Alfonso Sánchez-Muñoz

Alfonso Sánchez-Muñoz
Hospital Universitario Virgen de la Victoria de Málaga · oncologia

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98
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Introduction

Publications

Publications (98)
Article
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Introduction The incidence of brain metastases in ovarian cancer is quite rare, being approximately 1%–2%. According to retrospective studies, patients with BRCA 1/2 mutations present a higher risk. The trimodal approach based on surgery, radiotherapy, and chemotherapy presents better outcomes, but the prognosis remains poor with overall survival s...
Article
Full-text available
Cutaneous melanoma (CM) is the most lethal form of skin cancer if it becomes metastatic, where treatment options and survival chances decrease dramatically. Immunotherapy treatments based on the immunologic checkpoint inhibitors programmed death cell protein 1 (PD-1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4) constituted a main breakthrough in t...
Article
Full-text available
Resistance to Immune Checkpoint Blockade (ICB) constitutes the current limiting factor for the optimal implementation of this novel therapy, which otherwise demonstrates durable responses with acceptable toxicity scores. This limitation is exacerbated by a lack of robust biomarkers. In this study, we have dissected the basal TME composition at the...
Article
Background CDK4/6 inhibitors plus endocrine therapies are the current standard of care in the first-line treatment of HR+/HER2-negative metastatic breast cancer, but there are no well-established clinical or molecular predictive factors for patient response. In the era of personalised oncology, new approaches for developing predictive models of res...
Article
e13035 Background: CDK 4/6 inhibitors plus hormone therapy(HT) has been approved by FDA and EMA for the treatment of hormone receptor positive HER2 negative advanced breast cancer (HR+/HER2-BC) with improvement in PFS consistently demonstrated in several clinical trials. Benefit in OS has also been demonstrated in Monaleesa3 and Monarch2 clinical t...
Article
e13040 Background: The treatment of luminal MBC has undergone a substantial change with the use of cyclin dependent kinase 4/6 inhibitors (CDKIs). Nevertheless, there is not a clearly defined subgroup of patients who do not initially respond to CDKIs and show EP. Methods: MBC ER+/HER2- patients who have received at least one line of treatment were...
Article
Full-text available
Background: Double blockade with pertuzumab and trastuzumab combined with chemotherapy is the standard neoadjuvant treatment for HER2-positive early breast cancer. Data derived from clinical trials indicates that the response rates differ among intrinsic subtypes of breast cancer. The aim of this study is to determine if these results are valid in...
Article
Full-text available
The main obstacle for designing effective treatment approaches in breast cancer is the extensive and the characteristic heterogeneity of this tumor. The vast majority of critical genomic changes occurs during breast cancer progression, creating a significant variability within primary tumors as well as between the primary breast cancer and their me...
Conference Paper
Background Despite improvements in diagnosis and aggressive chemotherapy treatment, a proportion of young patients are still dying from germ cell cancer (GCC). We aim to identify additional prognostic factors that help to select patients that might benefit from new treatment strategies. Anaemia is prognostic in several tumours. Thus, our objective...
Article
Full-text available
Germ cell tumors (GCTs) are the most common type of solid tumor amongst patients between 15 and 35 years of age. They are also one of the types of tumor with the highest cure rate, due to their high sensitivity to cisplatin based chemotherapy. Nonetheless, around 15-20% of metastatic patients will not have curative options after a relapse on the fi...
Article
Background: Stage IS testicular cancer is defined by persistence of elevated serum tumor markers (TM) [alpha-fetoprotein (AFP) and/or beta human chorionic gonadotropin (BHCG)] after orchiectomy, without radiological evidence of metastatic disease. Current treatment recommendations include upfront cisplatin-based chemotherapy but are based on limit...
Article
Full-text available
Triple negative breast cancer (TNBC) is a heterogeneous disease with distinct molecular subtypes that differentially respond to chemotherapy and targeted agents. The purpose of this study is to explore the clinical relevance of Lehmann TNBC subtypes by identifying any differences in response to neoadjuvant chemotherapy among them. We determined Leh...
Article
Male breast cancer is a rare disease that is still poorly understood. It is mainly classified by immunohistochemistry as a luminal disease. In this study, we assess for the first time the correlation between molecular subtypes based on a validated six-marker immunohistochemical panel and PAM50 signature in male breast cancer, and the subsequent cli...
