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1. Implementing Standard Diagnosis and Treatment for Locally Advanced Breast Cancer Through Global Research in Latin America: Results From a Multicountry Pragmatic Trial

Author

Javier Retamales, Adrián Daneri-Navarro, Nora Artagaveytia, Daniela Alves da Quinta, Eliana Abdelhay, Osvaldo L. Podhajcer, Carlos Velázquez, Diego Giunta, Susanne Crocamo, Adriana Garibay-Escobar, Alicia Del Toro-Arreola, Robinson Rodriguez, Marta Aghazarian, Elsa Alcoba, Isabel Alonso, Renata Binato, Alicia I. Bravo, Juan Canton-Romero, Dirce M. Carraro, Mónica Castro, Juan Castro-Cervantes, Sandra Cataldi, Natalia Camejo, Laura Cortes-Sanabria, Maria Flores-Marquez, Guillermo Laviña, Eduardo Musetti, Benedicta Caserta, Mauricio Cerda, Alicia Colombo, Raul Delgadillo-Cristerna, Marisa Dreyer Breitenbach, Elmer Fernandez, Jorge Fernandez, Ramon Franco-Topete, Carolina Gabay, Fancy Gaete, Jorge Gamboa, Ricardo García-Gaeta, Mariana Gomez del Toro, Leivy P. Gonzalez-Ramirez, Marisol Guerrero, Manuel Herrera-Miramontes, Alejandra Lopez-Vasquez, Silvina Maldonado, Andrés Morán-Mendoza, Gilberto Morgan-Villela, Maria Aparecida Nagai, Nancy Navarro-Ruiz, Antonio Oceguera-Villanueva, Miguel Angel Ortiz, Jael Quintero, Antonio Quintero-Ramos, Gladys Ramirez-Rosales, Maritza Ramos-Ramirez, Marcia Maria Chiquitelli Marques, Ernesto Rivera Claisse, Diego Rodriguez-Gonzalez, Ana Romero-Gomez, Cristina Rosales, Efraín Salas-Gonzalez, Verónica Sanchotena, Laura Segovia, Aída A. Silva-García, Olivia Valenzuela-Antelo, Laura Venegas-Godinez, Livia Zagame, Jorge Gomez, Andrea S. Llera, and Bettina Müller

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

PURPOSEBreast cancer mortality rates in Latin America (LA) are higher than those in the United States, possibly because of advanced disease presentation, health care disparities, or unfavorable molecular subtypes. The Latin American Cancer Research Network was established to address these challenges and to promote collaborative clinical research. The Molecular Profiling of Breast Cancer Study (MPBCS) aimed to evaluate the clinical characteristics and treatment outcomes of LA participants with locally advanced breast cancer (LABC).PATIENTS AND METHODSThe MPBCS enrolled 1,449 participants from Argentina, Brazil, Chile, Mexico, and Uruguay. Through harmonized procedures and quality assurance measures, this study evaluated clinicopathologic characteristics, neoadjuvant chemotherapy response, and survival outcomes according to residual cancer burden (RCB) and the type of surgery.RESULTSOverall, 711 and 480 participants in the primary surgery and neoadjuvant arms, respectively, completed the 5-year follow-up period. Overall survival was independently associated with RCB (worse survival for RCBIII-adjusted hazard ratio, 8.19, P < .001, and RCBII [adjusted hazard ratio, 3.69, P < .008] compared with RCB0 [pathologic complete response or pCR]) and type of surgery (worse survival in mastectomy than in breast-conserving surgery [BCS], adjusted hazard ratio, 2.97, P = .001). The hormone receptor–negative-human epidermal growth factor receptor 2–positive group had the highest proportion of pCR (48.9%). The analysis of the ASCO Quality Oncology Practice Initiative breast module revealed high compliance with pathologic standards but lower adherence to treatment administration standards. Notably, compliance with trastuzumab administration varied widely among countries (33.3%-88.7%).CONCLUSIONIn LABC, we demonstrated the survival benefit of BCS and the prognostic effect of the response to available neoadjuvant treatments despite an important variability in access to key treatments. The MPBCS represents a significant step forward in understanding the real-world implementation of oncologic procedures in LA.

