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adjuvant therapy breast cancer

Irene E G van Hellemond, Ingeborg J H Vriens, Petronella G M Peer, Astrid C P Swinkels, Carolien H Smorenburg, Caroline M Seynaeve, Maurice J C van der Sangen, Judith R Kroep, Hiltje de Graaf, Aafke H Honkoop, Frans L G Erdkamp, Franchette W P J van den Berkmortel, Jos J E M Kitzen, Maaike de Boer, Wïlfred K de Roos, Sabine C Linn, Alexander L T Imholz, Vivianne C G Tjan-Heijnen
Background: Aromatase inhibitors (AIs) are given as adjuvant therapy for hormone receptor-positive breast cancer in postmenopausal women, also to those with chemotherapy-induced ovarian function failure. The current analysis reports on endocrine data of patients with chemotherapy-induced ovarian function failure who were included in the phase III DATA study assessing different durations of adjuvant anastrozole after tamoxifen. Methods: We identified all patients with chemotherapy-induced ovarian function failure...
December 1, 2017: Journal of the National Cancer Institute
C Wilson, R Bell, S Hinsley, H Marshall, J Brown, D Cameron, D Dodwell, R Coleman
The fracture impact of adjuvant bisphosphonates in breast cancer is not defined with most trials reporting changes in bone mineral density as a surrogate. The AZURE trial (ISRCTN79831382) evaluated the impact of adjuvant zoledronic acid (ZOL) on fractures. The AZURE trial is an academic, multi-centre, randomised phase III study evaluating the addition of ZOL 4 mg to standard therapy (neo/adjuvant chemotherapy and/or endocrine therapy) for 5 years (administered by intravenous (iv) infusion every 3-4 weeks for 6 doses, then 3 monthly × 8 and 6 monthly × 5) in patients with stage II/III early breast cancer...
March 12, 2018: European Journal of Cancer
Shulian Wu, Yudian Huang, Qinggong Tang, Zhifang Li, Hannah Horng, Jiatian Li, Zaihua Wu, Yu Chen, Hui Li
Preoperative neoadjuvant treatment in locally advanced breast cancer is recognized as an effective adjuvant therapy, as it improves treatment outcomes. However, the potential complications remain a threat, so there is an urgent clinical need to assess both the tumor response and changes in its microenvironment using non-invasive and precise identification techniques. Here, two-photon microscopy was employed to detect morphological alterations in breast cancer progression and recession throughout chemotherapy...
March 1, 2018: Biomedical Optics Express
Youssef H Zeidan, Joyce G Habib, Lieveke Ameye, Marianne Paesmans, Evandro de Azambuja, Richard D Gelber, Ian Campbell, Bo Nordenskjöld, Jorge Gutiérez, Michael Anderson, Ana Lluch, Michael Gnant, Aron Goldhirsch, Angelo Di Leo, David J Joseph, John Crown, Martine Piccart-Gebhart, Prudence A Francis
PURPOSE: To analyze the impact of postmastectomy radiation therapy (PMRT) for patients with T1-T2 tumors and 1 to 3 positive lymph nodes enrolled on the Breast International Group (BIG) 02-98 trial. METHODS AND MATERIALS: The BIG 02-98 trial randomized patients to receive adjuvant anthracycline with or without taxane chemotherapy. Delivery of PMRT was nonrandomized and performed according to institutional preferences. The present analysis was performed on participants with T1-T2 breast cancer and 1 to 3 positive lymph nodes who had undergone mastectomy and axillary nodal dissection...
February 6, 2018: International Journal of Radiation Oncology, Biology, Physics
Eunpi Cho, Qian Wu, Lena Rubinstein, Hannah Linden, Julie Gralow, Jennifer Specht, Vijayakrishna Gadi, Georgiana Ellis
Many studies have sought to optimize the dosing schedule of adjuvant chemotherapy in early-stage breast cancer. Here, we assessed the use of continuous metronomic weekly doxorubicin plus daily oral cyclophosphamide (AC) with continuous G-CSF growth factor support for 12 weeks followed by weekly nab-paclitaxel (nP) for 12 weeks. A nonrandomized phase II clinical trial was designed to assess (1) DFS at 2 years, (2) dose delivered, (3) use of nP in the adjuvant setting, and (4) toxicities. The dosing of A was 24 mg/m2 IV weekly and C was 60 mg/m2 oral daily (with scheduled filgrastim 5mcg/kg 6 days/week); nP, 100 mg/m2 IV weekly...
March 13, 2018: Breast Journal
Alex C Herskovic, Xian Wu, Paul J Christos, Himanshu Nagar
PURPOSE: We used the National Cancer Data Base to analyze practice patterns of adjuvant breast radiotherapy (RT) in elderly patients to see if a difference in overall survival (OS) could be detected. Additionally, we investigated factors that affected OS in these patients. PATIENTS AND METHODS: Women aged ≥ 65 years with hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative pathologic T1-T2N0M0 invasive breast cancer measuring up to 3 cm who were treated with breast conservation and adjuvant endocrine therapy without adjuvant chemotherapy were identified and stratified by use of adjuvant RT...