Article
Background: Disseminated germ cell cancers are at high risk of developing thromboembolic complications. We evaluated the prognostic value of venous thromboembolic events (VTE) in disseminated germ cell cancer. Methods: Patients with germ cell cancer receiving upfront platinum-containing chemotherapy between 2004 and 2014 were pooled from the Spani...
Article
This study aimed to assess the role of proliferation measured by Ki-67 as a predictive factor for pathologic complete response (pCR) to trastuzumab-based chemotherapy in patients with human epidermal growth factor receptor 2 (HER2)-positive (HER2(+)) breast cancer (BC). A total of 81 patients with HER2(+) BC were treated with a sequential schedule...
Article
Background: We aimed to analyze prognostic factors for relapse in stage I seminoma managed by either active surveillance or adjuvant chemotherapy, and to describe the long-term patterns of recurrence in both groups. Patients and methods: From 1994 to 2008, 744 patients were included in three consecutive, prospective risk-adapted studies by the S...
Article
Full-text available
Recurrence risk in breast cancer varies throughout the follow-up time. We examined if these changes are related to the level of expression of the proliferation pathway and intrinsic subtypes. Expression of estrogen and progesterone receptor, Ki-67, human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR) and cytokera...
Article
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To assess the impact in pathological complete response (pCR) and outcome of two dose-dense neoadjuvant chemotherapy (DDNC) regimens among different histological subtypes determined by hormonal receptor (HR) and HER2 status in breast cancer patients. A total of 127 breast cancer patients were treated with DDNC in two prospective studies. A: adriamyc...
Article
Background: To assess the molecular subtypes determined by hormonal receptors (HR) and human epidermal growth factor receptor 2 (HER2) status and the role of proliferation measured by the Ki-67 marker as predictive and prognostic factors in breast cancer patients treated with neoadjuvant chemotherapy. Methods: A total of 127 breast cancer patien...
Article
Full-text available
Surgery is the primary treatment for non-metastatic breast cancer. However, the risk of early recurrence remains after surgical removal of the primary tumor. Recurrence is suggested to result from hidden micrometastatic foci, which are triggered to escape from dormancy by surgical resection of the primary tumor. In this study, we focused on the dif...
Article
Chemotherapy remains as the only systemic treatment option available for basal-like breast cancer (BC) patients. Preclinical models and several phase II studies suggested that platinum salts are active drugs in this BC subtype though there is no randomized study supporting this hypothesis. This study investigates if the addition of carboplatin to a...
Article
Aim: The aim of this study was to assess the molecular subtype profiles of male breast cancer (MBC) and subsequent clinical outcome using a validated 6-marker immunohistochemical panel. Methods: A total of 43 cases of MBC were examined retrospectively using a semiquantitative immunohistochemical analysis of estrogen receptor (ER), progesterone r...
Article
10616 Background: Ki67 proliferation biomarker determined by immunohistochemistry (IHC) has been studied as a prognostic and predictive factor in Operable Breast Cancer (OBC). Ki67 modifications after neoadjuvant endocrine therapy have been correlated with long term outcome. However, there is no robust data about its predictive role in Neoadjuvant...
Article
Background: Gene expression profiling and their immunohistochemistry-based surrogates have consistently revealed prognostically significant breast cancer (BC) subtypes: Luminal A (Lum A), Luminal B (Lum B), HER2, Basal-like (BL) and Triple negative phenotype-nonbasal (TNP-nb). In addition, there are clinical evidence that hazard of BC recurrence va...
Article
Germ cell tumors (GCTs) are a heterogeneous group of tumors that are highly clinically relevant to oncologists. GCTs are generally highly sensitive to cisplatin-based chemotherapy and represent a model for curable neoplasms. Cisplatin-based combination therapy followed by surgical resection of the residual tumor is the cornerstone for GCTs treatmen...
Article
Full-text available
To confirm the efficacy of a risk-adapted treatment approach for patients with clinical stage I seminoma. The aim was to reduce both the risk of relapse and the proportion of patients receiving adjuvant chemotherapy while maintaining a high cure rate. From 2004 to 2008, 227 patients were included after orchiectomy in a multicenter study. Eighty-fou...
