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  • 1
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    Ramucirumab with cisplatin and fluoropyrimidine as first-line therapy in patients with metastatic gastric or junctional adenocarcinoma (RAINFALL): a double-blind, randomised, placebo-controlled, phase 3 trial
    Elsevier BV ; 2019
    In:  The Lancet Oncology Vol. 20, No. 3 ( 2019-03), p. 420-435
    Details
    In: The Lancet Oncology, Elsevier BV, Vol. 20, No. 3 ( 2019-03), p. 420-435
    Materialart: Online-Ressource
    ISSN: 1470-2045
    URL: Article
    DOI: 10.1016/S1470-2045(18)30791-5
    Sprache: Englisch
    Verlag: Elsevier BV
    Publikationsdatum: 2019
    ZDB Id: 2049730-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
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    Clinical and radiological response to locoregional and systemic treatments in well-differentiated gastroenteropancreatic neuroendocrine tumors with liver metastases treated at a reference center in Mexico.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 4_suppl ( 2023-02-01), p. 644-644
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 4_suppl ( 2023-02-01), p. 644-644
    Kurzfassung: 644 Background: liver metastases (LM) from well-differentiated gastroenteropancreatic neuroendocrine tumors (wd-GEP-NET) can develop in 28-77% of patients (pts) in their lifetime. Multiple treatments can provide radiological and symptomatic response. Our aim was to evaluate responses to locoregional (LRT) and systemic (SYST) treatments in wd-GEP-NET with LM. Methods: we included consecutive records of pts with confirmed histological diagnosis of wd-GEP-NET and radiological LM, treated at our institution between 2008-2019. Relevant variables were retrospectively extracted from electronic records. Radiological response was assessed with RECIST 1.1 by radiological independent review. Results: 55 pts, 45.5% male. Median age at LM diagnosis 49 years (IQR 41-63). Primary tumor sites: 49% pancreatic, 27.3% small intestine, 11% unknown, 12.7% others. WHO 2019 grade 1, 2 and 3 in 52.7, 41.8 and 1.8%, respectively. Twentynine tumors (52.7%) were functional, with carcinoid syndrome in n20. At LM diagnosis, 91% of pts had symptomatic disease: hormonal n8, local n4, systemic n4, hormonal + local n4, local + systemic n22, hormonal + systemic n5, hormonal + local + systemic n5. LM tumoral burden was 〈 10% in 22%, 11-50% in 43.6, 〉 50% in 30.9% of pts. 49.1% of pts had extra hepatic metastatic disease. LRT to LM was administered to 32 pts: TAE/TACE n26, ablation n8. SYST to 22 pts: somatostatin analog n15, Lutetium-177 n4, chemotherapy n2, everolimus n1. 1 pt did not receive treatment. Response to treatments is shown. In the LRT group, -- pts developed complications: n16 postembolization syndrome, n2 infections, n3 liver failure, n7 others. There was 1-procedure-related death. Conclusions: Patients treated with LRT at our institution achieved similar efficacy and safety results compared to those reported by previous studies.[Table: see text]
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.4_suppl.644
    RVK:
    XA 52760
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2023
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
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    SARS-CoV-2 Infection Rate in Patients With Cancer and Health Care Workers in a Chemoradiotherapy Unit During the Pandemic: A Prospective Cohort in Mexico
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  JCO Global Oncology , No. 7 ( 2021-12), p. 1639-1646
    Details
    In: JCO Global Oncology, American Society of Clinical Oncology (ASCO), , No. 7 ( 2021-12), p. 1639-1646
    Kurzfassung: Cancer treatment during the COVID-19 pandemic represents a challenge. Hospital visits to receive treatment and interaction with health care workers (HCW) represent potential contagious events. We aimed to determine SARS-CoV-2 infection rate among patients with cancer and HCW of a chemoradiotherapy unit localized in a center designated as a COVID-19 priority facility in Mexico City. We also determined the diagnostic performance of a clinical questionnaire (CQ) as a screening tool and anti–SARS-CoV-2 antibody seroconversion rate. METHODS HCW and patients with solid tumors attending the chemoradiotherapy unit signed informed consent. To determine SARS-CoV-2 infection rate prospectively, a nasopharyngeal swab for SARS-CoV-2 real-time quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) was performed every 2 weeks in asymptomatics. An electronic