Papers by Rolando Camacho
pages 5592-5598 H. MASUI ET AL. 'Mechanism of antitumor activity in mice for anti-epidermal growt... more pages 5592-5598 H. MASUI ET AL. 'Mechanism of antitumor activity in mice for anti-epidermal growth factor receptor monoclonal antibodies with different isotypes.' • CANCER RESEARCH vol. 47, no. 14 , 15 July 1987 , PHILADELPHIA PA, USA pages 3692-3696 U. RODECK ET AL. 'Tumor growth modulation by a monoclonal antibody to the epidermal growth factor receptor: Immunologically mediated and effector cellindependent effects.' • PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE USA vol. 89, no. 10 , 15 May 1992 , WASHINGTON DC, USA pages 4285-4289 P. CARTER ET AL. 'Humanization of an anti-p185HER2 antibody for human cancer therapy.'
Molecular Immunology, 2002
P3 (IgM-) is a monoclonal antibody (mAb) reacting with N-glycolyl neuraminic acid (NeuGc)-contain... more P3 (IgM-) is a monoclonal antibody (mAb) reacting with N-glycolyl neuraminic acid (NeuGc)-containing gangliosides and sulfated glycolipids. To explore the nature of the idiotope defined by 1E10, we used a phage-displayed random peptide library. After three rounds of selection, seven different phagotopes were isolated. Noteworthy, all the sequences were found to bear the basic amino acid-rich motifs KPPR (3) or RRPR/K (4). This recursive selection of basic sequences by 1E10 mAb confirmed previous suggestions of the involvement of charged residues in the interaction between ␥-type Ab2 and P3 mAb. The binding of 1E10 to phage peptides representing each group was completely inhibited by P3 mAb. In addition, other Ab2 to P3 were able to recognize these peptides. Thus, phage peptides seem to be mimotopes of the idiotope recognized by anti-idiotypic antibodies in P3. Phage motifs were represented in the lineal sequence of P3's heavy chain H-CDR3 and a 14-mer peptide representing this region was able to specifically inhibit 1E10 binding to P3. Previous studies showed that P3's idiotype was autoimmunogenic and shared by antibodies with different specificities. Now, we demonstrated that P3 mAb is able to activate a network cascade involving autologous anti-idiotypic and anti-anti-idiotypic T cells. Thus, P3's idiotype fulfill the three criteria previously established to define a "regulatory idiotype". Particularly, data presented here revealed the immunodominance of the H-CDR3 of this mAb as a T cell epitope. Thus, H-CDR3 is simultaneously involved in the interaction of P3 mAb with anti-idiotypic B and T cells, behaving as a potential regulatory idiotope.
Cancer, 2020
The adoption of the goal of universal health coverage and the growing burden of cancer in low-and... more The adoption of the goal of universal health coverage and the growing burden of cancer in low-and middle-income countries makes it important to consider how to provide cancer care. Specific interventions can strengthen health systems while providing cancer care within a resource-stratified perspective (similar to the World Health Organization-tiered approach). Four specific topics are discussed: essential medicines/essential diagnostics lists; national cancer plans; provision of affordable essential public services (either at no cost to users or through national health insurance); and finally, how a nascent breast cancer program can build on existing programs. A case study of Zambia (a country with a core level of resources for cancer care, using the Breast Health Global Initiative typology) shows how a breast cancer program was built on a cervical cancer program, which in turn had evolved from the HIV/AIDS program. A case study of Brazil (which has enhanced resources for cancer care) describes how access to breast cancer care evolved as universal health coverage expanded. A case study of Uruguay shows how breast cancer outcomes improved as the country shifted from a largely private system to a single-payer national health insurance system in the transition to becoming a country with maximal resources for cancer care. The final case study describes an exciting initiative, the City Cancer Challenge, and how that may lead to improved cancer services.
JCO Global Oncology
PURPOSE Delivering high-quality cancer care to patients through a multidisciplinary team (MDT) ca... more PURPOSE Delivering high-quality cancer care to patients through a multidisciplinary team (MDT) care approach remains a challenge, particularly in low- and middle-income countries characterized by fragmented health systems and limited human resources for cancer care. City Cancer Challenge (C/Can) is supporting cities in low- and middle-income countries as they work to improve access to equitable quality cancer care. C/Can has developed an innovative methodology to address the MDT gap, piloted in four cities—Asunciòn, Cali, Kumasi, and Yangon. METHODS Collaborating with a network of partners, C/Can and ASCO have developed a package of technical cooperation support focusing on two priority areas that have emerged as core needs: first developing consensus-based, city-wide patient management guidelines for the most common cancers and second, building capacity for the implementation of MDTs in institutions providing cancer care in the city. RESULTS The real-time application of C/Can's...
