Espinosa, E. (Enrique)
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- miRNA profiling in renal carcinoma suggest the existence of a group of pro-angionenic tumors in localized clear cell renal carcinoma(2020) Fresno-Vara, J.Á. (Juan Ángel); Pinto, Á. (Álvaro); López-Vacas, R. (Rocío); Farfán-Tello, C.A. (Carlos A.); Gámez-Pozo, A. (Angelo); Trilla-Fuertes, L. (Lucía); Villacampa, F. (Felipe); López-Camacho, E. (Elena); Prado-Vázquez, G. (Guillermo); Espinosa, E. (Enrique); Castellano, D. (Daniel); Velasco, G. (Guillermo) de; Zapater-Moros, A. (Andrea); Miranda, N. (Natalia)Renal cell carcinoma comprises a variety of entities, the most common being the clear-cell, papillary and chromophobe subtypes. These subtypes are related to different clinical evolution; however, most therapies have been developed for clear-cell carcinoma and there is not a specific treatment based on different subtypes. In this study, one hundred and sixty-four paraffin samples from primary nephrectomies for localized tumors were analyzed. MiRNAs were isolated and measured by microRNA arrays. Significance Analysis of Microarrays and Consensus Cluster algorithm were used to characterize different renal subtypes. The analyses showed that chromophobe renal tumors are a homogeneous group characterized by an overexpression of miR 1229, miR 10a, miR 182, miR 1208, miR 222, miR 221, miR 891b, miR 629-5p and miR 221-5p. On the other hand, clear cell renal carcinomas presented two different groups inside this histological subtype, with differences in miRNAs that regulate focal adhesion, transcription, apoptosis and angiogenesis processes. Specifically, one of the defined groups had an overexpression of proangiogenic microRNAs miR185, miR126 and miR130a. In conclusion, differences in miRNA expression profiles between histological renal subtypes were established. In addition, clear cell renal carcinomas had different expression of proangiogenic miRNAs. With the emergence of antiangiogenic drugs, these differences could be used as therapeutic targets in the future or as a selection method for tailoring personalized treatments.
- Nivolumab plus ipilimumab for treatment-naïve metastatic uveal melanoma: An open-label, multicenter, phase II trial by the spanish multidisciplinary melanoma group (GEM-1402)(Asco, 2020) Varela, M. (Mar); Rodríguez-Abreu, D. (Delvys); Rullan, A.J. (Antonio J.); Martin-Algarra, S. (Salvador); Goma, M. (Montserrat); López-Castro, R. (Rafael); Curiel, T. (Teresa); Carrión, L.A. (Lorenzo Alonso); Redrado, M. (Miriam); Espinosa, E. (Enrique); Piulats, J.M. (José María); Cruz-Merino, L. (Luis) de la; Berrocal, A. (Alfonso); Calvo-González, A. (Alfonso)Purpose: This study aimed to assess the efficacy of the combination of nivolumab (nivo) plus ipilimumab (ipi) as a first-line therapy with respect to the 12-month overall survival (OS) in patients with metastatic uveal melanoma (MUM) who are not eligible for liver resection. Methods: This was a single-arm, phase II trial led by the Spanish Multidisciplinary Melanoma Group (GEM) on nivo plus ipi for systemic treatment-naïve patients of age > 18 years, with histologically confirmed MUM, Eastern Cooperative Oncology Group-PS 0/1, and confirmed progressive metastatic disease (M1). Nivo (1 mg/kg once every 3 weeks) and ipi (3 mg/kg once every 3 weeks) were administered during four inductions, followed by nivo (3 mg/kg once every 2 weeks) until progressive disease, toxicity, or withdrawal. The primary end point was 12-month OS. OS, progression-free survival (PFS), and overall response rate were evaluated every 6 weeks using RECIST (v1.1). Safety was also evaluated. Logistic regression and Cox proportional hazard models comprising relevant clinical factors were used to evaluate the potential association with response to treatment and survival. Cytokines were quantified in serum samples for their putative role in immune modulation/angiogenesis and/or earlier evidence of involvement in immunotherapy. Results: A total of 52 patients with a median age of 59 years (range, 26-84 years) were enrolled. Overall, 78.8%, 56%, and 32% of patients had liver M1, extra-liver M1, and elevated lactate dehydrogenase. Stable disease was the most common outcome (51.9%). The primary end point was 12-month OS, which was 51.9% (95% CI, 38.3 to 65.5). The median OS and PFS were 12.7 months and 3.0 months, respectively. PFS was influenced by higher LDH values. Conclusions: Nivo plus ipi in the first-line setting for MUM showed a modest improvement in OS over historical benchmarks of chemotherapy, with a manageable toxicity profile.
