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Author: search.filters.author.Lazareva, EmilijaHas files: Yes

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    The highest frequency of BRCA1 c.3700_3704del detected among Albanians from Kosovo
    (Greater Poland Cancer Centre, Poland, 2022)
    Kostovska Maleva, Ivana
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    Jakovchevska, Simona
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    Özdemir, Milena Jakimovska
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    Kiprijanovska, Sanja
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    Kubelka-Sabit, Katerina
    Background: The spectrum of BRCA1 and BRCA2 mutations varies among populations; however, some mutations may be frequent in particular ethnic groups due to the “founder” effect. The c.3700_3704del mutation was previously described as a recurrent BRCA1 variant in Eastern European countries. This study aimed to investigate the frequency of c.3700_3704del BRCA1 mutation in Albanian breast and ovarian cancer patients from North Macedonia and Kosovo. Materials and methods: A total of 327 patients with invasive breast and/or ovarian cancer (111 Albanian women from North Macedonia and 216 from Kosovo) were screened for 13 recurrent BRCA1/2 mutations. Targeted NGS with a panel of 94 cancer-associated genes including BRCA1 and BRCA2 was performed in a selected group of 118 patients. Results: We have identified 21 BRCA1/2 pathogenic variants, 17 (14 BRCA1 and 3 BRCA2) in patients from Kosovo (7.9%) and 4 (1 BRCA1 and 3 BRCA2) in patients from North Macedonia (3.6%). All BRCA1/2 mutations were found in one patient each, except for c.3700_3704del BRCA1 mutation which was observed in 14 unrelated families, all except one originating from Kosovo. The c.3700_3704del mutation accounts for 93% of BRCA1 mutation positive cases and is present with a frequency of 6% among breast cancer patients from Kosovo. Conclusions: This is the first report of BRCA1/2 mutations among breast and ovarian cancer patients from Kosovo. The finding that BRCA1 c.3700_3704del represents a founder mutation in Kosovo with the highest worldwide reported frequency supports the implementation of fast and low-cost screening protocol, regardless of the family history and even a pilot population-based screening in at-risk population.
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    Real-world data of cardiotoxicity during long-term therapy with trastuzumab in human epidermal growth factor receptor-2-positive metastatic breast cancer
    (National Library of Serbia, 2022-12-16)
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    Lazareva, Emilija
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    Introduction/Objective. This study aims to investigate the cardiotoxicity of long-term therapy with trastuzumab in patients with HER2 positive metastatic breast cancer. Methods. A total of 48 patients with metastatic HER2 positive breast cancer were analyzed. The patients received long-term trastuzumab (time of application was longer than 20 months). The analyzed characteristics of the patients were: age, initial stage of the disease, application of anti-HER2 therapy and anthracyclines in the adjuvant setting, the number and type of applied systemic therapies concomitant with trastuzumab in the metastatic setting. Cardiac toxicity was assessed using left ventricular ejection fraction (LVEF) values at three time points: at the beginning, in the middle, and at the end of treatment period for each patient separately. Results. In 17 (35.4%) patients the trastuzumab treatment was temporary discontinued. The average time of trastuzumab therapy interval was 52.2 ? 23.5 months. The mean LVEF values were 66.73 ? 7.02%, 64.62 ? 5.7% and 63.44 ? 6.1%, respectively. The mean values of LVEF differed significantly in the observed three time points (F=4.9 p=0.009). Post hoc pairwise comparison, using Bonferonni correction, confirmed significantly lower mean LVEF values at the end point (at the end of treatment) compared with the mean LVEF values at the beginning of anti-HER2 treatment (p = 0.019), but within the reference range of LVEF ?50%. Conclusion. The data confirm good safety profile of long-term trastuzumab therapy in HER2 positive metastatic breast cancer patients considering cardiotoxicity.