El presente articulo describe una intervencion comunitaria con diseno cuasiexperimental cuyo prop... more El presente articulo describe una intervencion comunitaria con diseno cuasiexperimental cuyo proposito fue evaluar la eficacia de procedimientos educativos no tradicionales, centrados en metodologias por etapas y elaboracion individual de procesos de autorregulacion para desarrollar conductas protectoras de salud en el control del cancer. Se trabajo con 12 subgrupos de sujetos adultos de dos centros de trabajo, en quienes se fomentaron cambios en autocuidado de la salud, control del tabaquismo y control del estres. Dos grupos recibieron sendos procedimientos de intervencion y el restante fue un grupo control. La evaluacion pre y postintervencion se realizo con instrumentos que registraban indicadores de eficacia globales y especificos en cambios de estilos de vida. Los mejores resultados se obtuvieron con las metodologias PAP/PRISA-NO, las que se han generalizado como procederes de trabajo del Programa Nacional de Educacion en Cancer.
JCO Global Oncology
Diagnostic pathology services for oncology health systems are essential; yet, surveys, observatio... more Diagnostic pathology services for oncology health systems are essential; yet, surveys, observations, and hard data from across low- and middle-income countries have revealed that these services are almost always lacking adequate quality and often missing completely. The City Cancer Challenge Foundation (C/Can), the American Society for Clinical Pathology, and C/Can partner cities undertook intense analysis of their existing pathology services as part of a year-long assessment process including the specific formation of a pathology-focused team. Internal and external expert assessments identified sustainable solutions adapted to the local context and level of resources and created specific local implementation projects. Through local leadership, capacity development, and collaboration, services were improved city-wide in three cities: Cali, Colombia; Asunción, Paraguay; and Yangon, Myanmar. Common problems identified across cities included deficiencies in personnel training, equipmen...
Diagnostic pathology services for oncology health systems are essential; yet, surveys, observatio... more Diagnostic pathology services for oncology health systems are essential; yet, surveys, observations, and hard data from across low- and middle-income countries have revealed that these services are almost always lacking adequate quality and often missing completely. The City Cancer Challenge Foundation (C/Can), the American Society for Clinical Pathology, and C/Can partner cities undertook intense analysis of their existing pathology services as part of a year-long assessment process including the specific formation of a pathology-focused team. Internal and external expert assessments identified sustainable solutions adapted to the local context and level of resources and created specific local implementation projects. Through local leadership, capacity development, and collaboration, services were improved city-wide in three cities: Cali, Colombia; Asunción, Paraguay; and Yangon, Myanmar. Common problems identified across cities included deficiencies in personnel training, equipmen...
Resumen es: Las proyecciones de las cifras de incidencia de cancer indican un incremento futuro d... more Resumen es: Las proyecciones de las cifras de incidencia de cancer indican un incremento futuro de estas cifras en todo el mundo, los cambios mas conspicuos en paise...
Immunotherapy o f A dvanced B reast C ancer W ith a Heterophilic G anglioside ( NeuGcGM3) C ancer V accine
Purpose: A heterophilic ganglioside cancer vaccine was developed by combining NeuGcGM3 with the o... more Purpose: A heterophilic ganglioside cancer vaccine was developed by combining NeuGcGM3 with the outer membrane protein complex of Neisseria meningitidis to form very small size proteoliposomes (VSSP). A phase I clinical trial was performed to determine safety and immunogenicity of this vaccine. Patients and Methods: Stage III to IV breast cancer patients received up to 15 (200 g) doses of the vaccine by intramuscular injection. The first five doses (induction phase) were given at 2-week intervals, with the remaining treatment (maintenance) administered on a monthly basis. Results: Twenty-one patients, 11 of whom had metastatic disease, were included. Main toxicities included erythema and induration at the injection site, sometimes associated with mild pain, and low-grade fever (World Health Organization grades 1 and 2). All treated patients who completed the induction phase developed anti-NeuGcGM3 antibody titers between 1:1,280 and 1:164,000 immunoglobulin G (IgG), and 1:640 and 1:...
