Arriola
- Cancer Research Program, Hospital del Mar Medical Research Institute, Barcelona, Spain; Medical Oncology Department, Hospital del Mar - CIBERONC, Barcelona, Spain
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Lecuona CE, Hardy-Werbin M, Falgas EF, Mosquera JJG, Salamero MC, Te García IR, Vila MM. Second primary malignancies in patients with breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.108] [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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10
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Moliner L, Hardy-Werbin M, Duran X, Arpí O, Taus Á, Rocha P, Del Rey R, Galindo-Campos M, Rovira A, Albanell J, Arriola E. Association between serum HGF levels and neutrophil counts in small cell lung cancer and their impact on survival. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz264.009] [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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11
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Clavé S, Bellosillo B, Salido M, Tagmouti G, Taus Á, Rocha P, Hardy-Werbin M, Moliner L, Riera X, Fernández-Rodríguez C, Arriola E, Pijuan L. P2.09-34 Next-Generation Sequencing Implementation in Non-Small Cell Lung Cancer Molecular Diagnosis. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1683] [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: 11/29/2022]
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12
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Clavé S, Salido M, Rocha P, Hardy-Werbin M, Gibert J, Riera X, Weingartner E, Cerqueira G, Nichol D, Simmons J, Taus Á, Pijuan L, Bellosillo B, Arriola E. Identification of MET gene amplifications using next-generation sequencing in non-small cell lung cancer patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Rocha P, Rodrigo M, Moliner L, Hardy-Werbin M, Casadevall Aguilar D, Durán X, Arpí O, Clavé S, Salido M, Riera X, Menendez S, Taus Á, Pijuan L, Comerma L, Arriola Aperribay E. Higher PD-L1 expression correlates with lymphocyte infiltration in early non-small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz064.013] [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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14
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Hardy-Werbin M, Rocha P, Arpi O, Taus Á, Nonell L, Durán X, Villanueva X, Joseph-Pietras D, Nolan L, Danson S, Griffiths R, Lopez-Botet M, Rovira A, Albanell J, Ottensmeier C, Arriola E. Serum cytokine levels as predictive biomarkers of benefit from ipilimumab in small cell lung cancer. Oncoimmunology 2019; 8:e1593810. [PMID: 31069160 DOI: 10.1080/2162402x.2019.1593810] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 12/19/2018] [Revised: 02/22/2019] [Accepted: 02/28/2019] [Indexed: 01/22/2023] Open
Abstract
Background. Immunotherapy has shown efficacy in small cell lung cancer (SCLC), but only a subset of patients benefits. Surrogate biomarkers are urgently needed. Our aim was to evaluate serum Th1, Th2, and proinflammatory cytokines in two cohorts of SCLC patients before and during treatment with chemotherapy with or without ipilimumab and to correlate them with survival. Patients and methods. Two cohorts of SCLC patients were studied: patients treated with chemotherapy (n = 47), and patients treated with chemotherapy plus ipilimumab (n = 37). Baseline, on-treatment and after-treatment serum samples were evaluated for the presence of IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IFN-gamma, TNF-alpha, GM-CSF, and Mip-1alpha using a Luminex assay. Differential changes in cytokines between cohorts were analyzed. Associations between cytokine levels and their changes with overall survival were evaluated. Results. Patients treated with ipilimumab showed a global increase of all cytokines after treatment initiation. A high level of IL-8 at baseline was associated with worse prognosis regardless of treatment. Baseline increased IL-2 levels predicted sensitivity to ipilimumab, while high IL-6 and TNF-alpha predicted resistance. An on-treatment increase in IL-4 levels in patients treated with immune-chemotherapy was associated with a better overall survival. Conclusions. The addition of ipilimumab to standard chemotherapy in SCLC modulates the serum levels of cytokines. Baseline levels and their change over time relate to overall survival. Blood-based biomarkers are convenient for patients, and our results support prospective validation of cytokines as predictive biomarkers for ipilimumab in SCLC.
