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1.
Clin Transl Oncol ; 22(9): 1565-1579, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32062835

ABSTRACT

BACKGROUND: This article describes and compares approved targeted therapies and the newer immunotherapy agents. MATERIALS AND METHODS: This article especially performs an in-depth review of currently available data for tivozanib, explaining its mechanism of action, its safety profile and its role as an efficacy drug in the management of renal cancer. RESULTS: Despite the fact that the treatment of advanced RCC has been dramatically modified in recent years, durable remissions are scarce and it remains a lethal disease. For first- and second-line therapy, there is now growing evidence to guide the selection of the appropriate treatment. CONCLUSIONS: Several TKIs are standard of care at different settings. Among those approved TKIs, tivozanib has similar efficacy than others with a better safety profile. The use of prognostic factors is critical to the selection of optimal therapy.


Subject(s)
Carcinoma, Renal Cell/drug therapy , Kidney Neoplasms/drug therapy , Phenylurea Compounds/therapeutic use , Protein Kinase Inhibitors/therapeutic use , Quinolines/therapeutic use , Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors , Carcinoma, Renal Cell/genetics , Carcinoma, Renal Cell/metabolism , Carcinoma, Renal Cell/pathology , Clinical Trials as Topic , Consensus , Humans , Kidney Neoplasms/genetics , Kidney Neoplasms/metabolism , Kidney Neoplasms/pathology , Neoplasm Metastasis
2.
Clin. transl. oncol. (Print) ; 20(11): 1467-1473, nov. 2018. ilus, tab, graf
Article in English | IBECS | ID: ibc-173739

ABSTRACT

Purpose: The aim of this phase II study was to evaluate the activity and safety of the combination of cisplatin and vinorelbine with thoracic radiotherapy in unresectable locally advanced stage III non-small cell lung cancer (NSCLC). The primary endpoint was the objective response rate (ORR). Secondary objectives included toxicity profile, progression-free survival (PFS), and overall survival (OS). Materials and methods: A total of 48 NSCLC patients were enrolled (median age 60 years, 52% stage IIIA and 48% stage IIIB, 52% adenocarcinoma). Patients received three cycles of chemotherapy every 21 days [intravenous cisplatin 80 mg/m2 and intravenous vinorelbine 25 mg/m2 on day 1 and oral vinorelbine on day 8 (60 mg/m2)] concurrent with radiotherapy (66 Gy, administered at 1.8 Gy per day, five consecutive days per week). Results: ORR was 79.2% (72.9% showing partial response and 6.3% showing complete response). With a median follow-up of 20.7 months, median PFS was 12 months and median OS was 36 months. Grade 3/4 toxicities were: neutropenia (14.5%), anaemia (6.2%), vomiting (2%), and oesophagitis (4.2%). No toxic deaths were reported. Conclusion: This combined regimen shows efficacy and a manageable safety profile. PFS and OS outcomes are encouraging and warrant further research


No disponible


Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/therapy , Lung Neoplasms/therapy , Chemoradiotherapy/methods , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Cisplatin/administration & dosage , Neoplasm Staging , Vinca Alkaloids/administration & dosage , Radiotherapy/methods
3.
Clin Transl Oncol ; 20(11): 1467-1473, 2018 Nov.
Article in English | MEDLINE | ID: mdl-29696478

ABSTRACT

PURPOSE: The aim of this phase II study was to evaluate the activity and safety of the combination of cisplatin and vinorelbine with thoracic radiotherapy in unresectable locally advanced stage III non-small cell lung cancer (NSCLC). The primary endpoint was the objective response rate (ORR). Secondary objectives included toxicity profile, progression-free survival (PFS), and overall survival (OS). MATERIALS AND METHODS: A total of 48 NSCLC patients were enrolled (median age 60 years, 52% stage IIIA and 48% stage IIIB, 52% adenocarcinoma). Patients received three cycles of chemotherapy every 21 days [intravenous cisplatin 80 mg/m2 and intravenous vinorelbine 25 mg/m2 on day 1 and oral vinorelbine on day 8 (60 mg/m2)] concurrent with radiotherapy (66 Gy, administered at 1.8 Gy per day, five consecutive days per week). RESULTS: ORR was 79.2% (72.9% showing partial response and 6.3% showing complete response). With a median follow-up of 20.7 months, median PFS was 12 months and median OS was 36 months. Grade 3/4 toxicities were: neutropenia (14.5%), anaemia (6.2%), vomiting (2%), and oesophagitis (4.2%). No toxic deaths were reported. CONCLUSION: This combined regimen shows efficacy and a manageable safety profile. PFS and OS outcomes are encouraging and warrant further research.


