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Neoadjuvant endocrine therapy

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https://www.readbyqxmd.com/read/28197838/the-growing-role-of-cdk4-6-inhibitors-in-treating-hormone-receptor-positive-advanced-breast-cancer
#1
REVIEW
Ami N Shah, Massimo Cristofanilli
Single-agent endocrine therapy has been the standard therapeutic choice for the management of hormone receptor (HR)-positive, Her2-negative advanced breast cancer (ABC) for decades. However, the rapidly accumulating data regarding the biological role and safety of CDK4/6 inhibitors and the first-in-class approval of palbociclib have made these novel agents an essential component of treatment for HR-positive ABC. In the frontline setting, palbociclib in combination with endocrine therapy showed an improvement in progression-free survival (PFS) by 10 months to nearly 25 months when compared with endocrine therapy alone and a clinical benefit rate (CBR = stable disease >24 weeks + partial response + complete response) of 85%...
January 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28164759/neoadjuvant-therapy-for-her2-positive-breast-cancer
#2
Rachel Wuerstlein, Nadia Harbeck
In HER2-positive early breast cancer, neoadjuvant treatment with a combination of sequential chemotherapy and HER2-targeted therapy is currently the standard of care. This is followed by breast surgery, radiotherapy (if indicated), completion of 12 months of HER2-directed therapy, and -depending on the tumor biology - endocrine adjuvant therapy, and ultimately follow up. 10-year survival rates in the HER2-positive subgroup of breast cancer do reach now more than 75% with the introduction of first adjvuant and later neoadjuvant HER2-targeted therapies over the last 15 years...
February 2, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28155606/clinical-utility-of-neoadjuvant-endocrine-therapy-for-hormone-receptor-positive-breast-cancer
#3
Hans-Christian Kolberg, Bahriye Aktas, Cornelia Liedtke
Primary endocrine therapy is an option in cases of hormone receptor positive and HER2 negative non-metastatic breast cancer. Aromatase inhibitors are considered therapy of choice in postmenopausal patients. In premenopausal patients aromatase inhibitors in combination with LHRH-analogues are regarded superior to tamoxifen. Three different settings have to be discriminated: • Patients too frail for surgery are candidates for primary endocrine therapy in order to control the disease. Treatment duration is determined by the course of the disease...
February 1, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28155053/weight-changes-in-postmenopausal-breast-cancer-survivors-over-2%C3%A2-years-of-endocrine-therapy-a-retrospective-chart-review
#4
Kirsten A Nyrop, Allison M Deal, Jordan T Lee, Hyman B Muss, Seul Ki Choi, Samara Dixon, Amy Wheless, Lisa A Carey, Shlomit S Shachar
PURPOSE: Obesity and weight gain after breast cancer (BC) diagnosis can affect cancer outcomes. This study explores the question of weight change during the first 2 years of endocrine treatment (ET) to identify the independent effects of BC diagnosis and treatment on post-diagnosis weight trajectories in early-stage postmenopausal BC survivors. METHODS: The study design is a retrospective chart review. Chi square tests and ANOVA were used to compare patients who gained >2 kg, lost >2 kg, or had stable weight...
February 2, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28153783/feasibility-accuracy-and-prognosis-of-sentinel-lymph-node-biopsy-before-neoadjuvant-therapy-in-breast-cancer-a-prospective-study
#5
Amparo Garcia-Tejedor, Catalina Falo, Cecilia Quetglas, Teresa Soler, Belen Marqueta, Raul Ortega, Miguel Gil-Gil, Sonia Pernas, Eulalia Fernandez-Montolí, Maria J Pla, Anna Guma, Maite Bajen, Ana Benitez, Arantxa Eraso, Miriam Campos, Anna Petit, Jordi Ponce
BACKGROUND AND OBJECTIVE: It remains controversial whether sentinel lymph node biopsy (SLNB) should be performed before or after neoadjuvant therapy (NAT). We aimed to evaluate the feasibility and accuracy of SLNB before NAT at a single institution, and to determine its relation to patient prognosis. METHODS: A prospective study of T1c-T2-T3 N0 breast cancer patients, after ultrasound examination, who underwent SLNB prior to NAT. Overall, disease-specific and disease-free survival were calculated by Kaplan-Meier curves...
