Outcomes of Hispanic women with lymph-node positive, HER2 positive breast cancer treated with neoadjuvant chemotherapy and trastuzumab in Mexico

Villarreal‐Garza, Cynthia; Soto‐Pérez‐de‐Celis, Enrique; Sifuentes, Erika; Ruano, Santiago; Baez-Revueltas, Berenice; Lara‐Medina, Fernando; Arce-Salinas, Claudia; Alvarado‐Miranda, Alberto; Chávarri‐Guerra, Yanin; Caro-Sánchez, Claudia Haydeé Saraí; Castañeda-Soto, Noel; Bargalló-Rocha, Enrique; Mohar, Alejandro

doi:10.1016/j.breast.2015.01.011

Cited by 9 publications

(6 citation statements)

References 23 publications

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“…Survival was better in patients with ypT0-is and ypN0 than in those with residual invasive disease (p < 0.01). Response rates to trastuzumab-based neoadjuvant chemotherapy in Hispanics mimic that of other ethnic groups [97].…”

Section: Hormonotherapy and Anti-her2 Therapymentioning

confidence: 95%

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Genetics, Tumor Features and Treatment Response of Breast Cancer in Latinas

Castañeda

Castillo

Villarreal‐Garza

et al. 2018

Breast Cancer Manag.

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Practice pointsr Latinas with breast cancer have been associated with lower prevalence and higher mortality rates. r The access to healthcare system for Latinas has been described as lower than for white women. r Rates of grade III and triple-negative phenotype breast cancer are higher for Latinas than for white women. r BRCA mutation prevalence appears to be higher in Latinas than white women in the American population. r Distribution of BRCA mutation differs by country in Central, Latin America or Caribbean and recurrent mutations have been described in Mexico. r Finally, evaluated information about treatment efficacy and toxicity in Latinas with breast cancer indicate similar effects than in the white race.Breast cancer is a heterogeneous and genetic disease that has variability according to ethnicity and race with respect to incidence, clinical characteristics and prognosis. The incidence of breast cancer is lower but mortality is higher in Latinas than Caucasians in the US series. Risk factors appear to have different prevalence and impact in Latinas. Breast cancer in Latinas has particular clinic-pathological features including younger age, higher rates of triple-negative subtype and advanced stages. Molecular studies find that Latinas from every region have a specific BRCA incidence and a recurrent mutation, as well as differences in activity of molecular pathways. Treatment response rates and toxicity have also been compared, and no difference was found between Latinas and other ethnic groups.

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Section: Hormonotherapy and Anti-her2 Therapymentioning

confidence: 95%

“…Villarreal-Garza et al reported the outcomes of neoadjuvant trastuzumab in Mexican women with HER2+ disease [97]. A total of 109 (48.8%) patients achieved pCR.…”

Section: Hormonotherapy and Anti-her2 Therapymentioning

confidence: 99%

Genetics, Tumor Features and Treatment Response of Breast Cancer in Latinas

Castañeda

Castillo

Villarreal‐Garza

et al. 2018

Breast Cancer Manag.

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“…114 The electronic literature search conducted to inform this section of the neoadjuvant therapy guideline identified 14 articles (from a total of 101 abstracts) on the topic of health disparities. 88,[115][116][117][118][119][120][121][122][123][124][125][126][127] The available studies evaluated associations between a range of clinical and sociodemographic factors and the use and outcomes of neoadjuvant therapy for breast cancer. Killelea et al, 122 for example, examined racial differences in the frequency and outcomes of neoadjuvant chemotherapy use and reported that neoadjuvant chemotherapy was given more frequently to African American, Hispanic, and Asian women than to White women (P 5 .001).…”

