Browsing by Author "Nervi Nattero, Bruno"

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    A Molecular Stratification of Chilean Gastric Cancer Patients with Potential Clinical Applicability
    (2020) Pinto Paganini, Mauricio Arturo; Bravo Castillo, Maria Loreto; Sánchez Rojel, César Giovanni; Acevedo, Francisco; Mondaca Contreras, Sebastián Patricio; Ibañez, Carolina; Galindo A., Héctor; Madrid Arenas, Jorge; Nervi Nattero, Bruno; Peña Durán, José Esteban; Torres Montes, Paula Javiera; Owen, Gareth Ivor; Corvalán R., Alejandro; Garrido S., Marcelo; Córdova Delgado, M.; Retamal, I. N.; Muñoz Medel, M.; Durán, D.; Villanueva, F.; Koch, E.; Armisen, R.
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    A snapshot of cancer in Chile II: an update on research, strategies and analytical frameworks for equity, innovation and national development
    (2024) Vacarezza, Cristóbal; Araneda, Julieta; González Hevia, Pamela Andrea; Arteaga, Oscar; Marcelain, Katherine; Castellon, Enrique A.; Periera, Ana; Khoury, Maroun; Müller, Bettina; Lecaros, Juan A.; Salas, Sofia P.; Riquelme Pérez, Arnoldo; Corvalán R., Alejandro; de la Jara, Jorge J.; Ferreccio, Catterina; Goic B., Carolina; Nervi Nattero, Bruno; Roa, Juan C.; Owen, Gareth Ivor
    Abstract Introduction Chile has achieved developed nation status and boasts a life expectancy of 81 + years; however, the healthcare and research systems are unprepared for the social and economic burden of cancer. One decade ago, the authors put forward a comprehensive analysis of cancer infrastructure, together with a series of suggestions on research orientated political policy. Objectives Provide an update and comment on policy, infrastructure, gender equality, stakeholder participation and new challenges in national oncology. Assess the funding and distribution of cancer investigation. Present actions for the development of oncology research, innovation and patient care. Methods Triangulating objective system metrics of economic, epidemiological, private and public sector resources together with policy analysis, we assessed cancer burden, infrastructure, and investigation. We analyzed governmental and private-sector cancer databases, complemented by interviews with cancer stakeholders. Results Governmental policy and patient advocacy have led to the recognition of cancer burden, a cancer law, and a national cancer plan. Cancer has become the leading cause of death in Chile (59,876 cases and 31,440 cancer deaths in 2022), yet only 0.36% gross domestic product (GDP) is directed to research and development. Inequalities in treatment regimens persist. Prevention policy has lowered tobacco consumption, sugar intake via soft drinks and offered a high coverage of HPV vaccines. A high-quality cancer research community is expanding, and internationally sponsored clinical oncology trials are increasing. Conclusions The cancer law has facilitated advancement in policy. Prevention policies have impacted tobacco and sugar intake, while gender equality and care inequality have entered the public forum. Cancer research is stagnated by the lack of investment. Implementation of a cancer registry and biobanking, reinforcement of prevention strategies, development of human resources, promotion of clinical trial infrastructure and investment in new technologies must be placed as a priority to permit advancements in innovation and equitable cancer care.
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    Admission of Hematopoietic Cell Transplantation Patients to the Intensive Care Unit at the Pontificia Universidad Catolica de Chile Hospital
    (2015) Escobar, K.; Rojas, P.; Ernst Diaz, Daniel Matias; Bertín Cortes Monroy, Pablo; Nervi Nattero, Bruno; Jara, V.; Garcia, M.; Ocqueteau Tachini, Mauricio; Sarmiento Maldonado, Mauricio; Ramirez, P.