Subject(s)
Carcinoma, Non-Small-Cell Lung/therapy , Chemoradiotherapy , Lung Neoplasms/therapy , Adult , Aged , Carcinoma, Non-Small-Cell Lung/mortality , Carcinoma, Non-Small-Cell Lung/pathology , Cisplatin/administration & dosage , Cisplatin/adverse effects , Disease Progression , Female , Humans , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Rib Cage/radiation effects , Spain/epidemiology , Survival Analysis , Vinorelbine/administration & dosage , Vinorelbine/adverse effects
6.
Ann Oncol ; 28(7): 1508-1516, 2017 Jul 01.
Article in English | MEDLINE | ID: mdl-28472366

ABSTRACT

BACKGROUND: There is an urgent need to identify biomarkers to guide personalized therapy in castration-resistant prostate cancer (CRPC). We aimed to clinically qualify androgen receptor (AR) gene status measurement in plasma DNA using multiplex droplet digital PCR (ddPCR) in pre- and post-chemotherapy CRPC. METHODS: We optimized ddPCR assays for AR copy number and mutations and retrospectively analyzed plasma DNA from patients recruited to one of the three biomarker protocols with prospectively collected clinical data. We evaluated associations between plasma AR and overall survival (OS) and progression-free survival (PFS) in 73 chemotherapy-naïve and 98 post-docetaxel CRPC patients treated with enzalutamide or abiraterone (Primary cohort) and 94 chemotherapy-naïve patients treated with enzalutamide (Secondary cohort; PREMIERE trial). RESULTS: In the primary cohort, AR gain was observed in 10 (14%) chemotherapy-naïve and 33 (34%) post-docetaxel patients and associated with worse OS [hazard ratio (HR), 3.98; 95% CI 1.74-9.10; P < 0.001 and HR 3.81; 95% CI 2.28-6.37; P < 0.001, respectively], PFS (HR 2.18; 95% CI 1.08-4.39; P = 0.03, and HR 1.95; 95% CI 1.23-3.11; P = 0.01, respectively) and rate of PSA decline ≥50% [odds ratio (OR), 4.7; 95% CI 1.17-19.17; P = 0.035 and OR, 5.0; 95% CI 1.70-14.91; P = 0.003, respectively]. AR mutations [2105T>A (p.L702H) and 2632A>G (p.T878A)] were observed in eight (11%) post-docetaxel but no chemotherapy-naïve abiraterone-treated patients and were also associated with worse OS (HR 3.26; 95% CI 1.47-not reached; P = 0.004). There was no interaction between AR and docetaxel status (P = 0.83 for OS, P = 0.99 for PFS). In the PREMIERE trial, 11 patients (12%) with AR gain had worse PSA-PFS (sPFS) (HR 4.33; 95% CI 1.94-9.68; P < 0.001), radiographic-PFS (rPFS) (HR 8.06; 95% CI 3.26-19.93; P < 0.001) and OS (HR 11.08; 95% CI 2.16-56.95; P = 0.004). Plasma AR was an independent predictor of outcome on multivariable analyses in both cohorts. CONCLUSION: Plasma AR status assessment using ddPCR identifies CRPC with worse outcome to enzalutamide or abiraterone. Prospective evaluation of treatment decisions based on plasma AR is now required. CLINICAL TRIAL NUMBER: NCT02288936 (PREMIERE trial).


Subject(s)
Androstenes/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Biomarkers, Tumor/blood , Circulating Tumor DNA/blood , Phenylthiohydantoin/analogs & derivatives , Prostatic Neoplasms, Castration-Resistant/blood , Prostatic Neoplasms, Castration-Resistant/drug therapy , Receptors, Androgen/blood , Adult , Aged , Aged, 80 and over , Androstenes/adverse effects , Antineoplastic Agents, Hormonal/adverse effects , Benzamides , Biomarkers, Tumor/genetics , Circulating Tumor DNA/genetics , DNA Mutational Analysis , Disease Progression , Disease-Free Survival , Europe , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Multiplex Polymerase Chain Reaction , Multivariate Analysis , Mutation , Nitriles , Odds Ratio , Patient Selection , Phenylthiohydantoin/adverse effects , Phenylthiohydantoin/therapeutic use , Precision Medicine , Predictive Value of Tests , Proportional Hazards Models , Prospective Studies , Prostatic Neoplasms, Castration-Resistant/genetics , Prostatic Neoplasms, Castration-Resistant/mortality , Receptors, Androgen/genetics , Risk Factors , Time Factors , Treatment Outcome
7.
J Comp Neurol ; 525(12): 2677-2689, 2017 Aug 15.
Article in English | MEDLINE | ID: mdl-28472857

