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Hereditary cancer syndromes (HCS) are genetic diseases with an increased risk of developing cancer. This research describes the implementation of a cancer prevention model, genetic counseling, and germline variants testing in an oncologic center in Mexico. A total of 315 patients received genetic counseling, genetic testing was offered, and 205 individuals were tested for HCS. In 6 years, 131 (63.90%) probands and 74 (36.09%) relatives were tested. Among the probands, we found that 85 (63.9%) had at least one germline variant. We identified founder mutations in BRCA1 and a novel variant in APC that led to the creation of an in-house detection process for the whole family. The most frequent syndrome was hereditary breast and ovarian cancer syndrome (HBOC) (41 cases with BRCA1 germline variants in most of the cases), followed by eight cases of hereditary non-polyposic cancer syndrome (HNPCC or Lynch syndrome) (with MLH1 as the primarily responsible gene), and other high cancer risk syndromes. Genetic counseling in HCS is still a global challenge. Multigene panels are an essential tool to detect the variants frequency. Our program has a high detection rate of probands with HCS and pathogenic variants (40%), compared with other reports that detect 10% in other populations.

An early detection tool for latent COVID-19 infections in oncology staff and patients is essential to prevent outbreaks in a cancer center. (1) Background: In this study, we developed and implemented two early detection tools for the radiotherapy area to identify COVID-19 cases opportunely. (2) Methods: Staff and patients answered a questionnaire (electronic and paper surveys, respectively) with clinical and epidemiological information. The data were collected through two online survey tools: Real-Time Tracking (R-Track) and Summary of Factors (S-Facts). Cut-off values were established according to the algorithm models. SARS-CoV-2 qRT-PCR tests confirmed the positive algorithms individuals. (3) Results: Oncology staff members (n = 142) were tested, and 14% (n = 20) were positives for the R-Track algorithm; 75% (n = 15) were qRT-PCR positive. The S-Facts Algorithm identified 7.75% (n = 11) positive oncology staff members, and 81.82% (n = 9) were qRT-PCR positive. Oncology patients (n = 369) were evaluated, and 1.36% (n = 5) were positive for the Algorithm used. The five patients (100%) were confirmed by qRT-PCR. (4) Conclusions: The proposed early detection tools have proved to be a low-cost and efficient tool in a country where qRT-PCR tests and vaccines are insufficient for the population.

Breast cancer (BC) has one of the highest incidences and mortality worldwide. Single nucleotide polymorphisms (SNPs) in

Background: Genome-wide association studies (GWAS) for colorectal cancer (CRC) have detected high-risk genetic variants associated with CRC in several ethnic groups, but Latin American communities are still underrepresented. The aim was to identify variants related to CRC in an admixed Latin American population. Methods: The study was performed in 831 cases and 881 controls from Mexico, who were genotyped for 1,006,703 autosomal SNPs. Logistic regression was carried out including covariants, such as sex, age and genetic ancestry. Lastly, we performed a sequence-kernel association test (SKAT) to consider the joint effect of several SNPs lying in genes.Results: Eight chromosomal regions reached genome-wide significance level ( p < 5×10 -8 ): 1p36.22, 1p31.1, 1q42.13, 6p22, 7p14.1, 12q24.32, 16q12.2 and 21q22.2 and 63 variants reached borderline statistical significance ( p < 1×10 − 6 ). SKAT analysis detected 13 loci associated with CRC, none of them previously associated with CRC. Conclusions: We found 8 SNPs and 13 loci associated with CRC. These signals may contribute to enrich the panoply of genes involved with CRC. Further analyses remain to be done to validate the associations in other Latin American populations. This study highlights the importance of conducting GWAS in poorly explored admixed populations.

Objectives To evaluate the usefulness of a negative D-dimer in peripheral or central venous blood to screen for asymptomatic catheter-related thrombosis in cancer patients. Methods D-dimer was measured in blood from central venous catheter and peripheral venous samples in 48 patients with cancer. Asymptomatic catheter-related thrombosis was identified via Doppler ultrasound. Bland and Altman’s limits of agreement analysis was used to compare sample sites. Sensitivity and specificity of D-dimer was calculated. Results Overall, 33 of the central samples and 32 of the peripheral samples had D-dimer levels below the cutoff (≥0.3 mg/l). Mean central D-dimer was 0.31 ± 0.35 mg/l; peripheral 0.24 ± 0.22 mg/l (p = 0.5). Bland–Altman plot showed that the two sample sites were not equivalent. Catheter-related thrombosis was demonstrated in five patients, and there were three false negatives. Peripheral D-dimer had a negative predictive value of 90.9%. Conclusions A negative D-dimer may be useful for screening asymptomatic catheter-related thrombosis in patients with cancer, but the central and peripheral sample sites are not equivalent.