Article
Aim This study was a retrospective analysis of our experience with severe cross-hypersensitivity reactions (HSR) to the taxanes paclitaxel (P) and docetaxel (D) in patients with breast cancer. Patients and methods We evaluated patients with breast cancer treated with P or D who experienced severe HSR to one of the two taxanes. Severe HSR was define...
Article
To determine the impact of the expression of epidermal growth factor receptor (EGFR) on disease-free survival (DFS) and on pelvic relapse in patients with advanced cancer of the cervix receiving concurrent chemoradiotherapy. In 112 consecutive patients with advanced cancer of the cervix (11 stage IB2-IIA, 25 IIB, 63 IIIB, 13 IVA) treated with chemo...
Article
Oncologists should carefully weigh up the risks and benefits of palliative chemotherapy in patients with advanced solid tumours (AST) and poor general status from the standpoint both of medical and ethical issues and of healthcare resources required. This study is intended to assess the impact on overall survival of palliative chemotherapy in patie...
Article
Full-text available
Purpose: Several studies have reported a positive impact for taxanes in adjuvant breast cancer (BC) treatment in terms of reduced recurrence and mortality. However the impact of the magnitude on overall survival (OS) remains partially controversial. Methods: We examined the impact of taxane-containing adjuvant therapy for patients with early BC on...
Article
The prognosis and need or not for adjuvant therapy in patients with small breast tumors (≤1cm N0) is the subject of controversy as regards the clinical benefit obtained, toxicity, and the economical costs generated. A retrospective analysis was made of 238 patients with early-stage breast cancer (pT1≤1 cm N0M0) diagnosed between January 1993 and Ma...
Article
To retrospectively assess the efficacy and safety of bevacizumab plus low-dose metronomic oral cyclophosphamide in heavily pretreated patients with recurrent ovarian cancer. Patients with recurrent ovarian cancer and prior treatment with platinum- and taxane-based chemotherapy were included. Treatment consisted of bevacizumab 10 mg/kg intravenously...
Article
Adjuvant endocrine therapy is the most important systemic treatment for postmenopausal women with hormone-receptor-positive early breast cancer following surgery. Most trials have shown that the third-generation aromatase inhibitors, anastrozole, letrozole (LET), and exemestane, significantly prolong disease-free survival compared with tamoxifen. H...
Article
Full-text available
Mutational analysis of the KRAS gene has recently been established as a complementary in vitro diagnostic tool for the identification of patients with colorectal cancer who will not benefit from anti-epidermal growth factor receptor (EGFR) therapies. Assessment of the mutation status of KRAS might also be of potential relevance in other EGFR-overex...
Article
To determine the impact of c-erb-B2 overexpression on disease-free survival (DFS) and local relapse in patients with advanced cervical cancer (CC) receiving concurrent chemoradiotherapy treatment. A total of 136 patients with advanced CC (FIGO stage: IB2-IIA [12]; IIB [34]; IIIB [71]; IVA [19]; including both epidermoid [86] and adenocarcinoma [14]...
Article
Ovarian cancer is a chemosensitive tumour, but two thirds of women have a recurrence during the follow- up, even after an optimal surgical debulking followed by chemotherapy with a platinum and a taxane compound. Cytotoxic drugs are used in a second- or third-line setting but tumour progression is the rule. Also patients with the same histology ach...
Article
To evaluate the pathologic complete response (pCR) rate of a combination of epirubicin (E) and cyclophosphamide (C) followed by paclitaxel (P) and gemcitabine (G) (+ trastuzumab[T]) in Her2+ patients) in a sequential and dose-dense schedule as neoadjuvant chemotherapy for stages II and III patients with breast cancer. Secondary endpoints: clinical...
Article
Breast cancer is a heterogeneous disease characterised by a dysregulation of multiple pathways related to cell differentiation, cell cycle control, apoptosis, angiogenesis and development of metastasis. Acting against these pathways provides therapeutic targets for new targeted biologic therapies, which, in the future, might constitute a key for fi...
Article
Breast cancer is a heterogeneous disease characterised by a dysregulation of multiple pathways related to cell differentiation, cell cycle control, apoptosis, angiogenesis and development of metastasis. Acting against these pathways provides therapeutic targets for new targeted biologic therapies, which, in the future, might constitute a key for fi...