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    Advanced practice nursing as a proposal to improve access and coverage in oncology for Latin America
    (2021) Marquez Doren, Francisca; Palma Rivadeneira, Silvia; Soto Fuentes, Paz; Lucchini Raies, Camila; Pena Duran, Jose; Nervi Nattero, Bruno; Suarez Pierart, Paulina; Gonzalez Rodriguez, Rina; Rojas Silva, Noelia; Bustamante Troncoso, Claudia; Alcayaga Rojas, Claudia; Catoni Salamanca, Maria Isabel; Arechabala Mantuliz, Maria Cecilia
    PAHO/WHO proposes to implement the role of Advanced Practice Nurse (APN) in Latin America, to reduce gaps in coverage and access to health care. For this purpose, it is necessary to train nursing professionals with an expanded role, which allows them to collaborate in the diagnosis, treatment, and monitoring of people with specific diseases, under established protocols and clinical guidelines and within consolidated interdisciplinary health teams in a cost-effective way. One of the areas with the greatest coverage deficit in Latin America is adult oncology, with inequality in care opportunities for these patients. Part of the premature deaths attributable to this disease are due to the lack of access to timely diagnosis and treatment. As a contribution to the reduction of this gap, a training program of Advanced Nursing Practice was developed, addressing the most urgent needs in the field of oncology. The necessary competencies were defined to develop a professional-level master's degree program, considering prevention, early detection, diagnosis, treatment, and monitoring of people with oncological diseases at different levels of care. A program of this kind is an opportunity to reduce the access gap and coverage of health care for people with cancer, improving their quality of life and their survival.
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    Búsqueda de mutaciones en el gen UL 97 asociadas a resistencia a ganciclovir en citomegalovirus obtenidos desde muestras biológicas de pacientes chilenos
    (2010) Oyarzún Andrade, María Angélica; Bustos, Patricia; González Agüero, Marcela Margot; Domínguez Moreno, María Isabel; Aguayo González, Francisco Renan; Nervi Nattero, Bruno; Ferrés, Marcela
    Background: Long term use of ganciclovir (GCV) is associated with acquired resistance to it. Ninety percent of the responsible mutations occur in cytomegalovirus (CMV) UL97 gene. Aim: To search for these mutations, comparing nucleotide sequences of CMV-positive samples from post transplant and immunocompromised patients receiving GCV, with sequences of CMV isolates obtained from subjects not exposed to the drug. Patients and Methods: Codons 440 to 465 of gene UL97, including the most common mutations causing resistance to GCV, were amplified in 33 plasma samples from patients exposed to GCV and in 15 urine samples of newborns. Both populations and their nucleotide sequences were compared with the prototype strain CMV AD169. Results: Samples of exposed patients had multiple mutations but only one had a mutation associated with clinical resistance (M4601). Eight subjects had the D605E mutation, whose role in resistance is controversial. The remaining 150 mutations were silent mutations. Conclusions: A low frequency of mutations associated with CMV resistance to GCV was found in these exposed and unexposed samples. These mutations may reflect coexistence of multiple genetic variants of CMV. The absence of clinical expression of resistance, even with these mutations, can be explained by the use of GCV for a shorter lapse than that associated with the appearance of resistance. (Rev Med Chile 2010; 138: 421-427).
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    Convalescent plasma in COVID-19. Mortality-safety first results of the prospective multicenter FALP 001-2020 trial
    (2020) Gazitúa, R.; Briones, J. L.; Selman, C.; Villarroel Espíndola, F.; Aguirre, A.; González Steigmaier, R.; Cereceda, K.; Mahave, M.; Rubio, B.; Ferrer Rosende, P.; Sapunar, J.; Marsiglia, H.; Morales, R.; Yarad, F.; Balcells Marty, María Elvira; Rojas, Luis; Nervi Nattero, Bruno; Nien, J. K.; Garate, J.; Prieto, C.; Palma, S.; Escobar, C.; Bascuñan, J.; Muñoz, R.; Pinto, M.; Cardemil, D.; Navarrete, M.; Reyes, S.; Espinosa, V.; Yáñez, N.; Caglevic, C.
