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Morante Z, Ferreyra Y, Pinto JA, Valdivieso N, Castañeda C, Vidaurre T, Valencia G, Rioja P, Fuentes H, Cotrina JM, Neciosup S, Gomez HL. Subpopulation treatment effect pattern plot analysis: a prognostic model for distant recurrence-free survival to estimate delayed adjuvant chemotherapy initiation effect in triple-negative breast cancer. Front Oncol 2023; 13:1193927. [PMID: 38023174 PMCID: PMC10657890 DOI: 10.3389/fonc.2023.1193927] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Triple-negative breast cancer (TNBC) is a heterogeneous disease associated with a poor prognosis. Delaying in time to start adjuvant chemotherapy (TTC) has been related to an increased risk of distant recurrence-free survival (DRFS). We aimed to develop a prognostic model to estimate the effects of delayed TTC among TNBC risk subgroups. Materials and methods We analyzed 687 TNBC patients who received adjuvant chemotherapy at the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru). Database was randomly divided to create a discovery set (n=344) and a validation set (n=343). Univariate and multivariate Cox regression models were performed to identify prognostic factors for DRFS. Risk stratification was implemented through two models developed based on proportional hazard ratios from significant clinicopathological characteristics. Subpopulation treatment effect pattern plot (STEPP) analysis was performed to determine the best prognostic cut-off points for stratifying TNBC subgroups according to risk scores and estimate Kaplan-Meier differences in 10-year DRFS comparing TTC (≤30 vs.>30 days). Results In univariate analysis, patients aged ≥70 years (HR=4.65; 95% CI: 2.32-9.34; p=<0.001), those at stages pT3-T4 (HR=3.28; 95% CI: 1.57-6.83; p=0.002), and pN2-N3 (HR=3.00; 95% CI: 1.90-4.76; p=<0.001) were notably associated with higher risk. STEPP analysis defined three risk subgroups for each model. Model N°01 categorized patients into low (score: 0-31), intermediate (score:32-64), and high-risk (score: 65-100) cohorts; meanwhile, Model N°02: low (score: 0-26), intermediate (score: 27-55), and high (score: 56-100). Kaplan-Meier plots showed that in the discovery set, patients with TTC>30 days experienced a 17.5% decrease in 10-year DRFS rate (95%CI=6.7-28.3), and the impact was more remarkable in patients who belong to the high-risk subgroup (53.3% decrease in 10 years-DRFS rate). Similar results were found in the validation set. Conclusions We developed two prognostic models based on age, pT, and pN to select the best one to classify TNBC. For Model N°02, delayed adjuvant chemotherapy conferred a higher risk of relapse in patients ≥70 years and who were characterized by pT3/T4 and pN2/N3. Thus, more efforts should be considered to avoid delayed TTC in TNBC patients, especially those in high-risk subgroups.
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Affiliation(s)
- Zaida Morante
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
- Oncosalud, AUNA, Lima, Peru
| | - Yomali Ferreyra
- Departamento de Bioingeniería, Universidad de Ingeniería y Tecnología, Lima, Peru
| | - Joseph A. Pinto
- Centro de Investigación Básica y traslacional, Auna Ideas, Lima, Peru
| | - Natalia Valdivieso
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Carlos Castañeda
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Tatiana Vidaurre
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Guillermo Valencia
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Patricia Rioja
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Hugo Fuentes
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - José M. Cotrina
- Departamento de Cirugía en Mamas y Tejidos Blandos, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Silvia Neciosup
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Henry L. Gomez
- Oncosalud, AUNA, Lima, Peru
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Peru
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Valenzuela-Rodriguez G, Diaz-Arocutipa C, Collins JA, Lopez-Fernandez T, Gomez HL, Hernandez AV. Severe cardiac events induced by combination immunotherapy in patients with cancer: a meta-analysis. Arch Med Sci 2023; 19:1662-1670. [PMID: 38058705 PMCID: PMC10696972 DOI: 10.5114/aoms/168124] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/12/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction The use of combined immunotherapy could increase non-severe and severe cardiac events in patients with cancer. To examine the occurrence of severe cardiac adverse events of combined immunotherapy compared to single immunotherapy, we analysed 4 electronic databases from inception to August 2021. Material and methods We selected randomized controlled trials (RCTs) comparing combined versus single immunotherapy, for the treatment of melanoma, oesophagogastric cancer, renal cell carcinoma, and non-small cell lung cancer. Pre-defined combined immunotherapy included monoclonal antibodies against programmed cell death 1 (PD-1 inhibitors) plus against cytotoxic T lymphocyte antigen 4 (CTLA-4 inhibitors) or against programmed cell death ligand 1 (PD-L1 inhibitors) plus CTLA-4 inhibitors. The pooled risk ratios (RR) with their 95% confidence intervals (CI) were estimated using a random-effects model. Results Four RCTs involving 1581 patients were included, with a follow-up time between 18 and 39 months. The use of combined immunotherapy in comparison with single immunotherapy was not associated with an increased risk of severe cardiac adverse events: acute coronary syndromes (RR = 1.76, 95% CI: 0.29-10.83, very low certainty of evidence (CoE)), myocardial infarction (RR = 3.93, 95% CI: 0.44-35.39, very low CoE), heart failure (RR = 2.99, 95% CI: 0.61-14.79, very low CoE), and atrial fibrillation (RR = 2.26, 95% CI: 0.62-8.16, very low CoE). Conclusions Our meta-analysis shows that the risk of severe cardiac adverse events with combined immunotherapy seems similar to single immunotherapy, but the evidence is very uncertain. Therefore, more RCTs with longer follow-ups and adequately powered to assess cardiac adverse events are needed to confirm these findings.
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Affiliation(s)
- German Valenzuela-Rodriguez
- Clínica Delgado, Servicio de Medicina Interna y Cardiología, Lima, Peru
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Carlos Diaz-Arocutipa
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Jaime A Collins
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Servicio de Infectología, Departamento de Medicina Interna, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, Lima, Peru
| | - Teresa Lopez-Fernandez
- Unidad de Cardio-Oncología, Hospital Universitario La Paz, Madrid, España
- Servicio de Cardiología, Hospital Universitario Quirón Pozuelo, Madrid, España
| | - Henry L Gomez
- Clínica Delgado, Servicio de Oncología Clínica, Lima, Peru
- ONCOSALUD, Lima, Perú
| | - Adrian V Hernandez
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, Connecticut, USA
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Pagani O, Walley BA, Fleming GF, Colleoni M, Láng I, Gomez HL, Tondini C, Burstein HJ, Goetz MP, Ciruelos EM, Stearns V, Bonnefoi HR, Martino S, Geyer CE, Chini C, Puglisi F, Spazzapan S, Ruhstaller T, Winer EP, Ruepp B, Loi S, Coates AS, Gelber RD, Goldhirsch A, Regan MM, Francis PA. Adjuvant Exemestane With Ovarian Suppression in Premenopausal Breast Cancer: Long-Term Follow-Up of the Combined TEXT and SOFT Trials. J Clin Oncol 2023; 41:1376-1382. [PMID: 36521078 PMCID: PMC10419413 DOI: 10.1200/jco.22.01064] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/08/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022] Open
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.The combined analysis of SOFT-TEXT compared outcomes in 4,690 premenopausal women with estrogen/progesterone receptor-positive (ER/PgR+) early breast cancer randomly assigned to 5 years of exemestane + ovarian function suppression (OFS) versus tamoxifen + OFS. After a median follow-up of 9 years, exemestane + OFS significantly improved disease-free survival (DFS) and distant recurrence-free interval (DRFI), but not overall survival, compared with tamoxifen + OFS. We now report DFS, DRFI, and overall survival after a median follow-up of 13 years. In the intention-to-treat (ITT) population, the 12-year DFS (4.6% absolute improvement, hazard ratio [HR], 0.79; 95% CI, 0.70 to 0.90; P < .001) and DRFI (1.8% absolute improvement, HR, 0.83; 95% CI, 0.70 to 0.98; P = .03), but not overall survival (90.1% v 89.1%, HR, 0.93; 95% CI, 0.78 to 1.11), continued to be significantly improved for patients assigned exemestane + OFS over tamoxifen + OFS. Among patients with human epidermal growth factor receptor 2-negative tumors (86.0% of the ITT population), the absolute improvement in 12-year overall survival with exemestane + OFS was 2.0% (HR, 0.85; 95% CI, 0.70 to 1.04) and 3.3% in those who received chemotherapy (45.9% of the ITT population). Overall survival benefit was clinically significant in high-risk patients, eg, women age < 35 years (4.0%) and those with > 2 cm (4.5%) or grade 3 tumors (5.5%). These sustained reductions of the risk of recurrence with adjuvant exemestane + OFS, compared with tamoxifen + OFS, provide guidance for selecting patients for whom exemestane should be preferred over tamoxifen in the setting of OFS.[Media: see text].
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Affiliation(s)
- Olivia Pagani
- Interdisciplinary Cancer Service Hospital Riviera-Chablais Rennaz, Vaud, Switzerland
- Geneva University Hospitals, Lugano University and Swiss Group for Clinical Cancer Research (SAKK), Vaud, Switzerland
| | - Barbara A. Walley
- University of Calgary and Canadian Cancer Trials Group, Calgary, AB, Canada
| | - Gini F. Fleming
- The University of Chicago Medical Center and Alliance for Clinical Trials in Oncology, Chicago, IL
| | - Marco Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology, IRCCS, and International Breast Cancer Study Group, Milan, Italy
| | - István Láng
- Clinexpert-research, Budapest, Hungary (prior affiliation)
- National Institute of Oncology and International Breast Cancer Study Group, Budapest, Hungary
| | - Henry L. Gomez
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
- International Breast Cancer Study Group, Lima, Peru
| | - Carlo Tondini
- Osp. Papa Giovanni XXIII and International Breast Cancer Study Group, Bergamo, Italy
| | - Harold J. Burstein
- Susan F. Smith Center for Women's Cancers, Dana-Farber Cancer Institute, Harvard Medical School and Alliance for Clinical Trials in Oncology, Boston, MA
| | - Matthew P. Goetz
- Mayo Clinic and Alliance for Clinical Trials in Oncology, Rochester, MN
| | - Eva M. Ciruelos
- Medical Oncology Department, University Hospital 12 de Octubre and SOLTI Breast Cancer Research Cooperative Group, Madrid, Spain
| | - Vered Stearns
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and ECOG-ACRIN, Baltimore, MD
| | - Hervé R. Bonnefoi
- Institut Bergonié Comprehensive Cancer Centre, Université de Bordeaux, INSERM U1312, and European Organisation for Research and Treatment of Cancer (EORTC), Bordeaux, France
| | - Silvana Martino
- The Angeles Clinic and Research Institute and SWOG, Santa Monica, CA
| | - Charles E. Geyer
- University of Pittsburgh Medical Center Hillman Cancer Center and NRG Oncology, Pittsburgh, PA
| | - Claudio Chini
- Deaprment of Medical Oncology, Ospedale di Circolo e Fondazione, Lombardy, Italy
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine, Italy and Department of Medical Oncology, IRCCS, Centro di Riferimento Oncologico CRO di Aviano, Aviano, Italy
| | - Simon Spazzapan
- Department of Medical Oncology, IRCCS, Centro di Riferimento Oncologico CRO di Aviano, Aviano, Italy
| | - Thomas Ruhstaller
- University of Basel, Swiss Group for Clinical Cancer Research (SAKK) and International Breast Cancer Study Group, Basel, Switzerland
| | - Eric P. Winer
- Susan F. Smith Center for Women's Cancers, Dana-Farber Cancer Institute, Harvard Medical School and Alliance for Clinical Trials in Oncology, Boston, MA
- Yale Cancer Center, Yale School of Medicine; Smilow Cancer Hospital, New Haven, CT (prior affiliation)
| | - Barbara Ruepp
- International Breast Cancer Study Group Coordinating Center, Bern, Switzerland
| | - Sherene Loi
- International Breast Cancer Study Group and Peter MacCallum Cancer Center, University of Melbourne, Melbourne, Victoria, Australia
| | - Alan S. Coates
- International Breast Cancer Study Group and University of Sydney, Sydney, Australia
| | - Richard D. Gelber
- International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, Harvard TH Chan School of Public Health, Frontier Science Foundation, Boston, MA
| | - Aron Goldhirsch
- European Institute of Oncology, IRCCS, International Breast Cancer Study Group, Milan, Italy
- Deceased
| | - Meredith M. Regan
- International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Prudence A. Francis
- Peter MacCallum Cancer Center, St Vincent's Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
- Breast Cancer Trials Australia & New Zealand, University of Newcastle, Australia; International Breast Cancer Study Group, Melbourne, Australia
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Di Cosimo S, Ciniselli CM, Pizzamiglio S, Cappelletti V, Silvestri M, El-Abed S, Izquierdo M, Bajji M, Nuciforo P, Huober J, Cameron D, Chia S, Gomez HL, Iorio MV, Vingiani A, Pruneri G, Verderio P. End-of-neoadjuvant treatment circulating microRNAs and HER2-positive breast cancer patient prognosis: An exploratory analysis from NeoALTTO. Front Oncol 2023; 12:1028825. [PMID: 36798690 PMCID: PMC9927225 DOI: 10.3389/fonc.2022.1028825] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/30/2022] [Indexed: 02/03/2023] Open
Abstract
Background The absence of breast cancer cells in surgical specimens, i.e., pathological complete response (pCR), is widely recognized as a favorable prognostic factor after neoadjuvant therapy. In contrast, the presence of disease at surgery characterizes a prognostically heterogeneous group of patients. Here, we challenged circulating microRNAs (miRNAs) at the end of neoadjuvant therapy as potential prognostic biomarkers in the NeoALTTO study. Methods Patients treated within the trastuzumab arm (i.e., pre-operative weekly trastuzumab for 6 weeks followed by the addition of weekly paclitaxel for 12 weeks; post-operative FEC for 3 cycles followed by trastuzumab up to complete 1 year of treatment) were randomized into a training (n= 54) and testing (n= 72) set. RT-PCR-based high-throughput miRNA profile was performed on plasma samples collected at the end of neoadjuvant treatment of both sets. After normalization, circulating miRNAs associated with event free survival (EFS) were identified by univariate and multivariate Cox regression model. Results Starting from 23 circulating miRNAs associated with EFS in the training set, we generated a 3-circulating miRNA prognostic signature consisting of miR-185-5p, miR-146a-5p, miR-22-3p, which was confirmed in the testing set. The 3-circulating miRNA signature showed a C-statistic of 0.62 (95% confidence interval [95%CI] 0.53-0.71) in the entire study cohort. By resorting to a multivariate Cox regression model we found a statistical significant interaction between the expression values of miR-194-5p and pCR status (p.interaction =0.005) with an estimate Hazard Ratio (HR) of 1.83 (95%CI 1.14- 2.95) in patients with pCR, and 0.87 (95%CI 0.69-1.10) in those without pCR. Notably, the model including this interaction along with the abovementioned 3-circulating miRNA signature provided the highest discriminatory capability with a C-statistic of 0.67 (95%CI 0.58-0.76). Conclusions Circulating miRNAs are informative to identify patients with different prognosis among those with heterogeneous response after trastuzumab-based neoadjuvant treatment, and may be an exploitable tool to select candidates for salvage adjuvant therapy.
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Affiliation(s)
- Serena Di Cosimo
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara M. Ciniselli
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Pizzamiglio
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy,*Correspondence: Sara Pizzamiglio,
| | - Vera Cappelletti
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marco Silvestri
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Mohammed Bajji
- Institut Jules Bordet and l’Université Libre de Bruxelles (U.LB), Bruxelles, Belgium
| | - Paolo Nuciforo
- Molecular Oncology Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Jens Huober
- Breast Center, University of Ulm, Ulm, Germany,Breast Center, Cantonal Hospital St.Gallen, St. Gallen, Switzerland
| | | | - Stephen Chia
- University of British Columbia, Vancouver, BC, Canada
| | - Henry L. Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru,Department of Medical Oncology, Universidad Ricardo Palma, Lima, Peru
| | - Marilena V. Iorio
- Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Vingiani
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giancarlo Pruneri
- Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Verderio
- Unit of Bioinformatics and Biostatistics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Castaneda CA, Castillo M, Bernabe LA, Suarez N, Romero A, Sanchez J, Torres E, Enciso J, Tello K, Enciso N, Velarde M, De La Cruz M, Dunstan J, Cotrina JM, Abugattas J, Pinillos MA, Roque K, Fuentes H, Poquioma E, Guerra H, Gomez HL. Association between PIK3CA Mutations in Blood and Tumor-Infiltrating Lymphocytes in Peruvian Breast Cancer Patients. Asian Pac J Cancer Prev 2022; 23:3331-3337. [PMID: 36308356 PMCID: PMC9924322 DOI: 10.31557/apjcp.2022.23.10.3331] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between circulating tumor DNA (ctDNA) presence and tumor features including tumor-infiltrating lymphocyte (TIL) levels in Peruvian breast cancer patients. MATERIALS AND METHODS This was a prospective study conducted at the Instituto Nacional de Enfemedades Neoplasicas, Peru. We evaluated level of TIL and PIK3CA mutations in ctDNA. Clinical characteristics, including outcome data, were collected from the patient file. Survival was calculated from the date of blood sample drawn to the event time. Data collected were analyzed using SPSS software version 25. RESULTS We analyzed plasma samples from 183 breast cancer patients. most cases were of Luminal-B (44.8%) phenotype and stage II (41.5%), and median stromal TIL was 30%. PIK3CA mutation in ctDNA was detected in 35% cases (most with E545K) and was associated with lower TIL level (p=0.04). PIK3CA in ctDNA tended to be associated with advanced stages (p=0.09) in the whole series and with higher recurrence rates (p=0.053) in the non-metastatic setting. Patients with presence of PIK3CA in ctDNA tended to have shorter survival (p=0.083). CONCLUSION Presence of PIK3CA mutation in ctDNA was frequently found in our Peruvian breast cancer series, was associated with lower TIL levels and tended to predict poor outcomes.
