Identificación de los factores clínico-patológicos relacionados con la obtención de la respuesta completa patológica en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante. Validación del Residual Cancer Burden (RCB) como factor pronóstico

El objetivo primario de esta tesis es la validación externa de in índice de evaluación de la respuesta patológica tras la administración de quimioterapia neoadyuvante denominado Residual Cancer Burden y su comparación con otros sistemas de valoración de la respuesta patológica, el RDBN y el Sistema Miller & Payne.Este trabajo ha permitido demostrar que RCB es in factor pronóstico independiente relacionado con la supervivencia global y la supervivencia libre de enfermedad, tanto en el aálisis univariante como multivariante. Además, RCB ha demostrado tener in mayor valor pronóstico en relación con SG y SLE en comparación con RDBN y el Sistema de Miller & Payne, siendo estas diferencias estadísticamente significativas en la comparación con este ultimo índice

Early distant relapse after optimal local control in locally advanced rectal cancer

We present a case of locally advanced rectal cancer with initial optimal local control after neoadjuvant concurrent chemoradiotherapy followed by surgery; early liver recurrence then occurred and was treated again with curative intent with neoadjuvant combination chemotherapy followed by liver surgery. We reflect on this difficult problem and discuss relevant topics to this case report

Pre- and Post-Neoadjuvant Clinicopathological Parameters Can Help in the Prognosis and the Prediction of Response in HER2+ and Triple Negative Breast Cancer

Neoadjuvant treatment (NAT) is one of the most widely used options for HER2+ and triple negative (TN) early breast cancer (BC). Since around half of the patients treated with NAT do not achieve a pathologically complete response (pCR), biomarkers to predict resistance are urgently needed. The correlation of clinicopathological factors with pCR was studied in 150 patients (HER2 = 81; TN = 69) and pre- and post-NAT differences in tumour biomarkers were compared. Low estrogen receptor (ER) expression, high tumour-infiltrating lymphocytes (TILs) and low cT-stage were associated with pCR in HER2+ tumours (p = 0.022; p = 0.032 and p = 0.005, respectively). Furthermore, ER expression was also associated with residual cancer burden (RCB; p = 0.046) in the HER2+ subtype. Similarly, pre-NAT, low progesterone receptor expression (PR; 1–10%) was associated with higher RCB (p < 0.001) in TN tumours. Only clinical and pathological T-stage (cpT-stage) had prognostic capacity in HER2+ tumours, whereas pre-NAT cpT-stage and post-NAT TILs had this capacity for the prognosis of TN tumours. We conclude that ER and PR expression may help predict response to NAT in HER2 and TN BC and should be taken into account in residual tumours. Also, changes observed in the phenotype after NAT suggest the need to reevaluate biomarkers in surviving residual tumour cells