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Ortiz-Gómez T, Gomez AC, Chuima B, Zevallos A, Ocampo K, Torres D, Pinto JA. Frequency of SARS-CoV-2 variants identified by real-time PCR in the AUNA healthcare network, Peru. Front Public Health 2024; 11:1244662. [PMID: 38410127 PMCID: PMC10894931 DOI: 10.3389/fpubh.2023.1244662] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/26/2023] [Indexed: 02/28/2024] Open
Abstract
Introduction In Peru, on 11 February 2023, the Ministry of Health registered 4 million patients infected with COVID-19 and around 219,260 deaths. In 2020, the SARS-CoV-2 virus was acquiring mutations that impacted the properties of transmissibility, infectivity, and immune evasion, leading to new lineages. In the present study, the frequency of COVID-19 variants was determined during 2021 and 2022 in patients treated in the AUNA healthcare network. Methods The methodology used to detect mutations and identify variants was the Allplex™ SARS-CoV-2 Variants Assay I, II, and VII kit RT-PCR. The frequency of variants was presented by epidemiological weeks. Results In total, 544 positive samples were evaluated, where the Delta, Omicron, and Gamma variants were identified. The Delta variant was found in 242 (44.5%) patients between epidemiological weeks 39 and 52 in 2021. In the case of Gamma, it was observed in 8 (1.5%) patients at weeks 39, 41, 43, 45, and 46 of 2021. The Omicron variant was the most frequent with 289 (53.1%) patients during weeks 49 to 52 of 2021 and 1 to 22 of 2022. During weeks 1 through 22 of 2022, it was possible to discriminate between BA. 1 (n = 32) and BA.2 (n = 82). Conclusion The rapid identification of COVID-19 variants through the RT-PCR methodology contributes to timely epidemiological surveillance, as well as appropriate patient management.
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Affiliation(s)
| | - Andrea C Gomez
- Centro de Investigación Básica y Translacional, AUNA IDEAS, Lima, Peru
| | | | - Alejandra Zevallos
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Karen Ocampo
- Laboratorios AUNA, Área de Biología Molecular, Lima, Peru
| | - Diana Torres
- Laboratorios AUNA, Área de Biología Molecular, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada Norbert Wiener, Lima, Peru
| | - Joseph A Pinto
- Centro de Investigación Básica y Translacional, AUNA IDEAS, Lima, Peru
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Ponce-Cusi R, Bravo L, Paez KJ, Pinto JA, Pilco-Ferreto N. Host-Pathogen Interaction: Biology and Public Health. Methods Mol Biol 2024; 2751:3-18. [PMID: 38265706 DOI: 10.1007/978-1-0716-3617-6_1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Interactions between host and pathogenic microorganisms are common in nature and have a significant impact on host health, often leading to several types of infections. These interactions have evolved as a result of the ongoing battle between the host's defense mechanisms and the pathogens' invasion strategies. In this chapter, we will explore the evolution of host-pathogen interactions, explore their molecular mechanisms, examine the different stages of interaction, and discuss the development of pharmacological treatments. Understanding these interactions is crucial for improving public health, as it enables us to develop effective strategies to prevent and control infectious diseases. By gaining insights into the intricate dynamics between pathogens and their hosts, we can work towards reducing the burden of such diseases on society.
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Affiliation(s)
- Richard Ponce-Cusi
- Escuela Profesional de Medicina, Facultad de Ciencias de la Salud, Universidad Nacional de Moquegua, Moquegua, Peru.
| | - Leny Bravo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Kevin J Paez
- Escuela Profesional de Medicina Humana - Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | - Joseph A Pinto
- Escuela Profesional de Medicina Humana - Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | - Nesstor Pilco-Ferreto
- Unidad de Posgrado. Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru
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de Miguel-Perez D, Pickering EM, Malapelle U, Grier W, Pepe F, Pisapia P, Russo G, Pinto JA, Russo A, Troncone G, Culligan MJ, Scilla KA, Mehra R, Mohindra P, Arrieta O, Cardona AF, Del Re M, Sachdeva A, Hirsch FR, Wolf A, Friedberg JS, Rolfo C. Genomic profiling of tissue and blood predicts survival outcomes in patients with resected pleural mesothelioma. Eur J Cancer 2024; 196:113457. [PMID: 38008032 DOI: 10.1016/j.ejca.2023.113457] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE Pleural mesothelioma (PM) is an aggressive tumor still considered incurable, in part due to the lack of predictive biomarkers. Little is known about the clinical implications of molecular alterations in resectable PM tissues and blood. Here, we characterized genetic alterations to identify prognostic and predictive biomarkers in patients with resected PM. EXPERIMENTAL DESIGN Targeted next-generation sequencing was performed in retrospective pleural tumor tissue and paired plasma samples from stage IB-IIIB resected PM. Association between prognosis and presence of specific mutations was validated in silico. RESULTS Thirty PM tissues and paired blood samples from 12 patients were analyzed. High tissue tumor mutational burden (TMB) (>10 mutations/Mb), tissue median minor allele frequency (MAF) (>9 mutations/Mb), and blood TMB (>6 mutations/Mb), tissue KMT2C, PBRM1, PKHD1,EPHB1 and blood LIFR mutations correlated with longer disease-free survival and/or overall survival. High concordance (>80%) between tissue and blood was found for some mutations. CONCLUSIONS Tissue TMB and MAF, blood TMB, and specific mutations correlated with outcomes in patients with resected PM and should be further studied to validate their role as prognostic biomarkers and potentially predictive factors for combinations with immune-checkpoint inhibitors. This suggest that molecular profiling could identify longer survivors in patients with resected PM.
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Affiliation(s)
- Diego de Miguel-Perez
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Edward M Pickering
- Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Umberto Malapelle
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - William Grier
- Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, USA
| | - Francesco Pepe
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Pasquale Pisapia
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Gianluca Russo
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Joseph A Pinto
- Centro de Investigación Básica y Traslacional, Auna Ideas, Lima, Peru
| | - Alessandro Russo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Giancarlo Troncone
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Melissa J Culligan
- Department of Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, USA
| | - Katherine A Scilla
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ranee Mehra
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Pranshu Mohindra
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Andres F Cardona
- Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC) / Foundation for Clinical and Applied Cancer Research (FICMAC) / Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | - Marzia Del Re
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ashutosh Sachdeva
- Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Fred R Hirsch
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea Wolf
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph S Friedberg
- Department of Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, USA
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
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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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Ferreyra Y, Rosas G, Cock-Rada AM, Araujo J, Bravo L, Doimi F, Casas J, Clavo MDLÁ, Pinto JA, Belmar-López C. Landscape of germline BRCA1/BRCA2 variants in breast and ovarian cancer in Peru. Front Oncol 2023; 13:1227864. [PMID: 37664050 PMCID: PMC10470619 DOI: 10.3389/fonc.2023.1227864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/27/2023] [Indexed: 09/05/2023] Open
Abstract
Background There is an increasing amount of data from Latin America on the characterization of BRCA variants; however, there is limited information from Peru. We conducted a retrospective study to describe germline pathogenic/likely pathogenic(P/LP) variants and variants of uncertain/unknown significance (VUS) in the BRCA1 and BRCA2 genes in Peru, in patients with breast and ovarian cancer, candidates for treatment with poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors. Methods The patients were evaluated during the period 2019-2021. Genomic DNA was isolated from peripheral blood samples and targeted sequencing was performed using the Ampliseq BRCA panel. Genetic variant interpretation was carried out in accordance with the recommendations of the American College of Medical Genetics and ClinVar. During this period, 525 patients (143 with breast cancer and 382 with ovarian cancer) were studied. Results We found that 14.7% (21/143) of breast cancer patients and 20.7% (79/382) of ovarian cancer patients were carriers of P/LP variants in BRCA1/2. The most frequent pathogenic variants detected in BRCA1 were c.2105dupT (BIC: 2224insT, n=12, 18.75%), c.68_69delAG (BIC: 185delAG, n=6, 9.38%), c.140G>T and c.815_824dupAGCCATGTGG (n=5, 7.81%), while in BRCA2 were c.8023A>G (n=6, 16.67%), c.6024dupG (BIC: 6252insG, n=4, 11.11%), and c.9235delG (BIC: 9463delG, n=3, 8.33%). Regarding VUS, we found that 6.99% (10/143) of breast cancer patients and 7.33% (28/382) of ovarian cancer patients were carriers of a VUS in BRCA1/2. For BRCA1, the most frequent VUS was c.93C>G (n=2), and for BRCA2, c.5465A>T (n=4), c.3101T>C (n=3), c.205C>A and c.437T>C (n=2). Conclusion We found a frequency of 14.7% germline mutations in breast cancer patients and 20.7% in ovarian cancer patients. The most recurrent mutations were BRCA1 c.2105dupT and BRCA2 c.8023A>G. We found that BRCA2 c.8023A>G, c.6024dupG, and c.9235delG were not previously reported in Peruvian patients. BRCA1 c.2344dupA is a novel mutation that has not been previously reported in any database. The frequency of VUS in our cohort was 7.2%.
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Affiliation(s)
- Yomali Ferreyra
- Departamento de Bioingeniería, Universidad de Ingenieria y Tecnología, Lima, Peru
| | - Gina Rosas
- Departamento de Patología, Insituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Alicia M. Cock-Rada
- Departmento de Oncología Médica, Instituto de Cancerología Las Américas - Auna, Medellín, Colombia
| | - Jhajaira Araujo
- Centro de Investigación Básicas y traslacional, Auna Ideas, Lima, Peru
| | - Leny Bravo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | | | | | | | - Joseph A. Pinto
- Centro de Investigación Básicas y traslacional, Auna Ideas, Lima, Peru
| | - Carolina Belmar-López
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
- Oncogenomics, Auna, Lima, Peru
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Gomez AC, Ortiz T, Valenzuela A, Egoávil-Espejo R, Huerto-Huanuco R, Pinto JA, Lagos J, Ruiz J. Super-infection by multiple microorganisms in COVID-19 patients. Front Mol Biosci 2023; 10:1113969. [PMID: 36994427 PMCID: PMC10040592 DOI: 10.3389/fmolb.2023.1113969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
Introduction: This study aimed to describe the clinical characteristics of patients with COVID-19 co-infected with multiple multidrug-resistant bacteria.Methods: Patients hospitalized in the AUNA network between January and May 2021, diagnosed with COVID-19 and at least two other infecting microorganisms, were retrospectively included in the analysis. Clinical and epidemiological data were extracted from clinical records. The susceptibility levels of the microorganisms were determined using automated methods. Antibiotic resistance was established among infecting bacteria accounting for ≥5 isolates.Results: A total of 27 patients (21 male and 6 female patients) met the inclusion criteria, with a maximum of eight co-infecting bacteria or fungi during admission time. Seven patients (25.9%) died, with a higher but not significant lethality among women (50% vs. 19.0%). A total of 15 patients presented at least one established comorbidity, with hypertension being the most frequent. The time elapsed between COVID-19 diagnosis and hospital attendance was 7.0 days, with that of patients with a fatal outcome being longer than that of living patients (10.6 vs. 5.4). Up to 20 different microorganisms were isolated, with Pseudomonas aeruginosa being the most common (34 isolates). In general, antibiotic resistance levels were high, especially in Acinetobacter baumannii isolates, with resistance levels of 88.9% to all antimicrobial agents tested, except colistin (0%).Conclusion: In conclusion, the present results show the presence of multiple microorganisms that co-infect COVID-19 patients. When fatal outcome rates are in the range of other reports, the presence of a series of multidrug-resistant microorganisms is of concern, showing the need to reinforce control measures to limit the expansion of almost untreatable microorganisms.