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Affiliation(s)
- Carlos A. Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru. ,Faculty of Medical Sciences, Universidad Cientifica del Sur, Lima 15067, Peru. ,For Correspondence:
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Luis A. Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Nancy Suarez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Atocha Romero
- Department of Medical Oncology, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Ebert Torres
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Javier Enciso
- Laboratorio de Cultivo Celular e Inmunologia, Universidad Cientifica del Sur, Lima 15067, Peru.
| | - Katherine Tello
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Nataly Enciso
- Laboratorio de Cultivo Celular e Inmunologia, Universidad Cientifica del Sur, Lima 15067, Peru.
| | - Marco Velarde
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Miguel De La Cruz
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Jorge Dunstan
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Jose M. Cotrina
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Julio Abugattas
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Miguel A. Pinillos
- Department of Breast and Soft Tissues, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Katia Roque
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Hugo Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Ebert Poquioma
- Department of Epidemiology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
| | - Henry L. Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
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Araujo JM, De la Cruz-Ku G, Cornejo M, Doimi F, Dyer R, Gomez HL, Pinto JA. Prognostic Capability of TNBC 3-Gene Score among Triple-Negative Breast Cancer Subtypes. Cancers (Basel) 2022; 14:cancers14174286. [PMID: 36077821 PMCID: PMC9454544 DOI: 10.3390/cancers14174286] [Citation(s) in RCA: 2] [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: 07/15/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Triple-negative breast cancer (TNBC) is a complex and molecularly heterogeneous entity, with the poorest outcome compared with other breast cancer subtypes. Previously, we developed a TNBC 3-gene score with a significant prognostic capability. This study aims to test the 3-gene score in the different TNBC subtypes. Methods: Data from 204 TNBC patients treated with neoadjuvant chemotherapy were retrieved from public datasets and pooled (GSE25066, GSE58812, and GSE16446). After removing batch effects, cases were classified into Lehman’s TNBC subtypes and then the TNBC 3-gene score was used to evaluate the risk of distant recurrence in each subgroup. In addition, the association with tumor-infiltrating lymphocyte (TILs) levels was evaluated in a retrospective group of 72 TNBC cases. Results: The TNBC 3-gene score was able to discriminate patients with different risks within the pooled cohort (HR = 2.41 for high vs. low risk; 95%CI: 1.50−3.86). The score showed predictive capability in the immunomodulatory subtype (HR = 4.16; 95%CI: 1.63−10.60) and in the mesenchymal stem-like subtype (HR = 18.76; 95%CI: 1.68−208.97). In the basal-like 1, basal-like-2, and mesenchymal subtypes, the observed differential risk patterns showed no statistical significance. The score had poor predictive capability in the luminal androgen receptor subtype (p = 0.765). In addition, a low TNBC 3-gene score was related to a high level of TIL infiltration (p < 0.001). Conclusions: The TNBC 3-gene score is able to predict the risk of distant recurrence in TNBC patients, specifically in the immunomodulatory and mesenchymal stem-like subtype. Despite a small sample size in each subgroup, an improved prognostic capability was seen in TNBC subtypes with tumor-infiltrating components.
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Affiliation(s)
- Jhajaira M. Araujo
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima 15067, Peru
| | - Gabriel De la Cruz-Ku
- Department of Surgery, University of Massachusetts, Worcester, MA 01604, USA
- Universidad Cientifica del Sur, Lima 15067, Peru
| | - Melanie Cornejo
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
| | - Franco Doimi
- Departamento de Patología, Oncosalud-AUNA, Lima 15036, Peru
| | - Richard Dyer
- Departamento de Patología, Oncosalud-AUNA, Lima 15036, Peru
| | - Henry L. Gomez
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Peru
| | - Joseph A. Pinto
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
- Correspondence: ; Tel.: +51-1-5137900 (ext. 2231)
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Guio H, Aliaga-Tobar V, Galarza M, Pellon-Cardenas O, Capristano S, Gomez HL, Olivera M, Sanchez C, Maracaja-Coutinho V. Comparative Profiling of Circulating Exosomal Small RNAs Derived From Peruvian Patients With Tuberculosis and Pulmonary Adenocarcinoma. Front Cell Infect Microbiol 2022; 12:909837. [PMID: 35846752 PMCID: PMC9280157 DOI: 10.3389/fcimb.2022.909837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/24/2022] [Indexed: 12/05/2022] Open
Abstract
Tuberculosis (TB) is one of the most fatal infectious diseases, caused by the aerobic bacteria Mycobacterium tuberculosis. It is estimated that one-third of the world’s population is infected with the latent (LTB) version of this disease, with only 5-10% of infected individuals developing its active (ATB) form. Pulmonary adenocarcinoma (PA) is the most common and diverse form of primary lung carcinoma. The simultaneous or sequential occurrence of TB and lung cancer in patients has been widely reported and is known to be an issue for diagnosis and surgical treatment. Raising evidence shows that patients cured of TB represent a group at risk for developing PA. In this work, using sRNA-sequencing, we evaluated the expression patterns of circulating small RNAs available in exosomes extracted from blood samples of Peruvian patients affected by latent tuberculosis, active tuberculosis, or pulmonary adenocarcinoma. Differential expression analysis revealed a set of 24 microRNAs perturbed in these diseases, revealing potential biomarker candidates for the Peruvian population. Most of these miRNAs are normally expressed in healthy lung tissue and are potential regulators of different shared and unique KEGG pathways related to cancers, infectious diseases, and immunology.
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Affiliation(s)
- Heinner Guio
- Laboratorio de Referencia Nacional de Biotecnología y Biología Molecular, Instituto Nacional de Salud, Lima, Peru
- Facultad de Ciencias de la Salud, Universidad de Huanuco, Huánuco, Peru
- *Correspondence: Heinner Guio, ; Vinicius Maracaja-Coutinho,
| | - Victor Aliaga-Tobar
- Advanced Center for Chronic Diseases - ACCDiS, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile
- Centro de Modelamiento Molecular, Biofísica y Bioinformática - CMB, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile
| | - Marco Galarza
- Laboratorio de Referencia Nacional de Biotecnología y Biología Molecular, Instituto Nacional de Salud, Lima, Peru
| | - Oscar Pellon-Cardenas
- Laboratorio de Referencia Nacional de Biotecnología y Biología Molecular, Instituto Nacional de Salud, Lima, Peru
- Department of Genetics, Human of Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ, United States
| | - Silvia Capristano
- Laboratorio de Referencia Nacional de Biotecnología y Biología Molecular, Instituto Nacional de Salud, Lima, Peru
| | - Henry L. Gomez
- Departamento de Oncología Medica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Mivael Olivera
- Departamento de Oncología Medica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Cesar Sanchez
- Laboratorio de Referencia Nacional de Biotecnología y Biología Molecular, Instituto Nacional de Salud, Lima, Peru
| | - Vinicius Maracaja-Coutinho
- Advanced Center for Chronic Diseases - ACCDiS, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile
- Centro de Modelamiento Molecular, Biofísica y Bioinformática - CMB, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile
- Instituto Vandique, João Pessoa, Brazil
- *Correspondence: Heinner Guio, ; Vinicius Maracaja-Coutinho,
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8
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Calderon G, Castaneda CA, Castillo M, Sanchez J, Bernabe L, Suarez N, Tello K, Torres E, Cotrina JM, Dunstan J, De-La-Cruz M, Abugattas J, Guerra H, Manrique JE, Aguayo F, Gomez HL. Human Papillomavirus, Cytomegalovirus Infection and P16 Staining in Breast Tumors from Peruvian Women. Asian Pac J Cancer Prev 2022; 23:1571-1576. [PMID: 35633540 PMCID: PMC9587888 DOI: 10.31557/apjcp.2022.23.5.1571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/16/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: To evaluate the frequency distribution of viral infections in Peruvian Breast Cancer (BC) lesions and its association with clinicopathological features. Additionally, a prospective evaluation of p16 and Tumor-infiltrating lymphocytes (TIL) levels were performed for developing a comprehensive analysis. Methods: Detection of high risk- human papillomavirus (HR- HPV) through qPCR was performed in 447 BC and 79 non-cancer frozen samples. Paired paraffin samples from 238 BC were stained with Human cytomegalovirus (HCMV) and p16 immunohistochemistry. TIL was calculated in 397 BC cases. Results: HCMV was positive in 72.5%. HR- HPV was detected in 2.9% of BC and 1.3% of non-malignant samples. P16+ was found in 28.15% and median TIL percentage was 30. HR- HPV infection was associated with non-ductal histology (p=0.003) and p16+ (p=0.017). Positive P16+ was associated with higher T stage (p=0.022), grade (p=0.009), TIL level (p=0.002), and triple-negative phenotype (p=0.021). Conclusion: HCMV is frequent, but HR- HPV infection is unusual in Peruvian BC. P16+ is associated with HR- PVH infection, high TIL and aggressive features.
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Affiliation(s)
- Gabriela Calderon
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Carlos A Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.,Faculty of Health Sciences, Universidad Cientifica del Sur, Lima, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Luis Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Nancy Suarez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Katherine Tello
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Ebert Torres
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jose M Cotrina
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jorge Dunstan
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miguel De-La-Cruz
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Julio Abugattas
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Javier E Manrique
- Department of Health Promotion and Prevention, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Francisco Aguayo
- Laboratory of Oncovirology, Virology Program, Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, Santiago, Chile
| | - Henry L Gomez
- Laboratory of Oncovirology, Virology Program, Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, Santiago, Chile
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9
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Valencia GA, Rioja P, Morante Z, Ruiz R, Fuentes H, Castaneda CA, Vidaurre T, Neciosup S, Gomez HL. Immunotherapy in triple-negative breast cancer: A literature review and new advances. World J Clin Oncol 2022; 13:219-236. [PMID: 35433291 PMCID: PMC8966508 DOI: 10.5306/wjco.v13.i3.219] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/23/2021] [Accepted: 02/19/2022] [Indexed: 02/06/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is a highly complex, heterogeneous disease and historically has limited treatment options. It has a high probability of disease recurrence and rapid disease progression despite adequate systemic treatment. Immunotherapy has emerged as an important alternative in the management of this malignancy, showing an impact on progression-free survival and overall survival in selected populations. In this review we focused on immunotherapy and its current relevance in the management of TNBC, including various scenarios (metastatic and early -neoadjuvant, adjuvant-), new advances in this subtype and the research of potential predictive biomarkers of response to treatment.
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Affiliation(s)
| | - Patricia Rioja
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Zaida Morante
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Rossana Ruiz
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Hugo Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Carlos A Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Tatiana Vidaurre
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Silvia Neciosup
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
| | - Henry L Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15036, Peru
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10
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Valdiviezo N, Alcarraz C, Castro D, Salas R, Begazo-Mollo V, Galvez-Villanueva M, Medina Aguirre L, Garcia-León E, Quispe-Santivañez I, Cornejo-Raymundo C, Paz-Cornejo E, Sanchez-Vilela L, Bermudez-Alfaro V, Vargas-Nina JC, Pérez-Ramos C, Meza-Hoces A, Valdez Barreto PR, Huaringa-Leiva R, Muro-Cieza J, Aguilar-Vásquez V, Cuenca EY, Neciosup-Delgado S, Poma-Nieto N, Chavez-Gavino S, Fernandez-Rosas L, Araujo JM, Payet E, Gomez HL. Oncological Care During First Peruvian National Emergency COVID-19 Pandemic: A Multicentric Descriptive Study. Cancer Manag Res 2022; 14:1075-1085. [PMID: 35300062 PMCID: PMC8922040 DOI: 10.2147/cmar.s350038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/15/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Natalia Valdiviezo
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, 15038, Peru
- Correspondence: Natalia Valdiviezo, Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos 2520, Surquillo, Lima, 15038, Peru, Tel +51 992825055, Email
| | - Cindy Alcarraz
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, 15038, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Denisse Castro
- Departamento de Oncología Médica, Hospital Nacional Edgardo Rebagliati Martins, Lima, 15072, Peru
- Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres, Lima, 15024, Peru
| | - Renzo Salas
- Departamento de Oncología Médica, Hospital Nacional Edgardo Rebagliati Martins, Lima, 15072, Peru
| | - Victor Begazo-Mollo
- Departamento de Medicina Oncológica, Instituto Regional de Enfermedades Neoplásicas Sur, Arequipa, Perú
| | - Marco Galvez-Villanueva
- Departamento de Medicina Oncológica, Instituto Regional de Enfermedades Neoplásicas Norte, La Libertad, Perú
| | - Luz Medina Aguirre
- Departamento de Medicina Oncológica, Hospital Goyeneche, Arequipa, 04600, Perú
| | - Elica Garcia-León
- Departamento de Medicina Oncológica, Hospital Regional de Lambayeque, Lambayeque, 14001, Perú
| | | | | | - Eduardo Paz-Cornejo
- Departamento de Medicina Oncológica, Hospital Nacional Alberto Sabogal Sologuren, Lima, Peru
| | - Luis Sanchez-Vilela
- Departamento de Medicina Oncológica, Hospital de Apoyo II Santa Rosa, Piura, Peru
| | - Vanessa Bermudez-Alfaro
- Departamento de Medicina Oncológica, Hospital Nacional Guillermo Almenara Irigoyen, Lima, 15033, Peru
| | | | - Carlos Pérez-Ramos
- Departamento de Medicina Oncológica, Hospital María Auxiliadora, Lima, Peru
| | - Andrea Meza-Hoces
- Departamento de Medicina Oncológica, Hospital II E de Lamas, San Martin, Peru
| | - Paolo R Valdez Barreto
- Departamento de Medicina Oncológica, Hospital de Alta complejidad Virgen de la Puerta, La Libertad, Peru
| | | | - Johanny Muro-Cieza
- Departamento de Medicina Oncológica, Hospital Regional Docente de Cajamarca, Cajamarca, Peru
| | - Valeria Aguilar-Vásquez
- Departamento de Promoción de la Salud, Prevención y Control del Cáncer, Instituto Regional de Enfermedades Neoplásicas Norte, La Libertad, Perú
| | - Eduardo Yache Cuenca
- Departamento de Epidemiología, Instituto Regional de Enfermedades Neoplásicas Norte, La Libertad, Perú
| | - Silvia Neciosup-Delgado
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, 15038, Peru
| | - Nathaly Poma-Nieto
- Departamento de Medicina Oncológica, Hospital Nacional Daniel Alcides Carrión, Lima, Perú
| | - Sheyla Chavez-Gavino
- Departamento de Medicina Oncológica, Hospital Regional Eleazar Guzmán Barrón, Ancash, Perú
| | - Lenin Fernandez-Rosas
- Departamento de Cirugía Oncológica, Hospital Regional Eleazar Guzmán Barrón, Ancash, Perú
| | - Jhajaira M Araujo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Eduardo Payet
- Jefatura Institucional, Instituto Nacional de Enfermedades Neoplásicas, Lima, 15038, Peru
| | - Henry L Gomez
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, 15038, Peru
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11
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Gomez HL, Castaneda CA, Castillo M, Reuben J, Gao H, Suarez N, Bernabe LA, Cotrina JM, Dunstan J, Velarde M, Abugattas J, Guerra H. Concurrent Detection of Circulating Tumor Cells and Circulating Tumor DNA in Triple-negative Breast Cancer. Asian Pac J Cancer Care 2021. [DOI: 10.31557/apjcc.2021.6.4.373-377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: Circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) provide tumor information in breast cancer. Our objective was to characterize CTCs, and contrasted them with ctDNA PIK3CA mutation in 24 triple-negative breast cancer (TNBC). Methods: CTCs genes were characterized by AdnaTest protocol and ctDNA by digital PCR. Results: We found CTCs genes in 37.5% and ctDNA PIK3CA mutations in 29.16%. Three cases with CTCs genes had concurrent ctDNA PIK3CA mutations. MUC1 or GA733-2 were found in 4 cases, and 3 of them had concurrent ctDNA PIK3CA. CTCs ALDH1/TWIST1 were found in 2 cases, AKT2 in one and PI3Kα in another, and none had concurrent ctDNA PIK3CA mutations. There was no correlation between CTCs and ctDNA detection. All 3 cases with CTC & cDNA concurrent finding underwent death during follow-up. Conclusion: Infrequent concurrent detection of CTC and ctDNA presence suggests that both represent independent processes in TNBC patients, and could identify worst prognosis cases.
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12
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Castaneda CA, Castillo M, Bernabe LA, Sanchez J, Torres E, Suarez N, Tello K, Fuentes H, Dunstan J, De La Cruz M, Cotrina JM, Abugattas J, Guerra H, Gomez HL. A biomarker study in Peruvian males with breast cancer. World J Clin Oncol 2021; 12:926-934. [PMID: 34733614 PMCID: PMC8546657 DOI: 10.5306/wjco.v12.i10.926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/25/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast cancer (BC) frequency in males is extremely low and tumor features vary from its female counterpart. Breast cancer clinical and pathological features differ by race in women. Tumor infiltrating lymphocyte (TIL) levels, mismatch repair (MMR) protein loss, androgen receptor (AR) expression, and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female BC. There is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with BC.
AIM To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population.
METHODS This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018. Standard pathological features, TIL levels, MMR proteins, AR immunohistochemistry staining, and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material. Percentage of AR and estrogen receptor (ER) positive cells was additionally calculated by software after slide scanning. Statistical analyses included association tests, intraclass correlation test and Kaplan Meier overall survival curves.
RESULTS The median age was 63 years and most cases were ER-positive (85.7%), HER2 negative (87.2%), Luminal-A phenotype (60%) and clinical stage II (41.5%) among our male breast tumors. Median TIL was 10% and higher levels tended to be associated with Luminal-B phenotype and higher grade. AR-positive was found in 85.3% and was correlated with ER (intraclass index of 0.835, P < 0.001). Loss of MMR proteins was found in 15.4% and PIK3CA mutation (H1047R) in 14.3% (belonged to the Luminal-A phenotype). Loss of MMR proteins was associated with AR-negative (P = 0.018) but not with ER (P = 0.43) or TIL (P = 0.84). Early stages (P < 0.001) and lower grade (P = 0.006) were associated with longer overall survival. ER status, phenotype, AR status, TIL level, MMR protein loss nor PIK3CA mutation was not associated with survival (P > 0.05).
