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Alvarado-Miranda A, Lara-Medina FU, Muñoz-Montaño WR, Zinser-Sierra JW, Galeana PAC, Garza CV, Sanchez Benitez D, Limón Rodríguez JA, Arce Salinas CH, Guijosa A, Arrieta O. Capecitabine Plus Aromatase Inhibitor as First Line Therapy for Hormone Receptor Positive, HER2 Negative Metastatic Breast Cancer. Curr Oncol 2023; 30:6097-6110. [PMID: 37504314 PMCID: PMC10377785 DOI: 10.3390/curroncol30070454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/29/2023] Open
Abstract
(1) Background: recent evidence suggests that long low-dose capecitabine regimens have a synergistic effect with endocrine therapy as aromatase inhibitors (AIs), and might increase overall survival for hormone-receptor-positive, HER2-negative, metastatic breast cancer compared to both treatments. We performed a retrospective study to confirm the efficacy and expand the safety data for capecitabine plus AI (a combination henceforth named XELIA) for this indication. (2) We conducted a single-center retrospective cohort study of 163 hormone receptor-positive metastatic breast cancer patients who received either the XELIA regimen, capecitabine, or an aromatase inhibitor (AI) as single agents in first-line treatment. The primary endpoint was progression-free survival, and the secondary endpoints were overall survival, best objective response, and toxicity incidence. (3) Results: the median progression-free survival for patients receiving XELIA, AI, and capecitabine was 29.37 months (20.91 to 37.84; 95% CI), 20.04 months (7.29 to 32.80; 95% CI) and 10.48 (8.69 to 12.28; 95% CI), respectively. The overall response rate was higher in the XELIA group (29.5%) than in the AI (14.3%) and capecitabine (9.1%) groups. However, the differences in overall survival were not statistically significant. Apart from hand-foot syndrome, there were no statistically significant differences in adverse events between the groups. (4) Conclusions: this retrospective study suggests that progression-free survival and overall response rates improved with the XELIA regimen compared to use of aromatase inhibitors and capecitabine alone. Combined use demonstrated an adequate safety profile and might represent an advantageous treatment in places where CDK 4/6 is not available. Larger studies and randomized clinical trials are required to confirm the effects shown in our study.
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Affiliation(s)
| | | | | | - Juan W Zinser-Sierra
- Gastrointestinal Oncology Unit, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | | | - Cynthia Villarreal Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnológico de Monterrey, San Pedro Garza García 66278, Mexico
| | | | | | | | - Alberto Guijosa
- School of Medicine, Universidad Panamericana, Mexico City 03920, Mexico
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City 14080, Mexico
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Miaja Avila M, Moral de la Rubia J, Fonseca A, Cruz Ramos M, Villarreal Garza C, Becerril Gaitán A, Vaca Cartagena BF, Ferrigno Guajardo AS. Factor structure, internal consistency and distribution of Female Sexual Function Index among Mexican women with early diagnostic of breast cancer. Psicooncología 2021. [DOI: 10.5209/psic.77755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Female Sexual Dysfunction (FSD) occurs frequently in women with breast cancer due to oncologic treatments. It is essential to have a validated instrument to diagnose and quantify FSD in this population accurately. Objective: To validate the Female Sexual Function Index (FSFI). Method: The FSFI was applied to 272 sexually active Mexican women with recent diagnosis of breast cancer who had not initiated systemic cancer treatment. Results: The FSFI six-factor model is valid by confirmatory factor analysis, and the inventory and its factors have adequate internal consistency reliability. Conclusions: This study provides enough evidence about the reliability and factor structure of the FSFI questionnaire in the context of breast cancer clinical practice in Mexico.
