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1. Blocking soluble TNFα sensitizes HER2-positive breast cancer to trastuzumab through MUC4 downregulation and subverts immunosuppression

Author: Sofia Bruni, Florencia L Mauro, Cecilia J Proietti, Rosalia I Cordo-Russo, Martin A Rivas, Gloria Inurrigarro, Agustina Dupont, Dario Rocha, Elmer A Fernández, Ernesto Gil Deza, Daniel Lopez Della Vecchia, Sabrina Barchuk, Silvina Figurelli, David Lasso, Adrián D Friedrich, María C Santilli, María V Regge, Gabriel Lebersztein, Claudio Levit, Fabiana Anfuso, Teresa Castiglione, Patricia V Elizalde, Maria F Mercogliano, and Roxana Schillaci
Subjects: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Background The success of HER2-positive (HER2+) breast cancer treatment with trastuzumab, an antibody that targets HER2, relies on immune response. We demonstrated that TNFα induces mucin 4 (MUC4) expression, which shields the trastuzumab epitope on the HER2 molecule decreasing its therapeutic effect. Here, we used mouse models and samples from HER2+ breast cancer patients to unravel MUC4 participation in hindering trastuzumab effect by fostering immune evasion.Methods We used a dominant negative TNFα inhibitor (DN) selective for soluble TNFα (sTNFα) together with trastuzumab. Preclinical experiments were performed using two models of conditionally MUC4-silenced tumors to characterize the immune cell infiltration. A cohort of 91 patients treated with trastuzumab was used to correlate tumor MUC4 with tumor-infiltrating lymphocytes.Results In mice bearing de novo trastuzumab-resistant HER2+ breast tumors, neutralizing sTNFα with DN induced MUC4 downregulation. Using the conditionally MUC4-silenced tumor models, the antitumor effect of trastuzumab was reinstated and the addition of TNFα-blocking agents did not further decrease tumor burden. DN administration with trastuzumab modifies the immunosuppressive tumor milieu through M1-like phenotype macrophage polarization and NK cells degranulation. Depletion experiments revealed a cross-talk between macrophages and NK cells necessary for trastuzumab antitumor effect. In addition, tumor cells treated with DN are more susceptible to trastuzumab-dependent cellular phagocytosis. Finally, MUC4 expression in HER2+ breast cancer is associated with immune desert tumors.Conclusions These findings provide rationale to pursue sTNFα blockade combined with trastuzumab or trastuzumab drug conjugates for MUC4+ and HER2+ breast cancer patients to overcome trastuzumab resistance.
Published: 2023
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2. Invasive micropapillary carcinoma of the breast overexpresses MUC4 and is associated with poor outcome to adjuvant trastuzumab in HER2-positive breast cancer

Author: María F. Mercogliano, Gloria Inurrigarro, Mara De Martino, Leandro Venturutti, Martín A. Rivas, Rosalía Cordo-Russo, Cecilia J. Proietti, Elmer A. Fernández, Isabel Frahm, Sabrina Barchuk, Daniel H. Allemand, Silvina Figurelli, Ernesto Gil Deza, Sandra Ares, Felipe G. Gercovich, Eduardo Cortese, Matías Amasino, Pablo Guzmán, Juan C. Roa, Patricia V. Elizalde, and Roxana Schillaci
Subjects: Invasive micropapillary carcinoma of the breast (IMPC), HER2, Mucin 4 (MUC4), Trastuzumab, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background Invasive micropapillary carcinoma of the breast (IMPC) is a histological tumor variant that occurs with low frequency characterized by an inside-out formation of tumor clusters with a pseudopapillary arrangement. IMPC is an aggressive tumor with poor clinical outcome. In addition, this histological subtype usually expresses human epidermal growth factor receptor 2 (HER2) which also correlates with a more aggressive tumor. In this work we studied the clinical significance of IMPC in HER2-positive breast cancer patients treated with adjuvant trastuzumab. We also analyzed mucin 4 (MUC4) expression as a novel biomarker to identify IMPC. Methods We retrospectively studied 86 HER2-positive breast cancer patients treated with trastuzumab and chemotherapy in the adjuvant setting. We explored the association of the IMPC component with clinicopathological parameters at diagnosis and its prognostic value. We compared MUC4 expression in IMPC with respect to other histological breast cancer subtypes by immunohistochemistry. Results IMPC, either as a pure entity or associated with invasive ductal carcinoma (IDC), was present in 18.6% of HER2-positive cases. It was positively correlated with estrogen receptor expression and tumor size and inversely correlated with patient’s age. Disease-free survival was significantly lower in patients with IMPC (hazard ratio = 2.6; 95%, confidence interval 1.1–6.1, P = 0.0340). MUC4, a glycoprotein associated with metastasis, was strongly expressed in all IMPC cases tested. IMPC appeared as the histological breast cancer subtype with the highest MUC4 expression compared to IDC, lobular and mucinous carcinoma. Conclusion In HER2-positive breast cancer, the presence of IMPC should be carefully examined. As it is often not informed, because it is relatively difficult to identify or altogether overlooked, we propose MUC4 expression as a useful biomarker to highlight IMPC presence. Patients with MUC4-positive tumors with IMPC component should be more frequently monitored and/or receive additional therapies.
Published: 2017
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3. Evaluación de las necesidades de los pacientes respecto a la información y los cuidados médicos tras el diagnóstico de cáncer

Author: Ernesto Gil Deza, Daniela Gercovich, Eduardo Morgenfeld, Flavio Tognelli, Gastón Martín Reinas, Pablo López, Mónica Montiel, Carlos García Gerardi, Edgardo Rivarola, and Felipe Gustavo Gercovich
Subjects: Necesidades de los pacientes, oncología, comunicación médico paciente, encuesta., Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Psychology, BF1-990
Abstract: Objetivo: Estudiar las necesidades de los pacientes oncológicos sobre la información referida a su enfermedad y los cuidados al final de la vida. Métodos: 820 pacientes participaron de una encuesta sobre diagnóstico, pronóstico, eficacia y toxicidad de los tratamientos, así como también sobre cuidados paliativos, investigación clínica, apoyo psicológico, cuidados espirituales y deseos del final de la vida. Resultados: 695 pacientes conocen su diagnóstico, especialmente quienes tenían un mayor nivel educativo y un rango etario de 50-70 años. Seiscientos setenta y cuatro pacientes deseaban conocer su pronóstico, estando más predispuestos a conocerlo quienes tenían educación secundaria y superior. La mayoría (562 pacientes) deseaba conocer todo con respecto a la utilidad de los tratamientos, al igual que con respecto a la toxicidad (443) y valoraría contar con información sobre cuidados paliativos e investigación. Además consideraba la internación hospitalaria como el mejor lugar para morir (331). Las mujeres se mostraron más propensas a recibir ayuda psicológica y espiritual. Las condiciones más valoradas en el médico fueron: conocimiento (52,7%), Honestidad (45,5%) y Humanidad (44,3%). Un 82,3% de los pacientes valoraron positivamente la encuesta, mientras que el 58% la consideró útil. Sin embargo un 23,7% la recomendaría. Conclusiones: El estudio representa, en nuestro conocimiento, el primer intento en nuestro medio por identificar las necesidades y los deseos de los pacientes por conocer cuestiones vinculadas con su enfermedad. En este sentido hemos observado una búsqueda de participación activa en las decisiones vinculadas al manejo de la información y los tratamientos por parte de los pacientes.
Published: 2014
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4. The role of psychological distress in the relationship between illness perception and quality of life in patients with breast cancer

Author: Daniela Gercovich, Pablo Luis López, Diego Bortolato, Patricia Margiolakis, Mirta Morgenfeld, Laura Rosell, and Ernesto Gil Deza
Subjects: Percepción de Enfermedad, calidad de vida, distrés, psicooncología., Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Psychology, BF1-990
Abstract: Objective: To evaluate the associations between the illness perception dimensions and quality of life, assessing the modulatory role of psychological distress in patients with breast cancer, identifying which of these dimensions explained further variability in the different aspects of the quality of life. Methods: Seventy-five patients were evaluated with the Brief Illness Perception Questionnaire and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-30). We calculated bivariate and partial correlations to evaluate the associations between the illness perception dimensions and different aspects of quality of life, controlling for a distress measure. Subsequently, we performed linear regression analysis to evaluate the illness perception dimensions that could explain the variability in the quality of life scores. Results: Although significant associations between subscales of perception of illness and quality of life were found, most of them lost their significance when controlled by distress. In the regression models, variables that best predicted the variability in the quality of life were psychopathological diagnostic and distress. Conclusions: According with the study results, psychological distress and psychopathological diagnostic were the two variables that explained better the variability in the quality of life. For this reason it is essential to learn more about the role of these variables on the quality of life and morbidity and mortality associated with them.
Published: 2013
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5. Abstract P5-13-32: Mucin 4 expression in high risk breast cancer: Predicting and overcoming resistance to immunotherapy

Author: Roxana Schillaci, Sofia Bruni, Florencia Mauro, María F Mercogliano, Agustina Roldan-Deamicis, Cecilia J Proietti, Rosalía Cordo-Russo, Gloria Inurrigarro, Agustina Dupont, Carla Adami, Daniel Lopez Della Vecchia, Sabrina Barchuck, Silvina Figurelli, Ernesto Gil Deza, Sandra Ares, Felipe G Gercovich, and Patricia V Elizalde
Subjects: Cancer Research, Oncology, sense organs
Abstract: Background HER2-positive (+) and triple negative breast cancer (TNBC) have the worst survival among BC. BC patients are treated with chemotherapy (CT) and/or radiotherapy (RT), and HER2+ BC patients also receive targeted therapies, such as trastuzumab (Tz). The abundance of tumor infiltrating lymphocytes (TILs), in both HER2+ and TNBC, has a major good prognostic value. Thus, indicating that immunological evasion mechanisms are present in the tumor microenvironment (TME) hampering the efficacy of the treatments. We previously showed that soluble tumor necrosis factor α (sTNF) induces upregulation of mucin 4 (MUC4), which shields Tz epitope on HER2 impairing Tz binding and its effects. In preclinical models of de no5vo Tz-resistant tumors, administration of the sTNF blocking agent INB03 (DN) together with Tz inhibited tumor growth. We proved that MUC4 expression is an independent predictor of poor DFS in patients treated with adjuvant Tz. Our goal is to study whether MUC4 plays a role in tumor immune evasion in HER2+ and TNBC. Methods Untreated primary BC samples were assessed for TILs density (H&E) and MUC4 expression by immunohistochemistry. Tumors with TILs ≥30% and >50%, for TNBC and HER2+ BC respectively, and MUC4 scores 2 and 3 (0-3) were deemed positive. A cohort of 56 TNBC and 90 HER2+BC, stage I-III were retrospectively retrieved from Hospital Fernández and Instituto Henry Moore from 2013-2017, and clinicopathological and treatment characteristics were obtained from electronic records. TNBC were treated with adjuvant (41) or neoadjuvant CT +/- RT (15). HER2+BC patients received adjuvant Tz + CT. The association between MUC4 and OS was assessed by Kaplan Meier and log rank test and between MUC4 and TILs using Chi2. JIMT-1 HER2+ BC, de novo resistant tumors to Tz, containing a doxycycline (Dox)-inducible shRNA MUC4 plasmid (JIMT-1shMUC4) growing in nude mice were treated with IgG, Tz, DN or Tz + DN. Tumor growth was measured and macrophages and NK cells were determined in the TME by flow cytometry. Anti-asialo GM1 and clodronate-encapsulated liposomes were used to deplete NK cells and macrophages, respectively. Results We found an inverse relationship between TILs and MUC4 expression in HER2+ and TNBC (P=0.02 and P= 5 x10-5, respectively). Patients with MUC4+ TNBC have a shorter OS (P=0.03) and MUC4 was an independent predictor of OS [P=0.01; HR 4.9 (95%CI 1.4-17.0)]. To study MUC4 involvement in macrophage and NK cells recruitment in a Tz resistant model, nude mice bearing JIMT-1-shMUC4 tumors were treated or not with Dox to abolish MUC4 expression. Both groups received IgG, Tz, DN or DN + Tz. In control groups (without Dox), only Tz + DN administration was able to inhibit tumor growth (75% inhibition, P Citation Format: Roxana Schillaci, Sofia Bruni, Florencia Mauro, María F Mercogliano, Agustina Roldan-Deamicis, Cecilia J Proietti, Rosalía Cordo-Russo, Gloria Inurrigarro, Agustina Dupont, Carla Adami, Daniel Lopez Della Vecchia, Sabrina Barchuck, Silvina Figurelli, Ernesto Gil Deza, Sandra Ares, Felipe G Gercovich, Patricia V Elizalde. Mucin 4 expression in high risk breast cancer: Predicting and overcoming resistance to immunotherapy [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 P5-13-32.
Published: 2022
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6. Data from TNFα-Induced Mucin 4 Expression Elicits Trastuzumab Resistance in HER2-Positive Breast Cancer