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Affiliation(s)
- Andrea C. Gomez
- Centro de Investigación Básica y Translacional, AUNA IDEAS, Lima, Peru
| | - Tamin Ortiz
- Servicio de Microbiología y Biología Molecular, Laboratorios AUNA, Lima, Peru
| | - Angélica Valenzuela
- Servicio de Microbiología y Biología Molecular, Laboratorios AUNA, Lima, Peru
| | - Rocío Egoávil-Espejo
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos—“One Health”, Universidad Científica del Sur, Lima, Peru
| | - Rosario Huerto-Huanuco
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos—“One Health”, Universidad Científica del Sur, Lima, Peru
| | - Joseph A. Pinto
- Centro de Investigación Básica y Translacional, AUNA IDEAS, Lima, Peru
- *Correspondence: Joseph A. Pinto, ; Joaquim Ruiz,
| | - Jose Lagos
- Servicio de Microbiología y Biología Molecular, Laboratorios AUNA, Lima, Peru
| | - Joaquim Ruiz
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos—“One Health”, Universidad Científica del Sur, Lima, Peru
- *Correspondence: Joseph A. Pinto, ; Joaquim Ruiz,
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Horgan D, Hamdi Y, Lal JA, Nyawira T, Meyer S, Kondji D, Francisco NM, De Guzman R, Paul A, Bernard B, Reddy Nallamalla K, Park WY, Triapthi V, Tripathi R, Johns A, Singh MP, Phipps ME, Dube F, Rasheed HMA, Kozaric M, Pinto JA, Doral Stefani S, Aponte Rueda ME, Fujita Alarcon R, Barrera-Saldana HA. Framework for Adoption of Next-Generation Sequencing (NGS) Globally in the Oncology Area. Healthcare (Basel) 2023; 11:healthcare11030431. [PMID: 36767006 PMCID: PMC9914369 DOI: 10.3390/healthcare11030431] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Radical new possibilities of improved treatment of cancer are on offer from an advanced medical technology already demonstrating its significance: next-generation sequencing (NGS). This refined testing provides unprecedentedly precise diagnoses and permits the use of focused and highly personalized treatments. However, across regions globally, many cancer patients will continue to be denied the benefits of NGS as long as some of the yawning gaps in its implementation remain unattended. The challenges at the regional and national levels are linked because putting the solutions into effect is highly dependent on cooperation between regional- and national-level cooperation, which could be hindered by shortfalls in interpretation or understanding. The aim of the paper was to define and explore the necessary conditions for NGS and make recommendations for effective implementation based on extensive exchanges with policy makers and stakeholders. As a result, the European Alliance for Personalised Medicine (EAPM) developed a maturity framework structured around demand-side and supply-side issues to enable interested stakeholders in different countries to self-evaluate according to a common matrix. A questionnaire was designed to identify the current status of NGS implementation, and it was submitted to different experts in different institutions globally. This revealed significant variability in the different aspects of NGS uptake. Within different regions globally, to ensure those conditions are right, this can be improved by linking efforts made at the national level, where patients have needs and where care is delivered, and at the global level, where major policy initiatives in the health field are underway or in preparation, many of which offer direct or indirect pathways for building those conditions. In addition, in a period when consensus is still incomplete and catching up is needed at a political level to ensure rational allocation of resources-even within individual countries-to enable the best ways to make the necessary provisions for NGS, a key recommendation is to examine where closer links between national and regional actions could complement, support, and mutually reinforce efforts to improve the situation for patients.
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Affiliation(s)
- Denis Horgan
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
- Correspondence:
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
- Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, Tunis 1002, Tunisia
| | - Jonathan A. Lal
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
- Department of Genetics and Cell Biology, GROW School of Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Institute for Public Health Genomics, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Teresia Nyawira
- National Commission for Science, Technology and Innovation in Kenya (NACOSTI), Nairobi 00100, Kenya
| | | | - Dominique Kondji
- Health & Development Communication, Building Capacity for Better Health in Africa, Yaounde P.O. Box 2032, Cameroon
| | - Ngiambudulu M. Francisco
- Grupo de Investigação Microbiana e Imunológica, Instituto Nacional de Investigação em Saúde (National Institute for Health Research), Luanda 3635, Angola
| | - Roselle De Guzman
- Oncology and Pain Management Section, Manila Central University—Filemon D. Tanchoco Medical Foundation Hospital, Caloocan 1400, Philippines
| | - Anupriya Paul
- Department of Mathematics and Statistics, Faculty of Science, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Branka Bernard
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
- Mediterranean Institute for Life Sciences, 21000 Split, Croatia
| | | | - Woong-Yang Park
- Samsung Medical Center, Samsung Genome Institute, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Vijay Triapthi
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Ravikant Tripathi
- Department Health Government of India, Ministry of Labor, New Delhi 110001, India
| | - Amber Johns
- Cancer Division, Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Sydney 2010, Australia
| | - Mohan P. Singh
- Center of Biotechnology, University of Allahabad, Allahabad 211002, India
| | - Maude E. Phipps
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - France Dube
- Precision Medicine and Breast Cancer Department, Astra Zeneca, 1800 Concord Pike, Wilmington, DE 19803, USA
| | | | - Marta Kozaric
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
| | - Joseph A. Pinto
- Center for Basic and Translational Research, Auna Ideas, Lima 15036, Peru
| | | | | | - Ricardo Fujita Alarcon
- Centro de Genética y Biología Molecular, Universidad de San Martín de Porres, Lima 15024, Peru
| | - Hugo A. Barrera-Saldana
- Innbiogem SC/Vitagenesis SA at National Laboratory for Services of Research, Development, and Innovation for the Pharma and Biotech Industries (LANSEIDI) of CONACyT Vitaxentrum Group, Monterrey 64630, Mexico
- Schools of Medicine and Biology, Autonomous University of Nuevo Leon, Monterrey 66451, Mexico
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Araujo JM, Gómez AC, Jongh WZD, Ausejo J, Córdova I, Schwarz LJ, Bretel D, Fajardo W, Saravia-Huarca LG, Barboza-Meca J, Morante Z, Guillén JR, Gómez H, Cárdenas NK, Hernández L, Melo W, Villarreal-Garza C, Caglevic C, Palacio C, García H, Mejía G, Flores C, Vallejos C, Pinto JA. A nationwide pilot study on breast cancer screening in Peru. Ecancermedicalscience 2023; 17:1494. [PMID: 36816782 PMCID: PMC9937072 DOI: 10.3332/ecancer.2023.1494] [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: 08/22/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction A high prevalence of advanced breast cancer (BC) is a common scenario in Latin America. In Peru, the frequency of BC at Stages III/IV is ≈50% despite implementation of a programme for breast cancer screening (BCS) along the country. We carried out a study to assess the feasibility and develop an instrument to evaluate the knowledge, barriers and perception about BCS in a nationwide pilot study in Peru among candidates for BCS. Methods We conducted a systematic review of 2,558 reports indexed in PubMed, Scopus, Web of Science, Medline-Ovid and EMBASE, regarding to our study theme. In total, 111 were selected and a 51-items survey was developed (eight items about sociodemographic characteristics). Patients were recruited in public hospitals or private clinics, in rural and urban areas of nine departments of Peru. Results We surveyed 488 women from: Lima (150), Cajamarca (93), Ica (59), Arequipa (56), Loreto (48), Ancash (38), Junín (15), Puerto Maldonado (15) and Huancavelica (14); 27.9% of them were from rural areas. The mean of age was 53.3 years (standard deviation ± 9.1). Regarding education level, 29.8% had primary, 33.2% secondary and 37.0% higher education. In total, 28.7% of women did not know the term 'mammogram' and 47.1% reported never receiving a BCS (36.9% from urban and 73.5% from rural population). In women that underwent BCS, only 67% knew it is for healthy women. In total, 54.1% of patients had low levels of knowledge about risk factors for BC (i.e. 87.5% of women respond that injuries in the breast produce cancer). Cultural, economic and geographic barriers were significantly associated with having a mammogram where 56.9% of participants considered a cost ≤ 7 USD as appropriate. Mammogram was perceived as too painful for 54.9% of women. In addition, women with a self-perception of low-risk for BC and a fatalistic perception of cancer were less likely to have a BCS. Conclusion We found that it is feasible to conduct a large-scale study in Peru. The results of this pilot study highlight an urgent need of extensive education and awareness about BCS in Peru.
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Affiliation(s)
- Jhajaira M Araujo
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru,Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima 15067, Peru
| | - Andrea C Gómez
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Winston Zingg-De Jongh
- Department of Molecular and Cellular Medicine, Texas A&M University, TX 77843, E.E.U.U., USA
| | - Jhon Ausejo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Iván Córdova
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Luis J Schwarz
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Santiago de Surco, Lima 15038, Peru
| | - Williams Fajardo
- Servicio de Medicina Interna, Hospital Nacional Dos de Mayo, Lima 15003, Peru
| | | | | | - Zaida Morante
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Juan R Guillén
- Hospital Félix Torrealva Gutiérrez- ESSALUD, Ica 11001, Peru
| | - Henry Gómez
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Santiago de Surco, Lima 15038, Peru
| | - Nadezhda K Cárdenas
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Lady Hernández
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Walter Melo
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
| | - Cynthia Villarreal-Garza
- Centro de Cáncer de Mama, Hospital Zambrano Hellion, Tecnológico de Monterrey, 66278 San Pedro Garza García, Monterrey, México
| | - Christian Caglevic
- Cancer Research Department, Fundacion Arturo Lopez Perez, Santiago de Chile 7500921, Chile
| | - Carolina Palacio
- Departamento de Oncología Clínica, Instituto de Cancerología Las Américas - AUNA, Medellín 050022, Colombia
| | - Héctor García
- Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | - Gerson Mejía
- Departamento de Oncología Médica, Hospital Clínico VIEDMA, Cochabamba 0304, Bolivia
| | - Claudio Flores
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Carlos Vallejos
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru
| | - Joseph A Pinto
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 16036, Peru,Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica 11004, Peru
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9
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Ruiz J, Ocampo K, Salvador-Luján G, Reyes YV, Gómez AC, Valera-Krumdieck C, Baca-Cumpa AD, Soza G, Pinto JA, Ramos-Chirinos M, Lagos J, Riveros M, Pons MJ. First report of CrpP prevalence in a South American country. New Microbes New Infect 2023; 51:101082. [PMID: 36873288 PMCID: PMC9982198 DOI: 10.1016/j.nmni.2023.101082] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
The presence of crpP was established in 201 Pseudomonas aeruginosa isolates from 9 Peruvian hospitals. The 76.6% (154/201) of the isolates presented the crpP gene. Overall, 123/201 (61.2%) isolates were non-susceptible to ciprofloxacin. The prevalence of crpP-possessing P. aeruginosa in Peru is higher than in other geographical areas.
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Affiliation(s)
- Joaquim Ruiz
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - “One Health”, Universidad Científica del Sur, Lima, Peru
- Corresponding author. Antigua Panamericana Sur Km 19, Villa El Salvador, 15067, Lima, Peru.
| | - Karen Ocampo
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - “One Health”, Universidad Científica del Sur, Lima, Peru
| | | | - Yelinda V. Reyes
- Laboratorio de Enfermedades Entéricas y Nutrición, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andrea C. Gómez
- Centro de Investigación Básica y Traslacional Auna Ideas, Lima, Peru
| | | | | | | | - Joseph A. Pinto
- Centro de Investigación Básica y Traslacional Auna Ideas, Lima, Peru
| | | | | | - Maribel Riveros
- Laboratorio de Enfermedades Entéricas y Nutrición, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Ciencias Naturales y Matemática, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Maria J. Pons
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - “One Health”, Universidad Científica del Sur, Lima, Peru
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10
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López MJ, Carbajal J, Alfaro AL, Saravia LG, Zanabria D, Araujo JM, Quispe L, Zevallos A, Buleje JL, Cho CE, Sarmiento M, Pinto JA, Fajardo W. Characteristics of gastric cancer around the world. Crit Rev Oncol Hematol 2023; 181:103841. [PMID: 36240980 DOI: 10.1016/j.critrevonc.2022.103841] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/27/2022] Open
Abstract
Gastric cancer is one of the most important malignancies in the world due to the high burden of disease and lethality. In this work, we compared the main characteristics of gastric cancer between different regions of the world. We reviewed public repositories to retrieve epidemiological, molecular, clinicopathological, and risk factor data. Eastern Asia presents the highest incidence of gastric cancer, followed by eastern and central Europe. Intestinal histology was more frequent in Caucasians, while gastric tumors located in the cardias were less frequent in Africa and Latin America. TP53, LRP1B, and ARID1A are consistently the most frequently altered genes in all population groups. Gastric cancer is most frequent in men. African patients tend to be younger and have a higher proportion of women patients. Different patterns can be observed in the presentation of gastric cancer between different regions of the world. More research is needed in Latin America and Africa since these populations are underrepresented.