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Blazer KR, Chavarri-Guerra Y, Villarreal Garza C, Nehoray B, Mohar A, Daneri-Navarro A, del Toro A, Aguilar D, Arteaga J, Álvarez RM, Mejia R, Herzog J, Castillo D, Fernandez M, Weitzel JN. Development and Pilot Implementation of the Genomic Risk Assessment for Cancer Implementation and Sustainment (GRACIAS) Intervention in Mexico. JCO Glob Oncol 2021; 7:992-1002. [PMID: 34181458 PMCID: PMC8457783 DOI: 10.1200/go.20.00587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/29/2021] [Accepted: 04/22/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Genomic cancer risk assessment (GCRA) is standard-of-care practice that uses genomic tools to identify individuals with increased cancer risk, enabling screening for early detection and cancer prevention interventions. GCRA is not available in most of Mexico, where breast cancer (BC) is the leading cause of cancer death and ovarian cancer has a high mortality rate. METHODS Guided by an implementation science framework, we piloted the Genomic Risk Assessment for Cancer Implementation and Sustainment (GRACIAS) intervention, combining GCRA training, practice support, and low-cost BRCA1/2 (BRCA) gene testing at four centers in Mexico. The RE-AIM model was adapted to evaluate GRACIAS intervention outcomes, including reach, the proportion of new patients meeting adapted National Comprehensive Cancer Network criteria who participated in GCRA. Barriers to GCRA were identified through roundtable sessions and semistructured interviews. RESULTS Eleven clinicians were trained across four sites. Mean pre-post knowledge score increased from 60% to 67.2% (range 53%-86%). GCRA self-efficacy scores increased by 31% (95% CI, 6.47 to 55.54; P = .02). Participant feedback recommended Spanish content to improve learning. GRACIAS promoted reach at all sites: 77% in Universidad de Guadalajara, 86% in Instituto Nacional de Cancerología, 90% in Tecnológico de Monterrey, and 77% in Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Overall, a pathogenic BRCA variant was identified in 15.6% (195 of 1,253) of patients. All trainees continue to provide GCRA and address barriers to care. CONCLUSION We describe the first project to use implementation science methods to develop and deliver an innovative multicomponent implementation intervention, combining low-cost BRCA testing, comprehensive GCRA training, and practice support in Mexico. Scale-up of the GRACIAS intervention will promote risk-appropriate care, cancer prevention, and reduction in related mortality.
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Affiliation(s)
| | - Yanin Chavarri-Guerra
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Bita Nehoray
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Alejandro Mohar
- Instituto Nacional de Cancerologia, Mexico City, Mexico
- Instituto de Investigaciones Biomédicas, Mexico City, México
| | | | | | - Dione Aguilar
- Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
| | - Jazmin Arteaga
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Rosa Mejia
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Josef Herzog
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | | | - Maria Fernandez
- UTHealth, The University of Texas Health Science Center at Houston, Houston, TX
| | - Jeffrey N. Weitzel
- City of Hope Comprehensive Cancer Center, Duarte, CA
- Latin American School of Oncology (Escuela Latinoamericana de Oncología), Sierra Madre, CA
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Gomez-Macias GS, Molinar-Flores G, Lopez-Garcia CA, Santuario-Facio S, Decanini-Arcaute H, Valero-Elizondo J, Treviño-Alvarado V, Ortiz-Lopez R, Dono A, Esteban-Zubero E, Alatorre-Jimenez MA, Garza CV, Peña-Curiel O, Cardona-Huerta S. Immunotyping of tumor-infiltrating lymphocytes in triple-negative breast cancer and genetic characterization. Oncol Lett 2020; 20:140. [PMID: 32934708 PMCID: PMC7471657 DOI: 10.3892/ol.2020.12000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 07/13/2020] [Indexed: 12/13/2022] Open
Abstract
Tumor-infiltrating lymphocytes (TILs) reflect the host immune response against cancer cells. Immunomodulators have been recently suggested as a novel therapeutic strategy against triple-negative breast cancer (TNBC). However, the TIL profile in TNBC has not been thoroughly investigated. In the present study, the percentage, immunophenotype and genetic profiles of TILs in pre-surgical tumor samples of patients with TNBC were evaluated prior to neoadjuvant chemotherapy (NAC). Patients diagnosed with breast cancer at Hospital San José TecSalud were consecutively and prospectively enrolled in the present study between August 2011 and August 2015. The pathological response to NAC was evaluated using the de Miller-Payne and MD Anderson Cancer Center system. TIL percentage (low, intermediate, and high) was evaluated using special hematoxylin-eosin staining on the core needle biopsies. The immunophenotype of TILs was assessed by immunohistochemistry (IHC) for CD3+, CD4+ and CD8+. In addition, the gene expression profile of CD3, CD4, CD8, CD20, CD45, forkhead box P3, interleukin 6, programmed cell death 1 and CD274 molecule was assessed in all patients. A total of 26 samples from patients with TNBC prior to NAC were included in the present study. TILs were low in 30.7%, intermediate in 38.4% and elevated in 30.7% of tumors. CD3+ and CD4+ counts were associated with the pathological response to NAC (P=0.04). Finally, an overexpression pattern of CD3, CD4, CD8, CD45 and CD20 genes was observed in patients with a partial or complete pathological response. The present results demonstrated that TILs may predict the pathological response to NAC in patients with TNBC. Furthermore, a more accurate association was identified between the high expression levels of CD3, CD4, CD8, CD45 and CD20 genes and partial and complete pathological response, compared with the association between high expression and IHC alone.
