‎Asociace trojité pozitivity s prognostickými parametry a celkové přežití v populační studii 6 122 pacientů s her2 pozitivním karcinomem prsu: analýza reálné klinické praxe na základě výzkumné databáze‎

Triple-positive breast cancer (TPBC), i.e. HER2-positive (HER2+) and hormone receptors-positive breast cancer, is a specific subgroup of breast cancers. TPBC biology is characterized by strong mutual interactions between signaling pathways stimulated by estrogens and HER2 amplification. The present study aims to carry out a population-based analysis of treatment outcomes in a cohort of hormone receptor (HR) positive and negative breast cancer patients who were treated with anti-HER2 therapy in the Czech Republic. The BREAST research database was used as the data source for this retrospective analysis. The database covers approximately 95% of breast cancer patients treated with targeted therapies in the Czech Republic. The analysis included 6,122 HER2-positive patients. The patients were divided into two groups, based on estrogen receptor (ER) or progesterone receptor (PR) positivity: hormone receptor negative (HR-) patients had both ER- and PR-negative tumors (n=2,518), unlike positive (HR+) patients (n=3,604). HR+ patients were more often diagnosed premenopausal at the time of diagnosis, presented more often at stage I or II and their tumors were less commonly poorly differentiated. The overall survival (OS) was significantly higher in subgroups of HR+ patients according to treatment setting. When evaluated by stages, significantly higher OS was observed in HR+ patients diagnosed at stages II, III, and IV and regardless of tumor grade.Trojnásobně pozitivní karcinom prsu (TPBC), tj. HER2 pozitivní (HER2+) a hormonálně pozitivní karcinom prsu pozitivní na hormonální receptory, je specifickou podskupinou karcinomů prsu. Biologie TPBC je charakterizována silnými vzájemnými interakcemi mezi signálními cestami stimulované estrogeny a amplifikací HER2. Cílem této studie je provést populační analýzu výsledků léčby v kohortě pacientů s pozitivním a negativním karcinomem prsu s hormonálním receptorem (HR), kteří byli v České republice léčeni anti-HER2 terapií. Jako zdroj dat pro tuto retrospektivní analýzu byla použita výzkumná databáze BREAST. Databáze pokrývá přibližně 95 % pacientů s karcinomem prsu léčených cílenými terapiemi v České republice. Analýza zahrnovala 6 122 her2 pozitivních pacientů. Pacienti byli rozděleni do dvou skupin na základě pozitivity estrogenového receptoru (ER) nebo progesteronového receptoru (PR): pacienti s negativním hormonálním receptorem (HR-) měli nádory s ER i PR negativním nádorem (n=2 518), na rozdíl od pozitivních (HR+) pacientů (n=3 604). Hr+ pacientům byla v době diagnózy častěji diagnostikována premenopauza, častěji se prezentovala ve fázi I nebo II a jejich nádory byly méně často špatně diferencovány. Celkové přežití (OS) bylo významně vyšší v podskupinách pacientů s HR+ podle nastavení léčby. Při hodnocení podle fází byl pozorován významně vyšší OS u pacientů s HR+ diagnostikovaných ve stadiích II, III a IV a bez ohledu na stupeň nádoru.

Abstracts of the 33rd Annual Meeting of the Italian Society of Uro-Oncology (SIUrO)

Background: The upfront treatment of metastatic renal cell carcinoma (mRCC) has been revolutionized by the introduction of immune-based combinations. The role of cytoreductive nephrectomy (CN) in these patients is still debated. The ARON-1 study (NCT05287464) was designed to globally analyze real-world data of patients with mRCC receiving first-line immuno-oncology combinations. This sub-analysis was focused on the role of upfront or delayed partial or radical CN in three geographical areas (Western Europe, Eastern Europe, America/Asia). Patients and Methods: We conducted a multicenter retrospective observational study in patients with mRCC treated with firstline immune-based combinations from 55 centers in 19 countries. From 1,152 patients in the ARON-1 dataset, we selected 651 patients with de novo mRCC; 255 patients (39%) had undergone CN, partial in 14% and radical in 86% of cases; 396 patients (61%) received first-line immunebased combinations without previous nephrectomy. The primary endpoint was overall survival (OS) while progression-free survival (PFS) and the tumor response rate were secondary endpoints. Results: Median OS from the diagnosis of de novo mRCC was 41.6 months and not reached (NR) for the CN subgroup and 24.0 months for the no CN subgroup, (p<0.001). Median OS from the start of first-line therapy was NR in patients who underwent CN and 22.4 months in the no CN subgroup (p<0.001). Median OS was longer for patients who underwent CN compared to those who did not in all three geographical areas (Western Europe: NR vs. 23.7 months, p<0.001; Eastern Europe: NR vs. 29.8 months, p=0.005; America/Asia: 57.3 months vs. 25.5 months, p<0.001, respectively). Conclusion: No significant differences in terms of patients’ outcomes seem to clearly emerge from our analysis, even though the CN rate and the choice of the type of first-line immune-based combination varied across the different Cancer Centers participating in the ARON-1 project

Geographical differences in the management of metastatic de novo renal cell carcinoma in the era of immune-combinations

Background: The upfront treatment of metastatic renal cell carcinoma (mRCC) has been revolutionized by the introduction of immune-based combinations. The role of cytoreductive nephrectomy (CN) in these patients is still debated. The ARON-1 study (NCT05287464) was designed to globally analyze real-world data of mRCC patients receiving first-line immuno-oncology combinations. This sub-analysis is focused on the role of upfront or delayed partial or radical CN in three geographical areas (Western Europe, Eastern Europe, America/Asia). Methods: We conducted a multicenter retrospective observational study in mRCC patients treated with first-line immune combinations from 55 centers in 19 countries. From 1152 patients in the ARON-1 dataset, we selected 651 patients with de novo mRCC. 255 patients (39%) had undergone CN, partial in 14% and radical in 86% of cases; 396 patients (61%) received first-line immune-combinations without previous nephrectomy. Results: Median overall survival (OS) from the diagnosis of de novo mRCC was 41.6 months and not reached (NR) in the CN subgroup and 24.0 months in the no CN subgroup, respectively (P<0.001). Median OS from the start of first-line therapy was NR in patients who underwent CN and 22.4 months in the no CN subgroup (P<0.001). Patients who underwent CN reported longer OS compared to no CN in all the three geographical areas. Conclusions: No significant differences in terms of patients' outcome seem to clearly emerge, even if the rate CN and the choice of the type of first-line immune-based combination varies across the different Cancer Centers participating in the ARON-1 project