Ki-67 for quantifying tumor proliferation is widely used. In localized prostate cancer (PCa), despite a suggested predictive role of Ki-67 for outcomes after therapies, it has not been incorporated into clinical practice. Herein, we conduct a systematic review and meta-analysis of the literature reporting the association of Ki-67 and disease outcomes in PCa treated radically.Medline and EMBASE databases were searched without date or language restrictions, using "KI67" and "prostate cancer" MeSH terms. Studies reporting Ki-67 association with clinical outcomes (disease-free survival [DFS], biochemical failure-free survival, rate of distant metastases [DM], disease-specific survival [DSS], or overall survival [OS], or all of these) in patients with PCa managed actively were included, and relevant data extracted by 2 independent reviewers. Odds ratios (OR) were weighted and pooled in a meta-analysis using Mantel-Haenszel random-effect modeling.Twenty-one studies comprising 5,419 patients met eligibility for analysis, and 67.6% of patients had low Ki-67. Mean Ki-67 was 6.14%. High Ki-67 was strongly associated with worse clinical outcomes. DFS was better in those patients with low Ki-67 at 5 and 10 years (OR = 0.32, 95% CI: 0.23-0.44, P0.00001; OR = 0.31, 95% CI: 0.20-0.48, P0.00001). Similarly, low Ki-67 was related to improved DSS at 5 and 10 years (OR = 0.15, 95% CI: 0.10-0.21, P0.00001; OR = 0.16, 95% CI: 0.06-0.40, P0.00001). Association between low Ki-67 scores with improved OS (OR = 0.47; 95% CI: 0.37-0.61; P0.00001) and high Ki-67 scores with DM at 5 years (OR = 4.07; 95% CI: 2.52-6.58; P0.00001) was consistently observed.High Ki-67 expression in localized PCa is a factor of poor prognosis for DSS, biochemical failure-free survival, DFS, DM, and OS after curative-intent treatments. Incorporation into clinical routine of this widely available and standardized biomarker should be strongly considered.

Background Pathogenic variants (PVs) of BRCA genes entail a lifetime risk of developing breast cancer in 50–85% of carriers. Their prevalence in different populations has been previously reported. However, there is scarce information regarding the most common PVs of these genes in Latin-Americans. This study identified BRCA1 and BRCA2 PV frequency in a high-risk female population from Northeastern Mexico and determined the association of these mutations with the patients’ clinical and pathological characteristics. Methods Women were divided into three groups: aged ≤ 40 years at diagnosis and/or risk factors for hereditary breast cancer (n = 101), aged > 50 years with sporadic breast cancer (n = 22), and healthy women (n = 72). Their DNA was obtained from peripheral blood samples and the variants were examined by next-generation sequencing with Ion AmpliSeq BRCA1 and BRCA2 Panel using next-generation sequencing. Results PVs were detected in 13.8% group 1 patients (BRCA1, 12 patients; BRCA2, 2 patients). Only two patients in group 2 and none in group 3 exhibited BRCA1 PVs. Variants of uncertain significance were reported in 15.8% patients (n = 16). In group 1, patients with the triple-negative subtype, PV frequency was 40% (12/30). Breast cancer prevalence in young women examined in this study was higher than that reported by the National Cancer Institute Surveillance, Epidemiology (15.5% vs. 5.5%, respectively). Conclusions The detected BRCA1 and BRCA2 PV frequency was similar to that reported in other populations. Our results indicate that clinical data should be evaluated before genetic testing and highly recommend genetic testing in patients with the triple-negative subtype and other clinical aspects. Electronic supplementary material The online version of this article (10.1186/s12885-019-5950-4) contains supplementary material, which is available to authorized users.