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    Differential Effects of a Telemonitoring Platform in the Development of Chemotherapy-Associated Toxicity: A Randomized Trial Protocol
    (2024) Martínez, Felipe; Taramasco, Carla; Espinoza Sepúlveda, Manuel Antonio; Acevedo, Johanna; Goic Boroevic, Carolina; Nervi Nattero, Bruno
    Chemotherapy requires careful monitoring, but traditional follow-up approaches face significant challenges that were highlighted by the COVID-19 pandemic. Hence, exploration into telemonitoring as an alternative emerged. The objective is to assess the impact of a telemonitoring platform that provides clinical data to physicians overseeing solid tumor patients, aiming to enhance the care experience. The methodology outlines a parallel-group randomized clinical trial involving recently diagnosed patients with solid carcinomas preparing for curative intent chemotherapy. Eligible adult patients diagnosed with specific carcinoma types and proficient in Spanish, possessing smartphones, will be invited to participate. They will be randomized using concealed allocation sequences into two groups: one utilizing a specialized smartphone application called Contigo for monitoring chemotherapy toxicity symptoms and accessing educational content, while the other receives standard care. Primary outcome assessment involves patient experience during chemotherapy using a standardized questionnaire. Secondary outcomes include evaluating severe chemotherapy-associated toxicity, assessing quality of life, and determining user satisfaction with the application. The research will adhere to intention-to-treat principles. This study has been registered at ClinicalTrials.gov (NCT06077123)
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    Early versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial
    (2021) Balcells Marty, Maria Elvira; Rojas Orellana, Luis Esteban; Martínez Valdebenito, Constanza Pamela; Ceballos Valdivielso, María Elena Andrea; Ferrés Garrido, Marcela Viviana; Chang Rathkamp, Mayling Raquel; Vizcaya Altamirano, María Cecilia; Mondaca Contreras, Sebastián Patricio; Huete Garín, Isidro Álvaro; Castro López, Ricardo Adolfo; Sarmiento Maldonado, Mauricio; Villarroel Del Pino, Luis Antonio; Pizarro Ibáñez, Alejandra Valentina; Ross Pérez, Patricio Daniel; Santander Toro, Jaime Andrés; Lara Hernández, Bárbara Alejandra; Ferrada Koch, Marcela Patricia; Vargas Salas, Sergio Sebastián; Beltrán Pávez, Carolina; Soto Rifo, Ricardo; Valiente Echeverria, Fernando Andrés; Caglevic, Christian; Mahave, Mauricio; Selman Bravo, Carolina Antoniett; Gazitúa, Raimundo; Briones, José Luis; Villarroel Espíndola, Franz; Balmaceda Araque, Carlos Felipe; Espinoza Sepúlveda, Manuel Antonio; Pereira Garces, Jaime; Nervi Nattero, Bruno; Le Corre Perez, Monique Nicole
    Background: Convalescent plasma (CP), despite limited evidence on its efficacy, is being widely used as a compassionate therapy for hospitalized patients with COVID-19. We aimed to evaluate the efficacy and safety of early CP therapy in COVID-19 progression.", "Methods and findings", "The study was an open-label, single-center randomized clinical trial performed in an academic medical center in Santiago, Chile, from May 10, 2020, to July 18, 2020, with final follow-up until August 17, 2020. The trial included patients hospitalized within the first 7 days of COVID-19 symptom onset, presenting risk factors for illness progression and not on mechanical ventilation. The intervention consisted of immediate CP (early plasma group) versus no CP unless developing prespecified criteria of deterioration (deferred plasma group). Additional standard treatment was allowed in both arms. The primary outcome was a composite of mechanical ventilation, hospitalization for >14 days, or death. The key secondary outcomes included time to respiratory failure, days of mechanical ventilation, hospital length of stay, mortality at 30 days, and SARS-CoV-2 real-time PCR clearance rate. Of 58 randomized patients (mean age, 65.8 years; 50% male), 57 (98.3%) completed the trial. A total of 13 (43.3%) participants from the deferred group received plasma based on clinical aggravation. We failed to find benefit in the primary outcome (32.1% versus 33.3%, odds ratio [OR] 0.95, 95% CI 0.32-2.84, p > 0.999) in the early versus deferred CP group. The in-hospital mortality rate was 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17 p = 0.246), mechanical ventilation 17.9% versus 6.7% (OR 3.04, 95% CI 0.54-17.17, p = 0.246), and prolonged hospitalization 21.4% versus 30.0% (OR 0.64, 95% CI, 0.19-2.10, p = 0.554) in the early versus deferred CP group, respectively. The viral clearance rate on day 3 (26% versus 8%, p = 0.204) and day 7 (38% versus 19%, p = 0.374) did not differ between groups. Two patients experienced serious adverse events within 6 hours after plasma transfusion. The main limitation of this study is the lack of statistical power to detect a smaller but clinically relevant therapeutic effect of CP, as well as not having confirmed neutralizing antibodies in donor before plasma infusion.", "Conclusions", "In the present study, we failed to find evidence of benefit in mortality, length of hospitalization, or mechanical ventilation requirement by immediate addition of CP therapy in the early stages of COVID-19 compared to its use only in case of patient deterioration.