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Affiliation(s)
- María J López
- Facultad de Biología, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Junior Carbajal
- Facultad de Biología, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | | | - Luis G Saravia
- Departmento de Medicina Interna, Hospital Regional de Ica, Ica, Peru
| | - Daniel Zanabria
- Centro de Investigación Básica y Traslacional, Auna Ideas Foundation, Lima, Peru
| | - Jhajaira M Araujo
- Escuela de Medicina, Universidad Privada San Juan Bautista, Lima, Peru
| | - Lidia Quispe
- Departmento of Patología, Hospital Regional de Ica, Ica, Peru
| | | | - José L Buleje
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | | | - Marisol Sarmiento
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | - Joseph A Pinto
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru.
| | - Williams Fajardo
- Escuela de Medicina, Universidad Privada San Juan Bautista, Lima, Peru
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11
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Horgan D, Hamdi Y, Lal JA, Nyawira T, Meyer S, Kondji D, Francisco NM, De Guzman R, Paul A, Nallamalla KR, Park WY, Triapthi V, Tripathi R, Johns A, Singh MP, Phipps ME, Dube F, Abu Rasheed HM, Kozaric M, Pinto JA, Stefani SD, Aponte Rueda ME, Alarcon RF, Barrera-Saldana HA. Empowering quality data - the gordian knot of bringing real innovation into healthcare system. Diagnosis (Berl) 2022; 10:140-157. [PMID: 36548810 DOI: 10.1515/dx-2022-0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The introduction of Personalised Medicine (PM) into healthcare systems could benefit from a clearer understanding of the distinct national and regional frameworks around the world. Recent engagement by international regulators on maximising the use of real-world evidence (RWE) has highlighted the scope for improving the exploitation of the treasure-trove of health data that is currently largely neglected in many countries. The European Alliance for Personalised Medicine (EAPM) led an international study aimed at identifying the current status of conditions. METHODS A literature review examined how far such frameworks exist, with a view to identifying conducive factors - and crucial gaps. This extensive review of key factors across 22 countries and 5 regions revealed a wide variety of attitudes, approaches, provisions and conditions, and permitted the construction of a comprehensive overview of the current status of PM. Based on seven key pillars identified from the literature review and expert panels, the data was quantified, and on the basis of further analysis, an index was developed to allow comparison country by country and region by region. RESULTS The results show that United States of America is leading according to overall outcome whereas Kenya scored the least in the overall outcome. CONCLUSIONS Still, common approaches exist that could help accelerate take-up of opportunities even in the less prosperous parts of the world.
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Affiliation(s)
- Denis Horgan
- European Alliance for Personalised Medicine, Brussels, Belgium
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering Sam Higginbottom University of Agriculture, Technology and Sciences Prayagraj, India
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
- Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Jonathan A Lal
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering Sam Higginbottom University of Agriculture, Technology and Sciences Prayagraj, India
- Department of Genetics and Cell Biology, GROW School of Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Institute for Public Health Genomics, Maastricht University, Maastricht, Netherlands
| | - Teresia Nyawira
- National Commission for Science, Technology and Innovation in Kenya (NACOSTI), Nairobi Kenya, Kenya
| | | | - Dominique Kondji
- Health & Development Communication, Building Capacity for Better Health in Africa Building Capacities for Better Health in AFRICA, Yaounde, Cameroun
| | - Ngiambudulu M Francisco
- Grupo de Investigação Microbiana e Imunológica, Instituto Nacional de Investigação em Saúde (National Institute for Health Research), Luanda, Angola
| | - Roselle De Guzman
- Oncology and Pain Management Section, Manila Central University-Filemon D. Tanchoco Medical Foundation Hospital, Caloocan City, Philippines
| | - Anupriya Paul
- Department of Mathematics and Statistics, Faculty of Science, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, India
| | | | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Vijay Triapthi
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering Sam Higginbottom University of Agriculture, Technology and Sciences Prayagraj, India
| | - Ravikant Tripathi
- Department Health Govt of India, Ministry of labor, New Delhi, India
| | - Amber Johns
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Cancer Division, Sydney, Australia
| | - Mohan P Singh
- Center of Biotechnology, University of Allahabad, Allahabad, India
| | - Maude E Phipps
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - France Dube
- Astra Zeneca, Concord Pike, Wilmington, DE, USA
| | | | - Marta Kozaric
- European Alliance for Personalised Medicine, Brussels, Belgium
| | - Joseph A Pinto
- Center for Basic and Translational Research, Auna Ideas, Lima, Peru
| | | | | | - Ricardo Fujita Alarcon
- Centro de Genética y Biología Molecular, Universidad de San Martín de Porres, Lima, Perú
| | - Hugo A Barrera-Saldana
- Innbiogem SC/Vitagenesis SA at National Laboratory for Services of Research, Development, and Innovation for the Pharma and Biotech Industries (LANSEIDI) of CONACyT Vitaxentrum Group, Monterrey, Mexico
- Schools of Medicine and Biology, Autonomous University of Nuevo Leon, Monterrey, Mexico
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12
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Giannoni-Luza S, Acosta O, Murillo Carrasco AG, Danos P, Cotrina Concha JM, Miller HG, Pinto JA, Aguilar A, Araujo JM, Fujita R, Buleje J. Chip-based digital Polymerase Chain Reaction as quantitative technique for the detection of PIK3CA mutations in breast cancer patients. Heliyon 2022; 8:e11396. [DOI: 10.1016/j.heliyon.2022.e11396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/15/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
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13
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Horgan D, Mia R, Erhabor T, Hamdi Y, Dandara C, Lal JA, Domgue JF, Ewumi O, Nyawira T, Meyer S, Kondji D, Francisco NM, Ikeda S, Chuah C, De Guzman R, Paul A, Reddy Nallamalla K, Park WY, Tripathi V, Tripathi R, Johns A, Singh MP, Phipps ME, Dube F, Whittaker K, Mukherji D, Rasheed HMA, Kozaric M, Pinto JA, Doral Stefani S, Augustovski F, Aponte Rueda ME, Fujita Alarcon R, Barrera-Saldana HA. Fighting Cancer around the World: A Framework for Action. Healthcare (Basel) 2022; 10:2125. [PMID: 36360466 PMCID: PMC9690702 DOI: 10.3390/healthcare10112125] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 09/05/2023] Open
Abstract
Tackling cancer is a major challenge right on the global level. Europe is only the tip of an iceberg of cancer around the world. Prosperous developed countries share the same problems besetting Europe-and the countries and regions with fewer resources and less propitious conditions are in many cases struggling often heroically against a growing tide of disease. This paper offers a view on these geographically wider, but essentially similar, challenges, and on the prospects for and barriers to better results in this ceaseless battle. A series of panels have been organized by the European Alliance for Personalised Medicine (EAPM) to identify different aspects of cancer care around the globe. There is significant diversity in key issues such as NGS, RWE, molecular diagnostics, and reimbursement in different regions. In all, it leads to disparities in access and diagnostics, patients' engagement, and efforts for a better understanding of cancer.
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Affiliation(s)
- Denis Horgan
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Rizwana Mia
- Grants, Innovation & Product Development, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town 7505, South Africa
| | - Tosan Erhabor
- Medical Laboratory Science Council of Nigeria (MLSCN), Durumi, Abuja 900110, Nigeria
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
- Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, Tunis 1002, Tunisia
| | - Collet Dandara
- Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Jonathan A. Lal
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
- Institute for Public Health Genomics, Department of Genetics and Cell Biology, GROW School of Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Joel Fokom Domgue
- Departments of Epidemiology, and Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX 77030, USA
- Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde VF7W+4M9, Cameroon
| | - Oladimeji Ewumi
- Freelance Health Care, Life Sciences, Medical Artificial Intelligence Content Writer, Lagos 100253, Nigeria
| | - Teresia Nyawira
- National Commission for Science, Technology and Innovation in Kenya (NACOSTI), Nairobi 00100, Kenya
| | | | - Dominique Kondji
- Health & Development Communication, Building Capacities for Better Health in Africa, Yaounde P.O. Box 2032, Cameroon
| | - Ngiambudulu M. Francisco
- Grupo de Investigação Microbiana e Imunológica, Instituto Nacional de Investigação em Saúde (National Institute for Health Research), Luanda 3635, Angola
| | - Sadakatsu Ikeda
- Department of Precision Cancer Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Chai Chuah
- Singularity University, P.O. Box 165, Gold Coast, QLD 4227, Australia
| | - Roselle De Guzman
- Oncology and Pain Management Section, Manila Central University–Filemon D. Tanchoco Medical Foundation Hospital, Caloocan 1400, Philippines
| | - Anupriya Paul
- Department of Mathematics and Statistics, Faculty of Science, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | | | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Centre, Sungkyunkwan University, Seoul 06351, Korea
| | - Vijay Tripathi
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Ravikant Tripathi
- Ministry of Labor, Health Department Government of India, New Delhi 110001, India
| | - Amber Johns
- Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Cancer Division, Sydney, NSW 2010, Australia
| | - Mohan P. Singh
- Centre of Biotechnology, University of Allahabad, Allahabad 211002, India
| | - Maude E. Phipps
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - France Dube
- Astra Zeneca, 1800 Concord Pike, Wilmington, DE 19803, USA
| | | | - Deborah Mukherji
- Global Health Institute, American University of Beirut, Beirut VFXP+7QF, Lebanon
- Department of Hematology/Oncology, American University of Beirut Medical Centre, Beirut P.O. Box 11-0236, Lebanon
| | | | - Marta Kozaric
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
| | - Joseph A. Pinto
- Centre for Basic and Translational Research, Auna Ideas, Lima 15036, Peru
| | | | - Federico Augustovski
- Health Technology Assessment and Health Economics, Department of the Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires C1056ABH, Argentina
| | | | - Ricardo Fujita Alarcon
- Centro de Genética y Biología Molecular, Universidad de San Martín de Porres, Lima 15024, Peru
| | - Hugo A. Barrera-Saldana
- Innbiogem SC/Vitagenesis SA at National Laboratory for Services of Research, Development, and Innovation for the Pharma and Biotech Industries (LANSEIDI) of CONACyT Vitaxentrum Group, Monterrey 64630, Mexico
- Schools of Medicine and Biology, Autonomous University of Nuevo Leon, Monterrey 66451, Mexico
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14
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Ruiz R, Galvez-Nino M, Roque K, Montes J, Nuñez M, Raez L, Sánchez-Gambetta S, Jaúregui S, Viale S, Smith ES, Pinto JA, Mas L. Genomic landscape of the lung cancer in the young. Front Oncol 2022; 12:910117. [PMID: 36263208 PMCID: PMC9575317 DOI: 10.3389/fonc.2022.910117] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/02/2022] [Indexed: 12/04/2022] Open
Abstract
Background Lung cancer in the young is a rare entity of great interest due to the high frequency of targetable mutations. In this study, we explored the genomic landscape of non-small cell lung cancer (NSCLC) in young patients and compared it with genetic alterations in older patients. Methods Comparative study of the genomic profile of NSCLC young (≤40 years old) vs older patients (>40 years old) from Instituto Nacional de Enfermedades Neoplásicas (INEN) in Lima, Peru. Archival paraffin-embedded tumor samples were profiled with FoundationOne CDx assay to identify short variants alterations (insertions and deletions), copy number variations (CNV), tumor mutational burden and microsatellite instability in 324 driver genes and rearrangements in 28 commonly rearranged genes. A targetable alteration was defined as any alteration in a driver oncogene for which an FDA approved therapy existed at the time of study enrollment. Results Overall, 62 tumors were profiled, 32 from young and 30 from older patients. All clinicopathological features (smoking status, clinical stage, and histology) were similar between groups, except for gender (65.6% of females in the younger group vs 40% in the older group, P=0.043). At least one actionable mutation was present in 84.4% and 83.3% in younger and older patients, respectively. Alteration rates in the main genes were: BRAF, 3.1%(n=1) vs 0%; EGFR, 46.9% (n=15) vs 43.3% (n=13); ERBB2, 12.5% (n=4) vs 16.7% (n=5); KRAS, 15.6% (n=5) vs 16.7% (n=5); ALK, 6.3% (n=2) vs 3.3% (n=1); RET, 0.0% vs 3.3% (n=1); ROS1, 3.1% (n=1) vs 3.3% (n=1); NTRK1, 0.0% vs 3.3% (n=1) and MET, 3.1% (n=1) vs 13.3% (n=4). Mean TMB was 4.04 Mut/Mb (SD ± 3.98) for young vs 8.06 Mut/Mb (SD ± 9.84) for older patients (P=0.016). There were not significant differences in CNV, frequency of gene rearrangements, or microsatellites instability. Conclusion NSCLC in the young in our cohort was characterized by a high frequency of actionable genetic aberrations and a low TMB, which was also true for our older patients. The enrichment of actionable mutations in young patients described in other reports might be attributed to differences in the etiology and clinicopathological characteristics between younger and older patients and therefore not be applicable to all populations.