Published
2024
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2. The Transcriptomic Portrait of Locally Advanced Breast Cancer and Its Prognostic Value in a Multi-Country Cohort of Latin American Patients

Author

Andrea Sabina Llera, Eliana Saul Furquim Werneck Abdelhay, Nora Artagaveytia, Adrián Daneri-Navarro, Bettina Müller, Carlos Velazquez, Elsa B. Alcoba, Isabel Alonso, Daniela B. Alves da Quinta, Renata Binato, Alicia Inés Bravo, Natalia Camejo, Dirce Maria Carraro, Mónica Castro, Juan M. Castro-Cervantes, Sandra Cataldi, Alfonso Cayota, Mauricio Cerda, Alicia Colombo, Susanne Crocamo, Alicia Del Toro-Arreola, Raúl Delgadillo-Cisterna, Lucía Delgado, Marisa Dreyer-Breitenbach, Laura Fejerman, Elmer A. Fernández, Jorge Fernández, Wanda Fernández, Ramón A. Franco-Topete, Carolina Gabay, Fancy Gaete, Adriana Garibay-Escobar, Jorge Gómez, Gonzalo Greif, Thomas G. Gross, Marisol Guerrero, Marianne K. Henderson, Miguel E. Lopez-Muñoz, Alejandra Lopez-Vazquez, Silvina Maldonado, Andrés J. Morán-Mendoza, Maria Aparecida Nagai, Antonio Oceguera-Villanueva, Miguel A. Ortiz-Martínez, Jael Quintero, Antonio Quintero-Ramos, Rui M. Reis, Javier Retamales, Ernesto Rivera-Claisse, Darío Rocha, Robinson Rodríguez, Cristina Rosales, Efrain Salas-González, Verónica Sanchotena, Laura Segovia, Juan Martín Sendoya, Aida A. Silva-García, Alejandra Trinchero, Olivia Valenzuela, Vidya Vedham, Livia Zagame, United States-Latin American Cancer Research Network (US-LACRN), Osvaldo L. Podhajcer, Juan Abarca, Pamela Acevedo, Graciela Acosta, Gissel Acosta, Gabriela Acosta Haab, Ana Lilian Acosta Silva, Marta Aghazarian, Carola Aguayo, Bernardo Aizen, Gustavo Alarcon Lopez, Liz Almeida, Ana Alvarez, Viviane Andrade, Wenceslao Angeles-Bueno, Roberto Arai, Priscila Elvira Arambula Barreras, Ma. Isabel Aramburo Rubio, Gonzalo Ardao, Lilia A. Arellano-Jimenez, Claudia Arias, Ricardo Armisen, Mauricio Aspee, Rodrigo Assar, Itzel Reneé Astiazarán Rascón, Sebastian Astorga, Maxwell Aviles Rodriguez, Antônio Bailão Junior, Adolfo E. Barragan-Curiel, Adelfo Barragan-Ruiz, Fernanda Bermudez, Julia Bernachin, Wilfrido Bernal Herrera, Mara Bonet, Sarah Brnich, Claudio Bustamante, Miguel Angel Bustamante, Julio Bustos-Gomez, Felipe de J Bustos-Rodriguez, Janett Caballero Jasso, Angie Calfuman, Antonio Hugo José Froes Marques, Mónica Campos, Soledad Cano, Juan C. Canton-Romero, Ricardo Cappetta, Paulina Carmona, Fernando Carrizo, André Lopes Carvalho, Erika Carvallo, Julio Carzoglio, Monica Casalnuovo, Benedicta Caserta, Alvaro Castillo, César Castillo, Roger Chammas, Mario Alberto Chavez Zamudio, Loreto Chia, Elisa Chiarello, Daniela Chirico, Esther Cisneros-Quirarter, Minor Raul Cordero Bautista, Valeria Cornejo, Baldemar Corral Villegas, Andrés Cortés, Sandra Cortés, Laura Cortes-Sanabria, German Salvador Cortez Zamorano, Alejandro Corvalan, Adolfo Cruz, Alba d'Aurora, Sandra De la Fuente, Soledad De la Peña, Roberto de Leon Caballero, Mirian de Souza, César Del Castillo, Azucena Del-Toro-Valero, Mirtha Di Pretoro, Andrea Digonzelli, Jose El Ters, Paula Escobar, Marcela Estolaza, Adriane Feijo Evangelista, Marcelo Fanelli, Paulo Farias, Graciela Fernandez, José R. Filassi, Natalia Filgueiras, Diego Flaks, Edgar G. Flores-Ayala, Maria R. Flores-Marquez, David Franco Hughes, Karina Franco-Topete, Jimena Freire, Cristobal Fresno, Romina Gabrielli, Mario Gallegos, Jorge Gamboa, Daiana Ganiewich, Carlos Garbovesky, Ruben Alejandro Garcia