CENTRO PARA LA PREVENCIÓN Y EL CONTROL DEL CÁNCER (CECAN)

Project Title

Partner Organisations

Pontificia Universidad Católica de Chile

Internal ID

152220002

Principal Investigator

BRUNO NERVI NATTERO

Type

basic research

Status

VIGENTE

Start Date

2022

End Date

2027

Investigators

JOHANNA PATRICIA ACEVEDO ROMO

Organisations

Facultad de Medicina Clínica Alemana Universidad del Desarrollo

Publications

Now showing 1 - 10 of 18

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Perceived barriers to reaching equity in effective access to diagnosis and treatment for women with breast cancer in Chile
(Springer Science and Business Media LLC, 2025-02-05)
CAMPAÑA, CARLA
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CABIESES VALDES, BALTICA BEATRIZ
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OBACH KING, ALEXANDRA ALICE
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Francisca Vezzani
Scopus© Citations 1 2
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LINC00662 Promotes Aggressive Traits by Modulating OCT4 Expression through miR-335-5p in Gallbladder Cancer Cells
(2024)
Pablo Pérez-Moreno
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Ismael Riquelme
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Carolina Bizama
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Luis Vergara-Gómez
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Julio C. Tapia
<jats:p>Long non-coding RNAs (lncRNAs) are nucleotide sequences that participate in different biological processes and are associated with different pathologies, including cancer. Long intergenic non-protein-coding RNA 662 (LINC00662) has been reported to be involved in different cancers, including colorectal, prostate, and breast cancer. However, its role in gallbladder cancer has not yet been described. In this article, we hypothesize that LINC00662 has an important role in the acquisition of aggressiveness traits such as a stem-like phenotype, invasion, and chemoresistance in gallbladder cancer. Here, we show that LINC00662 is associated with larger tumor size and lymph node metastasis in patients with gallbladder cancer. Furthermore, we show that the overexpression of LINC00662 promotes an increase in CD133+/CD44+ cell populations and the expression of stemness-associated genes. LINC00662 promotes greater invasive capacity and the expression of genes associated with epithelial–mesenchymal transition. In addition, the expression of LINC00662 promotes resistance to cisplatin and 5-fluorouracil, associated with increased expression of chemoresistance-related ATP-binding cassette (ABC) transporters in gallbladder cancer (GBC) cell lines. Finally, we show that the mechanism by which LINC00662 exerts its function is through a decrease in microRNA 335-5p (miR-335-5p) and an increase in octamer-binding transcription factor 4 (OCT4) in GBC cells. Thus, our data allow us to propose LINC00662 as a biomarker of poor prognosis and a potential therapeutic target for patients with GBC.</jats:p>
1Scopus© Citations 2
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“Healthcare should be the same for everyone”: perceived inequities in therapeutic trajectories of adult patients with lung cancer in Chile, a qualitative study
(2023)
CAMPAÑA, CARLA
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CABIESES VALDES, BALTICA BEATRIZ
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OBACH KING, ALEXANDRA ALICE
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Francisca Vezzani
<jats:sec><jats:title>Background</jats:title><jats:p>Globally, it has been reported that different social determinants of health affect health outcomes in lung cancer (LC). Research on the therapeutic trajectories of patients (TTP) is a novel field for identifying barriers and facilitators in health. The objective of this study was to reveal perceived differences in TTP with LC in Chile according to selected social determinants of health (SDH) and the experiences of patients, health professionals, and civil society leaders.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This is a qualitative paradigm, one case-study design. Online semi-structured interviews were conducted with patients with LC, health professionals, and civil society leaders. The strategies for the recruitment process included social networks, civil society organizations, health professionals, and the snowball technique. A thematic analysis was carried out.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Selected SDH impact LC's TTP in Chile, particularly concerning health system access, health services, information, and patient navigation experiences. The analysis of the experiences of the participants allowed us to identify barriers related to the selected SDH in three stages of the TTP: initiation, examinations, and diagnosis and treatment. Individuals with limited education, those residing outside the capital, women, and those in the public health system encountered more barriers throughout their TTP.</jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p>Study findings suggest that being a woman with low education, from the public health system, and not from the capital might represent one of the most powerful intersections for experiencing barriers to effective healthcare in LC in Chile. It is necessary to monitor the TTP from an SDH perspective to guarantee the rights of access, opportunity, quality, and financial protection.</jats:p></jats:sec>
