Abstract only
1083
Background: The addition of Carboplatin to Trastuzumab and Paclitaxel improves the efficacy in HER2+ metastatic breast cancer (MBC). We have conducted a multicenter Phase II study ...to investigate the efficacy and safety of this combination given weekly × 3 followed by 1 week of rest. Primary endpoint was objective response rate and secondary endpoints were time to progression, overall survival and to study the toxicity profile of the combination. Methods: Between August 2003 and April 2006, 40 patients with HER2+ MBC (IHC 3+ or FISH+) have been included in the study. Pats received Trastuzumab (loading dose of 4 mg/kg/wk and 2 mg/kg/d following wks), Paclitaxel (80 mg/m
2
) and Carboplatin (AUC 2) all given weekly × 3 followed by 1 week of rest. Treatment was given until disease progression or unacceptable toxicity. Results: 40 pats had baseline data available. Median age was 54 yrs (range 29–75). 38 (95%) pats received prior adjuvant or neoadjuvant treatment. 11 (27,5%) pats have received one prior CT line for metastatic disease. 87,5% pats had PS 0 or 1 at study entry. Disease sites were liver 16 (40%), bone 12 (30%), lymph nodes 13 (32,5%) and lung 8 (20%). 19 (47,5%) had = 2 lesions. 97,5% had measurable disease. 36 pats have been evaluated for response: 11 CR (31%, 95% CI: 15–46%), 11 PR (31%, 15- 36%), 9 SD (25%, 9–36%), 5 PD (14%, 2–26%) and 4 NE resulting in an ORR of 61% (95% CI: 45–77%) and tumor growth control rate (RR+SD) of 86% of patients (95% CI: 75–97%). Median TTP was 12.1 mo (95% CI: 8.8–19.9 mo) and median duration of response and OS have not been reached yet. For a time of observation of 35 mo, the OS is 80,6%. 37 patients have received 194 cycles with a median of 5 cycles. Grade 3–4 toxicities/pats were: 3(7.5%) anaemia, 2 (5%) leucopenia, 8(20%) neutropenia, 1 (2,5%) febrile neutropenia, 1 (2,5%) trombopenia, 2(5%) asthenia, 2(5%) diarrhea, 3(7.5%) nausea, 2(5%) vomiting, 3(7.5%) mucositis Conclusions: This interim analysis shows an interesting activity with this regimen. One week of rest may be of better convenience for the patient and hospital but also may improve the tolerability profile and efficacy of the combination. Further results would be available for presentation.
No significant financial relationships to disclose.
Abstract
Aim: CTC detection has proved to be an independent prognostic factor in metastatic CRC. However, the prognostic role of CTC in early CRC has not been determined yet. We evaluated the ...potential role of CTC in identifying stage III CRC patients (pts) with a higher risk for relapse.
Methods: Prospective multicenter study of 519 pts with stage III CRC recruited between January 2009 and June 2010. CTC were enumerated with the CellSearch System in 7.5 ml of peripheral blood after primary tumor resection and before the start of adjuvant therapy. We present the first analysis after 3 years of follow-up. A total of 472 were included in this analysis (data from the remaining 47 pts were not available at the time of analysis).
Results: Stages: IIIA (n = 35, 7%), IIIB (n = 346, 73%), IIIC (n = 91, 19%). CTC ≥1, ≥2, ≥3 and ≥5 were detected in 166 (35%), 93 (20%), 57 (12%) and 34 (7%) pts, respectively. Median follow-up was 40 months. During this period 135 pts (29%) relapsed and 80 pts (18%) died. In the overall population, the presence of CTC ≥1 was not associated with an increased risk of relapse (HR for disease-free survival (DFS): 0.97, IC 95%: 0.68-1.38, P = 0.85) or death (HR for overall survival (OS): 1.03, IC 95%: 0.66-1.59, P = 0.89). CTC ≥2, ≥3 and ≥5 were not associated with worse DFS and OS. CTC ≥1 was significantly more frequent in pts with stage IIIC (IIIA 40%, IIIB 32%, IIIC 47%; P = 0.016), as it was a higher percentage of relapse (IIIA 21%, IIIB 17%, IIIC 58%). In pts with stage IIIA, CTC ≥1 and ≥2 were associated with an increased risk of relapse (CTC ≥1 vs. <1: HR 1.62, IC 95%: 0.33-8.05, P = 0.55; CTC ≥2 vs. <2: HR 1.93, IC 95%: 0.35-10.55, P = 0.45) and death (CTC ≥1 vs. <1: HR 2.04, IC 95%: 0.46-9.16, P = 0.35; CTC ≥2 vs. <2: HR 2.14, IC 95%: 0.47-9.69, P = 0.32), although statistical significance was not reached, probably due to the small sample size in this subgroup. Detection of CTC ≥1 and ≥2 was not associated with an increased risk of relapse or death in pts with stage IIIB and IIIC.