- Cancer survivors referred to a long-term survivorship outpatient service within academic medical oncology: descriptive study(2021) Gallego-Martínez, A. (Alejandro); Ruiz-Giménez, L. (Leticia); Martínez, B. (Beatriz); Ghanem, I. (Ismael); Feliu-Batlle, J. (Jaime); Cantero, J. M. (José Miguel); Zamora-Auñon, P. (Pilar); Espinosa, E. (Enrique); Castelo, B. (Beatriz); Redondo, A. (Andrés)Purpose Long-term cancer survivors (LTCS) are a vulnerable and continued growing population. To date, only few studies have been conducted in the Spanish population; none of them with a comprehensive analysis of the most common problems identified for cancer survivors in order to improve their care and quality of life. Methods We conducted an observational descriptive study in 347 patients recruited between January 2015 and December 2016 from our newly created medical office for the specific care and follow-up of LTCS. Variables that describe the medical history were completed by the oncologist and measures on common problems previously reported for LTCS, related to cancer diagnosis and treatment, function, lifestyle, and emotional concerns, were collected from the patient. Results The mean age of our patients was 65.1 years at the time of the study and a median time without any antitumor treatment of 5.7 years. At the time of cancer diagnosis, 298 patients (85.9%) had at least one related chronic disease and 184 patients (53%) were retired. In addition, in 17.9% of those who continued working, income had been reduced. The incidence of health problems showed an increase during follow-up, even after 5 years, and required evaluation in an emergency department in 157 cases (45.3%). Regardless of age or sex, 239 patients (68.9%) had a significant decrease in sexual activity and 120 (34.6%) were diagnosed with clinical depression. Conclusions LTCS are patients with significantly high socioeconomic, labor, sexual, health, and psychological problems, 5 years after completion of cancer treatment, especially in older survivors. Implications for Cancer Survivor Common concerns of LTCS were identified and are consistent across many countries. It is important to realize that even 5 or so years following treatment, both medical and non-medical problems can exist and may need attention by an expert.
- Phase II study of weekly Kahalalide F in patients with advanced malignant melanoma(Elsevier BV, 2009) Martin-Algarra, S. (Salvador); Plazaola, A. (Arrate); Manzano, J.L. (José Luis); López-López, J.; Carrión, L.A. (Lorenzo Alonso); Paz-Ares, L. (Luis); Espinosa, E. (Enrique); Tanovic, A. (Adnan); Rubio, J. (Jordi)This phase II clinical trial evaluated the antitumour response of Kahalalide F (KF) 650 lg/m2 given as a 1-h weekly infusion in advanced malignant melanoma patients, both untreated and those who relapsed or progressed after one line of systemic therapy. Of 24 enrolled patients (median age, 55 years; range, 28–89), 14 patients had been previously treated with chemotherapy or biological therapy. No RECIST responses occurred; five chemotherapynaı¨ve patients with cutaneous melanoma had disease stabilisation for P3 months; median progression-free survival was 1.7 months (95% CI, 1.2–1.9 months); and median overall survival was 10.8 months (95% CI, 5.0-upper limit not reached). The most common laboratory toxicities were non-cumulative increase of transaminases (ALT/AST) and gamma-glutamyltransferase (GGT). No patients experienced leukopenia and thrombocytopenia during the study. KF was a well-tolerated and safe chemotherapy regimen. Despite a favourable safety profile, this trial was closed after the first stage because of the lack of objective response in patients with malignant melanoma