Browsing by Author "Moreno, F"

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Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic
(John Wiley and Sons Inc, 2022) Villanueva, G; Sampor, C; Palma, J; Villarroel, M; Valencia, D; Lombardi, MG; Garcia, WG; Caceres, EL; Sobrero, V; Garcia, L; Cabrera, V; Maza, I; Velasquez,T; Ugaz, C; Vasquez, JM; Coronado, RD; Gonzalez, N; Aguiar, S; Dabezies A; Moreno, F; Sardinas, S; Gamboa, Y; Maradiegue, E; Fu, L; Gassant, P; Moreno, K; Gonzales, O; Schelotto, M; Luna-Fineman, S; Antoneli, CG; Fuentes-Alabi, S; Luciani, S; Cappellano, A; Chantada, G; Vasquez, L
Background: The ongoing coronavirus 2019 disease (COVID-19) pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year. Method: Four cross-sectional surveys were electronically distributed among pediatric onco-hematologists in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners. Results: Four hundred fifty-three pediatric onco-hematologists from 20 countries responded to the first survey, with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active ongoing patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed that at the beginning of the first wave, participants from countries with healthcare expenditure below 7% were more likely to report a decrease in outpatient procedures (odds ratio [OR]: 1.84, 95% CI: 1.19–2.8), surgeries (OR: 3, 95% CI: 1.9–4.6) and radiotherapy (OR: 6, 95% CI: 3.5–10.4). Suspension of surveillance consultations was higher in countries with COVID-19 case fatality rates above 2% (OR: 3, 95% CI: 1.4–6.2) and SCT suspensions in countries with COVID-19 incidence rate above 100 cases per 100,000 (OR: 3.48, 95% CI: 1.6–7.45). Paradoxically, at the beginning of the second wave with COVID-19 cases rising exponentially, most participants reported improvements in cancer services availability. Conclusion: Our data show the medium-term collateral effects of the pandemic on pediatric oncology care in LATAM, which might help delineate oncology care delivery amid current and future challenges posed by the pandemic. © 2022 Wiley Periodicals LLC.
International Society of Paediatric Oncology (SIOP) Global Mapping Program: Analysis of healthcare centers in countries of the Latin American Society of Pediatric Oncology (SLAOP)
(John Wiley and Sons Inc, 2024) Gorostegui-Obanos, M; Chantada, L; Filho, NPC; Gonzalez-Ramella, O; Serrano, B, MJ; Valencia, D; Sampor, C; Macedo, C; Ramirez, O; Sardinas, S; Lezcano, E; Calderón, P; Gamboa, Y; Fu, L; Gómez, W; Schelotto, M; Ugaz, C; Lobos, P; Moreno, K; Palma, J; Sánchez, G; Moschella, F; Gassant, PYH; Velasquez, T; Quintero, K; Forteza, M; Villarroel, M; Moreno, F; Alabi, SF; Vasquez, L; Lowe, J; Cappellano, A; Challinor, J; Chantada, GL
Background: The International Society of Paediatric Oncology Society Global Mapping Program aims to describe the local pediatric oncology capacities. Here, we report the data from Latin America. Methods: A 10-question survey was distributed among chairs of pediatric oncology services. Centers were classified according to patient volume into high- (HVC; 100 or more new cases per year), medium- (MVC; 31–99 cases), and low-volume centers (LVC; 30 cases or less), respectively. National referral centers (NRC) were identified. Results: Total 307 centers in 20 countries were identified (271 responded), and 264 responses were evaluable, accounting for 78% of the expected cases (21,359 cases per year). Seventy-seven percent of patients are treated in public centers, including additional support by civil society organizations. We found that 66% of the patients are treated in 70 centers of excellence, including 21 NRC. There was a median of one pediatric oncologist every 21 newly diagnosed patients (44 for NRC), and in 84% of the centers, nurses rotated to other services. A palliative care team was lacking in 25% of the centers. LVC with public funding have significantly lower probability of having a palliative care team or trained pediatric oncology surgeons. Psychosocial, pharmacy, and nutrition services were available in more than 93% of the centers. No radiotherapy facility was available on campus in nine of 21 NRC. Conclusions: Most children with cancer in Latin America are treated in public HVC. There is a scarcity of pediatric oncologists, specialized nurses and surgeons, and palliative care teams, especially in centers with public funding.