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    Prevention of chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients receiving adjuvant chemotherapy: Single institution experience
    (2020)
    Iljovska, Marina
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    Lazareva, Emilija
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    Introduction. The modern treatment of malignant diseases and the use of antineoplastic agents pose numerous challenges in terms of the side effects from applied specific oncological treatment. Despite to the significant progress in recent years, emesis and nausea are the two most common and most stressful side effects of cancer treatment and their successful management is still a great challenge. Chemotherapy-induced vomiting or nausea (CINV) significantly affects the quality of life of patients, can cause metabolic disorders, diarrhea, eating disorders and general physical and mental disorders and can question the further anti-tumor treatment of the patient. The prevention and the treatment of CINV and antiemetic therapy have central role in modern protocols for oncological treatment of malignant diseases, including breast cancer patients. Aim. The aim of our study was to obtain data about the efficacy of antiemetic prophylaxis in patients with breast cancer who received chemotherapy following the EC75 protocol in adjuvant setting and the compliance of the patients for the both acute and delayed emesis and nausea. Materials and methods. A prospective study was conducted in 32 breast cancer patients receiving chemotherapy following an EC75 protocol in an adjuvant setting for four consecutive chemotherapy cycles between February 2015 and June 2015. All patients received adequate premedication on day 1 prior to chemotherapy and appropriate oral postmedication was recommended in day 2-5 (with 5-HT3 antagonist and corticosteroid). The occurrence of acute and delayed nausea and emesis as well as taking the recommended postmedicaton by patients was evaluated through a specially structured questionnaire that beside general information contained the following information: the appearance of emesis and nausea within 24 hours after receiving chemotherapy and within the next 10 days, taking the recommended postmedication and the number of taken tablets and taking additional therapy besides the recommended. Results. Out of 32 patients, acute onset of nausea, nausea till day 5 and nausea from 5 to 10 day was recorded in 50%, 44% and 31% of patients, respectively. The results of the occurrence of acute emesis, emesis to to day 5 and nausea from 5 to 10 day were 16%, 9% and 0% respectively. Patients who received complete postmedication have reported acute nausea, nausea till day 5 and nausea from 5 to 10 day in 50%, 50% and 20%, while in patients with partial postmedication 50%, 59% and 39%, respectively. Conclusion. The obtained results do not indicate that acute and delayed nausea are more difficult to control. In patients’ good compliance, better control of both acute and postponed emesis is achieved, although the results obtained in patients with partial compliance may be due to failure to follow the recommended treatment. Despite the effectiveness of antiemetic prophylaxis and good compliance, there is a possibility for its improvement with introduction of new generations of antiemetics. Keywords: Chemotherapy, emesis, nausea, breast cancer, compliance
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    DUAL HER2 BLOCKADE WITH TRASTUZUMAB AND PERTUZAMB IN HER2- POSITIVE BREAST CANCER: SINGLE CENTER REAL WORLD DATA
    (Macedonian Association of Anatomists, 2020-12-30)
    Lazareva, Emilija
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    Agents targeting the human epidermal growth factor receptor 2 (HER2) have improved outcomes of advanced HER2-positive breast cancer with durable responses. We evaluated therapy with trastuzumab and pertuzumab in early and metastatic HER2-positive breast cancer patients. In this paper we discuss the practicalities of treating patients with this combination with a particular focus on treatment in the single center setting. We retrospectively identifed patients on adjuvant and frst-line anti-HER2 therapy at The University Clinic of Radiotherapy and Oncology Skopje for at least 1 year from 2019 to 2020. Demographics, treatments and adverse events were recorded. The combination of pertuzumab–trastuzumab has established efficacy in patients with HER2‐positive advanced/metastatic breast cancer. Management of treatment related side‐effects such as diarrhea, febrile neutropenia and neuropathy typically include dose reduction or switching taxane. Specific patients with poorer tolerance of chemotherapy such may require particular management strategies.The roles of trastuzumab and pertuzumab are now very well established in the frst-line setting; identifying predictors of long-term response to these would be important in selecting which patients might beneft from entry into future clinical trials assessing the long-term beneft of these newer agents in addition.