Munguia, Ricardo Garcia-Gaeta, Alma C. Garcia-Martinez, Liliana Gimenez, Hector Gómez Silveira, Mariana M. Gomez-Del Toro, Marcela Gonzalez, Alicia Gonzalez, Germán González, Cesar Osbaldo Gonzalez Mondaca, Leivy P. Gonzalez-Ramirez, Beatriz Gonzalez-Ulloa, Susana Gorostidy, Mariela Grass, Alfonso G. Guevara Torres, Lorena Gutierrez, Susan A. Gutierrez-Rubio, Adrián Hannois, Andrew Hart, Steffen Härtel, Marcos Henriquez, Rafael Hernandez Guevara, Miriam E. Hernandez-Franco, Manuel I. Herrera-Miramontes, Graciela Horton, Gladys Ibañez, Martín Ipiña, Beatriz Jalfin, Lilian Jara, Raul Jara, Maria Luisa Jaramillo, David Javalera-Castro, Maria Eugenia Jimenez, Hugo Ju, Nazareth Juárez Rusjan, Karen Juneman, Ligia Maria Kerr, Alejandra Krupelis, Flor Esmeralda Larios-Jimenez, Jose Domingo Latorre, Guillermo Laviña, Fernando Lavista, Irma Leticia León Duarte, Alberto Lescano, Verónica Lezano, Rossana Mendoza Lopez, Jose Guillermo Lopez Cervantes, Miguel Enrique Lopez Muñoz, Dora Loria, Alejandra Luque, Alejandro Maass, Maria do Socorro Maciel, Flavia Rotea Mangone, Jorge Mansilla, Katherine Marcelain, Carolina Mariani, Marcia Maria Chiquitelli Marques, Reyna J. Martinez-Arriaga, Hector R. Martinez-Ramirez, Marcela Martins, Alma G. Maya-Gonzalez, Brenda Mazzaferri, Yadira Medina-Mora, Mariana Menini, Silvia Míguez, Soledad Milans, Soledad Montes, Ana Verónica Morales Hernández, Giberto Morga-Villela, Carla Morong, Homero Muñoz, Ignacio Miguel Muse, Carina Mussetti, Eduardo Mussetti, Luis J. Najar-Acosta, Elisa Napolitano e Ferreira, Nancy E. Navarro-Ruiz, Cristina Noblía, João Soares Nunes, Daniela Núñez, Fabiola Núñez, Nilton Onari, Emma M. Oropeza-De Anda, David Ortega Tirado, Cynthia Aparecida Bueno de Toledo Osório, Carlos Eduardo Paiva, Paulina Peñaloza, Miguel Peredo-Navarro, David Pereira, Laura Perez Michel, Francisca Pino, Tania Pino, Natalia Pinto, Jessica Pizarro, Carlos Pressa, Enrique Ramirez, Gladys E. Ramirez-Rosales, Claudia Ramis, Maritza Ramos-Ramirez, Adela Rascon Alcantar, Silvana Ravaglio, Francois Richard, Omar Rios Méndez, Ramón Enrique Robles Zepeda, Iara Santana Rocha, Natalia Rodriguez, Vilma Rodriguez, Maria Teresa Rodriguez, Diego Rodriguez-Gonzalez, Rosemeire A Roela, Ana M Romero-Gomez, Ana M Rosales-Sandoval, Omar V Rubio-Plascencia, Florencia Russo, Gaciela Sabini, Isabel Saffie, Helena Salina Dias, Brenda Guadalupe Samaniego Soto, Julio San Martino, Benito Sanchez-Llamas, Daniel Sat-Muñoz, Mariana Savignano, Cristovam Scapulatempo Neto, Max Mano Senna, Carolina Silva, Jaime Silvera, Isabele Small, Fernando Soares, Iberê Soares, Silvana Soares dos Santos, Evandro Sobrosa de Mello, José Antonio Sola, Irene Sorín, Alejandra Sosa, Anabella Sosa, Claudio Sosa, Sandra Soto, Cristiano de Pádua Souza, Lucía Spangenberg, Gustavo Steffanof, Florencia Straminsky, Mónica Tapia, Raziel O. Tapia-Llanos, Geronimo M. Tavares-Macias, Guillermo Temperley, Veronica Terzieff, Vicente Teti, Javier Tognarelli, Verónica Toledo, Paulina Toro, Roberto Torres, Mariana Torres-Palomares, Rogelio Troyo-San Roman, Hernan Urbano, Nicolas Vacca, Daniel Vaimberg, María Lourdes Valencia Peña, Maria Lujan Vaselevich, Jaime Vazquez-Nares, Ezequiel Velez-Gomez, Laura N. Venegas-Godinez, Patricia Vercelli, Ricardo Verdugo, René Aloisio da Costa Vieira, Marta Vilensky, María José Villarubias, Manuel Isaac Villegas Gómez, Stella Viña, Silvia Vornetti, Anapaula Hidemi Uema Watanabe, Carlos Zamorano, Luis Zapata, and Zdenka Zlatar

