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https://www.readbyqxmd.com/read/29905023/neoadjuvant-endocrine-therapy-with-exemestane-followed-by-response-guided-combination-therapy-with-low-dose-cyclophosphamide-in-postmenopausal-patients-with-estrogen-receptor-positive-breast-cancer-a-multicenter-open-label-phase-ii-study
#1
Nobuaki Sato, Norikazu Masuda, Takashi Morimoto, Takayuki Ueno, Chizuko Kanbayashi, Koji Kaneko, Hiroyuki Yasojima, Shigehira Saji, Hironobu Sasano, Satoshi Morita, Shinji Ohno, Masakazu Toi
Patients with estrogen receptor (ER)-positive breast cancer are less likely to achieve a pathological complete response (pCR) with neoadjuvant chemotherapy. Neoadjuvant endocrine therapy may be more appropriate than neoadjuvant chemotherapy in these hormone-sensitive patients. Most patients with ER-positive breast cancer are postmenopausal, and therefore, generally older and less able to tolerate chemotherapy. We aimed to investigate the efficacy and safety of tailored neoadjuvant endocrine and chemoendocrine therapy for postmenopausal breast cancer patients...
June 14, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29901634/high-dose-fulvestrant-as-third-line-endocrine-therapy-for-breast-cancer-metastasis-to-the-left-kidney-a-case-report-and-literature-review
#2
Dandan Xia, Huiyu Wang, Runjie Wang, Chaoying Liu, Junying Xu
RATIONALE: Endocrine therapy plays an important role in the treatment of patients with hormone receptor-positive breast cancer. Renal metastasis of breast cancer is rare in clinical practice. PATIENT CONCERNS: We present here a 54-year-old woman with breast cancer after first line chemotherapy and second line endocrinotherapy (i.e., toremifene & exemestane) failure. DIAGNOSES: The patient was rarely diagnosed breast cancer metastasis to the kidney and a positive hormone status (ER and PR) but was negative for human epidermal factor receptor 2 (HER2)...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29885375/impact-of-age-on-breast-cancer-mortality-and-competing-causes-of-death-at-10-years-follow-up-in-the-adjuvant-team-trial
#3
M G M Derks, E Bastiaannet, W van de Water, N A de Glas, C Seynaeve, H Putter, J W R Nortier, D Rea, A Hasenburg, C Markopoulos, L Y Dirix, J E A Portielje, C J H van de Velde, G J Liefers
AIM: Due to increasing life expectancy, patients with breast cancer remain at risk of dying due to breast cancer over a long time. This study aims to assess the impact of age on breast cancer mortality and other cause mortality 10 years after diagnosis. METHODS: Postmenopausal patients with hormone-receptor positive breast cancer were included in the Tamoxifen and Exemestane Adjuvant Multinational (TEAM) trial between 2001 and 2006. Age at diagnosis was categorised as <65 years (n = 3369), 65-74 years (n = 1896) and ≥75 years (n = 854)...
June 6, 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29869408/extraction-and-determination-of-trace-amounts-of-three-anticancer-pharmaceuticals-in-urine-by-three-phase-hollow-fiber-liquid-phase-microextraction-based-on-two-immiscible-organic-solvents-followed-by-hplc
#4
Ali Nazaripour, Yadollah Yamini, Hasan Bagheri, Mohammad Tajik
An automated three-phase hollow fiber liquid-phase microextraction based on two immiscible organic solvents followed by high performance liquid chromatography with UV-vis detection was applied for the extraction and determination of exemestane, letrozole, and paclitaxel in water and urine samples. n-Dodecane was selected as the supported liquid membrane and its polarity was justified by trioctylphosphine oxide. Acetonitrile was used as an organic acceptor phase with desirable immiscibility with n-dodecane. All the effective parameters of the microextraction procedure such as type of the organic acceptor phase, the supported liquid membrane composition, extraction time, pH of the donor phase, hollow fiber length, stirring rate, and ionic strength were evaluated and optimized separately by a one variable at-a-time method...
