Validation of the International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) prognostic model for first-line pazopanib in metastatic renal carcinoma: the Spanish Oncologic Genitourinary Group (SOGUG) SPAZO study.

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.

Anaphylaxis produced by oxaliplatin.

We are discussing two patients, with clinically compatible reactions, who display an immediate hypersensitive mechanism following the administration of oxaliplatin, confirmed by the performance of cutaneous tests.

Análisis retrospectivo multicéntrico del tratamiento adyuvante con quimioradioterapia en pacientes con cáncer gástrico resecado. Resultados preliminares. Grupo Oncológico del Norte (G.O.N) / No disponible

INTRODUCCIÓN. En el carcinoma gástrico (CG), los resultados del estudio IT-0116 pusieron de manifiesto el beneficio del tratamiento con quimioterapia más radioterapia adyuvante después de cirugía radical R0, en un grupo de pacientes en los que la linfadenectomía D0 (inferior a D1) se había realizado en el 53% de los casos. Si los resultados de este estudio son trasladables a nuestros pacientes ha sido un punto de controversia. MATERIAL Y MÉTODOS. Hemos iniciado un análisis retrospectivo multicéntrico de los pacientes con CG que han recibido tratamiento adyuvante según la pauta de IT-0116. Analizamos las características de los pacientes, el tipo de linfadenectomía realizada, el número de ganglios analizados, el tratamiento recibido y la toxicidad. RESULTADOS. Analizamos 31pacientes. Se realizó una linfadenectomía D0 en 8(26%), D1 y entre D1-D2 en 12 (39%) y D2 en 9 (29%). Esplenectomía en 2 (6.5%). La mediana de ganglios analizados fue de 12 (2-38). El 90% presentaba ganglios positivos. De los 23 pacientes evaluables para la tolerancia al tratamiento, 17 pacientes (74%) completaron el tratamiento, 7 (32%) desarrollaron toxicidad hematológica grado 3-4 y 5 (20 %) toxicidad digestiva grado 3. La intensidad de dosis del 5FU fue del 86% (64-108%). CONCLUSIONES. En nuestros hospitales el número de pacientes con linfadenectomías D0 es inferior al del estudio IT-0116. Realizaremos análisis de supervivencia tras mayor tiempo de seguimiento (AU)

BACKGROUND. In gastric cancer, the results of Intergroup 0116 trial showed a benefit for adyuvant chemoradiotherapy after radical surgery. However, in 53% of this group of patients the lymphadenectomy had been D0 (less than D1). Controversy exists as to whether the results of this study can be applied to our patients. MATERIAL AND METHODS. We have conducted a retrospective multicentric analysis including patients with gastric cancer who have received adyuvant treatment with the IT-0116 regimen after complete resection. We analyze patients characteristics, the extent of lymph-node dissection, the number of cycles administered and toxicity. RESULTS. Thirty one patients were analyzed. 26% of the patients underwent a D0 dissection. A D1 lymphadenectomy or a lymphadenectomy between D1 and D2 were performed in 12 patients (39%) and a D2 in 9 patients (29%). 2 patients were splenectomized. The median number of nodes analyzed were 12 (2-38). 90% of the patients had positive-nodes. There were 23 patients evaluables for treatment toxicity. 17 patients (74%) completed treatment as planned. 7 patients (32%) developed hematologic toxicity grade 3-4 and 20% grade 3 diarrhea. The dose-intensity of fluorouracil was 83%(64-100%). CONCLUSIONS. We have less patients with a D0 lymphadenectomy in our hospitals than in the Intergroup trial. We will make a survival analysis after a longer follow-up (AU)

Mieloma múltiple IgA: a propósito de un caso / IgA multiple myeloma: review of one case

El mieloma múltiple es una enfermedad caracterizada por una proliferación de células neoplásicas plasmáticas en la médula ósea y la producción de una inmunoglobulina monoclonal.Se aporta el caso de un mieloma IgA y se describe la epidemiología, clínica, diagnóstico y tratamiento del mieloma múltiple. Se resalta la importancia de la diferenciación con la gammapatía monoclonal de significado incierto, que es la causa más común de banda mono clonal en suero u orina y que no requiere tratamiento quimioterápico. El seguimiento de estos pacientes a largo plazo determina que el 16 por ciento desarrollará un mieloma múltiple (AU)