V. Navarro

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Comparison of unidimensional and bidimensional measurements in metastatic non-small cell lung cancer

British Journal of Cancer (2002)

Javier Cortés J. Rodríguez Juan A. Díaz-González Carlos Garzón Alfonso Gúrpide

Tumour response evaluation after chemotherapy has become crucial in the development of many drugs. In contrast to the standard bidimensional WHO criteria, the recently described Response Evaluation Criteria In Solid Tumors are based on unidimensional measurements. The aim of the present study was to compare both methods in patients with metastatic non-small cell lung cancer. One hundred and sixty-four patients treated with two cisplatin-paclitaxel-based chemotherapy schedules between June 1994 and December 2000 were analysed. The measurements were reviewed by an independent panel of radiologists. Patient characteristics were: median age of 55 years (range 24–77 years) and a male to female ratio of 129 : 35. Adenocarcinoma and squamous carcinoma were the most common histologies. Vinorelbine was the third drug used in 77 patients and gemcitabine in 87. The ratio unidimensional/bidimensional was as follows: response 85 : 85; stable disease 32 : 32; progression 47 : 42 and not assessable 0 : 5. Kappa for agreement between responders was 0.951 (95% CI: 0.795–1.0) (P<0.001). Both WHO criteria and Response Evaluation Criteria In Solid Tumors give similar results in assessing tumour response in patients with non-small cell lung cancer after chemotherapy. The unidimensional measurement could replace the more complex bidimensional one.

Vinorelbine

10.1038/sj.bjc.6600449

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Residual neck disease management in squamous-cell carcinoma of the head and neck treated with radiotherapy plus cetuximab

Clinical & Translational Oncology (2016)

Robert Montal Marc Oliva Miren Taberna Leticia De avila Aleix Rovira

Concomitant

10.1007/s12094-016-1496-y

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Negative impact of steroids on the efficacy of immunotherapy in a multi- tumor cohort: time and dose-dependent

Research Square (Research Square) (2024)

Víctor Albarrán Patrícia Guerrero Coral García de Quevedo Carlos González Jesús Vicente Chamorro

Abstract Previous studies have suggested a negative impact of steroids on the efficacy of immune checkpoint inhibitors (ICI), but how this effect is modulated by the dosage and time of administration is yet to be clarified. We have performed a retrospective analysis of 475 patients with advanced solid tumors treated with ICI as monotherapy from 2015 to 2022. Data regarding immune-related adverse events (irAEs) and clinical outcomes were collected. For each patient, the daily steroid dose (in mg/kg of prednisone) was registered until disease progression or death. The impact of cumulative doses on response rates and survival outcomes was analyzed within different periods. The objective response rate (ORR) was significantly lower among patients exposed to steroids within 30 days before the first cycle of ICI (C1) (20.3% vs. 36.7%, p < 0.01) and within the first 90 days of treatment (25.7% vs. 37.7%, p = 0.01). This negative effect was confirmed by multivariable analysis. Higher mean steroid doses were observed among non-responders, and cumulative doses were inversely correlated with the disease control rate (DCR) around ICI initiation. Remarkably, poorer outcomes were observed even in patients belonging to the lowest dose quartile compared to the steroid-naïve population. The detrimental impact of steroids was not observed in long-term responders exposed to steroids after 6 months from C1. Our results suggest that the negative impact of steroids on ICI efficacy seems to be time-dependent, prevailing around ICI initiation, and may also be dose-dependent, with modulation of neutrophil-to-lymphocyte ratio as a potential underlying mechanism.

