Background The ESR1 gene encodes Estrogen Receptor alpha (ERα), which plays a role in the tumourigenesis of breast cancer. A single nucleotide polymorphism (SNP) in intron 1 of this gene called ESR1 PvuII (rs2234693) has been reported to increase the risk of breast cancer. This study aimed to investigate the ESR1 PvuII polymorphism as a prognostic and predictive factor guiding the choice of therapy for advanced breast cancer. Methods This retrospective study was conducted in 104 advanced breast cancer patients at Dharmais Cancer Hospital from 2011 to 2018. The ESR1 PvuII polymorphism was analysed by Sanger sequencing of DNA from primary breast tumour samples. Results The percentages of patients with ESR1 PvuII genotypes TT, TC, and CC were 42.3, 39.4, and 18.3%, respectively. Looking at prognosis, patients with ESR1 PvuII TC + CC had shorter overall survival than those with the TT genotype [HR = 1.79; 95% CI 1.05–3.04; p = 0.032]. As a predictive marker, TC + CC was associated with shorter survival (p = 0.041), but TC + CC patients on primary hormonal therapy had a median overall survival longer than TC + CC patients on primary chemotherapy (1072 vs 599 days). Conclusion The ESR1 PvuII TC + CC genotypes confer poor prognosis in advanced breast cancer, but these genotypes could be regarded as a good predictor of the therapeutic effect of hormonal treatment.

Background: There are no data of efficacy comparison between primary systemic therapy in stage 3B and 4 breast cancer patients in Indonesia. This study compared long term outcomes of breast cancer patients treated with neoadjuvant hormonal therapy (NAHT) and those treated with neoadjuvant chemotherapy (NACT)Methods: This was a cohort study conducted from 2011 to 2017. A total of 122 patients with stage 3B and 4 breast cancer received NAHT (n = 62) or NACT (n = 60) within a 6 cycles for NACT and 6 months for NAHT were included. Patients were excluded if they had a mastectomy before treatment, were pregnant, had been given hormonal therapy or chemotherapy before, had a contra-indication of chemotherapy, had a contra-indication of salpingo-oophorectomy bilateral for premenopausal patients, and declined to enter this study. The primary outcome of this study was overall survival. The outcomes were analysed using Kaplan-Meier for survival analysis and cox proportional hazard regression to estimate the hazard ratio.Results: There was a statistically significant difference in overall survival (p = 0.038). Median overall survival for NAHT patients was 1265 days and for NACT patients was 654 days. The hazard ratio showed NACT patients had a higher risk than NAHT patients (1.7 95% CI 1.03 – 2.9). Pathological complete response rate was higher in the NACT group than in the NAHT group (3.3% vs. 0%).Conclusions: Neoadjuvant hormonal therapy was superior to neoadjuvant chemotherapy in term of overall survival.

Background: BCR-ABL1 fusion gene, which originated from t (9;22), is an important biomarker for diagnosis, therapeutic approach, and prognosis in childhood leukemia. However, there are no data in Indonesia about the profile of BCR-ABL1 fusion gene for this disease. This study intends to demonstrate the profile of the BCR-ABL1 fusion gene in childhood leukemia at “Dharmais” Cancer Hospital.Methods: This descriptive retrospective study included 79 patients with childhood leukemia who performed the BCR-ABL1 examination in “Dharmais” Cancer Hospital during 2008–2018. Demographic data, leukemia types, BCR-ABL1 examination results, and protein isoforms developed by BCR-ABL1 fusion were obtained from Cancer Registry Data.Results: Among 79 patients’ data recorded in this study, 65.8% (52/79) were male and 34.2% (27/79) were female. A total of 74.7% (59/79) patients were diagnosed with Chronic Myelogenous Leukemia (CML), 21.5% (17/79) with Acute Lymphoblastic Leukemia (ALL), and 3.8% (3/79) with Acute Myelogenous Leukemia (AML). The profile of positive BCR-ABL1 in CML patients was 72.8% (43/59). About 97.7% (42/43) of CML patients with positive BCR-ABL1 fusion gene expressed 210-kDa protein, while only 2.3% (1/43) expressed 190-kDa protein.Conclusions: This study found that, from a total of 79 respondents, 45 of them showed a positive BCR-ABL result, with details of 43 in CML and 2 in ALL. Among the total of 43 CML patients with positive BCR-ABL1, 42 (97.7%) of them expressed 210-kDa protein isoform. Further research to investigate the relationship between protein isoforms and their clinical effects may also be important to discuss. The valuable recommendation suggests that BCR-ABL1 examination should be performed for all childhood leukemia patients in Indonesia, especially for CML and ALL.

