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  • 1
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. e18669-e18669
    Abstract: e18669 Background: Adherence to BCCPG improves outcomes for patients with breast cancer. However, the implementation of international BCCPG may not be feasible in low- and middle-income countries, and a potential solution may be developing BCCPG adapted to local contexts. The National Consensus on Diagnosis and Treatment of Breast Cancer ( Colima Consensus, http://consensocancermamario.com) is the Mexican BCCPG. This study aimed at evaluating physicians’ uptake of the Colima Consensus and identifying barriers impacting adherence. Methods: A cross-sectional, 30-item survey exploring adherence, barriers, and attitudes towards the Colima Consensus was e-mailed to Consensus attendees and members of the Mexican Society of Oncology and Mexican Mastology Association. Answers were collected between 06/21-09/21. Descriptive statistics, univariate, and multivariate analysis were used to analyze the associations between participants’ characteristics, adherence, attitudes, and barriers. Results: Among 1553 physicians invited to participate, 439 (28%) completed the survey. Fifty-four percent were male, 66% were age 30-49 years, and 39% practiced in Mexico City. Twenty-six percent were surgical, 13% medical, and 10% radiation oncologists. Ninety-two percent reported using the Consensus to guide decision-making, 78% adhered to its recommendations, 89% agreed with its recommendations, and 94% believed it was applicable to their clinical practice. Regarding attitudes towards the Consensus, 90% agreed/strongly agreed with it being a good educational tool, 89% a reliable source of information, and 90% thought it improved quality of care. The most common barriers to adherence were lack of resources (54%) and logistical problems (29%). Physicians working with a multidisciplinary team were less likely to cite lack of resources as reason for non-adherence (p 〈 0.01). Forty percent reported using the Consensus as their only BCCPG. Surgical oncologists (p 〈 0.01), those practicing in public hospitals (p 〈 0.01), in institutions with local BCCPG (p 〈 0.01), with ≤5 new patients/month (p 〈 0.01), and not involved in research (p 〈 0.01) were more likely to use the Consensus as their only BCCPG. In multivariate analysis, being a surgical oncologist (OR 3.26, p 〈 0.01) and working in a public hospital (OR 2.12, p 〈 0.01) increased the odds of using the Consensus as the only BCCPG. Conclusions: We show high levels of adherence and positive attitudes towards the Colima Consensus, with a significant proportion using it as their main BCCPG. Lack of resources and logistical issues were the main barriers to adherence. Our results highlight the relevance of local BCCPG and suggest a need for the creation of stratified recommendations adapted to various healthcare settings.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 2
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e15504-e15504
    Abstract: e15504 Background: Perioperative chemotherapy (QT) with platinum and fluoropyrimidines with or without anthracyclines is recommended option in patients with resectable gastric cancer (GC) at least cT2 or nodal involvement. Another option is surgery followed by QT with radiotherapy (QT/RT) or QT without RT in patients with D2 lymphadenectomy. Unfortunately, a considerable percentage of patients progress during neoadjuvant-QT (neo-QT) and some cases become inoperable cancer. These patients could benefit from curative surgery after diagnosis without neo-QT. Currently, histological/molecular markers have not been established to predict which patients can benefit from neo-QT. As potent analysis method, study of blood metabolites of resectable GC patients to establish a profile to differentiate responder patients (R-P) or not-responder (NR-P) to neoadjuvant-QT is promising. To establish a metabolomic profile or metabolomic signature and correlate with chemosensitivity, defined as pathological and clinical response is our endpoint. Methods: To this end we performend an untargeted metabolomic analysis by LC-HRMS of serum samples from resectable GC patients before neo-QT (n = 20 vs n = 10 healthy controls). Chemosensitive tumors were defined as those with good pathological response (Mandard 1 or 2) and partial response by TAC and chemoresistance tumors, defined as those with poor pathological response (Mandard 5) or/and progression by TAC. Reverse phase and HILIC chromatographic modes were applied to deal with highly polar as well as hydrophobic as required for untargeted metabolomics. For identification of potential biomarkers, we used in combination 2 independent variable selection techniques: principal component analysis and Student t test. Results: 11 patients were R-P and 9 patients were NR-P. We observed differences in metabolic profile between patients with GC & healthy controls and R-P & NR-P to neo-QT. Seven identified metabolites contributed most to the differentiating between R-P and NR-P. Conclusions: There are different metabolomic phenotypes among patients R-P and NR-P to neo-QT. It is necessary to validate a metabolomic signature to allow effective chemosensitivity prediction in patients with resectable GC.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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