SEOM–GEICAM–SOLTI clinical guidelines in advanced breast cancer (2022)

Advanced breast cancer represents a challenge for patients and for physicians due its dynamic genomic changes yielding to a resistance to treatments. The main goal is to improve quality of live and survival of the patients through the most appropriate subsequent therapies based on the knowledge of the natural history of the disease. In these guidelines, we summarize current evidence and available therapies for the medical management of advanced breast cancer

Osteonecrosis of the jaw as an adverse bisphosphonate event : Three cases of bone metastatic prostate cancer patients treated with zoledronic acid

Bisphosphonates offer a significant improvement in the quality of life for cancer patients; these potent inhibitors of bone resorption have been shown to markedly reduce the morbidity frequently resulting from bone metastases. Despite the success of bisphosphonates as therapeutic agents, however, toxicity in the form of osteonecrosis of the jaw (ONJ) is a rare complication whose incidence rate has climbed in recent years. ONJ is defined as an unexpected development of necrotic bone in the oral cavity, and is commonly associated with administration of the bisphosphonates Pamidronate and Zoledronate. Clinical features include local pain, soft-tissue swelling, and/or loose teeth; ONJ is also often correlated with previous dental procedures, such as tooth extractions, during biphosphonate therapy. Although additional risk factors--such as corticosteroids, chemotherapy, radiotherapy, trauma or infection?exhibit etiological associations with ONJ, the real pathobiology has not yet been fully elucidated. Here we report our findings on all 2005 OJN cases presented at our institution resulting from bone metastatic prostate cancer treated with zoledronic acid. The incidence of ONJ is nearly 3% (3 out of 104) in these patients

Procedimiento para el tratamiento de aguas residuales con fluoruros mediante obtención de fluoruro cálcico sintético.

Procedimiento para el tratamiento de aguas residuales con fluoruros mediante obtención de fluoruro cálcico sintético a partir de aguas residuales fluoradas se basa en la precipitación de fluoruro cálcico en un reactor de lecho fluidizado utilizando hidróxido cálcico como reactivo sin necesidad de ajuste de pH. La precipitación se produce sobre la superficie de partículas de carbonato cálcico contenidas en un reactor en el que se mantienen fluidizadas. La utilización de carbonato cálcico de pequeño tamaño de partícula como material de siembra de acuerdo a este procedimiento, permite la obtención de un producto precipitado caracterizado por tener una alta riqueza en fluoruro cálcico. El fluoruro cálcico obtenido presenta unas características adecuadas óptimas para su reutilización como materia prima en la fabricación de ácido fluorhídrico dada su baja humedad y contenido en sílice.Solicitud: 200501324 (26.05.2005)Nº Pub. de Solicitud: ES2270705A1 (01.04.2007)Nº de Patente: ES2270705B1 (01.06.2008

Review of concepts in therapeutic decision-making in HER2-negative luminal metastatic breast cancer

Purpose: Hormone receptor (HR)-positive, Human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) requires a therapeutic approach that takes into account multiple factors, with treatment being based on anti-estrogen hormone therapy (HT). As consensus documents are valuable tools that assist in the decision-making process for establishing clinical strategies and optimize the delivery of health services, this consensus document has been created with the aim of developing recommendations on cretiera for hormone sensitivity and resistance in HER2-negative luminal MBC and facilitating clinical decision-making. Methods: This consensus document was generated using a modification of the RAND/UCLA methodology, which included the definition of the project and identification of issues of interest, a non-exhaustive systematic review of the literature, an analysis and synthesis of the scientific evidence, preparation of recommendations, and external evaluation with a panel of 64 medical oncologists specializing in breast cancer. Results: A Spanish panel of experts reached consensus on 32 of the 32 recommendations/conclusions presented in the first round and were accepted with an approval rate of 100% about definition of metastatic disease not susceptible to local curative treatment, definition of hormone sensitivity and hormone resistance in metastatic luminal disease and therapeutic decision-making. Conclusion: We have developed a consensus document with recommendations on the treatment of patients with HER2-negative luminal MBC that will help to improve therapeutic benefits

Three decades of remote sensing analysis of forest decline related to climate change

Climate change is predicted to lead to increasingly intense and hotter droughts, causing physiological weakness followed by forest decline in many regions of the world. Long- and short-range remote sensing (satellites and unmanned aerial vehicles, commonly called drones) can sense drought-induced changes in vegetation. Although several studies have addressed forest decline events, none have analyzed the forest decline attributable to climate change using remote sensing in a concise manner. A bibliometric analysis was carried out to characterize the scientific production reported in the Web of Science repository. The search descriptors were a combination of keywords related to forest decline and remote sensing. The results showed 278 articles published between 1989 and 2021 in 92 journals, with an average annual increase of 31%. A total of 29 nodes and 220 scientific collaboration links were located, mainly led by researchers from USA, Germany and China. Keyword analysis using World-TreeMap reflected the association of different key forest decline phenomena such as drought stress and climate change. Although the use of satellite information to study and understand forest decline has been reported for just over three decades, the most notable feature of the present research was the limited role of drones with only 5 studies. This reveals an area of opportunity to take advantage of the main strengths of drones, i.e., spatial and temporal resolution, low cost compared to manned flights, and centimeter accuracy. Therefore, it is strongly recommended to increase studies to improve the use of multispectral sensors, thermal and LiDAR technology for long-term monitoring of forest decline related to climate change