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Affiliation(s)
- Max Hardy-Werbin
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Pedro Rocha
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Oriol Arpi
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Álvaro Taus
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Lara Nonell
- Microarrays analysis service, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Xavier Durán
- Statistics department, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Xavier Villanueva
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | | | - Luke Nolan
- Medical Oncology Department, University Hospital Southampton, Southampton, UK
| | - Sarah Danson
- Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, UK
| | | | - Miguel Lopez-Botet
- Immunology unit, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Ana Rovira
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Joan Albanell
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Christian Ottensmeier
- NIHR Experimental Cancer Medicine Centre, Southampton, UK.,Cancer Science Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Edurne Arriola
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
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15
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Simões da Rocha P, Ripoll E, Corbera A, Hardy-Werbin M, Fernandez-Alarza A, Orrillo M, Taus Á, Arriola E. Radiological identification of rapid progressions in advanced NSCLC patients treated with nivolumab. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.097] [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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16
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Rocha P, Hardy-Werbin M, Naranjo D, Taus Á, Rodrigo M, Zuccarino F, Roth R, Wood O, Ottensmeier CH, Arriola E. CD103+CD8+ Lymphocytes Characterize the Immune Infiltration in a Case With Pseudoprogression in Squamous NSCLC. J Thorac Oncol 2018; 13:e193-e196. [PMID: 29775806 DOI: 10.1016/j.jtho.2018.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/26/2018] [Accepted: 05/07/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Pedro Rocha
- Servei d'Oncologia Médica, Hospital del Mar, Barcelona, Spain
| | - Max Hardy-Werbin
- IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Dolores Naranjo
- Servei d'Anatomía Patologica, Hospital del Mar, Barcelona, Spain
| | - Álvaro Taus
- Servei d'Oncologia Médica, Hospital del Mar, Barcelona, Spain
| | - Maite Rodrigo
- Servei d'Anatomía Patologica, Hospital del Mar, Barcelona, Spain
| | | | - René Roth
- Biopharmaceutical New Technologies (BioNTech) Corporation, Mainz, Germany
| | - Oliver Wood
- CR UK and NIHR Experimental Cancer Medicine Centre Southampton, University of Southampton, Faculty of Medicine, Southampton, United Kingdom
| | - Christian H Ottensmeier
- CR UK and NIHR Experimental Cancer Medicine Centre Southampton, University of Southampton, Faculty of Medicine, Southampton, United Kingdom
| | - Edurne Arriola
- Servei d'Oncologia Médica, Hospital del Mar, Barcelona, Spain; IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.
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17
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Hardy-Werbin M, Rocha P, Arpí O, Taus Á, Jordà XD, Joseph-Pietras D, Rovira A, Albanell J, Ottensmeier C, Arriola E. Abstract LB-143: Th1/Th2 and inflammatory cytokines as biomarkers of response to ipilimumab in small cell lung cancer (SCLC) patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-lb-143] [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
Ipilimumab appears to benefit a subset of patients with SCLC but no predictive marker is available to date. Cytokines encompass a group of pleiotropic proteins secreted by immune and cancer cells with a crucial role in immune response (Th1/Th2 balance). Our study sought to evaluate the role of serum cytokine levels and changes during treatment as biomarkers of outcome with ipilimumab in SCLC.
Serial serum samples (pre and on-treatment at 9 weeks) from two cohorts (C) of patients with recently diagnosed SCLC were evaluated in this study. C1, with 47 patients treated with first-line platinum/etoposide (PE) and C2, with 37 patients treated with PE plus ipilimumab (10mg/kg) within the ICE trial. By means of a fluorescent multiplex immunobead assay (Luminex Technology) we analyzed serum concentrations of Th1 (IL-2, IFN-γ), Th2 (IL-4, -5, -6, -10) and inflammatory (IL-1β, IL-8, GM-CSF, TNF-α, MIP1-α) cytokines. Optimal cut-offs were determined by the Contal and O'Quigley method. We evaluated the associations of cytokine baseline levels and on-treatment changes with patient outcomes and compare these between cohorts. Statistical analysis was carried out with Stata/MP 14 (StataCorp LLC) and Prism 6.0 (GraphPad).
In the ipilimumab cohort, patients with increased baseline levels of IL-2 (>1.67 pg/mL) showed a median overall survival (OS) of 24.2 months (m) (9.5-not reached) vs. those with lower levels [7.9m (5.6-18.46); p=0.030]. On the contrary, those with higher levels of IL-6 (>3.74 pg/mL) or TNF-α (>9.17 pg/mL) had worse OS (9.5m vs. 18.5m; p=0.019 and 7.8 vs. 18.5m; p=0.003, respectively). Lastly, patients whose IL-8 levels decreased from baseline to the on-treatment time-point (ICE) by more than 28.3%, had a worse OS [7.9m (3.9-17) vs. 18.46m (9.5-30.5); p=0.008]. The rest of associations observed were common between both cohorts.
