RIVAS VERA, SOLANGE VERÓNICA
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RIVAS VERA, SOLANGE VERÓNICA
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rivas.sole@gmail.com
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57189370030

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Abstract C018: Disparities in the access to non-small cell lung cancer´s target therapies in Chile

2023 , RIVAS VERA, SOLANGE VERÓNICA , GONZÁLEZ, EVELYN , BLANCO MARTÍNEZ, ALEJANDRO , Carolina Ibáñez , Alejandro Corvalán , Marcelo Garrido , Gareth Owen , Katherine Marcelain , ARMISEN YAÑEZ, RICARDO AMADO

Comprehensive next-generation sequencing (NGS) panels designed to identify the tumor mutational profile are becoming the standard care to prescribe target therapies in developed countries. In non-small cell lung cancer (NSCLC), this approach significantly impacts the patient´s clinical results, measured as progression-free survival and/or overall survival, compared to conventional chemotherapies. However, as Latin American patients tend to experience more significant health disparities because of structural, sociodemographic, and psychosocial factors, in this work, our purpose is to measure the disparities in the access to NSCLC´s target therapies, specifically in Chile. DNAs and RNAs from 1643 NSCLC samples from Chile, Brazil, and Peru were sequenced to assess the mutational status in fifty-two cancer genes. After an NGS quality control, variants were called and annotated using the Variant Effect Predictor, Annovar, COSMIC, and OncoKB, to categorize somatic mutations. The following analysis focused on today’s actionable genes in NSCLC, with FDA-approved target therapies (EGFR, KRAS, ALK, MET, ERBB2, BRAF, ROS1, and RET). In this analysis, 46.5% of tumors evidenced driver mutations (764/1643); interestingly, from this subset, 86.9% showed one driver variant, 11.2% two drivers, 1.4% three drivers, and 0.5% evidenced between 4-6 driver mutations. However, 19.4% (495/1643) evidenced actionable variants. The most mutated genes and the most common actionable variants were 15.3% EGFR (37% EGFR L858R), followed by 4.9% KRAS (100% KRAS G12C), 4.5% ALK (95.4% EML4-ALK fusion), 3% MET (100% MET exon 14 skipping), and 2.3% ERBB2. Finally, 1.5% BRAF, 1% ROS1 gene fusions and 0.9% RET gene fusions. Considering the target therapies approved by Chile´s Instituto de Salud Publica until October 2021, and if all these patients were diagnosed in Chile, only 64% would receive a targeted drug. EGFR is the gene with more target therapies validated in Chile, although drugs against exon twenty insertion have not been approved yet. Chile does not account for any targeted treatment for patients with alterations in KRAS, MET, RET and ERBB2; although the FDA approved a specific drug against KRAS G12C very recently (May 28, 2021), different is the case of MET because the first inhibitor, crizotinib, was FDA approved four years ago. Interestingly, in 2021, two inhibitors against the most common MET alteration were FDA approved, but none have been approved in Chile yet. In Chile, almost all target therapies have been validated against EGFR, ALK, and BRAF; however, patients with KRAS, MET, RET, and ERBB2 cannot access specific drugs, so in these cases, the recommended therapeutic option is chemotherapy. It is important to note that the target drugs approval only ensures the availability of the drug in Chile. Still, few of the target drugs are part of financed drugs by the Chilean health system, so the question is, how could we increase the national access to existing target therapies?

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ADAR1 Transcriptome editing promotes breast cancer progression through the regulation of cell cycle and DNA damage response

2020 , Eduardo A. Sagredo , Alfredo I. Sagredo , Alejandro Blanco , Pamela Rojas De Santiago , RIVAS VERA, SOLANGE VERÓNICA , Rodrigo Assar , Paola Pérez , Katherine Marcelain , ARMISEN YAÑEZ, RICARDO AMADO

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Concordance Analysis of ALK Gene Fusion Detection Methods in Patients with Non–Small-Cell Lung Cancer from Chile, Brazil, and Peru

