We present a case of congenital epulis, diagnosed prenatally with US. Congenital epulis is a benign gingival tumour whose differential diagnosis includes other oral-facial masses such as haemangioma, granular cell myoblastoma and cystic hygroma. This tumour can cause obstruction of the airway or feeding problems in the newborn child. Surgical excision is the treatment of choice.
Background: Neoadjuvant endocrine therapy (NET) is an approach that allows real-time evaluation of drug efficacy as well as investigation of the biological and molecular changes that occur after estrogenic deprivation. This evaluation is mainly performed in surgical specimens after NET and it has been used as a research tool to obtain prognostic and predictive information using tumour response to decide adjuvant treatment. In this setting, there are not many validated biomarkers to predict response beyond Ki67 expression and Preoperative Prognostic Index (PEPI score) in NET. The aim of this study is to determine if the tumour cellularity size (TCS) in surgical specimen after NET correlates with PEPI score and Ki67 expression. Methods: Retrospective study of postmenopausal patients with estrogen receptor (ER) positive/HER2 negative resectable breast cancer, treated with an aromatase inhibitor for at least 4 months prior to surgery. Pathological characterization of tumour specimens: Evaluation of the percentage of residual tumour cellularity of formalin fixed paraffin embedded surgical specimens and immunohistochemistry characterization of ER and Ki67. Tumour cellularity size: calculated by combining the percentage of residual tumour cellularity and tumour pathological size. Results: N=104. Tumour characteristics at surgery and breakdown for the calculated PEPI score: table 1. Correlation between the percentage of Ki67 positive cells at surgery and TCS: (r=0.2503) p=0.04 (95% CI, 0.0014 to 0.4700). Correlation between TCS and PEPI score: (r=0.2582) p=0.05 (95% CI, -0.0131 to 0.4940). Conclusions: Tumour cellularity size is a promising biomarker to determine response and prognosis after NET. There is a need to find other biomarkers to predict response after NET. Table 1Pathology/Biomarker statusPEPI score RFS pointsNo. of patientspTNot available (NA)1pT1/T20102pT3/T431pNNA7Negative075Positive322KI67 levelNA10%-2.7%039>2.7%-7.3%131>7.3%-19.7%119>19.7%-53.1%213>53.1%31ER-status Allred scoreNA120-2303-8092PEPI scoreNA190281342533495561PEPI groupNot calculated19I (0 score)28II (1-3 score)42III (≥4 score)15 Citation Format: Joanna Ines Lopez Velazco, María Otaño, Lide Larburu, Ainhara Lahuerta, Kepa Elorriaga, Virginia Segur, Juan Carlos Irizabal, Ana Martínez, Lourdes Jáuregui, Maria M. Caffarel, Ander Urruticoechea. Tumour cellularity size as a biomarker to predict response after neoadjuvant endocrine therapy: Correlation analysis between Ki67 expression and PEPI score [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS5-39.
Background: Apatinib is an orally administered small-molecular receptor tyrosine kinase inhibitor (TKI) with potential antiangiogenic and antineoplastic activities. This study was conducted to assess efficacy and safety of lower-dose apatinib combined with nanoparticle albumin-bound paclitaxel (nab-p) and carboplatin as a neoadjuvant regimen for triple negative breast cancer (TNBC).Methods: This single arm study enrolled patients with operable TNBC. Patients received apatinib (250mg, po, d1-21), nab-p (260mg/m 2 , ivgtt, d1) concurrently with carboplatin (AUC¼5-6, ivgtt, d1) for 6 cycles, each 21-day cycle, followed by surgery. The primary endpoint was pathological complete response (pCR) rates, defined as no invasive or noninvasive tumor residuals in both breast and axillary lymph nodes (ypT0 ypN0), or no invasive tumor residuals in the breast, and no invasive or noninvasive tumor residuals in the axillary lymph nodes (ypT0/is ypN0). Secondary endpoints included objective response rate (ORR), disease free survival (DFS), overall survival (OS), and toxicity.Results: 18 female patients with a median age of 45 years (20-62 years) were enrolled from Sep. 22, 2018 to Dec. 24, 2019. All the 18 pts completed neoadjuvant chemotherapy followed by surgery, however, only 1 patient did not provide enough data for efficacy evaluation. Rates of ypT0 ypN0 and ypT0/is ypN0 were 35.2% (6/17) and 41.2% (7/17), respectively. ORR was 94.1% (16/17). DFS and OS had not been evaluated since short time follow-up. 8 pts experienced apatinib-related dose discontinuation during treatment. Carboplatin induced myelosuppression was the main reason of chemotherapy delay. The most common grade 3/4 treatment-related adverse events (AEs) were thrombocytopenia (11/18), anaemia (10/18), neutropenia (7/18) and hypertension (3/18). Adverse events were well controlled after drug discontinuation and dose adjustment. No treatment-related death was occurred.Conclusions: This neoadjuvant regimen, apatinib combined with nab-p and carboplatin, exhibited acceptable efficacy and manageable toxicity in neoadjuvant treatment of TNBC pts. Long-time follow-up are still needed.Clinical trial identification: NCT03650738.
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