ResumenIntroducciónEl uso de docetaxel quincenal en pacientes con cáncer de mama metastásico multitratado (más de 3 líneas de tratamiento previo) es una opción segura y eficaz, tolerable en pacientes de edad avanzada y en condiciones frágiles.ObjetivoDemostrar la eficacia y seguridad del docetaxel administrado cada 15 días a los pacientes con cáncer de mama metastásico previamente tratado con más de 3 esquemas de quimioterapia incluyendo el uso de paclitaxel y/o docetaxel de forma adyuvantes o neoadyuvante. Sabiendo que el concepto de reutilización de fármacos (rechallenge) en un momento adecuado ha demostrado ser eficaz en subgrupos específicos de pacientes.Material y métodosSe seleccionaron mujeres entre 21 y 80 años de edad, que hubieran recibido tratamiento en el Centro Universitario contra el Cáncer de la UANL, en Monterrey N.L. durante los años 2013 al 2015, considerando las siguientes variables para su análisis: edad, estado menopáusico, estado de receptores hormonales, sobreexpresión de HER2 neu, localización de los sitios metastásicos, estado funcional 0-3 y comorbilidades.ResultadosUn total de 16 pacientes fueron evaluables, de las 19 pacientes que cumplieron con los criterios de selección, 9 presentaron respuesta parcial (del 35%), 7 pacientes se mantuvieron con enfermedad estable, la supervivencia libre de progresión media fue de 5.2 meses (intervalo de confianza: 3.1-10.3 meses).ConclusionesLos pacientes con enfermedad recurrente 2 años después de la terapia previa con taxanos son los más beneficiados, ya que pueden recibir nuevamente taxanos. Los predictores de mayor importancia para el uso efectivo de docetaxel fueron la presencia de metástasis visceral y la duración del intervalo libre de enfermedad.AbstractIntroductionDocetaxel every 15 days could be an option for patients with progression after already having therapy with three treatment lines, since it may be safe and effective in advanced, elderly, and fragile patients.ObjectiveTo demonstrate the efficacy and safety of docetaxel in patients with metastatic cancer and a background of chemotherapy treatment with paclitaxel or docetaxel as adjuvants, as well as having presented with disease progression in a period of less than a year.Material and methodsWomen aged between 21 and 89 years old treated in the Centro Universitario Contra el Cáncer of the UANL in Monterrey NL, México, from 2013 to 2015. Variables considered were: age, menopausal status, hormone receptors status, over expression of HER2 neu, location of metastatic sites, performance status 0-3, and comorbidities.ResultsOnly 16 patients were evaluable among the 19 patients meeting the inclusion criteria. Nine patients (35%) had a partial response, and seven patients had stable disease status. Median progression free survival was 5.2 months; 95% CI; 3.1-10.3 months.ConclusionsPatients with relapsing disease within 2 years after previous therapy with taxanes benefited most, since they may receive taxanes again. The most important predictors for docetaxel efficacy were visceral metastases, and the duration of the disease free interval.

e19248 Background: International guidelines for genitourinary cancers recommend treatment decisions by a multidisciplinary tumor board (MTB). The benefits of a MTB include greater accuracy in staging and in the probability of receiving care in compliance with international clinical practice guidelines, greater access to clinical trials, better communication between treating physicians and cost-effective care with greater patient satisfaction, which could translate into better outcomes. Our objective was to assess the impact of a MTB in the management of patients with genitourinary tumors in a tertiary referral university center of México. Methods: We performed a retrospective analysis of all cases presented to the Genitourinary Tumor Committee of our hospital from March to August 2019. Results: A total of 84 patients were included in the analysis; of these 80% were men with a median age of 61 years. Of all the cases, 68% were first-time presentations with a median time from evaluation to presentation of 4 days. The most frequently discussed diagnoses were prostate, urothelial and renal cancer, each corresponding to about 28% of the sample. Forty-six percent of the cases presented were in metastatic disease. The median time for discussion of each case after its presentation was 10 minutes. Changes were made in the clinical stage and treatment plan proposed by the most responsible physician in 4% and 46% of the cases, respectively, achieving a unanimous consensus in 88%. After the MTB session, 29 patients were lost to medical follow-up and were not subsequently evaluated. Among the 55 patients who underwent reassessment, the recommendations of the MTB were applied in 92%. Conclusions: Discussion of urologic oncology cases at the MTB led to a change in the treatment plan in almost half of the patients. Although MTBs are an increasingly common practice in Mexico, this is the first study that describes the impact that these sessions have on the management of genitourinary tumors in our population. The high rate of loss to medical follow-up remains an important problem in developing countries, negatively affecting the prognosis of these patients.

e19356 Background: Phyllodes tumors of breast (PTB) comprise a wide range of rare fibroepithelial neoplasms representing less than 1% of all breast tumors. Studies that describe the clinical characteristics of Mexican women with PTB are scarce. Methods: We performed a retrospective analysis of all patients with newly diagnosed PTB treated at an oncology referral center in Northeast Mexico from 2013 to 2018. Results: Twenty-three women were included in the analysis. Median age at diagnosis was 51 years. Diagnosis was made by self-detection in all cases, with a median tumor size of 12.8 cm. Approximately 26% of patients had a history of benign breast disease. Regarding treatment received 39% underwent radical mastectomy whereas simple mastectomy and breast-conserving surgery were performed in 39 and 22%, respectively. PTB were classified as benign, borderline, and malignant in 17, 13, and 70% of cases, respectively. Patients with malignant PTB showed a heterologous component in 22% of cases (60% with mixed histology, 20% fibromyxosarcoma, and 20% osteosarcoma). Metastatic disease at diagnosis was documented in 3 patients. Relapse of disease was confirmed in eight patients, two of them corresponded with borderline histology and six to malignant subtype. Recurrence sites by frequency were locoregional only 38%; distant disease to the lungs only 12%; and combined metastases to lung, liver and central nervous system 50%. Regarding management of recurrence, four patients received chemotherapy, two received only radiotherapy, one was treated with radiotherapy and chemotherapy and one woman received surgical treatment with adjuvant radiotherapy. Among all patients analyzed, the median overall survival was 23.6 months. Conclusions: To our knowledge, this is one of the first studies analyzing the clinical-pathological characteristics of phyllodes tumors in the Mexican population.