CQ interrogating COVID-19–related symptoms was sent daily. Anti–SARS-CoV-2 immunoglobulin G (IgG) antibodies were measured at baseline and at the end of the study period. RESULTS From June to September 2020, we included 130 asymptomatic participants, 44.6% HCW and 55.4% patients with cancer. During a median follow-up of 85 days, 634 nasopharyngeal swabs were performed. Average SARS-CoV-2 monthly incidence was 4.6% (3.15%-7.47%), and cumulative infection rate was 13.8% (18 of 130). Cases were mostly asymptomatic (66%), and no hospitalizations or deaths were recorded. The CQ as a screening tool provided a sensitivity of 27.7%, a positive predictive value of 26.3%, and a positive likelihood ratio of 12. SARS-CoV-2 IgG seroconversion rate was 27.7% among those with a positive RT-PCR. CONCLUSION Patients with cancer on treatment can have uncomplicated COVID-19 outcomes. Biweekly RT-qPCR testing detects asymptomatic infections, prevents transmission, and should be implemented in units to increase patient safety. CQ increase RT-qPCR diagnostic yield and may prioritize testing in resource-deprived settings. Post-infection IgG seroconversion is unreliable.
    Materialart: Online-Ressource
    ISSN: 2687-8941
    URL: Article
    DOI: 10.1200/GO.21.00207
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2021
    ZDB Id: 3018917-2
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    Prospective prevalence estimation of BRCA1, BRCA2, and other germline mutations associated with hereditary pancreatic cancer (HPC) using a comprehensive gene panel in an unselected cohort of Mexican patients with pancreatic ductal adenocarcinoma (PDAC).
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 10609-10609
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 10609-10609
    Kurzfassung: 10609 Background: Prevalence of pathogenic or likely pathogenic germline variants (PGVs) in patients with PDAC varies across populations. There is limited information on the prevalence of PGVs among Mexican patients with PDAC. We prospectively tested an unselected cohort of newly diagnosed PDAC patients using a comprehensive gene panel in order to estimate the prevalence of BRCA1/2, and other germline mutations associated with HPC. Methods: The protocol was approved by the ethics committee at each institution: INCMNSZ, INCAN, and CM ABC Observatorio. Key inclusion criteria: age 〉 18 years and PDAC diagnosed within 6 months of inclusion. Patients were enrolled consecutively, regardless of age, personal or family history of cancer, known hereditary cancer syndrome, or stage of the disease. Written informed consent was obtained before any procedure. Clinical variables including family history of cancer were collected. We used the 84-gene Invitae Multi-Cancer Panel. Genetic testing had no cost for patients. Patient characteristics and family history were summarized using descriptive statistics (IBM SPSS Statistics Version 25). The trial was registered on Clinical Trials (NCT05305001). Results: From August 2020 to June 2022, 119 patients with newly diagnosed PDAC were identified. Of these, 107 patients were included: 58% women, median age was 63 y/o, clinical stages at diagnosis were: I (24%), II (22%), III (6%), and IV (48%). All patients had Hispanic ancestry except one (Ashkenazi Jewish). Only 7.5% (n = 8) had a personal history of other cancer, mainly breast cancer (N = 3); 62% had a family history of any cancer, while 47.6% had a first-degree relative (FDR) with any cancer. 11% (n = 12) had family history of pancreatic cancer (PC), and 9% (n = 10) had an FDR with PC. Five patients met clinical criteria for hereditary cancer syndrome: familial pancreatic cancer (4) and Lynch syndrome (1). PGVs were identified in 17.8% (n = 19) of patients. The prevalence of PGVs in genes associated with autosomal dominant risk of PC was 11.2%: CDKN2A(5.6%), ATM (3.7%), BRCA2 (0.93%), and MSH6 (0.93%). Two patients had a PGV associated with autosomal dominant predisposition to other cancers ( CHECK2 and NF1). Six patients (5.6%) had PGVs associated with autosomal recessive predisposition to rare syndromes with increased cancer risk other than PDAC (MUTYH, RECQL4, FH and WRN). Variants of uncertain significance were present in 42% of patients. Conclusions: In Mexican patients with PDAC, the prevalence of PGVs on BRCA1/2 is 〈 1%. The prevalence of PGVs in other susceptibility genes is 11%. Our results support the role of universal germline testing in Mexican patients with PDAC using a comprehensive gene panel. Selective testing for BRCA1/2 is discouraged.
