Nuestros investigadores

Jaime Espinos Jiménez

Publicaciones científicas más recientes (desde 2010)

Autores: Solans, B. ; López, A; Elizalde, Arlette María; et al.
Revista: BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
ISSN 1365-2125  2019  págs. 1-14
Autores: Solans, B. P.; López, A; Elizalde, Arlette María; et al.
Revista: BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
ISSN 0306-5251  Vol. 85  Nº 8  2019  págs. 1670 - 1683
AimsImmunotherapy is a rising alternative to traditional treatment in breast cancer (BC) patients in order to transform cold into hot immune enriched tumours and improve responses and outcome. A computational modelling approach was applied to quantify modulation effects of immunotherapy and chemotherapy response on tumour shrinkage and progression-free survival (PFS) in naive BC patients. MethodsEighty-three Her2-negative BC patients were recruited for neoadjuvant chemotherapy with or without immunotherapy based on dendritic cell vaccination. Sequential tumour size measurements were modelled using nonlinear mixed effects modelling and linked to PFS. Data from another set of patients (n=111) were used to validate the model. ResultsTumour size profiles over time were linked to biomarker dynamics and PFS. The immunotherapy effect was related to tumour shrinkage (P < .05), with the shrinkage 17% (95% confidence interval: 2-23%) being higher in vaccinated patients, confirmed by the finding that pathological complete response rates in the breast were higher in the vaccinated compared to the control group (25.6% vs 13.6%; P=.04). The whole tumour shrinkage time profile was the major prognostic factor associated to PFS (P < .05), and therefore, immunotherapy influences indirectly on PFS, showing a trend in decreasing the probability of progression with increased vaccine effects. Tumour subtype was also associated with PFS (P < .05), showing that luminal A BC patients have better prognosis. ConclusionsDendritic cell-based immunotherapy is effective in decreasing tumour size. The semi-mechanistic validated model presented allows the quantification of the immunotherapy treatment effects on tumour shrinkage and establishes the relationship between the dynamics of tumour size and PFS.
Autores: Inoges S; López, A; et al.
Revista: NEURO-ONCOLOGY
ISSN 1522-8517  Vol. 20  Nº Supl. 3  2018  págs. 243 - 243
Autores: Inoges S; Tejada, Sonia; López, A; et al.
Revista: JOURNAL OF TRANSLATIONAL MEDICINE
ISSN 1479-5876  Vol. 15  Nº 1  2017  págs. Article number 104
Background: Prognosis of patients with glioblastoma multiforme (GBM) remains dismal, with median overall survival (OS) of about 15 months. It is therefore crucial to search alternative strategies that improve these results obtained with conventional treatments. In this context, immunotherapy seems to be a promising therapeutic option. We hypothesized that the addition of tumor lysate-pulsed autologous dendritic cells (DCs) vaccination to maximal safe resection followed by radiotherapy and concomitant and adjuvant temozolomide could improve patients' survival. Methods: We conducted a phase-II clinical trial of autologous DCs vaccination in patients with newly diagnosed patients GBM who were candidates to complete or near complete resection. Candidates were finally included if residual tumor volume was lower than 1 cc on postoperative radiological examination. Autologous DCs were generated from peripheral blood monocytes and pulsed with autologous whole tumor lysate. The vaccination calendar started before radiotherapy and was continued during adjuvant chemotherapy. Progression free survival (PFS) and OS were analyzed with the Kaplan-Meier method. Immune response were assessed in blood samples obtained before each vaccines. Results: Thirty-two consecutive patients were screened, one of which was a screening failure due to insufficient resection. Median age was 61 years (range 42-70). Karnofsky performance score (KPS) was 90-100 in 29%, 80 in 35.5% and 60-70 in 35.5% of cases. MGMT (O6-methylguanine-DNA-methyltransferase) promoter was methylated in 45.2% of patients. No severe adverse effects related to immunotherapy were registered. Median PFS was 12.7 months (CI 95% 7-16) and median OS was 23.4 months (95% CI 16-33.1). Increase in post-vaccination tumor specific immune response after vaccines (proliferation or cytokine production) was detected in 11/27 evaluated patients. No correlation between immune response and survival was found. Conclusions: Our results suggest that the addition of tumor lysate-pulsed autologous DCs vaccination to tumor resection and combined radio-chemotherapy is feasible and safe. A multicenter randomized clinical trial is warranted to evaluate the potential survival benefit of this therapeutic approach. Trial registration This phase-II trial was registered as EudraCT: 2009-009879-35 and ClinicalTrials.gov Identifier: NCT01006044 retrospectively registered.