Subjects
breast cancer, Latin America, PAM50 subtypes, risk of recurrence, biological pathways, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

PurposesMost molecular-based published studies on breast cancer do not adequately represent the unique and diverse genetic admixture of the Latin American population. Searching for similarities and differences in molecular pathways associated with these tumors and evaluating its impact on prognosis may help to select better therapeutic approaches.Patients and MethodsWe collected clinical, pathological, and transcriptomic data of a multi-country Latin American cohort of 1,071 stage II-III breast cancer patients of the Molecular Profile of Breast Cancer Study (MPBCS) cohort. The 5-year prognostic ability of intrinsic (transcriptomic-based) PAM50 and immunohistochemical classifications, both at the cancer-specific (OSC) and disease-free survival (DFS) stages, was compared. Pathway analyses (GSEA, GSVA and MetaCore) were performed to explore differences among intrinsic subtypes.ResultsPAM50 classification of the MPBCS cohort defined 42·6% of tumors as LumA, 21·3% as LumB, 13·3% as HER2E and 16·6% as Basal. Both OSC and DFS for LumA tumors were significantly better than for other subtypes, while Basal tumors had the worst prognosis. While the prognostic power of traditional subtypes calculated with hormone receptors (HR), HER2 and Ki67 determinations showed an acceptable performance, PAM50-derived risk of recurrence best discriminated low, intermediate and high-risk groups. Transcriptomic pathway analysis showed high proliferation (i.e. cell cycle control and DNA damage repair) associated with LumB, HER2E and Basal tumors, and a strong dependency on the estrogen pathway for LumA. Terms related to both innate and adaptive immune responses were seen predominantly upregulated in Basal tumors, and, to a lesser extent, in HER2E, with respect to LumA and B tumors.ConclusionsThis is the first study that assesses molecular features at the transcriptomic level in a multicountry Latin American breast cancer patient cohort. Hormone-related and proliferation pathways that predominate in PAM50 and other breast cancer molecular classifications are also the main tumor-driving mechanisms in this cohort and have prognostic power. The immune-related features seen in the most aggressive subtypes may pave the way for therapeutic approaches not yet disseminated in Latin America.Clinical Trial RegistrationClinicalTrials.gov (Identifier: NCT02326857).

Published
2022
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3. Socioeconomic, Clinical, and Molecular Features of Breast Cancer Influence Overall Survival of Latin American Women