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.10609
    RVK:
    XA 52760
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2023
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
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    Evaluating adherence to post-treatment follow-up of colorectal cancer at a reference center in Mexico: A retrospective analysis.
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  Journal of Clinical Oncology Vol. 39, No. 3_suppl ( 2021-01-20), p. 51-51
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 3_suppl ( 2021-01-20), p. 51-51
    Kurzfassung: 51 Background: Adequate post-treatment surveillance for colorectal cancer (CRC) is recommended by all major societies with the intention to improve overall survival. However, compliance is variable and has not been studied in our country. Our aim was to evaluate the adherence to post-treatment surveillance NCCN guidelines for CRC at our Institution in Mexico City. Methods: We retrospectively reviewed charts from patients with stage I-III CRC who were diagnosed between January 2014 and December 2016. Adherence to surveillance was evaluated for the first 3 years after completion of oncologic treatment or until recurrence, whichever came first. We used an adherence composite definition previously defined by Cooper et al, where adequate compliance with guidelines was considered if patients had ≥2 physician visits per year for 3 years, ≥2 CEA tests per year for 2 years, and at least one colonoscopy in the 3-years surveillance period. Results: We included 90 patients. Mean age at diagnosis was 62 ± 12.5 years, 53% (n=48) were male, 68% (n=62) had colon cancer and 31% (n=28) rectal cancer. According to AJCC7 19% (n=17) were Stage I, 39% (n=35) II, and 42%(n=38) III. Median score for Charslon index at diagnosis was 4 (IQR 3-6). Results of follow-up adherence are presented in Table. Just 12% (n=11) of patients had a PET/CT or any other non-indicated imaging study for surveillance. Recurrence rate at the 3rd year of surveillance was 6.6% (n=6). A bivariate analysis was performed to find clinical and demographic factors associated to adherence and individual components of surveillance, we did not find any significative association. Conclusions: At our institution compliance with follow-up guidelines for CRC is good and higher than reported by other centers, though individual components have a decreasing trend in adherence every year. This could be explained because in our Institution cancer surveillance is performed by a medical oncologist. The main limitation of our study is that it involves an individual reference center in Mexico; thus, extrapolating data may not be feasible. [Table: see text]
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2021.39.3_suppl.51
    RVK:
    XA 52760
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2021
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
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    Clinical characteristics, treatment, and oncological outcomes in patients with ampullary cancer at a reference center in Mexico.
