Clinical utility of liquid biopsy and integrative genomic profiling in early-stage and oligometastatic cancer patients treated with radiotherapy.

BACKGROUND: Liquid biopsy and Integrative Genomic Profiling (IGP) are yet to be implemented into routine Radiation Oncology. Here we assess the utility of germline, tumour and circulating cell-free DNA-based genomic analyses for the clinical management of early-stage and oligometastatic cancer patients treated by precision radiotherapy. METHODS: We performed germline, tissue- and liquid biopsy NGS panels on 50 early-stage/oligometastatic cancer patients undergoing radiotherapy. We also monitored ctDNA variants in serial liquid biopsies collected during radiotherapy and follow-up and evaluated the clinical utility of such comprehensive approach. RESULTS: The integration of different genomic studies revealed that only 1/3 of the liquid biopsy variants are of tumour origin. Altogether, 55 tumour variants (affecting 3/4 of the patients) were considered potentially actionable (for treatment and prognosis), whereas potential follow-up biomarkers were identified in all cases. Germline cancer-predisposing variants were present in three patients, which would have not been eligible for hereditary cancer testing according to clinical guidelines. The presence of detectable ctDNA variants before radiotherapy was associated with progression-free survival both in oligometastatic patients and in those with early-stage. CONCLUSIONS: IGP provides both valuable and actionable information for personalised decision-making in Radiation Oncology.

Nutritional assessment of female patients newly diagnosed with breast cancer in a northern region of Spain / Evaluación nutricional de mujeres recién diagnosticadas de cáncer de mama en una cohorte del norte de España

Background: evidence from research suggests that the development of cancer disease is associated with environmental factors. There are few studies evaluating nutritional status in women suffering from cancer in Spain. Objectives: this study aimed to assess the nutritional status in breast cancer female patients at diagnosis in a northern region of Spain (Asturias), where breast cancer rates are particularly high when compared to the rest of Spain. Material and methods: a cross-sectional study was conducted in a sample of 76 newly diagnosed female cancer patients. Lifestyle factors, anthropometry, biochemical, and dietary intake data were collected immediately after diagnosis and prior to the initiation of the prescribed treatment. Results: a high percentage of these women diagnosed with cancer were sedentary (59.2%). Their average body mass index (BMI) was 27.3 ± 5.5 kg/m2. They also showed a high percentage of body fat, 38.3%, as well as a large waist circumference of 92.2 cm. Patients reported a low intake of fruits, vegetables, legumes, and nuts, and a high intake of red meat, meat products, and sweet foodstuffs as compared to the Spanish dietary guidelines (p < 0.01). Conclusion: the results showed a low intake of folate, calcium, and vitamin D, which is particularly relevant in women. In conclusion, these breast cancer patients showed overweight and high sedentarism levels, and reported unbalanced dietary patterns at the time of diagnosis

Introducción: la evidencia actual indica que el desarrollo de algunos tipos de cáncer está asociado a factores ambientales. Pocos estudios realizados en España han evaluado el estado nutricional de las mujeres con cáncer. Objetivos: el objetivo de este estudio ha sido evaluar el estado nutricional de las mujeres en el momento de ser diagnosticadas de cáncer de mama (CM) en una región del norte de España (Asturias), donde las cifras de cáncer de mama son particularmente elevadas en comparación con el resto de España. Material y métodos: se realizó un estudio transversal con una muestra de 76 mujeres recién diagnosticadas de cáncer de mama. Se recopilaron datos sobre su estilo de vida, antropometría, ingesta, bioquímica y dieta de forma inmediata tras el diagnóstico y antes del inicio del tratamiento. Resultados: un alto porcentaje de estas mujeres diagnosticadas de cáncer eran sedentarias (59,2%). El valor medio de su índice de masa corporal (IMC) era de 27,3 ± 5,5 kg/m2. Asimismo, estas pacientes mostraron un alto porcentaje de grasa corporal, del 38,3%, y un elevado perímetro de la cintura, de 92,2 cm. La dieta de todas las pacientes incluía una escasa ingesta de frutas, verduras, legumbres y frutos secos, y en cambio una ingesta elevada de carnes rojas y procesadas y alimentos dulces, en comparación con las recomendaciones dietéticas españolas (p < 0,01). Conclusión: los resultados también mostraron unas escasas ingestas de folato, calcio y vitamina D, particularmente preocupantes en las mujeres. En conclusión, la mayoría de las voluntarias con CM presentaban sobrepeso, altos niveles de sedentarismo y un patrón de dieta no equilibrada en el momento del diagnóstico

Nutritional assessment of female patients newly diagnosed with breast cancer in a northern region of Spain.

