Objectives: The aim of this study is to evaluate the breast panel biomarker changes and tumor intrinsic subtype after neoadjuvant chemotherapy among patients with residual invasive breast carcinoma whose breast specimens were processed at St. Luke’s Medical Center - Quezon City SLMC-QC) from 1 January 2017 to 30 June 2023. Methodology: Cases of residual invasive breast carcinoma status post neoadjuvant systemic therapy were identified by retrospective review of cases. The baseline characteristics, type of biopsy and resection procedures, pre – and post–neoadjuvant ER, PR and HER2 status and pre – and post–neoadjuvant tumor intrinsic subtype were analyzed using frequency and percentage. The comparison of the changes in pre- and post-neoadjuvant breast panel biomarkers were analyzed by using McNemar test while the changes in the intrinsic tumor subtype was done using Wilcoxon signed-rank test. Results: This study encompassed a total of 43 cases of residual invasive breast carcinoma following neoadjuvant systemic therapy. The data disclosed shifts in the breast molecular profile and intrinsic subtype post-administration of neoadjuvant systemic therapy. The alterations in hormone receptor status, ER and PR, were observed in 11.6% of cases, while HER-2 status exhibited changes in 2.3%. A 14% change in the tumor intrinsic subtype is observed. Among the initial 18 Luminal A cases, 1 transitioned to Luminal B, and among the 6 Luminal B cases, 2 become HER2 enriched subtypes. Furthermore, among the initial 12 HER2 enriched cases, three shifted to Luminal B, while all triple-negative cases remained unchanged after chemotherapy. Conclusion Based on our findings, alterations in the molecular profile of breast tumors, including shifts in intrinsic subtype after neoadjuvant chemotherapy (NAC), could impact patient prognosis. While the data generated from this study may not exhibit statistical significance, its clinical relevance is noteworthy. In summary, retesting of breast biomarkers in the resection specimen is recommended to accurately ascertain the appropriate use of targeted therapy.
Neoadjuvant Therapy

Endometrial polyp, being one of the most common causes of abnormal uterine bleeding, is formed from localized overgrowths of endometrial tissue brought about by increased estrogen levels. Sizes of polyps usually are less than 2cm, while those >4 cm are labeled as giant polyps. Such polyps can even occupy the entire endometrial cavity, making complete hysteroscopic removal difficult and prone to failure and morbidity. Limited literature regarding use of GnRH agonist in endometrial polyps are published, but given the idea that it induces a state of hypoestrogenism, it could be a promising approach for neoadjuvant treatment in such cases. In this paper, 3 cases of giant endometrial polyps with fertility problems were given GnRH agonists prior to resection. All cases have shown significant decrease in size of their polyps, making complete and successful hysteroscopic removal feasible.
Neoadjuvant Therapy ; Polyps

Objective: The study aimed to identify the pattern and clinicopathologic factors associated with locoregional failure (LRF) in locally-advanced breast cancer (LABC) patients who received neoadjuvant chemotherapy (NAC) and modified radical mastectomy (MRM) with or without adjuvant radiotherapy (RT). Methods: Retrospective cohort analysis of LABC patients who developed LRF following NAC and MRM with or without RT in the Breast Care Center, Philippine General Hospital from 2007-2010 was done. Clinicopathologic and treatment factors were compared between patients who developed and did not develop recurrence using Student's t-tests and Chi-square tests and logistic regression analysis, with p values ≤0.05 considered significant. Results: A total of 63 patients were included, 34 with locoregional recurrence (LR) and 29 without. Two-year locoregional recurrence rate (LRR) was 54% with mean time to recurrence at 263 days and chest wall as most common site. Simple logistic regression analysis showed age distribution, pathologic nodal status (pN), percentage positive pathologic lymph nodes, pathologic stage, lymphovascular invasion, and adjuvant RT to be predictors of LR. Furthermore, pN (OR 1.31, CI 1.07-1.59, p=0.01) and adjuvant RT (OR 0.14, CI 0.04-0.53, p=0.004) were independent predictors of LR on multiple logistic regression analysis. In the subset of patients without adjuvant RT, no independent predictor of LR was found on multiple logistic regression analysis. Conclusion Among patients with LABC who received NAC and MRM, locoregional recurrence occurred frequently, usually in the chest wall and within a year of treatment. The absence of adjuvant radiotherapy and increased number of positive pathologic lymph nodes were predictive of locoregional recurrence.
Neoadjuvant Therapy ; Recurrence

No abstract available.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Neoadjuvant Therapy