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 4_suppl ( 2022-02-01), p. 617-617
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 4_suppl ( 2022-02-01), p. 617-617
    Kurzfassung: 617 Background: Ampullary cancer (AC) represents 0.2% of gastrointestinal cancers. Given the rarity of the disease, information regarding treatment strategies and outcomes derives from studies that include the different types of periampullary cancers, which constitute a heterogeneous group. Our aim was to describe the clinical characteristics, treatment modalities and outcomes in patients (pts) with true AC treated at our institution. Methods: A retrospective review of medical records of all consecutive pts with histological diagnosis of AC evaluated at our institution from Jan 2009-Dec 2019. Clinical, pathological and laboratory variables at diagnosis were recorded. Overall survival (OS) was estimated by Kaplan-Meier and compared with the Log-rank test. Statistical significance was determined at P 〈 0.05. Results: 133 pts with AC were included. Median age was 62 yo (IQR 53-70), 51.9% were women. 25% had ampullary adenoma history. Symptoms at diagnosis: 89% jaundice, 63% weight loss and 56% abdominal pain. Median laboratory values were total bilirubin 1.7 mg/dL (0.7-5.1), albumin 3.7 g/dL (3.1-4.2), hemoglobin 12.6 g/dL (10.9-14.2), carbohydrate antigen (CA) 19-9 34.7 U/mL (6.4-113.9) and carcinoembryonic antigen (CEA) 2.6 ng/mL (1.2-4.2). Most tumors were moderately differentiated (59%). Histologic subtypes of adenocarcinoma were available in 84 pts: intestinal 46.4%, pancreaticobiliary 39.3% and mixed 14.3%. Stage at diagnosis was localized (46%), locally advanced N+ (29%) and advanced (25%). For those with localized/locally advanced disease, 91% (91/100) underwent surgical resection, 25.3% (23/91) received adjuvant chemotherapy (ChT), 69.6% (16/23) received single agent and 30.4% (7/23) duplet. Pts who received adjuvant Cht presented N+ in 69.6%, moderate differentiation in 73.9%, intestinal 47.8% and pancreaticobiliary subtype 43.5%. In advanced setting, 63.6% (21/33) received palliative Cht, 66.7% received a duplet regimen. Median OS was 32.8 (22.9-42.8) months (mos). Median OS according to stage was 152.1, 28.1 and 10.2 mos for localized, locally advanced, and advanced, respectively (P 〈 0.001). OS univariate analysis is shown in table. Conclusions: Most of pts presented with localized/locally advanced disease, were eligible to surgical resection and had a better survival. For those with N+ disease it is required to evaluate the role of adjuvant Cht. In the advanced setting, Cht improves prognosis.[Table: see text]
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2022.40.4_suppl.617
    RVK:
    XA 52760
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2022
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
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    Prevalence of advanced colorectal neoplasia according to risk categories at screening colonoscopy in a tertiary referral center.
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 4_suppl ( 2018-02-01), p. 578-578
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 4_suppl ( 2018-02-01), p. 578-578
    Kurzfassung: 578 Background: Colorectal cancer (CRC) is the third most common cancer in the world. There is strong evidence that screening for colorectal cancer improves survival in conutries with high incidence. Although Mexico is considered a country with a low incidence of CRC, 4694 potentially preventable deaths occur every year. There is no established CRC screening program in our country, risk stratification of the target populations to be screened may bring potential advantages, making the strategy more cost-effective. The Asia-Pacific Colorectal Screening (APCS) score, is a validated risk-stratification tool that helps identify individuals at risk for advanced colorectal neoplasm amongst the asymptomatic population. Methods: We performed a retrospective, cross-sectional analysis of database records from 1172 patients who underwent screening colonoscopy betwen january 2013 and november 2014. Results: The prevalence of advanced colorectal neoplasia was 2.9%. Applying the APCS stratification, 91 subjects (7.8%) were in the average risk tier, 849 subjects (72.4%) in the moderate risk tier and 232 (19.8%) subjects in the high risk tier. The prevalence of advanced neoplasia in the average risk, moderate risk and high risk groups was 0%, 2.6% and 5.1%, respectively. The subjects in the high risk tier had 2.21-fold (p = 0.021) increased prevalence of advanced neoplasia than those in the average-moderate tier. Conclusions: The APCS score is a simple risk stratification index for colorectal advanced neoplasm that uses elementary clinical information on age, gender, family history and smoking to stratify the risk of colorectal advanced neoplasm in asymptomatic subjects for priority of colorectal screening.
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2018.36.4_suppl.578
    RVK:
    XA 52760
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2018
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Treatment modalities and oncological outcomes in Mexican patients with localized gastric cancer.