e19296 Background: Precision medicine has led to important changes in the treatment paradigm for patients with lung adenocarcinoma (LA) with mutations in EGFR or rearrangements of ALK or ROS1. The objective of this study is to describe the proportion of patients with LA who had access to molecular testing and targeted molecular therapy at an oncology referral center in Northeast Mexico. Methods: A retrospective study was performed with information gathered from electronic health records of the Hospital Universitario “Dr. José E. González” in Monterrey, Mexico from 2014 to 2019. Patients with LA were identified based on ICD-10 codes (C34) and diagnosis was confirmed with histopathological reports. Results: A total of 316 cases of lung cancer were identified, of which, 194 (64%) were LA, and of those, 117 (60%) had access to molecular testing. Mutations in EGFR were detected in 47%; 38% in men and 59% in women. Rearrangements in ALK were observed in 6.4%, whereas no alterations in ROS1 were seen. Access to molecular testing increased from 2014 to 2019, with a rate of 42% to 67%, respectively. Among patients that were candidates to receive targeted molecular therapy only 37% had access in 2014 versus 66% in 2019. Conclusions: The frequency of mutations in EGFR among our patients with LA showed a high discrepancy with previous studies conducted in countries with a predominantly white population. In Latin America, reports range from 14% to 34% in Argentina and Mexico, respectively. In our study, we identified a higher proportion of mutations in EGFR when compared to what previously reported; however, limited access to molecular testing may bias our results. Despite the advances in treatment for patients with LA, the availability of molecular testing and personalized treatment remains a challenge for developing countries.

Low-penetrance susceptibility genes such as 5,10-methylenetetrahydrofolate reductase gene (MTHFR) have been considered in the progression of breast cancer (BC). Cancer is a result of genetic, environmental and epigenetic interactions; therefore, these genes should be studied in environmental context, because the results can vary between populations and even within the same country. The objective was to analyze the allelic and genotypic frequencies of the MTHFR C667T SNP in Mexican Mestizo patients with BC and controls from Northeastern Mexico.243 patients and 118 healthy women were studied. The analysis of the polymorphism was performed with a DNA microarray. Once the frequency of the polymorphism was obtained, Hardy-Weinberg equilibrium test was carried out for the genotypes. Chi square test was used to compare the distribution of frequencies.The allele frequency in patients was: C = 0.5406; T = 0.4594 and in controls C = 0.5678, T = 0.4322. Genotype in BC patients was: C / C = 29.9%, C / T = 48.3% and T / T = 21.8. The distribution in controls was: C / C = 31.4%, C / T = 50.8%, T / T = 17.8% (chi squared 0.77, p = 0.6801).Northeastern Mexican women in this study showed no association between MTFHR C667T SNP and the risk of BC. It seems that the contribution of this polymorphism to BC in Mexico varies depending on various factors, both genetic and environmental.existen genes de susceptibilidad de baja penentrancia, como el gen de la 5,10-metilentetrahidrofolato reductasa (MTHFR), que participan en la progresión del cáncer de mama (CM). El cáncer es resultado de interacciones genéticas, ambientales y epigenéticas. Estos genes deben ser estudiados en el contexto del medio ambiente, ya que los resultados pueden variar de una población a otra, incluso dentro del mismo país. El objetivo fue analizar las frecuencias alélicas y genotípicas del polimorfismo C667T del gen de la MTHFR en pacientes mestizos mexicanos con CM y controles del noreste de México.se estudiaron 243 pacientes y 118 mujeres sanas. El análisis del polimorfismo se realizó con una microarreglo de ADN. Una vez que se obtuvo la fre cuencia del polimorfismo, la prueba de equilibrio de Hardy-Weinberg se llevó a cabo para los genotipos. Se utilizó chi cuadrada para comparar la distribución de frecuencias.la frecuencia de los alelos en los pacientes fue: C = 0.5406, T = 0.4594 y en los controles C = 0.5678, T = 0.4322. El genotipo en pacientes con CM fue: C / C = 29.9%, C / T = 48.3% y T / T = 21.8. La distribución en los controles fue: C / C = 31.4%, C / T = 50.8%, T / T = 17.8% (chi cuadrada 0.77, p = 0.6801).en este estudio no se observó relación entre el SNP MTFHR C667T y el riesgo de CM. Al parecer la contribución de este polimorfismo al CM en México varía dependiendo de varios factores tanto genéticos como ambientales.

