Adenocarcinoma (ADC) of the lung is the most frequent pathology corresponding to non-small cell lung cancer (NSCLC). The advent of target therapy and the discovery of drugs that block signaling pathways related to cellular events involved in the progression of the disease have led to a better prognosis in cases of ADC. Some of the targeted therapy focuses on the blockade of epidermal growth factor receptor (EGFR), targeting mutations in exon 19 and 21, with favorable clinical outcomes. However, there is limited evidence with respect to unusual mutations as in exon 18 (g719x) and 20 (s768). In this report, we present a case of a 65-year-old female with two unusual mutations in the EGFR gene, in exon 18 (g719x) and 20 (s768i), without central nervous system (CNS) involvement; these mutations are typically resistant to standard therapy. We decided to administer osimertinib because of its favorable toxicity profile and with a view to preventing future CNS relapse.

Background: There are no comparative trials between the two most common schemes in HER2-positive early breast cancer treatment; BERENICE (with anthracyclines) and TRAIN-2 (without anthracyclines). In this study, we investigated the pathological complete response (pCR) and safety events achieved with each. Methods: This analytical retrospective observational study included 111 patients with early and locally advanced HER-2-positive breast cancer who initiated neoadjuvant treatment with an anthracycline-based scheme (four cycles of doxorubicin and cyclophosphamide, followed by four cycles of taxane, trastuzumab, and pertuzumab = AC-THP) and a non-anthracycline scheme (carboplatin, weekly paclitaxel, trastuzumab, and pertuzumab for six–nine cycles = TCbHP) at the National Cancer Institute in Colombia, between April 2020 and December 2024. The primary endpoint was the pCR. Safety was analyzed in patients who received at least one treatment cycle. Results: A total of 51 patients received AC-THP and 60 TCbHP (89.6% of which received six cycles). The pCR was 58.3% in ACHTP and 60.4% in TCbHP (p = 0.84). As a descriptive analysis, with the anthracycline-based scheme, there was a trend toward a higher pCR in patients with T3-T4, positive nodal involvement (N+), and positive hormone receptor (HR+). Cardiac toxicity events during the neoadjuvant phase were 9.8% in ACTHP and 3.3% in TCbHP. Grade 2 neuropathy events were higher in patients with the TCbHP scheme, at 23.3%, versus 9.8% in ACTHP. Conclusions: We found similar pCR rates between the schemes with anthracyclines and without anthracyclines. It is still pertinent to discuss the risk–benefit of using anthracycline-based regimens in patients with HR+, T3-T4, and N+. The cardiac adverse events reported in our patients were similar to those reported in the BERENICE trial.

Introducción: el carcinoma de seno es el de mayor incidencia y mortalidad en mujeres en el mundo y tiene gran importancia conocer cómo el estadio de la enfermedad al diagnóstico, la presencia de receptores hormonales y la sobreexpresión de HER2 afectan la sobrevida libre de la enfermedad y la sobrevida global en nuestra población. Métodos: se revisaron 228 historias clínicas de un centro oncológico de Bogotá (Colombia) de enero de 2005 a diciembre de 2013, se realizó un análisis de supervivencia con método de Kaplan-Meier, prueba log-rank y regresión de Cox. Resultados: la mediana de tiempo de seguimiento fue de 49,6 meses (4 años), el 76,8% de las pacientes se diagnosticó en estadios tempranos (I y II) y el 22,8% con sobreexpresión de HER2. La supervivencia libre de enfermedad a cinco años fue del 83,7% y la supervivencia global fue del 92,5%. El grado de diferenciación III (HR:4,11; IC 95%: 1,8-9,6), la sobreexpresión de HER2 (HR:2,41; IC 95%:1,1-5,6) y ≥4 ganglios comprometidos (HR:3,01; IC 95%:1,3-7,1) fueron factores de riesgo para recaída local o sistémica, con receptores estrogénicos positivos como factor protector (HR:0,71; IC 95%:0,01-0,46); mientras que los receptores estrogénicos positivos fueron un factor protector para muerte (HR:0,39; IC 95%:0,002-0,5). Conclusión: el grado de diferenciación, estatus de HER2 y el número de ganglios comprometidos son predictores de sobrevida libre de enfermedad, mientras que el estado de receptor hormonal es predictor de sobrevida global.