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 4_suppl ( 2020-02-01), p. 319-319
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 4_suppl ( 2020-02-01), p. 319-319
    Kurzfassung: 319 Background: gastric cancer is common in Mexico. Evaluation of treatment strategies is greatly important in early gastric cancer. National institutions rarely report their outcomes, limiting feedback and policy improvements. Methods: single-center retrospective review of patients with histologically confirmed localized gastric cancer diagnosed from Jan 2005 to Dec 2017. Overall survival (OS) and recurrence-free survival (RFS) were estimated by Kaplan-Meier curves and compared with log-rank rest. A p value 〈 0.05 was significant. Results: we included 78 cases, median age 63 years, 52.6% men. Surgery was the initial treatment in 46 patients (59%) and 87% achieved R0 resection. Adjuvant treatment was administered to 63% of patients. 29 patients (37.2%) started perioperative chemotherapy with 86.2% of them being resected, and 75.9% having R0 resection. 13 patients (44.8%) also received postoperative chemotherapy. Better performance status (p=0.036) and lower albumin levels (p=0.039) were found in patients with initial surgery vs those with perioperative chemotherapy. At the time of surgery, most patients had stage III disease in both groups but 5 patients had M1 disease despite negative initial laparoscopy in the chemotherapy group and 5 patients did not require aduvant tx given early stage in the surgery first group. Median OS and RFS are reported in table. Conclusions: Most patients in our center undergo initial surgery. We report a differential survival according to initial treatment. More advanced disease in chemotherapy first group may explain differences. Given non-random assignment, we could not show survival benefit of chemotherapy treated patients. [Table: see text]
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.4_suppl.319
    RVK:
    XA 52760
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2020
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Oncological outcomes in a cohort of patients with biliary tract carcinoma in a Mexican reference center.
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 15_suppl ( 2017-05-20), p. e15618-e15618
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e15618-e15618
    Kurzfassung: e15618 Background: In Mexico there is scarce information about oncological outcomes of biliary tract carcinomas (BTC). Methods: we retrospectively reviewed medical records from 150 patients with histologically confirmed BTC (excluding gallbladder cancer) treated in our institution from January 2005 to December 2015.Clinical and pathological information was recorded. Survival was estimated by Kaplan Meir method and compared by Log rank test. Results: we found 63.3% women and 36.7% men, with a median age of 62 years (23 - 88). Tumor localization was intrahepatic in 34.7%, hilar in 43.3% and distal in 22%. Clinical stage was advanced in 71%, regional in 13% and local in 16%. Diagnostic delay was 3.7 months (0.37 - 32.9). For patients with localized disease (which included local and regional disease, n=43), a potentially curative surgery was attempted in 64% (n=27), achieving a R0 resection in 59% (n=16) of cases. There was a 3.9 months (0.83-29.63) treatment initiation delay. There were 7 surgical deaths. For advanced disease (n=107), treatment initiation delay was 4.2 months (0.5 - 34.5), 59% (n=63) of patients did not received oncological active treatment, and 26% (n=28) of patients received a systemic palliative chemotherapy, more frequently gemcitabine (n=20). At progression just eleven patients received a second chemotherapy line. In localized disease resected patients by univariate analysis high levels of CA 19.9 (p=0.04) and CEA (0.03) were associated with decreased survival. For patients with advanced disease prognostic factors included poorly differentiated histology (p=0.04), high bilirrubin level (p=0.04), low albumin level (p=0.001), abscense of chemotherapy (p=0.000) and high CEA levels (p=0.03). Conclusions: Survival is poor in this Mexican cohort of patients with BTC possibly related to diagnostic and therapeutic delay and advanced disease at presentation. [Table: see text]
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2017.35.15_suppl.e15618
    RVK:
    XA 52760
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2017
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    Testicular cancer in Mexico: Clinicopathologic and prognostic study with analysis of causes of death and palliative requirements.
    American Society of Clinical Oncology (ASCO) ; 2014
    In:  Journal of Clinical Oncology Vol. 32, No. 15_suppl ( 2014-05-20), p. e20550-e20550
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 32, No. 15_suppl ( 2014-05-20), p. e20550-e20550
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2014.32.15_suppl.e20550
    RVK:
    XA 52760
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2014
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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