Author

Liz Maria de Almeida, Sandra Cortés, Marta Vilensky, Olivia Valenzuela, Laura Cortes-Sanabria, Mirian de Souza, Rafael Alonso Barbeito, Eliana Abdelhay, Nora Artagaveytia, Adrian Daneri-Navarro, Andrea S. Llera, Bettina Müller, Osvaldo L. Podhajcer, Carlos Velazquez, Elsa Alcoba, Isabel Alonso, Alicia I. Bravo, Natalia Camejo, Dirce Maria Carraro, Mónica Castro, Sandra Cataldi, Alfonso Cayota, Mauricio Cerda, Alicia Colombo, Susanne Crocamo, Alicia Del Toro-Arreola, Raul Delgadillo-Cristerna, Lucia Delgado, Marisa Dreyer Breitenbach, Elmer Fernández, Jorge Fernández, Wanda Fernández, Ramon A. Franco-Topete, Fancy Gaete, Jorge Gómez, Leivy P. Gonzalez-Ramirez, Marisol Guerrero, Susan A. Gutierrez-Rubio, Beatriz Jalfin, Alejandra Lopez-Vazquez, Dora Loria, Silvia Míguez, Andres de J. Moran-Mendoza, Gilberto Morgan-Villela, Carina Mussetti, Maria Aparecida Nagai, Antonio Oceguera-Villanueva, Rui M. Reis, Javier Retamales, Robinson Rodriguez, Cristina Rosales, Efrain Salas-Gonzalez, Laura Segovia, Juan M. Sendoya, Aida A. Silva-Garcia, Stella Viña, Livia Zagame, Beth Jones, Moysés Szklo, United States-Latin American Cancer Research Network (US-LACRN), Juan Abarca, Pamela Acevedo, Graciela Acosta, Ana Acosta, Gabriela Acosta Haab, Keyla Teresa Acosta-Torres, Marta Aghazarian, Carola Aguayo, Gustavo Alarcon-Lopez, Viviane Andrade, Wenceslao Angeles Bueno, Roberto Arai, Priscila Elvira Arambula-Barreras, Maria Isabel Arámburo-Rubio, Estrellita Araus, Gonzalo Ardao, Lilia A. Arellano-Jimenez, Felipe Argandoña, Claudia Arias, Ricardo Armisen, Mauricio Aspee, Rodrigo Assar, Itzel Reneé Astiazarán-Rascón, Sebastian Astorga, Maxwell Avilés-Rodrıguez, Antônio Bailão Junior, Adolfo E. Barragan-Curiel, Adelfo Barragan-Ruiz, Julia Bernachin, Wilfrido Bernal-Herrera, Renata Binato, Sarah Brnich, Claudio Bustamante, Miguel Angel Bustamante, Julio Bustos Gomez, Felipe de J. Bustos Rodriguez, Janett Caballero-Jasso, Angie Calfuman, Antonio Hugo, José Froes Marques Campos, Mónica Campos, Soledad Cano, Juan C. Canton-Romero, Paulina Carmona, Fernando Carrizo, Andre Lopes Carvalho, Erika Carvallo, Julio Carzoglio, Monica Casalnuovo, Benedicta Caserta, Alvaro Castillo, César Castillo, Juan M. Castro-Cervantes, Yascara Cerda, Roger Chammas, Mario Alberto Chavez-Zamudio, Loreto Chia, Daniela Chirico, Esther Cisneros-Quirarter, Minor Raul Cordero-Bautista, Valeria Cornejo, Baldemar Corral-Villegas, Andrés Cortés, German Salvador Cortez-Zamorano, Alejandro Corvalan, Adolfo Cruz, Alba d’Aurora, Sandra De la Fuente, Soledad De la Peña, Roberto de Leon-Caballero, César Del Castillo, Azucena Del-Toro-Valero, Mirtha Di Pretoro, Andrea Digonzelli, Jose El Ters, Paula Escobar, Marcela Estolaza, Adriane Feijo Evangelista, Marcelo Fanelli, Paulo Farias, Diego Flaks, Edgar G. Flores-Ayala, Maria R. Flores-Marquez, David Franco-Hughes, Karina Franco-Topete, Cristobal Fresno, Carolina Gabay, Mario Gallegos, Jorge Gamboa, Daiana Ganiewich, Carlos Garbovesky, Ricardo Garcia-Gaeta, Alma C. Garcia-Martinez, Rubén Alejandro Garcıa-Munguıa, Adriana Garibay-Escobar, Liliana Gimenez, Mariana M. Gomez-Del Toro, Germán González, César Osbaldo González Mondaca, Beatriz Gonzalez-Ulloa, Susana Gorostidy, Gonzalo Greif, Alfonso G. Guevara-Torres, Lorena Gutierrez, Adrián Hannois, Andrew Hart, Steffen Härtel, Marcos Henriquez, Miriam E Hernandez-Franco, Rafael Hernandez-Guevara, Manuel I Herrera-Miramontes, Graciela Horton, Gladys Ibañez, Martın Ipiña, Lilian Jara, Raul Jara, Maria Luisa Jaramillo, Beatriz Jardim, Maria Eugenia Jimenez, Victor M. Jimenez-Moreno, Hugo Ju, Nazareth Juárez Rusjan, Karen Juneman, Ligia Maria Kerr, Alejandra Krupelis, Guillermo Laviña, Fernando Lavista, Irma Leticia León-Duarte, Alberto Lescano, Verónica Lezano, Rossana Mendoza Lopez, Jose Guillermo López-Cervantes, Miguel Enrique Lopez-Muñoz, Francisca Lucena, Alejandra Luque, Alejandro Maass, Maria do Socorro Maciel, Silvina Maldonado, Flavia Rotea Mangone, Jorge Mansilla, Katherine Marcelain, Carolina Mariani, Marcia Maria Chiquitelli Marques, Reyna J Martinez-Arriaga, Hector R Martinez-Ramirez, Marcela Martins, Alma G Maya-Gonzalez, Mariana Menini, Soledad Milans, Soledad Montes, Ana Verónica Morales Hernández, Carla Morong, Eduardo Mussetti, Luis J Najar-Acosta, Elisa Napolitano e Ferreira, Nancy E Navarro Ruiz, Cristina Noblıa, João Soares Nunes, Fabiola Núñez, Nilton Onari, Emma M Oropeza-De Anda, David Ortega-Tirado, Miguel Angel Ortiz-Martinez, Cynthia Aparecida Bueno de Toledo Osório, Carlos Eduardo Paiva, Paulina Peñaloza, Miguel Peredo Navarro, David Pereira, Laura Perez-Michel, Francisca Pino, Tania Pino, Natalia Pinto, Jessica Pizarro, Jael Quintero, Antonio Quintero-Ramos, Enrique Ramirez, Gladys E Ramirez-Rosales, Claudia Ramis, Maritza Ramos Ramirez, Adela Rascon-Alcantar, Francois Richard, Omar Rios-Méndez, Ernesto Rivera-Claisse, Ramón E. Robles-Zepeda, Iara Santana Rocha, Natalia Rodriguez, Vilma Rodriguez, Maria Teresa Rodriguez, Diego Rodriguez-Gonzalez, Rosemeire A Roela, Ana M. Romero-Gomez, Ana M. Rosales-Sandoval, Lidia A. Rubio-Chavez, Omar V. Rubio-Plascencia, Florencia Russo, Gaciela Sabini, Isabel Saffie, Brenda Samaniego, Benito Sanchez-Llamas, Verónica Sanchotena, Daniel Sat-Muñoz, Mariana Savignano, Cristovam Scapulatempo Neto, Max Mano Senna, Carolina Silva, Jaime Silvera, Isabele Small, Fernando Soares, Iberê Soares, Silvana Soares dos Santos, Evandro Sobrosa de Mello, José Antonio Sola, Irene Sorın, Alejandra Sosa, Claudio Sosa, Cristiano de Pádua Souza, Lucıa Spangenberg, Gustavo Steffanof, Florencia Straminsky, Mónica Tapia, Raziel O. Tapia-Llanos, Geronimo M. Tavares-Macias, Veronica Terzieff, Vicente Teti, Javier Tognarelli, Verónica Toledo, Paulina Toro, Roberto Torres, Mariana Torres-Palomares, Alejandra Trinchero, Rogelio Troyo-San Roman, Hernan Urbano, Nicolas Vacca, Marıa Lourdes Valencia-Peña, Jaime Vazquez Nares, Ezequiel Velez-Gomez, Laura N. Venegas-Godinez, Ricardo Verdugo, René Aloisio da Costa Vieira, Manuel Isaac Villegas-Gómez, Silvia Vornetti, Anapaula H. U. Watanabe, Carlos Zamorano, Luis Zapata, and Zdenka Zlatar