Background: Breast cancer is the most diagnosed cancer among Indonesian women. Adjuvant chemotherapy plays a crucial role in the management of early breast cancer patients, with docetaxel-based regimens as a cornerstone therapy. The Asia-Pacific breast initiative II registry was established to evaluate safety parameters of docetaxel-based regimens in the Asia-Pacific region within 2009–2013 period. The result from Indonesia population is presented in this study.Methods: This study was a part of International, longitudinal, multicenter, and observational research which included a group of consecutive early breast cancer patients with an intermediate-to-high risk of recurrence that was being treated with various docetaxel-based (anthracycline and non-anthracycline) adjuvant chemotherapy regimens during 2009–2013 in real-world clinical settings.Results: The analysis included 49 subjects (2.8% of total study population). Majority of subjects received non-anthracycline-containing regimen (79.6%). Docetaxel was mainly prescribed in combination (63.27%). Chemotherapy-related adverse events were reported in all subjects. Mean number of cycles received by subjects was 5.5 cycles with dose intensity of 23.78 mg/m2/week.Conclusions: The Indonesian result, as part of the Asia-Pacific Breast Initiative II Registry, identified some important factors that are relevant to clinical practice, including patient’s characteristics and treatment pattern of docetaxel use as adjuvant chemotherapy regimens.

Krisis blastik pada lekemia mielositik kronik (CML) bisa berasal dari lini granulosit, monosit, eritrosit, limfoid (sel B atau sel T), dan megakariositik. Krisis blastik seri limfoid biasanya berupa sel B dengan fenotipik sel Pre-B, di mana Ig permukaan belum diekspresikan. Krisis blastik dari sel T sangat jarang didapatkan. Tujuan penelitian : mendeskripsikan gambaran fenotipik, transkrip fusi bcr-abl, dan CD3 sitoplasmik, dan terminal deoxynucleotidyl transferase pada kasus-kasus CML dengan krisis blastik seri limfoid-T. Laporan kasus dari 4 kasus leukemia mielogenik kronik dengan krisis blastik sel-sel T yang dikumpulkan dalam kurun waktu 17 tahun (1987-2004). Kasus-kasus tersebut telah dilakukan pemeriksaan analisis fenotipik dan genotipik pada awal diagnosis ditegakkan. Kesemua kasus menunjukkan adanya t(9;22)(q34;q11). Sampel sel-sel mononuklear pasien yang disimpan dalam bentuk 10%DMSO diperiksa Reverse Transkripsi (RT) PCR BCR_ABL multiplex untuk mendeteksi transkrip fusi bcr-abl, PCR CD3ε untuk mendeteksi Cd3 sitoplasmik, dan PCR TdT untuk mendeteksi terminal deoxynucleotidyl transferase. Hasil analisis antigen permukaan sel pada awal diagnosis menunjukkan 1 kasus CD7+, CD5-, dan CD2-; 1 kasus CD7+, CD5+, dan CD2-; dan 2 kasus CD7+, CD5+, dan CD2+ yang menunjukkan bahwa semua sel T krisis blastik CML berada pada stadium pre dan protimik. Dua kasus menunjukkan hasil positip untuk transkrip bcr-abl b2a2, 1 kasus positip pada e1a2, dan 1 kasus negatip. RT PCR CD3ε menunjukkan hasil positip pada semua kasus dan RT PCR TdT hanya positip pada 1 kasus. Hasil yang dikumpulkan diharapkan dapat menjadi dasar analisis lebih lanjut pada kasus CML dengan krisis blastik sel-sel T.