CONCLUSION Male BC is usually ER and AR positive, and Luminal-A. MMR loss and PIK3CA mutations are infrequent. Stage and grade predicted overall survival in our South American country population.
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Affiliation(s)
- Carlos A Castaneda
- Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15067, Peru
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis A Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Ebert Torres
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Nancy Suarez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Katherine Tello
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Hugo Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jorge Dunstan
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Miguel De La Cruz
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jose Manuel Cotrina
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Julio Abugattas
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry L Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
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13
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Gomez HL, Bargallo-Rocha JE, Billinghurst RJ, Núñez De Pierro AR, Coló FA, Gil LLB, Allemand C, McLean IL, Lema-Medina M, Herazo-Maya F, Terrier FJ, Cwilich RG, Leon M, Falcon SG, Castaño RE, Oliveira SC, Jakubowski DM, Chao C. Practice-Changing Use of the 21-Gene Test for the Management of Patients With Early-Stage Breast Cancer in Latin America. JCO Glob Oncol 2021; 7:1364-1373. [PMID: 34506221 PMCID: PMC8440019 DOI: 10.1200/go.21.00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE We present a physician survey of the impact of 21-gene Breast Recurrence Score test results on treatment decisions in clinical practice in Latin America. METHODS This prospective survey enrolled consecutive patients at 14 sites in Argentina, Colombia, Mexico, and Peru who had routine 21-gene testing. Physician surveys captured patient and tumor characteristics and treatment decisions before and after 21-gene test results. The survey spanned the period before and after Trial Assigning Individualized Options for Treatment (TAILORx) results reported (June 2018). Overall net percent change in adjuvant chemotherapy recommendations was estimated, and asymptotic 95% CIs with continuity correction were calculated. The proportion with a change between pretest treatment recommendation and actual treatment received was calculated overall and by Recurrence Score groups per TAILORx. RESULTS Between March 2015 and December 2019, the survey was completed for 647 patients; 20% were node-positive. The mean patient age was 54 years (24-85 years); 55% were postmenopausal; 17%, 63%, and 20% had grade 1, 2, and 3 tumors, respectively; and 30% had tumors > 2 cm. Recurrence Score (RS) results were as follows: 20% RS 0-10, 56% RS 11-25, and 24% RS 26-100. Overall, chemotherapy recommendations fell by a relative proportion of 39% (95% CI, 33.4 to 44.3) after 21-gene testing (33% decrease in node-negative and 55% decrease in node-positive). Among node-negative patients, the relative decrease in chemotherapy recommendations was 28% (95% CI, 18.9 to 39.5) before TAILORx and 36% (95% CI, 28.4 to 43.7) after. CONCLUSION To our knowledge, this large survey of 21-gene test practice patterns was the first conducted in Latin America and showed the relevance of 21-gene testing in low- and medium-resource countries to minimize chemotherapy overuse and underuse in breast cancer. The results showed substantial reductions in chemotherapy use overall—especially after TAILORx reported—indicating the practice-changing potential of that study.
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Affiliation(s)
- Henry L Gomez
- Oncosalud-AUNA, Lima, Peru.,Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | | | | | | | | | | | | | | | | | | | - Francisco J Terrier
- Breast-Clínica de la Mama y Hospital Italiano de La Plata, La Plata, Argentina
| | | | | | | | | | | | | | - Calvin Chao
- Exact Sciences Corporation, Redwood City, CA
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14
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Valencia GA, Rioja P, Morante Z, Araujo JM, Vallejos HD, Guerra H, Gomez HL. PIK3CA mutation in non-metastatic triple-negative breast cancer as a potential biomarker of early relapse: A case report. World J Clin Oncol 2021; 12:702-711. [PMID: 34513603 PMCID: PMC8394163 DOI: 10.5306/wjco.v12.i8.702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/18/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Currently, the detection of PIK3CA mutations is of special interest in personalized medicine because it is frequently found in triple-negative breast cancer (TNBC). The PI3KCA mutation is an independent negative prognostic factor for survival in metastatic breast cancer, and its prognostic value in liquid biopsy as a biomarker of treatment and early relapse is under investigation, both for metastatic disease and neoadjuvant scenario with curative intent.
CASE SUMMARY A 54-year-old female patient with TNBC clinical stage IIIA, who, after receiving neoadjuvant chemotherapy (based on anthracyclines and taxanes), surgery, radiotherapy, and adjuvant capecitabine, was detected with a PI3KCA mutation in tissue and peripheral blood (ctDNA in liquid biopsy). After 10 mo, the patient had disease relapse of left cervical node disease.
CONCLUSION The detection of PIK3CA mutation in TNBC after neoadjuvant treatment might be associated with early relapse or rapid disease progression.
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Affiliation(s)
| | - Patricia Rioja
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15000, Peru
| | - Zaida Morante
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15000, Peru
| | - Jhajaira M Araujo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima 15067, Peru
| | - Heberth Daniel Vallejos
- Department of Medical Oncology, Russian Scientific Center of Radiology and Radiotherapy, Konkovo 117485, Moscow, Russia
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15000, Peru
| | - Henry L Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Lima 15000, Peru
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Albain KS, Gray RJ, Makower DF, Faghih A, Hayes DF, Geyer CE, Dees EC, Goetz MP, Olson JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Wood WC, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge GW, Sparano JA. Race, Ethnicity, and Clinical Outcomes in Hormone Receptor-Positive, HER2-Negative, Node-Negative Breast Cancer in the Randomized TAILORx Trial. J Natl Cancer Inst 2021; 113:390-399. [PMID: 32986828 PMCID: PMC8599918 DOI: 10.1093/jnci/djaa148] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/22/2020] [Accepted: 09/09/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Black race is associated with worse outcomes in early breast cancer. We evaluated clinicopathologic characteristics, the 21-gene recurrence score (RS), treatment delivered, and clinical outcomes by race and ethnicity among women who participated in the Trial Assigning Individualized Options for Treatment. METHODS The association between clinical outcomes and race (White, Black, Asian, other or unknown) and ethnicity (Hispanic vs non-Hispanic) was examined using proportional hazards models. All P values are 2-sided. RESULTS Of 9719 eligible women with hormone receptor-positive, HER2-negative, node-negative breast cancer, there were 8189 (84.3%) Whites, 693 (7.1%) Blacks, 405 (4.2%) Asians, and 432 (4.4%) with other or unknown race. Regarding ethnicity, 889 (9.1%) were Hispanic. There were no substantial differences in RS or ESR1, PGR, or HER2 RNA expression by race or ethnicity. After adjustment for other covariates, compared with White race, Black race was associated with higher distant recurrence rates (hazard ratio [HR] = 1.60, 95% confidence intervals [CI] = 1.07 to 2.41) and worse overall survival in the RS 11-25 cohort (HR = 1.51, 95% CI = 1.06 to 2.15) and entire population (HR = 1.41, 95% CI = 1.05 to 1.90). Hispanic ethnicity and Asian race were associated with better outcomes. There was no evidence of chemotherapy benefit for any racial or ethnic group in those with a RS of 11-25. CONCLUSIONS Black women had worse clinical outcomes despite similar 21-gene assay RS results and comparable systemic therapy in the Trial Assigning Individualized Options for Treatment. Similar to Whites, Black women did not benefit from adjuvant chemotherapy if the 21-gene RS was 11-25. Further research is required to elucidate the basis for this racial disparity in prognosis.
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Affiliation(s)
- Kathy S Albain
- Loyola University Chicago Stritch School of Medicine, Cardinal Bernadin Cancer Center, Loyola University Medical Center, Maywood, IL, USA
| | | | - Della F Makower
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Amir Faghih
- Thunder Bay Regional Health Science Centre, Thunder Bay, Ontario, Canada
| | | | | | | | | | - John A Olson
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Tracy Lively
- National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | - Sunil S Badve
- Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Lynne I Wagner
- Wake Forest University Health Service, Winston Salem, NC, USA
| | | | | | | | | | - Henry L Gomez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | | | | | | | | | | | | | - Jeffrey Abrams
- National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | | | - Joseph A Sparano
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Valencia F, Laboriano J, Chirinos LA, Gomez HL. Abstract PS7-77: Pathological response after neoadjuvant chemotherapy and long-term outcomes among very young women with HER2 negative breast cancer. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps7-77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: To describe the pathological response rates (according to the MD Anderson RCB score) achieved by patients with 35 years old or younger, with HER2 negative breast cancer, who received neoadjuvant chemotherapy (NAC) and long term outcomes according to the response. Methods: A retrospective review of 526 medical records of women aged less than or equal to 35 years at diagnosis between 2009 and 2014 at INEN in Lima-Peru, who received NAC for invasive breast cancer, was performed. HER2 positive patients were excluded because of a lack of access to neoadjuvant anti-HER2 therapy during this period in our hospital. Descriptive statistics were used to describe baseline characteristics. OS was calculated from the date of diagnosis to death or last follow-up and presented as Kaplan-Meier curves. The comparison among patients who achieved pCR (RCB-0) and those with residual disease, was based on a log-rank test. Results: Seventy women (One with synchronous bilateral disease) were selected according to selection criteria, median age: 31.7 years old (IQR: 30.0-33.2). Hormone receptor-positive: 38 (53.5%). Clinical stage: IIA: 13(18.3%), IIB: 8(11.3%), IIIA: 25(35.2%), IIIB: 21 (29.6%) and IIIC: 4 (5.6%). Type of NAC: Anthracyclines 6 (8.6%), Anthracyclines and taxanes 55 (78.6%), Platin 5 (7.1%), Taxanes 4 (5.7%). Type of surgery: Conservative 16 (22.5%), radical 50 (70.4%), toilet 5 (7.0%). Type of pathological response RCB-0: 9(12.7%), RCB-I: 2(2.8%), RCB-II:29(40.8%), RCB-III: 24(33.8%), non-pCR: 7(9.9%). With a median follow-up of 46.5m, 5y OS: 100/100/79.3/45.8% according to RCB-0/I/II/III respectively (p=0.004). Conclusions: "Very young" women reach fewer pCR rates than reported for "young" and older women. Even so, RCB-0 can be considered as a biomarker of excellent prognosis and could be used as a surrogate biomarker to evaluate the efficacy of neoadjuvant therapy even in very young women who receive NAC.
Citation Format: Fernando Valencia, Jorge Laboriano, Luis A. Chirinos, Henry L. Gomez. Pathological response after neoadjuvant chemotherapy and long-term outcomes among very young women with HER2 negative breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-77.
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Affiliation(s)
| | | | - Luis A. Chirinos
- 3Universidad Científica del Sur - Facultad de Medicina Humana, Lima, Peru
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17
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De-la-Cruz-Ku G, Luyo M, Morante Z, Enriquez D, Möller MG, Chambergo-Michilot D, Flores L, Luque R, Saavedra A, Eyzaguirre-Sandoval ME, Luján-Peche MG, Noel N, Calderon H, Razuri C, Fuentes HA, Cotrina JM, Neciosup SP, Araujo J, Lema A, Pinto J, Gomez HL, Valcarcel B. Triple-negative breast cancer in Peru: 2000 patients and 15 years of experience. PLoS One 2020; 15:e0237811. [PMID: 32833983 PMCID: PMC7444821 DOI: 10.1371/journal.pone.0237811] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/02/2020] [Indexed: 12/24/2022] Open
Abstract
Background Epidemiological studies commonly identify the clinical characteristics and survival outcomes of patients with breast cancer at five years. Our study aims to describe the sociodemographic, clinicopathological characteristics and determine the long-term event-free survival (EFS) and overall survival (OS) of a Peruvian population with triple-negative breast cancer. Methods We reviewed the medical records of new cases treated at a single institution in the period 2000–2014. The survival analysis included patients with stages I-IV. Survival estimates at 10 years were calculated with the Kaplan-Meier method and compared with the Log-rank test. We further used multivariate Cox regression analysis to calculate prognostic factors of recurrence and mortality. Results Among the 2007 patients included, the median age at diagnosis was 49 years (19–95 years). Most patients presented histologic grade III (68.7%), tumor stage II (34.2%), and III (51.0%) at diagnosis. Local and distant relapse was present in 31.9 and 51.4% of the patients, respectively. The most frequent sites of metastasis were the lungs (14.5%), followed by bone (9.7%), brain (9.6%), and liver (7.9%). The median follow-up was 153 months. At 3, 5, and 10 years, the EFS of the population was 55%, 49%, and 41%, respectively, while the OS was 64%, 56%, and 47%, respectively. Moreover, an N3 lymph node status was the most important prognostic factor for both disease relapse (HR: 2.54, 95% CI: 2.05–3.15) and mortality (HR: 2.51, 95% CI: 2.01–3.14) at ten years. An older age and higher T staging were associated with a worse OS, while patients who received radiotherapy and adjuvant chemotherapy had better survival rates. Conclusion The sociodemographic features of Peruvian patients with TNBC are similar to those of other populations. However, our population was diagnosed at more advanced clinical stages, and thus, EFS and OS were lower than international reports while prognostic factors were similar to previous studies.
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Affiliation(s)
| | | | - Zaida Morante
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Mecker G. Möller
- Division of Surgical Oncology, University of Miami Miller School of Medicine, Jackson Memorial Hospital/Sylvester Comprehensive Cancer Center, Miami, FL, United States of America
| | - Diego Chambergo-Michilot
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Tau-RELAPED Group, Trujillo, Peru
| | - Lucero Flores
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
| | - Renato Luque
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad Científica de Estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | - Antonella Saavedra
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad Científica de Estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | - Miguel E. Eyzaguirre-Sandoval
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad Científica de Estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | - María G. Luján-Peche
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad Científica de Estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | - Naysha Noel
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
| | - Hafid Calderon
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad Científica de Estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | | | | | | | | | - Jhajaira Araujo
- Unidad de Investigación Básica y Translacional, Oncosalud-AUNA, Lima, Peru
| | - Alexandra Lema
- Health Sciences Faculty, Universidad de Cuenca, Cuenca, Ecuador
| | - Joseph Pinto
- Unidad de Investigación Básica y Translacional, Oncosalud-AUNA, Lima, Peru
| | - Henry L. Gomez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Bryan Valcarcel
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States of America
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Gomez HL, Castañeda C, Valencia F, Muñoz-Bermeo R, Torrico MDC, Neciosup S. ABC4 Consensus: First Latin American Meeting-Assessment, Comments, and Application of Its Recommendations. JCO Glob Oncol 2020; 6:819-827. [PMID: 32539467 PMCID: PMC7328106 DOI: 10.1200/go.20.00081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Breast cancer accounts for a high burden among all the neoplasms in Latin America, with more-advanced stages at presentation, which could result in high mortality rates. The 4th International Consensus Conference for Advanced Breast Cancer (ABC4) is focused on standardizing therapy for advanced breast cancer (ABC) and has held 5 meetings so far. ABC4 took place in Lisbon, Portugal, from November 2 to 4, 2017; however, the first Latin American ABC conference was held in Lima, Peru, from 18 to 19 May, 2018, chaired by Fatima Cardoso, MD, PhD. During these 2 days, the ABC4 consensus recommendations for advanced and locally advanced breast cancer were presented. Local treatment and systemic therapy were discussed with local experts, mainly focusing on anti-human epidermal growth factor receptor 2 therapy and newly approved drugs for hormone receptor-positive breast cancer, such as as CDK4/6, mammalian target of rapamycin, and poly (ADP-ribose) polymerase inhibitors for triple-negative breast cancer. The discussion focused additionally on access to drugs and ABC4 consensus recommendations as regards Latin American patients.
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Affiliation(s)
- Henry L Gomez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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19
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Ruiz R, Galvez-Nino M, Poquioma E, Limache-García A, Amorin E, Olivera M, Valdiviezo N, Trejo JM, Heredia A, Sarria G, Aguilar A, Raez L, Neciosup SP, Gomez HL, Payet E, Mas L. Lung Cancer in Peru. J Thorac Oncol 2020; 15:891-898. [PMID: 32471564 DOI: 10.1016/j.jtho.2020.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Rossana Ruiz
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Scientific and Academic Division, AUNA, Lima, Peru.
| | - Marco Galvez-Nino
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Ebert Poquioma
- Epidemiology and Cancer Statistics Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Universidad Privada de Ciencias Aplicadas, Lima, Peru
| | | | - Edgar Amorin
- Thoracic Surgery Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Thoracic Surgery Department, AUNA, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mivael Olivera
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical Oncology Department, AUNA, Lima, Peru
| | - Natalia Valdiviezo
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical Oncology Department, AUNA, Lima, Peru; Universidad Privada de Ciencias Aplicadas, Lima, Peru
| | - Juan M Trejo
- Radiation Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Adela Heredia
- Radiation Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Gustavo Sarria
- Radiation Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Radiation Oncology Department, AUNA, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Luis Raez
- Hematology/Oncology Department, Memorial Cancer Institute, Miami, Florida
| | - Silvia P Neciosup
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical Oncology Department, AUNA, Lima, Peru
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical Oncology Department, AUNA, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Payet
- Institutional Chief, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis Mas
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical Oncology Department, AUNA, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru
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20
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Moore HCF, Unger JM, Phillips KA, Boyle F, Hitre E, Moseley A, Porter DJ, Francis PA, Goldstein LJ, Gomez HL, Vallejos CS, Partridge AH, Dakhil SR, Garcia AA, Gralow JR, Lombard JM, Forbes JF, Martino S, Barlow WE, Fabian CJ, Minasian LM, Meyskens FL, Gelber RD, Hortobagyi GN, Albain KS. Final Analysis of the Prevention of Early Menopause Study (POEMS)/SWOG Intergroup S0230. J Natl Cancer Inst 2020; 111:210-213. [PMID: 30371800 DOI: 10.1093/jnci/djy185] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/10/2018] [Accepted: 09/11/2018] [Indexed: 11/12/2022] Open
Abstract
Premature menopause is a serious long-term side effect of chemotherapy. We evaluated long-term pregnancy and disease-related outcomes for patients in S0230/POEMS, a study in premenopausal women with stage I-IIIA estrogen receptor-negative, progesterone receptor-negative breast cancer to be treated with cyclophosphamide-containing chemotherapy. Women were randomly assigned to standard chemotherapy with or without goserelin, a gonadotropin-releasing hormone agonist, and were stratified by age and chemotherapy regimen. All statistical tests were two-sided. Of 257 patients, 218 were eligible and evaluable (105 in the chemotherapy + goserelin arm and 113 in the chemotherapy arm). More patients in the chemotherapy + goserelin arm reported at least one pregnancy vs the chemotherapy arm (5-year cumulative incidence = 23.1%, 95% confidence interval [CI] = 15.3% to 31.9%; and 12.2%, 95% CI = 6.8% to 19.2%, respectively; odds ratio = 2.34; 95% CI = 1.07 to 5.11; P = .03). Randomization to goserelin + chemotherapy was associated with a nonstatistically significant improvement in disease-free survival (hazard ratio [HR] = 0.55; 95% CI = 0.27 to 1.10; P = .09) and overall survival (HR = 0.45; 95% CI = 0.19 to 1.04; P = .06). In this long-term analysis of POEMS/S0230, we found continued evidence that patients randomly assigned to receive goserelin + chemotherapy were not only more likely to avoid premature menopause, but were also more likely to become pregnant without adverse effect on disease-related outcomes.
