Search

Introducción: Los tumores endometriales constituyen la neoplasia ginecológica más frecuente en mujeres occidentales, mientras que el cáncer ovárico es la de mayor tasa de mortalidad. El desarrollo de nuevos modelos preclínicos tridimensionales (organoides) que reproduzcan las características específicas del tumor permite llevar a cabo estudios de caracterización molecular y screening farmacológico, lo que podría orientar la selección de tratamientos y el pronóstico de las pacientes, de especial importancia en casos de alto riesgo, recidiva o progresión de la enfermedad a varias líneas de tratamiento. El principal objetivo de este trabajo es presentar un procedimiento del desarrollo de organoides a partir de muestras mínimamente invasivas de pacientes de cáncer de endometrio y ovario. Materiales y métodos: Se obtuvieron muestras de pacientes de cáncer endometrial (n=6) y cáncer ovárico (n=1). Se desarrolló un método de procesamiento para obtener una suspensión de célula única epitelial. Se compararon cualitativamente distintos protocolos descritos en la literatura, tanto a nivel de eficiencia de generación y rendimiento de los cultivos (BME droplet y BME bilayer organoid culture), como de mantenimiento (químico, mecánico y enzimático). Se llevó a cabo una caracterización preliminar de los organoides de tumor ovárico mediante inmunofluorescencia. Resultados: El método desarrollado permitió obtener una suspensión de células tumorales con una viabilidad >75% en todas las muestras. Se identificaron diferentes patrones morfológicos en las estructuras generadas. El método de cultivo BME droplets y el mecánico resultaron ser los más eficientes. La caracterización de los organoides de ovario demostró la expresión de PAX8, vimentina y citoqueratinas. Conclusiones: La tasa de éxito en la generación de organoides y el rendimiento sufrieron gran variabilidad, no pudiendo ser esta atribuida a las diferencias de viabilidad de la suspensión celular de partida. Se destaca la necesid, Introdución: Os tumores endometriais constitúen a neoplasia xinecolóxica máis frecuente nas mulleres occidentais, namentres que o cancro ovárico é a de maior taxa de mortalidade. O desenvolvemento de novos modelos preclínicos tridimensionais (organoides) que reproduzan as características específicas do tumor permite levar a cabo estudos de caracterización molecular e cribado farmacolóxico, o que podería orientar a selección de tratamentos e o pronóstico das pacientes, de especial importancia nos casos de alto risco, recidiva ou progresión da enfermidade a varias liñas de tratamento. O principal obxectivo deste traballo é presentar un procedemento da xeración de organoides a partir de mostras minimamente invasivas de pacientes de cancro de endometrio e ovario. Materiais e métodos: Obtivéronse mostras de pacientes de cancro endometrial (n=6) e cancro ovárico (n=1). Desenvolveuse un método de procesamento para obter unha suspensión de célula única epitelial. Comparáronse cualitativamente distintos protocolos descritos na literatura, tanto a nivel de eficiencia de xeración e rendemento dos cultivos (BME droplet e BME bilayer organoid culture), como de mantemento dos mesmos (químico, mecánico e encimático). Levouse a cabo unha caracterización preliminar dos organoides de tumor ovárico mediante inmunofluorescencia. Resultados: O método desenvolvido permitiu obter unha suspensión de células tumorais cunha viabilidade >75% en todas as mostras. Identificáronse diferentes patróns morfolóxicos nas estruturas xeradas. O método de cultivo de BME droplets e o mecánico resultaron ser os de maior eficiencia. A caracterización dos organoides de ovario demostrou a expresión de PAX8, vimentina e citoqueratinas. Conclusións: A taxa de éxito na xeración de organoides e no rendemento do cultivo sufriu unha grande variabilidade, non podendo ser atribuida ás diferenzas de viabilidade da suspensión celular de partida. Destácase a necesidade de estandarizar protocolos e desenvolver estudos q, Background: Endometrial tumors constitute the most frequent gynecological neoplasia in occidental women, whereas ovarian cancer is the one with the highest mortality rate. New 3D preclinical models (organoids) development that recapitulate specific characteristics of the original tumor allows to drive molecular characterization tests and drug screening, which could lead treatment selection and patient’s prognosis, especially important in high-risk cases, relapse or illness progression to several lines of therapy. The main objective of this project is to show a development organoid procedure from minimally invasive samples of endometrial and ovarian cancer patients. Methods: Endometrial cancer (n=6) and ovarian cancer (n=1) samples were obtained. A method for processing samples to achieve an epithelial single-cell suspension was developed. Several protocols described in literature were qualitatively compared, in terms of efficiency of the generation of structures comparing two techniques (BME droplet and BME bilayer organoid culture), and in terms of culture maintenance (chemical, mechanic and enzymatic). A preliminary characterization of ovarian organoids was conducted by immunofluorescence. Results: The developed method allowed to obtain a tumoral single-cell suspension with a viability >75% in all the samples. Different morphological patterns in the generated structures were observed. BME droplets culture and mechanic method showed to be the most efficient ones. Ovarian organoid characterization revealed PAX8, vimentin and cytokeratins expression. Conclusions: The success rate of organoids generation suffered high variability, which could not be attributed to differences in the suspension cell viability. It is highlighted the need of standardized protocols and studies to support clinical implementation

