Publication: Identificación de predictores de respuesta a quimioterapia neodayuvante con carboplatino-docetaxel de pacientes con cáncer de mama triple negativo
Loading...
Files
Official URL
Full text at PDC
Publication Date
2018-11-21
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
El cáncer de mama triple negativo (CMTN) representa el 15-20% de los cánceres de mama diagnosticados, y se caracteriza por una gran agresividad y un peor pronóstico a largo plazo. En las pacientes diagnosticadas en estadios localizados, este mal pronóstico se centra fundamentalmente en las pacientes que no alcanzan una buena respuesta tras quimioterapia neoadyuvante (QTNA), ya que la obtención de una respuesta patológica completa (pCR) tras QTNA se asocia a un excelente pronóstico a largo plazo. Con los tratamientos actuales y la incorporación de las sales de platino al tratamiento, se obtienen pCR en alrededor del 50% de las pacientes.La clasificación del cáncer de mama en subtipos intrínsecos mediante el análisis de expresión génica (PAM50) ha aportado información valiosa sobre la biología de esta enfermedad. El CMTN, definido por parámetros IHQ, es un diagnóstico de exclusión que engloba una enfermedad heterogénea. Aunque tradicionalmente se equiparó la definición de TN a basal-like por PAM50, hay evidencia de que ambos términos no son superponibles, y que sólo el 70-80% de los CMTN son basal-like. Además, han surgido nuevas clasificaciones moleculares específicas para el CMTN como el TNBCtype-4 de Lehmann. Por otro lado, un porcentaje significativo de pacientes presentan mutaciones en los genes de recombinación homóloga o en sus vías relacionadas, con una potencial implicación en la respuesta a QTNA...
Triple-negative breast cancer (TNBC) accounts for 15 to 20% of newly-diagnosed breast cancer, and is characterized by an aggressive course and poor prognosis. This detrimental prognosis in early-stage TNBC is mainly derived from patients not achieving a satisfactory response to neoadjuvant chemotherapy (NACT), as pathological complete response (pCR) has been strongly correlated with an excellent long-term survival. Currently, around 50% of the patients will achieve a pCR with the available neoadjuvant regimens.Gene expression profiling identified 4 breast cancer intrinsic subtypes, with valuable biologic and prognostic information. TNBC is a diagnosis of exclusion encompassing a heterogenous disease, and, although TNBC and basal-like (BL) were initially considered as synonymous, only 70 to 80% of TNBC are in fact BL. New molecular classifications specific for TNBC have arisen in the last years aiming to decipher TNBC heterogeneity, such as the TNBCtype-4 by Lehmann et al. In addition, a significant proportion of TNBC patients harbor germline mutations in homologous recombination genes, which may play a role in determining response to NACT...
Triple-negative breast cancer (TNBC) accounts for 15 to 20% of newly-diagnosed breast cancer, and is characterized by an aggressive course and poor prognosis. This detrimental prognosis in early-stage TNBC is mainly derived from patients not achieving a satisfactory response to neoadjuvant chemotherapy (NACT), as pathological complete response (pCR) has been strongly correlated with an excellent long-term survival. Currently, around 50% of the patients will achieve a pCR with the available neoadjuvant regimens.Gene expression profiling identified 4 breast cancer intrinsic subtypes, with valuable biologic and prognostic information. TNBC is a diagnosis of exclusion encompassing a heterogenous disease, and, although TNBC and basal-like (BL) were initially considered as synonymous, only 70 to 80% of TNBC are in fact BL. New molecular classifications specific for TNBC have arisen in the last years aiming to decipher TNBC heterogeneity, such as the TNBCtype-4 by Lehmann et al. In addition, a significant proportion of TNBC patients harbor germline mutations in homologous recombination genes, which may play a role in determining response to NACT...
Description
Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 25/09/2017