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    Effects on Quality of Life of a Telemonitoring Platform amongst Patients with Cancer (EQUALITE) A Randomized Trial Protocol
    (2024) Martínez, Felipe; Taramasco Toro, Carla; Espinoza Sepúlveda, Manuel Antonio; Acevedo, Johanna; Goic Boroevic, Carolina; Nervi Nattero, Bruno
    Cancer, a pervasive global health challenge, necessitates chemotherapy or radiotherapy treatments for many prevalent forms. However, traditional follow-up approaches encounter limitations, exacerbated by the recent COVID-19 pandemic. Consequently, telemonitoring has emerged as a promising solution, although its clinical implementation lacks comprehensive evidence. This report depicts the methodology of a randomized trial which aims to investigate whether leveraging a smartphone app called Contigo for disease monitoring enhances self-reported quality of life among patients with various solid cancers compared to standard care. Secondary objectives encompass evaluating the app’s impact on depressive symptoms and assessing adherence to in-person appointments. Randomization will be performed independently using an allocation sequence that will be kept concealed from clinical investigators. Contigo offers two primary functions: monitoring cancer patients’ progress and providing educational content to assist patients in managing common clinical situations related to their disease. The study will assess outcomes such as quality of life changes and depressive symptom development using validated scales, and adherence to in-person appointments. Specific scales include the EuroQol Group’s EQ-5D questionnaire and the Patient Health Questionnaire (PHQ-9). We hypothesize that the use of Contigo will assist and empower patients receiving cancer treatment, which will translate to better quality of life scores and a reduced incidence of depressive symptoms. All analyses will be undertaken with the intention-to-treat principle by a statistician unaware of treatment allocation. This trial is registered in ClinicalTrials under the registration number NCT06086990
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    Estimating the impact of the COVID-19 pandemic on diagnosis and survival of five cancers in Chile from 2020 to 2030: a simulation-based analysis
    (2021) Walbaum, Benjamin; Ward, Zachary J; Walbaum, Magdalena; Walbaum, Benjamin; Jose Guzman, Maria; Jímenez De La Jara, Jorge Adolfo; Nervi Nattero, Bruno; Atun, Rifat
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    Gallbladder Cancer Risk and Indigenous South American Mapuche Ancestry: Instrumental Variable Analysis Using Ancestry-Informative Markers
    (2023) Zollner, Linda; Boekstegers, Felix; Barahona Ponce, Carol; Scherer, Dominique; Marcelain, Katherine; Gárate-Calderón, Valentina; Waldenberger, Melanie; Morales Mejías, Erik; Rojas, Armando; Muñoz, César; Retamales, Javier; Toro, Gonzalo De; Vera Kortmann, Allan; Barajas, Olga; Rivera, María Teresa; Cortés, Analía; Loader, Denisse; Saavedra, Javiera; Gutiérrez, Lorena; Ortega, Alejandro; Bertrán, María Enriqueta; Bartolotti, Leonardo; Gabler, Fernando; Campos, Mónica; Alvarado, Juan; Moisán, Fabricio; Spencer, María Loreto; Nervi Nattero, Bruno; Carvajal-Hausdorf, Daniel; Losada, Héctor; Almau, Mauricio; Fernández, Plinio; Olloquequi, Jordi; Carter, Alice R.; Miquel P., Juan Francisco; Bustos, Bernabé I.; Fuentes Guajardo, Macarena; Gonzalez-Jose, Rolando; Bortolini, Maria Cátira; Acuña-Alonzo, Victor; Gallo, Carla; Ruiz Linares, Andrés; Rothhammer, Francisco; Bermejo, Justo Lorenzo
    A strong association between the proportion of indigenous South American Mapuche ancestry and the risk of gallbladder cancer (GBC) has been reported in observational studies. Chileans show the highest incidence of GBC worldwide, and the Mapuche are the largest indigenous people in Chile. We set out to assess the confounding-free effect of the individual proportion of Mapuche ancestry on GBC risk and to investigate the mediating effects of gallstone disease and body mass index (BMI) on this association. Genetic markers of Mapuche ancestry were selected based on the informativeness for assignment measure, and then used as instrumental variables in two-sample Mendelian randomization analyses and complementary sensitivity analyses. Results suggested a putatively causal effect of Mapuche ancestry on GBC risk (inverse variance-weighted (IVW) risk increase of 0.8% per 1% increase in Mapuche ancestry proportion, 95% CI 0.4% to 1.2%, p = 6.7 × 10−5) and also on gallstone disease (3.6% IVW risk increase, 95% CI 3.1% to 4.0%), pointing to a mediating effect of gallstones on the association between Mapuche ancestry and GBC. In contrast, the proportion of Mapuche ancestry showed a negative effect on BMI (IVW estimate −0.006 kg/m2, 95% CI −0.009 to −0.003). The results presented here may have significant implications for GBC prevention and are important for future admixture mapping studies. Given that the association between the individual proportion of Mapuche ancestry and GBC risk previously noted in observational studies appears to be free of confounding, primary and secondary prevention strategies that consider genetic ancestry could be particularly efficient.