International Society of Paediatric Oncology (SIOP) Global Mapping Programme: Latin American Society of Pediatric Oncology (SLAOP) country-level report
(John Wiley and Sons Inc, 2024) Cappellano, A; Gorostegui, M; Gonzalez-Ramella, O; Filho, NPC; Valencia, D; Chantada, L; Sampor, C; Serrano, MJ; Macedo, C; Ramirez, O; Sardinas, S; Lezcano, E; Calderón, P; Gamboa, Y; Fu, L; Gómez, W; Schelotto, M; Ugaz, C; Lobos, P; Aguiar, SDS; Moreno, K; Palma, J; Sánchez, G; Moschella, F; Gassant, PYH; Velasquez, T; Quintero, K; Moreno, F; Villarroel, M; Fuentes, Alabi, S; Vasquez, L; Challinor, J; Chantada, GL
Background: Latin American countries are improving childhood cancer care, showing strong commitment to implement the Global Initiative for Childhood Cancer, but there are scant publications of the situation at a continental level. Methods: As part of the International Society of Paediatric Oncology Global Mapping project, delegates of each country participating in the Latin American Society of Pediatric Oncology (SLAOP) and chairs of national pediatric oncology societies and cooperative groups were invited to provide information regarding availability of national pediatric cancer control programs (NPCCP), pediatric oncology laws, pediatric oncology tumor registries, and training programs and support to diagnosis and treatment. Results: Nineteen of the 20 countries participating in SLAOP responded. National delegates reported nine countries with NPCCP and four of them were launched in the past 5 years. National pediatric tumor registries are available in eight countries, and three provided published survival results. Fellowship programs for training pediatric oncologists are available in 12 countries. National delegates reported that eight countries provide support to most essential diagnosis and treatments and 11 provide partial or minimal support that is supplemented by civil society organizations. Seven countries have a pediatric oncology law. There are three international cooperative groups and four national societies for pediatric oncology. Conclusion: Despite many challenges, there were dramatic advances in survivorship, access to treatment, and availability of NPCCP in Latin America. Countries with highest social development scores in general provide more complete support and are more likely to have NPCCP, training programs, and reported survival results.
Pathological Response and Survival in Triple-Negative Breast Cancer Following Neoadjuvant Carboplatin plus Docetaxel
(American Association for Cancer Research Inc., 2018) Sharma, P; López-Tarruella, S; García-Saenz, JA; Khan, QJ; Gómez, HL; Prat, A; Moreno, F; Jerez-Gilarranz, Y; Barnadas, A; Picornell, AC; Monte-Millán MD; González-Rivera, M; Massarrah, T; Pelaez-Lorenzo, B; Palomero, MI; González Del Val, R; Cortés, J; Fuentes-Rivera H; Morales, DB; Márquez-Rodas, I; Perou, CM; Lehn, C; Wang, YY; Klemp, JR; Mammen, JV; Wagner, JL; Amin, AL; O'Dea, AP; Heldstab, J; Jensen, RA; Kimler, BF; Godwin, AK; Martín, M
Purpose: Prognostic value of pathologic complete response (pCR) and extent of pathologic response attained with anthracycline-free platinum plus taxane neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC) is unknown. We report recurrence-free survival (RFS) and overall survival (OS) according to degree of pathologic response in patients treated with carboplatin plus docetaxel NAC. Patients and methods: One-hundred and ninety patients with stage I-III TNBC were treated with neoadjuvant carboplatin (AUC6) plus docetaxel (75 mg/m2) every 21 days × 6 cycles. pCR (no evidence of invasive tumor in breast and axilla) and Residual cancer burden (RCB) were evaluated. Patients were followed for recurrence and survival. Extent of pathologic response was associated with RFS and OS using the Kaplan-Meier method. Results: Median age was 51 years, and 52% were node-positive. pCR and RCB I rates were 55% and 13%, respectively. Five percent of pCR patients, 0% of RCB I patients, and 58% of RCB II/III patients received adjuvant anthracyclines. Three-year RFS and OS were 79% and 87%, respectively. Three-year RFS was 90% in patients with pCR and 66% in those without pCR [HR = 0.30; 95% confidence interval (CI), 0.14-0.62; P = 0.0001]. Three-year OS was 94% in patients with pCR and 79% in those without pCR (HR = 0.25; 95% CI, 0.10-0.63; P = 0.001). Patients with RCB I demonstrated 3-year RFS (93%) and OS (100%) similar to those with pCR. On multivariable analysis, higher tumor stage, node positivity, and RCB II/III were associated with worse RFS. Conclusions: Neoadjuvant carboplatin plus docetaxel yields encouraging efficacy in TNBC. Patients achieving pCR or RCB I with this regimen demonstrate excellent 3-year RFS and OS without adjuvant anthracycline.