Author: Roxana Schillaci, Patricia V. Elizalde, Juan C. Roa, Pablo Guzmán, Felipe G. Gercovich, Sandra Ares, Ernesto Gil Deza, Daniel H. Allemand, Isabel Frahm, Gloria Inurrigarro, Cecilia J. Proietti, Martín A. Rivas, Leandro Venturutti, Mara De Martino, and María F. Mercogliano
Abstract: Purpose: Although trastuzumab administration improved the outcome of HER2-positive breast cancer patients, resistance events hamper its clinical benefits. We demonstrated that TNFα stimulation in vitro induces trastuzumab resistance in HER2-positive breast cancer cell lines. Here, we explored the mechanism of TNFα-induced trastuzumab resistance and the therapeutic strategies to overcome it.Experimental Design: Trastuzumab-sensitive breast cancer cells, genetically engineered to stably overexpress TNFα, and de novo trastuzumab-resistant tumors, were used to evaluate trastuzumab response and TNFα-blocking antibodies effectiveness respectively. Immunohistochemistry and antibody-dependent cell cytotoxicity (ADCC), together with siRNA strategy, were used to explore TNFα influence on the expression and function of its downstream target, mucin 4 (MUC4). The clinical relevance of MUC4 expression was studied in a cohort of 78 HER2-positive breast cancer patients treated with adjuvant trastuzumab.Results: TNFα overexpression turned trastuzumab-sensitive cells and tumors into resistant ones. Histopathologic findings revealed mucin foci in TNFα-producing tumors. TNFα induced upregulation of MUC4 that reduced trastuzumab binding to its epitope and impaired ADCC. Silencing MUC4 enhanced trastuzumab binding, increased ADCC, and overcame trastuzumab and trastuzumab-emtansine antiproliferative effects in TNFα-overexpressing cells. Accordingly, administration of TNFα-blocking antibodies downregulated MUC4 and sensitized de novo trastuzumab-resistant breast cancer cells and tumors to trastuzumab. In HER2-positive breast cancer samples, MUC4 expression was found to be an independent predictor of poor disease-free survival (P = 0.008).Conclusions: We identified TNFα-induced MUC4 expression as a novel trastuzumab resistance mechanism. We propose MUC4 expression as a predictive biomarker of trastuzumab efficacy and a guide to combination therapy of TNFα-blocking antibodies with trastuzumab. Clin Cancer Res; 23(3); 636–48. ©2016 AACR.
Published: 2023
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7. Supplementary Figure Legends from TNFα-Induced Mucin 4 Expression Elicits Trastuzumab Resistance in HER2-Positive Breast Cancer

Author: Roxana Schillaci, Patricia V. Elizalde, Juan C. Roa, Pablo Guzmán, Felipe G. Gercovich, Sandra Ares, Ernesto Gil Deza, Daniel H. Allemand, Isabel Frahm, Gloria Inurrigarro, Cecilia J. Proietti, Martín A. Rivas, Leandro Venturutti, Mara De Martino, and María F. Mercogliano
Abstract: Supplementary Figure Legends
Published: 2023
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8. Supplementary Figure 1 from TNFα-Induced Mucin 4 Expression Elicits Trastuzumab Resistance in HER2-Positive Breast Cancer

Author: Roxana Schillaci, Patricia V. Elizalde, Juan C. Roa, Pablo Guzmán, Felipe G. Gercovich, Sandra Ares, Ernesto Gil Deza, Daniel H. Allemand, Isabel Frahm, Gloria Inurrigarro, Cecilia J. Proietti, Martín A. Rivas, Leandro Venturutti, Mara De Martino, and María F. Mercogliano
Abstract: Supplementary Figure S1. Aggressive features of tumors overexpressing TNFα. A-C, H&E staining of BT-474 T2 tumors showing A, muscle and B, dermis infiltration (depicted by arrows). C, peritumor leukocyte infiltration (arrow). D, histopathological analysis of BT-474 T1 tumors. BT-474 T1 tumors were established and treated as described in Figure 2. First and second lines are H&E stainings and third line depicts HER2 staining by IHC. Arrows point out mitotic figures.
Published: 2023
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9. Supplementary Figure 2 from TNFα-Induced Mucin 4 Expression Elicits Trastuzumab Resistance in HER2-Positive Breast Cancer

Author: Roxana Schillaci, Patricia V. Elizalde, Juan C. Roa, Pablo Guzmán, Felipe G. Gercovich, Sandra Ares, Ernesto Gil Deza, Daniel H. Allemand, Isabel Frahm, Gloria Inurrigarro, Cecilia J. Proietti, Martín A. Rivas, Leandro Venturutti, Mara De Martino, and María F. Mercogliano
Abstract: Supplementary Figure S2. Determination and scoring of MUC4 and TNFα expression in breast cancer biopsies by IHC. A, tissue microarrays were used to establish a score of MUC4 by IHC analysis as described by Workman et al (17). Score 0 represents no stain to less than 30% of cells stained faintly, 1+ greater than 30% of cells stained with light to moderate intensity, 2+ greater than 50% of cells stained moderately, 3+ intense staining of majority of the epithelial population. The yellow arrow in the inset of MUC4 (score 0) shows positive staining in endothelial cells, used as an internal control. B, TNFα score was equivalent to that described for MUC4. For both proteins scores of 2+ and 3+ were considered as positive expression.
Published: 2023
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10. Revised Supplementary Tables from TNFα-Induced Mucin 4 Expression Elicits Trastuzumab Resistance in HER2-Positive Breast Cancer

Author: Roxana Schillaci, Patricia V. Elizalde, Juan C. Roa, Pablo Guzmán, Felipe G. Gercovich, Sandra Ares, Ernesto Gil Deza, Daniel H. Allemand, Isabel Frahm, Gloria Inurrigarro, Cecilia J. Proietti, Martín A. Rivas, Leandro Venturutti, Mara De Martino, and María F. Mercogliano
Abstract: Supplementary Table S1. Patient baseline characteristics. Supplementary Table S2. Growth rate of TNFα-producing and control BT-474 tumors treated with trastuzumab
Published: 2023
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11. Revised Supplementary Data from TNFα-Induced Mucin 4 Expression Elicits Trastuzumab Resistance in HER2-Positive Breast Cancer

Author: Roxana Schillaci, Patricia V. Elizalde, Juan C. Roa, Pablo Guzmán, Felipe G. Gercovich, Sandra Ares, Ernesto Gil Deza, Daniel H. Allemand, Isabel Frahm, Gloria Inurrigarro, Cecilia J. Proietti, Martín A. Rivas, Leandro Venturutti, Mara De Martino, and María F. Mercogliano
Abstract: Revised Supplementary Data
Published: 2023
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12. Supplementary Figure 3 from TNFα-Induced Mucin 4 Expression Elicits Trastuzumab Resistance in HER2-Positive Breast Cancer

Author: Roxana Schillaci, Patricia V. Elizalde, Juan C. Roa, Pablo Guzmán, Felipe G. Gercovich, Sandra Ares, Ernesto Gil Deza, Daniel H. Allemand, Isabel Frahm, Gloria Inurrigarro, Cecilia J. Proietti, Martín A. Rivas, Leandro Venturutti, Mara De Martino, and María F. Mercogliano
Abstract: Supplementary Figure S3. MUC4 expression and outcome of patients with luminal breast cancer respect. Kaplan-Meier analysis of the probability of DFS of patients with luminal breast cancer (HER2-negative, estrogen receptor-positive), based on the expression of MUC4. The clinicopathological characteristics of this cohort are shown in Supplementary Table S1.
Published: 2023
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13. Improving Clinical Communication : A Clinician's Guide to Building Better Skills and Patient Outcomes

Author: Ernesto Gil Deza and Ernesto Gil Deza
Subjects: Medicine, Medical care, Nursing, Oncology
Abstract: This is a book about medical communication. Communication is a skill, as such it is learnable and can be refined. Between what we learn in college and clinical practice there is a gap regarding communication with patients and their families that many health professionals want to fill. Thus, the goal of this book is to encourage readers to develop their communication skills in patient care. Chapters cover the possible therapeutic origin of the human word, the placebo effect of the medical word, the distinction between information and communication, and the importance of empathy while communicating with patients. An overview of the medical words throughout history up to our current practice is presented. In addition, the content helps to develop a strategy for nonverbal communication and to analyse the impact of empathy on communication and patient satisfaction. Current topics such as special needs for LGBTQ patient care, telehealth and virtual communication are also featured in this book. Knowing how to communicate is healthy not only for the patient but also for the doctor. Therefore, the prevention of medical burnout through adequate communication, both in routine practice, and with patients with special needs, as well as in telemedicine is also discussed. Finally, the author addresses a personal and non-transferable task: each individual must build their own toolbox for communication - the stories, the anecdotes, the metaphors, the silences with which each of the readers will use to communicate with their patients. The aim of this book is to bridge a gap between the graduate and postgraduate training for dealing with information and problems in communicating during clinical practice. Since it is never too late to acquire or improve our communication skills, this work will be a useful and valuable resource for any health professional interested in the subject.
Published: 2024

14. SUN-122 Nuclear PDCD4 Expression Predicts Good Clinical Outcome in Luminal A-Like and Luminal B-Like Breast Cancer Subtypes

Author: Pablo Guzmán, Juan Carlos Roa, Silvina Figurelli, Agustina Roldán Deamicis, Rosalia Ines Cordo Russo, Leandro Venturutti, Mauro E. Cenciarini, Felipe G. Gercovich, Agustina Dupont, María F. Chervo, Violeta A. Chiauzzi, Santiago Madera, Sabrina Barchuk, Daniel Lopez Della Vecchia, Cecilia Jazmín Proietti Anastasi, Patricia V. Elizalde, Matías G. Pereyra, Roxana Schillaci, Sandra L. Ares, and Ernesto Gil Deza
Subjects: business.industry, Tumor Biology: Diagnostics, Therapies, Endocrine Neoplasias, and Hormone Dependent Tumors, Endocrinology, Diabetes and Metabolism, Cancer, Luminal a, Luminal b, medicine.disease, Breast cancer, Cancer research, medicine, Biomarker (medicine), Tumor Biology, business, AcademicSubjects/MED00250
Abstract: Hormone receptor-positive (HR+, estrogen and/or progesterone receptor-positive) and HER2-negative breast cancer (BC) subtype is a biologically heterogeneous entity that comprises 70% of BCs. This subtype includes both luminal (Lum) A- and B-like subtypes, which have differences in prognosis and sensitivity to endocrine therapies. The development of biomarkers guiding treatment decisions in these settings is required. Tumor suppressor PDCD4 (programmed cell death 4), which can be found both in the nucleus (NPDCD4) or the cytoplasm (CPDCD4), inhibits tumor growth and metastasis, and its loss is associated with poor prognosis in solid tumors. To explore the clinical relevance of PDCD4 in BC, we analyzed its expression by immunohistochemistry in a cohort of 619 patients with primary invasive BC. We found that 34.7% of patients showed NPDCD4 and 21.3% showed CPDCD4. NPDCD4 positivity, but not CPDCD4, was associated with lower clinical stage (P = 0.0003), with presence of more differentiated tumors (P = 6.4x10-6), and with estrogen and progesterone receptor (PR) expression (P = 9.2x10-9 and P = 2.8x10-9, respectively). Kaplan-Meier analysis revealed that NPDCD4 expression was associated with a longer overall survival (OS) and disease-free survival (DFS) in LumA-like (P = 0.008 and P = 0.028, respectively) and LumB-like (P = 0.004 and P = 0.012, respectively) subtypes. Interestingly, patients with LumB-like tumors displaying NPDCD4 presented estimated OS and DFS rates similar to the ones observed in patients with LumA-like tumors also expressing NPDCD4, indicating that its presence improves the clinical outcome of LumB-like patients. Multivariate Cox regression analysis identified NPDCD4 as an independent predictor of good clinical outcome in both LumA-like (HR: 0.45, 95% CI 0.22-0.96, P = 0.038) and LumB-like (HR: 0.28, 95% CI 0.10-0.80, P = 0.018) subtypes. We validated our results by in silico analysis using expression data from the METABRIC cohort. Bioinformatics analysis of BC cells from the Cancer Cell Line Encyclopedia revealed a positive correlation between PDCD4 and PR expression (P = 0.015). Since LumB-like tumors present a higher risk of resistance to endocrine therapy and both PR and PDCD4 levels in this subtype are lower than in the LumA-like one, we postulated that the presence of PR may modulate PDCD4 expression. Silencing of PR expression in HR+ cells decreased PDCD4 protein levels while reconstitution of PR in a PR-null cell line increased them, confirming PR requirement for PDCD4 modulation. In line with PDCD4 physiological function, its knockdown increased cell migration capability of HR+ BC cells, whereas its restoration led to a decrease in cell migration of HR-negative BC models. Our findings identified NPDCD4 positivity as a novel biomarker of clinical outcome in LumA- and B-like subtypes and revealed PDCD4 reconstitution as a novel therapeutic strategy in BC.
Published: 2020

