Observational Multicenter Study on the Prognostic Relevance of Coagulation Activation in Risk Assessment and Stratification in Locally Advanced Breast Cancer. Outline of the ARIAS Trial

Abstract

A hypercoagulable state may either underlie or frankly accompany cancer disease at its onset or emerge in course of cancer development. Whichever the case, hypercoagulation may severely limit administration of cancer therapies, impose integrative supporting treatments and finally have an impact on prognosis. Within a flourishing research pipeline, a recent study of stage I-IIA breast cancer patients has allowed the development of a prognostic model including biomarkers of coagulation activation, which efficiently stratified prognosis of patients in the study cohort. We are now validating our risk assessment tool in an independent cohort of 108 patients with locally advanced breast cancer with indication to neo-adjuvant therapy followed by breast surgery. Within this study population, we will use our tool for risk assessment and stratification in reference to 1. pathologic complete response rate at definitive surgery, intended as our primary endpoint, and 2. rate of thromboembolic events, intended as our secondary endpoint. Patients’ screening and enrollment procedures are currently in place. The trial will be shortly enriched by experimental tasks centered on next-generation sequencing techniques for identifying additional molecular targets of treatments which may integrate current standards of therapy in high-risk patients.

Fully Automatic Segmentation of Gynaecological Abnormality Using a New Viola-Jones Model

“…Other applications include computer-aided fingerprint recognition and facial identification, satellite imaging usages, and remote sensing applications. However, four main categories of image processing techniques are often used, and they are described as follows [19].…”

Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer

“…This is the case of mutated KRAS in colorectal and lung cancer and IDH1 in brain cancer patients, the former being positively associated with TF upregulation, the latter being associated with hypermethylation of the F3 promoter of the TF gene leading to decreased TF expression and a decreased risk of VTE [ 11 ]. Other tumor mutations that have been involved in the prothrombotic state in carcinoma patients include ALK , ROS1 , and JAK2 , all participating in downstream signaling of inflammatory cytokines [ 11 ], while the burden of breast cancer mutational events, using a next-generation sequencing approach, is currently the focus of an ongoing trial [ 12 ]. Knowledge that a patient may be at an increased thrombotic risk due to the underlying tumor genotype is another piece of information that the treating clinician can consider when determining VTE risk stratification and may prove to be a significant advancement in the prevention of cancer-associated thrombosis [ 11 ].…”