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Affiliation(s)
| | - Joseph M Unger
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kelly-Anne Phillips
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia.,Breast Cancer Trials Australia and New Zealand (BCT-ANZ), Newcastle, Australia.,International Breast Cancer Study Group (IBCSG), Bern, Switzerland
| | | | - Erika Hitre
- National Institute of Oncology, Budapest, Hungary
| | - Anna Moseley
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - David J Porter
- Auckland Regional Cancer and Blood Service, Auckland, New Zealand
| | - Prudence A Francis
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia.,Breast Cancer Trials Australia and New Zealand (BCT-ANZ), Newcastle, Australia.,International Breast Cancer Study Group (IBCSG), Bern, Switzerland
| | | | - Henry L Gomez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | | | - Shaker R Dakhil
- Wichita NCORP, Wichita, KS.,Louisiana State University Health Sciences Center, New Orleans, LA
| | - Agustin A Garcia
- Louisiana State University Health Sciences Center, New Orleans, LA
| | - Julie R Gralow
- Seattle Cancer Care Alliance, and University of Washington, Seattle, WA
| | | | - John F Forbes
- Breast Cancer Trials Australia and New Zealand (BCT-ANZ), Newcastle, Australia.,Calvary Mater Hospital, Newcastle, Australia
| | | | - William E Barlow
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Lori M Minasian
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD
| | - Frank L Meyskens
- University of California at Irvine Chao Family Comprehensive Cancer Center, Orange, CA
| | - Richard D Gelber
- IBCSG Statistical Center, Dana-Farber Cancer Institute, Harvard Medical School, Harvard T.H. Chan School of Public Health and Frontier Science and Technology Research Foundation, Boston, MA
| | | | - Kathy S Albain
- Loyola University Medical Center, Cardinal Bernardin Cancer Center, Maywood, IL
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21
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Sparano JA, Gray RJ, Makower DF, Albain KS, Saphner TJ, Badve SS, Wagner LI, Kaklamani VG, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Toppmeyer DL, Brufsky AM, Goetz MP, Berenberg JL, Mahalcioiu C, Desbiens C, Hayes DF, Dees EC, Geyer CE, Olson JA, Wood WC, Lively T, Paik S, Ellis MJ, Abrams J, Sledge GW. Clinical Outcomes in Early Breast Cancer With a High 21-Gene Recurrence Score of 26 to 100 Assigned to Adjuvant Chemotherapy Plus Endocrine Therapy: A Secondary Analysis of the TAILORx Randomized Clinical Trial. JAMA Oncol 2020; 6:367-374. [PMID: 31566680 PMCID: PMC6777230 DOI: 10.1001/jamaoncol.2019.4794] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/04/2019] [Indexed: 12/23/2022]
Abstract
Importance A high 21-gene recurrence score (RS) by breast cancer assay is prognostic for distant recurrence of early breast cancer after local therapy and endocrine therapy alone, and for chemotherapy benefit. Objective To describe clinical outcomes for women with a high RS who received adjuvant chemotherapy plus endocrine therapy in the TAILORx trial, a population expected to have a high distant recurrence rate with endocrine therapy alone. Design, Setting, and Participants In this secondary analysis of data from a multicenter randomized clinical trial, 1389 women with hormone receptor-positive, ERBB2-negative, axillary node-negative breast cancer, and a high RS of 26 to 100 were prospectively assigned to receive adjuvant chemotherapy in addition to endocrine therapy. The analysis was conducted on May 12, 2019. Interventions The adjuvant chemotherapy regimen was selected by the treating physician. Main Outcomes and Measures Freedom from recurrence of breast cancer at a distant site, and freedom from recurrence, second primary cancer, and death (also known as invasive disease-free survival [IDFS]). Results Among the 9719 eligible women, with a mean age of 56 years (range 23-75 years), 1389 (14%) had a recurrence score of 26 to 100, of whom 598 (42%) had an RS of 26 to 30 and 791 (58%) had an RS of 31 to 100. The most common chemotherapy regimens included docetaxel/cyclophosphamide in 589 (42%), an anthracycline without a taxane in 334 (24%), an anthracycline and taxane in 244 (18%), cyclophosphamide/methotrexate/5-fluorouracil in 52 (4%), other regimens in 81 (6%), and no chemotherapy in 89 (6%). At 5 years, the estimated rate of freedom from recurrence of breast cancer at a distant site was 93.0% (standard error [SE], 0.8%), freedom of recurrence of breast cancer at a distant and/or local regional site 91.0% (SE, 0.8%), IDFS 87.6% (SE, 1.0%), and overall survival 95.9% (SE, 0.6%). Conclusions and Relevance The estimated rate of freedom from recurrence of breast cancer at a distant site in women with an RS of 26 to 100 treated largely with taxane and/or anthracycline-containing adjuvant chemotherapy regimens plus endocrine therapy in the prospective TAILORx trial was 93% at 5 years, an outcome better than expected with endocrine therapy alone in this population. Trial Registration ClinicalTrials.gov identifier: NCT00310180.
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Affiliation(s)
- Joseph A Sparano
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | | | - Della F Makower
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | | | - Thomas J Saphner
- Aurora Cancer Center (formerly Vince Lombardi Cancer Clinic), Two Rivers, Wisconsin
| | | | - Lynne I Wagner
- Northwestern University, Chicago, Illinois
- (now at) Wake Forest University Health Service, Winston Salem, North Carolina
| | - Virginia G Kaklamani
- Northwestern University, Chicago, Illinois
- (now at) University of Texas Health Science Center, San Antonio
| | | | - Henry L Gomez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | | | | | | | | | | | | | | | | | | | | | - Charles E Geyer
- the Massey Cancer Center, Virginia Commonwealth University School of Medicine, Richmond
| | - John A Olson
- Duke University Medical Center, Durham, North Carolina
- (now at) University of Maryland School of Medicine, Baltimore
| | | | - Tracy Lively
- National Institutes of Health, National Cancer Institute, Bethesda, Maryland
| | - Soonmyung Paik
- NSABP Pathology Office, Pittsburgh, Pennsylvania
- (now at) Yonsei University College of Medicine, Seoul, South Korea
| | - Matthew J Ellis
- Washington University, St Louis, Missouri
- (now at) Baylor College of Medicine, Houston, Texas
| | - Jeffrey Abrams
- National Institutes of Health, National Cancer Institute, Bethesda, Maryland
| | - George W Sledge
- Indiana University Hospital, Indianapolis
- (now at) Stanford University, Stanford, California
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22
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De-la-Cruz-Ku G, Valcarcel B, Morante Z, Möller MG, Lizandro S, Rebaza LP, Enriquez D, Luque R, Luján-Peche MG, Eyzaguirre-Sandoval ME, Saavedra A, Razuri C, Pinto JA, Fuentes HA, Neciosup SP, Gomez HL. Breast-conserving surgery vs. total mastectomy in patients with triple negative breast cancer in early stages: A propensity score analysis. Breast Dis 2020; 39:29-35. [PMID: 31903977 DOI: 10.3233/bd-190391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Breast-conserving surgery (BCS) as an alternative to total mastectomy (TM) in patients with early-stage triple-negative breast cancer (TNBC) is not widely spread. OBJECTIVE We aimed to compare the overall survival (OS) and disease-free survival (DFS) between both surgical approaches in early-stage TNBC patients at 10 years. METHODS We conducted a retrospective cohort study in TNBC female patients with stage I-IIa, treated at a single-center during the period of 2000-2014. We estimated and compared the survival rates with the Kaplan Meier and Long-rank test. Propensity scores were calculated with the generalized boosted regression model and were used in the multivariate Cox regression analysis with the covariate adjustment method. RESULTS We included 288 patients, 111 in the BCS vs. 177 in the TM group. The median follow-up was 102 months. Moreover, the patients in the BCS group had superior OS (85% vs. 81%, p = 0.56) and DFS (83% vs. 80%, p = 0.42) at 10 years. In the multivariate Cox analysis, BCS decreased the mortality risk (HR: 0.79, 95% CI: 0.37-1.67, p = 0.538), and the locoregional or distant recurrence risk (HR: 0.67, 95% CI: 0.32-1.41, p = 0.294), albeit with no statistical significance. CONCLUSION BCS is a safe alternative to TM in Latin-American patients with early-stage TNBC.
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Affiliation(s)
| | - Bryan Valcarcel
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
| | - Zaida Morante
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Mecker G Möller
- Division of Surgical Oncology, University of Miami Miller School of Medicine, Jackson Memorial Hospital/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Sofia Lizandro
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
| | - Lia P Rebaza
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Daniel Enriquez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Renato Luque
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad científica de estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | - María G Luján-Peche
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad científica de estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | - Miguel E Eyzaguirre-Sandoval
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad científica de estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | - Antonella Saavedra
- School of Medicine, Universidad Científica del Sur (UCSUR), Lima, Peru
- Sociedad científica de estudiantes de Medicina Humana (SCIEM UCSUR), Lima, Peru
| | | | - Joseph A Pinto
- Unidad de Investigación Básica y Translacional, Oncosalud-AUNA, Lima, Peru
| | - Hugo A Fuentes
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Silvia P Neciosup
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry L Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Castaneda CA, Castillo M, Aliaga K, Bernabe LA, Casavilca S, Sanchez J, Torres-Cabala CA, Gomez HL, Mas L, Dunstan J, Cotrina JM, Abugattas J, Chavez I, Ruiz E, Montenegro P, Rojas V, Orrego E, Galvez-Nino M, Felix B, Landa-Baella MP, Vidaurre T, Villa MR, Zevallos R, Taxa L, Guerra H. Level of tumor-infiltrating lymphocytes and density of infiltrating immune cells in different malignancies. Biomark Med 2019; 13:1481-1491. [DOI: 10.2217/bmm-2019-0178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: To correlate levels of tumor-infiltrating lymphocytes (TIL) evaluated using the International Immuno-Oncology Biomarker Working Group methodology, and both density of tumor-infiltrating immune cell and clinicopathological features in different malignancies. Methods: 209 pathological samples from gastric cancer, cervical cancer (CC), non-small-lung cancer, cutaneous melanoma (CM) and glioblastoma were tested for TIL in hematoxylin eosin, and density of CD3+, CD4+, CD8+, CD20+, CD68+ and CD163+ cells by digital analysis. Results: TIL levels were higher in invasive margin compartments (IMC). TIL in IMC, intratumoral and stromal compartments predicted survival. CC and gastric cancer had higher TIL in intratumoral; CC and CM had higher TIL in stromal compartment and IMC. CM had the highest density of lymphocyte and macrophage populations. CD20 density was associated with survival in the whole series. Conclusion: Standardized evaluation of TIL levels may provide valuable prognostic information in a spectrum of different malignancies.
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Affiliation(s)
- Carlos A Castaneda
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
- Faculty of Health Sciences, Universidad Científica del Sur, Lima 15067, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Karina Aliaga
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis A Bernabe
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Sandro Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Carlos A Torres-Cabala
- Departments of Pathology & Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis Mas
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jorge Dunstan
- Department of Soft Tissue Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jose M Cotrina
- Department of Soft Tissue Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Julio Abugattas
- Department of Soft Tissue Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Ivan Chavez
- Department of Abdominal Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Eloy Ruiz
- Department of Abdominal Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Paola Montenegro
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Victor Rojas
- Department of Chest Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Enrique Orrego
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Marco Galvez-Nino
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Brayam Felix
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Maria P Landa-Baella
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Tatiana Vidaurre
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Maria R Villa
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Rocio Zevallos
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Luis Taxa
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
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Castaneda CA, Castillo M, Torres-Cabala C, Bernabe LA, Casavilca S, Villegas V, Sanchez J, de la Cruz M, Dunstan J, Cotrina JM, Gomez HL, Chavez C, Landa-Baella MP, Tello K, Felix BF, Abugattas J. Relationship between tumor-associated immune infiltrate and p16 staining over clinicopathological features in acral lentiginous melanoma. Clin Transl Oncol 2019; 21:1127-1134. [PMID: 30778854 DOI: 10.1007/s12094-019-02033-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/01/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE This study aims to evaluate the association between composition of tumor-infiltrating lymphocytes (TIL) and expression of p16 in acral lentiginous melanoma (ALM), and their impact on prognosis. MATERIALS AND METHODS A cohort of 148 surgical pathology specimens of ALM was studied. TIL were evaluated by immunohistochemical detection of CD3 and CD8, along with CD20, CD4, CD68, and CD163 in a subset of 43 cases. p16 protein expression was also investigated in all the cases. RESULTS The median age was 66 years, median Breslow thickness was 6.0 mm, grade III TIL was found in 28.4% and lymph nodes were involved in 54.2%. Breslow thickness (p < 0.001), stage I-II (p < 0.001), negative lymph nodes (p < 0.001) and < 10% p16 (p = 0.01) were associated with longer survival. Grade III of TIL was associated with thinner Breslow thickness (p = 0.008) and lower mitosis (p = 0.047). A higher density of CD3 TIL was associated with male gender (p = 0.008), thinner Breslow thickness (p = 0.047), negative lymph node (p = 0.031), early stage (p = 0.046), and p16 nuclear expression of > 10% (p = 0.045). Higher CD8 TIL was associated with > p16 (p = 0.03). Survival analysis found that longer survival had a trend to be associated with high TIL (p = 0.090). Levels of CD3+ and CD8+ cells were correlated with those of CD4+, CD20+, CD68+ and CD163+ immune cells. CONCLUSIONS Higher levels of TIL tend to be associated with better overall survival in ALM. Loss of expression of p16 is associated with lower levels of CD3+ and CD8+ TIL, indicating a probable relationship between p16 and TIL immune response in ALM .
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Affiliation(s)
- C A Castaneda
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru.
- Faculty of Medicine, Universidad Privada San Juan Bautista, 15067, Lima, Peru.
| | - M Castillo
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - C Torres-Cabala
- Departments of Pathology and Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - L A Bernabe
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - S Casavilca
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas., Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - V Villegas
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - J Sanchez
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - M de la Cruz
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - J Dunstan
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - J M Cotrina
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - H L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - C Chavez
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - M P Landa-Baella
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - K Tello
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - B F Felix
- Medical Oncology Department and Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
| | - J Abugattas
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, 15038, Lima, Peru
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Castaneda CA, Castillo M, Enciso JA, Enciso N, Bernabe LA, Sanchez J, Guerra H, Chavez C, Landa-Baella M, De-La-Cruz M, Villa-Robles M, Tello K, Gomez HL. Role of undifferentiation markers and androgen receptor expression in triple-negative breast cancer. Breast J 2019; 25:1316-1319. [PMID: 31332870 DOI: 10.1111/tbj.13464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Carlos A Castaneda
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru.,Universidad Cientifica del Sur, Lima, Peru
| | - Miluska Castillo
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru.,Universidad Cientifica del Sur, Lima, Peru
| | | | | | - Luis A Bernabe
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Joselyn Sanchez
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Henry Guerra
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Carlos Chavez
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | | | | | | | - Katherine Tello
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - Henry L Gomez
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
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Ribi K, Luo W, Colleoni M, Karlsson P, Chirgwin J, Aebi S, Jerusalem G, Neven P, Di Lauro V, Gomez HL, Ruhstaller T, Abdi E, Biganzoli L, Müller B, Barbeaux A, Graas MP, Rabaglio M, Francis PA, Foukakis T, Pagani O, Graiff C, Vorobiof D, Maibach R, Di Leo A, Gelber RD, Goldhirsch A, Coates AS, Regan MM, Bernhard J. Quality of life under extended continuous versus intermittent adjuvant letrozole in lymph node-positive, early breast cancer patients: the SOLE randomised phase 3 trial. Br J Cancer 2019; 120:959-967. [PMID: 30967649 PMCID: PMC6734915 DOI: 10.1038/s41416-019-0435-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/28/2019] [Accepted: 03/07/2019] [Indexed: 11/25/2022] Open
Abstract
Background In the phase III SOLE trial, the extended use of intermittent versus continuous letrozole for 5 years did not improve disease-free survival in postmenopausal women with hormone receptor-positive breast cancer. Intermittent therapy with 3-month breaks may be beneficial for patients’ quality of life (QoL). Methods In the SOLE QoL sub-study, 956 patients completed the Breast Cancer Prevention Trial (BCPT) symptom and further QoL scales up to 24 months after randomisation. Differences in change of QoL from baseline between the two administration schedules were tested at 12 and 24 months using repeated measures mixed-models. The primary outcome was change in hot flushes at 12 months. Results There was no difference in hot flushes at 12 months between the two schedules, but patients receiving intermittent letrozole reported significantly more improvement at 24 months. They also indicated less worsening in vaginal problems, musculoskeletal pain, sleep disturbance, physical well-being and mood at 12 months. Overall, 25–30% of patients reported a clinically relevant worsening in key symptoms and global QoL. Conclusion Less symptom worsening was observed during the first year of extended treatment with the intermittent administration. For women experiencing an increased symptom burden of extended adjuvant endocrine therapy, an intermittent administration is a safe alternative. Clinical trial information Clinical trial information: NCT00651456.