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Affiliation(s)
- Gabriela Sofia Gomez-Macias
- Department of Pathology, Hospital San José TecSalud, Tecnológico de Monterrey, Monterrey, Nuevo León 64710, México.,Department of Pathology, Hospital Universitario, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | - Guillermo Molinar-Flores
- Department of Pathology, Hospital San José TecSalud, Tecnológico de Monterrey, Monterrey, Nuevo León 64710, México
| | - Carlos A Lopez-Garcia
- Department of Pathology, Hospital San José TecSalud, Tecnológico de Monterrey, Monterrey, Nuevo León 64710, México
| | - Sandra Santuario-Facio
- Laboratorio de Investigacion, Tecnologico de Monterrey, Monterrey, Nuevo León 64710, México
| | - Horacio Decanini-Arcaute
- Department of Pathology, Hospital Christus Muguerza of Alta Especialidad, Monterrey, Nuevo León 64060, México
| | - Javier Valero-Elizondo
- Breast Cancer Center, Hospital San José, TecSalud, Tecnológico de Monterrey, Monterrey, Nuevo León 64710, México
| | | | - Rocio Ortiz-Lopez
- Laboratorio de Investigacion, Tecnologico de Monterrey, Monterrey, Nuevo León 64710, México
| | - Antonio Dono
- Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston, Medical School, Houston, TX 77030, USA
| | | | | | - Cynthia Villarreal Garza
- Breast Cancer Center, Hospital San José, TecSalud, Tecnológico de Monterrey, Monterrey, Nuevo León 64710, México
| | - Omar Peña-Curiel
- Breast Cancer Center, Hospital San José, TecSalud, Tecnológico de Monterrey, Monterrey, Nuevo León 64710, México
| | - Servando Cardona-Huerta
- Breast Cancer Center, Hospital San José, TecSalud, Tecnológico de Monterrey, Monterrey, Nuevo León 64710, México
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Moral de la Rubia J, Miaja Avila M, Bajonero Canónico P, Villarreal Garza C. Propiedades Psicométricas del Cuestionario de Motivos a Favor y en Contra de la Reconstrucción Mamaria. PSIC 2019. [DOI: 10.5209/psic.65592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Antecedentes: Aunque la reconstrucción mamaria (RM) tras la mastectomía es una opción estética con buenos resultados, se realiza poco en México. Para estudiar sus razones se creó el Cuestionario de Motivos a favor y en contra de la Reconstrucción Mamaria (CMRM). La de validez de contenido del CMRM ha sido comprobada, pero no otras propiedades psicométricas. Objetivos: determinar su estructura factorial y comprobar su fiabilidad y validez de constructo concurrente. Método: Este estudio instrumental con diseño no experimental de corte transversal usó un muestreo intencional. Se aplicó el CMRM integrado por dos escalas, un cuestionario de imagen corporal y preguntas sobre datos sociodemográficos, clínicos y conducta sexual a 110 mujeres mexicanas mastectomizadas. Resultados: La escala de motivos a favor de la RM del CMRM presentó una estructura unidimensional, consistencia interna excelente y validez convergente. La escala de motivos en contra de la RM presentó una estructura de tres factores: miedos/preocupaciones/costos, aceptación/satisfacción con el estado actual y falta de información. Sus tres factores presentaron consistencia interna y validez convergente y discriminante. La correlación entre ambas escalas fue pequeña, pero la consistencia interna del CMRM fue excelente. La fuerza de asociación del CMRM fue muy fuerte con deseo de RM, media con edad e imagen corporal y pequeña con deseo de conservar la mama, frecuencias de relaciones sexuales antes del diagnóstico, búsqueda de información sobre RM y percepción del estado económico. Fue independiente de escolaridad, etapa del cáncer, tipo de mastectomía y estado civil. Conclusión: el cuestionario es fiable y válido.
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González Espinoza IR, Villarreal Garza C, Juárez León OA, Adel Álvarez LA, Cruz López JC, Téllez Bernal E. Cáncer de mama con receptores hormonales positivos: tratamiento adyuvante, primera línea en cáncer metastásico y nuevas estrategias (inhibición de mTOR). Gaceta Mexicana de Oncología 2015. [DOI: 10.1016/j.gamo.2015.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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