National cancer control plans across the Eastern Mediterranean region: challenges and opportunities to scale-up
The Lancet Oncology
National cancer control planning is crucial for countries in the WHO Eastern Mediterranean region... more National cancer control planning is crucial for countries in the WHO Eastern Mediterranean region. This region is challenged with an increase in cancer incidence leading to substantial disease burden, premature deaths, and increasing health-care costs in most countries. Huge inequity in cancer control planning and implementation exists between and within the countries. Over half of the countries (12 [55%] of 22) have standalone comprehensive National Cancer Control Plans and six (27%) have non-communicable disease plans that include cancer. The implementation of cancer plans has common challenges related to weak governance structure, few coordination mechanisms within countries, and inadequate human and financial resources. In most countries, the plan is not costed. Yet, the majority of countries (20 [91%]) reported having fully or partially funded plans. Additionally, political instability and conflicts affecting over half of the countries in the Eastern Mediterranean region have enormously affected cancer planning and implementation, both among the affected countries and those that host large numbers of refugees. In this Policy Review, we used the WHO regional framework for action on cancer to systematically analyse the status of cancer control planning and implementation across the six domains of cancer control, from prevention to palliation. We highlight the gaps, and the opportunities for bridging these gaps, to achieve scale-up on implementation of cancer control programmes in the Eastern Mediterranean region.
Cancer
Here we describe methodologies and health system prerequisites to support translation and impleme... more Here we describe methodologies and health system prerequisites to support translation and implementation of these guidelines into practice. METHODS: In October 2018, BHGI convened the 6th Global Summit on Improving Breast Healthcare through Resource Stratified Phased Implementation. The purpose of the Summit was to define a stepwise methodology ("phased implementation") for guiding the translation of resourceappropriate breast cancer control guidelines into real world practice. Three expert consensus panels developed phased implementation resource-appropriate recommendations for implementing these guidelines in LMICs as well as underserved communities in HICs. Each panel focused on one of three specific aspects of breast cancer care: 1) early detection, 2) treatment and 3) health system strengthening. RESULTS: Key findings from the Summit and subsequent manuscript preparation included the identification of phased implementation prerequisites that were explored during consensus debates. These core issues and concepts are key components for implementing breast healthcare that consider real world resource constraints. Communication and engagement across all levels of care is vital to any effectively operating healthcare system including effective communication with ministries of health and of finance, to demonstrate, need, outcomes and cost benefit. CONCLUSIONS: Underserved communities at all economic levels require effective strategies to deploy scarce resources to ensure access to timely, effective and affordable healthcare. Systematically strategic approaches translating guidelines into practice are needed to build health system capacity to meet the current and anticipated global breast-cancer burden.
Complicaciones de la cirugía laríngea radical
Rev Cuba Oncol, Dec 1, 1985
Receptores Hormonales y otros Factores Pronósticos en Cáncer de mama en Cuba. Cancerología vol. 3, p 19-27, 2008
Revista Del Instituto Nacional De Cancerologia, 2008
ABSTRACT Current clinical management of breast cancer patients needs information on known prognos... more ABSTRACT Current clinical management of breast cancer patients needs information on known prognostic factors, especially hormonal receptors, to establish prognosis and to select treatment options. These biological factors are relevant, not only to confirm the heterogeneity of the disease, but to design personalized treatments. In the present work, 1509 tumors from Cuban breast cancer patients were studied. Hormonal receptor (HR) expression was established and correlated with some prognostic factors as: age at diagnosis, tumor size, histological type, nuclear and histological grade, number of metastasized lymph nodes and clinical stage. Estrogen receptor (ER) expression results associate to lower nuclear and histological grade and smaller tumor size (p<0.05). The group of patients, 50 years old and older at diagnosis, showed higher expression of this HR (p<0.05). In general, patients with earlier clinical stages at diagnosis showed higher expression of ER (p<0.05). In this study, 53% of the tumors were ER + and 49% were PR +. For 38% of the tumors both receptors were positives and 28% negatives. The combination ER +/ PR – was seen in 23% of the cases while only 11% were ER -/ PR+. In fact, this report establishes that approximately 72 % of the Cuban breast cancer tumors expressed at least some level of hormonal dependence. This is the first HR report in Cuba, using Immunohistochemical methods in a representative sample of breast cancer tumors diagnosed in different provinces of the country.. Key words: Hormonal receptors, breast cancer, prognostic factors.
