Browsing by Author "Sánchez Rojel, César Giovanni"
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- ItemA Molecular Stratification of Chilean Gastric Cancer Patients with Potential Clinical Applicability(2020) Pinto Paganini, Mauricio Arturo; Bravo Castillo, Maria Loreto; Sánchez Rojel, César Giovanni; Acevedo, Francisco; Mondaca Contreras, Sebastián Patricio; Ibañez, Carolina; Galindo A., Héctor; Madrid Arenas, Jorge; Nervi Nattero, Bruno; Peña Durán, José Esteban; Torres Montes, Paula Javiera; Owen, Gareth Ivor; Corvalán R., Alejandro; Garrido S., Marcelo; Córdova Delgado, M.; Retamal, I. N.; Muñoz Medel, M.; Durán, D.; Villanueva, F.; Koch, E.; Armisen, R.
- ItemAccess disparities and underutilization of germline genetic testing in Chilean breast cancer patients(2023) Acevedo Claros, Francisco Nicolás; Walbaum García, Benjamín Vicente; Camus Appuhn, Mauricio Gonzalo; Manzor Véliz, Manuel; Muñiz Muñoz, María Sabrina; Medina Araya, Lidia; Petric Guajardo, Militza Paulina; Reyes, Paula; Domínguez, Francisco; Puschel Illanes, Klaus; Merino Lara, Tomás Rodrigo; Bravo, M. Loreto; Pinto, Mauricio P.; Ibáñez, Carolina; Hughes, Kevin; Sánchez Rojel, César GiovanniPurpose Latin American reports on genetic cancer risk assessments are scarce. In Chile, current breast cancer (BC) guidelines do not define strategies for germline genetic testing. Our study sought to quantify the disparities in access to genetic testing in Chilean BC patients, according to international standards and their clinical characteristics to explore improvement strategies.Methods Retrospective analysis of invasive BC databases including patients treated in a Public Hospital (PH) and in an Academic Private Center (AC) in Santiago, Chile between 2012 and 2021.Results Of 5438 BC patients, 3955 had enough data for National Comprehensive Cancer Network (NCCN) categorization. From these, 1911 (48.3%) fulfilled NCCN criteria for germline testing, of whom, 300 were tested for germline mutations and 268 with multigene panels. A total of 65 pathogenic variants were found in this subset. As expected, BRCA1/2 mutations were the most frequent (17.7%). Access to genetic testing was higher in AC versus PH (19.6% vs. 10.3%, p = 0.0001). Other variables associated with germline genetic testing were BC diagnosis after 2018, being 45 years old or younger at diagnosis, BC family history (FH), FH of ovarian cancer, non-metastatic disease, and triple-negative subtype.Conclusion In our cohort, 15% of BC patients who met NCCN criteria for germline testing were effectively tested. This percentage was even lower at the PH. Current recommendations encourage universal genetic testing for BC patients; however, our findings suggest that Chile is far from reaching such a goal and national guidelines in this regard are urgently needed. To our knowledge, this is the first study of its kind in Chile and Latin America.
- ItemAxillary web syndrome among Chilean women with breast cancer : incidence and possible predisposing factors(2020) Ramirez Parada, Karol Lilia; Garay-Acevedo, D.; Mella Abarca, Williams Andrés; Petric-Guajardo, M.; Sánchez Rojel, César Giovanni; McNeely, M. L.; Leao-Ribeiro, I.; Fernández Verdejo, Rodrigo
- ItemBreast cancer at extreme ages - A comparative analysis in Chile(2015) Acevedo Claros, Francisco Nicolás; Camus Appuhn, Mauricio Gonzalo; Sánchez Rojel, César Giovanni
- ItemCalorie Restriction and Time-Restricted Feeding: Effective Interventions in Overweight or Obese Patients Undergoing Radiotherapy Treatment with Curative Intent for Cancer(2024) Vega Huerta, Carmen Natalia; Barnafi Wittwer, Esteban Andrés; Sánchez Rojel, César Giovanni; Acevedo Claros, Francisco Nicolás; Walbaum García, Benjamín Vicente; Parada Daza, Alejandra Cristina; Rivas Segura, Nicolás Eduardo; Merino Lara, Tomás RodrigoThis study assesses the feasibility of calorie restriction (CR) and time-restricted feeding (TRF) in overweight and obese cancer patients who realized little to no physical activity undergoing curative radiotherapy, structured as a prospective, interventional, non-randomized open-label clinical trial. Of the 27 participants initially enrolled, 21 patients with breast cancer were selected for analysis. The participants self-selected into two dietary interventions: TRF, comprising a sugar and saturated fat-free diet calibrated to individual energy needs consumed within an 8 h eating window followed by a 16 h fast, or CR, involving a 25% reduction in total caloric intake from energy expenditure distributed across 4 meals and 1 snack with 55% carbohydrates, 15% protein, and 30% fats, excluding sugars and saturated fats. The primary goal was to evaluate the feasibility of these diets in the specific patient group. The results indicate that both interventions are effective and statistically significant for weight loss and reducing one’s waist circumference, with TRF showing a potentially stronger impact and better adherence. Changes in the LDL, HDL, total cholesterol, triglycerides, glucose and insulin were not statistically significant.