Serum levels of Th1/Th2 and inflammatory cytokines change during treatments in SCLC patients. Having a ‘control' cohort of SCLC patients treated with chemotherapy allowed us to specifically identify differential changes induced by ipilimumab. Our study suggests that cytokines could be explored as biomarkers of sensitivity (IL-2) or resistance (IL-6 and TNF-α) to ipilimumab when combined with chemotherapy. Changes of cytokine levels during treatment might also predict benefit (IL-8). These findings warrant prospective validation.
Citation Format: Max Hardy-Werbin, Pedro Rocha, Oriol Arpí, Álvaro Taus, Xavier Durán Jordà, Deborah Joseph-Pietras, Ana Rovira, Joan Albanell, Christian Ottensmeier, Edurne Arriola. Th1/Th2 and inflammatory cytokines as biomarkers of response to ipilimumab in small cell lung cancer (SCLC) patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr LB-143.
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Affiliation(s)
| | | | - Oriol Arpí
- 1IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | | | | | | | - Ana Rovira
- 1IMIM (Hospital del Mar Research Institute), Barcelona, Spain
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18
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Balaña C, Estival A, Teruel I, Hardy-Werbin M, Sepulveda J, Pineda E, Martinez-García M, Gallego O, Luque R, Gil-Gil M, Mesia C, Del Barco S, Herrero A, Berrocal A, Perez-Segura P, De Las Penas R, Marruecos J, Fuentes R, Reynes G, Velarde JM, Cardona A, Verger E, Panciroli C, Villà S. Delay in starting radiotherapy due to neoadjuvant therapy does not worsen survival in unresected glioblastoma patients. Clin Transl Oncol 2018; 20:1529-1537. [PMID: 29737461 DOI: 10.1007/s12094-018-1883-7] [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: 02/05/2018] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE We retrospectively examined the potential effect on overall survival (OS) of delaying radiotherapy to administer neoadjuvant therapy in unresected glioblastoma patients. PATIENTS AND METHODS We compared OS in 119 patients receiving neoadjuvant therapy followed by standard treatment (NA group) and 96 patients receiving standard treatment without neoadjuvant therapy (NoNA group). The MaxStat package of R identified the optimal cut-off point for waiting time to radiotherapy. RESULTS OS was similar in the NA and NoNA groups. Median waiting time to radiotherapy after surgery was 13 weeks for the NA group and 4.2 weeks for the NoNA group. The longest OS was attained by patients who started radiotherapy after 12 weeks and the shortest by patients who started radiotherapy within 4 weeks (12.3 vs 6.6 months) (P = 0.05). OS was 6.6 months for patients who started radiotherapy before the optimal cutoff of 6.43 weeks and 19.1 months for those who started after this time (P = 0.005). Patients who completed radiotherapy had longer OS than those who did not, in all 215 patients and in the NA and NoNA groups (P = 0.000). In several multivariate analyses, completing radiotherapy was a universally favorable prognostic factor, while neoadjuvant therapy was never identified as a negative prognostic factor. CONCLUSION In our series of unresected patients receiving neoadjuvant treatment, in spite of the delay in starting radiotherapy, OS was not inferior to that of a similar group of patients with no delay in starting radiotherapy.
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Affiliation(s)
- C Balaña
- Medical Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Ctra Canyet, s/n, 08916, Badalona (Barcelona), Spain.