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Affiliation(s)
- Rossana Ruiz
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Marco Galvez-Nino
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Katia Roque
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Jaime Montes
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Maria Nuñez
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Luis Raez
- Departamento de Patología, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Sergio Sánchez-Gambetta
- Memorial Cancer Institute/ Memorial Health Care System, Florida International University (FIU), Miami, FL, United States
| | - Sandra Jaúregui
- Memorial Cancer Institute/ Memorial Health Care System, Florida International University (FIU), Miami, FL, United States
| | - Sandra Viale
- Memorial Cancer Institute/ Memorial Health Care System, Florida International University (FIU), Miami, FL, United States
| | - Edward S. Smith
- Memorial Cancer Institute/ Memorial Health Care System, Florida International University (FIU), Miami, FL, United States
| | - Joseph A. Pinto
- Roche Farma, Lima, Peru
- Centro de Investigación Básica y Traslacional, Auna Ideas, Lima, Peru
- *Correspondence: Joseph A. Pinto,
| | - Luis Mas
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, 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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Zanabria D, Galvez-Nino M, Cho CE, Fajardo W, Saravia L, Araujo J, Alfaro A, Quispe L, Cornejo M, Medina P, Carbajal J, Montenegro P, Zevallos A, Aguilar A, Pinto JA. Abstract 3673: Socioeconomic disparities and the genomic landscape of gastric cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3673] [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: Gastric cancer is a malignancy of diverse etiology and exposition to risk factors may vary in distinct socioeconomic (SE) groups. Our aim was to compare the landscape of genomic alterations in malignant gastric tumors between different socioeconomic groups in Peru.
Methods: We conducted a preliminary prospective study in one private clinic and two public hospitals in Lima and Ica (Peru). We evaluated 20 patients with gastric carcinomas, 10 of which were classified as low SE status (LSE) and 10 as medium/high SE status (MHSE), according to the Peruvian Association of Market Intelligence Companies (APEIM) classification system. We conducted a comprehensive genomic profiling of gastric tumors with the FoundationOne CDx platform. We compared rates of alterations in single nucleotide variants, copy number variations, tumor mutation burden, microsatellite instability, and pathways altered.
Results: In our cohort, the mean age at diagnosis was 67.5 yo vs 61 yo, while 40% vs 55.6% were male patients, for LSE vs MHSE, respectively. We found alterations in driver genes in 19 patients (10 LSE and 9 MHSE). Histological analysis of the tumor samples revealed a higher proportion of intestinal histology in the LSE group (80%) compared to MHSE (55.6%). On the other hand, the diffuse subtype pattern was more prevalent in the MHSE group (33%) compared to LSE (20%). One case of mixed histology was observed in the high SE group. Both LSE and HMSE showed a similar distribution of Bormann Classification/type, where most of the samples were of class III/IV (75%) followed by class I/II (25%). Furthermore, genomic profiling analysis showed 45 driver alterations in LSE, while only 25 alterations were detected in MHSE. the most frequently altered genes were TP53 and KRAS in both SE groups, but with a higher incidence in LSE (60% and 20%, respectively). Components of the MAPK pathway were altered in 50% vs 33.3%, while the DNA repair pathway was altered in 20% vs 11%, in LSE vs MHSE, respectively. The PI3K/Akt pathway was altered in only one case of LSE. Median of tumor mutation burden was 6.1Mut/Mb in LSE vs 5.3Mut/Mb MHSE. Only one case with microsatellite instability was found in LSE.
Conclusions: Despite the limitations of this preliminary study, we observed some differences in the genomic background between patients from different socioeconomic groups. Therefore, the need of a thorough diagnosis approach that leads to the use of a comprehensive treatment that includes targeted therapy and immunotherapy could be different based on the SE status of the patient. Further research on this topic will be necessary.
Citation Format: Daniel Zanabria, Marco Galvez-Nino, Cristina Eunbee Cho, Williams Fajardo, Luis Saravia, Jhajaira Araujo, Alejandro Alfaro, Lidia Quispe, Melanie Cornejo, Paula Medina, Junior Carbajal, Paola Montenegro, Alejandra Zevallos, Alfredo Aguilar, Joseph A. Pinto. Socioeconomic disparities and the genomic landscape of gastric cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3673.
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Colonio C, Lecman L, Pinto JA, Vallejos C, Pinillos L. Life expectancy and cancer survival in Oncosalud: outcomes over a 15-year period in a Peruvian private institution. Ecancermedicalscience 2022; 15:1336. [PMID: 35211205 PMCID: PMC8816511 DOI: 10.3332/ecancer.2021.1336] [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: 06/12/2021] [Indexed: 11/06/2022] Open
Abstract
Background There is a large gap in the data on cancer outcomes in Latin America, making it difficult to establish adequate cancer control policies in the region. The aim of our study was to describe the survival, life expectancy estimates and life expectancy changes over time for a large cohort of Peruvian patients insured with Oncosalud, a private healthcare system. Patients and methods We evaluated a retrospective cohort of patients diagnosed between 2000 and 2015 in Oncosalud (Lima-Peru). Cases included colon, rectum, stomach, bladder, breast, prostate and non-melanoma skin cancers. Survival was evaluated with the Kaplan–Meier methodology. The standard period life table was used to estimate the excess mortality risks of patients in our cohort compared to the population covered by the Peruvian Superintendence of Banks, Insurance Companies and Pension Funds (SBS). The years of life lost was estimated based on SBS population, matching patients by age and sex. Results A large cohort of 7,687 Peruvian cancer patients managed in a 15-year period was eligible. If patients survive 5 years after a cancer diagnosis, life expectancy tends to be close to that of a population without cancer. The number of years of life lost at diagnosis was higher at the youngest ages, steadily decreasing thereafter. During the first years after cancer diagnosis, young patients face a much higher loss in life expectancy than older ones. Patients suffering from colon, rectum, stomach and bladder cancer are the most affected by the years of life lost. Conclusion In cancer patients surviving ≥ 5 years, life expectancy becomes similar to that observed in a population with similar socioeconomic characteristics. The estimated survival rate in our cohort is higher than that reported by public cancer registries in Peru. This could be explained by the different socio-economic background and access to specialised cancer care.
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Affiliation(s)
| | | | - Joseph A Pinto
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
| | - Carlos Vallejos
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
| | - Luis Pinillos
- Departamento de Radioterapia, Oncosalud-AUNA, Lima 15036, Peru
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Pinto JA, Ferreyra Y, Cock-Rada AM, Doimi F, Casas J, Araujo J, Rosas G, Bravo L, Belmar-López C. Abstract P3-12-24: Landscape of germline BRCA 1 and BRCA 2 mutations in breast cancer in Peru. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p3-12-24] [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 (BC) is the most common cancer and the second leading cause of cancer-related deaths worldwide. Mutations in tumor suppressor genes BRCA1 and BRCA2 are the most common cause of hereditary breast and ovarian cancer. Additionally, carriers of germline BRCA1/2 mutations also have an elevated risk of other malignancies. Identification of mutations within these genes is essential for determining early cancer detection and risk-reducing strategies in carriers and establishing a therapeutic approach in breast cancer patients. The aims of this study were to evaluate the prevalence and spectrumof germline BRCA1 and BRCA2 variants in peruvian breast cancer patients. METHODS: Patients with HER2Neu negative BC referred to ONCOGENOMICS laboratory from 2019 to2021 to assessed poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor treatment were included in the study. Blood samples were collected to assess the status of germline BRCA1 and BRCA2. Next Generation Sequencing (NGS) was performed using the Ampliseq for Illumina BRCA panel and run on the Illumina MiSeq. The Human Genome Variation Society (HGVS) nomenclature guidelines (http://varnomen.hgvs.org/) were used to annotate identified variants and the ClinVar database (www.ncbi.nlm.nih.gov/clinvar/) was used to determine the clinical significance of all reported variants. Current American College of Medical Genetics (ACMG) guidelines were also used for further classification. RESULTS: A total of 155 HER2Neu negative BC cases were evaluated. Median age at BRCA1/2 evaluation was 51 (23-82) years, 78.1% (121) were negative HR status (triple-negative BC, TNBC); 21.9% (34) were positive HR status; 33.5% (52) were clinical stage III and 66.5% (103) were clinical stage IV. Most patients were from Lima-Callao (65.8%) followed by patients from the coast (23.9%), highlands (9%) and rainforest(1.3%). Only 18.7% of patients were from public health centers. The prevalence of pathogenic (P) and likely pathogenic (LP) variants in BRCA1/2 was 13.5% (21) (13 in BRCA1 and 8 in BRCA2). The pathogenic variant in BRCA1 c.2105dupT (p.Leu702Phefs*10) was found in 3 cases (2 Lima-Callao and 1 coast). All variants identified in BRCA1 were in TNBC. In BRCA2, half of pathogenic variants were found in TNBC. The prevalence of variants of uncertain significance (VUS) was 6.4% (10). In BRCA2, we identified 7 VUS and the variant c.5465A>T (p.Asn1822Ile) was found in 3 cases with positive HR status. Only one VUS was found in BRCA1. CONCLUSION: BRCA1 and BRCA2 germline mutations were identified in 13.5% of peruvian HER2Neu negative BC patients. A higher rate of P/LP variants was found in BRCA1. TNBC patients demostrated a higher prevalence in BRCA1 variants.
Citation Format: Joseph A Pinto, Yomali Ferreyra, Alicia M Cock-Rada, Franco Doimi, Jhoysi Casas, Jhajaira Araujo, Gina Rosas, Leny Bravo, Carolina Belmar-López. Landscape of germline BRCA1 and BRCA2 mutations in breast cancer in Peru [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-24.
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Affiliation(s)
- Joseph A Pinto
- Centro de Investigacion Básica y Traslacional, AUNA Ideas, Lima, Peru
| | | | | | | | | | - Jhajaira Araujo
- Centro de Investigacion Básica y Traslacional, AUNA Ideas, Lima, Peru
| | - Gina Rosas
- Instituto Nacional de Enfermedades Neoplásicas, INEN, Lima, Peru
| | - Leny Bravo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Carolina Belmar-López
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
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Pinto JA, Araujo JM, Gómez HL. Sex, immunity, and cancer. Biochim Biophys Acta Rev Cancer 2021; 1877:188647. [PMID: 34767966 DOI: 10.1016/j.bbcan.2021.188647] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 02/07/2023]
Abstract
The composition of the tumor microenvironment is the complex result of the interaction between tumoral and host factors. Since there are several differences in the regulation of gene circuits between sexes, mainly influenced by sex hormones, the tumor-host interaction presents some differences, leading tumors to evolve under different conditions. Nowadays, it is well known the existence of sexual dimorphism in the regulation of the immune system, where women present an improved immunity to various infectious agents and, on the other hand, a higher incidence of autoimmune diseases than men. In oncology, differences in cancer susceptibility, response to treatment, and clinical outcomes between men and women patients are well known. Recently, sex-specific differences have also been reported in mutations in driver genes and the prognostic value of several biomarkers. Sex has been a widely forgotten biomarker in cancer therapy, but it has recently acquired great relevance due to the different results seen in immunotherapy treatment.
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Affiliation(s)
- Joseph A Pinto
- Escuela de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Panamericana Sur Km. 305, 11004 Ica, Peru.
| | - Jhajaira M Araujo
- Centro de Investigación Básica y Traslacional, AUNA-Ideas, Guardia Civil 571, San Borja, Lima 41, Peru
| | - Henry L Gómez
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este 2520, Surquillo, Lima 34, Peru
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Araujo JM, Rosas G, Belmar-López C, Raez LE, Rolfo CD, Schwarz LJ, Infante-Huaytalla U, Paez KJ, García LR, Alvarado H, Ramos FP, Delgado-Espinoza SS, Cardenas-Farfan JB, Cornejo M, Zanabria D, Colonio-Cossio C, Rojas-Jefferson M, Pinto JA. Influence of Sex in the Molecular Characteristics and Outcomes of Malignant Tumors. Front Oncol 2021; 11:752918. [PMID: 34737960 PMCID: PMC8562721 DOI: 10.3389/fonc.2021.752918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/03/2021] [Accepted: 09/29/2021] [Indexed: 01/22/2023] Open
Abstract
Background Sex is frequently underestimated as a prognostic biomarker in cancer. In this study, we evaluated a large cohort of patients and public datasets to determine the influence of sex on clinical outcomes, mutational status, and activation of immune pathways in different types of cancer. Methods A cohort of 13,619 Oncosalud-affiliated patients bearing sex-unrelated cancers was followed over a 20-year period. Hazard ratios (HRs) for death were estimated for female vs. male patients for each cancer type and then pooled in a meta-analysis to obtain an overall HR. In addition, the mutational status of the main actionable genes in melanoma (MEL), colorectal cancer (CRC), and lung cancer was compared between sexes. Finally, a gene set enrichment analysis (GSEA) of publicly available data was conducted, to assess differences in immune processes between sexes in MEL, gastric adenocarcinoma (GC), head and neck cancer (HNC), colon cancer (CC), liver cancer (LC), pancreatic cancer (PC), thyroid cancer (TC), and clear renal cell carcinoma (CCRCC). Results Overall, women had a decreased risk of death (HR = 0.73, CI95: 8%-42%), with improved overall survival (OS) in HNC, leukemia, lung cancer, lymphoma, MEL, multiple myeloma (MM), and non-melanoma skin cancer. Regarding the analysis of actionable mutations, only differences in EGFR alterations were observed (27.7% for men vs. 34.4% for women, p = 0.035). The number of differentially activated immune processes was higher in women with HNC, LC, CC, GC, MEL, PC, and TC and included cellular processes, responses to different stimuli, immune system development, immune response activation, multiorganism processes, and localization of immune cells. Only in CCRCC was a higher activation of immune pathways observed in men. Conclusions The study shows an improved survival rate, increased activation of immune system pathways, and an enrichment of EGFR alterations in female patients of our cohort. Enhancement of the immune response in female cancer patients is a phenomenon that should be further explored to improve the efficacy of immunotherapy.
