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Clinicopathological predictors of long-term benefit in breast cancer treated with neoadjuvant chemotherapy

World Journal of Clinical oncology 2018年第2期9卷 33-41页

作者： Marco Galvez Carlos A Castaneda Joselyn Sanchez Miluska Castillo Lia Pamela Rebaza Gabriela Calderon Miguel De La Cruz Jose Manuel Cotrina jul.o abugattas Jorge Dunstan Henry Guerra omar Mejia Henry L Gomez Department of Medical oncology Instituto Nacional de Enfermedades Neoplasicas Faculty of Medicine Universidad Peruana San Juan Bautista Department of Research Instituto Nacional de Enfermedades Neoplasicas Department of Breast Cancer Surgery Instituto Nacional de Enfermedades Neoplasicas Department of Pathology Instituto Nacional de Enfermedades Neoplasicas

AIM To investigate the survival impact of clinicopathological factors, including pathological complete response(p CR) and tumor-infiltrating lymphocytes(s TIL) levels according to subtypes, in breast cancer(BC) patients who received neo-adjuvant chemotherapy(NAC).METHoDS We evaluated 435 BC patients who presented and received NAC at the Instituto Nacional de Enfermedades Neoplasicas from 2003 to 2014. s TIL was analyzed as the proportion of tumor stroma occupied by lymphocytes, and was prospectively evaluated on hematoxylin and eosin-stained sections of the preN AC core biopsy. p CR was considered in the absence of infiltrating cancer cells in primary tumor and axillary lymph nodes. Analysis of statistical association between clinical pathological features, s TIL, p CR and survival were carried out using *** Median age was 49 years(range 24-84 years) and the most frequent clinical stage was ⅢB(58.3%). Luminal A, Luminal B, HER2-enriched and(triple-negative) TN phenotype was found in 24.6%, 37.9%, 17.7% and 19.8%, respectively. p CR was observed in 11% and median percentage of s TIL was 40%(2%-95%) in the whole population. p CR was associated to Ct1-2(P = 0.045) and to high s TIL(P = 0.029) in the whole population. There was a slight trend towards significance for s TIL(P = 0.054) in Luminal A. s TIL was associated with grade Ⅲ(P o-Luminal A subtype(P ositive(P = 0.002) and p CR(P = 0.029) in the whole population. Longer disease-free survival was associated with grade Ⅰ-Ⅱ(P = 0.006), cN 0(P ositive(P ositive(P onger disease-free survival was associated with grade Ⅰ-Ⅱ in Luminal A(P onger overall survival was associated wi

关键词： Breast cancer Subtype Tumor-infiltrating lymphocytes Neoadjuvant therapy Pathological complete response Survival

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Tumor infiltrating lymphocytes in triple negative breast cancer receiving neoadjuvant chemotherapy

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World Journal of Clinical oncology 2016年第5期7卷 387-394页

作者： Carlos A Castaneda Elizabeth Mittendorf Sandro Casavilca Yun Wu Miluska Castillo Patricia Arboleda Teresa Nunez Henry Guerra Carlos Barrionuevo Ketty Dolores-Cerna Carolina Belmar-Lopez jul.o abugattas Gabriela Calderon Miguel De La Cruz Manuel Cotrina Jorge Dunstan Henry L Gomez Tatiana Vidaurre Department of Research Instituto Nacional de Enfermedades Neoplasicas Department of Medical oncology Instituto Nacional de Enfermedades Neoplasicas Department of Surgical oncology the University of Texas MD Anderson Cancer Center Department of Pathology Instituto Nacional de Enfermedades Neoplasicas Department of Pathology Division of Pathology the University of Texas MD Anderson Cancer Center Department of Breast Cancer Surgery Instituto Nacional de Enfermedades Neoplasicas