| | - A Estival
- Medical Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Ctra Canyet, s/n, 08916, Badalona (Barcelona), Spain
| | - I Teruel
- Medical Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Ctra Canyet, s/n, 08916, Badalona (Barcelona), Spain
| | - M Hardy-Werbin
- Cancer Research Programm, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J Sepulveda
- Medical Oncology Service, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - E Pineda
- Medical Oncology Service, Hospital Clinic Provincial, Barcelona, Spain
| | | | - O Gallego
- Medical Oncology Service, Hospital de Sant Pau, Barcelona, Spain
| | - R Luque
- Medical Oncology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M Gil-Gil
- Medical Oncology Service, Institut Català d'Oncologia-IDIBELL, Hospitalet de Llobregat, Spain
| | - C Mesia
- Medical Oncology Service, Institut Català d'Oncologia-IDIBELL, Hospitalet de Llobregat, Spain
| | - S Del Barco
- Medical Oncology Service, Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | - A Herrero
- Medical Oncology Service, Hospital Miguel Servet, Saragossa, Spain
| | - A Berrocal
- Medical Oncology Service, Hospital General Universitario de Valencia, Valencia, Spain
| | - P Perez-Segura
- Medical Oncology Service, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - R De Las Penas
- Medical Oncology Service, Hospital Provincial de Castellón, Castellón, Spain
| | - J Marruecos
- Radiation Oncology Service, Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | - R Fuentes
- Radiation Oncology Service, Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | - G Reynes
- Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | - J M Velarde
- Institut Investigació Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Badalona, Spain
| | - A Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Foundation for Clinical and Applied Cancer Research, FICMAC, Bogotá, Colombia.,Biology Systems Department, Universidad el Bosque, Bogotá, Colombia
| | - E Verger
- Radiation Oncology Service, Hospital Clinic Provincial, Barcelona, Spain
| | - C Panciroli
- Institut Investigació Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Badalona, Spain
| | - S Villà
- Radiation Oncology Service, Institut Català d'Oncologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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19
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Taus Á, Camacho L, Rocha P, Hardy-Werbin M, Pijuan L, Piquer G, López E, Dalmases A, Longarón R, Clavé S, Salido M, Albanell J, Bellosillo B, Arriola E. Dynamics of EGFR Mutation Load in Plasma for Prediction of Treatment Response and Disease Progression in Patients With EGFR-Mutant Lung Adenocarcinoma. Clin Lung Cancer 2018; 19:387-394.e2. [PMID: 29656868 DOI: 10.1016/j.cllc.2018.03.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 12/04/2017] [Revised: 03/06/2018] [Accepted: 03/17/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND The assessment of epidermal growth factor receptor (EGFR) mutations is crucial for the management of patients with lung adenocarcinoma. Circulating tumor DNA (ctDNA)-based assessment offers advantages over tumor as a minimally invasive method able to capture tumor heterogeneity. PATIENTS AND METHODS Consecutive patients diagnosed with EGFR-mutant lung adenocarcinoma in tumor biopsy were included in this study. Plasma samples were obtained at different time points during the course of the disease. EGFR mutations in plasma were quantified using BEAMing (beads, emulsions, amplification, and magnetics) or digital PCR and were correlated with mutations in tumor and with radiologic response and progression. RESULTS Two hundred twenty-one plasma samples from 33 patients were analyzed. EGFR mutations in plasma were detected in 83% of all patients and 100% of those with extrathoracic metastases. The dynamics of the EGFR mutation load predicted response in 93% and progression in 89% of cases well in advance of radiologic evaluation. Progression-free survival for patients in whom ctDNA was not detected in plasma during treatment was significantly longer than for those in whom ctDNA remained detectable (295 vs. 55 days; hazard ratio, 17.1; P < .001). CONCLUSION The detection of EGFR mutations in ctDNA showed good correlation with that in tumor biopsy and predicted tumor response and progression in most patients. The liquid biopsy for ctDNA-based assessment of EGFR mutations is a reliable technique for diagnosis and follow-up in patients with EGFR-mutant lung adenocarcinoma in routine clinical practice.
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Affiliation(s)
- Álvaro Taus
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain; Universidad Autónoma de Barcelona (UAB), Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Laura Camacho
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Pedro Rocha
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Max Hardy-Werbin
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Lara Pijuan
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Gabriel Piquer
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Eva López
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Alba Dalmases
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Raquel Longarón
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Sergi Clavé
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Marta Salido
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Joan Albanell
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Beatriz Bellosillo
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Edurne Arriola
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
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Hardy-Werbin M, Arpí O, Taus A, Rocha P, Joseph-Pietras D, Nolan L, Danson S, Griffiths R, Lopez-Botet M, Rovira A, Albanell J, Ottensmeier CH, Arriola E. Assessment of neuronal autoantibodies in patients with small cell lung cancer treated with chemotherapy with or without ipilimumab. Oncoimmunology 2017; 7:e1395125. [PMID: 29308329 PMCID: PMC5749672 DOI: 10.1080/2162402x.2017.1395125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 08/23/2017] [Accepted: 10/17/2017] [Indexed: 12/17/2022] Open
Abstract
Small-cell lung cancer (SCLC) is often associated with paraneoplastic syndromes. To assess the role of anti-neuronal autoantibodies (NAAs) as biomarkers of treatment outcome, we assessed NAAs in serial samples from SCLC patients treated with chemoimmunotherapy compared to chemotherapy alone. We evaluated 2 cohorts: in cohort 1 (C1), 47 patients received standard platinum/etoposide, and in cohort 2 (C2), 38 patients received ipilimumab, carboplatin and etoposide. Serum samples at baseline and subsequent time points were analyzed for the presence of NAAs. NAAs were detected at baseline in 25 patients (53.2%) in C1 and in 20 patients (52.6%) in C2 (most frequently anti-Sox1). NAA at baseline was associated with limited disease (75% vs 50%; p: 0.096) and better overall survival (15.1 m vs 11.7 m; p: 0.032) in C1. Thirteen patients (28.9%) showed 2 or more reactivities before treatment; this was associated with worse PFS (5.5 m vs 7.3 m; p: 0.005) in patients treated with chemoimmunotherapy. NAA titers decreased after therapy in 68.9% patients, with no differential patterns of change between cohorts. Patients whose NAA titer decreased after treatment, showed longer OS [18.5 m (95% CI: 15.8 - 21.2)] compared with those whose NAA increased [12.3 m (95% CI: 8.1 - 16.5; p 0.049)], suggesting that antibody levels correlate to tumor load. Our findings reinforce the role of NAAs as prognostic markers and tumor activity/burden in SCLC, warrant further investigation in their predictive role for immunotherapy and raise concern over the use of immunotherapy in patients with more than one anti-NAA reactivity.