10.21203/rs.3.rs-4159119/v1

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65P Chemotherapy response score (CRS) and efficacy of PARP inhibitor (PARPi) treatment in advanced epithelial ovarian cancer (AEOC)

ESMO Open (2024)

Patricia Pérez de Aguado E.M. Vida Navas F. Longo Muñoz Eva Maria Guerra Alía M. Gion Cortes

BRCA 1/2 mutations (BRCAmut) and homologous recombination deficient (HRD) status are well-established prognostic and predictive factors of the magnitude of response to PARPi. CRS is also known as a prognostic value in patients with AEOC undergoing interval debulking surgery after neoadjuvant chemotherapy (NACT). The role of CRS in predicting PARPi response in AEOC is unclear and is the aim of this analysis. We conducted a retrospective study of 45 patients diagnosed AEOC, FIGO stage III-IV, treated with platinum-based NACT followed by interval debulking surgery, from April 2018 to June 2023. Somatic mutations and HR status were detected by BRCA MASTR Plus Dx, Myriad myChoice CDx Plus, Foundation One Medicine or SOPHiA Genetics and germline mutations were detected by Hereditary OncokitDx. Pathologic tumor response was evaluated using CRS (CRS1=no/minimal response; CRS2=appreciable response; CRS3=complete/near-complete response). Primary end point was Progression Free Survival (PFS) according to CRS (CRS1/2 vs 3) in patients receiving PARPi. 43 patients had high grade serous AOC and 2 had high grade endometroid AOC. 32 were stage III and 13 stage IV. 13 had CRS3 and 31 had CRS1/2, 1 undetermined. 36 (80%) had complete resection. Considering the entire population, 24.4% of tumors were BRCAmut and 37% had HRD status. 22 patients (48%) received PARPi (2 olaparib, 10 niraparib). Out of this 22: 12 had CRS3 and 10 had CRS1/2. PFS according to CRS in patients receiving PARPi were: BRCAmut & CRS3 23 months versus 43 months for the BRCAmut & CRS1/2 (p=0.49); HRD & CRS3 24 months versus 43 months for the HRD & CRS1/2 (p=0.47); HR proficient (HRP) & CRS3 25 months versus 13 months for the HRP & CRS1/2 (p=0.19). Due to small sample, we did not find any statistical differences on PFS in the different subgroups. Contrary to expectations, we did observe a tendency of longer PFS in CRS1/2 versus CRS3 for BRCAmut and HRD tumors, indicating no added value for CRS in these situations. In contrast, a tendency of better PARPi response in the CRS3 versus CRS1/2 was noticed in HRP subgroup, suggesting that platinum sensitivity according to CRS could predict a better PARPi response in HRP population.

PARP inhibitor

10.1016/j.esmoop.2024.103572

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Validation and comparison of Breast Graded Prognostic Assessment scores in patients with breast cancer and brain metastases

Clinical & Translational Oncology (2021)

Carles Fabregat-Franco Agostina Stradella V. Navarro Jenniffer Linares M. Galdeano

Triple-negative breast cancer

10.1007/s12094-021-02577-x

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Prospective assessment and validation of renal prognostic scores in oncology patients with acute renal failure

Journal of Clinical Oncology (2004)