- ItemCáncer de mama avanzado receptor de estrógeno positivo: Manejo sistémico actual(2018) Sánchez Rojel, César Giovanni; Valenzuela Velasquez, Yasna Daniela; Pérez-Sepúlveda, Alejandra; Villarroel Pérez, María Alejandra; Medina Araya, Lidia; Camus Appuhn, Mauricio Gonzalo; Acevedo Claros, Francisco NicolásEl cáncer de mama es la primera causa de muerte por cáncer en mujeres chilenas. Mientras la mayoría de las personas logra curarse de esta enfermedad, un 5% de los casos se presenta inicialmente con enfermedad avanzada y hasta un 20-30% de pacientes con enfermedad localizada pueden sufrir recurrencias sistémicas. La mayoría de las neoplasias mamarias son dependientes del estímulo estrogénico, de allí que la deprivación de estrógenos es la principal estrategia terapéutica. Recientemente, el uso de terapias molecularmente dirigidas en combinación con la terapia endocrina ha logrado mejorar los resultados de sobrevida del cáncer de mama avanzado, con menos efectos colaterales que aquellos producidos por la quimioterapia convencional. El conocimiento de los mecanismos de acción de estas nuevas terapias, sus toxicidades, vías de resistencia y selección de pacientes para lograr los mejores beneficios terapéuticos son aspectos relevantes en el manejo de la enfermedad. Presentamos una revisión del estado actual del manejo del cáncer de mama metastásico hormonodependiente con enfásis en el uso de terapias endocrinas combinadas con terapias moleculares.
- ItemCáncer de mama en mujeres adultas mayores, características clínicas e histopatológicas y resultados del tratamiento con intención curativa(2013) Sánchez Rojel, César Giovanni; Bakal, Federico L.; Camus Appuhn, Mauricio Gonzalo; Besa de C., Pelayo
- ItemCáncer de mama metastásico. Caracterización de una cohorte según subtipos(2014) Sánchez Rojel, César Giovanni; Acevedo Claros, Francisco Nicolás; Petric, G. M.; Galindo A., Héctor; Domínguez Covarrubias, Francisco José; León Ramírez, Augusto; Razmilic Valdés, Dravna Nichi; Espinoza, F.
- ItemCaracterísticas clínicas y pronóstico de pacientes con cáncer de mama HER2 positivo avanzado, en la era antes y después de terapias anti-HER2.(2018) Sánchez Rojel, César Giovanni; Domínguez Covarrubias, Francisco José; Galindo A., Héctor; Camus Appuhn, Mauricio Gonzalo; Oddo Benavides, David; Villarroel, Alejandra; Razmilic Valdés, Dravna Nichi; Navarro Ortega, María Elena; Pérez Sepúlveda, Alejandra Andrea; Medina Araya, Lidia; López, Valeska; Acevedo Claros, Francisco Nicolás
- ItemCaracterísticas clínico-patológicas y sobrevida de pacientes con cáncer de mama bilateral sincrónico(2014) Sánchez Rojel, César Giovanni; Acevedo Claros, Francisco Nicolás; Petric, M.; Domínguez Covarrubias, Francisco José; León Ramírez, Augusto; Razmilic Valdés, Dravna Nichi; Ceballos, C.; Espinoza, F.; Navarro Ortega, María Elena; Oddo Benavides, David; Camus, M.