Scopus© Citations 4 1
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Exploring the characteristics of cancer-centred civil society organisations in Chile: A qualitative study
(Public Library of Science (PLoS), 2025-05-16)
Antonia Roberts
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Francisca Vezzani
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CABIESES VALDES, BALTICA BEATRIZ
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OBACH KING, ALEXANDRA ALICE
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CAMPAÑA, CARLA
In Chile, civil society organisations in health have been historically active in population health and specifically in cancer; they have had an important role in addressing patients’ and families’ necessities. Although they occupy a central role, there is no clarity about who they are, how they are organised, the goals that guide their performance and how they materialize social participation in health. Based on that, this study aimed to explore the characteristics of civil society organisations that work in cancer in Chile and to identify the networks they build with other actors to achieve their goals. Materials and methods Qualitative case study using semi-structured online interviews with organisation representatives, politicians, decision-makers and academics related to cancer in Chile. Content analysis was performed, admitting emerging categories from the participants’ narratives.</jats:p> Results Three main profiles of organisations were identified: (i) Long-established organisations focused on influencing public policy and decision-making in cancer, (ii) Growing organisations focused on informing and supporting families and patients, (iii) Newly established organisations focused on patient well-being, such as sports activities. Relationships between groups and other actors involve perceived benefits like the growth of the organisations and funding for activities. However, perceived barriers and inequities are also identified, mainly lack of financial resources, competition between organisations and insufficient information. Discussion The objectives of civil society organisations in cancer are diverse and reflect multiple ways of practising social participation in health. Tensions generate unequal participation and missed opportunities to promote public health in cancer in Chile. The study highlights the importance of recognising cancer social organisations as essential actors in public health. It is crucial to involve them in formulating and implementing comprehensive responses to maximise the opportunities for progress in this field.
4
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A snapshot of cancer in Chile II: an update on research, strategies and analytical frameworks for equity, innovation and national development
(Springer Science and Business Media LLC, 2024-12-18)
Cristóbal Vacarezza
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Julieta Araneda
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Pamela Gonzalez
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Oscar Arteaga
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Katherine Marcelain
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Introduction</jats:title> <jats:p>Chile has achieved developed nation status and boasts a life expectancy of 81 + years; however, the healthcare and research systems are unprepared for the social and economic burden of cancer. One decade ago, the authors put forward a comprehensive analysis of cancer infrastructure, together with a series of suggestions on research orientated political policy.</jats:p> </jats:sec><jats:sec> <jats:title>Objectives</jats:title> <jats:p>Provide an update and comment on policy, infrastructure, gender equality, stakeholder participation and new challenges in national oncology. Assess the funding and distribution of cancer investigation. Present actions for the development of oncology research, innovation and patient care.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Triangulating objective system metrics of economic, epidemiological, private and public sector resources together with policy analysis, we assessed cancer burden, infrastructure, and investigation. We analyzed governmental and private-sector cancer databases, complemented by interviews with cancer stakeholders.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Governmental policy and patient advocacy have led to the recognition of cancer burden, a cancer law, and a national cancer plan. Cancer has become the leading cause of death in Chile (59,876 cases and 31,440 cancer deaths in 2022), yet only 0.36% gross domestic product (GDP) is directed to research and development. Inequalities in treatment regimens persist. Prevention policy has lowered tobacco consumption, sugar intake via soft drinks and offered a high coverage of HPV vaccines. A high-quality cancer research community is expanding, and internationally sponsored clinical oncology trials are increasing.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The cancer law has facilitated advancement in policy. Prevention policies have impacted tobacco and sugar intake, while gender equality and care inequality have entered the public forum. Cancer research is stagnated by the lack of investment. Implementation of a cancer registry and biobanking, reinforcement of prevention strategies, development of human resources, promotion of clinical trial infrastructure and investment in new technologies must be placed as a priority to permit advancements in innovation and equitable cancer care.</jats:p> </jats:sec>