Conclusions: CTC presence was more frequent in pts with higher risk of relapse. Detection of CTC ≥1 and ≥2 appears to be associated with worse DFS and OS, in pts with stage IIIA CRC. However, a longer follow-up of pts in this study is needed.
Disclosure: All authors have declared no conflicts of interest.
Rotura traqueal causada por estrangulamiento García López, P.; Fernández Vázquez, E.; Cueto Ladrón de Guevara, A.
Archivos de bronconeumología,
March 1998, Letnik:
34, Številka:
3
Journal Article
Cancer is a complex disease, and its study requires deep understanding of several biological processes and their regulation. It is an accepted fact that non-coding RNAs are vital components of the ...regulation and cross-talk among cancer-related signaling pathways that favor tumor aggressiveness and metastasis, such as neovascularization, angiogenesis, and vasculogenic mimicry. Both long non-coding RNAs (lncRNAs) and micro-RNAs (miRNAs) have been described as master regulators of cancer on their own; yet there is accumulating evidence that, besides regulating mRNA expression through independent mechanisms, these classes of non-coding RNAs interact with each other directly, fine-tuning the effects of their regulation. While still relatively scant, research on the lncRNA-miRNA-mRNA axis regulation is growing at a fast rate, it is only in the last 5 years, that lncRNA-miRNA interactions have been identified in tumor-related vascular processes. In this review, we summarize the current progress of research on the cross-talk between lncRNAs and miRNAs in the regulation of neovascularization, angiogenesis and vasculogenic mimicry.
Tracheal rupture caused by strangulation García López, P; Fernández Vázquez, E; Cueto Ladrón de Guevara, A
Archivos de bronconeumología
34, Številka:
3
Journal Article
The objective of this study was to investigate whether the BC tumor biology in women with larger breast volume, in obese women and especially in women with central adiposity at the moment of ...diagnosis of BC is more aggressive than in those women without these characteristics. 347 pre- and postmenopausal women with a recent diagnosis of BC were analyzed. In all patients, anthropometric measurements at the time of diagnosis was collected. In 103 of them, the breast volume was measured by the Archimedes method. The Breast volume, BMI, WHR and the menopausal status were related to different well-known pathological prognostic factors for BC. At the time of diagnosis, 35.4% were obese (BMI > 30 kg/m
), 60.2% had a WHR ≥ 0.85, 68.8% were postmenopausal and 44.7% had a breast volume considered "large" (> 600 cc). Between patients with a large breast volume, only a higher prevalence of ER (+) tumors was found (95.3% vs. 77.2%; p = 0.04) compared to those with small breast volumes. The obese BC patients showed significantly higher rates of large tumors (45.5% vs. 40.6%; p = 0.04), axillary invasion (53.6% vs. 38.8%; p = 0.04), undifferentiated tumors (38.2% vs. 23.2%) and unfavorable NPI (p = 0.04) than non-obese women. Those with WHR ≥ 0.85 presented higher postsurgical tumor stages (61.7% vs. 57.8%; p = 0.03), higher axillary invasion (39.9% vs. 36.0%; p = 0.004), more undifferentiated tumors (30.0% vs. 22.3%; p = 0.009), higher lymphovascular infiltration (6.5% vs. 1.6%; p = 0.02), and a higher NPI (3.6 ± 1.8 vs. 3.2 ± 1.8; p = 0.04). No statistically significant differences were found according to menopausal status. We conclude that obesity, but especially central obesity can be associated with a more aggressive tumour phenotype. No relation between breast volume and tumoral prognostic factors was found, except for a higher proportion of ER (+) tumor in women with higher breast volume.