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    Hippo-YAP1 Is a Prognosis Marker and Potentially Targetable Pathway in Advanced Gallbladder Cancer
    (2020) García Muñoz, Patricia; Rosa, L.; Vargas, S.; Weber, H.; Espinoza, J. A.; Suárez, F.; Nervi Nattero, Bruno; Obreque Castro, Javiera Constanza; Roa Strauch, Juan Carlos Enrique; Bizama, Carolina; Romero Calvo, I.; Elgueta, N.; Rivera, V.; Leal, P.; Viñuela, E.; Aguayo, G.; Muniz, S.; Sagredo, A.
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    Impact of Adjuvant FOLFOX on Quality of Life and Peripheral Neuropathy Incidence in Patients With Gastric Cancer: A Prospective Cohort Study
    (Elsevier Inc., 2023) Mondaca Contreras, Sebastián Patricio; Pinto, Mauricio P.; Briones Carvajal, Juan Rodrigo; Caire, Nicole; Peña Prado, José Tomas; Koch Hein, Erica Cristina; Muñiz Muñoz, Maria Sabrina; Herrera, María Elisa; Sanchez Rojel, Cesar Giovanni; Galindo Aranibar, Héctor Gonzalo; Pizarro Brito, Gonzalo Ignacio; Acevedo Claros, Francisco Nicolas; Ibáñez Cáceres, Carolina; Balmaceda Araque, Carlos Felipe; Norero, Enrique; Duran, Doris; Garrido Salvo, Marcelo Adán; Nervi Nattero, Bruno
    Objectives: Perioperative and adjuvant chemotherapy have demonstrated clinical benefits in localized gastric cancer. Nevertheless, the reports on their effects on patient's health-related quality of life (HRQoL) are scarce. Here, we prospectively assessed quality of life and the incidence of chemotherapy-induced peripheral neuropathy (CIPN) in a cohort of patients treated with adjuvant FOLFOX. Methods: Localized stomach or gastroesophageal junction adenocarcinoma patients who underwent curative resection were recruited at a single center. All patients received adjuvant FOLFOX6, and HRQoL and CIPN were assessed using the European organization for research and treatment of cancer quality life (EORTC) C30 and the EORTC CIPN20 questionnaires, respectively. Clinically significant deterioration of HRQoL was also assessed as a coprimary outcome in a longitudinal analysis. Results: We recruited a total of 63 patients. Median age was 62.5 years, and 75% had stomach tumors. Twenty-four weeks after the start of treatment, the probability of being free from HRQoL deterioration and CIPN was 29% (95% confidence interval [CI] 18%-42%) and 6% (95% CI 2%-17%), respectively. Five-year disease-free survival was 45% (95% CI 24%-64%) and 5-year overall survival was 63% (95% CI 48%-76%). Conclusions: Adjuvant FOLFOX is associated with a high rate of long-term survival in localized gastric cancer; nevertheless, it has detrimental effects on patients’ quality of life.