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Retrospective study on disparities in time-to-treatment by health insurance system in Chilean breast cancer patients
(Medwave Estudios Limitada, 2025-04-10)
ACEVEDO ROMO, JOHANNA PATRICIA
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Teresa Ip
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Lea Maureira
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Cesar Sanchez
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Claudia Osorio
Introduction Breast cancer is the most common malignancy in the Americas, and the second leading cause of cancer death. Disparities in the time to treatment can significantly impact patient outcomes and typically affect lower socioeconomic individuals and/or ethnic minorities. Our study sought to evaluate disparities in time to treatment at three health institutions in Chile according to their type of health insurance (public or private). Methods Our study analyzed a database of breast cancer patients diagnosed between 2017 and 2018. Analyses included descriptive statistics and a linear regression model that incorporated clinical and demographic variables. Additionally, using a proportional risks model, we analyzed the association between clinical variables and mortality. Results Public health insurance (National Health Fund, FONASA) was associated with longer time-to-treatment and extended treatment times versus private health insurance (Social Security Institutions, ISAPRE; p < 0.0001). As expected, a more advanced stage at diagnosis was associated with lower survival. Our proportional risks model found that age was a predictor of breast cancer mortality in stage II patients. Also, total treatment time significantly increased the risk of breast cancer mortality in stage I patients. Conversely, total treatment time did not affect mortality on stages II or III. Conclusions We found significant disparities in the time to treatment of Chilean breast cancer patients using FONASA versus private ISAPRE. FONASA patients experience delays in the initiation of treatment and longer total treatment times compared to their private insurance counterparts. Finally, longer time-to-treatment was associated with more advanced stages and increased mortality.
3
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The legal path for priority setting in Chile: a critical analysis to improve health planning and stewardship
(Frontiers Media SA, 2024-01-08)
Manuel Antonio Espinoza
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CABIESES VALDES, BALTICA BEATRIZ
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Carolina Goic
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Alejandro Andrade
<jats:p>Health systems have committed their path to universal health coverage using health planning to accomplish their goals of efficiency, equity and sustainability. Chile, a high-income country with a public-private mix health system, has made significant progress through several successive health policies implemented in the last 20 years which have been consistent with this approach. However, in the last 5 years, the national congress has produced several disease-specific laws, which have been mainly promoted by the civil society. These laws indicate the actions the health authority must perform to tackle the needs of the affected population, which ultimately determine the priorities of the health system. We argue that this legal pattern has become an alternative path to priority-setting, as opposed to health planning. We claim this “legal path” is a mechanism used by civil society in a context where the health authority fails to implement a robust and legitimate prioritization process. Although these laws have brought benefits to patients suffering the corresponding conditions, we highlight this approach does not guarantee improvements in equity, efficiency and health system performance. Instead, we advocate for taking back the control of the priority-setting based on health planning, through a new institutionalization of health technology assessment and quality of care.</jats:p>
Scopus© Citations 4 2
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Quadruple therapies show a higher eradication rate compared to standard triple therapy for <i>Helicobacter pylori</i> infection within the LEGACy consortium. A multicenter observational study in European and Latin American countries
(2024)
Patricio Medel‐Jara
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Diego Reyes Placencia
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Eduardo Fuentes López
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Oscar Corsi