Pathological Response in a Triple-Negative Breast Cancer Cohort Treated with Neoadjuvant Carboplatin and Docetaxel According to Lehmann's Refined Classification
(American Association for Cancer Research Inc., 2018) Echavarria, I; López-Tarruella, S; Picornell, A; García-Saenz, JÁ; Jerez, Y; Hoadley, K; Gomez, HL; Moreno, F; Monte-Millan, MD; Márquez-Rodas, I; Alvarez, E; Ramos-Medina, R; Gayarre, J; Massarrah, T; Ocaña, I; Cebollero, M; Fuentes, H; Barnadas, A; Ballesteros, AI; Bohn, U; Perou, CM; Martin, M
Purpose: Triple-negative breast cancer (TNBC) requires the iden- tification of reliable predictors of response to neoadjuvant chemotherapy (NACT). For this purpose, we aimed to evaluate the performance of the TNBCtype-4 classifier in a cohort of patients with TNBC treated with neoadjuvant carboplatin and docetaxel (TCb).Methods: Patients with TNBC were accrued in a nonrandomized trial of neoadjuvant carboplatin AUC 6 and docetaxel 75 mg/m2 for six cycles. Response was evaluated in terms of pathologic complete response (pCR, ypT0/is ypN0) and residual cancer burden by Symmans and colleagues. Lehmann's subtyping was performed using the TNBCtype online tool from RNAseq data, and germline sequencing of a panel of seven DNA damage repair genes was conducted.Results: Ninety-four out of the 121 patients enrolled in the trial had RNAseq available. The overall pCR rate was 44.7%. Lehmann subtype distribution was 34.0% BL1, 20.2% BL2, 23.4% M, 14.9% LAR, and 7.4% were classified as ER+. Response to NACT with TCb was significantly associated with Lehmann subtype (P = 0.027), even in multivariate analysis including tumor size and nodal involvement, with BL1 patients achieving the highest pCR rate (65.6%), followed by BL2 (47.4%), M (36.4%), and LAR (21.4%). BL1 was associated with a significant younger age at diagnosis and higher ki67 values. Among our 10 germline mutation carriers, 30% were BL1, 40% were BL2, and 30% were M.Conclusions: TNBCtype-4 is associated with significantly different pCR rates for the different subtypes, with BL1 and LAR displaying the best and worse responses to NACT, respectively. Clin Cancer Res; 24(8); 1845-52. ©2018 AACR.
TNBC-DX genomic test in early-stage triple-negative breast cancer treated with neoadjuvant taxane-based therapy
(Elsevier Ltd, 2024) Martín, M; Stecklein, SR; Gluz, O; Villacampa, G; Monte-Millán, M; Nitz, U; Cobo, S; Christgen, M; Brasó-Maristany, F; Álvarez, EL; Echavarría, I; Conte, B; Kuemmel, S; Bueno-Muiño, C; Jerez, Y; Kates, R; Cebollero, M; Kolberg-Liedtke, C; Bueno, O; García-Saenz, JÁ; Moreno, F; Grischke, E-M; Forstbauer, H; Braun, M; Warm, M; Hackmann, J; Uleer, C; Aktas, B; Schumacher, C; Wuerstleins, R; Graeser, M; zu, Eulenburg, C; Kreipe, HH; Gómez, H; Massarrah, T; Herrero, B; Paré, L; Bohn, U; López-Tarruella, S; Vivancos, A; Sanfeliu, E; Parker, JS; Perou, CM; Villagrasa, P; Prat, A; Sharma, P; Harbeck, N
Background: Identification of biomarkers to optimize treatment strategies for early-stage triple-negative breast cancer (TNBC) is crucial. This study presents the development and validation of TNBC-DX, a novel test aimed at predicting both short- and long-term outcomes in early-stage TNBC. The objective of this study was to evaluate the association between TNBC-DX and efficacy outcomes [pathologic complete response (pCR), distant disease-free survival (DDFS) or event-free survival (EFS), and overall survival (OS)] in the validation cohorts. Methods: Information from 1259 patients with early-stage TNBC (SCAN-B, CALGB-40603, and BrighTNess) was used to establish the TNBC-DX scores. Independent validation of TNBC-DX was carried out in three studies: (i) WSG-ADAPT-TN; (ii) MMJ-CAR-2014-01; and (iii) NeoPACT, including 527 patients with stage I-III TNBC undergoing neoadjuvant chemotherapy. In WSG-ADAPT-TN, patients were randomized to receive nab-paclitaxel plus gemcitabine or carboplatin. In MMJ-CAR-2014-01, patients received carboplatin plus docetaxel. In NeoPACT, patients received carboplatin plus docetaxel and pembrolizumab. Results: TNBC-DX test was created incorporating the 10-gene Core Immune Gene module, the 4-gene tumor cell proliferation signature, tumor size, and nodal staging. In the two independent validation cohorts without pembrolizumab, the TNBC-DX pCR score was significantly associated with pCR after adjustment for clinicopathological variables and treatment regimen [odds ratio per 10-unit increment 1.34, 95% confidence interval (CI) 1.20-1.52, P < 0.001]. pCR rates for the TNBC-DX pCR-high, pCR-medium, and pCR-low categories were 56.3%, 53.6%, and 22.5% respectively (odds ratio for pCR-high versus pCR-low 3.48, 95% CI 1.72-7.15, P < 0.001). In addition, the TNBC-DX risk score was significantly associated with DDFS [hazard ratio (HR) high-risk versus low-risk 0.24, 95% CI 0.15-0.41, P < 0.001] and OS (HR 0.19, 95% CI 0.11-0.35, P < 0.001). In the validation cohort with pembrolizumab, the TNBC-DX scores were significantly associated with pCR, EFS, and OS. Conclusions: TNBC-DX predicts pCR to neoadjuvant taxane–carboplatin in stage I-III TNBC and helps to forecast the patient's long-term survival in the absence of neoadjuvant anthracycline–cyclophosphamide, and independent of pembrolizumab use. © 2024 The Author(s)