15. Nuclear PDCD4 Expression Defines a Subset of Luminal B-Like Breast Cancers with Good Prognosis

Author: Cecilia J. Proietti, Sandra L. Ares, Ernesto Gil Deza, Pablo Guzmán, Juan Carlos Roa, Agustina Dupont, Agustina Roldán Deamicis, Roxana Schillaci, Rosalia Ines Cordo Russo, Sabrina Barchuk, Franco Izzo, Felipe G. Gercovich, Matías G. Pereyra, Leandro Venturutti, Fabiana Anfuso, Patricia V. Elizalde, Eduardo Cortese, Teresa Castiglioni, Violeta A. Chiauzzi, Mauro E. Cenciarini, Santiago Madera, Gabriel Lebersztein, Silvina Figurelli, Claudio Levit, María F. Chervo, and Daniel Lopez Della Vecchia
Subjects: 0301 basic medicine, Cancer Research, medicine.drug_class, Otras Ciencias Biológicas, Endocrinology, Diabetes and Metabolism, BIOMARKERS, Luma, Breast Neoplasms, Disease, HORMONE-DEPENDENT BREAST CANCER, Ciencias Biológicas, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Breast cancer, BREAST CANCER, Progesterone receptor, Medicine, Gene silencing, Humans, LUMINAL B-LIKE BREAST CANCER, PDCD4, Endocrine and Autonomic Systems, business.industry, RNA-Binding Proteins, medicine.disease, Prognosis, 030104 developmental biology, Oncology, Estrogen, 030220 oncology & carcinogenesis, Cancer research, Biomarker (medicine), Immunohistochemistry, Female, TUMOR SUPPRESSOR, business, Apoptosis Regulatory Proteins, CIENCIAS NATURALES Y EXACTAS
Abstract: The hormone receptor-positive (estrogen and/or progesterone receptor (PR)-positive) and HER2-negative breast cancer (BC) subtype is a biologically heterogeneous entity that includes luminal A-like (LumA-like) and luminal B-like (LumB-like) subtypes. Decreased PR levels is a distinctive biological feature of LumB-like tumors. These tumors also show reduced sensitivity to endocrine therapies and poorer prognosis than LumA-like tumors. Identification of biomarkers to accurately predict disease relapse in these subtypes is crucial in order to select effective therapies. We identified the tumor suppressor PDCD4 (programmed cell death 4), located in the nucleus (NPDCD4), as an independent prognostic factor of good clinical outcome in LumA-like and LumB-like subtypes. NPDCD4-positive LumB-like tumors presented overall and disease-free survival rates comparable to those of NPDCD4-positive LumA-like tumors, indicating that NPDCD4 improves the outcome of LumB-like patients. In contrast, NPDCD4 loss increased the risk of disease recurrence and death in LumB-like compared with LumA-like tumors. This, along with our results showing that LumB-like tumors present lower NPDCD4 positivity than LumA-like tumors, suggests that NPDCD4 loss contributes to endocrine therapy resistance in LumB-like BCs. We also revealed that PR induces PDCD4 transcription in LumB-like BC, providing a mechanistic explanation to the low PDCD4 levels in LumB-like BCs lacking PR. Finally, PDCD4 silencing enhanced BC cell survival in a patient-derived explant model of LumB-like disease. Our discoveries highlight NPDCD4 as a novel biomarker in LumA- and LumB-like subtypes, which could be included in the panel of immunohistochemical markers used in the clinic to accurately predict the prognosis of LumB-like tumors. Fil: Madera, Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Chervo, María Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Chiauzzi, Violeta Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Pereyra Matías G.. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Venturutti, Leandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Izzo, Franco. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Roldán Deamicis, Agustina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Guzmán, Pablo. Universidad de La Frontera. Núcleo Científico y Tecnológico en Recursos Naturales; Chile Fil: Dupont, Agustina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Roa, Juan Carlos. Universidad de La Frontera. Núcleo Científico y Tecnológico en Recursos Naturales; Chile. Universidad Católica de Chile; Chile Fil: Cenciarini, Mauro Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Barchuk, Sabrina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; Argentina Fil: Figurelli, Silvina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; Argentina Fil: Lopez Della Vecchia, Daniel Edgardo. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; Argentina Fil: Levit, Claudio. Sanatorio Sagrado Corazón. Servicio de Ginecología; Argentina Fil: Lebersztein, Gabriel. Sanatorio Sagrado Corazón. Servicio de Ginecología; Argentina Fil: Anfuso, Fabiana. Sanatorio Sagrado Corazón. Servicio de Ginecología; Argentina Fil: Castiglioni, Teresa. Centro de Patología Dr. Elsner; Argentina Fil: Cortese, Eduardo Mateo. Hospital Aeronáutico Central. Servicio de Ginecología; Argentina Fil: Ares, Sandra. Instituto Oncológico Henry Moore; Argentina Fil: Gil Deza, Ernesto. Instituto Oncológico Henry Moore; Argentina Fil: Gercovich, Felipe G.. Instituto Oncológico Henry Moore; Argentina Fil: Proietti Anastasi, Cecilia Jazmín. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Schillaci, Roxana. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Cordo Russo, Rosalía I.. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Elizalde, Patricia Virginia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina
Published: 2020

16. Invasive micropapillary carcinoma of the breast overexpresses MUC4 and is associated with poor outcome to adjuvant trastuzumab in HER2-positive breast cancer

Author: Elmer Andrés Fernández, Rosalía Cordo-Russo, Mara De Martino, Roxana Schillaci, Leandro Venturutti, Cecilia J. Proietti, Felipe G. Gercovich, Pablo Guzmán, Juan Carlos Roa, Isabel Frahm, Sabrina Barchuk, Matias Amasino, Patricia V. Elizalde, Gloria Inurrigarro, Silvina Figurelli, Daniel H. Allemand, Martín A. Rivas, María Florencia Mercogliano, Eduardo Cortese, Sandra L. Ares, and Ernesto Gil Deza
Subjects: 0301 basic medicine, Oncology, Cancer Research, Receptor, ErbB-2, TRASTUZUMAB, Estrogen receptor, Medicina Clínica, Mucin 4 (MUC4), Metastasis, 0302 clinical medicine, Antineoplastic Agents, Immunological, Surgical oncology, Trastuzumab, purl.org/becyt/ford/3.2 [https], Medicine, Mucinous carcinoma, skin and connective tissue diseases, Invasive micropapillary carcinoma of the breast (IMPC), Carcinoma, Ductal, Breast, Patología, purl.org/becyt/ford/3.1 [https], MUCIN 4 (MUC4), Middle Aged, Prognosis, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Survival Rate, Medicina Básica, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Biomarker (medicine), purl.org/becyt/ford/3 [https], Female, Medicina Critica y de Emergencia, medicine.drug, Research Article, Adult, medicine.medical_specialty, CIENCIAS MÉDICAS Y DE LA SALUD, Inmunología, Breast Neoplasms, INVASIVE MICROPAPILLARY CARCINOMA OF THE BREAST(IMPC), lcsh:RC254-282, 03 medical and health sciences, Breast cancer, Internal medicine, HER2, Genetics, Biomarkers, Tumor, Humans, Clinical significance, Neoplasm Invasiveness, Aged, Retrospective Studies, Mucin-4, business.industry, medicine.disease, Carcinoma, Papillary, 030104 developmental biology, Case-Control Studies, business, Follow-Up Studies
Abstract: Invasive micropapillary carcinoma of the breast (IMPC) is a histological tumor variant that occurs with low frequency characterized by an inside-out formation of tumor clusters with a pseudopapillary arrangement. IMPC is an aggressive tumor with poor clinical outcome. In addition, this histological subtype usually expresses human epidermal growth factor receptor 2 (HER2) which also correlates with a more aggressive tumor. In this work we studied the clinical significance of IMPC in HER2-positive breast cancer patients treated with adjuvant trastuzumab. We also analyzed mucin 4 (MUC4) expression as a novel biomarker to identify IMPC. Fil: Mercogliano, María Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Inurrigarro, Gloria. Sanatorio Mater Dei Hermanas de María de Schoenstatt; Argentina Fil: de Martino, Mara. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Venturutti, Leandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Rivas, Martin Alfredo. Cornell University; Estados Unidos Fil: Cordo Russo, Rosalia Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Proietti Anastasi, Cecilia Jazmín. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Fernandez, Elmer Andres. Universidad Católica de Córdoba; Argentina Fil: Frahm, Isabel. Sanatorio Mater Dei Hermanas de María de Schoenstatt; Argentina Fil: Barchuk, Sabrina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos ; Argentina Fil: Allemand, Daniel H.. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos ; Argentina Fil: Figurelli, Silvina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos ; Argentina Fil: Gil Deza, Ernesto. Instituto Oncológico Henry Moore; Argentina Fil: Ares, Sandra. Instituto Oncológico Henry Moore; Argentina Fil: Gercovich, Felipe G.. Instituto Oncológico Henry Moore; Argentina Fil: Cortese, Eduardo. Ministerio de Defensa. Fuerza Aérea Argentina. Hospital Aeronáutico Central ; Argentina Fil: Amasino, Matías. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Guzmán, Pablo. Universidad de La Frontera; Chile Fil: Roa, Juan C.. Universidad de La Frontera; Chile Fil: Elizalde, Patricia Virginia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Schillaci, Roxana. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina
Published: 2017
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17. COVID-19 and medical education: Rethinking student assessment—The Virtual Observational Standard Clinical Examination

Author: Leonel Smolje, Cesar Gonzalez, Monica Montiel, Felipe G. Gercovich, Ernesto Gil Deza, Carlos Fernando Garcia Gerardi, Flavio Tognelli, Mariana Abal, Alba Marin Ordoñez, Marta Dragosky, Edgardo G. J. Rivarola, Iohm-Usal-Ecoe, Maximiliano Brandon, Lourdes Gil Deza, Gaston Martin Reinas, Claudia Lorena Acuna, Eduardo L. Morgenfeld, María del Huerto Jaunarena, and N. Gercovich
Subjects: Cancer Research, Medical education, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), medicine.diagnostic_test, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Physical examination, Student assessment, Oncology, Pandemic, medicine, Observational study, business
Abstract: 11005 Background: The COVID-19 pandemic introduced new challenges for medical education. In particular, student assessment posed some of the most urging questions. How do we evaluate practical skills when our universities are on lockdown and our hospitals are working on a shortage of personnel? Is it possible to evaluate these skills via online means, mitigating the effects in students’ career development? This paper presents an online evaluation experience implemented at Instituto Oncológico Henry Moore-Universidad del Salvador, Buenos Aires in the postgraduate program of Clinical Oncology. The Virtual Observational Standard Clinical Examination (V-OSCE) is a technology-based adaptation of the Observational Standard Clinical Examination (OSCE) (JCO 34 (15), Abstract e18150, 2017) implemented in previous years. Methods: The V-OSCE took place in November 14, 2020 and consisted on a half-day evaluation during which students rotated through 8 stations (Table). The exam ran on three platforms: Blackboard Collaborate for the interactive elements of all stations; University online campus (Moodle platform) for student questionnaires, and Google Forms for the evaluators’ assessment of each student. Students and evaluators participated in various training sessions, and were given a month to practice before the exam. All interactions were recorded and an anonymous survey on students’ experience and opinions was conducted after the exam. Results: A total of 25 postgraduate Oncology students participated in the V-OSCE. 24 students (96%) completed all stations on time with minimum or no network connection issues. Student opinions: 24 students completed the exam experience anonymous survey; 23 found the exam tech-friendly and valued the practice time provided. When asked to score the exam in a scale of 1 to 10: 80% of the students ranked the exam with 9 or 10; and 20%, with 7 or 8. Conclusions: A) It is feasible to design new ways to assess medical students via online means. B) The experience of an OSCE can be translated to an online environment with minimum technological requirements. C) The COVID-19 pandemic effects are extensive, with serious implications in medical education. However, it has proved to be an opportunity to rethink our educational practices, design innovative formative experiences, and assess new skills that will remain significant even long after the pandemic has ended.[Table: see text]
Published: 2021
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18. Teleoncology: Assessing online communication skills of millennial medical students