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Gonzalo Latorre
<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Gastric cancer (GC) is one of the most lethal malignancies worldwide. <jats:italic>Helicobacter pylori</jats:italic> is the primary cause of GC; therefore, its eradication reduces the risk of developing this neoplasia. There is extensive evidence regarding quadruple therapy with relevance to the European population. However, in Latin America, data are scarce. Furthermore, there is limited information about the eradication rates achieved by antibiotic schemes in European and Latin American populations.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To compare the effectiveness of standard triple therapy (STT), quadruple concomitant therapy (QCT), and bismuth quadruple therapy (QBT) in six centers in Europe and Latin America.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A retrospective study was carried out based on the LEGACy registry from 2017 to 2022. Data from adult patients recruited in Portugal, Spain, Chile, Mexico, and Paraguay with confirmed <jats:italic>H</jats:italic>. <jats:italic>pylori</jats:italic> infection who received eradication therapy and confirmatory tests at least 1 month apart were included. Treatment success by each scheme was compared using a mixed multilevel Poisson regression, adjusting for patient sex and age, together with country‐specific variables, including prevalence of <jats:italic>H</jats:italic>. <jats:italic>pylori</jats:italic> antibiotic resistance (clarithromycin, metronidazole, and amoxicillin), and <jats:italic>CYP2C19</jats:italic> polymorphisms.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>772 patients were incorporated (64.64% females; mean age of 52.93 years). The total <jats:italic>H</jats:italic>. <jats:italic>pylori</jats:italic> eradication rates were 75.20% (255/339) with STT, 88.70% (159/178) with QCT, and 91.30% (191/209) with QBT. Both quadruple therapies (QCT‐QBT) showed significantly higher eradication rates compared with STT, with an adjusted incidence risk ratio (IRR) of 1.25 (<jats:italic>p</jats:italic>: <0.05); and 1.24 (<jats:italic>p</jats:italic>: <0.05), respectively. The antibiotic‐resistance prevalence by country, but not the prevalence of <jats:italic>CYP2C19</jats:italic> polymorphism, showed a statistically significant impact on eradication success.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Both QCT and QBT are superior to STT for <jats:italic>H</jats:italic>. <jats:italic>pylori</jats:italic> eradication when adjusted for country‐specific antibiotic resistance and <jats:italic>CYP2C19</jats:italic> polymorphism in a sample of individuals residing in five countries within two continents.</jats:p></jats:sec>
Scopus© Citations 3 5
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Differential Effects of a Telemonitoring Platform in the Development of Chemotherapy-Associated Toxicity: A Randomized Trial Protocol
(2024)
Felipe Martínez
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Carla Taramasco
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Manuel Espinoza
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ACEVEDO ROMO, JOHANNA PATRICIA
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Carolina Goic
<jats:p>Chemotherapy requires careful monitoring, but traditional follow-up approaches face significant challenges that were highlighted by the COVID-19 pandemic. Hence, exploration into telemonitoring as an alternative emerged. The objective is to assess the impact of a telemonitoring platform that provides clinical data to physicians overseeing solid tumor patients, aiming to enhance the care experience. The methodology outlines a parallel-group randomized clinical trial involving recently diagnosed patients with solid carcinomas preparing for curative intent chemotherapy. Eligible adult patients diagnosed with specific carcinoma types and proficient in Spanish, possessing smartphones, will be invited to participate. They will be randomized using concealed allocation sequences into two groups: one utilizing a specialized smartphone application called Contigo for monitoring chemotherapy toxicity symptoms and accessing educational content, while the other receives standard care. Primary outcome assessment involves patient experience during chemotherapy using a standardized questionnaire. Secondary outcomes include evaluating severe chemotherapy-associated toxicity, assessing quality of life, and determining user satisfaction with the application. The research will adhere to intention-to-treat principles. This study has been registered at ClinicalTrials.gov (NCT06077123).</jats:p>
4Scopus© Citations 2
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Barriers to accessing formal cancer care from the perspective of informal caregivers: a qualitative study
(Springer Science and Business Media LLC, 2025-04-21)
CAMPAÑA, CARLA
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CABIESES VALDES, BALTICA BEATRIZ
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OBACH KING, ALEXANDRA ALICE
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Francisca Vezzani
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Angela Estay
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