GEICAM Guidelines for the Management of Patients with Breast Cancer During the COVID-19 Pandemic in Spain

Breast cancer (BC) is the most common cancer in women in Spain. During the COVID-19 pandemic caused by the SARSCoV-2 virus, patients with BC still require timely treatment and follow-up; however, hospitals are overwhelmed with infected patients and, if exposed, patients with BC are at higher risk for infection and serious complications if infected. Thus, health care providers need to evaluate each BC treatment and in-hospital visit to minimize pandemic-associated risks while maintaining adequate treatment efficacy. Here we present a set of guidelines regarding available options for BC patient management and treatment by BC subtype in the context of the COVID-19 pandemic. Owing to the lack of evidence about COVID-19 infection, these recommendations are mainly based on expert opinion, medical organizations’ and societies’ recommendations, and some published evidence. We consider this a useful tool to facilitate medical decision making in this health crisis situation we are facing

Primary breast cancer and health related quality of life in Spanish women: The EpiGEICAM case-control study

This study evaluates the impact of breast cancer (BC) in health related quality of life (HRQL) and in psychological distress (PD) during the initial phases of the disease and looks for contributing factors. A multicentric case-control study, EpiGEICAM, was carried out. Incident BC cases and age- and residence- matched controls were included. Clinical, epidemiological, HRQL (SF-36) and PD information (GHQ-28) was collected. We used multivariable logistic regression models to estimate OR of low HRQL and of PD in cases compared to controls, and to identify factors associated with low HRQL and with PD. Among 896 BC cases and 890 control women, cases had poorer scores than both, the reference population and the control group, in all SF-36 scales. BC women with lower education, younger, active workers, never smokers, those with comorbidities, in stage IV and with surgical treatment had lower physical HRQL; factors associated with low mental HRQL were dissatisfaction with social support, being current smoker and having children. Cases had a fivefold increased odds of PD compared to controls. Managing comorbidities and trying to promote social support, especially in younger and less educated women, could improve well-being of BC patients

Trajectories of alcohol consumption during life and the risk of developing breast cancer

Background Whether there are lifetime points of greater sensitivity to the deleterious effects of alcohol intake on the breasts remains inconclusive. Objective To compare the influence of distinctive trajectories of alcohol consumption throughout a woman's life on development of breast cancer (BC). Methods 1278 confirmed invasive BC cases and matched (by age and residence) controls from the Epi-GEICAM study (Spain) were used. The novel group-based trajectory modelling was used to identify different alcohol consumption trajectories throughout women's lifetime. Results Four alcohol trajectories were identified. The first comprised women (45%) with low alcohol consumption (= 15 g/day), never having a low alcohol consumption. Comparing with the first trajectory, the fourth doubled BC risk (OR 2.19; 95% CI 1.27, 3.77), followed by the third (OR 1.44; 0.96, 2.16) and ultimately by the second trajectory (OR 1.17; 0.86, 1.58). The magnitude of BC risk was greater in postmenopausal women, especially in those with underweight or normal weight. When alcohol consumption was independently examined at each life stage, >= 15 g/day of alcohol consumption in adolescence was strongly associated with BC risk followed by consumption in adulthood. Conclusions The greater the alcohol consumption accumulated throughout life, the greater the risk of BC, especially in postmenopausal women. Alcohol consumption during adolescence may particularly influence BC risk.This study was funded by the Fundacion Cientifica Asociacion Espanola Contra el Cancer (AECC) (Scientific Foundation of the Spanish Association against Cancer 2006 & 2016) (Marina Pollan), Sociedad Espanola de Oncologia Medica (SEOM) (Spanish Society of Medical Oncology) (Miguel Martin), Scholarship 'Contrato de atraccion de talento' from Community of Madrid (Carolina Donat-Vargas), Fundacion Cerveza y Salud 2005 (Beer and Health Foundation 2005) (Miguel Martin) and Federacion de Asociaciones de Mujeres con Cancer de Mama (FECMA) (Spanish Federation of Associations of Women with Breast Cancer) (Miguel Martin, Marina Pollan)

Breast cancer PAM50 signature: correlation and concordance between RNA-Seq and digital multiplexed gene expression technologies in a triple negative breast cancer series