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Affiliation(s)
- Karin Ribi
- Quality of Life Office, International Breast Cancer Study Group Coordinating Center, Bern, Switzerland
| | - Weixiu Luo
- International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Marco Colleoni
- Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Per Karlsson
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy/Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Jacquie Chirgwin
- Box Hill and Maroondah Hospitals, Monash University, Victoria, Australia
| | - Stefan Aebi
- Luzerner Kantonsspital, Lucerne, Switzerland
| | | | - Patrick Neven
- Multidisciplinary Breast Center, University Hospitals, KU Leuven, Leuven, Belgium
| | | | - Henry L Gomez
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Thomas Ruhstaller
- Breast Center St. Gallen, Swiss Group for Clinical Cancer Research and International Breast Cancer Study Group, Bern, Switzerland
| | - Ehtesham Abdi
- The Tweed Hospital, Tweed Heads, NSW & Griffith University Gold Coast, Southport, Australia
| | - Laura Biganzoli
- Hospital of Prato-AUSL Toscana Centro, Istituto Toscano Tumori, Prato, Italy
| | - Bettina Müller
- Chilean Cooperative Group for Oncologic Research (GOCCHI), Providencia, Santiago, Chile
| | | | | | | | - Prudence A Francis
- Peter MacCallum Cancer Center, University of Melbourne, Melbourne and Breast Cancer Trials Australia & New Zealand, University of Newcastle, Newcastle, Australia
| | - Theodoros Foukakis
- Department of Oncology, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Olivia Pagani
- Institute of Oncology of Southern Switzerland, Bellinzona, Geneva University Hospitals, Geneva, Swiss Group for Clinical Cancer Research (SAKK) and International Breast Cancer Study Group, Bern, Switzerland
| | - Claudio Graiff
- Division of Medical Oncology, Ospedale Centrale di Bolzano, Bolzano, Italy
| | | | - Rudolf Maibach
- International Breast Cancer Study Group Coordinating Center, Bern, Switzerland
| | - Angelo Di Leo
- Hospital of Prato-AUSL Toscana Centro, Istituto Toscano Tumori, Prato, Italy
| | - Richard D Gelber
- International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Harvard T.H. Chan School of Public Health and Frontier Science and Technology Research Foundation, Boston, MA, USA
| | - Aron Goldhirsch
- International Breast Cancer Study Group and IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Alan S Coates
- International Breast Cancer Study Group and University of Sydney, Sydney, Australia
| | - Meredith M Regan
- International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Jürg Bernhard
- Quality of Life Office, International Breast Cancer Study Group Coordinating Center and Bern University Hospital, Inselspital, Bern, Switzerland.
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Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer CE, Dees EC, Goetz MP, Olson JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge GW. Abstract GS4-07: Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs4-07] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Black race is associated with worse outcomes in localized hormone receptor (HR)-positive breast cancer in population-based and in clinical trial cohorts, whether using self-identified race (Albain et al. JNCI 2009 [PMID: 19584328; Sparano et al. JNCI 2012 [PMID: 22250182) or genetically-identified race (Schneider et al. J Precision Oncol 2017 [PMID: 29333527]). This disparity persists after adjustment for treatment delivery parameters (Hershman et al. JCO 2009 [PMID:19307504]). We evaluated clinicopathologic characteristics, treatment delivered and clinical outcomes in the Trial Assigning Individualized Options for Treatment (TAILORx) by race and ethnicity (Sparano et al. NEJM 2018 [PMID: 29860917]).
Methods: The analysis included 9719 evaluable TAILORx participants. The association between clinical outcomes and race (white, black, Asian, other/unknown) and ethnicity (Hispanic vs. non-Hispanic) was examined, including invasive disease-free survival (iDFS), distant relapse-free interval (DRFI), relapse-free interval (RFI), and overall survival (OS). Proportional hazards models were fit including age (5 categories), tumor size (>2 cm vs. <=2 cm), histologic grade (high vs. medium vs. low vs. unknown), continuous recurrence score (RS), race, and ethnicity in the overall population and randomized treatment arms in the RS 11-25 cohort.
Results: The study population included 8189 (84%) whites, 693 (7%) blacks, 405 (4%) Asians, and 432 (4%) with other/unknown race. Regarding ethnicity, 7635 (79%) were non-Hispanic, 889 (9%) Hispanic, and 1195 (12%) unknown. There was no significant difference in RS distribution (p=0.22) in blacks compared with whites, or in median (17 vs. 17) or mean RS (19.1 vs. 18.2). There was likewise no difference in Hispanic vs. non-Hispanic ethnicity for RS distribution (p=0.72) or median (17 vs. 17) or mean RS (18.5 vs. 18.0). Black race (39% vs. 30%) and Hispanic ethnicity (39% vs. 30%) were both associated with younger age (</=50 years) at diagnosis. The use and type of adjuvant chemotherapy and endocrine therapy, and duration of endocrine therapy, were similar in black (vs. white) and Hispanic (vs. non-Hispanic) populations. In proportional hazards models, black race (compared with white race) was associated with worse clinical outcomes in the entire population and in those with a RS 11-25 (see table). Hispanic ethnicity was generally associated with better outcomes (compared with non-Hispanic ethnicity). For the cohort with a RS of 11-25, there was no evidence for chemotherapy benefit for any racial or ethnic group.
Race (black vs.white) and clinical outcomes in proportional hazards modelsClinical endpointEntire Population (N=693 black) Hazard ratio for eventRS 11-25 (N=471 black) Hazard ratio for eveniDFS1.33 (p=0.005)1.49 (p=0.001)DRFI1.21 (p=0.28)1.60 (p=0.02)RFI1.39 (p=0.02)1.80 (p<0.001)OS1.52 (p=0.005)1.67 (p=0.003
Conclusions: In patients eligible and selected for participation in TAILORx, black women had worse clinical outcomes despite similar 21-gene assay RS results and comparable systemic therapy. This adds to an emerging body of evidence suggesting a biologic basis or other factors contributing to racial disparities in HR-positive breast cancer that requires further evaluation.
Citation Format: Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer, Jr. CE, Dees EC, Goetz MP, Olson, Jr. JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge, Jr. GW. Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS4-07.
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Affiliation(s)
- K Albain
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - RJ Gray
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JA Sparano
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DF Makower
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - KI Pritchard
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DF Hayes
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - CE Geyer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - EC Dees
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MP Goetz
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JA Olson
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - T Lively
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - SS Badve
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TJ Saphner
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - LI Wagner
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TJ Whelan
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MJ Ellis
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - S Paik
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - WC Wood
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - PM Ravdin
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MM Keane
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - HL Gomez
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - PS Reddy
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TF Goggins
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - IA Mayer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - AM Brufsky
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DL Toppmeyer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - VG Kaklamani
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JL Berenberg
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - J Abrams
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - GW Sledge
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
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Valencia FS, Ruiz R, Neciosup SP, Mas LA, Aliaga KM, Huaman F, Ruiz J, Vasquez E, Llacctahuaman N, Pedraza R, Paz M, Aguirre W, Gomez HL. Implementation of Computerized Physician Order Entry for Chemotherapy: A Latin American Experience. JCO Clin Cancer Inform 2019; 2:1-12. [PMID: 30652618 DOI: 10.1200/cci.18.00041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We describe the implementation process of a computerized physician order entry (CPOE) for outpatient chemotherapy at a Latin American hospital, with the intent of providing other institutions with general guidance and insight through our experience. METHODS In 2012, under the direction of the Department of Medicine of the Instituto Nacional de Enfermedades Neoplásicas, a multidisciplinary team composed of oncologists, nurses, pharmacists, and informatics engineers was formed to develop software for a CPOE for chemotherapy within a preexistent homegrown electronic medical record system in various phases. This included mapping and redesigning processes in an entirely electronic format, integrating the needs of the user for the development of electronic order sets, developing a checkpoint and a warning system to minimize prescription errors, and finally, training all the staff in implementation of the system. RESULTS A CPOE for outpatient chemotherapy was successfully implemented in 2016. We have successfully standardized 266 chemotherapy orders, including for both solid tumors and hematologic malignancies, on the basis of appropriate guidelines. The software is linked to laboratory results and allows entry of important details for the patient's safety, such as anthropometric information for an automatic dose calculation and ranges for safe prescription. In addition, it is linked to the nursing plan sheets. Finally, it is possible to assess and continuously monitor the complex process of chemotherapy prescription. CONCLUSION This is the first report of implementation of a CPOE for chemotherapy in our region. The system was designed by a multidisciplinary team with its own resources. Our experience demonstrates the feasibility of computerizing the chemotherapy prescription process, constituting a tangible example for other institutions with potential impact on patient care.
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Affiliation(s)
- Fernando S Valencia
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Rossana Ruiz
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Silvia P Neciosup
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Luis A Mas
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Karina M Aliaga
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Flor Huaman
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Jenny Ruiz
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Edinson Vasquez
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Noel Llacctahuaman
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Robert Pedraza
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Missael Paz
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Willam Aguirre
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
| | - Henry L Gomez
- All authors: Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima, Peru
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Castaneda CA, Rebaza P, Castillo M, Gomez HL, De La Cruz M, Calderon G, Dunstan J, Cotrina JM, Abugattas J, Vidaurre T. Critical review of axillary recurrence in early breast cancer. Crit Rev Oncol Hematol 2018; 129:146-152. [PMID: 30097233 DOI: 10.1016/j.critrevonc.2018.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 11/07/2016] [Revised: 05/20/2018] [Accepted: 06/18/2018] [Indexed: 01/07/2023] Open
Abstract
Around 2% of early breast cancer cases treated with axillary lymph node dissection (ALND) underwent axillary recurrence (AR) and it has a deleterious effect in prognosis. Different scenarios have incorporated Sentinel Lymph Node (SLN) Biopsy (SLNB) instead of ALND as part of the standard treatment and more effective systemic treatment has also been incorporated in routine management after first curative surgery and after regional recurrence. However, there is concern about the effect of SLNB alone over AR risk and how to predict and treat AR. SLN biopsy (SLNB) has been largely accepted as a valid option for SLN-negative cases, and recent prospective studies have demonstrated that it is also safe for some SLN-positive cases and both scenarios carry low AR rates. Different studies have identified clinicopathological factors related to aggressiveness as well as high-risk molecular signatures can predict the development of locoregional recurrence. Other publications have evaluated factors affecting prognosis after AR and find that time between initial treatment and AR as well as tumor aggressive behavior influence patient survival. Retrospective and prospective studies indicate that treatment of AR should include local and systemic treatment for a limited time.
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Affiliation(s)
- Carlos A Castaneda
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
| | - Pamela Rebaza
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miguel De La Cruz
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Gabriela Calderon
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jorge Dunstan
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jose Manuel Cotrina
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Julio Abugattas
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Tatiana Vidaurre
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Araujo JM, Ponce J, Murillo A, Rebaza P, Danos P, Aguilar A, Fujita R, Gomez HL, Pinto JA, Buleje J. Abstract 1585: Evaluation of circulating free DNA in non-metastatic breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Circulating free DNA (cfDNA) is becoming an important tool in diagnosis and prognosis in several types of cancer. In this study we evaluated the association between cfDNA concentrations in peripheral blood with tumoral features of non-metastatic breast cancer patients.
Methods cfDNA was extracted from plasma of peripheral blood of patients with non-metastatic breast cancer and healthy controls. In patients, blood samples were collected before and after surgery, while in controls samples were collected after their results of breast cancer screening. Detection of copy number of PUM1 and RNaseP genes were performed in a QuantStudio® 3D Digital PCR System and quantification was obtained with QuantStudio® 3D AnalysisSuite™ Cloud Software. Raw values were compared among the different clinicopathologic features.
Results In total 26 patients and 25 controls were included. There were significant differences between controls and patients for levels counts of PUM1 and RNaseP genes (p<0.0001 in both cases). In patients, median concentrations before and after surgery for PUM1 were 10.6 copies/uL (range: 2.2-16.3) vs. 7.6 copies/uL (range: 1.3-12.8), respectively (P=0.04) and for RNaseP were 6.6 copies/uL (range: 0.9-20.0) vs. 5.3 copies/uL (range: 0.5-16.0), respectively (P=0.103). Hormonal tumors produced more cfDNA in terms of RNaseP at diagnosis (7.9 vs. 5.6, P=0.049). When we compared patients according to their hormonal status with controls, RNaseP was able to identified positive hormonal receptors patients (P<0.0001). There were no significant differences between other clinicopathologic features. There was a significant decrease after surgery of RNaseP levels in node negative tumors (P=0.049) and PUM1 levels in >10mm tumors (P=0.041).
Conclusions Our results suggest that PUM1 is a better diagnostic biomarker for non-metastatic breast cancer because RNaseP loss sensitivity in negative hormone receptor cases. Hormonal tumors produced more circulating free DNA. RNaseP could be used to monitor node negative patients and PUM1 to patients with >10mm tumors.
Citation Format: Jhajaira M. Araujo, Jaime Ponce, Alexis Murillo, Pamela Rebaza, Pierina Danos, Alfredo Aguilar, Ricardo Fujita, Henry L. Gomez, Joseph A. Pinto, Jose Buleje. Evaluation of circulating free DNA in non-metastatic breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1585.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jose Buleje
- 2Universidad de San Martín de Porres, Lima, Peru
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Galvez M, Castaneda CA, Sanchez J, Castillo M, Rebaza LP, Calderon G, Cruz MDL, Cotrina JM, Abugattas J, Dunstan J, Guerra H, Mejia O, Gomez HL. Clinicopathological predictors of long-term benefit in breast cancer treated with neoadjuvant chemotherapy. World J Clin Oncol 2018; 9:33-41. [PMID: 29651385 PMCID: PMC5893995 DOI: 10.5306/wjco.v9.i2.33] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/19/2017] [Accepted: 02/05/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the survival impact of clinicopathological factors, including pathological complete response (pCR) and tumor-infiltrating lymphocytes (sTIL) levels according to subtypes, in breast cancer (BC) patients who received neo-adjuvant chemotherapy (NAC).
METHODS We evaluated 435 BC patients who presented and received NAC at the Instituto Nacional de Enfermedades Neoplasicas from 2003 to 2014. sTIL was analyzed as the proportion of tumor stroma occupied by lymphocytes, and was prospectively evaluated on hematoxylin and eosin-stained sections of the preNAC core biopsy. pCR was considered in the absence of infiltrating cancer cells in primary tumor and axillary lymph nodes. Analysis of statistical association between clinical pathological features, sTIL, pCR and survival were carried out using SPSSvs19.
RESULTS Median age was 49 years (range 24-84 years) and the most frequent clinical stage was IIIB (58.3%). Luminal A, Luminal B, HER2-enriched and (triple-negative) TN phenotype was found in 24.6%, 37.9%, 17.7% and 19.8%, respectively. pCR was observed in 11% and median percentage of sTIL was 40% (2%-95%) in the whole population. pCR was associated to Ct1-2 (P = 0.045) and to high sTIL (P = 0.029) in the whole population. There was a slight trend towards significance for sTIL (P = 0.054) in Luminal A. sTIL was associated with grade III (P < 0.001), no-Luminal A subtype (P < 0.001), RE-negative (P < 0.001), PgR-negative (P < 0.001), HER2-positive (P = 0.002) and pCR (P = 0.029) in the whole population. Longer disease-free survival was associated with grade I-II (P = 0.006), cN0 (P < 0.001), clinical stage II (P = 0.004), ER-positive (P < 0.001), PgR-positive (P < 0.001), luminal A (P < 0.001) and pCR (P = 0.002). Longer disease-free survival was associated with grade I-II in Luminal A (P < 0.001), N0-1 in Luminal A (P = 0.045) and TNBC (P = 0.01), clinical stage II in Luminal A (P = 0.003) and TNBC (P = 0.038), and pCR in TNBC (P < 0.001). Longer overall survival was associated with grade I-II (P < 0.001), ER-positive (P < 0.001), PgR-positive (P < 0.001), Luminal A (P < 0.001), cN0 (P = 0.002) and pCR (P = 0.002) in the whole population. Overall survival was associated with clinical stage II (P = 0.017) in Luminal A, older age (P = 0.042) in Luminal B, and pCR in TNBC (P = 0.005).
CONCLUSION Predictive and prognostic values of clinicopathological features, like pCR and sTIL, differ depending on the evaluated molecular subtype
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Affiliation(s)
- Marco Galvez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Carlos A Castaneda
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
- Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima 15067, Peru
| | - Joselyn Sanchez
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Miluska Castillo
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Lia Pamela Rebaza
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Gabriela Calderon
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Miguel De La Cruz
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jose Manuel Cotrina
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Julio Abugattas
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Jorge Dunstan
- Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry Guerra
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Omar Mejia
- Department of Research, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
| | - Henry L Gomez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
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Ruiz R, Morante Z, Mantilla R, Mas L, Casanova L, Gomez HL. Primary cutaneous T-cell lymphoma: experience from the Peruvian National Cancer Institute. An Bras Dermatol 2018; 92:649-654. [PMID: 29166501 PMCID: PMC5674697 DOI: 10.1590/abd1806-4841.20176825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/04/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Primary cutaneous T-cell lymphomas constitute a heterogeneous and rare group of diseases with regional particularities in Latin America. OBJECTIVE To determine the clinicopathological features, relative frequency and survival among patients from a Peruvian institution. METHODS Primary cutaneous T-cell lymphomas were defined based on the absence of extracutaneous disease at diagnosis. Classification was performed following the 2008 World Health Organization Classification of Neoplasms of the Hematopoietic and Lymphoid tissues. Risk groups were established according to the 2005 World Health Organization-EORTC classification for cutaneous lymphomas. Data of patients admitted between January 2008 and December 2012 were analyzed. RESULTS 74 patients were included. Mean age was 49.5 years. In order of frequency, diagnoses were: mycosis fungoides (40.5%), peripheral T-cell lymphoma not otherwise specified (22.95%), adult T-cell lymphoma/leukemia (18.9%), CD30+ lymphoproliferative disorders (6.8%), hydroa vacciniforme-like lymphoma (5.4%), extranodal NK/T-cell lymphoma (4.1%) and Sézary syndrome (1.4%). Predominant clinical patterns were observed across different entities. Mycosis fungoides appeared mainly as plaques (93%). Peripheral T-cell lymphoma not otherwise specified and adult T-cell lymphoma/leukemia presentation was polymorphic. All patients with hydroa vacciniforme-like lymphoma presented with facial edema. All cases of extranodal NK/T-cell lymphoma appeared as ulcerated nodules/tumors. Disseminated cutaneous involvement was found in 71.6% cases. Forty-six percent of patients were alive at 5 years. Five-year overall survival was 76.4% and 19.2%, for indolent and high-risk lymphomas, respectively (p<0.05). High risk group (HR: 4.6 [2.08-10.18]) and increased DHL level (HR: 3.2 [1.57-6.46]) emerged as prognostic factors for survival. STUDY LIMITATIONS Small series. CONCLUSION Primary cutaneous T-cell lymphomas other than mycosis fungoides or CD30+ lymphoproliferative disorders are aggressive entities with a poor prognosis.