The epidermal growth factor receptor (EGFR) is a member of the ErbB family of membrane tyrosine-kinase receptors. Studies exploring the prognostic role of EGFR-overexpression in early breast cancer have shown variable results, and the true prognostic value of EGFR is unknown.A systematic review of identified publications exploring the association between EGFR-overexpression (as defined from different techniques and cut-offs) and outcomes [disease-free (DFS) and, overall survival (OS)] in women with early breast cancer. The hazard ratios (HR) for DFS and OS were weighted and pooled in a meta-analysis using generic inverse variance and random effects modeling.Fifty-three studies comprising 21,418 women were included. EGFR-overexpression was found in 27% of the patients. Primary analysis included studies reporting HRs from multivariable analyses (10 studies including 4857 patients with HRs for OS and 17 studies comprising 8747 patients with HRs for DFS), EGFR-overexpression was associated with worse OS (HR 1.98, 95% CI: 1.59-2.47, p .001) and DFS (HR 1.59, 95% CI 1.30-1.95, p .001). The influence of EGFR overexpression on DFS was greater in women with triple negative tumors compared to women with non-triple negative tumors (HR 2.35 versus HR 1.45, respectively; p = .01). Analysis looking at odd ratios for both 5-year and 10-year for DFS and OS showed similar results.EGFR-overexpression appears to be associated with reduced OS and DFS in women with early breast cancer. Patients with triple negative and EGFR-overexpression have poorer OS and DFS than those with triple negative tumors and normal EGFR expression.

10513 Background: The Burnout Syndrome takes relevance for its investigation since 1986, when Maslach developed a survey for its study with 3 subscales that include the symptoms generated by exhaustion and chronic labor stress. Health workers are especially vulnerable to the development of this syndrome, which is greater centers with exposure to patients with severe and/or chronic ailments. Thus, the mental structure maturity level with which the individual functions takes relevance, since it is linked to the quality of judgment of the clinician. Few studies consider this aspect because of the complexity of having the instruments and professionals to assess it. It has been questioned whether Burnout or this occupational exhaustion damages the quality of life of the individual, and if it also negatively impacts their work performance, and the quality of care provided to patients. Methods: Observational, cross-sectional and correlational study. It analyses the relationship between Burnout and the characteristics of the mental-structural functioning level in oncology staff, and its association with the level of functionality of the mental structures within the work environment. Prior validation of the instrument was conducted, FIAD-15, with acceptable Alpha of 0.81. Results: Data were obtained from 1,060 subjects, including administrative, nursing and medical members of the Oncology Service staff, as well as, students. Out of these, 1,036 subjects answered the questionnaire appropriately and were considered in the analysis. 413 (39.86%) presented Burnout. The prevalence was higher in men (45.17%) than in women (34.56%). A significant association was found between Burnout frequency and levels of mental functioning. On the functionality of the mental structures, 80% had functional, high and intermediate levels, while 20% of the total population showed a borderline level of functionality (severe). In women, Burnout frequency was higher in borderline levels, followed by those of functional and high level. In men, Burnout was higher in those at the borderline level, followed by functional and intermediate; it was much lower in high level subjects. Conclusions: The mental structure functionality levels found in the oncology staff are associated with Burnout; which is lower in men with structures with high functionality and in women in the intermediate level. Subjects with borderline structures suffer greater Burnout. Further studies should be carried out to support these findings in the future and open new lines of research.

e23113 Background: Most studies report that tumor related pain occurs between 46% and 92%. The prevalence of pain by clinical stage is 15% in initial stages, 30% in middle stages, 74% in metastatic cancer and, 87% in terminal disease. In the face of chronic diseases such as cancer, patient's relationships with their social networks are affected; among them the interpersonal relationships between the patient and his networks and these towards the patient. With this, the patient’s quality of life is affected. Most of the recent studies on health-related quality of life come from pharmaceutical groups, so it is necessary for other groups to be vigorously involved in the study of the effect of medical interventions on the quality of life, as well as on the impact on health and on the social support of patients with chronic diseases. Methods: In order to obtain the data, validated questionnaires were used as instruments to evaluate the quality of life, measuring psychosocial and health variables, as well as for the detection of the type and quality of psychosocial support perceived by the subjects. The instruments were applied to 207 patients of the Oncology Service of the University Center Against Cancer of the University Hospital “Dr. Jose Eleuterio Gonzalez” in Nuevo Leon, Mexico, during a session of 25 to 30 minutes. Results: Data were collected from 207 patients with chronic oncological pain. The satisfaction index with psychosocial support had a high linear correlation ( r = .640) with the quality of life index. On the other hand, the number of caregivers was not correlated with this last index. Fatigue was the symptom most frequently associated with a decrease in the quality of life index. In addition, pain correlated with all variables except the cognitive index. Conclusions: Satisfaction with the perceived social support is a factor associated with the quality of life in patients with chronic oncological pain; however, the number of caregivers is not. There was no relationship between the size of the network and satisfaction with it. Also, the symptoms associated with chronic oncological pain affect quality of life, identity and social functionality and roles, which in turn impact on the quality of life perceived by patients.

