Abstract INTRODUCTION Racotumomab is a therapeutic vaccine based on a monoclonal anti-idiotypic antibody developed by the Molecular Immunology Center in Havana, Cuba, that is registered in Cuba and Argentina for treatment of non-small cell lung cancer. It induces a specific humoral and cellular immuneresponse against the N-glycolyl GM3 (NeuGcGM3) ganglioside present in tumor cells, thereby provoking the death of these cells. OBJECTIVE Evaluate racotumomab vaccine use as switch maintenance and second-line therapy for patients with inoperable non-small cell lung cancer in routine clinical practice, outside the framework of clinical studies, and assess the overall survival, stage-specific survival and safety in these patients. METHODS A descriptive, retrospective study was carried out in patients diagnosed with non-small cell lung cancer not suitable for surgical treatment, who received racotumomab as a part of switch maintenance or second-line treatments. Overall survival was defined from diagnosis and from the first immunization, until death. RESULTS We included 71 patients treated with racotumomab, 57.7% (41/71) of whom were in stages IIIB and IV of non-small cell lung cancer. Of the patients, 84.5% (60/71) had no adverse events, and 15.5% (11/71) had mild adverse reactions. The median overall survival was 24.5 months, calculated from the first immunization, 17.2 months for those who received racotumomab as switch maintenance and 6.8 months for patients who had progressed after the first line of treatment. CONCLUSIONS Racotumomab in routine clinical practice prolonged overall survival in patients with non-small cell lung cancer treated in switch maintenance, and in stage IV patients who received the treatment as second-line therapy. The vaccine was well tolerated.

ABSTRACT Introduction: HER2 overexpression in breast carcinoma is associated with the adverse clinical course and shorter survival, so it is necessary to determine the histopathological characteristics present in infiltrating breast carcinoma in patients with it, in order to establish correct and individualized therapy. Objectives: To determine the histopathological characteristics that are most frequently present in breast carcinoma with overexpression of HER2 gene in the studied patients. Methods: Observational, cross-sectional study from January 2010 to December 2012. Nine three patients were included. Sociodemographic, clinical, and pathological variables were explored. Absolute and relative frequencies were used in the statistical analysis. Results: The mean age was 55.1 years; 68.8% were white skinned. The most affected breast was the right one in 45.2% and the most frequent location was the upper-external quadrant in 26.9%. Invasive ductal carcinoma represented 71% of the total. Nuclear grade 3 was found in 81.7% cases and tumor necrosis 88.2%. Estrogen receptors were positive in 50.5% and progesterone receptors were negative in 59.1%. Histological analysis of breast cancer will be useful to individualize the therapy of each patient. Conclusions: It is important to continue the investigation with the incorporation of other variables of interest, such as response to treatment and survival, in addition to the in situ hybridization test detected by fluorescence in the patients of the universe in which HER2 2+ was found to define the status and better guide the treatment.

RESUMEN Introducción: La sobreexpresión del HER2 en el carcinoma de mama está asociada a un curso clínico adverso y menor sobrevida por lo que resulta necesario determinar las características histopatológicas presentes en el carcinoma de mama infiltrante en las pacientes que lo padecen, con el fin de establecer una terapéutica correcta e individualizada. Objetivos: Determinar las características histopatológicas más frecuentes presentes en el carcinoma de mama con sobreexpresión del gen HER2. Métodos: Estudio observacional, transversal en el período de enero 2010 a diciembre 2012. Se incluyeron 93 pacientes. Se exploraron variables sociodemográficas, clínicas e hstopatológicas. En el análisis estadístico se utlizaron frecuenicas absolutas y relativas. Resultados: La media de edad fue de 55,1 años y el 68,8 % era de piel blanca. La mama más afectada fue la derecha con el 45,2 % y la localización más frecuente el cuadrante supero-externo con el 26,9 %. El carcinoma ductal invasivo representó el 71 % del total. El grado nuclear 3 se encontró en 81,7 % casos y la necrosis tumoral 88,2 %. Los receptores estrogénicos fueron positivos en 50,5 % y los receptores de progesterona fueron negativos en 59,1 %. El análisis histológico del cáncer de mama será de utilidad para individualizar la terapia de cada una de las pacientes. Conclusiones: Es importante continuar la investigación con la incorporación de otras variables de interés, tales como, respuesta al tratamiento y supervivencia, además de la prueba de hibridización in situ detectada por fluorescencia en las pacientes del universo en las que se constató HER2 2+ para definir su estatus y orientar mejor su tratamiento.

Triple negative breast cancer is an aggressive tumor that, in the clinic, rarely presents with a paraneoplastic neurological syndrome associated with a metastatic carcinoma of unknown origin. This article reports a patient with such an association and that was discussed in Institutional Pathological Clinic.

El cáncer de mama triple negativo es un tumor agresivo que, muy pocas veces en la clínica, se presenta con un síndrome neurológico paraneoplásico asociado a un carcinoma metastásico de origen desconocido. Este artículo reporta una paciente con tal asociación y que su caso fue discutida en Clínica Patológica Institucional.