Browsing by Subject "Neoadjuvant chemotherapy"

Now showing 1 - 6 of 6
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    Clinical meaning of stromal tumor infiltrating lymphocytes (sTIL) in early luminal B breast cancer
    (MDPI, 2023-05-20) García-Torralba, Esmeralda; Pérez Ramos, Miguel; Ivars Rubio, Alejandra; Navarro-Manzano, Esther; Blaya Boluda, Noel; Morena Barrio, Pilar de la; García Garre, Elisa; Martínez Díaz, Francisco; Chaves-Benito, Asunción; García-Martínez, Elena; Ayala de la Peña, Francisco; Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica
    Luminal breast cancer (BC) is associated with less immune activation, and the significance of stromal lymphocytic infiltration (sTIL) is more uncertain than in other BC subtypes. The aim of this study was to investigate the predictive and prognostic value of sTIL in early luminal BC. The study was performed with an observational design in a prospective cohort of 345 patients with predominantly high-risk luminal (hormone receptor positive, HER2 negative) BC and with luminal B features (n = 286), in which the presence of sTIL was analyzed with validated methods. Median sTIL infiltration was 5%(Q1–Q3range(IQR),0–10). We found thatsTIL were associated with characteristics of higher biological and clinical aggressiveness (tumor and lymph node proliferation and stage, among others) and that the percentage of sTIL was predictive of pathologic complete response in patients treated with neoadjuvant chemotherapy (OR: 1.05, 95%CI 1.02–1.09, p < 0.001). The inclusion of sTIL (any level of lymphocytic infiltration: sTIL > 0%) in Cox regression multivariable prognostic models was associated with a shorter relapse-free interval (HR: 4.85, 95%CI 1.33–17.65, p = 0.016) and significantly improved its performance. The prognostic impact of sTIL was independent of other clinical and pathological variables and was mainly driven by its relevance in luminal B BC.
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    Clinical significance of SPRY4-IT1 in efficacy and survival prediction in breast cancer patients undergoing neoadjuvant chemotherapy
    (Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2020) Zheng, Ang; Zhang, Lin; Song, Xinyue; Jin, Feng
    Breast cancer is the most frequent malignancy and the leading cause of cancer death among females. Long noncoding RNAs (lncRNAs) are under investigation as novel prognostic biomarkers in cancer. The aim of the study was to investigate the expression, clinical implications and prognostic significance of lncRNA SPRY4-IT1, and to identify the predictive value of SPRY4-IT1 on the outcome of chemotherapy in breast cancer patients undergoing neoadjuvant chemotherapy (NACT). Bioinformatics indicated SPRY4-IT1 was related to chemo-resistance in breast cancer. SPRY4-IT1 expression was assessed by qRT-PCR in breast cancer tissues and matched normal breast tissues (n=26 pairs). SPRY4-IT1 expression was also detected by in situ hybridization (ISH) in 60 paraffin slices with complete clinical datum. In this study, SPRY4-IT1 was significantly more expressed in cancer tissues than in normal tissues (P<0.05). Increased SPRY4-IT1 expression was significantly correlated with increased rates of lymph node metastasis (P=0.002) and recurrence (P=0.017). Both were independent factors of SPRY4-IT1 expression (P<0.05). High-SPRY4-IT1 patients had significantly lower overall survival and disease-free survival. High SPRY4-IT1 expression indicated poor clinical response in the whole group, luminal A subgroup and luminal B subgroup (P<0.05) and pathological complete response in the whole group. Overexpression of SPRY4-IT1 promoted chemo- resistance of MCF-7 and MDA-MB-231 cells to epirubicin. SPRY4-IT1 has the potential to be a biomarker to predict NACT efficacy and prognosis in breast cancer patients
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    microRNA expression profiles as decision-making biomarkers in the management of bladder cancer
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2017) Amir, Sharon; Mabjeesh, Nicola J.
    Bladder cancer (BC) is generally divided into non-muscle-invasive BC (NMIBC) and muscle-invasive BC (MIBC). The standard treatment protocol for MIBC patients is radical cystectomy preceded by neoadjuvant chemotherapy (NAC). About one-half of the MIBC patients show a priori resistance to chemotherapy, and are therefore exposed to the risks of disease progression and toxicity from ineffective NAC. The discovery of microRNA (miRNA) regulation in tumorigenesis has provided new directions for the development of a new type of BC biomarkers. In this review, we describe the emerging miRNAs as BC biomarkers for different purposes, including diagnosis, prognosis and therapeutic response. miRNA expression profile changes with alteration of the tissue phenotype. This phenomenon is utilized to predict tumor diagnosis, cancer subclass, disease stage, prognosis and therapeutic response. We classified the miRNAs which are involved in bladder cancer according to malignant potential, chemoresistance, discrimination between normal to cancerous and clinical outcome. Focusing on the major obstacle regarding MIBC patient's NAC response, we summarized the miRNAs that are deregulated and have the potential to identify the patients resistant to NAC, such as miR-34, miR-100, miR-146b and miR-9 and miR-193a-3p. In conclusion, miRNAs expression profile of bladder cancer patient is a promising tool that can serve as biomarker for different aims. Based on this profile we propose upfront radical cystectomy instead of standard NAC to those MIBC patients who are at higher risk for chemoresistance and poor response.
