Papers by ALAN ALEXIS RODRIGUEZ GONZALEZ
Annals of Oncology, 2012
Back ground: preoperative radiotherapy in resectable rectal cancer has a number of potential adva... more Back ground: preoperative radiotherapy in resectable rectal cancer has a number of potential advantages, most importantly, preventing local recurrence, increasing survival and down-staging effect. Purpose: This study was done to compare between the effect of preoperative radiotherapy and postoperative radiotherapy in treatment of resectable rectal carcinoma. The primary endpoints are local recurrence rate, overall survival (OS) and disease free survival (DFS). The secondary endpoints are to evaluate down-staging, treatment toxicity, and ability to do sphincter preservation, aiming at choosing the optimal treatment modality. Patients and methods: This study included 100 patients with resectable rectal carcinoma who presented to
The American Journal of Tropical Medicine and Hygiene, 2019
Lower respiratory tract infections (LRTIs) are the leading cause of deaths in children < 5 years ... more Lower respiratory tract infections (LRTIs) are the leading cause of deaths in children < 5 years old worldwide, particularly affecting low-resource settings such as Aweil, South Sudan. In these settings, diagnosis can be difficult because of either lack of access to radiography or clinical algorithms that overtreat children with antibiotics who only have viral LRTIs. Point-of-care ultrasound (POCUS) has been applied to LRTIs, but not by nonphysician clinicians, and with limited data from low-resource settings. Our goal was to examine the feasibility of training the mid-level provider cadre clinical officers (COs) in a Médecins Sans Frontières project in South Sudan to perform a POCUS algorithm to differentiate among causes of LRTI. Six COs underwent POCUS training, and each subsequently performed 60 lung POCUS studies on hospitalized pediatric patients < 5 years old with criteria for pneumonia. Two blinded experts, with a tiebreaker expert adjudicating discordant results, served as a reference standard to calculate test performance characteristics, assessed image quality and CO interpretation. The COs performed 360 studies. Reviewers rated 99.1% of the images acceptable and 86.0% CO interpretations appropriate. The inter-rater agreement (κ) between COs and experts for lung consolidation with air bronchograms was 0.73 (0.63-0.82) and for viral LRTI/bronchiolitis was 0.81 (0.74-0.87). It is feasible to train COs in South Sudan to use a POCUS algorithm to diagnose pneumonia and other pulmonary diseases in children < 5 years old.
Pharmacogenetics and Genomics, 2013
Objective Although KRAS mutation status has been identified as a strong predictor of response to ... more Objective Although KRAS mutation status has been identified as a strong predictor of response to anti-epidermal growth factor receptor (EGFR) therapies, not all wild-type patients respond. The lethal-7 (let-7) family of microRNAs regulates KRAS activity. A functional polymorphism (rs61764370) has been described in the let-7 complementary site (LCS6). We hypothesized a possible association between this KRAS let-7 LCS6 polymorphism and the response to anti-EGFR treatments in KRAS and BRAF wild-type metastatic colorectal cancer patients (mCRC). Materials and methods We studied the association of the KRAS let-7 LCS6 polymorphism with the response in 100 refractory mCRC patients treated with anti-EGFR antibodies. To assess the real effect of this polymorphism in relation to the treatment administered, we also studied this association in an independent cohort of patients treated exclusively with chemotherapy. The KRAS let-7 LCS6 polymorphism was genotyped using the BioMark system in blood and tumor DNA samples. The BRAF V600E mutation was analyzed in tumor samples. Results The KRAS let-7 LCS6 G-allele showed a statistically significant association with nonresponse to anti-EGFR-based treatment: 31.9% of patients with the T/T genotype presented a complete or a partial response versus no patients with T/G or G/G genotypes (P = 0.004). No statistically significant differences were observed in the patients who received chemotherapy only. Conclusion These data support the pharmacogenetic role of the KRAS let-7 LCS6 polymorphism in predicting the efficacy of anti-EGFR-based therapy in mCRC patients with the KRAS and the BRAF wild-type genotype. Pharmacogenetics and Genomics
Human pathology, Jan 24, 2017
Recently, we reported 2 mixed endometrioid endometrial carcinomas with a low-grade serous-like co... more Recently, we reported 2 mixed endometrioid endometrial carcinomas with a low-grade serous-like component which doesn't fit into any of the 4 molecular groups described by The Cancer Genome Atlas (TCGA). In order to understand the nature of these tumors, we have done an immunohistochemical and molecular genetic study of these two cases and added a third case. Immunoreactivity for p53, ER, Ki67, WT1, MLH1, PMS2, MSH2, and MSH6 were assessed. Targeted next-generation sequencing for somatic mutations, including genes commonly implicated in carcinogenesis including TP53, KRAS, and PIK3CA, and Sanger sequencing for PTEN and POLE were also performed. All patients were nulliparous and had morbid obesity. Their tumors showed a micropapillary component that resembled that of ovarian low-grade serous carcinoma and merged with villoglandular endometrioid carcinoma. The invasive tumor glands exhibited a microcystic, elongated, or fragmented (MELF) pattern and contained psammoma bodies. Two t...
Human pathology, Jan 10, 2017
Undifferentiated endometrial carcinoma is an aggressive type of uterine cancer which is occasiona... more Undifferentiated endometrial carcinoma is an aggressive type of uterine cancer which is occasionally associated with a low-grade endometrioid carcinoma component. This combination is referred to as "dedifferentiated endometrioid endometrial carcinoma." Neuroendocrine expression may occur in undifferentiated endometrial carcinoma but its significance in dedifferentiated endometrial carcinomas is unknown. To gain insight into the pathogenesis of these tumors we have analyzed the immunophenotype (ARID1A, MLH1, PMS2, MSH2, MSH6, p53, b-catenin, SMARCB1, synaptophysin, chromogranin A, and CD56) and mutational status (PTEN, KRAS, PIK3CA, TP53 and POLE) of 4 dedifferentiated endometrial carcinomas with strong and diffuse neuroendocrine expression. All tumors demonstrated neuroendocrine expression in ≥70% of the cells in the undifferentiated carcinoma areas. Loss of expression of at least 1 DNA mismatch repair protein was observed in 2 cases and p53 immunoreaction was aberrant (mu...
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Papers by ALAN ALEXIS RODRIGUEZ GONZALEZ