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Affiliation(s)
- Rosana Ruiz
- Medical Oncology Service, Instituto Nacional de Enfermedades Neoplásicas (INEN) - Surquillo, Peru
| | - Zaida Morante
- Medical Oncology Service, Instituto Nacional de Enfermedades Neoplásicas (INEN) - Surquillo, Peru
| | - Raul Mantilla
- Education Department, Instituto Nacional de Enfermedades Neoplásicas (INEN) - Surquillo, Peru
| | - Luis Mas
- Medical Oncology Service, Instituto Nacional de Enfermedades Neoplásicas (INEN) - Surquillo, Peru
| | - Luis Casanova
- Medical Oncology Service, Instituto Oncológico Miraflores - Miraflores, Peru
| | - Henry L Gomez
- Medical Oncology Service, Instituto Nacional de Enfermedades Neoplásicas (INEN) - Surquillo, Peru
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Pagani O, Regan MM, Fleming GF, Walley BA, Colleoni M, Láng I, Gomez HL, Tondini C, Burstein HJ, Goetz MP, Ciruelos EM, Stearns V, Debled M, Martino S, Geyer CE, Pinotti G, Coates AS, Goldhirsch A, Gelber RD, Francis PA. Abstract GS4-02: Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor positive (HR+) early breast cancer (BC): Update of the combined TEXT and SOFT trials. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-gs4-02] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The combined results of TEXT and SOFT, after 5.7 years median follow-up, found adjuvant E+OFS significantly improved disease-free survival (DFS) vs T+OFS in premenopausal women with HR+ BC (Pagani et al, NEJM 2014). Follow-up was immature for overall survival (OS). We report a planned update with visit cut-off of 31Dec16 after 9 years median follow-up.
Methods: TEXT and SOFT enrolled premenopausal women with HR+ early BC from Nov 2003 to Apr 2011 (2660 TEXT, 3047 SOFT in the intention-to-treat populations). TEXT randomized women within 12wk of surgery to 5 yrs E+OFS vs T+OFS; chemotherapy (CT) was optional and concurrent with OFS. SOFT randomized women to 5 yrs E+OFS vs T+OFS vs T alone, within 12wk of surgery if no CT planned, or within 8mo of completing (neo)adjuvant CT after premenopausal status was (re-)established. OFS was by choice of 5yr GnRH agonist triptorelin, oophorectomy or ovarian irradiation. Both trials were stratified by CT use. The primary endpoint was DFS: randomization until invasive local, regional, distant recurrence or contralateral breast; invasive second malignancy; death. Secondary endpoints included invasive breast cancer-free interval (BCFI), distant recurrence-free interval (DRFI) and OS. Stratified Cox models estimated hazard ratios; Kaplan-Meier method estimated 8yr endpoint rates. NCT00066703/NCT00066690.
Results: DFS for patients assigned E+OFS (n=2346) continued to be significantly improved over T+OFS (n=2344): 8yr DFS was 86.8% vs. 82.8%. The 8yr BCFI was improved by 4.1% (89.3% vs 85.2%) and 8yr DRFI by 2.1% (91.8% vs 89.7%). There was no difference in OS in patients assigned E+OFS vs T+OFS: 93.4% vs 93.3% OS at 8yrs. For 1996 women without CT there have been 45 deaths, with 98% OS at 8yrs with both treatments.
EndpointN. EventsHazard Ratio (95% CI) E+OFS vs T+OFSDFS7200.77 (0.67-0.90); P<0.001BCFI6000.74 (0.63-0.87)DRFI4330.80 (0.65-0.96)OS3200.98 (0.79-1.22)
Overall toxicity was not significantly worse with E+OFS than with T+OFS (32% vs 31% grade 3-4 targeted AEs). Hot flashes, musculoskeletal symptoms and hypertension were the most frequent targeted grade 3-4 AEs. Overall, 15% of patients stopped all protocol-assigned treatment early. Patients assigned E+OFS had increased risk of assigned oral endocrine therapy cessation (25% vs 19% for patients assigned T+OFS by 4yrs) but not of triptorelin cessation (18% vs 19% by 4yrs, respectively).
Conclusions: After 9 yrs median follow-up, adjuvant E+OFS, as compared with T+OFS, shows a sustained reduction of the risk of recurrence but did not improve overall survival. As in postmenopausal women, oncologists need to consider potential absolute benefits and properly select patients at sufficient risk for recurrence for whom E+OFS seems indicated. Follow-up continues, which will further clarify the effect of E+OFS for safety, late recurrence and overall survival.
Citation Format: Pagani O, Regan MM, Fleming GF, Walley BA, Colleoni M, Láng I, Gomez HL, Tondini C, Burstein HJ, Goetz MP, Ciruelos EM, Stearns V, Debled M, Martino S, Geyer Jr CE, Pinotti G, Coates AS, Goldhirsch A, Gelber RD, Francis PA. Randomized comparison of adjuvant aromatase inhibitor exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor positive (HR+) early breast cancer (BC): Update of the combined TEXT and SOFT trials [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr GS4-02.
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Affiliation(s)
- O Pagani
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - MM Regan
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - GF Fleming
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - BA Walley
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - M Colleoni
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - I Láng
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - HL Gomez
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - C Tondini
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - HJ Burstein
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - MP Goetz
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - EM Ciruelos
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - V Stearns
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - M Debled
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - S Martino
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - CE Geyer
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - G Pinotti
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - AS Coates
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - A Goldhirsch
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - RD Gelber
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
| | - PA Francis
- SOFT and TEXT Investigators, International Breast Cancer Study Group, Breast International Group and North American Breast Cancer Group
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Schroder C, Cardoso F, Dijkstra N, van Leeuwen-Stok E, Linderholm B, Morgenstern D, Van Poznak C, Wolff AC, Poncet C, Gomez HL, Aalders K, Bjelic-Radisic V, Werutsky G, Tryfonidis K, Coens C, Giordano SH, Ruddy KJ. Abstract P5-23-02: Quality of life (QoL) in male breast cancer (BC): Prospective study of the EORTC10085/TBCRC029/BIG2-07/NABCG International male BC program. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-23-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Male BC is a rare disease (dx) for which management is extrapolated from trials in female BC. Comprehensive prospective data about QoL in men with BC could inform treatment. The international Male BC Consortium conducted a prospective registry of male BC patients of all stages who newly presented to a participating center between October 2013 and February 2017. A QoL substudy was conducted as part of this registry at most participating sites.
Methods: Informed consent for participation in the QoL substudy was requested from new enrollees. Those who consented were asked to complete a survey including the EORTC QLQ-C30 and BR23 (breast cancer specific module), adapted by replacing female-specific items with male-specific sexual activity/function items from the prostate module (PR25). Outcomes were scored according to standard EORTC QLQ procedures on a 0-100 scale (with higher scores on QoL/functioning scales representing better QoL and functioning, and higher scores on symptom scales representing worse symptoms). Forms were analyzed centrally by EORTC. In order to compare to female BC, we used reference data from 2782 mixed age (62% under age 60) women with BC (of whom 1,147 had recurrent or metastatic dx, and 464 had stage 1-2 dx) reported in the EORTC QLQ-C30 Reference Values manual (2008).
Results: A total of 557 men were enrolled in EORTC10085, 445 at sites participating in the QoL substudy. Consent forms were received from 422/445 (95%) for the substudy. Baseline survey (required to be completed within 30 days of enrollment) compliance was 85% (359/422). Median age at diagnosis was 67 years. There were 111 men (45%) with node-positive M0/MX dx and 27 men (8%) with M1 dx. Their median global health status score at baseline was 75 (IQR 67-83), higher than that documented historically in female BC (67, with IQR 50-83, in both the 2782 women with mixed stage and the subgroup of 464 with stage 1-2 tumors). The participating men's median social functioning score was 100 (IQR 67-100), also higher than the 83.3 (IQR 67-100) reported in mixed stage female BC patients, though no different than the 100 (IQR 67-100) found in women with stage 1-2 dx. Men's most commonly reported symptoms included fatigue (median score 13.9, IQR 0-33), insomnia (median score 0, IQR 0-33), and pain (median score 0, IQR 0-33), for which women's median scores were 33 (IQR 11-44), 33 (IQR 0-33), and 17 (IQR 0-50) with mixed stage dx, and 22 (IQR 0-33), 33 (IQR 0-33), and 17 (IQR 0-33) with stage 1-2 dx. Men's median sexual activity score was 33.3 (IQR 0-50), with less sexual activity reported by older patients and men with M1 dx. In those who were sexually active, median sexual function score was 83 (IQR 75-92), with no difference by age or stage.
Conclusions: QoL and symptom burden in male BC patients appears no worse (and possibly better) than that in female patients. Future analyses of 1- and 5-year surveys from this study will assess the impact of specific treatments on changes in symptoms and QoL over time. These data will be useful in future efforts to tailor treatments and target interventions for male BC.
Funding: Breast Cancer Research Foundation, Dutch Pink Ribbon Foundation, Swedish BRO, and EBCC Council.
Citation Format: Schroder C, Cardoso F, Dijkstra N, van Leeuwen-Stok E, Linderholm B, Morgenstern D, Van Poznak C, Wolff AC, Poncet C, Gomez HL, Aalders K, Bjelic-Radisic V, Werutsky G, Tryfonidis K, Coens C, Giordano SH, Ruddy KJ. Quality of life (QoL) in male breast cancer (BC): Prospective study of the EORTC10085/TBCRC029/BIG2-07/NABCG International male BC program [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-23-02.
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Affiliation(s)
- C Schroder
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - F Cardoso
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - N Dijkstra
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - E van Leeuwen-Stok
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - B Linderholm
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - D Morgenstern
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - C Van Poznak
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - AC Wolff
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - C Poncet
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - HL Gomez
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - K Aalders
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - V Bjelic-Radisic
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - G Werutsky
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - K Tryfonidis
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - C Coens
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - SH Giordano
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
| | - KJ Ruddy
- University Medical Center Groningen, Groningen, Netherlands; Champalimaud Clinical Center, Lisbon, Portugal; Dutch Breast Cancer Trialists' Research Group (BOOG), Amsterdam, Netherlands; Sahlgrenska University Hospital & Swedish Association of Breast Oncologists (SABO), Gothenburg, Sweden; Dana-Farber Cancer Institute, Boston, MA; Unversity of Michigan, Ann Arbor, MI; Johns Hopkins Medicine, Lutherville, MD; European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Medical University of Graz, Graz, Austria; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN
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Ribi K, Luo W, Colleoni M, Karlsson P, Chirgwin J, Aebi S, Jerusalem G, Neven P, Di Lauro V, Gomez HL, Ruhstaller T, Abdi E, Di Leo A, Müller B, Maibach R, Gelber RD, Goldhirsch A, Coates AS, Regan MM, Bernhard J. Abstract P5-18-01: Extended continuous vs intermittent adjuvant letrozole in postmenopausal women with lymph node-positive, early breast cancer (IBCSG 37-05/BIG 1-07 SOLE): Impact on patient-reported symptoms and quality of life. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-18-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: SOLE efficacy results presented at ASCO 2017 showed that extended intermittent vs continuous letrozole for 5 years did not improve disease-free survival in postmenopausal women who had received 4-6 years of adjuvant endocrine therapy for hormone-receptor positive (HR+), lymph-node positive breast cancer. Previous studies showed that the burden by symptoms related to endocrine therapy can be substantial. Even if symptoms improve during the treatment course, extending treatment implies continuation of symptoms. We compared differences in patient-reported symptoms (PRS) and quality of life (QoL) between extended continuous and intermittent letrozole over the first two years of trial treatment.
Methods: From Nov 2007 to Dec 2010, 956 postmenopausal women who were disease-free following 4-6 years of prior adjuvant endocrine therapy for HR+, node-positive breast cancer were enrolled in the QoL substudy of the randomized phase III trial SOLE at selected centers. Patients receive extended continuous letrozole (2.5 mg daily) for 5 years or intermittent letrozole, taken for the first 9 months of years 1-4, and 12 months in year 5. 955 patients completed the 18-item Breast Cancer Prevention Trial (BCPT) Symptom Scales and further symptom-specific and global QoL indicators at baseline, and at 6, 12, 18 and 24 months after randomization. Differences in change of PRS and QoL from baseline between the two administration schedules were tested at 12 and 24 months for 8 symptom scales, 4 additional symptom and 4 global QoL indicators using mixed models with repeated measures.
Results: Small changes in PRS and QoL scores were observed between baseline and 12 months after randomization, i.e. at the end of the first treatment-free interval in the intermittent arm. These changes showed a consistent pattern of greater worsening for patients receiving continuous compared to patients receiving intermittent letrozole. Patients receiving continuous letrozole reported a significantly greater worsening in vaginal problems (p<.02), musculoskeletal pain (p<.03), sleep disturbance (p<.01), physical wellbeing (p<.01) and mood (p<.03). At 24 months (after 2nd treatment-free interval) patients with intermittent letrozole reported a greater improvement in hot flushes (p<.03) than those with continuous letrozole. Changes in the other outcomes did not significantly differ between arms at 24 months.
Conclusion: Although changes in PRS and QoL were small, there was a consistent pattern favoring the intermittent arm. For several symptoms and global QoL indicators, significantly less worsening was observed with the intermittent administration, mainly during the first year of extended treatment, due to small improvements during the treatment-free interval. Froma QoL perspective, women who suffer from endocrine side-effects in the extended setting may benefit from an intermittent administration.
Citation Format: Ribi K, Luo W, Colleoni M, Karlsson P, Chirgwin J, Aebi S, Jerusalem G, Neven P, Di Lauro V, Gomez HL, Ruhstaller T, Abdi E, Di Leo A, Müller B, Maibach R, Gelber RD, Goldhirsch A, Coates AS, Regan MM, Bernhard J. Extended continuous vs intermittent adjuvant letrozole in postmenopausal women with lymph node-positive, early breast cancer (IBCSG 37-05/BIG 1-07 SOLE): Impact on patient-reported symptoms and quality of life [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-18-01.
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Affiliation(s)
- K Ribi
- International Breast Cancer Study Group, Breast International Group
| | - W Luo
- International Breast Cancer Study Group, Breast International Group
| | - M Colleoni
- International Breast Cancer Study Group, Breast International Group
| | - P Karlsson
- International Breast Cancer Study Group, Breast International Group
| | - J Chirgwin
- International Breast Cancer Study Group, Breast International Group
| | - S Aebi
- International Breast Cancer Study Group, Breast International Group
| | - G Jerusalem
- International Breast Cancer Study Group, Breast International Group
| | - P Neven
- International Breast Cancer Study Group, Breast International Group
| | - V Di Lauro
- International Breast Cancer Study Group, Breast International Group
| | - HL Gomez
- International Breast Cancer Study Group, Breast International Group
| | - T Ruhstaller
- International Breast Cancer Study Group, Breast International Group
| | - E Abdi
- International Breast Cancer Study Group, Breast International Group
| | - A Di Leo
- International Breast Cancer Study Group, Breast International Group
| | - B Müller
- International Breast Cancer Study Group, Breast International Group
| | - R Maibach
- International Breast Cancer Study Group, Breast International Group
| | - RD Gelber
- International Breast Cancer Study Group, Breast International Group
| | - A Goldhirsch
- International Breast Cancer Study Group, Breast International Group
| | - AS Coates
- International Breast Cancer Study Group, Breast International Group
| | - MM Regan
- International Breast Cancer Study Group, Breast International Group
| | - J Bernhard
- International Breast Cancer Study Group, Breast International Group
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Ruiz R, Namuche F, Flores C, Aguilar A, Gomez HL. Abstract P1-06-12: Optimizing the use of oncotype Dx in early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-06-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Oncotype Dx (ODX) prognosticates the risk of recurrence and predicts the benefit of adjuvant chemotherapy in estrogen-receptor-positive breast cancer (BC). However, its cost makes it prohibitive for many health care systems. Our objective was to develop a model that uses routine clinical and pathological parameters to identify ODX high risk patients which require adjuvant chemotherapy.
Methods: We retrospectively reviewed ODX and pathology reports from 190 early BC patients treated between 2014 and 2016 in a specialized cancer center. Our population was divided into a training (n:133) and validation set (n:57). In the training set, among available clinico-pathological variables (age, T, ER, PR, Ki67, Elston-Ellis grade) a multiple linear regression model was carried out to select those significantly associated with ODX. Coefficients of statistically significant variables were used to build an equation. The equation was applied in the training set. These results were confronted to ODX categories. The best threshold for selecting high risk patients was identified in the training set and tested in the validation set.
Results: Among the tested variables, tumor size (pT), progesterone receptor (PR), Ki67 and Ellston-Ellis grade were significantly associated with ODX RS (Table 1). The linear predictor is: (0.2544 x pT) – (0.0739 x PR) + (0.0861 x Ki67) + (5.4232 x Elston grade). The threshold score for this equation was set on 14 to discriminate high from low-intermediate risk patients. The test was able to correctly classify high risk patients with a sensitivity of 78%, a specificity of 72% and a negative predictive value of 98%.