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    Influence of SARS-CoV-2 mRNA Vaccine Booster among Cancer Patients on Active Treatment Previously Immunized with Inactivated versus mRNA Vaccines: A Prospective Cohort Study
    (2023) Mondaca Contreras, Sebastián Patricio; Walbaum, Benjamín; Corre, Nicole Le; Ferrés Garrido, Marcela Viviana; Valdés, Alejandro; Martínez-Valdebenito, Constanza; Ruiz-Tagle, Cinthya; Macanas Pirard, Patricia; Ross, Patricio; Cisternas, Betzabé; Pérez, Patricia; Cabrera, Olivia; Cerda, Valentina; Ormazábal, Ivana; Barrera Vásquez, Aldo Vincen; Prado, María E.; Venegas, María I.; Palma, Silvia; Broekhuizen, Richard; Kalergis, Alexis; Bueno, Susan M.; Espinoza, Manuel A.; Balcells Marty, María Elvira; Nervi Nattero, Bruno
    Cancer patients on chemotherapy have a lower immune response to SARS-CoV-2 vaccines. Therefore, through a prospective cohort study of patients with solid tumors receiving chemotherapy, we aimed to determine the immunogenicity of an mRNA vaccine booster (BNT162b2) among patients previously immunized with an inactivated (CoronaVac) or homologous (BNT162b2) SARS-CoV-2 vaccine. The primary outcome was the proportion of patients with anti-SARS-CoV-2 neutralizing antibody (NAb) seropositivity at 8–12 weeks post-booster. The secondary end points included IgG antibody (TAb) seropositivity and specific T-cell responses. A total of 109 patients were included. Eighty-four (77%) had heterologous vaccine schedules (two doses of CoronaVac followed by the BNT162b2 booster) and twenty-five had (23%) homologous vaccine schedules (three doses of BNT162b2). IgG antibody positivity for the homologous and heterologous regimen were 100% and 96% (p = 0.338), whereas NAb positivity reached 100% and 92% (p = 0.13), respectively. Absolute NAb positivity and Tab levels were associated with the homologous schedule (with a beta coefficient of 0.26 with p = 0.027 and a geometric mean ratio 1.41 with p = 0.044, respectively). Both the homologous and heterologous vaccine regimens elicited a strong humoral and cellular response after the BNT162b2 booster. The homologous regimen was associated with higher NAb positivity and Tab levels after adjusting for relevant covariates.
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    Mendelian Randomization Analysis of the Relationship Between Native American Ancestry and Gallbladder Cancer Risk
    (2022) Zollner, L.; Boekstegers, F.; Ponce, C.B.; Scherer, D.; Marcelain, K.; Gárate-Calderón, V.; Waldenberger, M.; Morales, E.; Rojas, A.; Munoz, C.; Müller, B.; Retamales, J.; de Toro, G.; Kortmann, A.V.; Barajas, O.; Rivera, M.T.; Cortés, A.; Loader, D.; Saavedra, J.; Gutiérrez, L.; Ortega, A.; Bertrán, M.E.; Bartolotti, L.; Gabler, F.; Campos, M.; Alvarado, J.; Moisán, F.; Spencer, L.; Nervi Nattero, Bruno; Carvajal, D.; Losada, H.; Almau, M.; Fernández, P.; Olloquequi, J.; Carter, A.R.; Miquel, Juan Francisco; Bustos, B.I.; Guajardo, M.F.; Gonzalez-Jose, R.; Bortolini, M.C.; Acuña-Alonzo, V.; Gallo, C.; Linares, A.R.; Rothhammer, F.; Bermejo, J.L.
    Background A strong association between the proportion of Native American ancestry and the risk of gallbladder cancer (GBC) has been reported in observational studies. Chileans show the highest incidence of GBC worldwide, and the Mapuche are the largest Native American people in Chile. We set out to investigate the causal association between Native American Mapuche ancestry and GBC risk, and the possible mediating effects of gallstone disease and body mass index (BMI) on this association. Methods Markers of Mapuche ancestry were selected based on the informativeness for assignment measure and then used as instrumental variables in two-sample mendelian randomization (MR) analyses and complementary sensitivity analyses. Result We found evidence of a causal effect of Mapuche ancestry on GBC risk (inverse variance-weighted (IVW) risk increase of 0.8% for every 1% increase in Mapuche ancestry proportion, 95% CI 0.4% to 1.2%, p = 6.6×10-5). Mapuche ancestry was also causally linked to gallstone disease (IVW risk increase of 3.6% per 1% increase in Mapuche proportion, 95% CI 3.1% to 4.0%, p = 1.0×10-59), suggesting a mediating effect of gallstones in the relationship between Mapuche ancestry and GBC. In contrast, the proportion of Mapuche ancestry showed a negative causal effect on BMI (IVW estimate -0.006 kg/m2 per 1% increase in Mapuche proportion, 95% CI -0.009 to -0.003, p = 4.4×10-5). Conclusions The results presented here may have significant implications for GBC prevention and are important for future admixture mapping studies. Given that the association between Mapuche ancestry and GBC risk previously noted in observational studies appears to be causal, primary and secondary prevention strategies that take into account the individual proportion of Mapuche ancestry could be particularly efficient.