2021 , Gonzalo Sepúlveda-Hermosilla , Matías Freire , Alejandro Blanco , Javier Cáceres , Rodrigo Lizana , Liliana Ramos , Rodrigo Assar Cuevas , Diego Ampuero , Osvaldo Aren , Sara Chernilo , María L. Spencer , Giuliano Bernal , Jacqueline Flores , Germán Rasse , Carolina Sánchez , Katherine Marcelain , RIVAS VERA, SOLANGE VERÓNICA , Gabriela P. Branco , María Galli de Amorim , Diana N. Nunes , Emmanuel Dias-Neto , Helano C. Freitas , Cristina Fernández , Paola Pérez , ARMISEN YAÑEZ, RICARDO AMADO , Luiz Araujo , Luis Pires , Nils Skare , Gustavo Girotto , Manuela Zereu , Helano Freitas , Hakaru Tadokoro , Ana Caroline Gelatti , Jose Fernando Moura , Clarissa Mathias , Pedro Rafael De Marchi , Fernando Silva , Mayler Olombrada Nunes de Santos , Marianna Deway Andrade Dracoulakis , Renata Pinho Costa , Luciana Castro , Paulo Guilherme de Oliveira Salles , Clodoaldo Zago Campos , Maria Andrade Livia , Sara Chernilo , Osvaldo Arén Frontera , Eduardo Yanez Ruiz , Monica Ahumada Olea , Giuliano Bernal , Loreto Spencer , Alejandro Ortega Vasquez , German Rasse , Juan Bertoglio , Jose David Zorrilla Silvera , Hernan Moron Escobar , Luis Riva Gonzalez , Luis Alberto Mas Lopez , José Luis Fernando Hurtado De Mendoza Acurio , Giovanna Victoria Abrill Mendoza , Alfredo Aguilar , Gerardo Campos Siccha , Ricardo Sanchez Sevillano , Cristina Fernández , Sylvia Chandía , Pablo Araos , Ana Mejías , Francisca Angulo , Carolina Sánchez , Jessica Troncoso , David Jara , Marcela Astete , María Jesús Galleguillos , Emmanuel Dias-Neto , Helano Carioca Freitas , María Galli de Amorim , Diana Noronha Nunes , Gabriela Branco , Marina Eloi , Melissa Pizzi , Jordana Silva , Thais F. Bartelli , Katherine Marcelain , Jessica Toro , Luciana Oliveira-Cruz , Daniela Diez

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NTRK genomic alterations in Latin-American cancer patients.

2021 , CARVAJAL HAUSDORF, DANIEL EDUARDO , Claudio Salas , Katherine Marcelain , Francisco Perez , Evelin Feliu , Kurt Schalper , Solange Rivas , ARMISEN YAÑEZ, RICARDO AMADO

e15088 Background: The neurotrophic receptor tyrosine kinase genes NTRK1-3 encode the tropomyosin receptor kinase proteins TRKA, TRKB, and TRKC, respectively. TRK fusions lead to overexpression of the chimeric protein, resulting in constitutively active, ligand-independent downstream signaling. NTRKs act as oncogenes, they can be targeted, and it is estimated that they are present in up to 0.3% of tumors. The incidence of actionable alterations in these genes is currently unknown in Latin-American patients. We investigated the presence of NTRK1-3 mutations/rearrangements in 3 independent patient series from several tertiary hospitals from Chile, Brazil and Peru. Methods: 1795 FFPE tumor samples from multiple institutions divided in 3 series were analyzed using 2 NGS panels: Oncomine Focus Assay (OFA; 52 genes) and Oncomine Comprehensive Assay (OCA; 161 genes. Data on NTRK1-3 SNVs, indels, CNVs and fusions was obtained. Bioinformatic workflows were used to study the biologic significance of these alterations. Results: Using OCA (series 1-2), 31 somatic variants were found in gastric, CRC, gallbladder, lung and pancreatic cases out of 300 patients. From these, 13 were located in the tyrosine kinase domain. Using OFA, no NTRK alteration were detected (series 3, 1495 NSCLC cases). Conclusions: NTRK alterations are rare events in Latin-American cancer patients. In 3 series including 1,795 patients, 31 somatic variants were detected. No NTRK fusions or CNVs were identified. The presence of NTRK mutations in the tyrosine kinase domain warrants further research into their potential to benefit from FDA/EMA-approved targeted therapies. [Table: see text]

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Ski Is Required for Tri-Methylation of H3K9 in Major Satellite and for Repression of Pericentromeric Genes: Mmp3, Mmp10 and Mmp13, in Mouse Fibroblasts

2020 , Claudio Cappelli , Hugo Sepulveda , Solange Rivas , Víctor Pola , Ulises Urzúa , Gerardo Donoso , Eduardo Sagredo , David Carrero , Emmanuel Casanova-Ortiz , Alfredo Sagredo , Marisel González , Marcia Manterola , Gino Nardocci , ARMISEN YAÑEZ, RICARDO AMADO , Martin Montecino , Katherine Marcelain

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