e15536 Background: Squamous cell carcinoma and adenocarcinoma represent approximately 95% of malignant tumors of the esophagus. For most cases of the 20th century, squamous cell carcinoma was the predominant lineage. In the 1960s, squamous cell carcinoma accounted for more than 90% of all esophageal tumors in the United States of America, and adenocarcinoma was considered so uncommon that some oncological associations questioned its existence. However over time the incidence of esophageal adenocarcinoma (predominantly in the distal esophagus and gastroesophageal junction) has increased dramatically in Western countries, with adenocarcinoma now causing more than 60% of all esophageal cancers in the United States of America, unlike the rest of the world, where squamous cell carcinoma continues to predominate. Squamous cell carcinoma and adenocarcinoma differ in a significant number of clinical features, including tumor location and predisposing factors. Smoking and alcoholism are major risk factors for the development of squamous cell carcinoma, while the Barrett's esophagus with intestinal metaplasia (a complication of gastroesophageal reflux disease), obesity, and smoking are the risk factors related to adenocarcinoma of the esophagus. Objectives: To determine the incidence of esophageal adenocarcinoma in Mexico and its main characteristics, such as epidemiology, histological type and main risk factors. Methods: A descriptive analysis was conducted in which the histological type, age of diagnosis, location, age of the patients and risk factors were compared. Results: Average age on the studied population was 67.4 years (minimum 37, maximum 91); 74.3% of the subjects were male and 20.4%, female. It was found that the predominant histological type was Adenocarcinoma in 40.7% against 28.3% of the Epidermoid. Average age of diagnosis was at 65.88 years (minimum 37, maximum 89). In frequency of localization, lower third in 22.1%, union GE in 20.4%, middle third in 15%, and upper third in 12.4%). The predominant risk factors in our study were smoking (31%), alcoholism (36.3%) and GERD (12.4%). Conclusions: Oesophageal adenocarcinoma continues to be the most prevalent presentation of esophageal cancer in our population, despite epidemiological changes over time.

Aim: Pharmacogenetic studies in breast cancer (BC) may predict the efficacy of tamoxifen and the toxicity of paclitaxel and capecitabine. We determined the frequency of polymorphisms in the CYP2D6 gene associated with activation of tamoxifen, and those of the genes CYP2C8, CYP3A5 and DPYD associated with toxicity of paclitaxel and capecitabine. We also included a IL-10 gene polymorphism associated with advanced tumor stage at diagnosis. Patients & methods: Genomic DNAs from 241 BC patients from northeast Mexico were genotyped using DNA microarray technology. Results: For tamoxifen processing, CYP2D6 genotyping predicted that 90.8% of patients were normal metabolizers, 4.2% ultrarapid, 2.1% intermediate and 2.9% poor metabolizers. For paclitaxel and the CYP2C8 gene, 75.3% were normal, 23.4% intermediate and 1.3% poor metabolizers. Regarding the DPYD gene, only one patient was a poor metabolizer. For the IL-10 gene, 47.1% were poor metabolizers. Conclusion: These results contribute valuable information towards personalizing BC chemotherapy in Mexican women. Original submitted 1 February 2013; revision submitted 22 April 2013

OBJECTIVE To investigate clinical outcomes and 3-year persistence of human papillomavirus (HPV) infections among women in Mexico. METHODS A prospective study enrolled sexually active women attending primary healthcare clinics in metropolitan Monterrey, Mexico, between June 3 and August 30, 2002. Baseline data were collected and participants underwent HPV screening. Patients with HPV infections were asked to attend a repeat screening appointment after 3 years, when the same screening data were gathered. Descriptive analyses were performed and the prevalence of cervical lesions and viral infections were examined. RESULTS In total, 1188 patients who underwent initial HPV screening were included. Cervical lesions were detected in 5 (0.4%) patients and 239 (20.1%) patients had HPV infections; 129 (54.0%) of these patients attended 3-year follow-up. Among the 357 HPV serotypes identified, the most prevalent serotypes were HPV-59, HPV-52, HPV-16, and HPV-56, detected 62 (17.4%), 38 (10.6%), 27 (7.6%), and 18 (5.0%) times, respectively. Of the 129 patients attending 3-year follow-up, 104 (80.6%) were clear from HPV infections, 13 (10.1%) patients had persistent HPV infections, and 12 (9.3%) had HPV infections with different HPV types. CONCLUSIONS The HPV prevalence was 20.1% in the present study; the most prevalent infections were HPV-59, HPV-52, HPV-16, and HPV-56. At 3-year follow-up, 25 (19.4%) patients had HPV infections.