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Affiliation(s)
- M. Hardy-Werbin
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - O. Arpí
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A. Taus
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - P. Rocha
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - D. Joseph-Pietras
- NIHR Experimental Cancer Medicine Centre, Southampton, United Kingdom
| | - L. Nolan
- Medical Oncology Department, University Hospital Southampton, Southampton, United Kingdom
| | - S. Danson
- Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, United Kingdom
| | - R. Griffiths
- Medical Oncology Department, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - M. Lopez-Botet
- Immunology unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A. Rovira
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J. Albanell
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - C. H. Ottensmeier
- Cancer Science Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Experimental Cancer Medicine Centre, Southampton, United Kingdom
| | - E. Arriola
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
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Hardy-Werbin M, Rocha P, Arpí O, Taus Á, Joseph-Pietras D, Rovira A, Albanell J, Ottensmeier C, Arriola E. P1.15-001 Ipilimumab Increases Th1/Th2 and Inflammatory Cytokines Counteracting Chemotherapy Effects in Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1037] [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: 10/18/2022]
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22
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Casadevall D, Clavé S, Taus Á, Hardy-Werbin M, Rocha P, Lorenzo M, Menéndez S, Salido M, Albanell J, Pijuan L, Arriola E. Heterogeneity of Tumor and Immune Cell PD-L1 Expression and Lymphocyte Counts in Surgical NSCLC Samples. Clin Lung Cancer 2017; 18:682-691.e5. [PMID: 28549836 DOI: 10.1016/j.cllc.2017.04.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [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: 01/09/2017] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Immune-checkpoint inhibitors against programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) have shown remarkable therapeutic activity in non-small-cell lung cancer (NSCLC). However, biomarker-based patient selection remains a challenge. Our aim was to assess the heterogeneity of various immune markers between different tumor areas of surgically resected NSCLC specimens. MATERIALS AND METHODS We included 94 adenocarcinoma (ADC) and 50 squamous cell carcinoma (SCC) specimens. Two distinct tumor areas of each tumor sample were selected and incorporated into tissue microarrays. PD-L1 expression in tumor cells (TCs) and immune cells (ICs) was assessed using clone SP142 (Ventana). PDL1 gene amplification was assessed using fluorescence in situ hybridization. CD3 and CD8 densities were quantified using digital image-based analysis. Heterogeneity was assessed using kappa agreement index (KI) and intraclass correlation coefficient. RESULTS Prevalence of PD-L1 expression was 16.8% in TCs and 27.8% in ICs. Eleven tumors (7.6%) showed PDL1 amplification. In ADC, KI of PD-L1 TC and IC expression between cores was 0.465 and 0.260, compared with 0.274 and 0.124 in SCC, respectively. Higher concordance was observed for PDL1 amplification (KI, 0.647 in ADC and KI, 1 in SCC). Eleven (61.1%) of 18 amplified cores showed PD-L1 staining in < 5% of TCs. Intraclass correlation coefficients for CD3 and CD8 were 0.293 and 0.186 in ADC and 0.489 and 0.610 in SCC samples, respectively. CONCLUSIONS We found significant heterogeneity of PD-L1 expression in both ADC and SCC samples, especially in the IC compartment. Heterogeneous expression of PD-L1 could misclassify patients for PD-1/PD-L1-directed therapies.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Adenocarcinoma/surgery
- Adult
- Aged
- Aged, 80 and over
- B7-H1 Antigen/genetics
- Biomarkers, Tumor/metabolism
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Non-Small-Cell Lung/surgery
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Female
- Gene Amplification
- Gene Expression Regulation, Neoplastic
- Humans
- In Situ Hybridization, Fluorescence
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Lung Neoplasms/surgery
- Lymphocyte Count
- Male
- Middle Aged
- Patient Selection
- Retrospective Studies
- Tissue Array Analysis
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Affiliation(s)
- David Casadevall
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergi Clavé
- Servei de Patologia, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Álvaro Taus
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Max Hardy-Werbin
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Pedro Rocha
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain
| | - Marta Lorenzo
- Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | - Marta Salido
- Servei de Patologia, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Joan Albanell
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
| | - Lara Pijuan
- Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | - Edurne Arriola
- Servei d'Oncologia Mèdica, Hospital del Mar, Barcelona, Spain; Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
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23
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Gil Moreno MDLLGIL, Moran T, Martinez LV, Hardy-Werbin M, Angelats L, Perez G, Centeno C, Tudela C, Soldevila L, Megadja N, Raya P, Andreo F, Martinez C, Garcia S, Mila M, Mate JL, Guasch I, Margeli V, Estival A, Carcereny E. Impact of three and further treatment lines in advanced non-small cell lung cancer patients according to molecular profile: A retrospective analysis. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e19131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Teresa Moran
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Laia Vilà Martinez
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Max Hardy-Werbin
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Laura Angelats
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Geovanna Perez
- Radiation Oncology Department. Catalan Institue of Oncology-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Carmen Centeno
- Pneumology Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Carol Tudela
- Internal Medicine Department.Hospital Germans Trias i Pujol, Badalona, Spain
| | - Laua Soldevila
- Internal Medicine Department.Hospital Germans Trias i Pujol, Badalona, Spain
| | - Natalia Megadja
- Pneumology Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Patricia Raya
- Pneumology Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Felipe Andreo
- Pneumology Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Carlos Martinez
- Thoracic Surgery Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Samuel Garcia
- Thoracic Surgery Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Marta Mila
- Nuclear Medicine Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Jose Luis Mate
- Pathology Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Ignasi Guasch
- Radiology Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Victor Margeli
- Radiology Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Anna Estival
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Enric Carcereny
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
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24
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Carcereny Costa E, Estival A, Martinez LV, Gil Moreno MDLLGIL, Moran T, Gutierrez B, Perez EN, Luis Y, Jove J, Buges C, Quiroga V, Cuadra-Urteaga JL, Cros S, Hardy-Werbin M, Teruel I, Ahlal S, Pardo N, Indacochea A, Capdevila L, Rosell R. Prevalence of ROS1 translocation, HER2, and BRAF mutations in a cohort of advanced Non-Small Cell Lung Cancer (NSCLC) patients (p) triple negative (TN). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e22139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Enric Carcereny Costa
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Anna Estival
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Laia Vilà Martinez
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Teresa Moran
- Institut Catala d'Oncologia, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Beatriz Gutierrez
- Radiation Oncology Department. Catalan Institute of Oncology-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Eli Nancy Perez
- Pneumology Department. Hospital Germans Trias i Pujol, Badalona, Spain
| | - Yolanda Luis
- Radiation Oncology Department. Catalan Institute of Oncology-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Josep Jove
- Radiation Oncology Department. Catalan Institute of Oncology-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Cristina Buges
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Vanesa Quiroga
- Institut Català d'Oncologia - Hospital Germans Trias i Pujol, Badalona, Spain
| | - Jose Luis Cuadra-Urteaga
- Institut Català d'Oncologia Badalona- HU Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Sara Cros
- Fundació Privada Hospital Asil de Granollers, Granollers, Spain
| | - Max Hardy-Werbin
- Medical Oncology Department. Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Iris Teruel
- Institut Català d'Oncologia Badalona-HU Germans Trias i Pujol, Barcelona, Spain
| | - Sara Ahlal
- Institut Català d'Oncologia Badalona- HU Germans Trias i Pujol, Badalona, Spain
| | - Nuria Pardo
- Medical Oncology Department. Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Laia Capdevila
- Medical Oncology Department. Xarxa Sanitaria Santa Tecla, Tarragona, Spain
| | - Rafael Rosell
- Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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25
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Cirauqui B, Quiroga V, Gil M, Vilà L, Indacochea A, Ahlal S, Hardy-Werbin M, Teruel I, Pollán C, Margeli M. PO-155: Second primary tumors in a cohort of almost 600 patients with head and neck cancer. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34915-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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