Author: Leonel Smolje, Edgardo G. J. Rivarola, Claudia Lorena Acuna, Sandra L. Ares, Flavio Tognelli, Alba Marin Ordoñez, Iohm-Usal-Ecoe, Monica Montiel, Felipe G. Gercovich, Lourdes Gil Deza, Cesar Gonzalez, Daniela Gercovich, Ernesto Gil Deza, Carlos Fernando Garcia Gerardi, Marta Dragosky, Maximiliano Brandon, Eduardo L. Morgenfeld, Mariana Abal, and Gaston Martin Reinas
Subjects: Cancer Research, Medical education, Telemedicine, Oncology, Coronavirus disease 2019 (COVID-19), business.industry, Medicine, In patient, Communication skills, business
Abstract: e13616 Background: COVID-19 posed new challenges in patient care and led to an increase in teleoncology. This paper analyzes telemedicine communication skills of millennial medical students of the postgraduate program of Clinical Oncology at Universidad del Salvador, Buenos Aires. Methods: Student assessment was based on a video call interaction with simulated patients in two stations (30 minutes each) of the Virtual Observational Standard Clinical Examination (V-OSCE), implemented in November 2020. Students received virtual communication guidelines and participated in training sessions to use the video call platform. All interactions were recorded. Assessment items (Table). Results: A total of 25 students were evaluated: 1 (4%) was ineligible due to network connection issues; 24 (96%) participated in both interactions. We analyzed 48 interactions in total. Opening: 6/48 interactions completed all five required items. Most recurring problems: not checking for patient’s previous experience with teleoncology (37/48) and not providing an alternative communication channel in case of technical difficulties (40/48). Middle: the results were similar to in-person interaction observed in previous exams, 35/48 interactions completed all required items. End: 16/48 interactions completed both items. In 32/48 the student did not check for patient understanding of the information provided. Only 3/48 interactions completed all 12 items. Conclusions: A) The V-OSCE is a useful tool to practice and evaluate teleoncology communication skills. B) The Middle Moment of the interactions was similar to an in-person interaction. However, the Opening and End of the interview were more challenging. The most critical struggles being: checking for patient’s previous experience in teleoncology, providing an alternative communication channel in case of technical difficulties and checking for patient understanding. C) COVID-19 established new forms of communication that are likely to remain even after the pandemic has ended. It is important to address this demand for online communication skills in medical education curricula.[Table: see text]
Published: 2021
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19. Del cáncer y sus demonios : Un mapa de la esperanza

Author: Ernesto Gil Deza and Ernesto Gil Deza
Abstract: ¿Qué es el cáncer? ¿Siempre se necesita una biopsia? ¿Porqué se comporta de esa manera? ¿Es posible imaginar en un futuro una humanidad libre de cáncer? ¿Tengo cáncer porque hice algo mal? ¿El tumor puede tener un origen psicológico? ¿Como sé si el tumor está diseminado? ¿Qué nuevos tratamientos existen? ¿ Siempre se usa quimioterapia? ¿El tumor puede volver a aparecer? ¿Se le puede decir a un paciente la verdad? ¿Le interesa a los pacientes conocer el pronóstico? ¿Es razonable participar en estudios de investigación? ¿Sirven los tratamientos alternativos? ¿El apoyo psicológico es útil? ¿Qué son los cuidados paliativos? ¿Como sobrevivir al cáncer? ¿Se puede volver a creer, a esperar, a confiar? En la tradición de los mejores libros de divulgación científica aplicados a la medicina, el doctor Gil Deza nos deja asombrados y emocionados con un recorrido fascinante por la relación entre los pacientes y el cáncer. Igual que Oliver Sacks o Henry Marsh, Gil Deza nos enseña que es posible escribir con elegancia y erudición sobre padecimientos, enfermos y recuperaciones, sin golpes bajos ni concesiones infantiles. No es este un libro de autoayuda ni explora terrenos sensacionalistas; es un libro con historias de pacientes y de médicos, de miedos y desafíos, de sanación y de victorias, de luchas y de esperanza. Gil Deza cree, y nos enseña, que hay un modo de contar y describir el enfrentamiento con el cáncer donde se juega gran parte de los que nos define como seres humanos: la empatía y el amor como herramientas indispensables para aplicar los conocimientos científicos.
Published: 2019

20. High incidence of brain metastasis in young patients with lung adenocarcinoma

Author: Gaston Martin Reinas, Alba Marin Ordoñez, Edgardo G. J. Rivarola, Monica Montiel, Maximiliano Brandon, Mariana Abal, Felipe G. Gercovich, Eduardo L. Morgenfeld, Ernesto Gil Deza, Ilene Ramirez, and Liliana D Gonzalez
Subjects: Oncology, Cancer Research, medicine.medical_specialty, Lung, business.industry, medicine.disease, medicine.anatomical_structure, Internal medicine, medicine, Adenocarcinoma, High incidence, Lung cancer, business, Brain metastasis
Abstract: e21677 Background: Young patients with lung cancer are unusual. This paper focuses on our experience with Young Patients (
Published: 2020
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21. 'Smoke and screens': How streaming spreads the habit of smoking

Author: Edgardo G. J. Rivarola, Carlos Fernando Garcia Gerardi, Ernesto Gil Deza, Dario Niewiadomski, Ilene Ramirez, Alba Marin Ordoñez, Mariana Abal, Maximiliano Brandon, Eduardo L. Morgenfeld, N. Gercovich, Lourdes Gil Deza, Flavio Tognelli, and Felipe G. Gercovich
Subjects: Smoke, Cancer Research, Oncology, business.industry, media_common.quotation_subject, Medicine, Advertising, Habit, business, Media content, media_common
Abstract: e13563 Background: In Argentina, half of the media content reaches viewers through streaming platforms. This papers studies the frequency of smoking in fifty of the most watched programs on Netflix Argentina, and the average exposure to this habit in one hour of viewing. Methods: Between October 1, 2019, and January 10, 2020, we observed fifty of the most watched series on Netflix Argentina, set in the twentieth century or afterwards. The programs were grouped by Netflix Maturity Rating to analyze the frequency of smoking in shows available to different age groups. We established if smoking was present in the show and randomly selected one episode of each to time the amount of smoking. All times were standardized to 60 minutes to compare episodes of different duration. Results: Table shows the frequency of smoking in each of the Netflix Maturity Rating categories. The average exposure time to smoking is 2.5 minutes (r = 0-8 min) every 60 minutes. Conclusions: 1) Viewers are exposed to smoking in 64% of the most watched series on Netflix Argentina, for an equivalent of time to at least three tobacco advertisements per hour. 2) Smoking takes place in 50% to 73% of the series available to teenage viewers (rated 13+ or 16+). 3) Netflix has publicly committed to eradicate smoking from its series. We must ensure this commitment is fulfilled and extended to other streaming platforms and production companies. [Table: see text]
Published: 2020
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22. Vitiligo is correlated with clinical benefits in patients with advanced cutaneous melanoma treated with immune checkpoint inhibitors (ICI)

Author: Marcelo Muino, Mariana Abal, Carlos Fernando Garcia Gerardi, Liliana D Gonzalez, Felipe G. Gercovich, Marcelo Andres Nunell, Cesar Gonzalez, Flavio Tognelli, Ernesto Gil Deza, Edgardo G. J. Rivarola, Alba Marin Ordoñez, Eduardo L. Morgenfeld, and Gaston Martin Reinas
Subjects: Oncology, Cancer Research, medicine.medical_specialty, business.industry, Immune checkpoint inhibitors, Vitiligo, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal medicine, Cutaneous melanoma, Medicine, In patient, skin and connective tissue diseases, business, 030215 immunology
Abstract: e22023 Background: Use of ICI changed the treatment of Advanced Cutaneous Melanoma Patients (ACMP). This paper analyzes the evolution of ACMP who develop vitiligo during ICI treatment at Instituto Oncológico Henry Moore (IOHM). Methods: We selected all ACMP that received ICI between August 2015 and December 2019. We collected clinical data and compared Group A (ACMP with vitiligo) with Group B (ACMP without vitiligo) on: response rate (RR), time from ICI treatment initiation to progression (TTP) and overall survival (OS), defined as time from ICI treatment initiation to death. Outcomes were assessed using table tests and Kaplan-Meier curves with log-rank test. Results: Out of 32 ACMP treated with ICI, 12 Pt (37%) were in Group A and 20 Pt (63%) were in Group B. Table shows group characteristics and outcomes. Conclusions: 1) During treatment with ICI, 12 out of 32 (37%) advanced cutaneous melanoma patients were afflicted with vitiligo. 2) Two out of three patients who responded to ICI treatment developed vitiligo and obtained better TTP and OS than those without vitiligo. 3) According to these results, vitiligo is the consequence of the immune system reactivation responsible for considerable clinical benefits. Further studies should analyze if it is feasible to reduce ICI doses in patients who develop this adverse effect. 4) In this small and retrospective series, Nivolumab was more frequently correlated with vitiligo and clinical benefits, but we need prospective studies to decide which ICI treatment is the most effective. [Table: see text]
Published: 2020
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23. Real-world evidence: A retrospective-cohort study of castration-resistant advanced prostate cancer (CRAPC) patients treated with abiraterone 1000 mg or 250 mg

Author: Edgardo G. J. Rivarola, Sandra L. Ares, Felipe G. Gercovich, Claudia Lorena Acuna, Ernesto Gil Deza, Liliana D Gonzalez, Cesar Gonzalez, Carlos Fernando Garcia Gerardi, Leonel Smolje, Dario Niewiadomski, Marcelo Muino, and Eduardo L. Morgenfeld
Subjects: Oncology, Cancer Research, medicine.medical_specialty, business.industry, Retrospective cohort study, Castration resistant, Real world evidence, medicine.disease, Stoma, Abiraterone, chemistry.chemical_compound, Prostate cancer, chemistry, Internal medicine, medicine, business
Abstract: e19315 Background: The efficacy of Abiraterone 250 mg with food was established ten years ago (Ryan JCO 2010). Recent publications (Szmulewitz JCO 2018) have concluded that 1000 mg on an empty stomach or 250 mg with food have similar results. This paper focuses on our experience with patients treated with either scheme at Instituto Oncológico Henry Moore (IOHM). Methods: Between July 2013 and December 2019, CRAPC patients were treated with Abiraterone 1000 mg on an empty stomach (Group A) or 250 mg with breakfast (Group B), according to the decision of the attending physician. Both groups received 5 mg of Prednisone twice a day. All cases from Group B were included and they were matched in a 1:2 ratio with Group A by two criteria: age at diagnosis and interval between diagnosis and Abiraterone. We studied: A) response rate of PSA at 12 weeks, B) time to progression, C) post-Abiraterone survival and D) overall survival. Results: We included 99 patients in the study: 66 in Group A and 33 in Group B. The table below shows population characteristics and results. Conclusions: 1) Abiraterone 1000 mg on an empty stomach or 250 mg with food both have similar outcomes. 2) In Argentina, the monthly cost of Abiraterone 1000 mg per patient is equivalent to USD 5,300. This cost can be reduced by 75% with Abiraterone 250 mg with food without losing efficacy. [Table: see text]
Published: 2020
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24. Lessons on humanity: The voice of cancer patients through a literary contest