ABSTRACT

Cross-modal reorganization in the auditory and visual cortices has been reported after hearing and visual deficits mostly during the developmental period, possibly underlying sensory compensation mechanisms. However, there are very few data on the existence or nature and timeline of such reorganization events during sensory deficits in adulthood. In this study, we assessed long-term changes in activity-dependent immediate early genes c-Fos and Arc/Arg3.1 in auditory and neighboring visual cortical areas after bilateral deafness in young adult rats. Specifically, we analyzed qualitatively and quantitatively c-Fos and Arc/Arg3.1 immunoreactivity at 15 and 90 days after cochlea removal. We report extensive, global loss of c-Fos and Arc/Arg3.1 immunoreactive neurons in the auditory cortex 15 days after permanent auditory deprivation in adult rats, which is partly reversed 90 days after deafness. Simultaneously, the number and labeling intensity of c-Fos- and Arc/Arg3.1-immunoreactive neurons progressively increase in neighboring visual cortical areas from 2 weeks after deafness and these changes stabilize three months after inducing the cochlear lesion. These findings support plastic, compensatory, long-term changes in activity in the auditory and visual cortices after auditory deprivation in the adult rats. Further studies may clarify whether those changes result in perceptual potentiation of visual drives on auditory regions of the adult cortex.


Subject(s)
Auditory Cortex/metabolism , Cytoskeletal Proteins/metabolism , Gene Expression Regulation/physiology , Hearing Loss/pathology , Nerve Tissue Proteins/metabolism , Proto-Oncogene Proteins c-fos/metabolism , Visual Cortex/metabolism , Animals , Auditory Pathways/metabolism , Cochlea/injuries , Cochlea/metabolism , Cochlea/pathology , Disease Models, Animal , Evoked Potentials, Auditory , Hearing Loss/metabolism , Male , Rats , Rats, Wistar , Spiral Ganglion/pathology
8.
Clin. transl. oncol. (Print) ; 18(11): 1114-1122, nov. 2016. tab
Article in English | IBECS | ID: ibc-156877

ABSTRACT

Purpose. Head and neck cancer is a highly heterogeneous disease comprising a large number of tumors located in the cervicofacial area. This study aimed to determine the epidemiological characteristics of squamous-cell carcinomas of the head and neck in the Spanish population, and the distribution of risk factors based on tumor locations. Methods/patients. A cohort of 459 patients (75 oral cavity, 167 oro-/hypopharyngeal and 217 laryngeal cancers) recruited in 19 hospitals participating in the Spanish head and neck cancer cooperative group were included over 3 years (2012-2014). Epidemiological parameters and risk factors were obtained from a self-administered questionnaire, and tumor characteristics were obtained from clinical records. Multivariate multinomial logistic regression was used to assess factors associated with tumor location. Results. Most patients were males (88.4 %), smokers (95 %) and drinkers (76.5 %). Relative to laryngeal cancer, pharyngeal cancer and oral cancer were more common in women than men (OR 3.58, p = 0.003 and 4.33, p = 0.001, respectively); pharyngeal cancer was more associated with rural environment (OR 1.81, p = 0.007) and weekly alcohol intake (10-140 g: OR 2.53, p = 0.012; 141-280 g: OR 2.47, p = 0.023; >280 g: OR 3.20, p = 0.001) and less associated with pack-years of smoking (21-40 packs: OR 0.46, p = 0.045; 41-70 packs: OR 0.43, p = 0.023; ≥71 packs: OR 3.20, p = 0.015). Conclusions. The distribution of these tumors differs between the sexes, with a higher proportion of oral cavity and pharyngeal tumors in women than in men. Oro-/hypopharyngeal cancers were more strongly associated with rural areas and with alcohol consumption, although less strongly associated with smoking than laryngeal tumors (AU)


No disponible


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/epidemiology , Carcinoma, Squamous Cell/diagnosis , Risk Factors , Laryngeal Neoplasms/complications , Cohort Studies , Multivariate Analysis , Surveys and Questionnaires
9.
Clin Transl Oncol ; 18(11): 1114-1122, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27112939