Triple-negative breast cancer (TNBC) is characterized by the absence of hormone receptor and HER2 expression, and therefore a lack of therapeutic targets. Anthracyclines and taxane-based neoadjuvant chemotherapy have historically been the cornerstone of treatment of early TNBC. However, genomic and transcriptomic analyses have suggested that TNBCs include various subtypes, characterized by peculiar genomic drivers and potential therapeutic targets. Therefore, several efforts have been made to expand the therapeutic landscape of early TNBC, leading to the introduction of platinum and immunomodulatory agents into the neoadjuvant setting. This review provides a comprehensive overview of the currently available evidence regarding platinum agents and immune-checkpoint-inhibitors for the neoadjuvant treatment of TNBC, as well as the novel target therapies that are currently being evaluated in this setting. Taking into account the economic issues and the side effects of the expanding therapeutic options, we focus on the potential efficacy biomarkers of the emerging therapies, in order to select the best therapeutic strategy for each specific patient.

The recent identification of rearrangements of neurotrophic tyrosine receptor kinase (NTRK) genes and the development of specific fusion protein inhibitors, such as larotrectinib and entrectinib, have revolutionised the diagnostic and clinical management of patients presenting with tumours with these alterations. Tumours that harbour NTRK fusions are found in both adults and children; and they are either rare tumours with common NTRK fusions that may be diagnostic, or more prevalent tumours with rare NTRK fusions. To assess currently available evidence on this matter, three key Spanish medical societies (the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Pathological Anatomy (SEAP), and the Spanish Society of Paediatric Haematology and Oncology (SEHOP) have brought together a group of experts to develop a consensus document that includes guidelines on the diagnostic, clinical, and therapeutic aspects of NTRK -fusion tumours. This document also discusses the challenges related to the routine detection of these genetic alterations in a mostly public Health Care System.

The recent identification of rearrangements of neurotrophic tyrosine receptor kinase (NTRK) genes and the development of specific fusion protein inhibitors, such as larotrectinib and entrectinib, have revolutionised the diagnostic and clinical manage- ment of patients presenting with tumours with these alterations. Tumours that harbour NTRK fusions are found in both adults and children; and they are either rare tumours with common NTRK fusions that may be diagnostic, or more prevalent tumours with rare NTRK fusions. To assess currently available evidence on this matter, three key Spanish medical societies (the Span- ish Society of Medical Oncology (SEOM), the Spanish Society of Pathological Anatomy (SEAP), and the Spanish Society of Paediatric Haematology and Oncology (SEHOP) have brought together a group of experts to develop a consensus document that includes guidelines on the diagnostic, clinical, and therapeutic aspects of NTRK-fusion tumours. This document also discusses the challenges related to the routine detection of these genetic alterations in a mostly public Health Care System.

The recent identification of rearrangements of neurotrophic tyrosine receptor kinase (NTRK) genes and the development of specific fusion protein inhibitors, such as larotrectinib and entrectinib, have revolutionised the diagnostic and clinical manage- ment of patients presenting with tumours with these alterations. Tumours that harbour NTRK fusions are found in both adults and children; and they are either rare tumours with common NTRK fusions that may be diagnostic, or more prevalent tumours with rare NTRK fusions. To assess currently available evidence on this matter, three key Spanish medical societies (the Span- ish Society of Medical Oncology (SEOM), the Spanish Society of Pathological Anatomy (SEAP), and the Spanish Society of Paediatric Haematology and Oncology (SEHOP) have brought together a group of experts to develop a consensus document that includes guidelines on the diagnostic, clinical, and therapeutic aspects of NTRK-fusion tumours. This document also discusses the challenges related to the routine detection of these genetic alterations in a mostly public Health Care System.