Article
During the last decade we have assisted in the development of new therapeutic strategies for the treatment of ovarian cancer, based on the best knowledge of molecular biology. One of the most promising strategies under investigation is antiangiogenic therapy. Bevacizumab is a monoclonal humanised antibody targeting vascular endothelial growth facto...
Article
During the last decade we have been developing new therapeutic strategies for the treatment of ovarian cancer, based on the best knowledge of the molecular biology. New drugs like bevacizumab are showing antiangiogenic antitumour activity in ovarian cancer in preclinical models and in clinical trials. Bevacizumab is a monoclonal human antibody that...
Article
The objective was to determine the impact of the coexpression of epidermal growth factor receptor (EGFR) and tumor marker c-erbB-2 on disease-free survival (DFS) and pelvic relapse-free survival (PRFS) in patients with locally advanced cervical cancer (LACC) receiving concurrent chemoradiotherapy. The expression of EGFR and c-erbB-2 was assessed by...
Article
Metastatic breast cancer (MBC) occurs in 20-30% of women with breast cancer and is an incurable disease. Treatment is palliative and directed to prolong survival, decrease symptoms and improve patients' quality of life. For patients with hormone receptor-negative disease or for hormone receptor-positive disease that has become resistant to endocrin...
Article
Metastatic breast cancer (MBC) occurs in 20-30% of women with breast cancer and is an incurable disease. Treatment is palliative and directed to prolong survival, decrease symptoms and improve patients' quality of life. For patients with hormone receptor-negative disease or for hormone receptor-positive disease whose disease has became resistant to...
Article
Full-text available
To study the role of breast cancer molecular subtypes according to hormone receptors and HER2 status as a predictive factor for pathological complete response (pCR) to neoadjuvant chemotherapy. Eligible patients received one of the two chemotherapy schedules every two weeks with prophylactic growth factor support; schedule A: epirubicin 90 mg/m2-cy...
Article
Full-text available
The role of molecular and biological factors in ovarian cancer is controversial. We investigated the levels of the estrogen (ER) and progesterone (PR) receptors, HER2/neu, p-53 and Ki 67 in patients with advanced ovarian cancer and correlated the results with the clinical course in order to define their predictive or prognostic significance. Paraff...
Article
Cardiac toxicity induced by treatment with intravenous 5-fluorouracil and oral capecitabine is an infrequent side effect (2%) but cannot be ignored. This is because of the frequent use of these chemotherapy agents in various tumours and the potential severity of the toxicity (2.2% mortality due to heart attack or cardiogenic shock). We describe tw...
Article
Los marcadores tumorales séricos (MTS) son utilizados de manera habitual en la monitorización de la respuesta y en el seguimiento de los pacientes oncológicos tras las diversas terapias administradas. Presentamos tres casos clínicos con falsas elevaciones de MTS, como son CA 15-3, CA 12-5 y CA 19-9, en pacientes diagnosticados y tratados de carcino...
Article
Serum tumor markers are often used for the evaluation of the response and follow-up of oncologic patiets after different dispensed therapies. We report three clinicl cases of false elevation of CA 15-3, CA 12-5 and CA 19-9 serum tumor markers during the follow-up of patients diagnosed and treated for breast cancer, ovarian cancer and colorectal can...
Article
C� Springer-Verlag 2005 The use of tunneled intravascular catheters in oncology patients is associated with infectious complications. Although catheter removal is recommended in such cases, catheters are often indispensable and expensive, and the clinical condition of the patient can preclude removal. The antibiotic-lock technique (ALT) is an alter...
Article
8037 Background: Cancer patients with febrile neutropenia (FN) are currently assessed on clinical grounds only. Procalcitonin (PCT) is a pro-hormone that demonstrated significant sensitivity and specificity as a marker of severe infection in patients with hematologic malignancies and FN. This study prospectively evaluated the efficacy of baseline P...
Article
Cancer patients with fever and neutropenia currently are assessed on clinical grounds only. The current study prospectively evaluated the efficacy of baseline procalcitonin (PCT) in the detection of bacteremia and in the prediction of outcome in patients with solid tumors and febrile neutropenia. PCT levels were determined at baseline and every 48...