ABSTRACT

PURPOSE: Head and neck cancer is a highly heterogeneous disease comprising a large number of tumors located in the cervicofacial area. This study aimed to determine the epidemiological characteristics of squamous-cell carcinomas of the head and neck in the Spanish population, and the distribution of risk factors based on tumor locations. METHODS/PATIENTS: A cohort of 459 patients (75 oral cavity, 167 oro-/hypopharyngeal and 217 laryngeal cancers) recruited in 19 hospitals participating in the Spanish head and neck cancer cooperative group were included over 3 years (2012-2014). Epidemiological parameters and risk factors were obtained from a self-administered questionnaire, and tumor characteristics were obtained from clinical records. Multivariate multinomial logistic regression was used to assess factors associated with tumor location. RESULTS: Most patients were males (88.4 %), smokers (95 %) and drinkers (76.5 %). Relative to laryngeal cancer, pharyngeal cancer and oral cancer were more common in women than men (OR 3.58, p = 0.003 and 4.33, p = 0.001, respectively); pharyngeal cancer was more associated with rural environment (OR 1.81, p = 0.007) and weekly alcohol intake (10-140 g: OR 2.53, p = 0.012; 141-280 g: OR 2.47, p = 0.023; >280 g: OR 3.20, p = 0.001) and less associated with pack-years of smoking (21-40 packs: OR 0.46, p = 0.045; 41-70 packs: OR 0.43, p = 0.023; ≥71 packs: OR 3.20, p = 0.015). CONCLUSIONS: The distribution of these tumors differs between the sexes, with a higher proportion of oral cavity and pharyngeal tumors in women than in men. Oro-/hypopharyngeal cancers were more strongly associated with rural areas and with alcohol consumption, although less strongly associated with smoking than laryngeal tumors.


Subject(s)
Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/pathology , Head and Neck Neoplasms/epidemiology , Head and Neck Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Alcohol Drinking/adverse effects , Carcinoma, Squamous Cell/etiology , Female , Head and Neck Neoplasms/etiology , Humans , Male , Middle Aged , Risk Factors , Smoking/adverse effects , Spain/epidemiology , Squamous Cell Carcinoma of Head and Neck
10.
Arch. Soc. Esp. Oftalmol ; 91(1): 20-22, ene. 2016. tab
Article in Spanish | IBECS | ID: ibc-147955

ABSTRACT

INTRODUCCIÓN: Las perforaciones digestivas por ingestión de cuerpo extraño (CE) suponen un 21% del total en nuestro medio. METODOLOGÍA: Se recogen todos los casos de perforación del aparato digestivo por ingestión de CE desde 1990 (29 casos), de forma retrospectiva, y se analiza las características de la visión de estos pacientes. RESULTADOS Y DISCUSIÓN: La edad media fue de 74,2 años (todos présbitas), con predilección por sexo femenino (1,9:1). El CE ingerido con más frecuencia fue la espina de pescado (55%). La agudeza visual de cerca corregida obtuvo un valor medio de 0,73, si bien la real (solo uno de ellos usaba gafa para comer) era de 0,145. Cuatro de ellos (20%) eran ojos únicos, y solo 12 (60%) presentaba TNO+. Al menos 13 (65%) tenían algún grado de catarata. CONCLUSIONES: La mejora de la agudeza visual de cerca, ya sea con cirugía de catarata temprana y/o lentes intraoculares multifocales podría disminuir el número de perforaciones digestivas


INTRODUCTION: Intestinal perforation due to ingestion of a foreign body accounts for 21% of the total in our hospital. METHODS: All cases of intestinal perforation due to foreign body ingestion occurring since 1990 were collected (29 cases), and the visual characteristics of these patients were analysed. RESULTS AND DISCUSSION: The mean age was 74.2 years (all of them presbyopic) with the majority being female (1.9:1). The most frequently ingested foreign body was fish bone (55%). The corrected near visual acuity obtained a mean value of 0.73, while the real visual accuity (only one of them wore glasses to eat) was 0.145. Four patients (20%) had only one eye, and the TNO test was positive in only 12 (60%). At least 13 (65%) had some degree of cataract. CONCLUSIONS: Improving near visual acuity with either early cataract surgery and/or multifocal intraocular lenses may decrease the number of gastrointestinal perforations


Subject(s)
Humans , Male , Female , Aged , Intestinal Perforation/complications , Intestinal Perforation/diagnosis , Foreign Bodies/complications , Foreign Bodies/surgery , Foreign Bodies , Eye Diseases/complications , Eye Diseases , Retrospective Studies , Visual Acuity/physiology
11.
Arch Soc Esp Oftalmol ; 91(1): 20-2, 2016 Jan.
Article in English, Spanish | MEDLINE | ID: mdl-26560165

ABSTRACT

INTRODUCTION: Intestinal perforation due to ingestion of a foreign body accounts for 21% of the total in our hospital. METHODS: All cases of intestinal perforation due to foreign body ingestion occurring since 1990 were collected (29 cases), and the visual characteristics of these patients were analysed. RESULTS AND DISCUSSION: The mean age was 74.2 years (all of them presbyopic) with the majority being female (1.9:1). The most frequently ingested foreign body was fish bone (55%). The corrected near visual acuity obtained a mean value of 0.73, while the real visual accuity (only one of them wore glasses to eat) was 0.145. Four patients (20%) had only one eye, and the TNO test was positive in only 12 (60%). At least 13 (65%) had some degree of cataract. CONCLUSIONS: Improving near visual acuity with either early cataract surgery and/or multifocal intraocular lenses may decrease the number of gastrointestinal perforations.