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Affiliation(s)
- Jhajaira M Araujo
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima, Peru.,Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Gina Rosas
- Departamento de Patología, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Carolina Belmar-López
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru.,Departamento de Genómica, Oncogenomics, Lima, Peru
| | - Luis E Raez
- Memorial Cancer Institute/Memorial Health Care System, Florida International University (FIU), Pembroke Pines, FL, United States
| | - Christian D Rolfo
- Center for Thoracic Oncology/Tisch Cancer Institute, Mount Sinai, New York, NY, United States
| | - Luis J Schwarz
- Escuela Profesional de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | | | - Kevin J Paez
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Luis R García
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Hober Alvarado
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Fany P Ramos
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | | | - Jhon B Cardenas-Farfan
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Melanie Cornejo
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima, Peru
| | | | | | | | - Joseph A Pinto
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima, Peru
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Posada-Arango AM, García-Madrigal J, Echeverri-Isaza S, Alberto-Castrillón G, Martínez D, Gómez AC, Pinto JA, Pinillos L. Thrombosis in abdominal vessels associated with COVID-19 Infection: A report of three cases. Radiol Case Rep 2021; 16:3044-3050. [PMID: 34306276 PMCID: PMC8286875 DOI: 10.1016/j.radcr.2021.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/07/2021] [Accepted: 07/10/2021] [Indexed: 01/08/2023] Open
Abstract
Hypercoagulability related to SARS-CoV-2 infection is one of the main extrapulmonary complications of COVID-19. We present three cases of intrabdominal thrombotic complications related to the state of hypercoagulability of COVID-19 and its tomographic features. Hypercoagulability state should be taking into account in the interpretation of radiological images in all infected patients with COVID-19.
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Affiliation(s)
- Ana María Posada-Arango
- Department of Radiology, Oncosalud- AUNA, Peru Ave. Guardia Civil N 227, San Borja, Lima, Peru
| | - Joaquín García-Madrigal
- Department of Radiology, Clinic Las Americas, Medellin, Colombia.,Department of Radiology, Clinic el Rosario, Medellin, Colombia
| | - Santiago Echeverri-Isaza
- Department of Radiology, Clinical Interventionist Las Americas and Hospital Pablo Tobon Uribe, Medellin, Colombia
| | | | - David Martínez
- Department of Radiooncology, Oncosalud- AUNA, Lima, Peru
| | - Andrea C Gómez
- Basic and Translational Research Center, AUNA Ideas, Lima, Peru
| | - Joseph A Pinto
- Basic and Translational Research Center, AUNA Ideas, Lima, Peru
| | - Luis Pinillos
- Department of Radiology, Oncosalud- AUNA, Peru Ave. Guardia Civil N 227, San Borja, Lima, Peru
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Payet E, Perez J, Sarria G, Neciosup S, Berrospi F, Vilchez S, Dunstan J, Perez R, Vassallo M, Salgado S, Caparachín N, Pinto JA, Holguin A. Characteristics of COVID-19 in cancer patients: a cross-sectional study in Peru. Ecancermedicalscience 2021; 15:1246. [PMID: 34267802 PMCID: PMC8241454 DOI: 10.3332/ecancer.2021.1246] [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: 11/26/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cancer patients are at higher risk of infection and severity of Coronavirus Disease-19 (COVID-19). Management of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is challenging due to the scarce scientific information and treatment guidelines. In this work, we present our Institutional experience with our first 100 patients with oncological malignancies and COVID-19. PATIENTS AND METHODS We conducted a cross-sectional study of the first 100 patients hospitalised at the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru) who were positive for SARS-CoV-2 by reverse transcriptase (RT)-PCR during the period 30 March to 20 June. Clinicopathological variables of the oncological disease as well as risk factors, management and outcomes to COVID-19 were evaluated. RESULTS The mean age was 43.5 years old (standard deviations: ±24.8) where 57% were male patients. In total, 44%, 37% and 19% were adult patients bearing solid tumours, adults with haematologic malignancies and paediatric patients, respectively. Hypertension was the most frequent comorbidity (23%) followed by chronic lung disease (10%). COVID-19-associated symptoms included cough (65%), fever (57%) and dyspnoea (56%). Twelve percent of patients were asymptomatic. Nosocomial infections were more frequent in paediatric patients (84.2%) than in adult patients (16.0%). Patients with uncontrolled oncological disease were most frequent (72%). Anaemia was present in 67% of patients, 68% had lymphopenia, 62% had ferritin value > 500 mcg/L, 85% had elevated lactate dehydrogenase (LDH), 83% D-dimer > 500 ng/mL and 80% C-Reactive Protein > 8 mg/L. The most common complication was acute respiratory failure (42%). Overall fatality rate was 39% where the main cause of mortality was acute respiratory distress syndrome (64.1%). CONCLUSION Paediatric patients had better outcomes than adult populations, and a high number of asymptomatic carriers and nosocomial infection, early diagnosis are recommended. Considering oncological treatments 30 days before COVID-19 diagnosis, our data did not reveal an increased mortality.
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Affiliation(s)
- Eduardo Payet
- Departamento de Cirugía en Abdomen, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Joan Perez
- Departamento de Cirugía Ginecológica, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Gustavo Sarria
- Departamento de Radioterapia, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Silvia Neciosup
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Francisco Berrospi
- Departamento de Cirugía en Abdomen, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Sheila Vilchez
- Departamento de Cirugía en Mamas y Tejidos Blandos, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Jorge Dunstan
- Departamento de Cirugía en Mamas y Tejidos Blandos, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Ronald Perez
- Departamento de Medicina Crítica, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Mauricio Vassallo
- Escuela Profesional de Medicina, Universidad Peruana de Ciencias Aplicadas, Av Prolongación Primavera 2390, Lima 15023, Peru
| | - Santiago Salgado
- Escuela Profesional de Medicina, Universidad Peruana de Ciencias Aplicadas, Av Prolongación Primavera 2390, Lima 15023, Peru
| | - Nanto Caparachín
- Unidad de Gestión de Riesgos y Seguridad del Paciente, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
| | - Joseph A Pinto
- Escuela Profesional de Medicina Humana, Filial Ica, Universidad Privada San Juan Bautista, Carretera Panamericana Sur Km 300, Ica, 11004, Peru
| | - Alexis Holguin
- Departamento de Infectología, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru
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Murillo Carrasco A, Acosta O, Ponce J, Cotrina J, Aguilar A, Araujo J, Rebaza P, Pinto JA, Fujita R, Buleje J. PUM1 and RNase P genes as potential cell-free DNA markers in breast cancer. J Clin Lab Anal 2021; 35:e23720. [PMID: 33522650 PMCID: PMC8059717 DOI: 10.1002/jcla.23720] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cell-free DNA (cfDNA) is used in clinical research to identify biomarkers for diagnosis of and follow-up on cancer. Here, we propose a fast and innovative approach using traditional housekeeping genes as cfDNA targets in a copy number analysis. We focus on the application of highly sensitive technology such as digital PCR (dPCR) to differentiate breast cancer (BC) patients and controls by quantifying regions of PUM1 and RPPH1 (RNase P) in plasma samples. METHODS We conducted a case-control study with 82 BC patients and 82 healthy women. cfDNA was isolated from plasma using magnetic beads and quantified by spectrophotometry to estimate total cfDNA. Then, both PUM1 and RPPH1 genes were specifically quantified by dPCR. Data analysis was calibrated using a reference genomic DNA in different concentrations. RESULTS We found RNase P and PUM1 values were correlated in the patient group (intraclass correlation coefficient [ICC] = 0.842), but they did not have any correlation in healthy women (ICC = 0.519). In dPCR quantification, PUM1 showed the capacity to distinguish early-stage patients and controls with good specificity (98.67%) and sensitivity (100%). Conversely, RNase P had lower cfDNA levels in triple-negative BC patients than luminal subtypes (p < 0.025 for both), confirming their utility for patient classification. CONCLUSION We propose the PUM1 gene as a cfDNA marker for early diagnosis of BC and RNase P as a cfDNA marker related to hormonal status and subtype classification in BC. Further studies with larger sample sizes are warranted.
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Affiliation(s)
- Alexis Murillo Carrasco
- Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Instituto de Investigación, Universidad de San Martín de Porres, Lima, Perú
| | - Oscar Acosta
- Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Instituto de Investigación, Universidad de San Martín de Porres, Lima, Perú.,Facultad de Farmacia y Bioquímica, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Jaime Ponce
- Oncosalud-AUNA, Unidad de la Mama, Lima, Perú
| | - José Cotrina
- Departamento de Cirugía de Mamas, Instituto Nacional de Enfermedades Neoplásicas-INEN, Lima, Perú
| | - Alfredo Aguilar
- Oncosalud-AUNA, Unidad de Investigación Básica y Traslacional, Lima, Perú
| | - Jhajaira Araujo
- Oncosalud-AUNA, Unidad de Investigación Básica y Traslacional, Lima, Perú
| | | | - Joseph A Pinto
- Oncosalud-AUNA, Unidad de Investigación Básica y Traslacional, Lima, Perú
| | - Ricardo Fujita
- Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Instituto de Investigación, Universidad de San Martín de Porres, Lima, Perú
| | - José Buleje
- Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Instituto de Investigación, Universidad de San Martín de Porres, Lima, Perú
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24
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Montenegro P, Pinillos L, Young F, Aguilar A, Tirado-Hurtado I, Pinto JA, Vallejos C. Telemedicine and the current opportunities for the management of oncological patients in Peru in the context of COVID-19 pandemic. Crit Rev Oncol Hematol 2021; 157:103129. [PMID: 33227573 PMCID: PMC7581359 DOI: 10.1016/j.critrevonc.2020.103129] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 12/29/2022] Open
Abstract
COVID-19 pandemic is the more challenging public health emergency of the century, producing the collapse of health systems and unprecedented levels of morbidity and mortality around the world, especially in low resource settings. Patients with chronic diseases are the most affected, not only due to the high susceptibility to SARS-CoV-2 infection but also due to the decrease in opportunities for timely care. In this dark landscape, telemedicine, before limited to very specific scenarios, has become one of our main tools to manage cancer patients, particularly in Latin America where COVID-19 has had a strong impact on the public health. Telemedicine can provide rapid access to specialized cancer care in a scenario complicated, reducing the exposure of patients and healthcare personnel to the SARS-CoV-2. In this review, we would like to share our experience and our workflow using telemedicine at Oncosalud-AUNA, a private clinic in Peru.
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Affiliation(s)
| | | | | | | | | | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, AUNA, Lima41, Peru
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25
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Torres-Roman JS, Martinez-Herrera JF, Carioli G, Ybaseta-Medina J, Valcarcel B, Pinto JA, Aguilar A, McGlynn KA, La Vecchia C. Breast cancer mortality trends in Peruvian women. BMC Cancer 2020; 20:1173. [PMID: 33261561 PMCID: PMC7706041 DOI: 10.1186/s12885-020-07671-x] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common malignancy in Latin American women, but with a wide variability with respect to their mortality. This study aims to estimate the mortality rates from BC in Peruvian women and to assess mortality trends over 15 years. METHODS We calculated BC age-standardized mortality rate (ASMR) per 100,000 women-years using the world standard SEGI population. We estimated joinpoint regression models for BC in Peru and its geographical areas. The spatial analysis was performed using the Moran's I statistic. RESULTS In a 15-year period, Peru had a mortality rate of 9.97 per 100,000 women-years. The coastal region had the highest mortality rate (12.15 per 100,000 women-years), followed by the highlands region (4.71 per 100,000 women-years). In 2003, the highest ASMR for BC were in the provinces of Lima, Arequipa, and La Libertad (above 8.0 per 100,000 women-years), whereas in 2017, the highest ASMR were in Tumbes, Callao, and Moquegua (above 13.0 per women-years). The mortality trend for BC has been declining in the coastal region since 2005 (APC = - 1.35, p < 0.05), whereas the highlands region experienced an upward trend throughout the study period (APC = 4.26, p < 0.05). The rainforest region had a stable trend. Spatial analysis showed a Local Indicator of Spatial Association of 0.26 (p < 0.05). CONCLUSION We found regional differences in the mortality trends over 15 years. Although the coastal region experienced a downward trend, the highlands had an upward mortality trend in the entire study period. It is necessary to implement tailored public health interventions to reduce BC mortality in Peru.