Author: Lourdes Gil Deza, Marta Dragosky, Dario Niewiadomski, Eduardo L. Morgenfeld, Felipe G. Gercovich, Ernesto Gil Deza, N. Gercovich, Leonel Smolje, Claudia Lorena Acuna, Alba Marin Ordoñez, Edgardo G. J. Rivarola, Inés Danussi, Flavio Tognelli, Marcelo Muino, Daniela Gercovich, and Sandra L. Ares
Subjects: Cancer Research, Oncology, Aesthetics, business.industry, Humanity, Medicine, Cancer, Narrative, CONTEST, business, medicine.disease
Abstract: e24189 Background: Most cancer narratives are provided by skilled American and British writers (Broyard, Hitchens, Jobs, Kalanithi, Pausch, Sacks, Sontag or Wishart). This paper highlights the voice of ordinary Latin American patients who wrote about their experience. Methods: Between February 2, 2019 and March 3, 2019, the first author encouraged cancer patients to narrate their experience with the disease for an online literary contest (“ www.oncologiaesperanzadora.com ”). After studying all submissions, we grouped attitudes, feelings, metaphors and descriptions used in different domains related to the course of the disease. A text-mining study was conducted to identify the context of keywords in each of the domains. Results: In total, 224 literary works were submitted to the contest. Characteristics of the population: sex F/M: 184/40; age at time of contest: 53 yo (18-82); time between diagnosis and submission to contest: 8 y (1-73); country of origin: Argentina (201), other countries (23); diagnosis: breast (130), hematological (15), colorectal (13), melanoma (6), lung (5), head and neck (5), kidney (3), other (47). The table shows keywords found in each of the domains. Conclusions: 1) Cancer patients are willing to share their story if they are given the opportunity. 2) Through the narratives of the disease, it is possible to study its impact on patients’ lives and the different coping strategies. 3) Reading the experience of patients with the disease in their own voice is a valuable instrument for medical education. [Table: see text]
Published: 2020
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25. Caring for transgender cancer patients: Shortcomings of medical education

Author: Marcelo Andres Nunell, Alfredo Navigante, Lourdes Gil Deza, Carlos Fernando Garcia Gerardi, Rubén Lovisolo, Marcelo Muino, María del Huerto Jaunarena, Estefania E Kaminski, Monica Montiel, Inés Danussi, Mariana Abal, Mariano G Fernandez, Daniela Gercovich, Ernesto Gil Deza, Felipe G. Gercovich, Eduardo L. Morgenfeld, Usal-Hm Ecoe, Flavio Tognelli, Gaston Martin Reinas, Leonel Smolje, and Cesar Gonzalez
Subjects: Cancer Research, medicine.medical_specialty, Oncology, business.industry, Family medicine, education, Transgender, medicine, Cancer, Specific knowledge, business, medicine.disease
Abstract: 11002 Background: Caring for transgender patients requires specific knowledge and skills. Medical schools spend less than 5 hours on average training for treatment of LGBT patients (Obedin-Maliver, JAMA, 306 (9), 971). This paper assesses the knowledge on the topic and skills of postgraduate Oncology students from Universidad del Salvador at the Observational Standard Clinical Examination (OSCE) 2019 (JCO 34 (15), Abstract e18150, 2017). Methods: At one of the stations of OSCE 2019, students had thirty minutes to complete a clinical record of a simulated transman patient with ovarian cancer stage IIIC. Based on the real case of Robert Eads, actors were trained with the documentary on his life “Southern Comfort”. Students were assessed on: A) knowledge of the transman condition, B) use of preferred gender pronoun by the patient, C) discontinuation of testosterone treatment, D) recommendation of genetic study, E) treatment of ovarian cancer according to NCCN guidelines, F) moral discomfort with LGBT patient care. All interviews were filmed or recorded by an observer. All films, recordings and clinical records were reviewed to rate the students' performance. Results: A total of 25 postgraduate Oncology students took the OSCE 2019. Assessment: A) 5/25 (20%) lacked knowledge of the transman condition, B) 3/25 (12%) did not use the patient's preferred gender pronoun, C) 17/25 (68%) discontinued testosterone, D) 23/25 (92%) requested genetic study, E) all students treated ovarian cancer according to NCCN guidelines, F) none expressed moral discomfort with LGBT patient care. Conclusions: 1) It is feasible to assess the knowledge and skills required for treatment of transgender patients in Oncology. 2) We found shortcomings of student's medical training regarding transgender patients: one in five did not understand the patient's condition, three did not use the patient´s preferred gender pronoun during the interview and more than half suspended the necessary hormone therapy for their condition. 3) This emphasizes the need to deepen our medical and communication skills in order to assist the transgender population and should be included in future ASCO-ASH milestones for specialty accreditation.
Published: 2020
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26. Erratum to propeller thoracodorsal artery perforator flap for breast reconstruction

Author: Guillermo Artero, Alberto Rancati, Claudio Angrigiani, Ernesto Gil Deza, Gustavo Gercovich, and Ezequiel Escudero
Subjects: Thoracodorsal artery, medicine.medical_specialty, animal structures, business.industry, medicine.artery, medicine, Propeller, Surgery, Original Article, Erratum, business, Breast reconstruction
Abstract: The thoracodorsal artery perforator (TDAP) flap has been described for breast reconstruction. This flap requires intramuscular dissection of the pedicle. A modification of the conventional TDAP surgical technique for breast reconstruction is described, utilizing instead a propeller TDAP flap. The authors present their clinical experience with the propeller TDAP flap in breast reconstruction alone or in combination with expanders or permanent implants.From January 2009 to February 2013, sixteen patients had breast reconstruction utilizing a propeller TDAP flap. Retrospective analysis of patient characteristics, clinical indications, procedure and outcomes were performed. The follow-up period ranged from 4 to 48 months.Sixteen patients had breast reconstruction using a TDAP flap with or without simultaneous insertion of an expander or implant. All flaps survived, while two cases required minimal resection due to distal flap necrosis, healing by second intention. There were not donor-site seromas, while minimal wound dehiscence was detected in two cases.The propeller TDAP flap appears to be safe and effective for breast reconstruction, resulting in minimal donor site morbidity. The use of this propeller flap emerges as a true alternative to the traditional TDAP flap.
Published: 2018

27. Business versus science: High drug prices conspire against oncological research

Author: Leonardo Smolje, Marcelo Muino, Felipe G. Gercovich, Mariana Abal, Eduardo L. Morgenfeld, Edgardo G. J. Rivarola, Ernesto Gil Deza, Gaston Martin Reinas, and Marvin Albert Mizrahi
Subjects: Clinical trial, Drug, Cancer Research, medicine.medical_specialty, Oncology, business.industry, media_common.quotation_subject, Drug prices, Medicine, business, Intensive care medicine, Pharmaceutical industry, media_common
Abstract: e14580 Background: It has been consistently proven that pivotal clinical trials (PCT) for drug registration or new drug indications (NDI), sponsored by the pharmaceutical industry, obtain better results than independent confirmatory studies (ICS). The interplay between PCT and ICS has supported better treatment selections and more realistic expectations: hope vs hype.The aim of this paper is to analyze the amount of ICS publications in Oncology within the last decade. Methods: All new FDA approved oncological drugs or NDI for solid tumors between 2005 and 2017 were taken into account. The PCT that led to their approval were identified, and between October and November 2019 a thorough search for related ICS (published or ongoing) was conducted on MEDLINE, ASCO Abstracts, NEJM, Lancet Oncology, JAMA, JCO, Cancer, PLOS ONE, PLOS Medicine and www.Clinicaltrials.gov. Results: Fifty-five new drugs or NDI were analyzed (Abemaciclib, Abiraterone, Ado-trastuzumab emtasine, Afatinib, Alectinib, Atezolizumab, Avelumab, Axitinib, Bendamustine, Bevacizumab, Brigatinib, Cabozantinib, Ceritinib, Cobimetinib, Crizotinib, Dabrafenib, Degarelix, Denosumab, Durvalumab, Eribuline mesylate, Everolimus, Ipilimumab, Irinotecan liposome, Ixabepilone, Lapatinib, Lenvatinib, Necitumumab, Neratinib, Nilotinib, Niraparib, Nivolumab, Olaparib, Osimertinib, Paclitaxel protein bound, Palbociclib, Panitumumab, Pazopanib, Pembrolizumab, Pertuzumab, Ramucirumab, Regorafenib, Ribociclib, Rucaparib, SipuleucelT, Sonidegib, Sorafenib, Sunitinib, Topotecan, Trabectedin, Trametinib, Trastuzumab, Vandetanib, Vemurafenib, Vismodegib, Ziv-afilbercept). Until November 30, 2019, no published or ongoing ICS were found in any of the cases. Conclusions: a) For the past decade, none of the PCT used for approval of new oncological drugs or NDI were replicated by ICS (without pharmaceutical industry sponsorship). b) We ignore the reasons for these approval methods but they raise suspicion and unnecessary discomfort. c) From an ethical point of view, patients’ Informed Consent must specify that expected results for the new drug or NDI are based exclusively on trials sponsored by the selling pharmaceutical company, unless other ICS are published. d) The current state of affairs can only be reverted if regulatory agencies and the scientific community demand ICS as part of the drug approval process or post-marketing duties.
Published: 2019
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28. Psycho-Oncology: Cancer patients with past suicide attempts, or a family history of suicide

Author: Mirta Morgenfeld, Edgardo G. J. Rivarola, Eduardo L. Morgenfeld, Carlos Fernando Garcia Gerardi, Claudia Lorena Acuna, Felipe G. Gercovich, Flavio Tognelli, Ernesto Gil Deza, Daniela Gercovich, and Cesar Gonzalez
Subjects: Cancer Research, medicine.medical_specialty, education.field_of_study, business.industry, Population, Psycho-oncology, Cancer, Suicide rates, medicine.disease, Oncology, Medicine, Family history, business, Psychiatry, education
Abstract: e23173 Background: “The suicide rate in cancer patients is twice that observed in the general population in the United States” (JNCI vol 100, 24, page 1750, 2008). This paper focuses ona population with great psychological risk: cancer patients (Pt) with previous suicide attempts (SA) or a family history of suicide (FS); both grouped under SAFS for the purpose of this study. Methods: Between 9/26/2012 and 11/28/2018 all new patients (Pt) admitted to IOHM filled out a Past Medical History Form (PMHF) (ASCO 2013 ABST. e17539) with their preexisting clinical conditions. The database was locked and anonymized. Those with a history of SAFS before cancer diagnosis were selected. Results: Out of 15,617 Pt, 184 Pt (1.2%) were SAFS(141 Pt were SA, 39 Pt were FS and 4 Pt were both). The relative risk ofSA was ten times larger for those with FS. Psychiatric Medication: Antipsychotics: 15Pt (8%), Antidepressants: 23 Pt (12%) and Benzodiazepines 45 Pt(24%), No treatment 101 Pt (55%). Population Characteristics: Sex: F:144 Pt . M: 40 Pt. Age: 56y (r = 26-88). Tumor Dx: Breast (65 Pt ) - Gastrointestinal (24 Pt) - Urological (21 Pt ) - Lung (21 Pt ) -Gynecological (19 Pt) - Hematological (11 Pt) -Head &Neck (8 Pt) - Endocrine (7 Pt) - Other (8 Pt). Stages: Early (0-I-II-III): 130 Pt, Advanced: 54 Pt. Ob-Gyn history:25 Pt (17%) nulliparous, 18 Pt (12%) with one child, 77 Pt (53%) with 2 or 3 children and 24 Pt (17%) with more than 3 children; 62 Pt (43%) had previous abortions. Average severe comorbidities (respiratory and psychiatric) was 3 per Pt (r = 0-18). Toxic habits: Smoking: 120 Pt (65%), Alcohol: 37 Pt (20%) and Illicit Drugs: 4 Pt (2%). Follow-up: 19 months (r = 0-70). No Pt had any SA, or commited suicide, during the follow-up.Living patients:177 (96%). Conclusions: 1) In our vast cohort, 184 Pt (1.2%) were identified as highly vulnerable psychiatric Pt due to SAFS. 2) Given the high psychological risk and stressful cancer diagnosis, 83 Pt (45%) were prescribed psychiatric drugs. 3) Follow-up of SAFS Pt by a multidisciplinary team is requiredfor adequate Pt and family support.
Published: 2019
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29. Diabetes mellitus: An adverse prognosis in cancer patients—Study of a cohort treated at Instituto Oncológico Henry Moore (IOHM)