June 4, 2018: Journal of Separation Science
https://www.readbyqxmd.com/read/29863451/tailoring-adjuvant-endocrine-therapy-for-premenopausal-breast-cancer
#5
Prudence A Francis, Olivia Pagani, Gini F Fleming, Barbara A Walley, Marco Colleoni, István Láng, Henry L Gómez, Carlo Tondini, Eva Ciruelos, Harold J Burstein, Hervé R Bonnefoi, Meritxell Bellet, Silvana Martino, Charles E Geyer, Matthew P Goetz, Vered Stearns, Graziella Pinotti, Fabio Puglisi, Simon Spazzapan, Miguel A Climent, Lorenzo Pavesi, Thomas Ruhstaller, Nancy E Davidson, Robert Coleman, Marc Debled, Stefan Buchholz, James N Ingle, Eric P Winer, Rudolf Maibach, Manuela Rabaglio-Poretti, Barbara Ruepp, Angelo Di Leo, Alan S Coates, Richard D Gelber, Aron Goldhirsch, Meredith M Regan
Background In the Suppression of Ovarian Function Trial (SOFT) and the Tamoxifen and Exemestane Trial (TEXT), the 5-year rates of recurrence of breast cancer were significantly lower among premenopausal women who received the aromatase inhibitor exemestane plus ovarian suppression than among those who received tamoxifen plus ovarian suppression. The addition of ovarian suppression to tamoxifen did not result in significantly lower recurrence rates than those with tamoxifen alone. Here, we report the updated results from the two trials...
June 4, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29862467/therapeutic-drug-monitoring-of-oral-anti-hormonal-drugs-in-oncology
#6
REVIEW
Stefanie L Groenland, Merel van Nuland, Remy B Verheijen, Jan H M Schellens, Jos H Beijnen, Alwin D R Huitema, Neeltje Steeghs
Oral anti-hormonal drugs are essential in the treatment of breast and prostate cancer. It is well known that the interpatient variability in pharmacokinetic exposure is high for these agents and exposure-response relationships exist for many oral anti-hormonal drugs. Yet, they are still administered at fixed doses. This could lead to underdosing and thus suboptimal efficacy in some patients, while other patients could be overdosed resulting in unnecessary side effects. Therapeutic drug monitoring (TDM), individualized dosing based on measured blood concentrations of the drug, could therefore be a valid option to further optimize treatment...
June 4, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29862411/everolimus-plus-exemestane-vs-everolimus-or-capecitabine-monotherapy-for-estrogen-receptor-positive-her2-negative-advanced-breast-cancer-the-bolero-6-randomized-clinical-trial
#7
Guy Jerusalem, Richard H de Boer, Sara Hurvitz, Denise A Yardley, Elena Kovalenko, Bent Ejlertsen, Sibel Blau, Mustafa Özgüroglu, László Landherr, Marianne Ewertz, Tetiana Taran, Jenna Fan, Florence Noel-Baron, Anne-Laure Louveau, Howard Burris
Importance: Everolimus plus exemestane and capecitabine are approved second-line therapies for advanced breast cancer. Objective: A postapproval commitment to health authorities to estimate the clinical benefit of everolimus plus exemestane vs everolimus or capecitabine monotherapy for estrogen receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer. Design: Open-label, randomized, phase 2 trial of treatment effects in postmenopausal women with advanced breast cancer that had progressed during treatment with nonsteroidal aromatase inhibitors...
June 3, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29791862/hormone-dependent-breast-cancer-targeting-autophagy-and-pi3k-overcomes-exemestane-acquired-resistance
#8
Cristina Amaral, Tiago Vieira Augusto, Elisiário Tavares-da-Silva, Fernanda M F Roleira, Georgina Correia-da-Silva, Natércia Teixeira
The leading cause of cancer death in women around the world is breast cancer. The aromatase inhibitors (AIs) are considered a first-line treatment for estrogen receptor-positive (ER+ ) breast tumors, in postmenopausal women. Exemestane (Exe) is a powerful steroidal AI, however, despite its therapeutic success, Exe-acquired resistance may occur leading to tumor relapse. Our group previously demonstrated that autophagy acts as a pro-survival process in Exe-induced cell death of ER+ sensitive breast cancer cells...