February 20, 2018: Clinical Breast Cancer
Stephanie Strobl, Kerstin Wimmer, Ruth Exner, Yelena Devyatko, Michael Bolliger, Florian Fitzal, Michael Gnant
Bone health and breast cancer are two connected subjects, because breast cancer patients have a higher prevalence of osteopenia/osteoporosis and reduced bone health parameters than healthy woman of the same age. Therefore, the positive effect of adjuvant bisphosphonate therapy plays an important role in breast cancer treatment. Several randomized trials have studied bisphosphonates in the adjuvant setting in postmenopausal woman and demonstrated their potential to prevent treatment-induced bone loss. The prevention of fractures and the subsequent preservation of patients' quality of life are important arguments for the use of adjuvant bisphosphonates in postmenopausal breast cancer patients...
March 12, 2018: Current Treatment Options in Oncology
Lizhou Liu, Simone Petrich, Blair McLaren, Lyndell Kelly, G David Baxter
BACKGROUND: Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evaluated. Improved patient education and support has been suggested as a priority for breast cancer care...
March 2018: Journal of Integrative Medicine
Viktor Smanykó, Norbert Mészáros, Mihály Újhelyi, Georgina Fröhlich, Gábor Stelczer, Tibor Major, Zoltán Mátrai, Csaba Polgár
INTRODUCTION AND AIM: To report the clinical outcomes of second breast-conserving therapy with perioperative interstitial radiotherapy for the treatment of ipsilateral breast tumor recurrences. METHOD: Between 1999 and 2015, 33 patients, presenting with an ipsilateral breast tumor recurrence after previous breast conserving therapy, were salvaged by re-excision and perioperative high-dose-rate interstitial brachytherapy. A median of 8 (range: 4-24) catheters were implanted into the tumor bed intraoperatively...
March 2018: Orvosi Hetilap
Quyen D Chu, Meijiao Zhou, Prakash Peddi, Kaelen L Medeiros, Xiao-Cheng Wu
BACKGROUND: The Cancer and Leukemia Group B 9,343 demonstrated that postoperative radiation can be safely omitted in women ≥70 years who underwent breast-conserving therapy for clinical stage I (T1N0M0) estrogen receptor positive breast cancer treated with antihormonal therapy. Whether such results are observed in real-world population is unknown. In this hospital-based data, we report the survival outcomes of patients who received adjuvant radiation therapy versus those who did not...
March 7, 2018: Surgery
Fernando A Angarita, Sergio A Acuna, David R McCready, Jaime Escallon
INTRODUCTION: It is unknown whether the treatment disparity observed between young and elderly women extends to the management of positive margins after initial lumpectomy. The primary aim was to evaluate the management of positive margins after initial lumpectomy in elderly women. METHODS: Women ≥50 y who underwent lumpectomy for stage I-III tumors were identified. Tumor and treatment characteristics were collected across two subgroups: young (50-69 y) and elderly (≥70 y)...
February 21, 2018: European Journal of Surgical Oncology
Kimberly Blackwell, Joseph Gligorov, Ira Jacobs, Chris Twelves
Trastuzumab improves survival outcomes for patients with HER2-positive (HER2+ ) breast cancer, yet not all such women receive this important therapy. Trastuzumab was approved by the US Food and Drug Administration in 1998 and the European Medicines Agency in 2000 as treatment for HER2+ metastatic breast cancer (MBC). Observational studies between 2000 and 2015 in patients with HER2+ MBC suggest that nearly 12% in the United States, 27% to 54% in Europe, and 27.1% to 49.2% in China did not receive trastuzumab or any other HER2-targeted agent as first- and/or later-line for treatment of metastatic disease...
February 2, 2018: Clinical Breast Cancer
Harpreet Singh, Amanda J Walker, Laleh Amiri-Kordestani, Joyce Cheng, Shenghui Tang, Pamela Balcazar, Kimberly Barnett-Ringgold, Todd R Palmby, Xianhua Cao, Nan Zheng, Qi Liu, Jingyu Yu, William F Pierce, Selena R Daniels, Rajeshwari Sridhara, Amna Ibrahim, Paul G Kluetz, Gideon M Blumenthal, Julia A Beaver, Richard Pazdur
On July 17, 2017, the Food and Drug Administration (FDA) approved neratinib (NERLYNX, Puma Biotechnology, Inc) for the extended adjuvant treatment of adult patients with early-stage HER2-overexpressed/amplified breast cancer, to follow adjuvant trastuzumab-based therapy. Approval was based on data from ExteNET, a randomized, double-blind, placebo-controlled multicenter trial. Women with early-stage HER2-positive breast cancer and within two years of completing adjuvant trastuzumab were randomized to neratinib (n=1420) or placebo (n=1420) for one year...