Subject(s)
Cataract Extraction , Foreign Bodies/prevention & control , Intestinal Perforation/prevention & control , Visual Acuity , Aged , Cataract , Eating , Female , Humans , Intestinal Perforation/etiology , Lens Implantation, Intraocular , Lenses, Intraocular , Male , Retrospective Studies
12.
Ann Oncol ; 27(4): 706-11, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26658889

ABSTRACT

BACKGROUND: Patients with metastatic renal carcinoma (mRCC) treated with first-line pazopanib were not included in the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) prognostic model. SPAZO (NCT02282579) was a nation-wide retrospective observational study designed to assess the effectiveness and validate the IMDC prognostic model in patients treated with first-line pazopanib in clinical practice. PATIENTS AND METHODS: Data of 278 patients, treated with first-line pazopanib for mRCC in 34 centres in Spain, were locally recorded and externally validated. Mean age was 66 years, there were 68.3% male, 93.5% clear-cell type, 74.8% nephrectomized, and 81.3% had ECOG 0-1. Metastatic sites were: lung 70.9%, lymph node 43.9%, bone 26.3%, soft tissue/skin 20.1%, liver 15.1%, CNS 7.2%, adrenal gland 6.5%, pleura/peritoneum 5.8%, pancreas 5%, and kidney 2.2%. After median follow-up of 23 months, 76.4% had discontinued pazopanib (57.2% due to progression), 47.9% had received second-line targeted therapy, and 48.9% had died. RESULTS: According to IMDC prognostic model, 19.4% had favourable risk (FR), 57.2% intermediate risk (IR), and 23.4% poor risk (PR). No unexpected toxicities were recorded. Response rate was 30.3% (FR: 44%, IR: 30% PR: 17.3%). Median progression-free survival (whole population) was 11 months (32 in FR, 11 in IR, 4 in PR). Median and 2-year overall survival (whole population) were 22 months and 48.1%, respectively (FR: not reached and 81.6%, IR: 22 and 48.7%, PR: 7 and 18.8%). These estimations and their 95% confidence intervals are fully consistent with the outcomes predicted by the IMDC prognostic model. CONCLUSION: Our results validate the IMDC model for first-line pazopanib in mRCC and confirm the effectiveness and safety of this treatment.


Subject(s)
Carcinoma, Renal Cell/drug therapy , Molecular Targeted Therapy , Prognosis , Pyrimidines/administration & dosage , Sulfonamides/administration & dosage , Adult , Aged , Carcinoma, Renal Cell/pathology , Databases, Factual , Disease-Free Survival , Female , Humans , Indazoles , Kaplan-Meier Estimate , Male , Middle Aged , Pyrimidines/adverse effects , Retrospective Studies , Risk Factors , Spain , Sulfonamides/adverse effects
13.
Clin. transl. oncol. (Print) ; 16(11): 959-965, nov. 2014.
Article in English | IBECS | ID: ibc-128636

ABSTRACT

BACKGROUND: Brain metastases of testicular germ cell tumor (TGCT) are a rare event. Prognostic is poor and there is not much evidence on optimal management of these patients. PATIENTS AND METHODS: A review of case records of germ cell tumor patients within the Spanish Germ Cell Cancer Group data base from 1994 to 2012 was conducted. RESULTS: Thirty-three out of 6,200 cases (0.5 %). Nineteen patients (57 %) group 1: synchronous, 13 (40 %) group 2: metachronous and only one developed brain metastasis during cisplatin-based chemotherapy (excluded from the analysis). Median serum BHCG levels at initial diagnosis was higher in group 1, whereas elevated AFP serum levels were more common in group 2. Histology in the primary tumor: chorionic carcinoma for group 1 versus embryonal carcinoma for group 2. Mainly solitary brain metastasis in group 2 (54 versus 21 %, respectively). The median overall survival from the diagnosis of central nervous system involvement was 16 months for group 1 (CI 95 % 13.9-18) and 23 months (95 % CI 0-165) for group 2 (log rank p = 0.84). Long-term survivors were practically identical in the two groups (38.9 % group 1 versus 38.5 % group 2). Regardless of the timing of brain metastasis, those patients that achieved complete response to the treatment had better survival (log rank p 0.003). CONCLUSION: Although some distinctive clinical characteristics have been found between patients with synchronous versus metachronous brain metastasis from TGCT, the timing of brain metastasis did not seem to have prognostic influence, but due to the retrospective nature of the analysis and the results should be interpreted with caution (AU)