AIM To determine influence of neoadjuvant-chemotherapy(NAC) over tumor-infiltrating-lymphocytes(TIL) intriple-negative-breast-cancer(TNBC).METHoDS TILs were evaluated in 98 TNBC cases who came to Instituto Nacional de Enfermedades Neoplasicas from 2005 to 2010. Immunohistochemistry staining for CD3, CD4, CD8 and FoXP3 was performed in tissue microarrays(TMA) sections. Evaluation of H/E in full-face and immunohistochemistry in TMA sections was performed in pre and post-NAC samples. STATA software was used and P value onsidered statistically significant. RESULTS Higher TIL evaluated in full-face sections from pre-NAC tumors was associated to pathologic-complete-response(pCR)(P = 0.0251) and outcome(P = 0.0334). TIL evaluated in TMA sections showed low level of agreement with full-face sections(ICC = 0.017-0.20) and was not associated to pCR or outcome. TIL in post-NAC samples were not associated to response or outcome. PostNAC lesions with pC R had similar TIL levels than those without pCR(P = 0.6331). NAC produced a TIL decrease in full-face sections(P of TIL subpopulations was correlated with their absolute counts. Higher counts of CD3, CD4, CD8 and FoXP3 in pre-NAC samples had longer disease-free-survival(DFS). Higher counts of CD3 in pre-NAC samples had longer overallsurvival. Higher ratio of CD8/CD4 counts in pre-NAC was associated with pCR. Higher ratio of CD4/FoXP3 counts in pre-NAC was associated with longer DFS. Higher counts of CD4 in post-NAC samples were associated with *** TIL in pre-NAC full-face sections in TNBC are correlated to longer survival. TIL in full-face differ from TMA sections, absolute count and percentage analysis of TIL subpopulation closely related.

关键词： Triple-negative breast cancer Survival Tumor-infiltrating lymphocytes Neoadjuvant therapy

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Impact of mass screening for gluten-sensitive enteropathy in working population

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World Journal of Gastroenterology 2009年第11期15卷 1331-1338页

作者： Meritxell Mariné Fernando Fernández-Baares Montserrat Alsina Carme Farré Montserrat Cortijo Rebeca Santaolalla Antonio Salas Margarita Tomàs Elias abugattas Carme Loras Ingrid ordás Josep M Viver Maria Esteve Department of Gastroenterology University Hospital of Mútua de TerrassaResearch Foundation Mútua de TerrassaUniversity of Barcelona08221 TerrassaCataloniaSpain Department of Immunology(Catlab) University Hospital of Mútua de TerrassaResearch Foundation Mútua de TerrassaUniversity of Barcelona08221 TerrassaCataloniaSpain Department of Biochemistry Sant Joan de DéuHospitalEsplugues08950 CataloniaSpain occupational Health Department Egarsat(Prevention Society)Sant Cugat del Vallès08173 CataloniaSpain Department of Pathology University Hospital of Mútua de TerrassaResearch Foundation Mútua de TerrassaUniversity of Barcelona08221 TerrassaCataloniaSpain

AIM:To assess:(1)frequency and clinical relevanceof gluten sensitive enteropathy(GSE)detected by serology in a mass screening program;(2)sensitivity of antitransglutaminase(tTGA)and antiendomysium antibodies(EmA);and(3)adherence to gluten-free diet(GFD)and follow-up. METHoDS:one thousand,eight hundred and sixtyeight subjects recruited from an occupational health department underwent analysis for tTGA and EmA and, if positive,duodenal biopsy,DQ2/DQ8 genotyping, clinical feature recording,blood tests,and densitometry were ***>98%of individuals had tTGA off limit of normality and was considered positive when confirmed twice in the same *** to a GFD and follow up were registered. RESULTS:Twenty-six(1.39%)subjects had positive tTGA and/or EmA,and 21 underwent biopsy:six Marsh Ⅲ(oneⅢa,fourⅢb,oneⅢc),nine MarshⅠand six Marsh 0(frequency of GSE 1:125).The sensitivity of EmA for GSE was 46.6%(11.1%for MarshⅠ,100% for MarshⅢ),while for tTGA,it was 93.3%(88.8% for MarshⅠ,100%for MarshⅢ).All 15 patients with abnormal histology had clinical features related to ***ⅠandⅢsubjects had more abdominal pain than Marsh 0(P=0.029),and a similar trend was observed for distension and *** differences in the percentage of osteopenia were found between MarshⅠandⅢ(P=0.608).Adherence to follow-up was 69.2%.of 15 GSE patients,66.7%followed a GFD with 80%responding to it. CoNCLUSIoN:GSE in the general population is frequent and clinically relevant,irrespective of histological *** is the marker of *** screening programs are useful in identifying patients who can benefit from GFD and follow-up.