The recent identification of rearrangements of neurotrophic tyrosine receptor kinase (NTRK) genes and the development of specific fusion protein inhibitors, such as larotrectinib and entrectinib, have revolutionised the diagnostic and clinical manage- ment of patients presenting with tumours with these alterations. Tumours that harbour NTRK fusions are found in both adults and children; and they are either rare tumours with common NTRK fusions that may be diagnostic, or more prevalent tumours with rare NTRK fusions. To assess currently available evidence on this matter, three key Spanish medical societies (the Span- ish Society of Medical Oncology (SEOM), the Spanish Society of Pathological Anatomy (SEAP), and the Spanish Society of Paediatric Haematology and Oncology (SEHOP) have brought together a group of experts to develop a consensus document that includes guidelines on the diagnostic, clinical, and therapeutic aspects of NTRK-fusion tumours. This document also discusses the challenges related to the routine detection of these genetic alterations in a mostly public Health Care System.

The recent identification of rearrangements of neurotrophic tyrosine receptor kinase (NTRK) genes and the development of specific fusion protein inhibitors, such as larotrectinib and entrectinib, have revolutionised the diagnostic and clinical manage- ment of patients presenting with tumours with these alterations. Tumours that harbour NTRK fusions are found in both adults and children; and they are either rare tumours with common NTRK fusions that may be diagnostic, or more prevalent tumours with rare NTRK fusions. To assess currently available evidence on this matter, three key Spanish medical societies (the Span- ish Society of Medical Oncology (SEOM), the Spanish Society of Pathological Anatomy (SEAP), and the Spanish Society of Paediatric Haematology and Oncology (SEHOP) have brought together a group of experts to develop a consensus document that includes guidelines on the diagnostic, clinical, and therapeutic aspects of NTRK-fusion tumours. This document also discusses the challenges related to the routine detection of these genetic alterations in a mostly public Health Care System.

The recent identification of rearrangements of neurotrophic tyrosine receptor kinase (NTRK) genes and the development of specific fusion protein inhibitors, such as larotrectinib and entrectinib, have revolutionised the diagnostic and clinical management of patients presenting with tumours with these alterations. Tumours that harbour NTRK fusions are found in both adults and children; and they are either rare tumours with common NTRK fusions that may be diagnostic, or more prevalent tumours with rare NTRK fusions. To assess currently available evidence on this matter, three key Spanish medical societies (the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Pathological Anatomy (SEAP), and the Spanish Society of Paediatric Haematology and Oncology (SEHOP) have brought together a group of experts to develop a consensus document that includes guidelines on the diagnostic, clinical, and therapeutic aspects of NTRK-fusion tumours. This document also discusses the challenges related to the routine detection of these genetic alterations in a mostly public Health Care System.

The use of irreversible inhibitors of Bruton tirosine kinase (BTK) represents an important therapeutic advance for the treatment of chronic lymphocytic leukemia (CLL).The first in-class, ibrutinib, has been in clinical use for the treatment of chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL) and Walden-ström’s macroglobulinemia.More selective inhibitors are being studied. Acalabrutinib is a novel irreversible second-generation BTK inhibitor that was shown to be more selective and potent than ibrutinib. This may reduce toxicity related to off-target activity of ibrutinib on other kinases including EGFR, ITK and Tec family kinases, and may also overcome drug resistance related to incomplete BTK inhibition with the last, and may improve its toxicity profile.Studied for patients with CLL R/R, acalabrutinib is also being investigated for the frontline treatment of CLL as monotherapy and in combination. Recently it has received approval for the treatment for MCL in the relapsed/refractory setting, El uso de inhibidores irreversibles de la BTK representa un importante avance terapéutico para el tratamiento de la leucemia linfocítica crónica (LLC). El primero de la clase, ibrutinib, se utiliza actualmente para el tratamiento de la LLC, linfoma del manto (LM) y macroglobulinemia de Waldenström. Actualmente están en desarrollo numerosos inhibidores de la BTK más selectivos; uno de ellos, acalabrutinib(ACP-196), es un inhibidor irreversible de la BTK de nueva generación. Con respecto a ibrutinib ha mostrado mayor potencia de bloqueo de la enzima. Esta cualidad puede disminuir la resistencia a la droga relacionada con la inhibición incompleta de la misma que muestra su predecesor. Presenta además mayor selectividad, lo que reduce la actividad off-target ejercida sobre otras kinasas: EGFR, ITK, familia de kinasas TEC, etc., mejorando su perfil de toxicidad. Estudiado en pacientes con LLC recaída/refractaria, también está siendo evaluado en primera línea y en combinación con otras drogas. Recientemente ha sido aprobado para el tratamiento de pacientes con LM que hayan recibido al menos una línea previa de tratamiento.

