Browsing by Author "Sanhueza, Cristobal"
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Publication Multimorbidity profile among cancer-related hospitalization events in younger and older patients: a large-scale nationwide cross-sectional study(2025) Bernal, Yanara; Campaña, Carla; Sanhueza, Cristobal; Apablaza, Mauricio; Armisen, Ricardo; Delgado, IrisBackground Multimorbidity, the coexistence of two or more chronic diseases, among cancer patients offers critical insights into shared risk factors, while posing increasing challenges for healthcare systems due to the complexity of care required. Despite its relevance, research in multimorbidity across different age groups is limited in middle income countries. Methods We analyzed cancer-related hospitalizations between 2019 and 2023, using a nationwide Diagnosis-Related Groups database covering 68 Chilean health institutions. We examined the distribution of 40 chronic conditions, multimorbidity prevalence, comorbidity profile, and their distribution across age group, sex, and cancer diagnosis. Findings We identified 4,722,723 hospitalization events, including 149,270 unique adult patients hospitalized with cancer (mean of 63 ± 15.17 years old). Multimorbidity was present in 47.9% of all cancer-related hospitalizations, increasing steeply with age: 14% in patients aged 18–35, 24.9% in those 36–50, and 55.5% in patients >50 years. Obesity and diabetes were among the most common comorbid conditions across age groups, with significant variations by sex. Notably, obesity was more prevalent in younger patients, particularly those aged 18–35, whereas hypertension showed an inverse profile, increasing markedly with age. Interpretation Multimorbidity profile reflect both the clinical complexity of cancer care and potential shared biological and environmental pathways in carcinogenesis. These findings highlight the need to transition from diseasecentered to person-centered care models. In Chile, understanding multimorbidity in younger and middle-aged adults may inform precision prevention, integrated service delivery, and equitable planning for both oncologic and non-oncologic care. Funding This study was conducted without external funding.Publication Pembrolizumab in Combination with Neoadjuvant Chemoradiotherapy for Patients with Resectable Adenocarcinoma of the Gastroesophageal Junction(2022) Zhu, Mojun; Chen, Chunhua; Foster, Nathan; Hartley, Christopher; Mounajjed, Taofic; Salomao, Marcela; Fruth, Briant; Beamer, Staci; Kim, Yohan; Harrington, Susan; Pitot, Henry; Sanhueza, Cristobal; Feng, Yening; Herrmann, Joerg; McWilliams, Robert; Lucien, Fabrice; Huang, Bing; Wee, Wen; Bekaii, Tanios; Dong, Haidong; Wigle, Dennis; Ahn, Daniel; Hallemeier, Chris; Blackmon, Shanda; Yoon, HarryPurpose: This phase Ib/2 trial investigated pembrolizumab-containing trimodality therapy in patients with gastroesophageal junction (GEJ) adenocarcinoma. Patients and methods: Patients with GEJ adenocarcinoma (cT1-3NanyM0) received neoadjuvant pembrolizumab-containing chemoradiation (CROSS regimen) followed by surgical resection and adjuvant pembrolizumab. The primary endpoints were tolerability in the first 16 patients and pathologic complete response [pCR (ypT0N0)]. Secondary endpoints included progression-free survival (PFS) and overall survival (OS). An independent propensity-score-matched cohort (treated with CROSS without immunotherapy) was used for comparison. Exploratory analyses included immune biomarkers in the tumor microenvironment (TME) and plasma. Results: We enrolled 31 eligible patients, of whom 29 received all expected doses of neoadjuvant pembrolizumab and 28 underwent R0 resection. Safety endpoints were met. The primary efficacy endpoint was not met [7/31 (22.6%) achieved pCR]. Patients with high [i.e., combined positive score (CPS) ≥ 10] baseline expression of programmed death (PD)-L1 in the TME had a significantly higher pCR rate than those with low expression [50.0% (4/8) vs. 13.6% (3/22); P = 0.046]. Patients with high PD-L1 expression also experienced longer PFS and OS than propensity-score-matched patients. Among trial patients with PD-L1 CPS < 10, unprespecified analysis explored whether extracellular vesicles (EV) could identify further responders: an elevated plasma level of PD-L1-expressing EVs was significantly associated with higher pCR. Conclusions: Adding pembrolizumab to trimodality therapy showed acceptable tolerability but did not meet the pre-specified pCR endpoint. Exploratory analyses suggested that high PD-L1 expression in the TME and/or on EVs may identify patients most likely to achieve tumor response.