No disponible


Subject(s)
Testicular Neoplasms , Brain Neoplasms/secondary , Neoplasms, Multiple Primary , Neoplasms, Second Primary , Testicular Neoplasms/epidemiology
14.
Gene Ther ; 21(7): 673-81, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24807807

ABSTRACT

Suicide gene therapy (SGT) is a promising strategy for treating cancer. In this work, we show that thymidine phosphorylase (TP) deficiency, the underlying genetic defect in mitochondrial neurogastrointestinal encephalomyopathy (MNGIE), presents an opportunity to apply SGT using capecitabine, a commonly used prodrug that is converted into 5-fluorouracil by TP. Using an immortalised B-lymphoblastoid cell line from a patient with MNGIE, the tumourigenic EL-4 cell line, lentiviral vectors encoding TP and a double knockout (Tymp(-/-)Upp1(-/-)) murine model, we found that EL-4 cell-derived TP(+) tumours were exquisitely sensitive to capecitabine and generated a significant local bystander effect. In addition, we detected a spontaneous cytolytic immune response in a significant fraction of the animals surviving more than 20 days after termination of the therapy. These data indicate that, in individuals lacking TP expression, TP is a highly specific suicide gene, which can be used to treat tumours that could hypothetically arise in MNGIE patients undergoing gene therapy, as these tumours will likely originate from the gene-modified cells and will be selectively targeted by capecitabine. These observations have important implications for gene therapy for MNGIE.


Subject(s)
Genes, Transgenic, Suicide , Genetic Therapy/methods , Intestinal Pseudo-Obstruction/genetics , Intestinal Pseudo-Obstruction/therapy , Lentivirus/genetics , Mitochondrial Encephalomyopathies/genetics , Mitochondrial Encephalomyopathies/therapy , Thymidine Phosphorylase/metabolism , Animals , Capecitabine , Cell Line, Tumor , Combined Modality Therapy , Deoxycytidine/analogs & derivatives , Deoxycytidine/metabolism , Deoxycytidine/therapeutic use , Disease Models, Animal , Fluorouracil/analogs & derivatives , Fluorouracil/metabolism , Fluorouracil/therapeutic use , Gene Knockout Techniques , Genetic Vectors/administration & dosage , Humans , Intestinal Pseudo-Obstruction/pathology , Male , Mice , Mice, Inbred C57BL , Mitochondrial Encephalomyopathies/pathology , Muscular Dystrophy, Oculopharyngeal , Ophthalmoplegia/congenital , Thymidine Phosphorylase/genetics
15.
Clin Transl Oncol ; 16(11): 959-65, 2014 Nov.
Article in English | MEDLINE | ID: mdl-24719184

ABSTRACT

BACKGROUND: Brain metastases of testicular germ cell tumor (TGCT) are a rare event. Prognostic is poor and there is not much evidence on optimal management of these patients. PATIENTS AND METHODS: A review of case records of germ cell tumor patients within the Spanish Germ Cell Cancer Group data base from 1994 to 2012 was conducted. RESULTS: Thirty-three out of 6,200 cases (0.5 %). Nineteen patients (57 %) group 1: synchronous, 13 (40 %) group 2: metachronous and only one developed brain metastasis during cisplatin-based chemotherapy (excluded from the analysis). Median serum BHCG levels at initial diagnosis was higher in group 1, whereas elevated AFP serum levels were more common in group 2. Histology in the primary tumor: chorionic carcinoma for group 1 versus embryonal carcinoma for group 2. Mainly solitary brain metastasis in group 2 (54 versus 21 %, respectively). The median overall survival from the diagnosis of central nervous system involvement was 16 months for group 1 (CI 95 % 13.9-18) and 23 months (95 % CI 0-165) for group 2 (log rank p = 0.84). Long-term survivors were practically identical in the two groups (38.9 % group 1 versus 38.5 % group 2). Regardless of the timing of brain metastasis, those patients that achieved complete response to the treatment had better survival (log rank p 0.003). CONCLUSION: Although some distinctive clinical characteristics have been found between patients with synchronous versus metachronous brain metastasis from TGCT, the timing of brain metastasis did not seem to have prognostic influence, but due to the retrospective nature of the analysis and the results should be interpreted with caution.