Introduction: The objective of this review is to summarize results from clinical trials that tested cytotoxic drugs and target strategies for the treatment of platinum resistant (PR) recurrent ovarian cancer (ROC) with particular attention to Phase III and ongoing trials. Areas covered: Since platinum free interval (PFI) represents the most important predictive factor for response to platinum re-treatment in ROC, non-platinum regimens are conventionally considered the most appropriate approaches. Impressive progress has been made in recent decades, resulting in the identification of most effective cytotoxic agents and in the development of new target strategies. However, the efficacy of most of these drugs for the treatment of PR disease is still limited. Expert opinion: The most favorable benefit for the treatment of PR disease, has been described by the AURELIA trial that showed a 3.3 months increase in progression free survival (PFS) when bevacizumab was combined with non-platinum single agent chemotherapy in bevacizumab-naïve patients. Nevertheless, the use of novel agents is associated to important costs for just little gains in survival. Thus, in our opinion the economic evaluation, such as the incorporation of quality of life into the clinical studies is crucial for the development of future trials for PR-ROC.

OBJECTIVE: To evaluate usage patterns for nimotuzumab, safety and effectiveness in terms of survival in patients with high–grade gliomas treated in medical practice.METHODS: A cohort prospective, longitudinal, multicenter study was designed in adult patients with histological confirmation of high grade malignant glioma newly diagnosis to receive nimotuzumab according to prescription recommendations. Patients were followed for 3 years. We collected data on patterns of use, dosage and time of exposure to nimotuzumab. Reported adverse events were classified according to type, intensity and seriousness and also it was evaluated the survival time in months.RESULTS: Between December 2005 and August 2012, seventy patients received nimotuzumab grouped according to histology in 44 glioblastoma, 24 astrocytoma, anaplastic and 2 anaplastic oligoastrocytoma. All patients received nimotuzumab in combination with radiation, mostly concurrent (78.6 %); the remainder received it sequentially (21.4 %). Completed the induction phase planned 94.3 % of patients and continued in maintenance beyond 1 year 21.4 %. The events related to nimotuzumab were 24.1%. The most common were fever, chills, and cutaneous erythema of light and moderate intensity. It was founded no association between toxicity and therapeutic modality, neither with the number of doses received. Patients with anaplastic astrocytoma had a survival at diagnosis over 45 months and with glioblastoma of 14.8 months; with a survival rate at 3 years the 50.8 % and 20.2 % respectively.CONCLUSIONS: The results of this observational study accompaniment those described in controlled studies. Nimotuzumab can be a therapeutic alternative safe, advantageous and feasible as part of conventional treatment in health care conditions., OBJETIVO: Evaluar en la práctica médica los patrones de uso de nimotuzumab, perfil de seguridad y efectividad en términos de supervivencia en pacientes con gliomas de alto grado de malignidad.MÉTODOS: Se diseñó un estudio de cohorte, prospectivo, multicéntrico longitudinal, en pacientes adultos con confirmación histológica de glioma de nuevo diagnóstico de alto grado de malignidad que recibieran nimotuzumab según las recomendaciones de prescripción. Los pacientes se siguieron durante 3 años. Se colectaron datos sobre modalidades de uso, dosis y tiempo de exposición a nimotuzumab. Los eventos adversos reportados se clasificaron según tipo, intensidad y gravedad y también se evaluó el tiempo de supervivencia en meses.RESULTADOS: Entre Diciembre del 2005 y Agosto del 2012, setenta pacientes recibieron nimotuzumab agrupados según histología en 44 glioblastoma, 24 astrocitoma anaplásico y 2 oligoastrocitoma anaplásico. Todos los pacientes recibieron nimotuzumab en combinación con radioterapia, mayoritariamente concurrente (78,6 %). El resto lo recibió de forma secuencial (21,4 %). Completaron la fase de inducción planificada el 94,3 % y continuaron el mantenimiento más allá de 1 año el 21,4 %. El 24,1 % de los eventos se relacionaron con nimotuzumab, siendo los más comunes: fiebre, escalofríos y eritema cutáneo de intensidad ligera y moderada. No se encontró asociación entre la toxicidad y modalidad terapéutica, tampoco con el número de dosis recibida. Los pacientes con astrocitoma anaplásico tuvieron una supervivencia al diagnóstico sobre los 45 meses y con glioblastoma de 14,8 meses, con una tasa de supervivencia a 3 años del 50,8 % y 20,2 % respectivamente. CONCLUSIONES: Los resultados de este estudio observacional complementan los descritos en los estudios controlados. Nimotuzumab puede ser una alternativa terapéutica segura, ventajosa y factible como parte del tratamiento convencional en las condiciones asistenciales.