[Background]: Full RNA-Seq is a fundamental research tool for whole transcriptome analysis. However, it is too costly and time consuming to be used in routine clinical practice. We evaluated the transcript quantification agreement between RNA-Seq and a digital multiplexed gene expression platform, and the subtype call after running the PAM50 assay in a series of breast cancer patients classified as triple negative by IHC/FISH. The goal of this study is to analyze the concordance between both expression platforms overall, and for calling PAM50 triple negative breast cancer intrinsic subtypes in particular.[Results]: The analyses were performed in paraffin-embedded tissues from 96 patients recruited in a multicenter, prospective, non-randomized neoadjuvant triple negative breast cancer trial (NCT01560663). Pre-treatment core biopsies were obtained following clinical practice guidelines and conserved as FFPE for further RNA extraction. PAM50 was performed on both digital multiplexed gene expression and RNA-Seq platforms. Subtype assignment was based on the nearest centroid classification following this procedure for both platforms and it was concordant on 96% of the cases (N = 96). In four cases, digital multiplexed gene expression analysis and RNA-Seq were discordant. The Spearman correlation to each of the centroids and the risk of recurrence were above 0.89 in both platforms while the agreement on Proliferation Score reached up to 0.97. In addition, 82% of the individual PAM50 genes showed a correlation coefficient > 0.80.[Conclusions]: In our analysis, the subtype calling in most of the samples was concordant in both platforms and the potential discordances had reduced clinical implications in terms of prognosis. If speed and cost are the main driving forces then the preferred technique is the digital multiplexed platform, while if whole genome patterns and subtype are the driving forces, then RNA-Seq is the preferred method.M.M was supported by two research grants from Ministry of Economy and Competitiveness ISCIII-FIS grants (PI 12/02684): “Predictores genómicos de respuesta a la quimioterapia neoadyuvante con docetaxel-carboplatino en pacientes con cáncer de mama triple negativo”/“Genomic predictors of response to neoadjuvant chemotherapy with docetaxel-carboplatin in patients with triple negative breast cancer”; and (PI 15/00117): “Cáncer de mama triple negative: Predicción de respuesta a docetaxel-carboplatino neoadyuvante mediante caracterización de TILs y firmas inmunes basadas en secuenciación masiva de RNA”/” Triple negative breast cancer: Prediction of response to neoadjuvant docetaxel-carboplatin by characterization of TILs and immune signatures based on massive RNA sequencing”. C.M.P was supported by funds from the NCI Breast SPORE program (P50-CA58223).Peer reviewe

Filtros suavizadores en imágenes sintéticas de resonancia magnética cerebral: un estudio comparativo

This paper presents the evaluation of two computational techniques for smoothing noise that might be present in synthetic images or numerical phantoms of magnetic resonance (MRI). The images that will serve as the databases (DB) during the course of this evaluation are available freely on the Internet and are reported in specialized literature as synthetic images called BrainWeb. The images that belong to this DB were contaminated with Rician noise, this being the most frequent type of noise in real MRI images. Also, the techniques that are usually considered to minimize the impact of Rician noise on the quality of BrainWeb images are matched with the Gaussian filter (GF) and an anisotropic diffusion filter, based on the gradient of the image (GADF). Each of these filters has 2 parameters that control their operation and, therefore, undergo a rigorous tuning process to identify the optimal values that guarantee the best performance of both the GF and the GADF. The peak of the signal-to-noise ratio (PSNR) and the computation time are considered as key elements to analyze the behavior of each of the filtering techniques applied. The results indicate that: a) both filters generate PSNR values comparable to each other. b) The GF requires a significantly shorter computation time to soften the Rician noise present in the considered DB. Keywords: Synthetic Cerebral images, Magnetic resonance, Rician noise, Gaussian filter, Anisotropic diffusion filter, PSNR.Este artículo presenta la evaluación de dos técnicas computacionales para el suavizado de ruido, que puede estar presente en imágenes sintéticas o phantoms numéricos de resonancia magnética (MRI). Las imágenes que servirán como bases de datos (DB) para el desarrollo de la mencionada evaluación están disponibles, de manera libre, en la Internet y se reportan, en la literatura especializada, como imágenes sintéticas denominadas BrainWeb. Las imágenes pertenecientes a esta DB fueron contaminadas con ruido Riciano debido a que este es el tipo de ruido más frecuente en imágenes de MRI reales. Por otra parte, las técnicas consideradas para minimizar el impacto de este ruido, en la calidad de las imágenes de la BrainWeb, se hacen coincidir con el filtro Gausiano (GF) y un filtro de difusión anisotrópica, basado en el gradiente de la imagen (GADF). Cada uno de estos filtros posee 2 parámetros que controlan su funcionamiento y, por ende, deben someterse a un proceso de entonación riguroso para identificar los valores óptimos que garanticen el mejor desempeño tanto del GF como del GADF. El pico de la relación señal a ruido (PSNR) y el tiempo de cómputo son considerados como elementos clave para analizar el comportamiento de cada una de las técnicas de filtrado aplicadas. Los resultados indican que: a) Ambos filtros generan valores de PSNR comparables entre sí. b) El GF requiere de un tiempo de cómputo, significativamente, menor para suavizar el ruido Riciano presente en la DB considerada. Palabras clave: Imágenes sintéticas cerebrales, Resonancia magnética, Ruido Riciano, Filtro Gausiano, Filtro de difusión anisotrópica, PSNR