San Sebastián de los Reyes, Spain
San Sebastián de los Reyes, Spain

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De Duenas E.M.,Hospital Provincial Of Castellon | Hernandez A.L.,Hospital Clinico Of Valencia | Zotano A.G.,Instituto Valenciano Of Oncologia | Carrion R.M.P.,Clinica Quiron | And 19 more authors.
Breast Cancer Research and Treatment | Year: 2014

The objective of this study was to determine the conversion rate of human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER) and progesterone receptor (PR) between primary tumors and metastatic lesions in advanced breast cancer. Patients with suspected diagnosis of locally recurrent or metastatic breast cancer, either at first relapse or after successive disease progressions, who had an appropriately preserved sample from a primary tumor and were scheduled for a biopsy of the recurrent lesion, were included. Blinded determinations of receptor status on paired samples were performed by immunohistochemistry and fluorescence in situ hybridization at a central laboratory and compared with those performed locally. Overall, 196 patients were included and 184 patients were considered evaluable. Reasons for non-evaluability included the inability to perform biopsy (n = 4) or biopsy results showing normal tissue (n = 3), benign disease (n = 3) or a second neoplasia (n = 2). Conversion rates determined at local level were higher than those determined centrally (HER2: 16 vs. 3 %, ER: 21 vs. 13 %, PR: 35 vs. 28 %, respectively). There was substantial agreement regarding the expression of HER2 in primary tumors and metastases, and ER at metastases, between local and central laboratories. PR at any site and ER at primary site showed moderate agreement. Oncologists altered their treatment plans in 31 % of patients whose tumor subtype had changed. These results reinforce the recommendation for performing confirmatory biopsies of metastases, not only to avoid misdiagnosis of breast cancer relapse, but also to optimize treatment (clinicaltrials.gov identifier: NCT01377363). © 2014 The Author(s).


Quintela-Fandino M.,1 Spanish National Cancer Research Center | Urruticoechea A.,Instituto Catalan Of Oncologia Hospital Duran I Reynals Idibell | Guerra J.,Hospital Of Fuenlabrada | Gil M.,Instituto Catalan Of Oncologia Hospital Duran I Reynals Idibell | And 10 more authors.
British journal of cancer | Year: 2014

Previous small-molecule antiangiogenics have compromised chemotherapy dose intensity in breast cancer. We present a phase I trial of a novel selective agent, nintedanib, plus standard chemotherapy in early breast cancer. Her-2-negative breast cancer patients with tumours larger than 2 cm were eligible for dose-escalation trial (classic 3+3 method). The recommended phase II dose (RP2D) was 150 mg BID of nintedanib combined with standard dose of weekly paclitaxel followed by adriamycin plus cyclophosphamide. The dose-limiting toxicity was transaminase elevation. At the RP2D, the dose intensity was ∼100%. The pathologic complete response was 50%. The combination allows the delivery of full-dose intensity, while efficacy seems promising.

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