Author: Edgardo G. J. Rivarola, Julio Cesar Bragagnolo, Felipe G. Gercovich, Marta Dragosky, Pamela Perez, Monica Montiel, Silvina Laura Musini, N. Gercovich, Ernesto Gil Deza, Dario Niewiadomski, and Eduardo L. Morgenfeld
Subjects: Oncology, Cancer Research, medicine.medical_specialty, business.industry, Internal medicine, Diabetes mellitus, Cancer evolution, Cohort, medicine, Cancer, medicine.disease, business
Abstract: e18212 Background: Numerous studies have evaluated the unfavorable impact of diabetes mellitus (DM) on cancer evolution. The objective of this paper is to study the coexistence of DM and cancer diagnosis; and its influence on the evolution of a cohort followed at IOHM. Methods: Between 9/26/2012 and 11/28/2018 all new patients (Pt) admitted to IOHM filled out a Past Medical History Form (PMHF) (ASCO 2013 ABST. e17539) with their preexisting clinical conditions.The database was locked and anonymized. Those with a history of DM or who were taking insulin and/ or oral antidiabetics were selected (Group A). The stage and evolution of their tumors were compared with those of non-diabetic patients (Group B). Results: Out of 15,617 Pt, 1,829 Pt (11,7%) had DM (Group A); 1,087 Pt were being treated with oral hypoglycemics (59%); 178 Pt with insulin (10%) and 564 Pt (31%) were not on antidiabetics drugs. They were compared to 13,788 Pt without DM (Group B). Oncological treatment was similar in both groups. Mortality was greaterin DM Patients adjusted by sex, age, PS, BMI, Dx and stage; Multivariate Cox Regression (p = 0.0001). The results are presented in the chart below. Conclusions: 1) In a cohort of 15,617 cancer Pt, 11,7% had DM. 2) DM Pt's tumors were more advanced. 3) Under similar treatments, DM Pt presented higher mortality. 4) Based on this, we advocate for DM in oncological Pt to be considered as an independent adverse factor.[Table: see text]
Published: 2019
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30. p42/p44 MAPK-mediated Stat3Ser727 phosphorylation is required for progestin-induced full activation of Stat3 and breast cancer growth

Author: Martín A. Rivas, María Celeste Díaz Flaqué, Mercedes Tkach, Pablo Guzmán, Ernesto Gil Deza, Roxana Schillaci, Wendy Béguelin, Felipe G. Gercovich, Esteban Maronna, María Florencia Mercogliano, Cecilia J. Proietti, Patricia V. Elizalde, and Cinthia Rosemblit
Subjects: STAT3 Transcription Factor, MAPK/ERK pathway, Cancer Research, CIENCIAS MÉDICAS Y DE LA SALUD, Endocrinology, Diabetes and Metabolism, Breast Neoplasms, Medroxyprogesterone Acetate, Biology, medicine.disease_cause, STAT3, Mice, Endocrinology, Breast cancer, Cyclin D1, BREAST CANCER, PROGESTIN, Progesterone receptor, medicine, Animals, Humans, Phosphorylation, skin and connective tissue diseases, Cell Proliferation, Mitogen-Activated Protein Kinase 1, Mice, Inbred BALB C, Mitogen-Activated Protein Kinase 3, purl.org/becyt/ford/3.1 [https], Transfection, Bioquímica y Biología Molecular, medicine.disease, Medicina Básica, Oncology, Cancer cell, Cancer research, purl.org/becyt/ford/3 [https], Female, Carcinogenesis, P42/P44 MAPK
Abstract: Stat3 is a signaling node for multiple oncogenic pathways and is therefore frequently active in breast cancer. As experimental and clinical evidence reveals that progestins are key players in controlling mammary gland tumorigenesis, we studied Stat3 participation in this event. We have previously shown that progestins induce Stat3Tyr705 phosphorylation and its transcriptional activation in breast cancer cells. In this study, we demonstrate that progestins also induce Stat3 phosphorylation at Ser727 residue, which occurs via activation of c-Src/p42/p44 MAPK pathways in murine progestin-dependent C4HD cells and in T-47D cells. Expression of a Stat3S727A vector, which carries a serine-to-alanine substitution at codon 727, shows that Stat3Ser727 phosphorylation is required for full transcriptional activation of cyclin D1 gene expression by progestins and for in vivo Stat3 recruitment on cyclin D1 promoter. Transfection of Stat3S727A in murine and human breast cancer cells abolished progestin-induced in vitro and in vivo growth. Moreover, we found a positive correlation between progesterone receptor expression and nuclear localization of Stat3Ser727 phosphorylation in breast cancer biopsies. These data highlight Stat3 phosphorylation in Ser727 residue as a nongenomic action by progestins, necessary to promote breast cancer growth. Fil: Tkach, Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina Fil: Rosemblit, Cinthia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina Fil: Rivas, Martin Alfredo. Vall d; España. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina Fil: Proietti Anastasi, Cecilia Jazmín. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina Fil: Díaz Flaqué, María Celeste. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina Fil: Mercogliano, María Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina Fil: Beguelin, Wendy. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina Fil: Maronna, Esteban. Sanatorio Mater Dei; Argentina Fil: Guzman, Pablo. Universidad de la Frontera. Facultad de Medicina; Chile Fil: Gercovich, Felipe G.. Instituto Oncológico Henry Moore; Argentina Fil: Gil Deza, Ernesto. Instituto Oncológico Henry Moore; Argentina Fil: Elizalde, Patricia Virginia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina Fil: Schillaci, Roxana. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina
Published: 2013
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31. TNFα-Induced Mucin 4 Expression Elicits Trastuzumab Resistance in HER2-Positive Breast Cancer

Author: Leandro Venturutti, Daniel H. Allemand, Felipe G. Gercovich, Isabel Frahm, Sandra L. Ares, María Florencia Mercogliano, Martín A. Rivas, Ernesto Gil Deza, Roxana Schillaci, Patricia V. Elizalde, Gloria Inurrigarro, Pablo Guzmán, Juan Carlos Roa, Mara De Martino, and Cecilia J. Proietti
Subjects: 0301 basic medicine, Oncology, Cancer Research, Immunoconjugates, Receptor, ErbB-2, TRASTUZUMAB, medicine.medical_treatment, Ado-Trastuzumab Emtansine, Mice, 0302 clinical medicine, Antineoplastic Agents, Immunological, Trastuzumab, skin and connective tissue diseases, Antibody-dependent cell-mediated cytotoxicity, biology, Patología, Drug Synergism, Bioquímica y Biología Molecular, Neoplasm Proteins, Up-Regulation, Gene Expression Regulation, Neoplastic, Medicina Básica, 030220 oncology & carcinogenesis, Immunohistochemistry, Female, RNA Interference, Antibody, Adjuvant, CIENCIAS NATURALES Y EXACTAS, medicine.drug, Signal Transduction, medicine.medical_specialty, CIENCIAS MÉDICAS Y DE LA SALUD, Combination therapy, Recombinant Fusion Proteins, Mice, Nude, Breast Neoplasms, Disease-Free Survival, Ciencias Biológicas, 03 medical and health sciences, Breast cancer, BREAST CANCER, Stomach Neoplasms, Internal medicine, Cell Line, Tumor, medicine, Animals, Humans, Maytansine, neoplasms, Mucin-4, business.industry, Tumor Necrosis Factor-alpha, Antibody-Dependent Cell Cytotoxicity, Cancer, HER2 POSITIVE, medicine.disease, Xenograft Model Antitumor Assays, 030104 developmental biology, Drug Resistance, Neoplasm, biology.protein, business
Abstract: Although trastuzumab administration improved the outcome of HER2-positive breast cancer patients, resistance events hamper its clinical benefits. We demonstrated that TNFα stimulation in vitro induces trastuzumab resistance in HER2-positive breast cancer cell lines. Here, we explored the mechanism of TNFα-induced trastuzumab resistance and the therapeutic strategies to overcome it. Fil: Mercogliano, María Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: de Martino, Mara. Ministerio de Ciencia. Tecnología e Innovación Productiva. Agencia Nacional de Promoción Cientifíca y Tecnológica; Argentina Fil: Venturutti, Leandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Rivas, Martin Alfredo. Weill Cornell Medical College; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Proietti Anastasi, Cecilia Jazmín. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Inurrigarro, Gloria. Sanatorio Mater Dei; Argentina Fil: Frahm, Isabel. Sanatorio Mater Dei; Argentina Fil: Allemand, Daniel H.. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; Argentina Fil: Gil Deza, Ernesto. Instituto Oncológico Henry Moore; Argentina Fil: Ares, Sandra. Instituto Oncológico Henry Moore; Argentina Fil: Gercovich, Felipe G.. Instituto Oncológico Henry Moore; Argentina Fil: Guzmán, Pablo. Universidad de La Frontera; Chile Fil: Roa, Juan Carlos. Universidad de La Frontera; Chile. Pontificia Universidad Católica de Chile; Chile Fil: Elizalde, Patricia Virginia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Schillaci, Roxana. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina
Published: 2016

32. Risk factors for non-communicable diseases (NCD) prevalence before cancer diagnosis: A cohort study of 12,685 new patients assisted at Instituto Oncológico Henry Moore (IOHM) in the past five years

Author: Claudia Lorena Acuna, Silvina Laura Musini, Monica Montiel, Mariana Abal, Barbara Kuhne, Ernesto Gil Deza, Eduardo L. Morgenfeld, Edgardo G. J. Rivarola, Flavio Tognelli, and Felipe G. Gercovich
Subjects: Cancer Research, medicine.medical_specialty, business.industry, Cancer, medicine.disease, Colon cancer screening, medicine.anatomical_structure, Oncology, Internal medicine, medicine, Christian ministry, business, Cervix, Cohort study
Abstract: e13589Background: In 2013, the Argentinian Ministry of Health (MSNA) published a national survey on NCD risk factors prevalence and breast, cervix and colon cancer screening. This paper aims to des...
Published: 2018
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33. Second primary tumors in a cohort of more than 1,000 renal cancer patients treated at Instituto Oncológico Henry Moore (IOHM)

Author: Ernesto Gil Deza, Claudia Lorena Acuna, Diego Juarez, Dario Niewiadomski, Cesar Gonzalez, Leonardo Smolje, Eduardo L. Morgenfeld, Edgardo G. J. Rivarola, Gaston Martin Reinas, and Felipe G. Gercovich
Subjects: Oncology, Cancer Research, medicine.medical_specialty, business.industry, Internal medicine, Cohort, medicine, Cancer, Second primary cancer, medicine.disease, business
Abstract: e13631Background: Murphy and col (Jama Oncol. 2017.30605. Nov 2017) demonstrated a 3.5% to 36.9% prevalence range of second primary tumors (SPT) in cancer patients.This paper aims to show the incid...
Published: 2018
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34. Long-term outcome of penile squamous carcinoma: Single Argentinian institutional study

Author: Eduardo L. Morgenfeld, Leonardo Smolje, Mariana Abal, Felipe G. Gercovich, Edgardo G. J. Rivarola, Gaston Martin Reinas, Monica Montiel, Dario Niewiadomski, Ernesto Gil Deza, and Sandra L. Ares
Subjects: Oncology, Cancer Research, medicine.medical_specialty, business.industry, Retrospective cohort study, Malignancy, medicine.disease, humanities, Squamous carcinoma, Internal medicine, medicine, Penile cancer, business
Abstract: e16593Background: Squamous penile cancer is a rare malignancy affecting about 1 in 100,000 men worldwide per year. This retrospective study aims to evaluate treatments and outcome in penile cancer ...
Published: 2018
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35. Patients with advanced renal cell carcinoma: Immediate or delayed treatment? Study of a cohort of patients followed at Instituto Oncológico Henry Moore (IOHM)