Subject(s)
Brain Neoplasms/secondary , Neoplasms, Germ Cell and Embryonal/secondary , Testicular Neoplasms/pathology , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/drug therapy , Brain Neoplasms/mortality , Humans , Male , Middle Aged , Neoplasms, Germ Cell and Embryonal/drug therapy , Neoplasms, Germ Cell and Embryonal/mortality , Survival Analysis , Testicular Neoplasms/drug therapy , Testicular Neoplasms/mortality , Young Adult
16.
Clin. transl. oncol. (Print) ; 15(6): 425-433, jun. 2013. tab, ilus
Article in English | IBECS | ID: ibc-127384

ABSTRACT

We performed a literature search that shed light on the signaling pathways involved in the sorafenib activity as first- or subsequent-line treatment, taking into account its toxicity profile. Sorafenib appears to have better tolerability when compared with other agents in the same indication. Cross-resistance between tyrosine kinase inhibitors (TKIs) may be limited, even after failure with a previous VEGFR inhibitor, but the optimal sequence with TKIs remains to be determined. Randomized trials of second-line treatment options have showed either modest or no differences in terms of progression-free and overall survival (OS). Direct comparison between sorafenib and axitinib demonstrated differences in terms of PFS in favor of axitinib, but not in terms of OS as second-line treatment. In contrast, a phase III study showed a benefit in OS, favoring sorafenib when compared with temsirolimus. In conclusion, after using other VEGF inhibitor such as sunitinib, sorafenib is active and safe for the treatment of patients with advanced or metastatic RCC (AU)


Subject(s)
Humans , Male , Female , Protein-Tyrosine Kinases/administration & dosage , Protein-Tyrosine Kinases/deficiency , Protein-Tyrosine Kinases/history , Protein-Tyrosine Kinases/metabolism , Protein-Tyrosine Kinases/analysis , Protein-Tyrosine Kinases/chemical synthesis , Waist-Hip Ratio/methods
17.
Clin Transl Oncol ; 15(6): 425-33, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23401018

ABSTRACT

We performed a literature search that shed light on the signaling pathways involved in the sorafenib activity as first- or subsequent-line treatment, taking into account its toxicity profile. Sorafenib appears to have better tolerability when compared with other agents in the same indication. Cross-resistance between tyrosine kinase inhibitors (TKIs) may be limited, even after failure with a previous VEGFR inhibitor, but the optimal sequence with TKIs remains to be determined. Randomized trials of second-line treatment options have showed either modest or no differences in terms of progression-free and overall survival (OS). Direct comparison between sorafenib and axitinib demonstrated differences in terms of PFS in favor of axitinib, but not in terms of OS as second-line treatment. In contrast, a phase III study showed a benefit in OS, favoring sorafenib when compared with temsirolimus. In conclusion, after using other VEGF inhibitor such as sunitinib, sorafenib is active and safe for the treatment of patients with advanced or metastatic RCC.


Subject(s)
Carcinoma, Renal Cell/drug therapy , Kidney Neoplasms/drug therapy , Niacinamide/analogs & derivatives , Phenylurea Compounds/therapeutic use , Protein Kinase Inhibitors/therapeutic use , Protein-Tyrosine Kinases/antagonists & inhibitors , Carcinoma, Renal Cell/mortality , Clinical Trials as Topic , Humans , Kidney Neoplasms/mortality , Niacinamide/therapeutic use , Salvage Therapy , Sorafenib , Survival Rate , Treatment Outcome
18.
J Fish Biol ; 80(3): 572-94, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22380554

ABSTRACT

This study describes the structural and ultrastructural characteristics of gonadal sex differentiation and expression of Vasa, a germline marker, in different developmental stages of embryos and newborn fry of the barred splitfin Chapalichthys encaustus, a viviparous freshwater teleost endemic to Mexico. In stage 2 embryos, the gonadal crest was established; gonadal primordia were located on the coelomic epithelium, formed by scarce germ and somatic cells. At stage 3, the undifferentiated gonad appeared suspended from the mesentery of the developing swimbladder and contained a larger number of germ and somatic cells. At stages 4 and 5, the gonads had groups of meiotic and non-meiotic germ cells surrounded by somatic cells; meiosis was evident from the presence of synaptonemal complexes. These stages constituted a transition towards differentiation. At stage 6 and at birth, the gonad was morphologically differentiated into an ovary or a testis. Ovarian differentiation was revealed by the presence of follicles containing meiotic oocytes, and testicular differentiation by the development of testicular lobules containing spermatogonia in mitotic arrest, surrounded by Sertoli cells. Nuage, electron-dense material associated with mitochondria, was observed in germ cells at all gonadal stages. The Vasa protein was detected in all of the previously described stages within the germ-cell cytoplasm. This is the first report on morphological characteristics and expression of the Vasa gene during sexual differentiation in viviparous species of the Goodeidae family. Chapalichthys encaustus may serve as a model to study processes of sexual differentiation in viviparous fishes and teleosts.