OBJECTIVE: To evaluate usage patterns for nimotuzumab, safety and effectiveness in terms of survival in patients with high–grade gliomas treated in medical practice.METHODS: A cohort prospective, longitudinal, multicenter study was designed in adult patients with histological confirmation of high grade malignant glioma newly diagnosis to receive nimotuzumab according to prescription recommendations. Patients were followed for 3 years. We collected data on patterns of use, dosage and time of exposure to nimotuzumab. Reported adverse events were classified according to type, intensity and seriousness and also it was evaluated the survival time in months.RESULTS: Between December 2005 and August 2012, seventy patients received nimotuzumab grouped according to histology in 44 glioblastoma, 24 astrocytoma, anaplastic and 2 anaplastic oligoastrocytoma. All patients received nimotuzumab in combination with radiation, mostly concurrent (78.6 %); the remainder received it sequentially (21.4 %). Completed the induction phase planned 94.3 % of patients and continued in maintenance beyond 1 year 21.4 %. The events related to nimotuzumab were 24.1%. The most common were fever, chills, and cutaneous erythema of light and moderate intensity. It was founded no association between toxicity and therapeutic modality, neither with the number of doses received. Patients with anaplastic astrocytoma had a survival at diagnosis over 45 months and with glioblastoma of 14.8 months; with a survival rate at 3 years the 50.8 % and 20.2 % respectively.CONCLUSIONS: The results of this observational study accompaniment those described in controlled studies. Nimotuzumab can be a therapeutic alternative safe, advantageous and feasible as part of conventional treatment in health care conditions., OBJETIVO: Evaluar en la práctica médica los patrones de uso de nimotuzumab, perfil de seguridad y efectividad en términos de supervivencia en pacientes con gliomas de alto grado de malignidad.MÉTODOS: Se diseñó un estudio de cohorte, prospectivo, multicéntrico longitudinal, en pacientes adultos con confirmación histológica de glioma de nuevo diagnóstico de alto grado de malignidad que recibieran nimotuzumab según las recomendaciones de prescripción. Los pacientes se siguieron durante 3 años. Se colectaron datos sobre modalidades de uso, dosis y tiempo de exposición a nimotuzumab. Los eventos adversos reportados se clasificaron según tipo, intensidad y gravedad y también se evaluó el tiempo de supervivencia en meses.RESULTADOS: Entre Diciembre del 2005 y Agosto del 2012, setenta pacientes recibieron nimotuzumab agrupados según histología en 44 glioblastoma, 24 astrocitoma anaplásico y 2 oligoastrocitoma anaplásico. Todos los pacientes recibieron nimotuzumab en combinación con radioterapia, mayoritariamente concurrente (78,6 %). El resto lo recibió de forma secuencial (21,4 %). Completaron la fase de inducción planificada el 94,3 % y continuaron el mantenimiento más allá de 1 año el 21,4 %. El 24,1 % de los eventos se relacionaron con nimotuzumab, siendo los más comunes: fiebre, escalofríos y eritema cutáneo de intensidad ligera y moderada. No se encontró asociación entre la toxicidad y modalidad terapéutica, tampoco con el número de dosis recibida. Los pacientes con astrocitoma anaplásico tuvieron una supervivencia al diagnóstico sobre los 45 meses y con glioblastoma de 14,8 meses, con una tasa de supervivencia a 3 años del 50,8 % y 20,2 % respectivamente. CONCLUSIONES: Los resultados de este estudio observacional complementan los descritos en los estudios controlados. Nimotuzumab puede ser una alternativa terapéutica segura, ventajosa y factible como parte del tratamiento convencional en las condiciones asistenciales.

Ovarian cancer is burdened by the highest mortality rate among gynecological cancers. Gold standard is represented by the association of platinum- taxane -based chemotherapy and radical surgery. Despite several adjustments occurred in cytotoxic drug in last decades, most patients continue to relapse, and no significant enhancement has been reached in the overall survival. The development of drug resistance and the recurrence of disease have prompted the investigations of other targets that can be used in the treatment of ovarian cancers. Among such targets, polyadenosine diphosphate-ribose polymerase (PARP) represents a novel way to target specific patways involved in tumor growth. PARP accelerates the reaction of the polyADP-ribosylation of proteins implicated in DNA repair. PARP inhibitors have shown activity in cancers with BRCA mutations, with other deficient DNA repair genes or signaling pathways that modulate DNA repair, or in association with DNA damaging agents not involved in DNA repair dysfunction. A number of inhibitors for PARP has been developed, and such drugs are under investigation in clinical trials to identify their impact in the treatment of ovarian cancers. This review aims to summarize the recent researches and clinical progress on PARP inhibitors as novel target agents in ovarian cancer.