- ItemChilean Gastric Cancer Task Force : a study protocol to obtain a clinical and molecular classification of a cohort of gastric cancer patients(2018) Owen, Gareth Ivor; Pinto, Mauricio P.; Retamal, Ignacio N.; Fernández, María F.; Cisternas, Betzabe; Mondaca Contreras, Sebastián Patricio; Sánchez Rojel, César Giovanni; Galindo A., Héctor; Nervi, Bruno; Ibáñez Cáceres, Carolina; Acevedo Claros, Francisco Nicolás; Madrid Arenas, Jorge; Peña, José; Bravo Castillo, María Loreto; Maturana, María, José; Córdova Delgado, Miguel; Romero, Diego; De la Jara, Nathaly; Torres Montes, Paula Javiera; Rodríguez Fernández, María; Espinoza Sepúlveda, Manuel Antonio; Balmaceda, Carlos; Freire, Matías; Gárate Calderón, Valentina; Crovari Eulufi, Fernando; Jiménez Fonseca, Paula; Carmona Bayonas, Alberto; Zwenger, Ariel; Armisen, Ricardo; Corválan, Alejandro H.; Garrido Salvo, Marcelo; Owen, Gareth Ivor; Pinto, Mauricio P.; Retamal, Ignacio N.; Fernández, María F.; Cisternas, Betzabe; Mondaca, Sebastián; Sánchez Rojel, César Giovanni; Galindo Aranibar, Héctor Gonzalo; Nervi, Bruno; Ibáñez Cáceres, Carolina; Acevedo Claros, Francisco Nicolás; Madrid, Jorge; Peña, José; Bravo, María, Loreto; Maturana, María, José; Córdova Delgado, Miguel; Romero, Diego; De la Jara, Nathaly; Torres, Javiera; Rodríguez Fernández, María; Espinoza Sepúlveda, Manuel Antonio; Balmaceda, Carlos; Freire, Matías; Gárate Calderón, Valentina; Crovari Eulufi, Fernando; Jiménez Fonseca, Paula; Carmona Bayonas, Alberto; Zwenger, Ariel; Armisen, Ricardo; Corválan, Alejandro H.; Garrido, Marcelo
- ItemChilean Registry for Neuroendocrine Tumors: A Latin American Perspective(2019) Pinto, Mauricio P.; Muñoz Medel, Matías; Carrillo, Diego; Retamal, Ignacio N.; Bravo Castillo, María Loreto; Nervi Nattero, Bruno; Sánchez Rojel, César Giovanni; Galindo A., Héctor; Ibáñez Cáceres, Carolina; Peña Durán, José Esteban; Madrid Arenas, Jorge; Valenzuela, Yasna; Balmaceda, Carlos; Briones, Juan; Torres Montes, Paula Javiera; Nilo, Flavia; Guarda Vega, Francisco; Quintana, Juan Carlos; Orellana, Pilar; Mondaca Contreras, Sebastián Patricio; Acevedo Claros, Francisco Nicolás; Vicentini, Daniel; Córdova Delgado, Miguel; Owen, Gareth Ivor; Garrido Salvo, Marcelo
- ItemClinical characteristics, risk factors, and outcomes in Chilean triple negative breast cancer patients: a real-world study(2023) Acevedo Claros, Francisco Nicolás; Walbaum, Benjamin; Medina, Lidia; Merino Lara, Tomás Rodrigo; Camus Appuhn, Mauricio Gonzalo; Puschel Illanes, Klaus; Ramírez Parada, Karol Lilia; Manzor, Manuel; Veglia, Paulina; Martinez, Raul; Guerra, Constanza; Navarro, Marisel; Bauerle, Catherine; Domínguez Covarrubias, Francisco José; Sánchez Rojel, César GiovanniBackground Latin American (LA) studies on triple-negative breast cancer (TNBC) and their characteristics are scarce. This forces physicians to make clinical decisions based on data obtained from studies that include non-Hispanic patients. Our study sought to obtain local epidemiological data, including risk factors and clinical outcomes from a Chilean BC registry. Methods This was a retrospective population-cohort study that included patients treated at a community hospital (mid-low income) or an academic private center (high income), in the 2010-2021 period. Univariate and multivariate analyses were performed to identify prognostic factors associated with survival. Results 647 out of 5,806 BC patients (11.1%) were TNBC. These patients were younger (p = 0.0001) and displayed lower rates of screening-detected cases (p = 0.0001) compared to non-TNBC counterparts. Among TNBC patients, lower income (i. e., receiving treatment at a community hospital) was associated with poorer overall survival (HR: 1.53; p = 0.0001) and poorer BC specific survival (HR: 1.29; p = 0.004). Other risk factors showed no significant differences between TNBC and non-TNBC. As expected, 5-year OS was significantly shorter on TNBC versus non-TNBC patients (p = 0.00001). In our multivariate analyses TNBC subtype (HR: 2.30), locally advanced stage (HR: 7.04 for stage III), lower income (HR: 1.64), or non-screening detected BC (HR: 1.32) were associated with poorer OS. Conclusion To the best of our knowledge, this is the largest LA cohort of TNBC patients. Interestingly, the proportion of TNBC among Chileans was smaller compared to similar studies within LA. As expected, TNBC patients had poorer survival and higher risk for early recurrence versus non-TNBC. Other relevant findings include a higher proportion of premenopausal patients among TNBC. Also, mid/low-income patients that received medical attention at a community hospital displayed lower survival versus private health center counterparts.