关键词： Antitransglutaminase and antiendomysiumantibodies Celiac disease Lymphocytic enteritis Massscreening

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A biomarker study in Peruvian males with breast cancer

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World Journal of Clinical oncology 2021年第10期12卷 926-934页

作者： Carlos A Castaneda Miluska Castillo Luis A Bernabe Joselyn Sanchez Ebert Torres Nancy Suarez Katherine Tello Hugo Fuentes Jorge Dunstan Miguel De La Cruz Jose Manuel Cotrina jul.o abugattas Henry Guerra Henry L Gomez Faculty of Health Sciences Universidad Cientifica del SurLima 15067Peru Department of Medical oncology Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Department of Research Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Department of Pathology Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru Department of Breast Cancer Surgery Instituto Nacional de Enfermedades NeoplasicasLima 15038Peru

BACKGRoUND Breast cancer(BC)frequency in males is extremely low and tumor features vary from its female *** cancer clinical and pathological features differ by race in *** infiltrating lymphocyte(TIL)levels,mismatch repair(MMR)protein loss,androgen receptor(AR)expression,and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female *** is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with *** To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian *** This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June *** pathological features,TIL levels,MMR proteins,AR immunohistochemistry staining,and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin *** of AR and estrogen receptor(ER)positive cells was additionally calculated by software after slide *** analyses included association tests,intraclass correlation test and Kaplan Meier overall survival *** The median age was 63 years and most cases were ER-positive(85.7%),HER2 negative(87.2%),Luminal-A phenotype(60%)and clinical stage II(41.5%)among our male breast *** TIL was 10%and higher levels tended to be associated with Luminal-B phenotype and higher ***-positive was found in 85.3%and was correlated with ER(intraclass index of 0.835,Poss of MMR proteins was found in 15.4%and PIK3CA mutation(H1047R)in 14.3%(belonged to the Luminal-A phenotype).Loss of MMR proteins was associated with AR-negative(P=0.018)but not with ER(P=0.43)or TIL(P=0.84).Early stages(Power grade(P=0.006)were associated with longer overall *** status,phenotype,AR status,TIL level,MMR protein loss nor PIK3CA mutation was not associated

关键词： Male breast neoplasm Androgen receptor Tumor-infiltrating lymphocyte Mismatch repair protein PIK3CA mutation

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Implementation of a Telechemotherapy Module in the Peruvian Jungle with Adequate Quality of Life:Breaking the Access Gaps to Health with Teleoncology

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Journal of Cancer Therapy 2019年第8期10卷 677-691页

作者： Tatiana Vidaurre jule Vásquez Fernando Valencia Cindy Alcarraz Luis Más Nataly Poma Litol Becerra Gino Rodriguez Socorro Saldana Pepe Diaz Silvia Neciosup Karina Aliaga Roxana Regalado Miriam Salazar Kavita Sarwal Simon Sutcliffe jul.o abugattas Carlos Castaneda Mónica Calderón Hugo Fuentes Henry Gómez Medical oncologist Instituto Nacional de Enfermedades Neoplasicas(INEN)LimaPeru Hospital II-E Lamas San MartinPeru Instituto Nacional de Enfermedades Neoplasicas(INEN) LimaPeru International Cancer Control Congress Association(ICCCA) VancouverCanada

Background: Cancer is a leading cause of death worldwide as well as in Peru. The national cancer plan includes decentralization, but one of the greatest barriers is our complicated geography. San Martin is a department located in the Peruvian jungle where there are no public services for cancer care. our aim was to implement a “distance telemedicine-enabled” outpatient chemotherapy module, monitored by oncologists. Methods: The implementation was conducted in 3 stages: 1) Planning and organization: working teams were formed, a chemotherapy room was developed and people were trained. 2) Execution: patients from San Martín region, aged >18 years with pathological confirmation of cancer, requiring systemic chemotherapy, ECoG ourse of chemotherapy received at INEN without adverse reaction were selected. 3) Evaluation: adverse events, cost-user evaluation and quality of life (QoL) were assessed. Results: By November 2015, a module with a chemotherapy room with 18 chairs, a pharmacy, a hospitalization room, 1 medical office, a training room, a nutrition area, and a nursing station was implemented. 3 physicians, 3 nurses and 1 pharmacist were trained. Through March 2018, 501 sessions of teleoncology were completed to deliver 232 cycles of chemotherapy for 56 patients aged 19 - 78 years with different solid tumors, with no serious adverse event, without negatively affecting their QoL, and with an average out-of-pocket expense saving of 500 PEN. Conclusions: Using information and communication technology, a telechemotherapy module was successfully implemented in the Peruvian jungle, without adversely affecting the QoL of patients. Neither patients nor family members needed to travel to Lima to receive chemotherapy. This first program can be replicated in other rural and remote regions through non-specialized personnel and facilities, providing chemotherapy services equivalent to a tertiary center through trained health care professionals, supported through tel

关键词： Telechemotherapy Module Cancer Treatment Urban Tertiary Center Teleoncology

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