Background: Triple-negative breast cancer (TNBC) is a heterogeneous disease with aggressive biology and complex tumor evolution. Our purpose was to identify enrichment patterns of genomic alterations in metastatic triple-negative breast cancer (mTNBC). Methods: Genomic data were retrieved (mutations and copy number variations) from 550 primary TNBC tumors from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) and The Cancer Genome Atlas (TCGA) data sets and 58 mTNBC tumors from “Mutational Profile of Metastatic Breast Cancers” and “The Metastatic Breast Cancer Project.” Statistical analysis of microarray data between primary and metastatic tumors was performed using a chi-square test, and the percentage of mutation enrichment in mTNBC cases was estimated. P-values were adjusted for multiple testing with Benjamini-Hochberg method with a false-discovery rate (FDR) <.05. In addition, we identified dominant hallmarks of cancer in mTNBC. Results: Seven genes with mutations were enriched in mTNBC after correcting for multiple testing. These included TTN, HMCN1, RELN, PKHD1L1, DMD, FRAS1, and RYR3. Only RPS6KB2 amplification was statistically significant in mTNBC; on the contrary, deletion of the genes TET1, RHOA, EPHA5, SET, KCNJ5, ABCG4, NKX3-1, SDHB, IGF2, and BRCA1 were the most frequent. The molecular alterations related to the hallmark of “genetic instability and mutation” were predominant in mTNBC. Interestingly, the hallmark of “activating immune destruction” was the least represented in mTNBC. Conclusion: Despite the study limitations, we identified recurrent patterns of genomic alterations with potential contribution to tumor evolution. Deletions were the aberrations more commonly found in mTNBC. Several molecular alterations are potentially targetable.

Advances in high-throughput technologies and their involvement in the ‘omics’ of cancer have made possible the identification of hundreds of biomarkers and the development of predictive and prognostic platforms that model the management of cancer from evidence-based medicine to precision medicine. Latin America (LATAM) is a region characterised by fragmented healthcare, high rates of poverty and disparities to access to a basic standard of care not only for cancer but also for other complex diseases. Patients from the public setting cannot afford targeted therapy, the facilities offering genomic platforms are scarce and the use of high-precision radiotherapy is limited to few facilities. Despite the fact that LATAM oncologists are well-trained in the use of genomic platforms and constantly participate in genomic projects, a medical practice based in precision oncology is a great challenge and frequently limited to private practice. In breast cancer, we are waiting for the results of large basket trials to incorporate the detection of actionable mutations to select targeted treatments, in a similar way to the management of lung cancer. On the other hand and paradoxically, in the ‘one fit is not for all’ era, clinical and genomic studies continue grouping our patients under the single label ‘Latin American’ or ‘Hispanic’ despite the different ancestries and genomic backgrounds seen in the region. More regional cancer genomic initiatives and public availability of this data are needed in order to develop more precise oncology in locally advanced breast cancer.

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Object of study: The objective of the study was to determine the relationship between procedural activity and the satisfaction of female clients who are victims of family violence in the First Specialized Family Court. Methodology: A quantitative methodology was used, of a substantive type, at the correlation level. The level of the study was descriptive-correlational; the method was hypothetical-deductive, consisting of the observation of the problem, the formulation of the hypotheses, the design was non-experimental, since the variables were not actively manipulated, and it is also cross-sectional in nature. Importance: This research will provide the legal basis of the procedural activities and satisfaction of users who were victims of family violence of the First Specialized Family Court and family violence where there are inequalities in the exercise of force among the participants of a circle of relatives. Main results: The results show that 49% of the clients perceived an inadequate level, 35% a regular level and 16% an adequate level of procedural activity, while 43% perceived an inadequate level, 33% a regular level and 24% an adequate level of advice on the stages of the process. It concluded that there is a significant relationship between procedural activity and the satisfaction of the users who are victims of family violence in the first Specialized Family Court, since Spearman's Rho = 0.565 and ρ = 0.000 (ρ<0.05). Theoretical contributions:To make known that procedural activity are all acts performed before a judicial authority to resolve a conflict between several parties applying the current Law No. 30364, 2015, everyone has the right to effective judicial protection for the exercise or defense of their rights or interests, subject to due process.

Objetivos: Determinar los motivos por los cuales las estudiantes de Obstetricia elijen su carrera y cómo se ven influenciadas por los estereotipos de género. Diseño: Transversal. Institución: EAP de Obstetricia, Facultad de Medicina, UNMSM, Lima, Perú. Participantes: Estudiantes de Obstetricia. Intervenciones: Se aplicó un cuestionario auto-desarrollado a 322 estudiantes de Obstetricia, estratificadas proporcionalmente del primer al quinto año de estudio, de tres secciones: 1) Datos sociodemográficos; 2) Inventario de motivos para la elección de una carrera de Salud; y, 3) Inventario de masculinidad y feminidad. Se realizó análisis bivariado con prueba t, chi cuadrado, Kruskal-Wallis con p&lt;0,05 y nivel de confianza del 95%. Principales medidas de resultados: La asociación entre la internalización de estereotipos de género y los motivos de elección de la carrera. Resultados: La escala de feminidad (p = 0,130) y masculinidad (p = 0,036) no difirieron entre los estudiantes del primero al quinto año. Los motivos de elección de la carrera fueron: vocación de servicio (10,29±1,69), interés científico (9,60±1,71). El rasgo feminidad estuvo asociado a vocación de servicio (p=0,000). Conclusiones: Las estudiantes de obstetricia presentaron predominancia de rasgos femeninos y eligieron su carrera por vocación de servicio e interés científico.

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e19258 Background: Immunotherapy has changed the landscape of cancer treatment. The aim of this work was to describe the adverse events related to immunotherapy treatment in diverse type of malignant tumors using real-world data. Methods: This is a retrospective review of patients with diverse type of advanced malignancies treated with immunotherapy at Oncosalud-AUNA (Lima-Peru) during the period 2016-2018. We present a descriptive analysis of the clinicopathological and treatment features of the patients, as well as data of safety of immunotherapeutic agents. Results: In total, 37 patients were included in the study. The median age was 67 years (38 to 84 years); 64.9% of patients were male; 54.1% were smoker/former smoker and 45.9% non-smokers. Regarding to the primary tumor, 75.7% were lung cancers (82.1%, adenocarcinomas and 17.9%, squamous cell carcinomas), 16.2% were melanomas, 5.4, head and neck cancers and 2.7%, were bladder cancers. Central nervous system metastases were present in 29.7% of patients. Immunotherapy was given after a first line in 43.2% of cases, 40.5% after the second line and 16.2%, after the third line of treatment. The types of immunotherapy were prembrolizumab in 54.1%, nivolumab in 40.5%, atezolizumab in 2.7% and avelumab in 2.7%. 27% of cases had combination of immuno with chemotherapy. Finally, regarding to adverse events, 94.6% had any adverse event; 48.6% fatigue and asthenia; 35.1%, nausea; 32.4, pruritus/rash; 27.7%, decreased appetite; 18.9%, hypo/hyperthyroidism; 13.5%, diarrhea/colitis; 10.8%, pneumonitis and 5.4%, infusion-related reactions. Conclusions: During the study period we had a slightly higher incidence of adverse events than reported by other works. It could be probably due to the age of patients and several prior lines of treatment.