Conclusion: With further refinement ODX could be omitted in patients classified as high risk by our predictor therefore restricting and optimizing the use of ODX to a smaller population of patients. The observed ODX distribution in our patients is similar to previously reported series suggesting that this equation could be informative in similar clinical settings. Additional external testing using new datasets is ongoing.
Citation Format: Ruiz R, Namuche F, Flores C, Aguilar A, Gomez HL. Optimizing the use of oncotype Dx in early breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-06-12.
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Affiliation(s)
- R Ruiz
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - F Namuche
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - C Flores
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - A Aguilar
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - HL Gomez
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Namuche F, Ruiz R, Flores C, Gomez HL, Aguilar A. Abstract P6-09-11: Ki67 cut offs and oncotype DX recurrence score in early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-09-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The gene expression profiling assay OncotypeDx (ODX) predicts the likelihood of estrogen receptor (ER) positive breast cancer (BC) recurrence and assesses the likely benefit from both hormonal therapy and chemotherapy. Many clinical scores that estimate the risk category of ODX are being tested. Ki67 is frequently incorporated into these assessments, although there is no standard cut-off for its use.
Methods: We retrospectively reviewed the electronic medical records of 190 patients with early stage ER+ BC for whom ODX recurrence score (RS) was available. Patients were diagnosed and treated at a specialized cancer center between 2014 and 2016. Our objective was to find out the degree to which an optimal ki67 cut-off correlates with ODX risk category. We also aim to determine an association between classical clinicopathological variables (St. Gallen (SG) 2015) could predict ODX risk category. Chi square test was used.
Results: The characteristics of patients according to ODX risk category are shown in Table 2. Mean age at diagnosis was 59 years (range 28-89). Mean tumor diameter was 15mm, 84.2% were intermediate grade and 4.7% patients had lymph node involvement. Mean expression of ER, PR and Ki67 were 87%, 53% and 22%, respectively. According to ODX 62.1% patients were low risk, 30.5% were intermediate risk and 7.4% were high risk. An overall concordance of 46.8% (73/190) was found between SG 2015 and the risk category of ODX (75.7% for low, 33.3% for intermediate and 23.9% for high RS). When changing SG Ki67 cutoffs to ≤20% (for low Ki67) and ≥30% (for high Ki67), an overall concordance of 56.3% (107/190) was found (69.6% for low, 47.3% for intermediate and 23.9% for high RS) and this was statistically significant (p=0.00) (Table 3).
Conclusion: In our population there is no a direct correlation between classical clinicopathological variables and ODX score. Despite being a specialized center, the utility of classical clinicopathological variables for predicting ODX risk category is limited.
Citation Format: Namuche F, Ruiz R, Flores C, Gomez HL, Aguilar A. Ki67 cut offs and oncotype DX recurrence score in early breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-11.
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Affiliation(s)
- F Namuche
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - R Ruiz
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - C Flores
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - HL Gomez
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - A Aguilar
- Oncosalud, Lima, Peru; INEN, Lima, Peru
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Moore HCF, Unger JM, Phillips KA, Boyle F, Hitre E, Moseley A, Porter D, Francis PA, Goldstein LJ, Gomez HL, Vallejos CS, Partridge AH, Dakhil SR, Garcia AA, Gralow J, Lombard JM, Forbes JF, Martino S, Barlow WE, Fabian CJ, Minasian L, Meyskens FL, Gelber RD, Hortobagyi GN, Albain KS. Abstract P1-15-01: Final analysis of SWOG S0230/Prevention of early menopause study (POEMS). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-15-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: The SWOG S0230/POEMS study demonstrated a 70% reduction in ovarian failure (OF) with goserelin coadministration during chemotherapy (CT) for ER-negative early breast cancer (BC; Moore H et al, NEJM 2015). Goserelin use was also associated with more pregnancies as well as favorable disease free survival (DFS) and overall survival (OS). Here we report the final analysis after 5 years of follow-up.
METHODS: Premenopausal women age <50 with stage I-IIIA ER/PR-negative BC to be treated with cyclophosphamide-containing CT were randomized to receive standard CT with or without monthly goserelin 3.6 mg SQ starting at least 1 week prior to the first CT dose. The primary endpoint was OF at 2-years, defined as amenorrhea for the prior 6 months and post-menopausal FSH. Secondary endpoints included pregnancies, disease free survival (DFS) and overall survival (OS). An unplanned analysis of rate of menses recovery at 2 years (presence of menses within 6 months of the 2 year time-point or pregnancy within the first 2 years) was also conducted. OF and pregnancy endpoints were analyzed using multivariable logistic regression adjusting for stratification factors (age and CT regimen); DFS and OS were examined using multivariable Cox regression, adjusting for stratification factors and stage. Two-sided p-values are reported unless otherwise specified in accordance with protocol design.
RESULTS: Among 257 randomized participants, 218 were eligible and evaluable. One hundred thirty-six eligible and evaluable patients had OF data and 186 had menstrual data. Median age was 37.7 years. Among the 136 patients with OF data, the odds ratio (OR) for OF at 2 years was 0.30 (95% CI 0.1-0.98; one-sided p=0.023) comparing CT with goserelin to standard CT alone. Among 186 patients with menstrual data, 80% recovered menses by 2 years in the goserelin arm compared with 70% in the standard arm (OR=1.74, 95% CI: 0.83-3.66, p=0.15). Pregnancies, DFS and OS are reported for all 218 eligible and evaluable patients. With a median follow-up of 5.1 years, 22% of patients in the goserelin group had at least one pregnancy compared with 12% in the standard group (OR 2.38, 95% CI 1.08-5.26, p=0.03). Cumulative incidence of pregnancy at 5 years is 23% in the goserelin arm compared with 12% in the standard group. Five-year Kaplan-Meier DFS estimates are 88% in the goserelin arm compared with 79% in the standard arm (HR=0.50, p=0.05). Five-year OS is 92% with goserelin versus 83% in the standard arm (HR=0.47, p=0.06). Including all 257 randomized patients, HR for DFS and OS are 0.67 and 0.48 (p=0.18 and p=0.05).
CONCLUSION: Ovarian suppression with goserelin during chemotherapy for hormone receptor-negative breast cancer reduces OF risk and, after 5 years of follow-up, continues to be associated with more pregnancies and improved survival compared with chemotherapy without goserelin.
SUPPORT: NIH/NCI grant awards CA189974, CA180888, CA180819, CA074362; AstraZeneca
Citation Format: Moore HCF, Unger JM, Phillips K-A, Boyle F, Hitre E, Moseley A, Porter D, Francis PA, Goldstein LJ, Gomez HL, Vallejos CS, Partridge AH, Dakhil SR, Garcia AA, Gralow J, Lombard JM, Forbes JF, Martino S, Barlow WE, Fabian CJ, Minasian L, Meyskens FL, Gelber RD, Hortobagyi GN, Albain KS. Final analysis of SWOG S0230/Prevention of early menopause study (POEMS) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-15-01.
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Affiliation(s)
- HCF Moore
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - JM Unger
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - K-A Phillips
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - F Boyle
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - E Hitre
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - A Moseley
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - D Porter
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - PA Francis
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - LJ Goldstein
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - HL Gomez
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - CS Vallejos
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - AH Partridge
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - SR Dakhil
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - AA Garcia
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - J Gralow
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - JM Lombard
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - JF Forbes
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - S Martino
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - WE Barlow
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - CJ Fabian
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - L Minasian
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - FL Meyskens
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - RD Gelber
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - GN Hortobagyi
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
| | - KS Albain
- Cleveland Clinic, Cleveland, OH; SWOG Statiscial Center, Fred Hutchinson Cancer Research Center, Seattle, WA; Peter MacCallum Cancer Center, Melbourne, VIC, Australia; University of Sydney, Sidney, NSW, Australia; National Institute of Oncology, Budapest, Hungary; Aukland Regional Cancer Center and Blood Service, Auckland, New Zealand; Fox Chace Cancer Center, Philadelphia, PA; Instituto de Enfermedades Neoplasicas, Lima, Peru; Oncosalud SAC, Lima, Peru; Dana Farber Cancer Institute, Boston, MA; Cancer Center of Kansas, Wichita, KS; Louisiana State University Health Sciences Center, New Orleans, LA; Seattle Cancer Care Alliance, Seattle, WA; Calvary Mater Newcastle, Waratah, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Callaghan, NSW, Australia; The Angeles Clinic and Research Institute, Santa Monica, CA; University of Kansas, Westwood, KS; National Cancer Institute, Bethesda, MD; University of California at Irvine, Orange, CA; University of Texas MD Anderson Cancer Center, Houston,
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Rebaza LP, Castaneda CA, Castillo M, Bernabe LA, Sanchez J, Calderon G, Dunstan J, la Cruz MD, Cotrina JM, Abugattas J, Guerra H, Villa-Robles MR, Poma N, Mejia O, Gomez HL. Androgen expression & clinicopathological features in male breast cancer. Breast Cancer Management 2018. [DOI: 10.2217/bmt-2017-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: To investigate prognostic features in male breast cancer (MBC). Methods: Clinicopathological information from 40 MBC patients was retrospectively reviewed. Androgen receptor (AR) and estrogen receptor (ER) were prospectively stained out in 22 cases and counted through software program analysis. Results: Median age was 65.5 years; most cases were Stage II (40%), Grade II (37.5%), ER ≥10% (72.5%) and PgR ≥10% (75%). AR >10% was found in 17 of 22 cases. Although AR expression was correlated with ER, there are some cells without coexpression. Axillary node involvement was associated with DFS (p = 0.001) and age (p = 0.002) was associated with overall survival. Conclusion: ER is expressed in most MBC cases and is correlated with AR. Axillary involvement and age were associated with survival.
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Affiliation(s)
- Lia P Rebaza
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Carlos A Castaneda
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
- Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima 15067, Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Luis A Bernabe
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Joselyn Sanchez
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Gabriela Calderon
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Jorge Dunstan
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Miguel de la Cruz
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Jose M Cotrina
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Julio Abugattas
- Department of Breast Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Henry Guerra
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Maria R Villa-Robles
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Nathaly Poma
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Omar Mejia
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Lima, Peru
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40
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Castaneda CA, Castillo M, Villarreal-Garza C, Rabanal C, Dunstan J, Calderon G, La Cruz MD, Guerra H, Cotrina JM, Abugattas J, Gomez HL. Genetics, tumor features and treatment response of breast cancer in Latinas. Breast Cancer Management 2018. [DOI: 10.2217/bmt-2017-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Breast cancer is a heterogeneous and genetic disease that has variability according to ethnicity and race with respect to incidence, clinical characteristics and prognosis. The incidence of breast cancer is lower but mortality is higher in Latinas than Caucasians in the US series. Risk factors appear to have different prevalence and impact in Latinas. Breast cancer in Latinas has particular clinic-pathological features including younger age, higher rates of triple-negative subtype and advanced stages. Molecular studies find that Latinas from every region have a specific BRCA incidence and a recurrent mutation, as well as differences in activity of molecular pathways. Treatment response rates and toxicity have also been compared, and no difference was found between Latinas and other ethnic groups.
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Affiliation(s)
- Carlos A Castaneda
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
- Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima, Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, Nuevo Leon, Mexico
- Breast Cancer Clinic & Research Department, Instituto Nacional de Cancerologia, Tlalplan, Mexico
| | - Connie Rabanal
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jorge Dunstan
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Gabriela Calderon
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Miguel De La Cruz
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry Guerra
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Jose M Cotrina
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Julio Abugattas
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Araujo JM, Prado A, Cardenas NK, Zaharia M, Dyer R, Doimi F, Bravo L, Pinillos L, Morante Z, Aguilar A, Mas LA, Gomez HL, Vallejos CS, Rolfo C, Pinto JA. Repeated observation of immune gene sets enrichment in women with non-small cell lung cancer. Oncotarget 2018; 7:20282-92. [PMID: 26958810 PMCID: PMC4991454 DOI: 10.18632/oncotarget.7943] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 11/19/2015] [Accepted: 02/11/2016] [Indexed: 12/26/2022] Open
Abstract
There are different biological and clinical patterns of lung cancer between genders indicating intrinsic differences leading to increased sensitivity to cigarette smoke-induced DNA damage, mutational patterns of KRAS and better clinical outcomes in women while differences between genders at gene-expression levels was not previously reported. Here we show an enrichment of immune genes in NSCLC in women compared to men. We found in a GSEA analysis (by biological processes annotated from Gene Ontology) of six public datasets a repeated observation of immune gene sets enrichment in women. "Immune system process", "immune response", "defense response", "cellular defense response" and "regulation of immune system process" were the gene sets most over-represented while APOBEC3G, APOBEC3F, LAT, CD1D and CCL5 represented the top-five core genes. Characterization of immune cell composition with the platform CIBERSORT showed no differences between genders; however, there were differences when tumor tissues were compared to normal tissues. Our results suggest different immune responses in NSCLC between genders that could be related with the different clinical outcome.
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Affiliation(s)
- Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Alexandra Prado
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Nadezhda K Cardenas
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima 09, Peru
| | - Mayer Zaharia
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Richard Dyer
- Departamento de Patología, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Franco Doimi
- Departamento de Patología, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Leny Bravo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima 09, Peru
| | - Luis Pinillos
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Zaida Morante
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima 41, Peru
| | - Alfredo Aguilar
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Luis A Mas
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Henry L Gomez
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Carlos S Vallejos
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Christian Rolfo
- Phase I - Early Clinical Trials Unit, Antwerp University Hospital, Antwerp, 2650 Edegem, Belgium
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
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42
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Castaneda CA, Torres-Cabala C, Castillo M, Villegas V, Casavilca S, Cano L, Sanchez J, Dunstan J, Calderon G, De La Cruz M, Cotrina JM, Gomez HL, Galvez R, Abugattas J. Tumor infiltrating lymphocytes in acral lentiginous melanoma: a study of a large cohort of cases from Latin America. Clin Transl Oncol 2017; 19:1478-1488. [PMID: 28577153 DOI: 10.1007/s12094-017-1685-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/24/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Acral lentiginous melanoma (ALM) is a poor prognosis subtype and is the most prevalent in non-Caucasian populations. The presence of tumor infiltrating lymphocytes (TILs) has been associated with poor prognosis in melanoma. A large cohort of ALM cases was studied to determine status of TIL and its association with outcome. METHODS All patients with cutaneous melanoma presenting from 2005 to 2012 at Instituto Nacional de Enfermedades Neoplasicas in Peru were retrospectively identified. Clinicopathological information was obtained from the medical charts. A prospective evaluation of TIL was performed. Analysis of association between ALM and clinicopathological features including TIL as well as survival analysis compared the outcome of ALM to whole group and extremity NALM was performed. RESULTS 537 ALM from a total of 824 cutaneous melanoma cases were studied. Older age (p = 0.022), higher Breslow (p = 0.008) and ulceration (p < 0.001) were found to be more frequent in ALM. Acral had worse overall survival (OS) compared with the whole group (p = 0.04). Clinical stage (CS) I-II patients had a median OS of 5.3 (95% CI 4.3-6.2) for ALM and 9.2 (95% CI 5.0-7.0) for extremity NALM (p = 0.016). Grade 0 (absence of TIL), I, II and III were found in 7.5, 34.5, 32.1, and 25.9%, respectively. Lower TIL grade was associated with larger tumor size (p = 0.003), higher Breslow (p = 0.001), higher Clark level (p = 0.007), higher CS (p = 0.002), extremity location (p = 0.048), histological subtype ALM (p = 0.024) and better OS (p = 0.001). CONCLUSIONS ALM is highly prevalent in Peru and carries poor outcome. Lower TIL levels were associated with poor outcome and ALM.
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Affiliation(s)
- C A Castaneda
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru.
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru.
| | - C Torres-Cabala
- Departments of Pathology and Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - M Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - V Villegas
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - S Casavilca
- Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - L Cano
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - J Sanchez
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - J Dunstan
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - G Calderon
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - M De La Cruz
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - J M Cotrina
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - H L Gomez
- Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - R Galvez
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
| | - J Abugattas
- Breast Cancer Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos Este 2520, Surquillo, 15038, Lima, Peru
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Ruiz R, Serrano M, Ruiz EF, Mantilla R, Valdivieso N, Olivera M, Álvarez M, Mas L, Gomez HL. [Clinical-pathological features and survival in young women with cervical cancer: a retrospective analysis from the instituto nacional de enfermedades neoplásicas]. ACTA ACUST UNITED AC 2017; 34:218-227. [PMID: 29177379 DOI: 10.17843/rpmesp.2017.342.2653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 05/24/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the clinical and histological characteristics and prognostic factors of cervical cancer (CC) in young Peruvian patients. MATERIALS AND METHODS Retrospective analysis of patients younger than 35 years old diagnosed with CC between 2008 and 2012 in the Instituto Nacional de Enfermedades Neoplásicas. RESULTS 449 patients had epithelial neoplasms. The main histological types were: squamous cell carcinoma (84.9%), adenocarcinoma (11.0%) and adenosquamous carcinoma (2.4%). The average tumor size was 4.98 cm. Anemia (55.7%), elevated creatinine (21.2%) and hydronephrosis (13.8%) were also identified. 82.3% of the patients presented locally advanced disease. Stages IIB (47.4%) and IIIB (25.8%) were the most common. Overall 5-year survival was 59.5% (I, 90.9%; II, 57.5%; III, 42.7% and IV, 13.3%). Elevated creatinine, anemia, tumor size, parametrial involvement and hydronephrosis were factors that affected survival. No significant relation was found between histological type and survival. The presence of anemia (adjusted hazard ratio [aHR]: 2.5; 95% confidence interval [CI 95%]: 1.6-4.0) and hydronephrosis (aHR: 1.6; CI 95%: 1.0-4.0) were independently associated with survival; likewise, the parametrial commitment with (aHR: 3.3; CI 95%: 1.5-7.2) or without (aRH: 2.6; CI 95%: 1.3-5.3) extension to the pelvic bone. CONCLUSIONS Cervical cancer in young Peruvians is diagnosed in advanced stages. Overall survival in each stage is similar to the reported in older patients. The importance of conventional prognosis- related factors was confirmed. Anemia was an important independent prognostic factor requiring further investigations.