Subjects
global excellence, oncology, Latin America, breast cancer, molecular subtypes, risk factors, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Molecular profile of breast cancer in Latin-American women was studied in five countries: Argentina, Brazil, Chile, Mexico, and Uruguay. Data about socioeconomic characteristics, risk factors, prognostic factors, and molecular subtypes were described, and the 60-month overall cumulative survival probabilities (OS) were estimated. From 2011 to 2013, 1,300 eligible Latin-American women 18 years or older, with a diagnosis of breast cancer in clinical stage II or III, and performance status ≦̸1 were invited to participate in a prospective cohort study. Face-to-face interviews were conducted, and clinical and outcome data, including death, were extracted from medical records. Unadjusted associations were evaluated by Chi-squared and Fisher’s exact tests and the OS by Kaplan–Meier method. Log-rank test was used to determine differences between cumulative probability curves. Multivariable adjustment was carried out by entering potential confounders in the Cox regression model. The OS at 60 months was 83.9%. Multivariable-adjusted death hazard differences were found for women living in Argentina (2.27), Chile (1.95), and Uruguay (2.42) compared with Mexican women, for older (≥60 years) (1.84) compared with younger (≤40 years) women, for basal-like subtype (5.8), luminal B (2.43), and HER2-enriched (2.52) compared with luminal A subtype, and for tumor clinical stages IIB (1.91), IIIA (3.54), and IIIB (3.94) compared with stage IIA women. OS was associated with country of residence, PAM50 intrinsic subtype, age, and tumor stage at diagnosis. While the latter is known to be influenced by access to care, including cancer screening, timely diagnosis and treatment, including access to more effective treatment protocols, it may also influence epigenetic changes that, potentially, impact molecular subtypes. Data derived from heretofore understudied populations with unique geographic ancestry and sociocultural experiences are critical to furthering our understanding of this complexity.