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    Mortality of Adult Patients With Cancer Admitted to an Intensive Care Unit in Chile : A Prospective Cohort Study
    (2018) Panay, S.; Ruiz, C.; Abarca García, María; Nervi Nattero, Bruno; Salazar, I.; Caro, P.; Muniz, S.; Briones, J.; Bruhn, Alejandro; Mondaca Contreras, Sebastián Patricio
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    Nuevas terapias sistémicas para el tratamiento del melanoma
    (2016) Droppelmann, Nicolás; León Ramírez, Augusto; Goñi Espíldora, Ignacio; González Díaz, Hernán; Domínguez Covarrubias, Francisco José; Camus Appuhn, Mauricio Gonzalo; Nervi Nattero, Bruno; Uribe González, Pablo Francisco; Molgó Novell, Montserrat; Acevedo Claros, Francisco Nicolás
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    Rapamycin and WYE-354 suppress human gallbladder cancer xenografts in mice
    (2015) Weber, Helga; Leal, Pamela; Stein, Stefan; Kunkel, Hana; García Cañete, Patricia; Bizama, Carolina; Espinoza, Jaime A.; Riquelme, Ismael; Nervi Nattero, Bruno; Araya, Juan C.; Grez, Manuel; Roa Strauch, Juan Carlos Enrique
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    Reduced Immune Response to Inactivated Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine in a Cohort of Immunocompromised Patients in Chile
    (Oxford University Press for the Infectious Diseases Society of America, 2022) Balcells Marty, María Elvira; Le Corre Pérez, Monique Nicole; Durán Santa Cruz, Josefina Gracia; Ceballos Valdivielso, María Elena Andrea; Vizcaya Altamirano, María Cecilia; Mondaca Contreras, Sebastián Patricio; Dib Marambio, Martin Javier; Rabagliati Borie, Ricardo Miguel; Sarmiento Maldonado, Mauricio; Burgos Cañete, Paula Isabel; Espinoza Sepúlveda, Manuel Antonio; Ferres Garrido, Marcela Viviana; Martínez Valdebenito, Constanza Pamela; Ruiz-Tagle Seguel, Cinthya Grace; Ortiz Koh, Catalina Alejandra; Ross Pérez, Patricio Daniel; Budnik Bitran, Sigall; Solari Gajardo, Sandra; Vizcaya Vergara, María De Los Ángeles; Lembach, Hanns; Berríos Rojas, Roslye; Melo González, Felipe; Rios Raggio, Mariana; Kalergis Parra, Alexis Mikes; Bueno Ramírez, Susan Marcela; Nervi Nattero, Bruno
    Background Inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have been widely implemented in low- and middle-income countries. However, immunogenicity in immunocompromised patients has not been established. Herein, we aimed to evaluate immune response to CoronaVac vaccine in these patients. Methods This prospective cohort study included 193 participants with 5 different immunocompromising conditions and 67 controls, receiving 2 doses of CoronaVac 8-12 weeks before enrollment. The study was conducted between May and August 2021, at Red de Salud UC-CHRISTUS, Santiago, Chile. Neutralizing antibody (NAb) positivity, total anti-SARS-CoV-2 immunoglobulin G antibody (TAb) concentrations, and T-cell responses were determined. Results NAb positivity and median neutralizing activity were 83.1% and 51.2% for the control group versus 20.6% and 5.7% (both P < .001) in the solid organ transplant group, 41.5% and 19.2% (both P < .0001) in the autoimmune rheumatic diseases group, 43.3% (P < .001) and 21.4% (PP = .001) in the cancer with solid tumors group, 45.5% and 28.7% (both P < .001) in the human immunodeficiency virus (HIV) infection group, 64.3% and 56.6% (both differences not significant) in the hematopoietic stem cell transplant group, respectively. TAb seropositivity was also lower for the solid organ transplant (20.6%; P < .0001), rheumatic diseases (61%; P < .001), and HIV groups (70.9%; P = .003), compared with the control group (92.3%). On the other hand, the number of interferon gamma spot-forming T cells specific for SARS-CoV-2 tended to be lower in all immunocompromising conditions but did not differ significantly between groups. Conclusions Diverse immunocompromising conditions markedly reduce the humoral response to CoronaVac vaccine. These findings suggest that a boosting vaccination strategy should be considered in these vulnerable patients.