Café previene eventos tempranos en pacientes con cáncer de mama tratadas con tamoxifeno y modula el estado del receptor hormonal
27-04-2017
Este trabajo tuvo como objetivo investigar el impacto del consumo de café en las características tumorales y riesgo de eventos tempranos en relación con el tratamiento de cáncer de seno, estimando la presencia de genotipos CYP1A2 Y CYP2C8, la cual podría confundir la asociación. Un estudio de cohorte fue adelantado aplicando un cuestionario sobre estilo de vida a 634 pacientes en el sur de Suecia quienes iban a ser intervenidos quirúrgicamente. La presencia de los citocromos CYP1A2*1F y CYP2C8*3 fue genotipificada en cada paciente. Los datos clínicos y características del tumor fueron obtenidos de los registros de los pacientes, registros demográficos, e informes de patología. El consumo de café fue clasificado en las siguientes categorías: bajo (0-1 tazas/día), moderado (2-4 tazas/día), o alto (5 + tazas/día). La proporción de tumores receptor de estrógeno negativos (ER-) aumentó con el aumento de consumo de café (p = 0.042). El consumo moderado a alto fue asociado con una frecuencia inferior en el status de receptor discordante (ER + PgR-) OR 0.38 (0.23-0.63) comparado con un consumo bajo de café. El tiempo de seguimiento promedio fue 4.92 (IQR 3.01-6.42) años. Los pacientes tratados con tamoxifeno con tumores ER + (n = 310) que consumieron dos o más tazas/día presentan una disminución del riesgo considerable de eventos tempranos comparados con pacientes cuyo consumo fue bajo, HR ajustado fue 0.40 (0.19-0.83). El consumo bajo combinado con al menos un alelo CYP1A2*1F C (n = 35) o CYP2C8*3 (n = 13) fue asociado con un alto riesgo para eventos tempranos en pacientes tratados con tamoxifeno comparado con otros pacientes tratados con tamoxifeno, HR ajustado 3.49 (1.54-7.91) y 6.15 (2.46-15.36), respectivamente. CONCLUSIÓN: Un consumo moderado a alto de café está asociado con una reducción significativa de riesgo de eventos tempranos en pacientes tratados con tamoxifeno y con status de receptor hormonal modificado. De ser confirmado, nuevas recomendaciones en cuanto al consumo de café durante el tratamiento con tamoxifeno podrían ser realizadas.
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