Revista Del Instituto Nacional De Cancerologia, 2009
L CÁNCER DE MAMA es uno de los tumores de mayor incidencia y mortalidad en la población a nivel m... more L CÁNCER DE MAMA es uno de los tumores de mayor incidencia y mortalidad en la población a nivel mundial. Se ubica dentro del grupo de las entidades clínicas más estudiadas, donde el manejo de la enfermedad, establecer el pronóstico y la terapéutica, están condicionados por el análisis de los parámetros clínico-patológicos, entre los cuales resulta esencial, la evaluación de los receptores hormonales (RH) y del receptor del factor de crecimiento epidérmico tipo 2 (HER2). En este trabajo se determinó la expresión del HER2 en 1,509 tumores de mujeres cubanas diagnosticadas con cáncer de mama entre los años 2000 y 2006 y se correlacionó su expresión tisular con los factores pronósticos morfológicos y clínicos, que se evalúan de manera estándar en el momento de la decisión terapéutica. La positividad del HER2 encontrada en los tumores mamarios analizados fue 23.7% y su sobreexpresión de 16.8 %. Las correlaciones realizadas entre el marcador tumoral y el grado nuclear e histológico, la dimensión mayor del tumor, la pérdida de los receptores de estrogeno (RE) y con la edad, mostraron significancia estadística (p<0.05). El estudio en las pacientes menores de 40 años reveló una mayor expresión de este marcador (p=0.04). Los tumores triple negativos constituyeron el 19.9% de la muestra. Estos resultados constituyen el primer reporte de la expresión del HER2 en Cuba y confirman su asociación con los factores pronósticos clínico-anatomopatológicos.
Cancer and demographic transition in Latin America and the Caribbean
Revista Cubana De Salud Publica, Sep 1, 2006
The Lancet. Oncology, 2015
Supportive care and palliative care are now recognised as critical components of global cancer co... more Supportive care and palliative care are now recognised as critical components of global cancer control programmes. Many aspects of supportive and palliative care services are already available in some low-income and middle-income countries. Full integration of supportive and palliative care into breast cancer programmes requires a systematic, resource-stratified approach. The Breast Health Global Initiative convened three expert panels to develop resource allocation recommendations for supportive and palliative care programmes in low-income and middle-income countries. Each panel focused on a specific phase of breast cancer care: during treatment, after treatment with curative intent (survivorship), and after diagnosis with metastatic disease. The panel consensus statements were published in October, 2013. This Executive Summary combines the three panels' recommendations into a single comprehensive document covering breast cancer care from diagnosis through curative treatment in...
Journal of Cancer Therapy, 2014
Background: Treatment is an important component of a comprehensive cancer control approach and it... more Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is imperative to generate evidence-based tools to assist health policy makers from low resourced countries in planning efficient and equitable treatment services for a defined population based on what it is feasible to these settings. Methods: The intended cancer specific treatment planned and written in the patients' medical record (treatment prescription) of untreated adult cancer cases (≥18 years of age), excluding non-melanoma skin cancer, was recorded in a chronological way from 1 January 2012 onwards in a group of eight comprehensive cancer centres located in middle income countries and offering the main modalities of cancer
Journal of Global Oncology, 2016
Purpose To provide evidence-based, resource-stratified global recommendations to clinicians and p... more Purpose To provide evidence-based, resource-stratified global recommendations to clinicians and policymakers on the management and palliative care of women diagnosed with invasive cervical cancer. Methods ASCO convened a multidisciplinary, multinational panel of cancer control, medical and radiation oncology, health economic, obstetric and gynecologic, and palliative care experts to produce recommendations reflecting resource-tiered settings. A systematic review of literature from 1966 to 2015 failed to yield sufficiently strong quality evidence to support basic- and limited-resource setting recommendations; a formal consensus-based process was used to develop recommendations. A modified ADAPTE process was also used to adapt recommendations from existing guidelines. Results Five existing sets of guidelines were identified and reviewed, and adapted recommendations form the evidence base. Eight systematic reviews, along with cost-effectiveness analyses, provided indirect evidence to i...
JCO Global Oncology, 2021
The effective implementation of locally adapted cancer care solutions in low- and middle-income c... more The effective implementation of locally adapted cancer care solutions in low- and middle-income countries continues to be a challenge in the face of fragmented and inadequately resourced health systems. Consequently, the translation of global cancer care targets to local action for patients has been severely constrained. City Cancer Challenge (C/Can) is leveraging the unique value of cities as enablers in a health systems response to cancer that prioritizes the needs of end users (patients, their caregivers and families, and health care providers). C/Can’s City Engagement Process is an implementation framework whereby local stakeholders lead a staged city-wide process over a 2- to 3-year period to assess, plan, and execute locally adapted cancer care solutions. Herein, the development and implementation of the City Engagement Process Framework (CEPF) is presented, specifying the activities, outputs, processes, and indicators across the process life cycle. Lessons learned on the appl...
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Papers by Rolando Camacho