Cardiotoxicity and predictive biomarkers for metastatic colorectal cancer

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Published: 10 Nov 2010
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Prof Josep Tabernero - Vall d'Hebron Institute of Oncology, Barcelona, Spain

Prof Josep Tabernero discusses his research into cardiotoxicity and predictive biomarkers for metastatic colorectal cancer and his role as Chair of the ESMO Fellowship & Award Committee. Prof Tabernero explains specifically which biomarkers he is interested in and discusses what developments he expects to see in the next couple of years. Cardiotoxicity has not been thoroughly investigated in clinical trials; Prof Tabernero talks about why this is so and outlines some of the more common types of cardiotoxicity.

ESMO 2010


Professor Josep Tabernero - Vall d'Hebron Institute of Oncology, Barcelona, Spain


Cardiotoxicity and predictive biomarkers for metastatic colorectal cancer



Welcome to, thank you so much for giving us five minutes at this very big and very busy ESMO meeting which you’ve had a lot to do with organising, congratulations. You’re also, of course, presenting some of your science so tell us about that.


Thank you very much for your kind invitation. At this meeting at ESMO several things are going to be presented; from my side I’m going to present major aspects on cardiotoxicity and also aspects on predictive biomarkers for metastatic colorectal cancer, in particular for targeted therapies. We have several new insights on these topics, especially in the second one, and I think that this is really important for patients, it’s important for science. So we are improving on what we believe on targeted therapies and personalised treatment, so ESMO this year…


It’s good.


It’s good, yes.


Which biomarkers are you studying in colorectal cancer?


Well we said KRAS testing, focusing on EGFR inhibitors. We have looked through the European consultation on other mutations like BRAF, PA3K and NRAS, but also we are intensively looking at TB53. I think that in the next years this will be a major topic because we will be able to build over KRAS testing with all these new biomarkers in order to decide the best treatment for the right patient.


The KRAS ruling with making it an eligibility criteria for the targeted drugs was a breakthrough in terms of the regulatory authorities, certainly in Europe. So you reckon that it’s going to be KRAS plus a couple of others in two years’ time, the next ESMO?


Absolutely, I’m sure of that. I don’t know when, but this will be the way so certainly through that it will be KRAS plus other mutations, other mutations or gene signatures. This is the feeling, yes.


That’s very exciting. Now, tell me about cardiotoxicity – is this trastuzumab or other drugs?


Actually this is related to different drugs. Unfortunately cardiotoxicity is a type of toxicity that is not very well described in clinical trials mainly because it’s not really very frequent, but also for those drugs it’s a little bit more frequent you observe this kind of toxicity over time, not immediately during or after the treatment. So that’s why we don’t have references that clearly assess the real incidence for that.  Actually we have different kinds of toxicity, so we have cardiac insufficiency, probably this is the most well-known, especially related to anti-cyclins but also now with the addition of trastuzumab we have been seeing it a little bit more. Also important toxicity is more related to the rhythm like, for example, QT prolongations, potentially really very dangerous. This is an important topic that is being faced now, especially with these new drugs, kinase inhibitors, and also the interaction that these drugs may have with other drugs commonly used in elderly patients or in ill patients that may even increase the rate for QT prolongations.


But you’re also an important man in ESMO, you look after the grants committee? Is that in good shape?


Yes, I’m chairing the grants and the fellowships committee. I think that, as in the other committees, ESMO is increasing in size, it’s increasing in quality and I’m very glad to be part of the ESMO committees because we think that this is the way to improve medical oncology, not only in Europe but worldwide. So an important task of our committee is to provide fellowships for ESMO members from worldwide to come to different institutions to do, for example, translational research or clinical research. So this is a piece of help to improve the quality of medical oncology.


Thank you very much indeed, Professor Tabernero, that’s very good of you to give us some time. Congratulations on organising a very good ESMO meeting in Milan.