A phase I-II study to evaluate gene-mediated cytotoxic immunotherapy in newly diagnosed prostate cancer before radical prostatectomy was conducted in Monterrey, Mexico. First, to investigate delivery of adenovirus to the prostate, fluorescently labeled vector was injected into fresh prostatectomy specimens and distribution was visually analyzed. The optimal volume and site instillation was then used for transrectal ultrasound guided intraprostatic injection in 10 patients with adenocarcinoma scheduled for radical prostatectomy. Each received two apical and two basal 0.5 ml injections of AdV-tk for a total of 1 × 10(11) vp followed by 14 days of prodrug. Nine patients continued to tumor resection: six high risk, one intermediate and two low risk. In vivo vector distribution was analyzed from the resected tissue of four patients. Patients were monitored for tumor progression and acute and long-term safety. For vector delivery, two apical and two basal injections of 0.5 ml led to optimal organ-wide distribution ex vivo and in vivo. Cytotoxicity was evidenced by transient rise in PSA and tumor histology. There were no significant adverse events deemed related to the treatment and no late toxicities after median follow-up of 11.3 years. All six high-risk patients had positive surgical margins and one had seminal vesicle involvement. Despite slow PSA rise post surgery in three of these patients, none developed metastases. The intermediate- and low-risk patients had complete resections and none have progressed. In conclusion, in vivo transrectal ultrasound guided instillation of an adenoviral vector into four sites in the prostate was practical as an outpatient procedure, well tolerated and led to distribution throughout the intraprostatic tumor mass. AdV-tk demonstrated no significant acute or late toxicities. Trends in PSA and disease progression conveyed the possibility of a sustained immune response against residual disease.

Introduction: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype, lacking expression of estrogen, progesterone and HER2 receptors. Evidence suggests that TNBC present more frequently in young African-American and Hispanic women, with lower socioeconomic status, hormonal environment and obesity. To this date, there are no studies that have compared TNBC versus nonTNBC in a homogeneous population. Comparison of these groups may help to identify genes that are key hallmarks in TNBC patients. Objective: To analyze the expression profile of TNBC versus nonTNBC in a homogeneous population from northwestern Mexico, in order to find distinctive biological pathways characteristics to TNBC. Methods: A prospective study was conducted involving a total of 50 patients (25 TNBC and 25 nonTNBC) undergoing neoadjuvant chemotherapy (NAC) for breast cancer. Both groups were similar in mean age at diagnosis (51 vs 47 years), mean of glucose levels (107 mg/dl vs 104 mg/dl) and BMI (28 vs 29) for TNBC and nonTNBC respectively. Core biopsies were obtained for histological diagnosis and gene expression, total RNA was isolated and expression profiling performed. Some of the differentially expressed genes were selected and validated by qPCR Results: Seventy percentage of the population presented BMI > 25. We identified a genomic profile expression composed of 40 genes associated with TNBC phenotype. Out of 40 genes, 9 were overexpressed (FOXC1, PRKX/PRKY, UGT8, BCL11A, HMGA1, LPIN1, FAM171A1, HAPLN3, y ANKRD11) and 31 under-expressed. Interestingly, some of these genes were previously associated to breast cancer. HMGA1, PRKX and LPIN1 participate in the insulin metabolism, UGT8 in the sphingolipids metabolism, while two others are transcription factors associated with metastasis and poor prognosis (FOXC1) and tumor growth (BCL11A). Conclusions: To our knowledge this is the first study in Latin American woman reporting a genomic signature for TNBC strongly associated with aberrant metabolism itself, such as seen in obesity. Understanding cell metabolism may help to clarify the mechanism for tumor development and progression in TNBC patients. Citation Format: Santuario-Facio SK, Cardona-Huerta S, Perez-Paramo YX, Treviño V, Hernandez-Cabrera F, Rojas-Martinez A, Psdilla-Rivas G, Muñoz-Maldonado G, Barbosa-Quintana A, Barbosa-Quintana O, Garza-Guajardo R, Gonzalez-Guerrero JF, Martinez-Rodriguez JL, Ortiz-López R. Gene expression profile of triple negative breast cancer in patients highlight biomarkers involved in cell metabolism. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-03-20.

In this study we evaluated the activity and toxicity of a combination of 5-fluorouracil continuous infusion and vinorelbine as second or third line chemotherapy in metastatic breast cancer (MBC). PATIENTS AN METHODS: A total 24 patients who had received doxorrubicin and/or paclitaxel were included in this study. The regimen consisted in 5-fluorouracil 1 gr/m(2) BSA continuous infusion for 3 days and vinorelbine 30 mg/m(2) intravenous (IV) on day 1. The cycles were repeated every 21 days for 6 cycles.Objective responses were recorded in 37.5% (12.5% complete remission). The median disease-free survival was calculated 6.33 +/- 8.12 months (CI 95% of 3.43 months). Toxicity was observed in 12.5% of the patients and no treatment related deaths were recorded.The combination of 5-fluorouracil/vinorelbine at the dose administered is an effective regime in patients with MBC, with low toxicity and cost.