INTRODUCTION: Background: evidence from research suggests that the development of cancer disease is associated with environmental factors. There are few studies evaluating nutritional status in women suffering from cancer in Spain. Objectives: this study aimed to assess the nutritional status in breast cancer female patients at diagnosis in a northern region of Spain (Asturias), where breast cancer rates are particularly high when compared to the rest of Spain. Material and methods: a cross-sectional study was conducted in a sample of 76 newly diagnosed female cancer patients. Lifestyle factors, anthropometry, biochemical, and dietary intake data were collected immediately after diagnosis and prior to the initiation of the prescribed treatment. Results: a high percentage of these women diagnosed with cancer were sedentary (59.2%). Their average body mass index (BMI) was 27.3 ± 5.5 kg/m2. They also showed a high percentage of body fat, 38.3%, as well as a large waist circumference of 92.2 cm. Patients reported a low intake of fruits, vegetables, legumes, and nuts, and a high intake of red meat, meat products, and sweet foodstuffs as compared to the Spanish dietary guidelines (p < 0.01). Conclusion: the results showed a low intake of folate, calcium, and vitamin D, which is particularly relevant in women. In conclusion, these breast cancer patients showed overweight and high sedentarism levels, and reported unbalanced dietary patterns at the time of diagnosis.

INTRODUCCIÓN: Introducción: la evidencia actual indica que el desarrollo de algunos tipos de cáncer está asociado a factores ambientales. Pocos estudios realizados en España han evaluado el estado nutricional de las mujeres con cáncer. Objetivos: el objetivo de este estudio ha sido evaluar el estado nutricional de las mujeres en el momento de ser diagnosticadas de cáncer de mama (CM) en una región del norte de España (Asturias), donde las cifras de cáncer de mama son particularmente elevadas en comparación con el resto de España. Material y Métodos: se realizó un estudio transversal con una muestra de 76 mujeres recién diagnosticadas de cáncer de mama. Se recopilaron datos sobre su estilo de vida, antropometría, ingesta, bioquímica y dieta de forma inmediata tras el diagnóstico y antes del inicio del tratamiento. Resultados: un alto porcentaje de estas mujeres diagnosticadas de cáncer eran sedentarias (59,2%). El valor medio de su índice de masa corporal (IMC) era de 27,3 ± 5,5 kg/m2. Asimismo, estas pacientes mostraron un alto porcentaje de grasa corporal, del 38,3%, y un elevado perímetro de la cintura, de 92,2 cm. La dieta de todas las pacientes incluía una escasa ingesta de frutas, verduras, legumbres y frutos secos, y en cambio una ingesta elevada de carnes rojas y procesadas y alimentos dulces, en comparación con las recomendaciones dietéticas españolas (p < 0,01). Conclusión: los resultados mostraron unas escasas ingestas de folato, calcio y vitamina D, particularmente preocupantes en las mujeres. En conclusión, la mayoría de las voluntarias con CM presentaban sobrepeso, altos niveles de sedentarismo y un patrón de dieta no equilibrada en el momento del diagnóstico.

Reduced folate carrier (RFC) as a predictive marker for response to pemetrexed in advanced non-small cell lung cancer (NSCLC).

INTRODUCTION: RFC is the major transport system in mammalian cells for folate cofactors and antifolate therapeutics. The aim of this study was to assess the predictive value of RFC expression in patients receiving pemetrexed for advanced NSCLC. METHODS: The study was carried out in a population of 48 patients with advanced NSCLC which have received pemetrexed monotherapy in second and third line. RFC expression was assessed using a two-step model of immunohistochemical staining in paraffin-embedded tissue samples. RESULTS: RFC expression was detected in 16 (33 %) patients. In the global population, the median progression free survival (PFS) and the median overall survival (OS) were 3.3 and 6.5 months respectively. The subgroup of patients with expression of RFC had a tendency to better median PFS (4.5 vs 2.8 months; p = 0.926) and median OS (11.7 vs 4.8; p = 0.150). In patients with adenocarcinoma histology and RFC expression median OS after treatment with pemetrexed was 14.4 months versus 5.0 in those with adenocarcinoma but without RFC expression (p = 0.039). CONCLUSIONS: These results suggest the possible relation between RFC expression and response to treatment with antifolates (pemetrexed) independently of the tumor histology. Further studies are required to confirm these results.