Published
2022
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4. Psychological care program for participants of cancer genetic counseling with high risk of breast and ovarian cancer

Author

Reyna Martínez-Arriaga, Aída Araceli Silva-García, Azucena Del Toro-Valero, Livia Zagame, Leivy Patricia González-Ramírez, Rebeca Robles-García, Antonio Oceguera-Villanueva, and Adrian Daneri-Navarro

Subjects
Oncology, medicine.medical_specialty, business.industry, Internal medicine, Genetic counseling, medicine, Cancer, business, medicine.disease, Care program, Ovarian cancer
Published
2020
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5. Evaluation of psychosocial aspects in participants of cancer genetic counseling

Author

Adrian Daneri-Navarro, Reyna Martínez-Arriaga, Azucena Del Toro-Valero, Aída Araceli Silva-García, Leivy Patricia González-Ramírez, Antonio Oceguera-Villanueva, Livia Zagame, and Erendira Camacho-Cárdenas

Subjects
0301 basic medicine, medicine.medical_specialty, lcsh:QH426-470, Genetic counseling, 030105 genetics & heredity, Anxiety, Hospital Anxiety and Depression Scale, lcsh:RC254-282, Depressive symptomatology, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Cancer genetic counseling, medicine, Psychological Health Interview, In patient, Psychiatry, Genetics (clinical), business.industry, Research, Cancer, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Depression scale, lcsh:Genetics, Oncology, 030220 oncology & carcinogenesis, medicine.symptom, business, Psychosocial
Abstract

Background The instrument called “Hospital Anxiety and Depression Scale” (HADS) is frequently used to evaluate anxious and depressive symptomatology in patients who receive Cancer Genetic Counseling (CGC). However, this instrument cannot identify all of the psychosocial factors, such as the antecedents of the patients’ emotional states or their concerns. The objective of the present research was to compare cases detected with psychosocial alterations by means of HADS and a Psychological Health Interview (PHI). Methods A transversal analytical design was used. One hundred ten participants were included (97.3% females and 2.7% males). The average age was 45 years ±10 years. Results The PHI identified twice the amount of participants with psychosocial alterations than did HADS, which only detected 43% of these participants. Conclusions The results of our study suggest that the PHI should be applied in addition to HADS to identify participants who would require psychological support due to recurrent concerns.

Published
2017
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6. Abstract 608: Molecular features of breast cancer involved in classification and prognosis of a multi-country Latin American cohort: The US-LACRN-MPBCS breast cancer cohort

Author

Andrés Morán-Mendoza, Ramon Antonio Franco-Topete, Maria Aparecida Nagai, Araceli Silva-García, Raul Delgadillo-Cisterna, Rui Manuel Reis, Marisol Guerrero, Lucía Delgado, Elmer Andrés Fernández, Sandra Cataldi, Javier Retamales, Darío Rocha, Susanne Crocamo, Jorge Sobral Fernández, Wanda Fernández, Antonio Oceguera-Villanueva, Antonio Quintero-Ramos, Dirce Maria Carraro, Mauricio Cerda, Robinson Rodríguez, Efrain Salas-González, Bettina Müller, Juan Manuel Castro-Cervantes, Laura Segovia, Eliana Abdelhay, Alfonso Cayota, Nora Artagaveytia, Alicia del Toro Arreola, Natalia Camejo, Renata Binato, Juan M. Sendoya, Livia Zagame, Mónica Castro, Marianne Marianne Henderson, Gonzalo Greif, Osvaldo Podhajcer, Alicia I. Bravo, M. M. D. Breitenbach, Fancy Gaete, Isabel Alonso, Adrian Daneri-Navarro, Cristina Rosales, Carlos Velázquez Contreras, Elsa Alcoba, Jorge Gomez, Andrea Sabina Llera, and Vidya Vedham