Javier Lavilla José Luis Pérez‐Gracia Alfonso Gúrpide E. Rossich V. Navarro

8098 Background: Cancer patients are prone to develop renal complications due to their disease or to treatment. Some prognostic scores have shown to be useful to assess the risk of patients with Acute Renal Failure (ARF). However, none of them has been validated specifically in cancer patients. Therefore, we performed a prospective study to validate in cancer patients commonly used ARF prognostic scores. Methods: Cancer patients with ARF (>20% creatinine increase over baseline), were prospectively included. We collected clinical data (ARF etiology, Karnofsky performance status score -KPSS-, underlying disease and treatment), renal prognostic scores (Liaño's Individual Severity Index -ISI- and Multiorgan Dysfunction Index -MFI-) and analytical parameters (serum creatinine and urine n-acetyl glucosaminidase -NAG-). Statistical analysis (chi-square, ANOVA, multiple regression analysis and logistic regression) was performed with SPSS 9.0. Results: From January 02 to April 03, 149 patients were assessed. Mean age was 57 years and 77% were male. Etiology of ARF was: pre-renal 17%; renal 27%; mixed: 49%; obstructive 3%; unknown 4%. Tumor types were: genitourinary 43%; skin 16%; gastrointestinal 15%; lung: 9%; breast 5%; and others 9%. Specific ARF-related mortality rate was 17% and the main causes of death were cardiovascular (50%) and respiratory diseases (25%). Mean KPSS was 76 (SD 1.26). KPSS was associated (p<0.001) with basal (r = −0.365) and peak creatinine (r = −0.355) and urine levels of NAG, a marker of tubular damage (p<0.001, r =−0.617). KPSS was also associated (p<0.001) with validated renal prognostic scores ISI (r = −0.298) and MFI (r = −0.479). MFI index significantly correlated with survival (p<0.0001) and ISI prognostic value was of borderline significance (p=0.065). Conclusions: MFI index is a useful tool to assess ARF specific mortality risk in cancer patients with ARF. Low KPSS in cancer patients with ARF is associated with greater tubular damage and worse evolution, including higher mortality and risk of multiple organ failure. Adequate preventive measures, early diagnosis and management are crucial in these patients. No significant financial relationships to disclose.

Etiology

10.1200/jco.2004.22.90140.8098

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Citations (1)

Prospective assessment and validation of renal prognostic scores in oncology patients with acute renal failure

Journal of Clinical Oncology (2004)

Javier Lavilla José Luis Pérez‐Gracia Alfonso Gúrpide E. Rossich V. Navarro

8098 Background: Cancer patients are prone to develop renal complications due to their disease or to treatment. Some prognostic scores have shown to be useful to assess the risk of patients with Acute Renal Failure (ARF). However, none of them has been validated specifically in cancer patients. Therefore, we performed a prospective study to validate in cancer patients commonly used ARF prognostic scores. Methods: Cancer patients with ARF (>20% creatinine increase over baseline), were prospectively included. We collected clinical data (ARF etiology, Karnofsky performance status score -KPSS-, underlying disease and treatment), renal prognostic scores (Liaño's Individual Severity Index -ISI- and Multiorgan Dysfunction Index -MFI-) and analytical parameters (serum creatinine and urine n-acetyl glucosaminidase -NAG-). Statistical analysis (chi-square, ANOVA, multiple regression analysis and logistic regression) was performed with SPSS 9.0. Results: From January 02 to April 03, 149 patients were assessed. Mean age was 57 years and 77% were male. Etiology of ARF was: pre-renal 17%; renal 27%; mixed: 49%; obstructive 3%; unknown 4%. Tumor types were: genitourinary 43%; skin 16%; gastrointestinal 15%; lung: 9%; breast 5%; and others 9%. Specific ARF-related mortality rate was 17% and the main causes of death were cardiovascular (50%) and respiratory diseases (25%). Mean KPSS was 76 (SD 1.26). KPSS was associated (p<0.001) with basal (r = −0.365) and peak creatinine (r = −0.355) and urine levels of NAG, a marker of tubular damage (p<0.001, r =−0.617). KPSS was also associated (p<0.001) with validated renal prognostic scores ISI (r = −0.298) and MFI (r = −0.479). MFI index significantly correlated with survival (p<0.0001) and ISI prognostic value was of borderline significance (p=0.065). Conclusions: MFI index is a useful tool to assess ARF specific mortality risk in cancer patients with ARF. Low KPSS in cancer patients with ARF is associated with greater tubular damage and worse evolution, including higher mortality and risk of multiple organ failure. Adequate preventive measures, early diagnosis and management are crucial in these patients. No significant financial relationships to disclose.

Etiology

10.1200/jco.2004.22.14_suppl.8098

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Influence of Treatment Received in Long-Surviving Patients of Head-and-Neck Cancer

International Journal of Radiation Oncology*Biology*Physics (2014)

Miren Taberna Cinta Hierro Silvia Vázquez V. Navarro E. Vilajosana

Concomitant

10.1016/j.ijrobp.2013.11.222

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Relation dose volume histograms and quality of life in prostate cancer