January 30, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28128984/implementing-neoadjuvant-endocrine-strategies-in-er-positive-her2-negative-breast-cancer
#6
Alexios Matikas, Theodoros Foukakis, Ilias Michalakis, Vassilis Georgoulias
Although neoadjuvant chemotherapy has been widely adopted as it increases breast conservation rates, permits the in vivo testing of the activity of chemotherapeutics and offers the opportunity to conduct translational research based on longitudinal assessments of tumor tissue, neoadjuvant endocrine therapy has been met with skepticism owing to slow regression rates and a low chance for pathologic remission. Areas Covered: Herein, the results of clinical trials comparing different endocrine agents as neoadjuvant treatment, endocrine therapy with chemotherapy, treatment duration, novel combinations and putative biomarkers are reviewed, with the aim to better understand the current and future role of this modality in clinical practice...
January 27, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28057031/-18-fdg-pet-ct-for-predicting-the-outcome-in-er-her2-breast-cancer-patients-comparison-of-clinicopathological-parameters-and-pet-image-derived-indices-including-tumor-texture-analysis
#7
David Groheux, Antoine Martineau, Luis Teixeira, Marc Espié, Patricia de Cremoux, Philippe Bertheau, Pascal Merlet, Charles Lemarignier
BACKGROUND: This study investigated the value of some clinicopathological parameters and 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)FDG-PET/CT) indices, including textural features, to predict event-free survival (EFS) in estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2-) locally advanced breast cancer (BC) patients. METHODS: FDG-PET/CT indices and clinicopathological parameters were assessed before neoadjuvant chemotherapy (NAC)...
January 5, 2017: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/28045625/ki67-proliferation-index-as-a-tool-for-chemotherapy-decisions-during-and-after-neoadjuvant-aromatase-inhibitor-treatment-of-breast-cancer-results-from-the-american-college-of-surgeons-oncology-group-z1031-trial-alliance
#8
Matthew J Ellis, Vera J Suman, Jeremy Hoog, Rodrigo Goncalves, Souzan Sanati, Chad J Creighton, Katherine DeSchryver, Erika Crouch, Amy Brink, Mark Watson, Jingqin Luo, Yu Tao, Michael Barnes, Mitchell Dowsett, G Thomas Budd, Eric Winer, Paula Silverman, Laura Esserman, Lisa Carey, Cynthia X Ma, Gary Unzeitig, Timothy Pluard, Pat Whitworth, Gildy Babiera, J Michael Guenther, Zoneddy Dayao, David Ota, Marilyn Leitch, John A Olson, D Craig Allred, Kelly Hunt
Purpose To determine the pathologic complete response (pCR) rate in estrogen receptor (ER) -positive primary breast cancer triaged to chemotherapy when the protein encoded by the MKI67 gene (Ki67) level was > 10% after 2 to 4 weeks of neoadjuvant aromatase inhibitor (AI) therapy. A second objective was to examine risk of relapse using the Ki67-based Preoperative Endocrine Prognostic Index (PEPI). Methods The American College of Surgeons Oncology Group (ACOSOG) Z1031A trial enrolled postmenopausal women with stage II or III ER-positive (Allred score, 6 to 8) breast cancer whose treatment was randomly assigned to neoadjuvant AI therapy with anastrozole, exemestane, or letrozole...