Humans ; Neoadjuvant Therapy ; Stomach Neoplasms ; therapy

Colorectal Neoplasms ; therapy ; Humans ; Neoadjuvant Therapy

Insufficient treatment and overtreatment in the management of colorectal cancer greatly influence patients' outcome. The clinicopathological stage of carcinoma located in colon and rectum is different for anatomical differences. The indication of adjuvant chemotherapy varies in colon or rectal cancer. Locally advanced rectal cancer should receive neoadjuvant treatment, however, the optimal regimen is still controversial.
Colorectal Neoplasms ; therapy ; Humans ; Neoadjuvant Therapy

The incidence of pancreatic cancer has been rising worldwide,while its clinical diagnosis and treatment remain a great challenge. To present the update and improvements in the clinical diagnosis and treatment of pancreatic cancer in recent years, Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association updated "Guidelines for the diagnosis and treatment of pancreatic cancer in China （2021）" based on the Guideline of Management of Pancreatic Cancer in China which had been published in 2014. This updated guideline was formulated after reviewing evidence-based and problem-oriented literatures published from 2015-2021,mainly focusing on highlight issues regarding diagnosis and surgical treatment of pancreatic cancer,conversion strategies for locally advanced pancreatic cancer,treatment of pancreatic cancer with oligo metastasis,adjuvant and neoadjuvant therapy,standardized processing of surgical specimens and evaluation of surgical margin status,systemic treatment for unresectable pancreatic cancer,genetic testing,as well as postoperative follow up of patients with pancreatic cancer. Forty recommendation items were finally proposed based on the above issues,and the quality of evidence and strength of recommendations were graded using the Grades of Recommendation,Assessment,Development,and Evaluation system. This guideline aims to improve the ability of clinical diagnosis and therapy,especially surgical treatment of pancreatic cancer in China,and furtherly improve the prognosis of pancreatic cancer patients.
China ; Humans ; Neoadjuvant Therapy ; Pancreatic Neoplasms/therapy*

In order to improve the overall treatment level of pancreatic cancer in China, Study Group of Pancreatic Surgery in China Society of Surgery of Chinese Medical Association and Pancreatic Disease Committee of China Research Hospital Association have formulated the guideline for neoadjuvant therapy of pancreatic cancer in China (2020 edition). Based on the GRADE system, the guideline has conducted a discussion on the indication, regimen selection, therapeutic effect evaluation, pathological diagnosis and surgery strategy, etc. This guideline has quantified the evidence level of the current clinical researches and provided recommendations for the clinical practice in the neoadjuvant therapy of pancreatic cancer. The guideline has highlighted the role of multiple disciplinary team and represented the conversion of treatment concept in pancreatic cancer. Neoadjuvant therapy has prolonged the survival of the part of pancreatic cancer patients. However, more high-quality clinical researches are in urgent need to improve the level of evidence, optimize the clinical practice and improve the survival of patients.
China ; Humans ; Neoadjuvant Therapy ; Pancreatic Neoplasms ; therapy

Rationale/Objective: Neoadjuvant chemotherapy (NAC) is recommended for locally-advanced breast cancer (LABC) to improve resectability and provide in-vivo tumor response assessment. This study aimed to describe the clinical and pathologic tumor response of LABC patients after response-guided NAC. Methods: This is a retrospective cohort analysis of 128 LABC patients who underwent NAC using sequential doxorubicin/cyclophosphamide (AC) – docetaxel (T) regimen at the Philippine General Hospital Breast Care Center. Clinical and pathologic response rates were analyzed according to clinicopathologic variables including tumor intrinsic subtype. Results: Objective clinical response (complete and partial) was observed in 88% (111/128) of patients with 11% (14/128) achieving pathologic complete response (pCR). The hormone receptor-negative/ Her2-enriched (HR-/Her2+) subtype had the highest pCR rate (23.5%) followed by triple negative subtype (HR-/Her2-) at 19%. The hormone receptor-positive/Her2-positive (HR+/Her2+) subtype had the lowest pCR (4.7%). Two patients with initial poor response to AC but had good response upon shifting to T achieved pCR. Twelve patients (9.4%) had poor response to AC and T chemotherapy. Patients who were pre-menopausal (p=0.04), had ductal histology (p=0.03), with a HR-/Her2- (p=0.002) or HR+/Her2+ subtype (p=0.03) had good response to AC. Intrinsic subtype was not significantly associated with treatment response in those who received docetaxel. There was strong association between the pathologic and clinical responses (Spearman’s Rho score 0.69, p-value <0.0001). Conclusion Clinical and pathologic response to NAC was highly dependent on tumor subtype. Clinical response was predictive of pathologic response. Response-guided NAC allowed direct and early evaluation of tumor treatment response that allowed for treatment modifications.
Breast Neoplasms ; Neoadjuvant Therapy ; Drug Therapy