Autores: Baraibar, Iosune; et al.
Revista: CANCER RESEARCH
ISSN 0008-5472  Vol. 77  Nº Supl. 4  2017  págs. P6-07-32
Autores: Isabel Martinez-Fernandez, Maria; Legaspi Folgueira, Jairo; Valtuena Peydro, German; et al.
Revista: INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER
ISSN 1525-1438  Vol. 26  Nº 6  2016  págs. 1162-1168
Autores: Murillo Jaso, L.; Rodríguez-Spiteri, Natalia; et al.
Revista: JOURNAL OF CLINICAL ONCOLOGY
ISSN 0732-183X  Vol. 33  Nº 15 Supl.  2015  págs. e11617
Background: Amplification of the HER-2 gene occurs in 20% of breast cancer (BC) patients (pts). Trastuzumab administered concurrently with chemotherapy (CT) is the standard of care in the neoadjuvant setting. Moreover, the use of a combination of antiHER2 therapies with CT are related to an increased pCR, which could be a surrogate marker for survival. Methods: We retrospectively analyzed three historic cohorts with overexpressing HER2 BC. They received neoadjuvant CT based on dose dense anthracyclines followed by three schedules of antiHER2 therapy: 1) docetaxel plus trastuzumab (DT; n = 33 pts); 2) DT plus CBDCA (DTP; n = 17 pts); and 3) DT plus double blockade with triweekly pertuzumab or daily L (750mg/day; n = 12) (DTD; n = 14) before surgery. Study endpoints were safety, pCR (breast + axilla) based on Miller&Payne criteria and DFS. Results: Sixty-four pts with HER2 overexpressing BC were studied since 2005. Baseline characteristics were well balanced. The median age was 48 (range 23-80). Coexpression of ER and HER2 in each cohort was 48% in DT, 53%% in DTP and 57% DTD (p = 0.855) as well as initial BC stages (p = 0.64). Grade 3-4 toxicity in DT, DTP and DTD were respectively: asthenia 0%, 5.8% and 0% (p = 0.71), hand-foot syndrome 3%, 5.8% and 0% in DT, DTP and DTD (p = 0.719), anemia 0%, 5.8% and 0% (p = 0.71) leukopenia 6%, 11.7% and 0% in DTD (p = 0.60) and diarrhea in 35.7% in DTD (p = 0.002). We did not find differences in pCR (42.4% in the DT, 29.4%% in the DTP and 42.8% in DTD cohorts; p = 0.67), axillar response (type D) was significantly superior in the DTD cohort with the followed distribution of 51.1%, 52.9% and 85.7% respectively (p = 0.04). However breast responses were similar in the three cohorts (p = 0.9). With a median follow-up of 72, 90 and 21 months respectively, the number of pts who progressed were 12.1%, 11.7% and 0% in DT, DTP and DTD. Conclusions: We did not find differences in pCR in any cohort. The best significant axillary responses were in the DTD cohort, however this fact did not impact in total pCR. DTD cohort has more gastrointestinal toxicity. To date, median survival has not been reached.
Autores: Diez Valle, Ricardo; López, A; Inoges S; et al.
Revista: WORLD JOURNAL OF CLINICAL ONCOLOGY
ISSN 2218-4333  Vol. 3  Nº 11  2012  págs. 142-149
Active immunotherapy with tumor lysate-pulsed, autologous dendritic cells is feasible, safe, well tolerated and biologically efficacious. A phase-II study is ongoing to possibly improve further on our very encouraging clinical results.
Autores: Inoges S; et al.
Revista: CANCER RESEARCH
ISSN 0008-5472  Vol. 72  Nº Sup.24  2012 
Autores: Gastaminza, Gabriel; Goikoetxea, María José; et al.