Introducción. En melanoma metastásico, uno de los estándares de tratamiento es la inmunoterapia anti-PD-1 y anti-CTLA-4. El objetivo de esta investigación fue determinar factores pronósticos asociados con la supervivencia de pacientes con melanoma metastásico, con primera línea con inmunoterapia anti-PD-1 o anti-PD-1 y anti-CTLA-4, en el Instituto Nacional de Cancerología de Colombia. Métodos. Se revisaron 63 historias clínicas del Instituto Nacional de Cancerología de enero de 2016 a abril de 2020. Se realizó un análisis de supervivencia con método de Kaplan-Meier, prueba log-rank y regresión de Cox. Resultados. La mayoría de los pacientes fueron mujeres (58,7%); 47,6% tenían subtipo lentiginoso acral, 17,4% BRAF mutado, 20,6% compromiso en SNC, 50,8% recibieron nivolumab, 41,3% pembrolizumab y 7,9% nivolumab + ipilimumab. La mediana de supervivencia libre de progresión fue de 7,3 meses, con una tasa a 1, 2 y 3 años de 38%, 22% y 12% respectivamente; la mediana de supervivencia global fue 12,2 meses con una tasa a 1, 2 y 3 años de 50%, 25% y 19%. Como factor pronóstico protector para SLP se encontró el recibir nivolumab en comparación con pembrolizumab (HR=0,427; IC95% 0,21-0,86) y para SG el estado funcional al diagnóstico (ECOG 2 HR=12,38; IC95% 2,20-69,45). Conclusión. La SLP y SG fueron menores a la de ensayos clínicos aleatorizados en población caucásica, pero similar a la encontrada en estudios que incluyen mayor proporción del subtipo histológico lentiginoso acral, como la nuestra. Se encontraron como factores pronósticos el tipo de inmunoterapia utilizada y el estado funcional al diagnóstico.

Background: Breast-conserving surgery (BCS) is one of the major surgical advances in breast cancer treatment. This study evaluated the oncological outcomes of BCS in patients with non-metastatic breast cancer at a referral cancer center in a medium-resource country between 2013 and 2019. Methods: An observational, analytical, retrospective cohort study was conducted on patients with stage I–IIIC breast cancer treated at the Instituto Nacional de Cancerología (Bogotá, Colombia) from September 2013 to March 2019. Demographic data, tumor characteristics, treatment types, and survival outcomes were retrospectively collected. Results: A total of 409 patients were included. In 64.1% of cases, BCS was performed as the initial treatment and in 35.9%, after neoadjuvant chemotherapy (NACT). With a median follow-up of 85.2 months, tumor recurrence was documented in 9.04% of patients, local recurrence in 2.9%, regional in 2.2%, and distant in 5.6%. The identified risk factors for mortality were a locally advanced clinical stage (HR 5.13; p = 0.01), triple-negative subtype (HR 8.02; p < 0.01), and nodal involvement of more than four lymph nodes in the surgical specimen (HR 4.00; p < 0.01). Conclusions: Breast-conserving surgery is an oncologically safe procedure for patients with early and locally advanced breast cancer who respond to NACT. The time to recurrence and overall survival are determined by the clinical stage, axillary tumor burden, and biological subtype of the disease.

Background: Breast‐conserving surgery (BCS) is one of the major surgical advances in breast cancer treatment. This study evaluated the oncological outcomes of BCS in patients with nonmetastatic breast cancer at a referral cancer center in a medium‐resource country between 2013 and 2019. Methods: An observational, analytical, retrospective cohort study was conducted on patients with stage I–IIIC breast cancer treated at the Instituto Nacional de Cancerología (Bogotá, Colombia) from September 2013 to March 2019. Demographic data, tumor characteristics, treatment types, and survival outcomes were retrospectively collected. Results: A total of 409 patients were included. In 64.1% of cases, BCS was performed as initial treatment, and in 35.9%, after neoadjuvant chemotherapy (NACT). With a median follow‐up of 85.2 months, tumor recurrence was documented in 9.04% of patients, local recurrence in 2.9%, regional in 2.2%, and distant in 5.6%. The identified risk factors for mortality were locally advanced clinical stage (HR 5.13; p =0.01), triple‐negative subtype (HR 8.02; p <0.01), and nodal involvement of more than four lymph nodes in the surgical specimen (HR 4.00; p <0.01). Conclusions: Breast‐conserving surgery is an oncologically safe procedure for patients with early and locally advanced breast cancer who respond to NACT. Time to recurrence and overall survival are determined by the clinical stage, axillary tumor burden, and biological subtype of the disease.