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Affiliation(s)
- Rossana Ruiz
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | | | - Eloy F Ruiz
- Unidad de Conocimiento y Evidencia CONEVID, Universidad Peruana Cayetano Heredia. Lima, Perú
| | - Raul Mantilla
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | | | - Mivael Olivera
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Manuel Álvarez
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Luis Mas
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Henry L Gomez
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
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Pinto JA, Mas LA, Gomez HL. High Epidermal Growth Factor Receptor Mutation Rates in Peruvian Patients With Non-Small-Cell Lung Cancer: Is It a Matter of Asian Ancestry? J Glob Oncol 2017; 3:429-430. [PMID: 28831453 PMCID: PMC5560464 DOI: 10.1200/jgo.2016.008201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Joseph A Pinto
- , , and Oncosalud-AUNA, San Borja; and , Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Luis A Mas
- , , and Oncosalud-AUNA, San Borja; and , Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Henry L Gomez
- , , and Oncosalud-AUNA, San Borja; and , Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Pinto JA, Mas LA, Vallejos CS, Araujo J, Bravo L, Aguilar A, Morante Z, Bretel D, Gomez HL, Rolfo C. Abstract 2614: Decrease of benefit from immune checkpoint inhibitors in women with non-small cell lung cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: In a previous work we found differences in immune gene sets enrichment in NSCLC between genders, regardless their smoking status, where women had higher expression of gene sets associated with immune processes. Based in this fact, we hypothesize fewer benefits from immune checkpoint inhibitors in women patients compared than men patients.
Objectives: Evaluate the benefit (in terms of progression-free survival) of women patients from immune checkpoint inhibitors nivolumab and pembrolizumab in published randomized phase III trials.
Methods: We evaluated by meta-analysis four randomized phase III studies, two of prembrolizumab (Herbst et al., 2015 and Reck et al., 2016) and two of nivolumab (Borghaei et al., 2015 and Brahmer et al., 2015). We analyzed TCGA data for lung adenocarcinoma to evaluate differences in the expression of PDCD1, CD274 genes (encoding for PD-1 and PD-L1, respectively).
Results: For all studies, it was observed an overall HR=0.79 (CI95%:0.71-0.87;P<0.00001), although was observed a significant heterogeneity between studies (P=0.002). In male patients, was observed an overall HR=0.71 (CI95%:0.62-0.80;P<0.00001) with significant heterogeneity between studies (P=0.002). For female patients, there was not seen a clear benefit from nivolumab or pembrolizumab (overall HR=0.97, CI95%:0.82-1.14;P=0.67). There was not heterogeneity between the cohorts (P=0.45). There were not differences in the expression of PDCD1 and CD274 genes according to gender in the TCGA data (P=0.371 and 0.144, respectively).
Conclusion: Although there are not differences between genders in the expression of PDCD1 and CD274 genes , such as is previously described for expression for PD-1 and PDL-1 proteins, in our meta-analysis we shown that women have modest benefit from anti immune checkpoint inhibitors. Blockade of PD1 and PD-L1 is a promising therapy in lung cancer; however, a better stratification of patients should be done.
Meta-analysis of four phase III randomized studiesStudyAll patientsMenWomenWeightHazard Ratio IV, Fixed, 95% CIWeightHazard Ratio IV, Fixed, 95% CIWeightIV, Fixed, 95% CIReck et al., 201610.6%0.50 [0.37, 0.68]10.4%0.39 [0.26, 0.581]8.0%0.71[0.40, 1.26Brahmer et al., 201513.7%0.63 [0.48, 0.8217.8%0.63 [0.46, 0.86]11.2%0.75[0.46, 1.22]Borghaei et al., 201530.3%0.91 [0.76, 1.0926.6%0.81 [0.63, 1.04]37.8%1.02[0.78, 1.33]Herbst et al., 201545.40.85 [0.73, 0.98]45.2%0.78 [0.64, 0.95]43.0%1.04[0.81, 1.33]Total (95% Cl)100.0%0.79 [0.71, 0.87]100.0%0.71 [0.62, 0.80100.0%0.97[0.82, 1.14]Heterogeneity: Chi2=14.73,df=3 (P=0.002); I2= 80% Test for overall effect: Z= 4.73 (P <0.00001)Heterogeneity: Chi2=11.12, df=3 (P=0.01); I2=73% Test for overall effect: Z= 5.28 (P<0.00001)Heterogeneity: Ch2=2.67, df=3 (P= 0.45); I2=0% Test for overall effect: Z= 0.42 (P= 0.67)
Citation Format: Joseph A. Pinto, Luis A. Mas, Carlos S. Vallejos, Jhajaira Araujo, Leny Bravo, Alfredo Aguilar, Zaida Morante, Denisse Bretel, Henry L. Gomez, Christian Rolfo. Decrease of benefit from immune checkpoint inhibitors in women with non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2614. doi:10.1158/1538-7445.AM2017-2614
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Affiliation(s)
| | | | | | | | - Leny Bravo
- 2Universidad Privada San Juan Bautista, Lima, Peru
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Buleje J, Guevara-Fujita M, Acosta O, Huaman FDP, Danos P, Murillo A, Pinto JA, Araujo JM, Aguilar A, Ponce J, Vigil C, Castaneda C, Calderon G, Gomez HL, Fujita R. Mutational analysis of BRCA1 and BRCA2 genes in Peruvian families with hereditary breast and ovarian cancer. Mol Genet Genomic Med 2017; 5:481-494. [PMID: 28944232 PMCID: PMC5606899 DOI: 10.1002/mgg3.301] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 01/05/2017] [Revised: 05/05/2017] [Accepted: 05/09/2017] [Indexed: 12/21/2022] Open
Abstract
Background Breast cancer is one of the most prevalent malignancies in the world. In Peru, breast cancer is the second cause of death among women. Five to ten percent of patients present a high genetic predisposition due to BRCA1 and BRCA2 germline mutations. Methods We performed a comprehensive analysis of BRCA1 and BRCA2 genes by Sanger sequencing and multiplex ligation‐dependent probe amplification (MLPA) to detect large rearrangements in patients from 18 families, which met the criteria for hereditary breast cancer. Results In this series, we found four pathogenic mutations, three previously reported (BRCA1: c.302‐1G>C and c.815_824dup10; BRCA2: c.5946delT) and a duplication of adenines in exon 15 in BRCA1 gene (c.4647_4648dupAA, ClinVar SCV000256598.1). We also found two exonic and four intronic variants of unknown significance and 28 polymorphic variants. Conclusion This is the first report to determine the spectrum of mutations in the BRCA1/BRCA2 genes in Peruvian families selected by clinical and genetic criteria. The alteration rate in BRCA1/BRCA2 with proven pathogenic mutation was 22.2% (4 out 18) and this finding could be influenced by the reduced sample size or clinical criteria. In addition, we found three known BRCA1/BRCA2 mutations and a BRCA1 c.4647_4648dupAA as a novel pathogenic mutation.
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Affiliation(s)
- Jose Buleje
- Centro de Genética y Biología MolecularFacultad de Medicina HumanaUniversidad de San Martín de PorresLimaPerú
| | - Maria Guevara-Fujita
- Centro de Genética y Biología MolecularFacultad de Medicina HumanaUniversidad de San Martín de PorresLimaPerú
| | - Oscar Acosta
- Centro de Genética y Biología MolecularFacultad de Medicina HumanaUniversidad de San Martín de PorresLimaPerú
| | - Francia D P Huaman
- Centro de Genética y Biología MolecularFacultad de Medicina HumanaUniversidad de San Martín de PorresLimaPerú
| | - Pierina Danos
- Centro de Genética y Biología MolecularFacultad de Medicina HumanaUniversidad de San Martín de PorresLimaPerú
| | - Alexis Murillo
- Centro de Genética y Biología MolecularFacultad de Medicina HumanaUniversidad de San Martín de PorresLimaPerú
| | - Joseph A Pinto
- Unidad de Investigación Básica y TraslacionalOncosalud-AUNALimaPerú
| | | | - Alfredo Aguilar
- Unidad de Investigación Básica y TraslacionalOncosalud-AUNALimaPerú
| | | | | | | | | | | | - Ricardo Fujita
- Centro de Genética y Biología MolecularFacultad de Medicina HumanaUniversidad de San Martín de PorresLimaPerú
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Pinto JA, Rolfo C, Raez LE, Prado A, Araujo JM, Bravo L, Fajardo W, Morante ZD, Aguilar A, Neciosup SP, Mas LA, Bretel D, Balko JM, Gomez HL. In silico evaluation of DNA Damage Inducible Transcript 4 gene (DDIT4) as prognostic biomarker in several malignancies. Sci Rep 2017; 7:1526. [PMID: 28484222 PMCID: PMC5431475 DOI: 10.1038/s41598-017-01207-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 03/27/2017] [Indexed: 01/17/2023] Open
Abstract
DDIT4 gene encodes a protein whose main action is to inhibit mTOR under stress conditions whilst several in vitro studies indicate that its expression favors cancer progression. We have previously described that DDIT4 expression is an independent prognostic factor for tripe negative breast cancer resistant to neoadjuvant chemotherapy. We herein report that high DDIT4 expression is related to the outcome (recurrence-free survival, time to progression and overall survival) in several cancer types. We performed in silico analysis in online platforms, in pooled datasets from KM Plotter and meta-analysis of individual datasets from SurvExpress. High levels of DDIT4 were significantly associated with a worse prognosis in acute myeloid leukemia, breast cancer, glioblastoma multiforme, colon, skin and lung cancer. Conversely, a high DDIT4 expression was associated with an improved prognostic in gastric cancer. DDIT4 was not associated with the outcome of ovarian cancers. Analysis with data from the Cell Miner Tool in 60 cancer cell lines indicated that although rapamycin activity was correlated with levels of MTOR, it is not influenced by DDIT4 expression. In summary, DDIT4 might serve as a novel prognostic biomarker in several malignancies. DDIT4 activity could be responsible for resistance to mTOR inhibitors and is a potential candidate for the development of targeted therapy.
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Affiliation(s)
- Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja. Lima 41, Peru
| | - Christian Rolfo
- Phase I-Early Clinical trials Unit, Antwerp University Hospital & Center for Oncological Research (CORE), Antwerp, Belgium
| | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Pembroke Pines, FL, USA
| | - Alexandra Prado
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja. Lima 41, Peru
| | - Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja. Lima 41, Peru
| | - Leny Bravo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Av. José Antonio Lavalle s/n Hacienda Villa, Chorrillos. Lima 09, Peru
| | - Williams Fajardo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Av. José Antonio Lavalle s/n Hacienda Villa, Chorrillos. Lima 09, Peru
| | - Zaida D Morante
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja. Lima 41, Peru
| | - Alfredo Aguilar
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja. Lima 41, Peru
| | - Silvia P Neciosup
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja. Lima 41, Peru
| | - Luis A Mas
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja. Lima 41, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínico Oncológicos Peruano (GECOPERU), Lima, Lima 33, Peru
| | - Justin M Balko
- Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN, 37232-6307, USA
| | - Henry L Gomez
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja. Lima 41, Peru. .,Departamento de Medicina Oncológica, Instituto Peruano de Enfermedades Neoplásicas, Av. Angamos Este 2520, Surquillo. Lima 34, Peru.
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Hyams DM, Schuur E, Angel Aristizabal J, Bargallo Rocha JE, Cabello C, Elizalde R, García-Estévez L, Gomez HL, Katz A, Nuñez De Pierro A. Selecting postoperative adjuvant systemic therapy for early stage breast cancer: A critical assessment of commercially available gene expression assays. J Surg Oncol 2017; 115:647-662. [PMID: 28211064 PMCID: PMC5484338 DOI: 10.1002/jso.24561] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 12/15/2016] [Accepted: 12/15/2016] [Indexed: 12/13/2022]
Abstract
Risk stratification of patients with early stage breast cancer may support adjuvant chemotherapy decision-making. This review details the development and validation of six multi-gene classifiers, each of which claims to provide useful prognostic and possibly predictive information for early stage breast cancer patients. A careful assessment is presented of each test's analytical validity, clinical validity, and clinical utility, as well as the quality of evidence supporting its use.
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Affiliation(s)
- David M Hyams
- Desert Surgical Oncology, Eisenhower Medical Center, Rancho Mirage, California
| | | | | | | | | | | | | | - Henry L Gomez
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Artur Katz
- Hospital Sírio-Libanes, Sao Paulo, Brazil
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Ponce J, Vigil C, Araujo JM, Castañeda C, Calderon G, Buleje JL, Acosta O, Danos P, Huaman F, Guevara-Fujita ML, Aguilar A, Pinto JA, Gomez HL, Fujita R. Abstract P5-09-08: Molecular evaluation of Peruvian patients with hereditary breast cancer reveals a novel germline mutation in BRCA1. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-09-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Breast cancer is the leading cancer in women worldwide, while in Peru is the second most frequent cancer with a high incidence of triple negative breast cancers (21%). There is no previous information about BRCA1/BRCA2 mutations in Peruvian high-risk breast cancer patients. Prior studies from International diagnostic laboratories only presented results of our population as a pooled Hispanic data. Our aim was to characterize mutations in BRCA1/BRCA2 genes in Peruvian patients with breast cancer with hereditary patterns.
Methods
We evaluated mutations in BRCA1/BRCA2 genes by Sanger sequencing and large genomic rearrangements by multiplex ligation-dependent probe amplification (MLPA) in 18 families with hereditary breast cancer criteria identified at the Breast Unit of Oncosalud-AUNA (Lima-Peru). Molecular analysis was done in the facilities of Genetics and Molecular Biology Center at the San Martin de Porres University (Lima-Peru).
Results
Sequencing identified 4 pathogenic mutations in 4/18 families, three previously detected (BRCA1: c.302-1G>C y c.815_824dup10; BRCA2: c.5946delT) and a novel germline mutation in exon 15 of BRCA1 (c.4647_4648dupAA, ClinVar SCV000256598.1) producing a frameshift variant. MLPA revealed 2 amplifications in exon 7 (duplication and triplication) in BRCA1 in unrelated patients with potential pathogenic effects, one of this co-existed with the BRCA2: c.5946delT mutation. In addition, three variants of uncertain significance were found (c.140G>T, in exon 5 of BRCA1 and c.464G>A and c.938C>T in exon 5 and 10 of BRCA2, respectively).
Conclusions
After a comprehensive evaluation we found an alteration rate of 27.8% (5/18) in BRCA1/BRCA2 in families with criteria for hereditary breast cancer. We reported BRCA1 c.4647_4648dupAA as a novel mutation. Further studies including a larger sample size of Peruvian patients should evaluate the prevalence or founder effect of this mutation in our population.
Citation Format: Ponce J, Vigil C, Araujo JM, Castañeda C, Calderon G, Buleje JL, Acosta O, Danos P, Huaman F, Guevara-Fujita ML, Aguilar A, Pinto JA, Gomez HL, Fujita R. Molecular evaluation of Peruvian patients with hereditary breast cancer reveals a novel germline mutation in BRCA1 [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-09-08.
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Affiliation(s)
- J Ponce
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - C Vigil
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - JM Araujo
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - C Castañeda
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - G Calderon
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - JL Buleje
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - O Acosta
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - P Danos
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - F Huaman
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - ML Guevara-Fujita
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - A Aguilar
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - JA Pinto
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - HL Gomez
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
| | - R Fujita
- Breast Unit, Oncosalud-AUNA, Lima, Peru; Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru; Genetics and Molecular Biology Center, Universidad San Martin de Porres, Lima, Peru
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Castaneda CA, Mittendorf E, Casavilca S, Wu Y, Castillo M, Arboleda P, Nunez T, Guerra H, Barrionuevo C, Dolores-Cerna K, Belmar-Lopez C, Abugattas J, Calderon G, De La Cruz M, Cotrina M, Dunstan J, Gomez HL, Vidaurre T. Tumor infiltrating lymphocytes in triple negative breast cancer receiving neoadjuvant chemotherapy. World J Clin Oncol 2016; 7:387-394. [PMID: 27777881 PMCID: PMC5056330 DOI: 10.5306/wjco.v7.i5.387] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/22/2016] [Accepted: 09/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To determine influence of neoadjuvant-chemotherapy (NAC) over tumor-infiltrating-lymphocytes (TIL) in triple-negative-breast-cancer (TNBC).
METHODS TILs were evaluated in 98 TNBC cases who came to Instituto Nacional de Enfermedades Neoplasicas from 2005 to 2010. Immunohistochemistry staining for CD3, CD4, CD8 and FOXP3 was performed in tissue microarrays (TMA) sections. Evaluation of H/E in full-face and immunohistochemistry in TMA sections was performed in pre and post-NAC samples. STATA software was used and P value < 0.05 was considered statistically significant.
RESULTS Higher TIL evaluated in full-face sections from pre-NAC tumors was associated to pathologic-complete-response (pCR) (P = 0.0251) and outcome (P = 0.0334). TIL evaluated in TMA sections showed low level of agreement with full-face sections (ICC = 0.017-0.20) and was not associated to pCR or outcome. TIL in post-NAC samples were not associated to response or outcome. Post-NAC lesions with pCR had similar TIL levels than those without pCR (P = 0.6331). NAC produced a TIL decrease in full-face sections (P < 0.0001). Percentage of TIL subpopulations was correlated with their absolute counts. Higher counts of CD3, CD4, CD8 and FOXP3 in pre-NAC samples had longer disease-free-survival (DFS). Higher counts of CD3 in pre-NAC samples had longer overall-survival. Higher ratio of CD8/CD4 counts in pre-NAC was associated with pCR. Higher ratio of CD4/FOXP3 counts in pre-NAC was associated with longer DFS. Higher counts of CD4 in post-NAC samples were associated with pCR.
CONCLUSION TIL in pre-NAC full-face sections in TNBC are correlated to longer survival. TIL in full-face differ from TMA sections, absolute count and percentage analysis of TIL subpopulation closely related.
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