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Affiliation(s)
- J Smith Torres-Roman
- Universidad Cientifica del Sur, Lima, Peru. .,Instituto de Investigación, Universidad Católica Los Ángeles de Chimbote, Chimbote, Peru. .,Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru.
| | - Jose Fabian Martinez-Herrera
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru.,Cancer Center, Medical Center American British Cowdray, Mexico City, Mexico
| | - Greta Carioli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | | | - Bryan Valcarcel
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Alfredo Aguilar
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
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26
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Araujo JM, Gomez AC, Pinto JA, Rolfo C, Raez LE. Profile of entrectinib in the treatment of ROS1-positive non-small cell lung cancer: Evidence to date. Hematol Oncol Stem Cell Ther 2020; 14:192-198. [PMID: 33290717 DOI: 10.1016/j.hemonc.2020.11.005] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022] Open
Abstract
ROS proto-oncogene 1 (ROS1) encodes a type I integral membrane protein with tyrosine kinase activity and whose activating alterations are involved in the aggressiveness of several tumor types. Fusions involving ROS1 gene are present in 1-2% of lung adenocarcinomas and other solid tumors. Entrectinib, also known as RXDX-101, is a potent second-generation, multitarget oral inhibitor against NTRK1, NTRK2, NTRK3, ALK, and ROS1 with the ability to cross the blood-brain barrier. Results of Phase I and II trials have led the Food and Drug Administration to grant approval to entrectinib for the treatment of patients with metastatic, ROS1-positive non-small cell lung cancer (NSCLC). In this review, we will describe the biology of ROS1, as well as results of the efficacy and safety of different clinical trials evaluating entrectinib in ROS1-positive NSCLC.
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Affiliation(s)
- Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Andrea C Gomez
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Christian Rolfo
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute/Memorial Health Care System, Florida International University, Miami, FL, USA.
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27
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Morante Z, Ruiz R, Araujo JM, Pinto JA, Cruz-Ku GDL, Urrunaga-Pastor D, Namuche F, Flores C, Mantilla R, Luján MG, Fuentes H, Schwarz L, Aguilar A, Neciosup S, Gómez HL. Impact of the Delayed Initiation of Adjuvant Chemotherapy in the Outcome of Triple Negative Breast Cancer. Clin Breast Cancer 2020; 21:239-246.e4. [PMID: 33221201 DOI: 10.1016/j.clbc.2020.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Received: 08/06/2020] [Accepted: 09/15/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Adjuvant chemotherapy decreases the recurrence risk and improves survival rates; however, it is unclear whether a delayed initiation is associated with adverse outcomes, especially in triple negative breast cancer (TNBC). In this study, we evaluated the influence of the time to start adjuvant chemotherapy (TTC) in the outcomes of TNBC. PATIENTS AND METHODS We retrospectively analyzed 15 years of data from patients with TNBC who received adjuvant chemotherapy at the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru). TTC was categorized into 4 groups: ≤ 30, 31 to 60, 61 to 90, and ≥ 91 days. We evaluated overall survival (OS) and distant recurrence-free survival (DRFS). Cox proportional hazard models were used to identify prognostic factors. RESULTS In total, 687 patients were included. The mean age at diagnosis was 49.1 years (SD, 11.8 years), and most (62.6%) patients had pathologic stage T2. The median TTC was 48.1 days (SD, 27.4 days); 189 (27.5%) received chemotherapy ≤ 30 days; 329 (47.9%), between 31 and 60 days; 115 (16.7%), between 61 and 90 days; and 54 (7.9%) in ≥ 90 days. In the multivariate analysis, a TTC between 31 and 60 days (hazard ratio [HR], 1.78; 95% confidence interval [CI], 1.17-2.72), 61 and 90 days (HR, 2.38; 95%CI, 1.43-3.97), and ≥ 91 days (HR, 2.45; 95% CI, 1.32-4.55) was associated with an increased mortality in contrast with a TTC < 30 days. Although a TTC between 31 and 60 days, 61 and 90 days, and ≥ 91 days was associated with an increased risk of DRFS (HR, 1.86; 95% CI, 1.24-2.79; HR, 2.34, 95% CI, 1.42-3.867; and HR, 3.16; 95% CI, 1.78-5.61, respectively). CONCLUSION A delaying in TTC ≥ 30 days was associated with poorer outcomes. Our data suggest that several efforts should be conducted to avoid a delayed TTC in patients with TNBC.
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Affiliation(s)
- Zaida Morante
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru; Grupo de Estudios Clínico Oncológicos Peruano (GECOPERU), Lima, Peru
| | - Rossana Ruiz
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | | | - Diego Urrunaga-Pastor
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru
| | - Fernando Namuche
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Claudio Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Raúl Mantilla
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - María G Luján
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Hugo Fuentes
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Luis Schwarz
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Alfredo Aguilar
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Silvia Neciosup
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Henry L Gómez
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Grupo de Estudios Clínico Oncológicos Peruano (GECOPERU), Lima, Peru.
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28
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Rentería ER, Céspedes P, Cerna K, Morante Z, Bazán E, Ausejo J, Fajardo W, Pinto JA. Epidemiologic Patterns of COVID-19 Incidence in the Province of Lima. Ann Epidemiol 2020; 54:27-28. [PMID: 33413888 PMCID: PMC7587072 DOI: 10.1016/j.annepidem.2020.09.018] [Citation(s) in RCA: 2] [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: 08/12/2020] [Revised: 08/28/2020] [Accepted: 09/10/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Edana R Rentería
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
| | - Pamela Céspedes
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
| | - Karla Cerna
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
| | | | - Elsi Bazán
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
| | - Jhon Ausejo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
| | - Williams Fajardo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
| | - Joseph A Pinto
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
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29
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Zevallos A, Bravo L, Bretel D, Paez K, Infante U, Cárdenas N, Alvarado H, Posada AM, Pinto JA. The hispanic landscape of triple negative breast cancer. Crit Rev Oncol Hematol 2020; 155:103094. [PMID: 33027724 DOI: 10.1016/j.critrevonc.2020.103094] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 10/18/2019] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is a heterogeneous and complex disease characterized by the absence of immunohistochemical expression of estrogen receptor, progesterone receptor and HER2. These breast tumors present an aggressive biology and offer few opportunities to be treated with targeted therapy resulting in bad disease outcomes. The epidemiology of TNBC is intriguing where the understanding of its biology has progressed quickly. One of the peculiarities of this type of cancer is a high prevalence in Afrodescendants and Hispanic patients compared to Caucasian women. In this review we describe some features of TNBC, focusing in the Hispanic population, such as epidemiological, clinicopathological features and molecular features and the correlation between TNBC prevalence and the human development index.
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Affiliation(s)
- Alejandra Zevallos
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Leny Bravo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos Peruano, GECOPERU, Lima, Peru
| | - Kevin Paez
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Ulises Infante
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Nadezhda Cárdenas
- Escuela de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | - Hober Alvarado
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | | | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud - AUNA, Lima, Peru.
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30
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Abstract
Introduction: ALK rearrangements are present in 2-7% of non-small cell lung cancer (NSCLC) cases, where the EML4-ALK fusion is the most frequent. Rearrangement of ALK with other fusion partners occurs only in ≈5% of NSCLC ALK-positive. These patients have benefited from ALK inhibitors, and currently, there are three generations of drugs as the standard of care. The first-generation ALK inhibitor crizotinib is approved in the front-line setting for the treatment of advanced NSCLC; unfortunately, these tumors may eventually develop resistance to this molecule. The Second-generation ALK inhibitors, ceritinib, alectinib, and brigatinib, are approved for patients recently diagnosed or in relapse. The third-generation inhibitor lorlatininb is approved for patients who have developed resistance to any ALK inhibitor.Areas covered: In this review, an unstructured search in Pubmed and SCOPUS was conducted. We summarized the mechanisms of resistance to ALK inhibitors and its consequences in the treatment-decision making in advanced or metastatic NSCLC after failure to a first-line ALK inhibitor.Expert opinion: Currently, there are a growing number of options of therapeutic agents against ALK+ NSCLC (approved and in development); however, adequate selection and sequencing of agents are crucial to deal with the tumor evolution.
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Affiliation(s)
- Joseph A Pinto
- Unidad De Investigación Básica Y Traslacional, Oncosalud-AUNA, Lima, Perú
| | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute/Memorial Health Care System, Florida International University, Miami, FL, USA
| | - Gelenis Domingo
- Thoracic Oncology Program, Memorial Cancer Institute/Memorial Health Care System, Florida International University, Miami, FL, USA
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31
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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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32
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Saravia CH, Flores C, Schwarz LJ, Bravo L, Zavaleta J, Araujo J, Neciosup S, Pinto JA. Patterns of Mutation Enrichment in Metastatic Triple-Negative Breast Cancer. Clin Med Insights Oncol 2019; 13:1179554919868482. [PMID: 31447598 PMCID: PMC6689917 DOI: 10.1177/1179554919868482] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 07/04/2019] [Indexed: 12/31/2022]
Abstract
Background: Triple-negative breast cancer (TNBC) is a heterogeneous disease with aggressive biology and complex tumor evolution. Our purpose was to identify enrichment patterns of genomic alterations in metastatic triple-negative breast cancer (mTNBC). Methods: Genomic data were retrieved (mutations and copy number variations) from 550 primary TNBC tumors from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) and The Cancer Genome Atlas (TCGA) data sets and 58 mTNBC tumors from “Mutational Profile of Metastatic Breast Cancers” and “The Metastatic Breast Cancer Project.” Statistical analysis of microarray data between primary and metastatic tumors was performed using a chi-square test, and the percentage of mutation enrichment in mTNBC cases was estimated. P-values were adjusted for multiple testing with Benjamini-Hochberg method with a false-discovery rate (FDR) <.05. In addition, we identified dominant hallmarks of cancer in mTNBC. Results: Seven genes with mutations were enriched in mTNBC after correcting for multiple testing. These included TTN, HMCN1, RELN, PKHD1L1, DMD, FRAS1, and RYR3. Only RPS6KB2 amplification was statistically significant in mTNBC; on the contrary, deletion of the genes TET1, RHOA, EPHA5, SET, KCNJ5, ABCG4, NKX3-1, SDHB, IGF2, and BRCA1 were the most frequent. The molecular alterations related to the hallmark of “genetic instability and mutation” were predominant in mTNBC. Interestingly, the hallmark of “activating immune destruction” was the least represented in mTNBC. Conclusion: Despite the study limitations, we identified recurrent patterns of genomic alterations with potential contribution to tumor evolution. Deletions were the aberrations more commonly found in mTNBC. Several molecular alterations are potentially targetable.
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Affiliation(s)
- César H Saravia
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Claudio Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Perú
| | - Luis J Schwarz
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Perú
| | - Leny Bravo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Jenny Zavaleta
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Jhajaira Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Perú
| | - Silvia Neciosup
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Perú
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Perú
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Araujo JM, Raez LE, Rolfo CD, Schwarz LJ, Infante-Huaytalla U, Paez KJ, García LR, Alvarado H, Ramos FP, Delgado-Espinoza SS, Cardenas-Farfan JB, Barboza-Meca JJ, Caballero-Alvarado J, Pinto JA. Abstract 1518: Gene expression profile and gender differences related with immune processes in solid tumors. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1518] [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: We have described before differences in gene expression profile (GEP) of immune gene-sets between genders in non-small cell lung cancers (NSCLC). On the other hand, there are reports mentioning the benefit of immune checkpoint inhibitors (ICI) could be influenced by gender, suggesting differences in immune processes (IP). We decided to evaluate if there are gender-specific differences in solid tumors including melanoma, gastric adenocarcinomas (GAC), head and neck cancer (HNC) and clear renal cell carcinoma (CCRCC).
Methods: GEO (https://www.ncbi.nlm.nih.gov/geo/) datasets were retrieved and analyzed for melanoma, GAC, HNC and CCRCC that contained GEP across Affymetrix and Illumina Microarrays of primary tumors. Datasets were manually verified and cases without gender information or non-tumoral tissue were excluded. Cell lines were not considered in our analysis. Data was pre-processed and gene-set enrichment analysis (GSEA) was conducted individually in the datasets GSE6791, GSE30784, GSE78060, GSE34105, GSE65858 (HNC); GSE73731, GSE36895, GSE11904, GSE40435 (CCRCC); GSE26899, GSE26901 (GAC) and GSE15605 (melanoma). Immune process (IP) grouped by gene ontology and identified with a p-value<0.05 and a FDR<25% were considered enriched.
