Characterization of triple negative breast cancer gene expression profiles in Mexican patients

Triple negative breast cancer (TNBC) is an aggressive type of cancer that accounts for ~23% of breast tumors in Mexico. In an attempt to understand in an improved way the behavior of TNBC, throughout the years, gene expression in these tumors has been studied. Lehman et al identified 6 subtypes of gene expression in TNBC with distinct characteristics. In the present study, it was aimed to assess clinical, pathological and prognostic characteristics of TNBC in a Mexican-based cohort. A total of 55 patients diagnosed with TNBC at Mexico's National Institute of Cancer (INCan) were included. Tumor needle biopsy samples were obtained and subjected to microarray analysis. Patients were thus classified into one of the 6 TNBC molecular subtypes. The prognostic, clinical and pathological information of patients was obtained, and differences across molecular subtypes were sought. Out of the 55 included patients, the following subtypes were identified: 9 basal-like-1, 11 basal-like-2 (BSL2), 16 immunomodulatory (IM), 12 mesenchymal, 6 androgen receptor-like and 1 mesenchymal stem-like. Mean follow-up time was 47.1 months. The IM molecular subtype had the best overall survival (OS) (median OS was not reached). BSL2 had the worst OS (15 months). A complete pathologic response to neoadjuvant chemotherapy was obtained more often in the IM subtype (P=0.032). No significant associations were found between any of the clinical or pathological characteristics and the TNBC molecular subtypes. The results obtained from the present study should be considered when seeking to implement a clinical-molecular model for TNBC patient care, particularly in Hispanic-based populations, as they have been frequently underrepresented in clinical studies assessing TNBC molecular subtypes.

Evaluación de cribado de la calidad de vida en cuidadores primarios informales de pacientes oncológicos

Objetivo: determinar las propiedades psicométricas de un instrumento de CV (CQoLC) y evaluar la calidad de vida (CV) de los cuidadores primarios (CPI) de pacientes con cáncer. Material y método: estudio tres fases: (1) evaluación de CV en CPI con un instrumento validado para población general y de pacientes que requieren atención médica (InCaViSa); (2) adaptación y piloteo del CQoLC y; (3) evaluación de confiabilidad, validez y normas del CQoLC. Se incluyeron 317 CPI de pacientes con diferentes diagnósticos oncológicos. Se realizaron análisis descriptivos de la CV reportada por los CPI. Para piloteo del instrumento se estimó el porcentaje de CPI que tuvieron dificultades para comprender algún reactivo. En la fase de validación se realizó un análisis factorial por ejes principales y la estructura propuesta se sometió a un análisis factorial confirmatorio (AFC). La confiabilidad se obtuvo a través del Alfa de Cronbach y el coeficiente Omega de McDonald’s. Finalmente, se estimaron los parámetros para calificación del CQoLC. Resultados: los CPI obtuvieron puntajes de “baja” a “muy baja” CV en la mayoría de las subescalas del InCaViSa. El CQoLC no mostró dificultades para su comprensión y se obtuvo una versión de nueve reactivos, distribuidos en cuatro indicadores, que explican el 45,62% de la varianza con adecuado ajuste en el AFC y adecuados índices de confiabilidad (Alfas de Cronbach de 0,496 a 0,866 y coeficiente Omega de McDonald’s = 0,868). Conclusiones: la CV de los CPI de pacientes con cáncer se encuentra afectada importantemente. El CQoLC es un instrumento especializado, que demostró ser adecuado como herramienta de cribado en las mediciones de auto-reporte.

Micro-RNAs as Potential Predictors of Response to Breast Cancer Systemic Therapy: Future Clinical Implications

Despite advances in diagnosis and new treatments such as targeted therapies, breast cancer (BC) is still the most prevalent tumor in women worldwide and the leading cause of death. The principal obstacle for successful BC treatment is the acquired or de novo resistance of the tumors to the systemic therapy (chemotherapy, endocrine, and targeted therapies) that patients receive. In the era of personalized treatment, several studies have focused on the search for biomarkers capable of predicting the response to this therapy; microRNAs (miRNAs) stand out among these markers due to their broad spectrum or potential clinical applications. miRNAs are conserved small non-coding RNAs that act as negative regulators of gene expression playing an important role in several cellular processes, such as cell proliferation, autophagy, genomic stability, and apoptosis. We reviewed recent data that describe the role of miRNAs as potential predictors of response to systemic treatments in BC. Furthermore, upon analyzing the collected published information, we noticed that the overexpression of miR-155, miR-222, miR-125b, and miR-21 predicts the resistance to the most common systemic treatments; nonetheless, the function of these particular miRNAs must be carefully studied and further analyses are still necessary to increase knowledge about their role and future potential clinical uses in BC.