Calderon-Garciduenas AL, Paras-Barrientos FU, Cardenas-Ibarra L, Gonzalez-Guerrero JF, Villarreal-Rios E, Staines-Boone T, Barrera-Saldana HA. Risk factors of breast cancer in Mexican women. Salud Publica Mex 2000;42:26-33. Abstract Objective. To investigate the association between family history (FH) of neoplasia, gyneco-obstetric factors and breast cancer (BC) in a case-control study. In cases, to analyze those variables in relation with early onset of BC, the manner of detection (self-examination, prompted by pain, or casual), the size of tumor, and the elapsed time to seek medical attention. Material and methods. Data from 151 prevalent BC cases and 235 age-matched controls were analyzed by multiple logistic regression, to assess the influence of BC risk factors. Results. Ten per cent of patients and 1% of controls had first-degree relatives (FDR) with BC. Family history of FDR with BC (OR, 11.2; 95% CI 2.42-51.92) or with gastric or pancreatic cancer (OR, 17.7; 95% CI 2.2- 142.6) was associated with BC risk. Breastfeeding at or under 25 years of age was protective against BC (OR, 0.40; 95% CI 0.24-0.66). The manner of tumor detection did not influence its size at the time of diagnosis. Conclusions. Our study confirms that FH of BC and/or of gastric or pancreatic carcinoma are risk factors for BC, while lactation at 25 years of age or earlier is protective. Calderon-Garciduenas AL, Paras-Barrientos FU, Cardenas-Ibarra L, Gonzalez-Guerrero JF, Villarreal-Rios E, Staines-Boone T, Barrera-Saldana HA. Factores de riesgo de cancer de mama en mujeres mexicanas. Salud Publica Mex 2000;42:26-33.

The authors present the first Phase I gene transfer clinical trial initiated in Latin America. The study population was low to high risk prostate cancer patients scheduled to undergo surgical tumor removal. The study was designed to evaluate the safety of the procedure, vector distribution within the tumor and pathologic effects of a four quadrant transrectal intra-prostatic injection of a non-replicating adenoviral vector carrying the HSV-tk gene (AdV-tk). Differences in these parameters after treatment with intravenous ganciclovir (GCV) vs oral valacyclovir (VCV) were also evaluated. Each subject received 1X1011 vector particles followed by 14 days of GCV or VCV prior to radical prostatectomy. No significant vector related toxicity was observed any of the ten analyzed patients; one subject abandoned the study prior to surgery for personal reasons. Vector sequences were detected in all tumors, with 30% to 85% positive distribution-cores from each gland, even in a specimen removed 15 weeks after vector injection. Pathological analyses demonstrated zones of regional tumor necrosis and inflammation of tumor tissue associated with significant CD8+ T-cell infiltration. Biological activity of the vector was evidenced by a spike in circulating PSA levels shortly after injection followed by an overall decrease from starting PSA concentration to the level observed just prior to surgery in seven of ten patients. No differences were observed between the two prodrugs. Patient follow-up has continued for an average of 52.8 months (range: 38 to 64 months) with encouraging results. These data demonstrate the safety and distribution-efficacy of simple outpatient procedure and oral prodrug for AdV-tk in prostate cancer.

4801 Background: Metastatic renal cell carcinoma (mRCC) has a poor prognosis, but survival is quite different among different subgroups of patients, it doesn’t matter how they were treated. Some cl...

Background Persistent infection with high-risk human papillomavirus (HPV) is a major risk factor for malignant lesions and cervical cancer. A widely studied element in the search for genetic factors influencing risk HPV infection diseases is allelic variation of the human leukocyte antigen (HLA) locus. The study was designed to search for HLA susceptibility alleles contributing to the persistence of HPV infection in Mexican women. Methods A total of 172 subjects were divided into three groups: 1) HPV–persistent patients; 2) HPV–cleared; and 3) HPV–reinfected patients. They were screened for HPV types using a polymerase chain reaction (PCR). PCR-sequence specific oligonucleotide probes (PCR-SSOP) was used for HLA DRB1 and DQB 1 typing. Results We observed that HLA-DQB1*0501 allele might be associated with susceptibility of reinfection with HPV (p = 0.01, OR = 4.9, CI 95% = 1.3 -18.7). Allele frequency of HLA-DRB1*14 was particularly reduced in patients with cancer when compared with the HPV–persistent group (p = 0.04), suggesting that this allele is a possible protective factor for the development of cervical cancer (OR = 2.98). HLA-DRB1*07 might be associated with viral clearance (p = 0.04). Conclusions Genetic markers for HPV infection susceptibility are different in each population, in Mexicans several HLA-DQB1 alleles might be associated with an enhanced risk for viral persistence. In contrast, DRB1*14, seems to confer protection against cervical cancer.