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Título:

Implementing Standard Diagnosis and Treatment for Locally Advanced Breast Cancer Through Global Research in Latin America: Results From a Multicountry Pragmatic Trial

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Autor:

Retamales, Javier
Daneri-Navarro, Adrián
Artagaveytia, Nora
Alves da Quinta, Daniela
Abdelhay, Eliana
Podhajcer, Osvaldo L.
Aghazarian, Marta
Alonso, Isabel
Caserta, Benedicta
Musetti, Eduardo

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Tipo de documento:

Artículo

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Descriptores:

ADULTO
ANCIANO
PERSONA DE MEDIANA EDAD
NEOPLASIAS DE LA MAMA
MUJERES
PATOLOGÍA
DIAGNÓSTICO
MORTALIDAD
TERAPÉUTICA
EPIDEMIOLOGÍA
TERAPIA NEOADYUVANTE

Año de publicación:

2024

Contenido:

Resumen:

Purpose: Breast cancer mortality rates in Latin America (LA) are higher than those in the United States, possibly because of advanced disease presentation, health care disparities, or unfavorable molecular subtypes. The Latin American Cancer Research Network was established to address these challenges and to promote collaborative clinical research. The Molecular Profiling of Breast Cancer Study (MPBCS) aimed to evaluate the clinical characteristics and treatment outcomes of LA participants with locally advanced breast cancer (LABC). Patients and methods: The MPBCS enrolled 1,449 participants from Argentina, Brazil, Chile, Mexico, and Uruguay. Through harmonized procedures and quality assurance measures, this study evaluated clinicopathologic characteristics, neoadjuvant chemotherapy response, and survival outcomes according to residual cancer burden (RCB) and the type of surgery. Results: Overall, 711 and 480 participants in the primary surgery and neoadjuvant arms, respectively, completed the 5-year follow-up period. Overall survival was independently associated with RCB (worse survival for RCBIII-adjusted hazard ratio, 8.19, P < .001, and RCBII [adjusted hazard ratio, 3.69, P < .008] compared with RCB0 [pathologic complete response or pCR]) and type of surgery (worse survival in mastectomy than in breast-conserving surgery [BCS], adjusted hazard ratio, 2.97, P = .001). The hormone receptor-negative-human epidermal growth factor receptor 2-positive group had the highest proportion of pCR (48.9%). The analysis of the ASCO Quality Oncology Practice Initiative breast module revealed high compliance with pathologic standards but lower adherence to treatment administration standards. Notably, compliance with trastuzumab administration varied widely among countries (33.3%-88.7%). Conclusion: In LABC, we demonstrated the survival benefit of BCS and the prognostic effect of the response to available neoadjuvant treatments despite an important variability in access to key treatments. The MPBCS represents a significant step forward in understanding the real-world implementation of oncologic procedures in LA.

Descripción:

Javier Retamales 1, Adrián Daneri-Navarro 2, Nora Artagaveytia 3, Daniela Alves da Quinta 4 5, Eliana Abdelhay 6, Osvaldo L Podhajcer 4, Carlos Velázquez 7, Diego Giunta 8, Susanne Crocamo 6, Adriana Garibay-Escobar 7, Alicia Del Toro-Arreola 2, Robinson Rodriguez 3, Marta Aghazarian 9, Elsa Alcoba 10, Isabel Alonso 11, Renata Binato 6, Alicia I Bravo 12, Juan Canton-Romero 13, Dirce M Carraro 14, Mónica Castro 15, Juan Castro-Cervantes 16, Sandra Cataldi 9, Natalia Camejo 3, Laura Cortes-Sanabria 16, Maria Flores-Marquez 16, Guillermo Laviña 3, Eduardo Musetti 11, Benedicta Caserta 11, Mauricio Cerda 17, Alicia Colombo 17, Raul Delgadillo-Cristerna 16, Marisa Dreyer Breitenbach 18, Elmer Fernandez 19, Jorge Fernandez 20, Ramon Franco-Topete 21, Carolina Gabay 15, Fancy Gaete 22, Jorge Gamboa 23, Ricardo García-Gaeta 2, Mariana Gomez Del Toro 2, Leivy P Gonzalez-Ramirez 2, Marisol Guerrero 24, Manuel Herrera-Miramontes 2, Alejandra Lopez-Vasquez 7, Silvina Maldonado 12, Andrés Morán-Mendoza 13, Gilberto Morgan-Villela 16, Maria Aparecida Nagai 25, Nancy Navarro-Ruiz 2, Antonio Oceguera-Villanueva 26, Miguel Angel Ortiz 27, Jael Quintero 7, Antonio Quintero-Ramos 2, Gladys Ramirez-Rosales 2, Maritza Ramos-Ramirez 2, Marcia Maria Chiquitelli Marques 28, Ernesto Rivera Claisse 29, Diego Rodriguez-Gonzalez 2, Ana Romero-Gomez 2, Cristina Rosales 10, Efraín Salas-Gonzalez 13, Verónica Sanchotena 10, Laura Segovia 30, Aída A Silva-García 21, Olivia Valenzuela-Antelo 7, Laura Venegas-Godinez 2, Livia Zagame 4, Jorge Gomez 31; Latin American Cancer Research Network (LACRN); Andrea S Llera 4, Bettina Müller 1 32
Affiliations 1Grupo Oncologico Cooperativo Chileno de Investigacion, Santiago, Chile. 2Universidad de Guadalajara, Guadalajara, Mexico. 3Hospital Universitario de Clínicas "Manuel Quintela," Montevideo, Uruguay. 4Fundación Instituto Leloir-CONICET, Buenos Aires, Argentina. 5Universidad Argentina de la Empresa (UADE), Instituto de Tecnología (INTEC), Buenos Aires, Argentina. 6Instituto Nacional de Câncer Rio de Janeiro, Rio de Janeiro, Brazil. 7Universidad de Sonora, Sonora, Brazil. 8Instituto Universitario Hospital Italiano de Buenos Aires-CONICET, Buenos Aires, Argentina. 9Instituto Nacional de Cancer, Montevideo, Uruguay. 10Hospital Municipal de Oncología María Curie, Buenos Aires, Argentina. 11Centro Hospitalario Pereira Rossell, Montevideo, Uruguay. 12Hospital Regional de Agudos Eva Perón, Buenos Aires, Argentina. 13Hospital de Gineco-Obstricia CMNO-IMSS, Guadalajara, Mexico. 14AC Camargo Cancer Center, São Paulo, Brazil. 15Instituto de Oncología Angel Roffo, Buenos Aires, Argentina. 16Hospital de Especialidades CMNO-IMSS, Guadalajara, Mexico. 17Universidad de Chile, Santiago, Chile. 18Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil. 19Fundación para el Progreso de la Medicina, Cordoba, Argentina. 20Instituto de Salud Publica, Santiago, Chile. 21OPD Hospital Civil de Guadalajara, Guadalajara, Mexico. 22Hospital Luis Tisne, Santiago, Chile. 23Hospital Clínico San Borja Arriaran, Santiago, Chile. 24Hospital San Jose, Santiago, Chile. 25Instituto de Câncer de São Paulo, São Paulo, Brazil. 26Instituto Jalisciense de Cancerologia, Guadalajara, Mexico. 27Hospital General Regional No. 1, IMSS Obregon, Sonora, Mexico. 28Hospital de Câncer de Barretos, Barretos, Brazil. 29Centro Estatal de Oncología, Hermosillo, Mexico. 30Hospital Barros Luco Trudeau, Santiago, Chile. 31Health Sciences Center, Texas A&M University, College Station, TX. 32Instituto Nacional del Cáncer, Santiago, Chile.

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Editorial:

American Society of Clinical Oncology

EN:

JCO Global Oncology. 2024;10

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Citación:

Retamales J, Daneri-Navarro A, Artagaveytia N y otros. Implementing Standard Diagnosis and Treatment for Locally Advanced Breast Cancer Through Global Research in Latin America: Results From a Multicountry Pragmatic Trial. JCO Global Oncology [en línea]. 2024;10. 15 p.

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Cobertura geográfica:

AMÉRICA LATINA

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Licencia Creative Commons Atribución (CC - By 4.0)

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