Author: Sandra L. Ares, Dario Niewiadomski, Edgardo G. J. Rivarola, Felipe G. Gercovich, Eduardo L. Morgenfeld, Claudia Lorena Acuna, Ernesto Gil Deza, and Gaston Martin Reinas
Subjects: Oncology, Cancer Research, medicine.medical_specialty, business.industry, Renal cell carcinoma, Internal medicine, Cohort, medicine, Cancer, Delayed treatment, business, medicine.disease
Abstract: e16073 Background: Most of the treatment guidelines for advanced renal cancer (RCC) agree about what drugs must be used, but don’t indicate when the treatment should be started. This decision is left to the desire of the patient (pt) and/or the common sense of the doctor. The aim of this paper is to study which could be the best time of initiation of systemic treatment (Tx) in advanced RCC. Methods: Between 1/1/2001 and 11/30/2016, 828 patients diagnosed with RCC were followed at IOHM. We selected all pt with clear cell or papillary stage IV RCC who received systemic Tx; 80 pt met this inclusion criteria. We reviewed all the clinical records of this population and separated two groups according to the time of initiation of systemic treatment: Group A (Immediate = within three months of diagnosis) or Group B (Delayed = beyond three months of diagnosis). We compared the population’s characteristics and outcome of each group. Results: The results are shown in the table. Conclusions: 1) In this cohort of 80 patients with advanced clear cell or papillary RCC, 47 pt (59%) received systemic treatment immediately after diagnosis and 33 pt (41%) postponed it at least three months. 2) Both groups were similar in age, surgical treatment, metastatic sites and systemic treatments. 3) There was no difference in survival rates with immediate or delayed treatments. [Table: see text]
Published: 2017
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36. Patient safety: A progressive deprescribing model in patients with advanced solid tumors assisted at Instituto Oncológico Henry Moore (IOHM)

Author: Mariana Abal, Marcelo Muino, Monica Montiel, Carlos Fernando Garcia Gerardi, Edgardo G. J. Rivarola, Eduardo L. Morgenfeld, Ernesto Gil Deza, Sandra L. Ares, Flavio Tognelli, and Felipe G. Gercovich
Subjects: Polypharmacy, Cancer Research, medicine.medical_specialty, business.industry, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, Health care, Medicine, In patient, 030212 general & internal medicine, Deprescribing, business, Intensive care medicine
Abstract: 6594 Background: "Deprescribing is the process of withdrawal of an inappropriate medication, supervised by a health care professional with the goal of managing polypharmacy and improving outcomes" ( Br J Clin Pharmacol 80:6, 1254. 2015). The aim of this paper is to present a model for deprescribing used at IOHM. Methods: Between 09/26/2012 and 09/26/2016, 10,053 pt filled out a Past Medical History Form, listing all the medications they were taking regularly. We selected all the pt. with advanced solid tumors (AST). In each pt the expected survival was established in order to evaluate the usefulness of the Tx. The drugs were classified in three groups: A) Green: Adequate (must be maintained); B) Yellow: Questionable (could be maintained or removed) or C) Red: Avoidable (must be removed). Results: We registered 2,103 pt who met the inclusion criteria. Sex F/M: 905 /1198. Median age 63 y (r = 19-99). A total of 1,629 pt. (77%) were taking medications on a regular basis. The total amount of medications was 5,679 . Median medications per patient: 3 (range: 1-14). Eighty percent of the pt (1,298 pt) were receiving questionable of avoidable medications. The following table shows the distribution of medications per group. Conclusions: A) In this cohort of 2,103 pt with AST, half of them had an average life expectancy of less than one year. B) 1,298 out of 1,629 pt (80%) were receiving a questionable medication C) 596/5,769 (10%) of the registered drugs, had to be suspended immediately and at least a thousand more could be eliminated. d) Obstacles to deprescribing were essentially medical ignorance, fear and inexperience. [Table: see text]
Published: 2017
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37. Incidental vs. clinical diagnosis of renal cell carcinoma (RCC): Population, treatment and outcome in a cohort of 828 patients followed at Instituto Oncológico Henry Moore (IOHM)

Author: Carlos Fernando Garcia Gerardi, Dario Niewiadomski, Eduardo L. Morgenfeld, Leonardo Smolje, Monica Montiel, Felipe G. Gercovich, Ernesto Gil Deza, Mariana Abal, Flavio Tognelli, Edgardo G. J. Rivarola, and Claudia Lorena Acuna
Subjects: Cancer Research, education.field_of_study, Pediatrics, medicine.medical_specialty, business.industry, Incidence (epidemiology), Population, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Oncology, Renal cell carcinoma, 030220 oncology & carcinogenesis, Clinical diagnosis, Cohort, medicine, education, business, Small tumors, Developed country
Abstract: e16075 Background: For the past three decades, it has been observed in developed countries an increase in the incidence of RCC, at the expense of small tumors incidentally found. This study compares the epidemiology, treatment and evolution of the patients (pt) with incidental RCC (Group A) or clinical RCC (Group B). Methods: Between 1/1/2001 and 11/30/2016, 29,440 new pt with histological diagnosis of cancer were incorporated to the IOHM database. We selected all those coded under the WHO ICD10 code C64. The medical records were reviewed, registering the epidemiological data, treatments and evolution of each patient Results: We identified 828 pt out of 29,940 pt (2.8%) who met the inclusion criteria. Group A = 507 pt (61%) and Group B = 321 pt (39%). The table below shows the characteristics of both groups. Conclusions: 1) In this cohort the incidental diagnosis of RCC represented 60% of the cases and correlated with early stages and less aggressive tumors. 2) The appropriate selection of patients allowed partial nephrectomies in 103/828 Pt. (12% of the cases). 3) With a median follow-up of 30 months the survival rate of this population exceeded 90% in the early stages and was close to 50% in advanced cases. [Table: see text]
Published: 2017
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38. Evaluación de las necesidades de los pacientes respecto a la información y los cuidados médicos tras el diagnóstico de cáncer

Author: Monica Montiel, Felipe G. Gercovich, Carlos Fernando Garcia Gerardi, Ernesto Gil Deza, Gaston Martin Reinas, Flavio Tognelli, Eduardo L. Morgenfeld, Edgardo G. J. Rivarola, Pablo López, and Daniela Gercovich
Subjects: Clinical Psychology, lcsh:Psychology, Oncology, encuesta, lcsh:BF1-990, comunicación médico paciente, Necesidades de los pacientes, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, oncología, lcsh:RC254-282
Abstract: Objetivo: Estudiar las necesidades de los pacientes oncológicos sobre la información referida a su enfermedad y los cuidados al final de la vida. Métodos: 820 pacientes participaron de una encuesta sobre diagnóstico, pronóstico, eficacia y toxicidad de los tratamientos, así como también sobre cuidados paliativos, investigación clínica, apoyo psicológico, cuidados espirituales y deseos del final de la vida. Resultados: 695 pacientes conocen su diagnóstico, especialmente quienes tenían un mayor nivel educativo y un rango etario de 50-70 años. Seiscientos setenta y cuatro pacientes deseaban conocer su pronóstico, estando más predispuestos a conocerlo quienes tenían educación secundaria y superior. La mayoría (562 pacientes) deseaba conocer todo con respecto a la utilidad de los tratamientos, al igual que con respecto a la toxicidad (443) y valoraría contar con información sobre cuidados paliativos e investigación. Además consideraba la internación hospitalaria como el mejor lugar para morir (331). Las mujeres se mostraron más propensas a recibir ayuda psicológica y espiritual. Las condiciones más valoradas en el médico fueron: conocimiento (52,7%), Honestidad (45,5%) y Humanidad (44,3%). Un 82,3% de los pacientes valoraron positivamente la encuesta, mientras que el 58% la consideró útil. Sin embargo un 23,7% la recomendaría. Conclusiones: El estudio representa, en nuestro conocimiento, el primer intento en nuestro medio por identificar las necesidades y los deseos de los pacientes por conocer cuestiones vinculadas con su enfermedad. En este sentido hemos observado una búsqueda de participación activa en las decisiones vinculadas al manejo de la información y los tratamientos por parte de los pacientes.
Published: 2014
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39. Design and validation of an Observational Standard Clinical Examination (OSCE) for clinical oncology based on ASCO/ASH curricular milestones

Author: Gustavo De Simone, Estefania E Kaminski, Monica Montiel, Mariano G Fernandez, Gaston Martin Reinas, Rancati Alberto, Alfredo Navigante, Carlos Fernando Garcia Gerardi, Edgardo G. J. Rivarola, Ernesto Gil Deza, Eduardo L. Morgenfeld, Felipe G. Gercovich, Luis Loviscek, and Daniela Gercovich
Subjects: Clinical Oncology, Cancer Research, medicine.medical_specialty, Oncology, medicine.diagnostic_test, Objective structured clinical examination, business.industry, Medicine, Observational study, Medical physics, Physical examination, business, Objective assessment
Abstract: e18150Background: In the last 30 years the Objective Structured Clinical Examination (OSCE) has gained popularity as an objective assessment tool of medical skills. In 2014 the 39 ASCO/ASH curricul...
Published: 2016
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40. Evaluation of empathy in a structured Observational Exam of Clinical Skills (OSCE) in the career of oncology at Instituto Oncológico Henry Moore-Universidad del Salvador (HM-ONCOUSAL)

Author: Sandra L. Ares, Carlos Fernando Garcia Gerardi, Felipe G. Gercovich, Gabriela Malcervelli, Ernesto Gil Deza, M. Abal, Daniela Gercovich, Hugo Hirsch, Flavio Tognelli, Edgardo G. J. Rivarola, Luis Loviscek, Gustavo De Simone, Monica Montiel, and Eduardo L. Morgenfeld
Subjects: Cancer Research, Medical education, Oncology, business.industry, media_common.quotation_subject, Medicine, Empathy, Observational study, business, Clinical skills, media_common
Abstract: e18151Background: Empathy is defined as "The ability to understand another's experience, to communicate and confirm that understanding with the other person and to then act in a helpful manner" (Me...
Published: 2016
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41. Second malignant neoplasm (SMN) in a cohort of early stage cancer survivors (ESCS) followed at Instituto Oncológico Henry Moore (IOHM) in the last 15 years

Author: Edgardo G. J. Rivarola, Dario Niewiadomski, Ernesto Gil Deza, Flavio Tognelli, Felipe G. Gercovich, Claudia Lorena Acuna, Eduardo L. Morgenfeld, and N. Gercovich
Subjects: Oncology, Cancer Research, medicine.medical_specialty, education.field_of_study, business.industry, Incidence (epidemiology), Population, medicine.disease, Primary tumor, Surgery, Early-stage cancer, Median follow-up, Internal medicine, Cohort, medicine, Secondary tumors, Stage (cooking), business, education
Abstract: e13057Background: The prolonged survival achieved when tumors are treated at early stages allows the diagnosis of a SMN in many patients during the follow up period.The following study aims to present the incidence of secondary tumors in a cohort of ESCS patients (Pt) followed at IOHM. Methods: A search of the IOHM database was carried out, looking for Pt that had been registered between 1/12/2000 and 1/6/2015 with early stage (0-I-II-III) tumors and had been followed for more than six months. Those with a SMN were identified. In all of these, the following was studied: Dx, detection (screening vs symptomatic), presentation (synchronic vs metachronic) and stage. Results: It was possible to find 12038 ESCS that met selection criteria. Population characteristics: Median age at Dx of primary tumor: 58 years (r 18-98y). Sex: male 4689 Pt (39%) / female 7335 Pt (61%). Median follow up was 40 months (r 6-183m). The table below shows primary tumors and most frequent SMN. In 476/556 Pt (86%), SMN was metachronic ...
Published: 2016
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42. Rate of second malignant neoplasm in a cohort of early stage uveal melanoma followed at Instituto Oncológico Henry Moore (IOHM) in the last 15 years

Author: Edgardo G. J. Rivarola, Ernesto Gil Deza, Flavio Tognelli, Marcelo Muino, Felipe G. Gercovich, Eduardo L. Morgenfeld, and Gaston Martin Reinas
Subjects: Cancer Research, medicine.medical_specialty, business.industry, Melanoma, Ocular Melanoma, medicine.disease, Dermatology, eye diseases, stomatognathic diseases, Oncology, Cohort, Medicine, Neoplasm, sense organs, Stage (cooking), business
Abstract: 9587Background: Uveal melanoma (UM) is a rare neoplasm with a 3.3% rate of second malignant neoplasm (SMN) according to the Collaborative Ocular Melanoma Study (COMS) (Diener-West m et al. Arch Oph...
Published: 2016
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43. Retrospective study of patients with malignant pleural mesothelioma treated and followed at Instituto Oncológico Henry Moore (IOHM)