Revista: Journal of investigational allergology & clinical immunology
ISSN 1018-9068  Vol. 21  Nº 2  2011  págs. 108 - 112
Desensitization is a useful procedure in patients who are allergic to their chemotherapy agents..
Autores: Aramendía, José Manuel; Espinos, Jaime; et al.
Revista: CANCER CHEMOTHERAPY AND PHARMACOLOGY
ISSN 0344-5704  Vol. 65  Nº 3  2010  págs. 457 - 465
Purpose Capecitabine is effective against metastatic breast cancer (MBC). We hypothesized that sequential treatment with dose-dense epirubicin/cyclophosphamide (EC) and docetaxel/capecitabine would be active and tolerable in the adjuvant/neoadjuvant setting. Methods In this prospective phase II clinical trial patients with HER2-negative and node-positive or locally advanced tumors were eligible to receive four cycles of EC (100/600 mg/m2) every 2 weeks with G-CSF on days 3¿10, followed by four cycles of docetaxel/capecitabine (75/1,000 mg/m2 b.i.d., days 1¿14) every 3 weeks. Results Fifty-five patients were enrolled with median age of 49, and 80% had hormone receptor-positive disease. The median tumor size was 2.5 cm, with a median of two axillary nodes involved. Seventy-five percent of the first 20 patients had grade 2/3 hand-foot syndrome (HFS). Dose reduction of capecitabine to 800 mg/m2 reduced the grade 2/3 HFS incidence to 31% in the remaining patients. No grade 4/5 toxicities were observed. All 20 patients treated preoperatively responded, with 5 (25%) pathologic complete responses and 3 additional pT0N1 tumors. At a median follow-up of 48 (range 28¿60) months, the event-free and overall survival rates are 91 and 98%, respectively. Conclusions Sequential treatment with dose-dense EC followed by docetaxel/capecitabine, using a lower capecitabine dose than that approved for MBC, has an acceptable toxicity profile and encouraging activity when used as neoadjuvant or adjuvant treatment of breast cancer.
Autores: Martínez-Monge, Rafael; Aramendía, José Manuel; et al.
Revista: INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER
ISSN 1048-891X  Vol. 20  Nº 1  2010  págs. 133 - 140
Objectives: This study was undertaken to determine the tolerability of a 7-week schedule of external beam radiation therapy, high-dose-rate brachytherapy, and weekly cisplatin and paclitaxel in patients with locally advanced carcinoma of the cervix. Methods: Twenty-nine patients with International Federation of Gynecology and Obstetrics stages IB2 to IVa cervical cancer were treated with 40 mg/m2 per week of intravenous (i.v.) cisplatin and 50 mg/m2 per week of i.v. paclitaxel combined with 45 Gy of pelvic external beam radiation therapy and 30 Gy of high-dose-rate brachytherapy. Results: Eleven patients (37.9%) were able to complete the 6 scheduled cycles of chemotherapy. The median number of weekly chemotherapy cycles administered was 5 (range, 2-7). Thirty-five (20.1%) of 174 cycles of chemotherapy were not given because of toxicity. The median dose intensity of cisplatin was 31 mg/m2 per week (95% confidence interval [CI], 25.2-36.8); that of paclitaxel was 44 mg/m2 per week (95% CI, 39.9-48.3). Twenty-two patients (78.6%) were able to complete the planned radiation course in less than 7 weeks. Median radiation treatment length was 45 days (95% CI, 43.4-46.6). After a median follow-up of 48 months, 7 patients (24.1%) experienced severe (Radiation Therapy Oncology Group grade 3 or higher) late toxicity. No fatal events were observed. Seven patients have failed, 1 locally and 6 at distant sites. The 8-year local/pelvic control rate was 95.7%, and the 8-year freedom from systemic failure rate was 76.1%. Eight-year actuarial disease-free survival and overall survival were 63.1% and 75.9%, respectively. Conclusions: This study demonstrated unacceptable toxicity of combining the stated doses of concurrent cisplatin and paclitaxel chemotherapy with definitive radiotherapy for patients with advanced cervical cancer. Additional phase I/II trials are recommended to clearly establish the recommended phase II dose for these drugs.