May 20, 2018: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/29790419/rictor-gene-amplification-is-correlated-with-metastasis-and-therapeutic-resistance-in-triple-negative-breast-cancer
#9
Said El Shamieh, Fatima Saleh, Salim Moussa, Joseph Kattan, Fadi Farhat
Triple-negative breast cancer (TNBC) is characterized by its aggressive behavior, metastasis and lack of targeted therapies. Herein, we discuss the clinical, histopathological and genetic profile of a woman diagnosed with TNBC. Since the patient had no durable response to chemotherapy, a genetic profiling was carried out. Next-generation sequencing analysis of 592 genes showed a missense mutation, p.E545A in PIK3CA, thus the patient was started on the mTOR inhibitor everolimus, in combination with exemestane, which controlled her pain; however, the disease progressed aggressively...
May 23, 2018: Pharmacogenomics
https://www.readbyqxmd.com/read/29781326/progression-free-survival-with-endocrine-based-therapies-following-progression-on-non-steroidal-aromatase-inhibitor-among-postmenopausal-women-with-hr-her2-metastatic-breast-cancer-a-network-meta-analysis
#10
Rajeev Ayyagari, Derek Tang, Oscar Patterson-Lomba, Zhou Zhou, Jipan Xie, David Chandiwana, Anand A Dalal, Polly Ann Niravath
OBJECTIVE: To quantify the comparative efficacy of currently available endocrine-based therapies (ETs) for postmenopausal women with HR+/HER2- mBC after NSAI progression. DESIGN: network meta-analysis (NMA) Methods: Randomized clinical trials of ETs for HR+/HER2- mBC were identified via a systematic literature review using Medline, EMBASE, Cochrane Library, and key conference proceedings. All trials met the following inclusion criteria: 1) included women with HR+/HER2- mBC, 2) previous treatment with ETs or chemotherapy as first-line therapy, 3) treatment with ET as monotherapy or in combination with targeted therapy, 4) PFS was reported, and 5) published in 2007 (when HER2 testing became standardized) or later...
May 21, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29780257/effect-of-first-line-endocrine-therapy-in-patients-with-hormone-sensitive-advanced-breast-cancer-a-network-meta-analysis
#11
Tingting Zhang, Fubin Feng, Wenge Zhao, Jinhui Tian, Yan Yao, Chao Zhou, Shengjie Dong, Congcong Wang, Chuanxin Zang, Qingliang Lv, Changgang Sun
Background: Endocrine therapy is the cornerstone treatment for patients with hormone receptor-positive advanced breast cancer. We aimed to assess the effectiveness of various first-line endocrine monotherapies or combinations to determine the optimal sequence in a network meta-analysis. Materials and methods: We searched PubMed, EMBASE, and the Cochrane Library for randomized controlled trials (RCTs) from inception up to November 21, 2017. We included only RCTs that assessed the effectiveness of the following treatments as a monotherapy or in combination as the first-line treatment: tamoxifen, anastrozole, letrozole, exemestane, fulvestrant, palbociclib, and ribociclib...
2018: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29766362/exploration-of-tumour-infiltrating-lymphocytes-as-a-predictive-biomarker-for-adjuvant-endocrine-therapy-in-early-breast-cancer
#12
Erik J Blok, Charla C Engels, Geeske Dekker-Ensink, Elma Meershoek-Klein Kranenbarg, Hein Putter, Vincent T H B M Smit, Gerrit-Jan Liefers, James P Morden, Judith M Bliss, R Charles Coombes, John M S Bartlett, Judith R Kroep, Cornelis J H van de Velde, Peter J K Kuppen
PURPOSE: Tumour-infiltrating lymphocytes (TILs) have been shown to be prognostic for disease-free survival and predictive for the benefit of chemotherapy in patients with early breast cancer, but have not been studied for endocrine therapy. EXPERIMENTAL DESIGN: The number of CD8-positive TILs was assessed in a subcohort of 236 patients in the Intergroup Exemestane Study. AQ After 2-3 years of adjuvant tamoxifen, AQpatients were randomized between the schemes of continuation for 5 years on tamoxifen and switching to exemestane...