Section: Health Disparitiesmentioning

confidence: 99%

Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline

Korde

Somerfield

Carey

et al. 2021

JCO

573

336

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PURPOSE To develop guideline recommendations concerning optimal neoadjuvant therapy for breast cancer. METHODS ASCO convened an Expert Panel to conduct a systematic review of the literature on neoadjuvant therapy for breast cancer and provide recommended care options. RESULTS A total of 41 articles met eligibility criteria and form the evidentiary basis for the guideline recommendations. RECOMMENDATIONS Patients undergoing neoadjuvant therapy should be managed by a multidisciplinary care team. Appropriate candidates for neoadjuvant therapy include patients with inflammatory breast cancer and those in whom residual disease may prompt a change in therapy. Neoadjuvant therapy can also be used to reduce the extent of local therapy or reduce delays in initiating therapy. Although tumor histology, grade, stage, and estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) expression should routinely be used to guide clinical decisions, there is insufficient evidence to support the use of other markers or genomic profiles. Patients with triple-negative breast cancer (TNBC) who have clinically node-positive and/or at least T1c disease should be offered an anthracycline- and taxane-containing regimen; those with cT1a or cT1bN0 TNBC should not routinely be offered neoadjuvant therapy. Carboplatin may be offered to patients with TNBC to increase pathologic complete response. There is currently insufficient evidence to support adding immune checkpoint inhibitors to standard chemotherapy. In patients with hormone receptor (HR)-positive (HR-positive), HER2-negative tumors, neoadjuvant chemotherapy can be used when a treatment decision can be made without surgical information. Among postmenopausal patients with HR-positive, HER2-negative disease, hormone therapy can be used to downstage disease. Patients with node-positive or high-risk node-negative, HER2-positive disease should be offered neoadjuvant therapy in combination with anti-HER2-positive therapy. Patients with T1aN0 and T1bN0, HER2-positive disease should not be routinely offered neoadjuvant therapy. Additional information is available at www.asco.org/breast-cancer-guidelines .

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“…Villarreal-Garza et al analyzed Hispanic women with HER2-positive breast cancer in Mexico treated with trastuzumab-based neoadjuvant chemotherapy (NACT), and showed that pCR rates mirror the rates of other ethnicities and further concluded that healthcare access to appropriate therapy rather than ethnicity has the greatest influence on breast cancer prognoses [10]. Another noteworthy study by Killelea et al used the National Cancer Database from 2010 to 2011 to identify potential racial differences in women being treated for stage I to III breast cancer [11].…”

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of HER2+ Breast Cancer Outcomes at a County Hospital: Do Published Outcomes Hold up in the Real World?

Tareen

Rodríguez

Bolos

2020

Cureus

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Introduction: Landmark trials repeatedly demonstrate that pertuzumab and trastuzumab plus standard chemotherapy have the best outcomes in human epidermal growth factor receptor 2 (HER2) positive breast cancer in the neoadjuvant, adjuvant, and metastatic setting. However, many of these multicenter landmark trials lack diversity and studied largely Caucasian populations. Our goal is to address this underrepresentation of minorities, and compare pathologic complete response (pCR) rates in our predominantly Hispanic population with HER2 positive breast cancer receiving the same neoadjuvant chemotherapy (NACT) at Olive View-UCLA Medical Center (OVMC) to that of pCR rates observed in the TRYPHAENA trial.Methods: For this retrospective cohort study, we compiled a list of 53 patients aged 18 and older, 52 female and 1 male, with HER2 positive breast cancer identified by fluorescence in situ hybridization treated at OVMC from December 2015 to May 2018. Our population was 57% Hispanic, 13% white, 13% Filipino, 11% Asian, 2% black, and 4% other. The complete list included patients receiving standard neoadjuvant, adjuvant, and metastatic chemotherapy regimens. We analyzed 23 female patients with HER2 positive breast cancer staged I to IIIC, receiving standard NACT (docetaxel, carboplatin, trastuzumab, and pertuzumab). Metastatic HER2 positive breast cancer patients were excluded. The primary outcome studied was pCR rates after receiving NACT. pCR was defined as the absence of invasive cancer cells from tissue samples removed after surgery. Secondary outcomes measured were side effects of chemotherapy. pCR rates and side effects were compared to TRYPHAENA. Data regarding insurance status, breast cancer detection modality, and time to seek medical attention were recorded.Results: 50% of our patients who received NACT achieved pCR. Our pCR rates mirrored those observed in the TRYPHAENA trial (51.9%). The most common side effect observed in our population was diarrhea. A higher proportion (37.5%) of our patients had liver function test (LFT) elevation compared to the TRYPHAENA trial (3.9%). Baseline LFTs were normal prior to treatment in 96% of patients. In terms of modality of detection, 70% were self-palpated, 26% were detected through routine mammography, and 4% were found incidentally. Average time from mass discovery to seeking medical attention was 3.4 months. Only 26% had medical insurance at diagnosis. Although not included in our study, 28% of our patients were initially diagnosed with stage IV metastatic disease.Conclusion: Our study found that pCR rates in our primarily Hispanic population compared well to the response rates observed in landmark trials with largely Caucasian populations. Genetic variations in chemosensitivity may have a minimal influence on cancer care outcomes in this population.

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Outcomes of Hispanic women with lymph-node positive, HER2 positive breast cancer treated with neoadjuvant chemotherapy and trastuzumab in Mexico

Cited by 9 publications

References 23 publications

Genetics, Tumor Features and Treatment Response of Breast Cancer in Latinas

Genetics, Tumor Features and Treatment Response of Breast Cancer in Latinas

Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline

Retrospective Analysis of HER2+ Breast Cancer Outcomes at a County Hospital: Do Published Outcomes Hold up in the Real World?

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