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Breast cancer, Latin Americans, business.industry, Internal medicine, Cohort, Medicine, business, medicine.disease, Multi country
Abstract

Although gene expression-derived PAM50 intrinsic subtypes (LumA, LumB, HER2E and Basal) were reported in Latin American breast cancer, most studies did not adequately represent the unique and diverse genetic admixture of the Latin American population and/or included a small number of individuals. As a result of these limitations, confirmation of the prognostic value of available intrinsic subtype classification signatures in a diverse cohort of Latin American women is of utmost importance. We assessed the general distribution and prognostic performance of PAM50-based intrinsic and immunohistochemistry (IHC)-based surrogate subtype classifications in Latin American women included in the Molecular Profile of Breast Cancer Study (MPBCS), an initiative of the US-Latin America Cancer Research Network (US-LACRN) comprising institutions of Argentina, Brazil, Chile, Mexico and Uruguay. MPBCS focused on stage II-III breast cancer in Latin American women. Eligible enrolled patients (n=1300) were characterized clinically, pathologically and epidemiologically and followed-up for 5 years. IHC subtypes were assessed according to St Gallen's 2013 criteria, using Ki67 to discriminate LumB from LumA tumors. A total of 1071 tumors were characterized by gene-expression microarrays. PAM50 classification defined 45% of tumors as LumA, 19.7% as LumB, 13.8% as HER2E and 17.5% as Basal. Normal-like tumors (6.3%) were excluded from the analysis. The 5-year prognostic ability of PAM50 and IHC classifications, both at the cancer-specific (OS) and progression-free survival (PFS), was tested. The prognosis for LumA tumors was significantly better than for other subtypes, while Basal-like tumors had the worst prognosis. The prognostic power of IHC-based subtypes (C-index 0.698 for OS, 0.635 for PFS) was very similar to that of PAM50 (C-index 0.678 for OS, 0.639 for PFS), indicating that in US-LACRN-MPBCS, contrary to other cohorts, surrogate subtypes are as useful as PAM50 for discriminating recurrence risk. PAM50-derived risks of recurrence (RORs), in particular ROR-S (C-index 0.699 for OS, 0.649 for PFS), clearly discriminated risk into low, intermediate and high-risk groups. Transcriptomic pathway analysis showed high proliferation (i.e. cell cycle control and DNA damage repair) associated with LumB, HER2E and Basal tumors, and a strong dependency on the estrogen pathway for LumA. Overall, a general concordance of the molecular features of US-LACRN-MPBCS breast cancer tumors with those of other cohorts was confirmed. The shift towards non-luminal subtypes could be partly attributable to the recruitment bias towards advanced stages. Further refinement of analyses using molecular ancestry assignation may help to reveal more subtle differences in this heterogeneously admixed population. Citation Format: Andrea S. Llera, Eliana Abdelhay, Osvaldo Podhajcer, Nora Artagaveytia, Adrián Daneri-Navarro, Bettina Müller, Carlos Velázquez Contreras, Darío Rocha, Juan Martín Sendoya, Renata Binato, Elmer Fernández, Elsa Alcoba, Isabel Alonso, Alicia I. Bravo, Natalia Camejo, Dirce Carraro, Mónica Castro, Juan M. Castro-Cervantes, Sandra Cataldi, Alfonso Cayota, Mauricio Cerda, Susanne Crocamo, Raul Delgadillo-Cisterna, Lucía Delgado, Alicia del Toro Arreola, Marisa Dreyer Breitenbach, Jorge Fernández, Wanda Fernández, Ramon A. Franco-Topete, Fancy Gaete, Jorge Gómez, Gonzalo Greif, Marisol Guerrero, Marianne Marianne Henderson, Andres de J Moran-Mendoza, María Aparecida Nagai, Antonio Oceguera-Villanueva, Antonio Quintero-Ramos, Rui Reis, Javier Retamales, Robinson Rodríguez, Cristina Rosales, Efrain Salas-González, Laura Segovia, Araceli Silva-García, Vidya Vedham, Livia Zagame, The US-Latin American Cancer Research Network. Molecular features of breast cancer involved in classification and prognosis of a multi-country Latin American cohort: The US-LACRN-MPBCS breast cancer cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 608.

Published
2021
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