Subject(s)
Cyprinodontiformes/embryology , Morphogenesis , Sex Determination Processes , Animals , Biomarkers/metabolism , Cyprinodontiformes/anatomy & histology , Cyprinodontiformes/physiology , Embryo, Nonmammalian/anatomy & histology , Embryonic Development , Female , Fish Proteins/genetics , Fish Proteins/metabolism , Male , Sex Characteristics
19.
J Mol Histol ; 42(6): 535-43, 2011 Dec.
Article in English | MEDLINE | ID: mdl-21932034

ABSTRACT

In sheep embryos, steroidogenic activity has been reported as taking place during the period of sexual differentiation. In the case of mouse embryos, the sporadic detection or absence of steroidogenic enzymes suggests that the ovary is inactive. The purpose of this work was to establish if mouse undifferentiated gonads express steroidogenic enzymes in a similar way as in sheep embryos. To know this, we analyzed the mRNA expression pattern of 3ß-Hsd1 and P450arom as well as protein expression pattern of 3ß-HSD1 and Testosterone in normal undifferentiated and differentiated gonads from both male and female mice embryo. Our data indicate that there is expression of 3ß-Hsd1 in XX gonads during gonad differentiation period. Nevertheless the Testosterone which would indicate steroidogenic activity is not produced. Besides, the absence of P450arom indicates that the production of Estradiol as observed in the ovaries of sheep does not occur. The detection of 3ß-Hsd1 in the early stages of ovarian development, as well as the absence of Testosterone suggests that XX gonads are not steroidogenic and that 3ß-Hsd1 enzyme may play a different role than in the steroidogenesis process.


Subject(s)
3-Hydroxysteroid Dehydrogenases/biosynthesis , Aromatase/biosynthesis , Ovary/enzymology , Sex Differentiation/physiology , Testis/enzymology , 3-Hydroxysteroid Dehydrogenases/genetics , Animals , Aromatase/genetics , Estradiol/biosynthesis , Estradiol/genetics , Estradiol/metabolism , Female , Heat-Shock Proteins/genetics , Heat-Shock Proteins/metabolism , Male , Mice , Ovary/cytology , Ovary/growth & development , RNA, Messenger/genetics , Sex Differentiation/genetics , Testis/cytology , Testis/growth & development , Testosterone/biosynthesis , Testosterone/genetics , Testosterone/metabolism
20.
Cancer Genomics Proteomics ; 8(2): 93-101, 2011.
Article in English | MEDLINE | ID: mdl-21471519

ABSTRACT

BACKGROUND: Mutations in signalling pathways essential for embryonic development often lead to tumourigenesis, as is also true for Notch. The aim of this study was to assess the relationship between Notch1 to -4 and their ligands with anatomopathological features of the patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: This study investigated the pattern of protein expression in RCC specimens using tissue microarray technology. A total of 80 paraffin-embedded RCC samples were retrospectively analysed together with ACHN and A.704 cell lines. RESULTS: Notch1 showed significant positive correlation with chromophobe RCC, no broken capsule, Furhman grade I and when the number of nodes involved was small [(N=1); p=0.039, 0.016, 0.037 and 0.001, respectively)]. Notch3 showed higher expression when the tumour was located in the right kidney (p=0.048). CONCLUSION: Notch1 may be useful in the future as a biomarker for the differential diagnosis of different RCC histological subtypes. Notch1 to -3 may also have potential use as a strong prognostic factor.


Subject(s)
Carcinoma, Renal Cell/metabolism , Kidney Neoplasms/metabolism , Ligands , Receptors, Notch/biosynthesis , Adaptor Proteins, Signal Transducing , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/biosynthesis , Calcium-Binding Proteins/biosynthesis , Carcinoma, Renal Cell/pathology , Cell Line, Tumor , Female , Humans , Immunohistochemistry , Intercellular Signaling Peptides and Proteins/biosynthesis , Intracellular Signaling Peptides and Proteins , Kidney Neoplasms/pathology , Male , Membrane Proteins/biosynthesis , Middle Aged , Prognosis , Proteomics/methods , Proto-Oncogene Proteins/biosynthesis , Receptor, Notch1/biosynthesis , Receptor, Notch2/biosynthesis , Receptor, Notch3 , Receptor, Notch4 , Serrate-Jagged Proteins , Tissue Array Analysis
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