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    Past, present and future of primary systemic treatment in breast cancer
    (Baishideng Publishing Group, 2013-05-10) Alonso-Romero, José Luis; Piñero Madrona, Antonio; Medicina
    Primary systemic treatment is a fundamental part of breast cancer therapy, and it is applied to non-surgical and locally advanced tumours as well as surgical tumours to increase the likelihood of conservative treatment. Its aim is to achieve the best possible survival with better cosmetic results and with the lowest number of treatment-related secondary effects. Before treatment is started, it is necessary to attain the best knowledge of the biological features and locoregional extension of the tumour. To do so, it is necessary to obtain a biopsy of the lesion with a wide bore needle, as well as good radiological knowledge of the disease. Therefore, currently, the use of a dynamic magnetic resonance imaging (MRI) of the breast should be included in all cases. In addition, before it is started, especially in those tumours in which conservative treatment is considered, one or several radiopaque markers should be put into place to make it possible to locate the area to be treated if there is a considerable or complete response. Systemic treatment is mainly based on combined chemotherapy with anthracyclins and taxanes, in addition to some biological agents with demonstrated efficiency for increasing the likelihood of complete disease response (trastuzumab in patients with Her-2/neu overexpression). However, there is room for neoadjuvant hormone treatment, in patients with hormone receptor overexpression, especially in those cases in which chemotherapy is contraindicated as well as in elderly patients with a relatively short life expectancy. The assessment of preoperative treatment should be based on adequate radiological tests, and nowad these should include MRI before taking decisions about adequate surgical treatment. The objective of primary treatment is to be able to increase survival and improve the chances of local treatment in the case of locally advanced treatment, achieving results that are at least equal to those of adjuvant treatment in the case of surgical tumours, but with greater chances of conservative surgery. Although the objective is survival, achieving complete pathological response seems to be a reasonable related objective, although these are more closely linked in some tumour subtypes.
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    Predictive markers for pathological complete response (pCR) after neo-adjuvant chemotherapy in HER2-positive breast carcinoma
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2024) Van Bockstal, Mieke R.; Dano, Hélène; Benhaddi, Naima; Dubois, Dominique; Vanderveken, Jonathan; Van Marcke, Cédric; Vandermeulen, Ad; Duhoux, Francois P.; Vernaeve, Hilde; Berlière, Martine; Galant, Christine
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    Usefulness of lymphocyte-to-monocyte, neutrophil-to-monocyte and neutrophil-to-lymphocyte ratios as prognostic markers in breast cancer patients treated with neoadjuvant chemotherapy
    (Springer, 2017-08-07) Marín Hernández, C.; Piñero Madrona, A.; Galindo Fernández, P. J.; Ruiz Merino, G.; Alonso-Romero, José Luis; Parrilla Paricio, P.; Gil Vázquez, P. J.; Medicina
    Background: Nowadays, neoadjuvant chemotherapy (nCT) in breast cancer is more and more standardized, not only in advanced tumours but also in those for which there is an attempt to achieve breast-conserving surgery. In literature, we can find evidences of the relationship between several types of tumours and systemic inflammatory response. Our objective is to analyse the prognostic value of blood parameters (lymphocytes, neutrophils, monocytes, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-monocyte ratio (NMR) and neutrophil-to-lymphocyte ratio (NLR) in breast cancer (BC) patients treated with nCT. Methods: A retrospective cohort of 150 breast cancer patients treated with nCT and subsequently with surgery was analysed. Data about the patients, histology, response to chemotherapy and peripheral blood values of lymphocytes, monocytes and neutrophils was collected, and used to calculate the LMR, NMR and NLR. Univariate and multivariate analyses were performed for the variables to see the relationship of the ratios to disease-free survival (DFS) and overall survival (OS). Results: Patients with high LMR (≥5.46) and low NLR (<3.33) were associated with a lower percentage of relapse (P = 0.048 and P = 0.015, respectively) and, above all, NLR was associated with a better survival (P = 0.024), being those factors that predict a good progress. Conclusion: High LMR and low NLR can be considered as favourable prognostic factors in BC patients treated with nCT.