- ItemClinico-pathologic subtypes of breast cancer primary tumors are related to prognosis after recurrence(2016) Sánchez Rojel, César Giovanni; Camus Appuhn, Mauricio Gonzalo; Medina Araya, Lidia; Oddo Benavides, David; Artigas, Rocío; Pérez Sepúlveda, Alejandra Andrea; Domínguez Covarrubias, Francisco José; Razmilic Valdés, Dravna Nichi; Navarro Ortega, María Elena; Galindo A., Héctor; Acevedo Claros, Francisco Nicolás
- ItemCorrelation between Ki67 and histological grade in breast cancer patients treated with preoperative chemotherapy(2014) Petric Guajardo, Militza Paulina; Martínez Riquelme, Santiago Felipe; Acevedo Claros, Francisco Nicolás; Oddo Benavides, David; Artigas Barrenechea, Rocío; Camus Appuhn, Mauricio Gonzalo; Sánchez Rojel, César GiovanniBackground and Aim: Breast cancer (BC) is a heterogeneous disease and cell proliferation markers may help to identify subtypes of clinical interest. We here analyzed the correlation between cell proliferation determined by Ki67 and HG in BC patients undergoing preoperative chemotherapy (PCT). Materials and Methods: We obtained clinical/pathological data from patients with invasive BC treated at our institution from 1999 until 2012. Expression of estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor type 2 (HER2) and Ki67 were determined by immuno-histochemistry (IHC). Clinicopathological subtypes were defined as: Luminal A, ER and/or PR positive, HER2 negative, HG 1 or 2; Luminal B, ER and/or PR positive, HER2 negative or positive and/or HG 3; triple negative (TN), ER, PR and HER2 negative independent of HG; HER2 positive, ER, PR negative and HER2 positive, independent of HG. By using Ki67, a value of 14% separated Luminal A and B tumors, independently of the histological grade. We analyzed correlations between Ki67 and HG, to define BC subtypes and their predictive value for response to PCT. Results: 1,560 BC patients were treated in the period, 147 receiving PCT (9.5%). Some 57 had sufficient clinicopathological information to be included in the study. Median age was 52 years (26-72), with 87.7% invasive ductal carcinomas (n=50). We performed IHC for Ki67 in 40 core biopsies and 50 surgical biopsies, 37 paired samples with Ki67 before and after chemotherapy being available. There was no significant correlation between Ki67 and HG (p=0.237), both categorizing patients into different subtypes. In most cases Ki67 decreased after PCT (65.8%). Only 3 patients had pathologic complete response (cPR). Conclusions: In our experience we did not find associations between Ki67 and HG. Determination of clinicopathological luminal subtypes differs by using Ki67 or HG.
- ItemCost-minimization analysis of subcutaneous versus intravenous trastuzumab administration in Chilean patients with HER2-positive early breast cancer(2020) Rojas Orellana, Luis; Muniz, S.; Medina Araya, Lidia; Peña Durán, José Esteban; Acevedo Claros, Francisco Nicolás; Pinto Paganini, Mauricio Arturo; Sánchez Rojel, César Giovanni
- ItemEndocrine-Therapy-Resistant ESR1 Variants Revealed by Genomic Characterization of Breast-Cancer-Derived Xenografts(2013) Li, Shunqiang; Shen, Dong; Shao, Jieya; Crowder, Robert; Liu, Wenbin; Prat, Aleix; He, Xiaping; Liu, Shuying; Hoog, Jeremy; Sánchez Rojel, César Giovanni; Lu, Charles
- ItemEpigenetic activation of the prostaglandin receptor EP4 promotes resistance to endocrine therapy for breast cancer(2017) Hiken, J.; Mcdonald, J.; Decker, K.; Sánchez Rojel, César Giovanni; Hoog, J.; Vanderkraats, N.; Jung, K.; Akinhanmi M.; Rois, L.; Ellis, M.; Edwards, J.
- ItemEribulin-induced radiation recall dermatitis: a case report and brief review of the literature(2020) Tran, WT; Ibáñez Cáceres, Carolina.; Pinto, Mauricio P.; Sánchez Rojel, César Giovanni; Czarnota, GJ; Merino Lara, Tomas Rodrigo
- ItemFactors influencing the implementation of shared decision-making in breast cancer care: protocol for a mixed-methods study(2023) Bravo Valenzuela, Paulina Fabiola; Dois C., Angelina M.; Villarroel Del Pino, Luis Antonio; González Aguero, Marcela Margot; Fernandez González, Loreto; Sánchez Rojel, César Giovanni; Martínez, Alejandra; Turen Croquevielle, Valentina; Quezada, Constanza; Guasalaga María, Elisabeth; Härter, MartinChile is committed to actively involving patients in their healthcare. However, little is known about how this is translated into clinical encounters. Breast cancer (BC) is the first cause of cancer-related death in Chilean women. National policy guarantees standard care, and treatment decisions should be made along this process that can have long-term consequences for women. So, BC is a particularly well-suited case study to understand the complexity of patient participation in decision-making.