May 15, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29752687/a-phase-ii-study-evaluating-the-efficacy-of-zoledronic-acid-in-prevention-of-aromatase-inhibitor-associated-musculoskeletal-symptoms-the-zap-trial
#13
Cesar A Santa-Maria, Aditya Bardia, Amanda L Blackford, Claire Snyder, Roisin M Connolly, John H Fetting, Daniel F Hayes, Stacie C Jeter, Robert S Miller, Anne Nguyen, Katie Quinlan, Gary L Rosner, Shannon Slater, Anna Maria Storniolo, Antonio C Wolff, Jane Zorzi, Nora Lynn Henry, Vered Stearns
PURPOSE: Aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) are common adverse events of AIs often leading to drug discontinuation. We initiated a prospective clinical trial to evaluate whether bisphosphonates are associated with reduced incidence of AIMSS. METHODS: In the single-arm trial, the Zoledronic Acid Prophylaxis (ZAP) trial, we compared the incidence of AIMSS against historical controls from the Exemestane and Letrozole Pharmacogenomics (ELPh) trial...
May 11, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29720397/increased-long-qt-and-torsade-de-pointes-reporting-on-tamoxifen-compared-with-aromatase-inhibitors
#14
Virginie Grouthier, Benedicte Lebrun-Vignes, Andrew M Glazer, Philippe Touraine, Christian Funck-Brentano, Antoine Pariente, Carine Courtillot, Anne Bachelot, Dan M Roden, Javid J Moslehi, Joe-Elie Salem
OBJECTIVE: A prolonged QTc (LQT) is a surrogate for the risk of torsade de pointes (TdP). QTc interval duration is influenced by sex hormones: oestradiol prolongs and testosterone shortens QTc. Drugs used in the treatment of breast cancer have divergent effects on hormonal status. METHODS: We performed a disproportionality analysis using the European database of suspected adverse drug reaction (ADR) reports to evaluate the reporting OR (ROR χ2 ) of LQT, TdP and ventricular arrhythmias associated with selective oestrogen receptor modulators (SERMs: tamoxifen and toremifene) as opposed to aromatase inhibitors (AIs: anastrozole, exemestane and letrozole)...
May 2, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29707743/cost-effectiveness-of-second-line-endocrine-therapies-in-postmenopausal-women-with-hormone-receptor-positive-and-human-epidermal-growth-factor-receptor-2-negative-metastatic-breast-cancer-in-japan
#15
Verin Lertjanyakun, Nathorn Chaiyakunapruk, Susumu Kunisawa, Yuichi Imanaka
BACKGROUND: Exemestane (EXE), exemestane + everolimus (EXE + EVE), toremifene (TOR), and fulvestrant (FUL) are second-line endocrine therapies for postmenopausal hormone receptor-positive (HR +)/human epidermal growth factor receptor 2-negative (HER2 -) metastatic breast cancer (mBC) in Japan. Although the efficacy of these therapies has been shown in recent studies, cost-effectiveness has not yet been determined in Japan. OBJECTIVE: This study aimed to examine the cost-effectiveness of second-line endocrine therapies for the treatment of postmenopausal women with HR + and HER2 - mBC...
April 30, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29651367/-lazarus-response-to-olaparib-in-a-virtually-chemonaive-breast-cancer-patient-carrying-gross-brca2-gene-deletion
#16
Vladimir M Moiseyenko, Vyacheslav A Chubenko, Fedor V Moiseyenko, Lyudmila A Zagorskaya, Yuliya A Zaytseva, Nataliya E Gesha, Evgeny N Zykov, Valeriya I Ni, Elena V Preobrazhenskaya, Anna P Sokolenko, Evgeny N Imyanitov
This report describes an estrogen receptor-positive breast cancer patient, who relapsed at two and a half years after the completion of adjuvant chemotherapy while being on the aromatase inhibition. Based on the clinical evidence for potential sensitivity of the tumor to hormone ablation, everolimus was added to continuing exemestane treatment. Oral chemotherapy was administered at further disease progression, however, it lasted only for 10 days due to rapidly deteriorating condition of the patient. BRCA test was performed just before the failure of endocrine therapy and revealed a gross deletion within BRCA2 gene...