Author: Gabriela Malcervelli, Claudia Lorena Acuna, Carlos Fernando Garcia Gerardi, Edgardo G. J. Rivarola, Flavio Tognelli, Dario Niewiadomski, M. Abal, Eduardo L. Morgenfeld, Ernesto Gil Deza, and Felipe G. Gercovich
Subjects: Oncology, Cancer Research, medicine.medical_specialty, Pleural mesothelioma, business.industry, Mortality rate, Retrospective cohort study, respiratory system, medicine.disease, respiratory tract diseases, chemistry.chemical_compound, chemistry, Internal medicine, Antifolate, medicine, Neoplasm, business
Abstract: e20085Background: Malignant pleural mesothelioma (MPM) is a rare and aggressive neoplasm with a high mortality rate. The only recommended treatment is a platinum doublet with an antifolate based on...
Published: 2016
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44. Discrepancies between immunohistochemistry (IHC) form core biopsy (CB) and surgical specimen (SP) in patients with early breast cancer (EBC): A clinical decision-making challenge

Author: Sandra L. Ares, N. Gercovich, Marcelo Muino, Edgardo G. J. Rivarola, Gabriela Malcervelli, Eduardo L. Morgenfeld, Silvina Laura Musini, Ernesto Gil Deza, and Felipe G. Gercovich
Subjects: Cancer Research, medicine.medical_specialty, Pathology, business.industry, Retrospective cohort study, Surgical specimen, Gastroenterology, Oncology, Clinical decision making, Internal medicine, medicine, Immunohistochemistry, In patient, business, Core biopsy, Kappa, Early breast cancer
Abstract: e12072Background: Various studies analyze the differences found between the IHC from CB and the SP. The discordance in this information can bring serious problems when it comes to making clinical decisions. Methods: In this retrospective study, we evaluated female patients with invasive EBC that were admitted to IOHM between June of 2014 and December of 2015, but only those in which the CB and SP had been carried out by the same medical team and whose IHC (Ki67, ER, PR and Her2) had been carried out by the same certified pathology laboratory. All tumors were classified as: Luminal A (LA); Luminal B Her2 negative (LB); Luminal B Her positive (LBH+); Her2 and Triple negative (TN). The correlation between ICH of the CB and SP was studied according to the Kappa test. Results: Seventy-three patients were included. Median age 53 years (r = 26-89) Stages (I = 27;II = 26,III = 20). In 45 cases (62%) there was no discrepancy but in 28 cases (38%) there was a discrepancy between the IHC from CB and the SP, which ha...
Published: 2016
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45. Rol del distrés psicológico en la relación entre percepción de enfermedad y calidad de vida en pacientes con cáncer de mama

Author: Daniela Gercovich, Pablo Luis López, Diego Bortolato, Patricia Margiolakis, Mirta Morgenfeld, Laura Rosell, and Ernesto Gil Deza
Subjects: lcsh:Psychology, quality of life, Percepción de Enfermedad, distrés, Illness Perception, lcsh:BF1-990, calidad de vida, psicooncología, distress, psychooncology, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, lcsh:RC254-282
Abstract: Objective: To evaluate the associations between the illness perception dimensions and quality of life, assessing the modulatory role of psychological distress in patients with breast cancer, identifying which of these dimensions explained further variability in the different aspects of the quality of life. Methods: Seventy-five patients were evaluated with the Brief Illness Perception Questionnaire and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-30). We calculated bivariate and partial correlations to evaluate the associations between the illness perception dimensions and different aspects of quality of life, controlling for a distress measure. Subsequently, we performed linear regression analysis to evaluate the illness perception dimensions that could explain the variability in the quality of life scores. Results: Although significant associations between subscales of perception of illness and quality of life were found, most of them lost their significance when controlled by distress. In the regression models, variables that best predicted the variability in the quality of life were psychopathological diagnostic and distress. Conclusions: According with the study results, psychological distress and psychopathological diagnostic were the two variables that explained better the variability in the quality of life. For this reason it is essential to learn more about the role of these variables on the quality of life and morbidity and mortality associated with them. Objetivo: estudiar las asociaciones entre las dimensiones de percepción de enfermedad y la calidad de vida, evaluando el rol modulador del distrés psicológico en pacientes con cáncer de mama e identificando cuáles de dichas dimensiones explicaba en mayor medida la variabilidad en los distintos aspectos de la calidad de vida. Método: setenta y cinco pacientes fueron evaluadas con el Cuestionario de Percepción de Enfermedad Breve y el Cuestionario de Calidad de Vida de la Organización Europea para la Investigación y el Tratamiento de Cáncer (EORTC QLQC30). Se calcularon correlaciones bivariadas y parciales para evaluar las asociaciones entre las dimensiones de percepción de enfermedad y distintos aspectos de la calidad de vida, controlando por una medida de distrés. Posteriormente, se ha realizado un análisis de regresión lineal para evaluar las dimensiones de percepción de enfermedad que podrían explicar la variabilidad en la calidad de vida. Resultados: si bien se encontraron asociaciones significativas entre las subescalas de percepción de enfermedad y calidad de vida, la mayoría de ellas perdían su significación cuando se controlaba por distrés. En los modelos de regresión, las variables que mejor predecían la variabilidad de la calidad de vida fueron el diagnóstico psicopatológico y el distrés. Conclusiones: de acuerdo a los resultados del presente estudio, el distrés psicológico y el diagnóstico psicopatológico fueron las dos variables que más explicaban la variabilidad de la calidad de vida. Por tal motivo se hace imprescindible profundizar en el rol de dichas variables en la calidad de vida y en la morbimortalidad asociada a ellas.
Published: 2012

46. The role of psychological distress in the relationship between illness perception and quality of life in patients with breast cancer

Author: Diego Bortolato, Ernesto Gil Deza, P. Margiolakis, Laura Rosell, Mirta Morgenfeld, Pablo López, and Daniela Gercovich
Subjects: media_common.quotation_subject, Illness Perception, psicooncología, distress, Regression analysis, psychooncology, Bivariate analysis, medicine.disease, Developmental psychology, Clinical Psychology, Distress, Breast cancer, Oncology, Quality of life, quality of life, Percepción de Enfermedad, distrés, Perception, calidad de vida, medicine, Psychology, Partial correlation, media_common, Clinical psychology, Psychopathology
Abstract: Objetivo: estudiar las asociaciones entre las dimensiones de percepción de enfermedad y la calidad de vida, evaluando el rol modulador del distrés psicológico en pacientes con cáncer de mama e identificando cuáles de dichas dimensiones explicaba en mayor medida la variabilidad en los distintos aspectos de la calidad de vida. Método: setenta y cinco pacientes fueron evaluadas con el Cuestionario de Percepción de Enfermedad Breve y el Cuestionario de Calidad de Vida de la Organización Europea para la Investigación y el Tratamiento de Cáncer (EORTC QLQC30). Se calcularon correlaciones bivariadas y parciales para evaluar las asociaciones entre las dimensiones de percepción de enfermedad y distintos aspectos de la calidad de vida, controlando por una medida de distrés. Posteriormente, se ha realizado un análisis de regresión lineal para evaluar las dimensiones de percepción de enfermedad que podrían explicar la variabilidad en la calidad de vida. Resultados: si bien se encontraron asociaciones significativas entre las subescalas de percepción de enfermedad y calidad de vida, la mayoría de ellas perdían su significación cuando se controlaba por distrés. En los modelos de regresión, las variables que mejor predecían la variabilidad de la calidad de vida fueron el diagnóstico psicopatológico y el distrés. Conclusiones: de acuerdo a los resultados del presente estudio, el distrés psicológico y el diagnóstico psicopatológico fueron las dos variables que más explicaban la variabilidad de la calidad de vida. Por tal motivo se hace imprescindible profundizar en el rol de dichas variables en la calidad de vida y en la morbimortalidad asociada a ellas. Objective: To evaluate the associations between the illness perception dimensions and quality of life, assessing the modulatory role of psychological distress in patients with breast cancer, identifying which of these dimensions explained further variability in the different aspects of the quality of life. Methods: Seventy-five patients were evaluated with the Brief Illness Perception Questionnaire and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-30). We calculated bivariate and partial correlations to evaluate the associations between the illness perception dimensions and different aspects of quality of life, controlling for a distress measure. Subsequently, we performed linear regression analysis to evaluate the illness perception dimensions that could explain the variability in the quality of life scores. Results: Although significant associations between subscales of perception of illness and quality of life were found, most of them lost their significance when controlled by distress. In the regression models, variables that best predicted the variability in the quality of life were psychopathological diagnostic and distress. Conclusions: According with the study results, psychological distress and psychopathological diagnostic were the two variables that explained better the variability in the quality of life. For this reason it is essential to learn more about the role of these variables on the quality of life and morbidity and mortality associated with them.
Published: 2012

47. Automatic identification of family cancer risk

Author: Daniela Gercovich, N. Gercovich, Edgardo G. J. Rivarola, Ernesto Gil Deza, Angela Gomez, Gaston Martin Reinas, Juan Pollola, Eduardo L. Morgenfeld, and Felipe G. Gercovich
Subjects: Cancer Research, medicine.medical_specialty, Oncology, business.industry, Genetic counseling, Family medicine, Medicine, Identification (biology), Cancer risk, business
Abstract: e12571 Background: In the last 15 years at least 17 ASCO publications, 2 NCNN guidelines y 2 INC (Instituto Nacional del Cancer-Argentine) publications evaluated the necessity of genetic counseling...
Published: 2015
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48. Freakoncology: Is there an optimistic denial in the ipilimumab publications?

Author: Edgardo G. J. Rivarola, Felipe G. Gercovich, Mario Javier Nacul, Carlos Fernando Garcia Gerardi, Ernesto Gil Deza, and Eduardo L. Morgenfeld
Subjects: Cancer Research, Denial, Psychotherapist, Optimism, Oncology, business.industry, media_common.quotation_subject, Medicine, Ipilimumab, business, media_common, medicine.drug
Abstract: e20122 Background: optimism in oncologists is essential but excess optimism leads us to deny reality. To study this phenomenon in scientific publications we searched for “Ipilimumab” in PubMed. Met...
Published: 2015
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49. Colorectal carcinoma in children, adolescents, and young adults

Author: Diana Cascallar, Marcelo Scopinaro, Diego Amaral, Viviana B Perelli, Ernesto Gil Deza, Guillermo L. Chantada, Felipe G. Gercovich, and Mercedes Garc a Lombardi
Subjects: Oncology, Adult, Male, medicine.medical_specialty, Pediatrics, Adolescent, Colorectal cancer, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Advanced disease, Humans, Young adult, Child, Digestive System Surgical Procedures, Retrospective Studies, business.industry, Age Factors, Hematology, medicine.disease, Treatment Outcome, Pediatrics, Perinatology and Child Health, Early adolescents, Female, Presentation (obstetrics), business, Colorectal Neoplasms, Progressive disease
Abstract: The authors conducted a retrospective evaluation of patients younger than 30 years with colorectal carcinoma in Argentina. Patients were divided into group 1 (patients treated at pediatric institutions from 0 to 20 years of age, n = 14) and group 2 (patients from 21 to 30, n = 7, treated at adult centers). Group 1 had significantly more advanced disease and a poorer prognosis. Six patients (2/14 in group 1 and 4/7 in group 2) survive disease-free. Thirteen patients died of progressive disease, 1 died of a non-tumor-related cause, and 1 is still on treatment. Patients younger than 20 years have a poorer prognosis, probably because of advanced disease on presentation.
Published: 2005

50. Polypharmacy in oncology patients

Author: Monica Montiel, Gabriel Lebersztein, Ernesto Gil Deza, Gaston Martin Reinas, Edgardo G. J. Rivarola, Nelson Kohen, Felipe G. Gercovich, and Eduardo L. Morgenfeld
Subjects: Secondary prevention, Polypharmacy, Cancer Research, medicine.medical_specialty, business.industry, Cancer, Disease, medicine.disease, Oncology, medicine, Oncology patients, Intensive care medicine, Older people, business
Abstract: e17582 Background: Cancer is a disease that primarily affects older people who have been taking numerous drugs for the treatment of multimorbidities or for primary or secondary prevention before ca...
Published: 2014
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