Results: The number of IP enriched in women was higher than men in HNC (306 IP), GAC (297 IP) followed by melanoma (128 IP) and CCRCC (30 IP). Pathways significantly enriched in women in the four evaluated malignancies were: activation of immune response, activation of innate immune response, antigen receptor mediated signaling pathway, immune response regulating cell surface receptor signaling pathway, positive regulation of innate immune response, regulation of innate immune response and T cell receptor signaling pathway. In contrast to other cancers, only CCRCC showed enrichment of immune gene sets in males.
Conclusions: We find strong patterns of GEP of immune genes in tumors from female patients, suggesting gender-specific patterns of response to ICI. This pool of immune genes differentially expressed could be used as candidate biomarkers for prediction of response to immunotherapy.
Citation Format: Jhajaira M. Araujo, Luis E. Raez, Christian D. Rolfo, Luis J. Schwarz, Ulises Infante-Huaytalla, Kevin J. Paez, Luis R. García, Hober Alvarado, Fany P. Ramos, Sheyla S. Delgado-Espinoza, Jhon B. Cardenas-Farfan, Joshuan J. Barboza-Meca, Jose Caballero-Alvarado, Joseph A. Pinto. Gene expression profile and gender differences related with immune processes in solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1518.
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Affiliation(s)
| | - Luis E. Raez
- 2Memorial Cancer Institute/Memorial Health Care System, Florida International University (FIU), FL
| | - Christian D. Rolfo
- 3University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, MD
| | | | | | - Kevin J. Paez
- 4Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Luis R. García
- 4Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Hober Alvarado
- 4Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Fany P. Ramos
- 4Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
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Saravia CH, Flores CJ, Schwarz LJ, Bravo L, Zavaleta J, Araujo JM, Neciosup SP, Pinto JA. Patterns of mutation enrichment in metastatic triple-negative breast cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e12596] [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: 11/20/2022] Open
Abstract
e12596 Background: Triple-Negative breast cancer (TNBC) is a group of heterogeneous tumors with aggressive biology. The purpose of this research was to evaluate enrichment patterns of genomic alterations in metastatic TNBC (mTNBC). Methods: We retrieved genomic data (mutations and copy number variation) from 550 primaries TNBC (pTNBC) from the projects METABRIC and TCGA and 58 mTNBC from the projects “Mutational Profile of Metastatic Breast Cancers” and “The metastatic Breast Cancer Project”. Differences in the proportions of mutations between primary vs. metastatic tumors were evaluated by the Chisquare test and the percentage of enrichment in mTNBC was estimated. Pvalues were adjusted for multiple testing with the Benjamini-Hochberg method with and a FDR < 0.05. In addition we conducted an analysis of the hallmarks of cancers enriched in mTNBC. Results: In total, mutations in eight genes were significantly enriched in mTNBC after correcting for multiple testing. These genes included TTN, HMCN1, RELN, PKHD1L1, DMD, FRAS1 and RYR3. In the other hand, only amplification of RPS6KB2 was enriched in mTNBC. Deletions were enriched more frequently in the genes TET1, RHOA, EPHA5, SET, KCNJ5, ABCG4, NKX3-1, SDHB, IGF2, BRCA1, among others. The hallmark of “genetic instability and mutation” was over represented while the hallmark “activating immune destruction” was the least represented between the enriched genetic alterations in mTNBC. Conclusions: Despite the study limitations, we identified that deletions are the aberrations more commonly enriched in mTNBC while some biological processes could be targetable in order to improve the therapeutic opportunities in TNBC.
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Affiliation(s)
- Cesar H. Saravia
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Claudio J. Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Luis Jesus Schwarz
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Leny Bravo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Jenny Zavaleta
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Silvia P. Neciosup
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Joseph A. Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
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Affiliation(s)
- Joseph A. Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Perú
| | - Luis E. Raez
- Thoracic Oncology Program, Memorial Cancer Institute/Memorial Health Care System, Florida International University, Miami, USA
| | - Helena Oliveres
- Phase I-Early Clinical Trials Unit, Oncology Department, Antwerp University Hospital, Antwerp, Belgium
| | - Christian C. Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
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Raez LE, Pinto JA, Schrock AB, Ali SM. EGFR-RAD51 Fusion: A Targetable Partnership Originated from the Tumor Evolution? J Thorac Oncol 2019; 13:e33-e34. [PMID: 29472054 DOI: 10.1016/j.jtho.2017.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/05/2017] [Indexed: 01/24/2023]
Affiliation(s)
- Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Pembroke Pines, Florida.
| | - Joseph A Pinto
- Basic and Translational Investigation Unit, Oncosalud-Auna, San Borja, Lima, Peru
| | | | - Siraj M Ali
- Foundation Medicine, Inc., Cambridge, Massachusetts
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Rosas G, Ruiz R, Araujo JM, Pinto JA, Mas L. ALK rearrangements: Biology, detection and opportunities of therapy in non-small cell lung cancer. Crit Rev Oncol Hematol 2019; 136:48-55. [PMID: 30878128 DOI: 10.1016/j.critrevonc.2019.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/06/2019] [Accepted: 02/13/2019] [Indexed: 12/26/2022] Open
Abstract
The ALK receptor tyrosine kinase (ALK) gene encodes a transmembrane protein rearranged in 2-7% of non-small cell lung cancer (NSCLC) cases. This gene has become the second most studied therapeutic target after EGFR due to the implied therapeutic opportunities. While the diagnostic of ALK rearrangements is well established, small molecules targeting ALK are in constant evolution because tumor cells eventually will develop mechanisms of resistance. In this review we describe the biology of the ALK gene, alterations, epidemiology, diagnostic tests as well as strategies of treatment.
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Affiliation(s)
- Gina Rosas
- Departamento de Patología, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este, 2520, Surquillo, Lima 34, Peru
| | - Rossana Ruiz
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja, Lima 41-Peru; Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este, 2520, Surquillo, Lima 34-Peru
| | - Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja, Lima 41-Peru
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja, Lima 41-Peru
| | - Luis Mas
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av. Guardia Civil 571, San Borja, Lima 41-Peru; Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos Este, 2520, Surquillo, Lima 34-Peru.
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Salvador JF, Pinto JA, Araujo JM, Tirado-Hurtado I, Flores CJ, Chirinos LA, Requena MC, Carpio S, Finzel Pérez A, Aguilar A, Demol F, Schwarz LJ. Abstract P4-01-09: Combined analysis of tissue and blood biopsies by NGS in patients with advanced breast cancer identifies targetable molecular alterations. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-01-09] [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: Targeted-next generation sequencing (t-NGS) analysis in tissue and peripheral blood is increasingly performed in patients with advanced cancer. Liquid biopsy is a non-invasive method that allows to understand the molecular changes occurring in the tumor in real-time, derived from intratumor heterogeneity and/or therapeutic pressure. In the present work we sought to elucidate the ability of liquid biopsy to detect mutations related with acquired resistance.
Methods: 190 formalin-fixed paraffin-embedded (FFPE) samples from primary and metastatic tumors of patients with advanced breast cancer (ABC) were analyzed by OncoDEEP® (1000X depth of coverage of 75 gene alterations including point mutations, insertions/deletions, gene fusions and copy number variations), and comparison between targeted-NGS results from matched primary/metastatic tumors (FFPE) and cell-free DNA (cfDNA) recovery from plasma analyzed by OncoSTRAT&GO® in 34 patients with ABC (193 genes with 1000x and 40 genes with 10000x depth coverage for FFPE and plasma, respectively).
Results: Of the 190 FFPEs analyzed by OncoDEEP®, 41% were triple negative breast cancer (TNBC), 49% hormone receptor positive (HR+) and 11% were HER2+. Mutations in TP53 (44.2%), PIK3CA (41.1%) and ERBB2 (9.47%) were the most frequent. As expected, PIK3CA and TP53 mutations were significantly higher in HR+ and TNBC tumors, respectively (PIK3CA: 53.8% for HR+ vs 28.6% and 30% for TNBC and HER2+, respectively; TP53 68.8% for TNBC vs 26.9 and 30% in HR+ and HER2+, respectively; in both cases p<0.001). Interestingly, the alteration c.1459-7C>T in JAK1 (unknown significance) was detected in 8% of patients (9.7% and 6.5% in HR+ and TNBC, respectively). Also, in contrast to other reports, high frequencies of APC alterations were found exclusively in HR+ tumors (previously reported as germline mutations). From the OncoSTRAT&GO® analysis (tumor tissue and cfDNA), ESR1 and FGFR mutations in HR+ ABC were significantly more present in cfDNA (9/20 mutations found [45%]] compared to tumor tissue analysis (18/93 mutations found [19.3%]) (p=0.02), and in three patients, mutations in ESR1 and FGRF were only detected in cfDNA. Finally, 11/34 cases (32.3%) showed gene mutations only in cfDNA with predominant alterations in MAPK signaling pathway (54.5%), TP53 (36.4%) and ESR1 (18.2%), the latest as previously described.
Conclusions: JAK1 and APC mutations need further evaluation to establish their clinical significance in ABC. The combination of tumor tissue and cfDNA t-NGS analyses into clinical routine enables detailed and comprehensive evaluation of tumor heterogeneity under therapeutic pressure; in our cohort, known mutations for acquired resistance to endocrine therapy (ESR1 and FGFR2) were better detected by cfDNA compared to tumor tissue (45% vs 19.3%) in HR+ ABC patients, increasing the probability to identify early drug resistance to prioritize patients' selection into clinical trials with targeted agents.
Citation Format: Salvador JF, Pinto JA, Araujo JM, Tirado-Hurtado I, Flores CJ, Chirinos LA, Requena MC, Carpio S, Finzel Pérez A, Aguilar A, Demol F, Schwarz LJ. Combined analysis of tissue and blood biopsies by NGS in patients with advanced breast cancer identifies targetable molecular alterations [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 P4-01-09.
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Affiliation(s)
- JF Salvador
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - JA Pinto
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - JM Araujo
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - I Tirado-Hurtado
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - CJ Flores
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - LA Chirinos
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - MC Requena
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - S Carpio
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - A Finzel Pérez
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - A Aguilar
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - F Demol
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
| | - LJ Schwarz
- Oncosalud-AUNA, Lima, Peru; Universidad Científica del Sur, Lima, Peru; OncoDNA, Gosselies, Belgium
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Pinto JA, Raez LE. Old myths about old patients: the case of non-small cell lung cancer. Transl Lung Cancer Res 2019; 7:S362-S363. [PMID: 30705856 DOI: 10.21037/tlcr.2018.09.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 15036, Peru
| | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Florida International University (FIU), Pembroke Pines, FL, USA
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Pinto JA, Saravia CH, Flores C, Araujo JM, Martínez D, Schwarz LJ, Casas A, Bravo L, Zavaleta J, Chuima B, Alvarado H, Fujita R, Gómez HL. Precision medicine for locally advanced breast cancer: frontiers and challenges in Latin America. Ecancermedicalscience 2019; 13:896. [PMID: 30792813 PMCID: PMC6372295 DOI: 10.3332/ecancer.2019.896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 07/14/2018] [Indexed: 12/18/2022] Open
Abstract
Advances in high-throughput technologies and their involvement in the 'omics' of cancer have made possible the identification of hundreds of biomarkers and the development of predictive and prognostic platforms that model the management of cancer from evidence-based medicine to precision medicine. Latin America (LATAM) is a region characterised by fragmented healthcare, high rates of poverty and disparities to access to a basic standard of care not only for cancer but also for other complex diseases. Patients from the public setting cannot afford targeted therapy, the facilities offering genomic platforms are scarce and the use of high-precision radiotherapy is limited to few facilities. Despite the fact that LATAM oncologists are well-trained in the use of genomic platforms and constantly participate in genomic projects, a medical practice based in precision oncology is a great challenge and frequently limited to private practice. In breast cancer, we are waiting for the results of large basket trials to incorporate the detection of actionable mutations to select targeted treatments, in a similar way to the management of lung cancer. On the other hand and paradoxically, in the 'one fit is not for all' era, clinical and genomic studies continue grouping our patients under the single label 'Latin American' or 'Hispanic' despite the different ancestries and genomic backgrounds seen in the region. More regional cancer genomic initiatives and public availability of this data are needed in order to develop more precise oncology in locally advanced breast cancer.