March 9, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Fiona Griffin, Laure Marignol
Melatonin is an endogenous hormone primirarily known for its action on the circadian rhythms. But preclinical studies are reporting both its radioprotective and radiosensitising properties, possibly mediated through an interaction between melatonin and the regulation of estrogens. Melatonin pre-treatment prior to ionising radiation was associated with a decrease in cell proliferation and an increase in p53 mRNA expression, leading to an increase in the radiosensitivity of breast cancer cells. At the same time, a decrease in radiation- induced side effects was described in breast cancer patients and in rodent models...
March 9, 2018: International Journal of Radiation Biology
Gulisa Turashvili, Monica Gonzalez-Loperena, Edi Brogi, Maura Dickler, Larry Norton, Monica Morrow, Hannah Y Wen
BACKGROUND: Given the limited data, systemic treatment of male breast cancer has been extrapolated from female patients. The 21-gene recurrence score (RS) assay estimates the risk of distant recurrence and chemotherapy benefit in early-stage, ER+/HER2- female breast cancer. We assessed the association between RS and type of treatment in male breast cancer. METHODS: We identified male patients with ER+/HER2- breast cancer and available RS results treated at our institution in 2006-2016...
March 8, 2018: Annals of Surgical Oncology
Katsuhiko Nakatsukasa, Hiroshi Koyama, Yoshimi Ouchi, Kouichi Sakaguchi, Yoshifumi Fujita, Takayuki Matsuda, Makoto Kato, Eiichi Konishi, Tetsuya Taguchi
Adjuvant aromatase inhibitor (AI) therapy, for hormone receptor-positive breast cancer, in postmenopausal women is associated with bone loss, leading to an increased risk of fractures. Denosumab, an antibody raised against the receptor activator of nuclear factor-κB ligand, has been proven to protect against AI-induced bone loss. Hence, we aimed to determine whether denosumab is effective in postmenopausal Japanese women with osteoporosis, treated with AI. We prospectively evaluated the bone mineral density (BMD) in the lumbar spine and the bilateral femoral neck in 102 postmenopausal women with clinical hormone receptor-positive breast cancer, stages I-IIIA, during a postoperative period of 12 months...
March 8, 2018: Journal of Bone and Mineral Metabolism
Akihiko Ozaki, Morihito Takita, Tetsuya Tanimoto
Introduction Globally, laws and guidelines for managing conflict of interest are increasingly implemented to achieve transparency in financial ties between physicians and pharmaceutical and medical device industries, yet little information is available regarding the limitations of the current frameworks for disclosing these financial ties. Case In June 2017, the Capecitabine for Residual Cancer as Adjuvant Therapy (CREATE-X) trial was published in the New England Journal of Medicine. In this study, which suggested the post-surgery addition of capecitabine would improve survival of high-risk breast cancer patients, the cost of capecitabine for off-label use was illegally claimed to the Japanese public health insurance system, rather than being covered by the research budget...
March 8, 2018: Investigational New Drugs
Beom Seok Kwak
We report here on a case of 51-year-old woman with metastatic small cell carcinoma of the breast that came from her cancer of the uterine cervix. She underwent radical hysterectomy with bilateral salpingo-oophorectomy due to small cell carcinoma of the uterine cervix, and adjuvant radiotherapy was administered to the pelvis. Breast metastasis with a palpable mass then occurred 3 months after the primary surgery. Simple mastectomy and adjuvant chemotherapy were performed. She initially showed a good response to the therapy, yet she ultimately died of multiple metastases with a fulminating disease course...
January 2018: Case Reports in Oncology
Libo Yang, Xiaorong Zhong, Tianjie Pu, Yan Qiu, Feng Ye, Hong Bu
BACKGROUND: Neoadjuvant chemotherapy (NAC) is widely used in advanced breast cancer patients. However, there is little known about conversion frequency of estrogen receptor (ER) and/or progesterone receptor (PR) status for hormone receptor positive-breast cancer patients after NAC and their correlation with prognosis. METHODS: In this study, 231 breast cancer patients with residual disease after NAC were enrolled and divided into receptor stable group (having no conversion in both ER and PR status pre- and post-NAC) and any receptor conversion group (having any conversion in either ER or PR status)...
March 7, 2018: World Journal of Surgical Oncology
Deborah Repullo, Marie Diaz, Stéphane Holbrechts, Maria Gomez-Galdón, Dirk Van Gestel, Ali Bohlok, Gabriel Liberale, Vincent Donckier
BACKGROUND: The development of a second primary tumor is a potential late side effect of radiotherapy. Particularly, an increased risk of secondary cancers, mostly of digestive or breast origin, has been observed in patients treated with high-dose radiotherapy for Wilms tumor (WT) in childhood. However, hepatocellular carcinoma (HCC) has been very rarely described as a potentially radiotherapy-induced tumor. We describe the case of a patient with an aggressive HCC 50 years after the treatment of a WT...
March 7, 2018: World Journal of Surgical Oncology
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