585 Background: Pathological complete response (pCR) is a well-known surrogate for DFS and OS in triple negative breast cancer (TNBC). New approaches are being tested to increase pCR rate. We compared the standard of care (AC-T) vs Carboplatin/Docetaxel (CbD) for locally-advanced TNBC. Our objective is to determine whether CbD will increase the pCR rate, with PFS and OS as secondary objectives. Methods: A single arm phase II prospective trial with historical controls. 61 stage II-III TNBC patients were included between 2013-2014 at Instituto Nacional de Enfermedades Neoplasicas (Peru). 27 patients received Carboplatin 6AUC + Docetaxel 75mg/m2 q21d for 6cy, and 34pts, Adriamycin 60mg/m2 + Cyclophosphamide 600mg/m2 q21d for 4cy followed by weekly paclitaxel 80mg/m2 for 12 weeks. The Miller and Payne method was used to evaluate pathological response after definitive surgery. Results: Median age was 47 years, most patients were premenopausal (55.7%), median tumor size was 61 mm (T3=32.8%, T4=50.8%) and most patients had LN+ve (77%). There was a significantly greater tumor size in the CbD arm (mean 72.8 vs 52.2mm, p=0.007), no toxicity differences were noted. Only pCR was independently associated with OS/PFS on multivariate analysis. pCR was achieved in 37% (n=10) and 23.5% (n=8) in the CbD and AC-T groups, respectively (p=0.44). Partial pathological response was achieved in 37% (n=10) and 38.2% (n=13) patients in AC-T and CbD respectively. No characteristics were associated to pCR on logistic regression. At 2-year follow-up, all patients with pCR were alive and without recurrence, while patients with partial response achieved a 2-year PFS of 75% and, 2-year OS of 83.5%. The non-respondent group had the worse outcomes (2-year PFS: 32.7%, 2-year OS: 58.7%). The CbD group had a better 2-year PFS and OS (73.1% and 84%, respectively) than the AC-T group (59.3% and 71%, respectively), however no-statistical difference was found. Conclusions: CbD is an effective and promising neoadjuvant chemotherapy regimen for TNBC. Despite a larger mean tumor size in the CbD group, a non-significant trend towards higher pCR rate and longer PFS and OS was observed and warrants further exploration.
e20081 Background: Lung cancer still remains as the principal death cause in many regions around the world. Its mortality varies according to the regions and study periods. In Peru it represents the sixth most frequent malignant neoplasm and the fourth cause of cancer related death. We reported the spatial autocorrelation and the temporal variation in lung cancer mortality rate in Peru. Methods: Data of lung cancer mortality in Peru between 2005-2014 was obtained from the Ministry of Health. Information on the number of inhabitants was obtained from National Institute of Statistics and Informatics. Age standardized mortality rate (ASMR) was calculated based on the 2011 world standard population. Spatial autocorrelation was determined according to Moran’s Index and the Local G Cluster Map to explore the cluster patterns between regions. Results: During the study period 16,839 deaths due to lung cancer were reported. The lung cancer mortality rate in Peru increased from an ASMR of 12.8 (95% CI: 11.9-13.7) by 100,000 persons in 2005 to 13.4 (95% CI: 12.5-14.3) in 2014. According to the quartiles, the ASMR was higher in the north, south and east, and lowest in others regions. The spatial distribution of the ASMR showed a significant spatial autocorrelation (Moran´s I: p = 0.025). Also, during the study period, the ASMR showed a significant increase and decrease in some regions and in others it was constant. Conclusions: In Peru, lung cancer mortality rate showed a spatial and temporal variation in different regions. The increase in mortality rate in some regions requires identification of risk factors in order to establish public measures to reduce the risk of lung cancer mortality.
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