Lhospitalet, Spain
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Garcia-Gutierrez V.,Hospital Universitario Ramon jal | Martinez-Trillos A.,Hospital Clinic | Lopez Lorenzo J.L.,Fundacion Jimenez Diaz | Bautista G.,Hospital Universitario Puerta Of Hierro | And 24 more authors.
American Journal of Hematology | Year: 2015

The role of bosutinib as rescue treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML) patients after failing three previous tyrosine kinase inhibitors (TKIs) is currently unknown. We report here the largest series (to our knowledge) of patients treated with bosutinib in fourth-line, after retrospectively reviewing 30 patients in chronic phase, and pretreated with imatinib, nilotinib, and dasatinib. With a median follow up of 11.1 months, the probability to either maintain or improve their CCyR response was 56.6% (17/30) and 11 patients (36.7%) achieved or maintained their baseline MMR. In patients not having baseline CCyR, the probabilities of obtaining CCyR, MMR, and MR4.5 were 13, 11, and 14%, respectively. The probabilities of obtaining MMR and deep molecular response MR4.5 in patients with baseline CCyR were 40.0% (6/15) and 20.0% (3/15). At 20 months, progression-free survival was 73%. Grade 3-4 hematological toxicities were more frequent in resistant than intolerant patients (45.4 vs. 0.0%). Nonhematological toxicities were also more frequent in resistant patients, being diarrhea the most conspicuous one. Bosutinib seems to be an appropriate treatment option for patients resistant or intolerant to three prior TKI's. © 2015 Wiley Periodicals, Inc.


Casas F.,Hospital Clinic | Vinolas N.,Hospital Clinic | Ferrer F.,Hospital Duran y Reynals | Agusti C.,Hospital Clinic | And 5 more authors.
Journal of Thoracic Oncology | Year: 2011

INTRODUCTION: Long-term results of a phase II study on the use of induction chemotherapy (CHT) using paclitaxel (P)-carboplatin (C) followed by a concurrent radiation therapy (RT) and weekly P and consolidation PC were reviewed. PATIENTS AND METHODS: Thirty-two patients with stage III non-small cell lung cancer started treatment with induction CHT (two cycles of P 175 mg/m, day 1 and C, area under the curve 6, day 1, given at 3-week interval), after which accelerated RT with a concomitant boost ("field-in-a-field") (1.8 Gy large fields and the boost dose 0.88 Gy) was administered in 23 fractions with 61.64 Gy and concurrent weekly P (45 mg/m). Consolidation with two cycles of PC was administered. RESULTS: The median follow-up for all 32 patients was 17.2 months (range, 3.8-107 months). The median survival time was 16.9 months, and the 5-year survival and 10-year survival were 25% and 17.5%, respectively. The median time for disease progression was 9.5 months, and disease-free survival was 21% at 5 and 10 years. The median time to local progression was 14.6 months, and the 5- to 10-year local progression-free survival was 35.7%. The median time to distant metastasis was 17.5 months. Toxicity was acceptable, with only one (3.1%) patient experiencing grade 5 (lung) toxicity and another patient presenting grade 4 toxicity (leucopenia). CONCLUSIONS: The results of this single-institutional phase II study of induction CHT followed by concurrent RT-CHT and consolidation CHT in very unfavorable patient population showed acceptable results with acceptable toxicity. Copyright © 2010 by the international Association fot the Study of lung Cancer.


Benito-Aracil L.,Hospital Duran y Reynals | Yague-Munoz C.,Hospital Duran y Reynals | Iglesias-Casals S.,Hospital Duran y Reynals | Salinas-Masdeu M.,Hospital Duran y Reynals | And 3 more authors.
Enfermeria Clinica | Year: 2010

Objective: To compare the predictive skills of the BRCAPro predictive model and nurses with different training/experience levels in identifying families with a personal and family history of breast cancer as likely candidates to being studied genetically. Method: Descriptive study in which 2 nurses with different levels of training in genetic counselling have estimated the probability of being carrier of a mutation in the BRCA1/BRCA2 genes of 157 families. The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of both nurses and the BRCAPro model were calculated. Results: The nurse with less experience demonstrated more specificity (N2:0.84) compared to the nurse with more experience (N1:0.23) and to BRCAPro model (0.47). The sensitivity of the nurses was 0.95 (N1) and 0.28 (N2), whereas that of BRCAPro was 0.74. The PPV was similar in the three cases. The NPV of the nurse with more experience (0.93) was higher than that of BRCAPro model (0.85) and the nurse with less experience (0.72). Conclusions: Clinical experience contributes to obtaining a high sensitivity, but with a significant decrease of specificity. The BRCAPro predictive model obtains intermediate values between both nurses. The BRCAPro predictive model could be a useful tool to help improve those values with lower scores, that is, the specificity and PPV for nurses with more experience and the sensitivity and NPV for those with less experience. © 2010 Elsevier España, S.L.


To compare the predictive skills of the BRCAPro predictive model and nurses with different training/experience levels in identifying families with a personal and family history of breast cancer as likely candidates to being studied genetically.Descriptive study in which 2 nurses with different levels of training in genetic counselling have estimated the probability of being carrier of a mutation in the BRCA1/BRCA2 genes of 157 families. The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of both nurses and the BRCAPro model were calculated.The nurse with less experience demonstrated more specificity (N2:0.84) compared to the nurse with more experience (N1:0.23) and to BRCAPro model (0.47). The sensitivity of the nurses was 0.95 (N1) and 0.28 (N2), whereas that of BRCAPro was 0.74. The PPV was similar in the three cases. The NPV of the nurse with more experience (0.93) was higher than that of BRCAPro model (0.85) and the nurse with less experience (0.72).Clinical experience contributes to obtaining a high sensitivity, but with a significant decrease of specificity. The BRCAPro predictive model obtains intermediate values between both nurses. The BRCAPro predictive model could be a useful tool to help improve those values with lower scores, that is, the specificity and PPV for nurses with more experience and the sensitivity and NPV for those with less experience.

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