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Affiliation(s)
- Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Perú
| | - César H Saravia
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Perú
| | - Claudio Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Perú
| | - Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Perú
| | - David Martínez
- Departamento de Radioterapia, Oncosalud-AUNA, Lima 15036, Perú
| | - Luis J Schwarz
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Perú
| | - Alberto Casas
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima 15067, Perú
| | - Leny Bravo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima 15067, Perú
| | - Jenny Zavaleta
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima 15067, Perú
| | | | - Hober Alvarado
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica 11004, Perú
| | - Ricardo Fujita
- Centro de Genética y Biología Molecular, Universidad de San Martín de Porres, Lima 15024, Perú
| | - Henry L Gómez
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Perú.,Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, 15038, Perú
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Pinto JA, Pinillos L, Villarreal-Garza C, Morante Z, Villarán MV, Mejía G, Caglevic C, Aguilar A, Fajardo W, Usuga F, Carrasco M, Rebaza P, Posada AM, Tirado-Hurtado I, Flores C, Vallejos CS. Barriers in Latin America for the management of locally advanced breast cancer. Ecancermedicalscience 2019; 13:897. [PMID: 30792814 PMCID: PMC6372299 DOI: 10.3332/ecancer.2019.897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 07/03/2018] [Indexed: 01/21/2023] Open
Abstract
Breast cancer (BC) is a highly prevalent malignancy in Latin American women, most cases being diagnosed at locally advanced or metastatic stages when options for cancer care are limited. Despite its label as a public health problem in the region, Latin American BC patients face several barriers in accessing standard of care treatment when compared with patients from developed countries. In this review, we analyse the landscape of the four main identified barriers in the region: i) high burden of locally advanced/advanced BC; ii) inadequate access to medical resources; iii) deficient access to specialised cancer care and iv) insufficient BC research in Latin America. Unfortunately, these barriers represent the main factors associated with the BC poor outcomes seen in the region. Targeted actions should be conducted independently by each country and as a region to overcome these limitations and create an enhanced model of BC care.
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Affiliation(s)
- Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Peru
| | - Luis Pinillos
- Departamento de Radioterapia, Oncosalud-AUNA, Lima 15036, Peru
| | - Cynthia Villarreal-Garza
- Departamento de Investigación y de Tumores Mamarios, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Zaida Morante
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Peru.,Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima 15038, Peru
| | - Manuel V Villarán
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Peru
| | - Gerson Mejía
- Departamento de Oncología Médica, Hospital Clínico Viedma, Cochabamba 00725, Bolivia
| | - Christian Caglevic
- Medical Oncology Department, Clinica Alemana, Santiago 5951, Chile.,Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 700, Chile
| | - Alfredo Aguilar
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Peru
| | - Williams Fajardo
- Departamento de Medicina Especializada, Hospital Nacional Dos de Mayo, Lima 15003, Peru
| | - Franz Usuga
- Grupo de Radioterapia Oncológica, Instituto Nacional de Cancerología, Bogotá 9-85, Colombia
| | - Marcia Carrasco
- Departamento de Oncología, Hospital Santa Rosa, Lima 95405, Peru.,Unidad de la Mama, Oncosalud-AUNA, Lima 15036, Peru
| | | | - Ana M Posada
- Unidad de la Mama, Oncosalud-AUNA, Lima 15036, Peru
| | | | - Claudio Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima 15036, Peru
| | - Carlos S Vallejos
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, 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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Tirado-Hurtado I, Araujo JM, Saravia CH, Requena M, Rolfo CD, Raez LE, Pinto JA, Flores CJ. Selection of highly stable genes for the transcriptomic evaluation of lung cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e24318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- I. Tirado-Hurtado
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Cesar H. Saravia
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - María Requena
- Unidad de Investigación Clínica, Oncosalud-AUNA, Lima, Peru
| | - Christian Diego Rolfo
- Phase I-Early Clinical Trials Unit, Oncology Department, Antwerp University Hospital (UZA) and Center for Oncological Research (CORE) Antwerp University, Edegem, Belgium
| | - Luis E. Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL
| | - Joseph A. Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Claudio J. Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
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Araujo JM, Flores CJ, Tirado-Hurtado I, Rolfo CD, Raez LE, Prado A, Saravia CH, Pinto JA. RNA-Seq data analysis to identify enriched metabolic pathways and a prognostic signature in squamous cell lung cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e24288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Claudio J. Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - I. Tirado-Hurtado
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Christian Diego Rolfo
- Phase I-Early Clinical Trials Unit, Oncology Department, Antwerp University Hospital (UZA) and Center for Oncological Research (CORE) Antwerp University, Edegem, Belgium
| | - Luis E. Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL
| | - Alexandra Prado
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Cesar H. Saravia
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Joseph A. Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
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45
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Luque Benavides RG, Morante Z, De la Cruz Ku GA, Enriquez D, Luján M, Eyzaguirre E, Saavedra A, Araujo JM, Pinto JA, Fuentes HA, Neciosup SP, Gomez HL. Brain metastasis due to triple-negative breast cancer in the Peruvian population. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e14013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Zaida Morante
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | | | | | | | | | | | | | - Joseph A. Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
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46
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Pinto JA, Vallejos CS, Raez LE, Mas LA, Ruiz R, Torres-Roman JS, Morante Z, Araujo JM, Gómez HL, Aguilar A, Bretel D, Flores CJ, Rolfo C. Gender and outcomes in non-small cell lung cancer: an old prognostic variable comes back for targeted therapy and immunotherapy? ESMO Open 2018; 3:e000344. [PMID: 29682332 PMCID: PMC5905840 DOI: 10.1136/esmoopen-2018-000344] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [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: 02/20/2018] [Revised: 03/09/2018] [Accepted: 03/12/2018] [Indexed: 12/26/2022] Open
Abstract
Background There are well-known differences in gender outcome in non-small cell lung cancer (NSCLC) and other cancers. In this work, we evaluated several randomised clinical trials to explore the gender influence in the outcome of patients with NSCLC treated with targeted therapy and immunotherapy. Methods We performed a series of meta-analysis to compare the gender outcome in the routine setting for overall survival and progression-free survival (PFS) in phase III randomised clinical trials comparing EGFR inhibitors versus chemotherapy (OPTIMAL, LUX-lung 3, LUX-lung 6, EURTAC, ENSURE and WTJOG); ALK inhibitors versus chemotherapy (ASCEND 4, ASCEND 5, PROFILE 1014 and NCT009323893) and anti-PD1 checkpoint inhibitors versus chemotherapy (CheckMate 017, CheckMate 026, CheckMate 057, KEYNOTE 010 and KEYNOTE 024). Results Female patients with NSCLC have a reduced risk of death compared with men (HR=0.73; 95% CI 0.67 to 0.79; p<0.00001). Women had a better benefit from EGFR inhibitors than men (HR=0.34; 95% CI 0.28 to 0.40; p<0.00001 vs HR=0.44; 95% CI 0.34 to 0.56; p<0.00001, respectively). The benefit from ALK inhibitors was similar for both genders (HR=0.51; 95% CI 0.42 to 0.61; p<0.00001 vs HR=0.48; 95% CI 0.39 to 0.59; p<0.00001, for women and men, respectively). Anti-PD1 inhibitors significantly improved the PFS in male patients when compared with chemotherapy (HR=0.76; 95% CI 0.68 to 0.86; p<0.00001); in contrast, women showed no benefit in 5/5 randomised trials (HR=1.03; 95% CI 0.89 to 1.20; p=0.69). Conclusions In this exploratory study, some targeted treatments were influenced by gender. Despite differences in outcomes that could be attributed to different histology, EGFR and smoking status, gender should be evaluated more deeply as prognostic variable in patients with NSCLC.
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Affiliation(s)
- Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | | | - Luis E Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Pembroke Pines, Florida, USA
| | - Luis A Mas
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima, Peru
| | - Rossana Ruiz
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima, Peru
| | - Junior S Torres-Roman
- Facultad de Medicina Humana, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Zaida Morante
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima, Peru
| | - Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Henry L Gómez
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima, Peru
| | - Alfredo Aguilar
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Lima, Peru
| | - Claudio J Flores
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
| | - Christian Rolfo
- Phase I-Early Clinical Trials Unit, Oncology Department, Antwerp University Hospital, Antwerp, Belgium
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Tirado-Hurtado I, Fajardo W, Pinto JA. DNA Damage Inducible Transcript 4 Gene: The Switch of the Metabolism as Potential Target in Cancer. Front Oncol 2018; 8:106. [PMID: 29707520 PMCID: PMC5906527 DOI: 10.3389/fonc.2018.00106] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [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: 11/22/2017] [Accepted: 03/26/2018] [Indexed: 12/02/2022] Open
Abstract
DNA damage inducible transcript 4 (DDIT4) gene is expressed under stress situations turning off the metabolic activity triggered by the mammalian target of rapamycin (mTOR). Several in vitro and in vivo works have demonstrated the ability of DDIT4 to generate resistance to cancer therapy. The link between the metabolism suppression and aggressiveness features of cancer cells remains poorly understood since anti-mTOR agents who are part of the repertoire of drugs used for systemic treatment of cancer achieving variable results. Interestingly, the high DDIT4 expression is associated with worse outcomes compared to tumors with low DDIT4 expression, seen in a wide variety of solid and hematological tumors, which suggests the driver role of this gene and provide the basis to target it as part of a new therapeutic strategy. In this review, we highlight our current knowledge about the biology of DDIT4 and its role as a prognostic biomarker, encompassing the motives for the development of target drugs against DDIT4 as a better target than mTOR inhibitors.
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Affiliation(s)
| | - Williams Fajardo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Lima, Peru
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48
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Passiglia F, Caglevic C, Giovannetti E, Pinto JA, Manca P, Taverna S, Listì A, Gil-Bazo I, Raez LE, Russo A, Rolfo C. Primary and metastatic brain cancer genomics and emerging biomarkers for immunomodulatory cancer treatment. Semin Cancer Biol 2018; 52:259-268. [PMID: 29391205 DOI: 10.1016/j.semcancer.2018.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 11/17/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 12/17/2022]
Abstract
Recent studies with immunomodulatory agents targeting both cytotoxic T-lymphocyte protein 4 (CTLA4) and programmed cell death 1 (PD1)/programmed cell death ligand 1 (PDL1) have shown to be very effective in several cancers revealing an unexpected great activity in patients with both primary and metastatic brain tumors. Combining anti-CTLA4 and anti-PD1 agents as upfront systemic therapy has revealed to further increase the clinical benefit observed with single agent, even at cost of higher toxicity. Since the brain is an immunological specialized area it's crucial to establish the specific composition of the brain tumors' microenvironment in order to predict the potential activity of immunomodulatory agents. This review briefly summarizes the basis of the brain immunogenicity, providing the most updated clinical evidences in terms of immune-checkpoint inhibitors efficacy and toxicity in both primary and metastatic brain tumors with the final aim of defining potential biomarkers for immunomodulatory cancer treatment.
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Affiliation(s)
- F Passiglia
- Department of Surgical,Oncological and Stomatological Disciplines, University of Palermo, Italy
| | - C Caglevic
- Unit of Investigational Cancer Drugs, Instituto Oncologico Fundación Arturo López Pérez, Santiago, Chile
| | - E Giovannetti
- Department Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands
| | - J A Pinto
- Unit of Basic and Translational Research, Oncosalud-AUNA, Lima, Peru
| | - P Manca
- Medical Oncology Department, Campus Biomedico, University of Rome, Rome, Italy
| | - S Taverna
- Department of Surgical,Oncological and Stomatological Disciplines, University of Palermo, Italy
| | - A Listì
- Department of Surgical,Oncological and Stomatological Disciplines, University of Palermo, Italy
| | - I Gil-Bazo
- Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - L E Raez
- Thoracic Oncology Program, Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA
| | - A Russo
- Department of Surgical,Oncological and Stomatological Disciplines, University of Palermo, Italy
| | - C Rolfo
- Phase I-Early Clinical Trials Unit, Oncology Department, Antwerp University Hospital (UZA) and Center for Oncological Research (CORE) Antwerp University, Edegem, Antwerp, Belgium.
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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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Abstract
Radiotherapy was the first nonsurgical treatment for malignant tumours and represents one of the oldest disciplines of oncology. In Latin America, as in many parts of the world, the history of modern oncology begins with the implementation of radiation therapy facilities. The development of radiotherapy in Latin America was possible thanks to the seminal work of radiation oncologists in different countries. As a large territory, there is a need to implement modern facilities and equipment, but unfortunately there are disparities in the access and quality of radiotherapy services across Latin America and even within individual countries. In this review, we describe the history, challenges and success in the implementation of radiotherapy and the frustration caused by the lack of facilities in several Latin American countries.
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Affiliation(s)
- Luis Pinillos
- Departamento de Radioterapia, Oncosalud-AUNA, Av Paseo de la República 3650, San Isidro, Lima 15046, Peru
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, Av Guardia Civil 571, San Borja, Lima 15036, Peru
| | - Gustavo Sarria
- Departamento de Radioterapia, Oncosalud-AUNA, Av Paseo de la República 3650, San Isidro, Lima 15046, Peru
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