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RESUMEN La quimioterapia neoadyuvante basada en cisplatino ha demostrado un claro beneficio en cáncer de vejiga músculo invasivo (MIBC) EC II o IIIA, logrando un impacto en la sobrevida libre de progresión y sobrevida global. Esta revisión actualizada se centra en el tratamiento neoadyuvante del MIBC, incluyendo las recomendaciones actuales de las guías de práctica clínica internacionales y/o locales, así como el estudio de nuevos agentes terapéuticos (inmunoterapia, terapias dirigidas) además de la investigación de potenciales biomarcadores predictivos de respuesta a inmunoterapia.
ABSTRACT Cisplatin-based neoadjuvant therapy has shown clear benefits in clinical stage II or IIIA muscle invasive bladder cancer (MIBC), achieving an impact in progression-free survival and overall survival. This updated review focuses on neoadjuvant therapy for MIBC, including the current recommendations from international and/or local practice guidelines, as well as studies of new therapeutic agents (immunotherapy, targeted therapy), on top of research on potential biomarkers that may predict response to immunotherapy.
RESUMO
BACKGROUND: Currently, the detection of PIK3CA mutations is of special interest in personalized medicine because it is frequently found in triple-negative breast cancer (TNBC). The PI3KCA mutation is an independent negative prognostic factor for survival in metastatic breast cancer, and its prognostic value in liquid biopsy as a biomarker of treatment and early relapse is under investigation, both for metastatic disease and neoadjuvant scenario with curative intent. CASE SUMMARY: A 54-year-old female patient with TNBC clinical stage IIIA, who, after receiving neoadjuvant chemotherapy (based on anthracyclines and taxanes), surgery, radiotherapy, and adjuvant capecitabine, was detected with a PI3KCA mutation in tissue and peripheral blood (ctDNA in liquid biopsy). After 10 mo, the patient had disease relapse of left cervical node disease. CONCLUSION: The detection of PIK3CA mutation in TNBC after neoadjuvant treatment might be associated with early relapse or rapid disease progression.