February 4, 2018: Curēus
https://www.readbyqxmd.com/read/29610032/personalized-prevention-in-high-risk-individuals-managing-hormones-and-beyond
#17
D Gareth Evans, Sacha J Howell, Anthony Howell
Increasing numbers of women are being identified at 'high-risk' of breast cancer, defined by The National Institute of Health and Care Excellence (NICE) as a 10-year risk of ≥8%. Classically women have been so identified through family history based risk algorithms or genetic testing of high-risk genes. Recent research has shown that assessment of mammographic density and single nucleotide polymorphisms (SNPs), when combined with established risk factors, trebles the number of women reaching the high risk threshold...
June 2018: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29566104/everolimus-plus-endocrine-therapy-for-postmenopausal-women-with-estrogen-receptor-positive-human-epidermal-growth-factor-receptor-2-negative-advanced-breast-cancer-a-clinical-trial
#18
Melanie Royce, Thomas Bachelot, Cristian Villanueva, Mustafa Özgüroglu, Sergio J Azevedo, Felipe Melo Cruz, Marc Debled, Roberto Hegg, Tatsuya Toyama, Carla Falkson, Joon Jeong, Vichien Srimuninnimit, William J Gradishar, Christina Arce, Antonia Ridolfi, Chinjune Lin, Fatima Cardoso
Importance: Cotargeting the mammalian target of rapamycin pathway and estrogen receptor may prevent or delay endocrine resistance in patients receiving first-line treatment for advanced breast cancer. Objective: To investigate the combination of everolimus plus endocrine therapy in first-line and second-line treatment settings for postmenopausal women with estrogen receptor-positive, human epidermal growth receptor 2-negative advanced breast cancer. Design, Setting, and Participants: In the multicenter, open-label, single-arm, phase 2 BOLERO-4 (Breast Cancer Trials of Oral Everolimus) clinical trial, 245 patients were screened for eligibility; 202 were enrolled between March 7, 2013, and December 17, 2014...
March 22, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29554282/effects-of-celecoxib-and-low-dose-aspirin-on-outcomes-in-adjuvant-aromatase-inhibitor-treated-patients-cctg-ma-27
#19
Kathrin Strasser-Weippl, Michaela J Higgins, Judith-Anne W Chapman, James N Ingle, George W Sledge, George T Budd, Matthew J Ellis, Kathleen I Pritchard, Mark J Clemons, Tanja Badovinac-Crnjevic, Lei Han, Karen A Gelmon, Manuela Rabaglio, Catherine Elliott, Lois E Shepherd, Paul E Goss
Background: Celecoxib and low-dose aspirin might decrease risk of breast cancer recurrence. Methods: In the Canadian Cancer Trials Group MA.27, postmenopausal hormone receptor-positive breast cancer patients were randomly assigned (2 × 2) to adjuvant exemestane or anastrozole, and celecoxib or placebo. Low-dose aspirin of 81 mg or less was a stratification factor. Due to concerns about cardiac toxicity, celecoxib use was stopped in December 2004, while stratification by aspirin use was removed through protocol amendment...
March 15, 2018: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/29531841/impact-of-clinical-response-to-neoadjuvant-endocrine-therapy-on-patient-outcomes-a-follow-up-study-of-jfmc34-0601-multicentre-prospective-neoadjuvant-endocrine-trial
#20
Takayuki Ueno, Shigehira Saji, Norikazu Masuda, Katsumasa Kuroi, Nobuaki Sato, Hiroyuki Takei, Yutaka Yamamoto, Shinji Ohno, Hiroko Yamashita, Kazufumi Hisamatsu, Kenjiro Aogi, Hiroji Iwata, Takeharu Yamanaka, Hironobu Sasano, Masakazu Toi
Background: Neoadjuvant endocrine therapy (NET) has been demonstrated to improve breast-conserving rate and is a widely accepted treatment option for postmenopausal patients with hormone receptor-positive breast cancer. There are few reports on the association of NET response and long-term outcomes. Objectives: To investigate the prognostic value of clinical response to NET. Methods: Long-term outcomes of NET were examined in 107 patients who participated in the multicentre prospective neoadjuvant exemestane study, JFMC34-0601...
2018: ESMO Open
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