January 3, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28002848/multidisciplinary-approach-to-neoadjuvant-endocrine-therapy-in-breast-cancer-a-comprehensive-review
#9
Tomás Reinert, Susana Ramalho, Rodrigo Gonçalves, Carlos Henrique Barrios, Marcia Silveira Graudenz, José Bines
Breast cancer is the most common type of cancer and the leading cause of cancer-related death among women worldwide. Hormone receptor-positive (HR+) tumors represent the most common form of this disease, with more than 70% of breast cancers expressing these receptors. Response and benefit to neoadjuvant chemotherapy (NCT) varies according to HR expression, with lower responses in luminal tumors as compared with hormone receptor-negative (HR-) and human epidermal growth factor receptor 2-positive (HER2+) tumors...
December 2016: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/27986713/abemaciclib-shows-promise-for-early-breast-cancer
#10
(no author information available yet)
Treatment with the CDK4/6 inhibitor abemaciclib, alone or in combination with endocrine therapy, significantly lowered expression of the protein Ki67-a key marker of cell proliferation-in women with hormone receptor-positive, HER2-negative breast cancer. The findings from the phase II neoMONARCH trial suggest that CDK4/6 inhibition may be effective for neoadjuvant treatment of early breast cancer.
December 16, 2016: Cancer Discovery
https://www.readbyqxmd.com/read/27919974/a-phase-ii-study-of-adjuvant-chemotherapy-of-tegafur-uracil-for-patients-with-breast-cancer-with-her2-negative-pathologic-residual-invasive-disease-after-neoadjuvant-chemotherapy
#11
Satoru Tanaka, Mitsuhiko Iwamoto, Kosei Kimura, Yuko Takahashi, Hiyoya Fujioka, Nayuko Sato, Risa Terasawa, Kanako Kawaguchi, Ayana Ikari, Tomo Tominaga, Saki Maezawa, Nodoka Umezaki, Junna Matsuda, Kazuhisa Uchiyama
BACKGROUND: There is no consensus on the need for adjuvant chemotherapy for patients with pathological residual invasive breast cancer (non-pCR) after neoadjuvant chemotherapy (NAC). We evaluated the tolerability and safety of tegafur-uracil (UFT) as adjuvant chemotherapy for patients with human epidermal growth factor receptor 2-negative breast cancer that resulted in non-pCR after NAC. PATIENTS AND METHODS: We treated patients with 270 mg/m(2) UFT per day for 2 years after definitive surgery and radiotherapy, if necessary...
2016: Anticancer Research
https://www.readbyqxmd.com/read/27915204/powerpiinc-preoperative-window-of-endocrine-therapy-provides-information-to-increase-compliance-trial-changes-in-tumor-proliferation-index-and-quality-of-life-with-7-days-of-preoperative-tamoxifen
#12
Adam L Cohen, Rachel E Factor, Kathi Mooney, Mohamed E Salama, Mark Wade, Victoria Serpico, Emily Ostrander, Edward Nelson, Jane Porretta, Cindy Matsen, Philip Bernard, Ken Boucher, Leigh Neumayer
OBJECTIVES: A decrease in Ki67 during neoadjuvant therapy predicts response to tamoxifen. Previous trials have shown a decreased Ki67 in breast tumors with as little as two or more weeks of preoperative tamoxifen. Shortening the preoperative treatment time in window of opportunity clinical trials makes these trials more attractive to women. POWERPIINC examined the effect of 7 days of preoperative tamoxifen on breast tumor proliferation and patient symptoms. METHODS: Women with untreated stage I/II, ER-positive, invasive breast cancer with no contraindications to tamoxifen were enrolled...
February 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27903675/a-pam50-based-chemo-endocrine-score-for-hormone-receptor-positive-breast-cancer-with-an-intermediate-risk-of-relapse
#13
Aleix Prat, Ana Lluch, Arran K Turnbull, Anita K Dunbier, Lourdes Calvo, Joan Albanell, Juan de la Haba-Rodríguez, Angels Arcusa, Ignacio Chacón, Pedro Sánchez-Rovira, Arrate Plazaola, Montse Muñoz, Laia Paré, Joel S Parker, Nuria Ribelles, Begona Jimenez, Abdul Aziz Bin Aiderus, Rosalía Caballero, Barbara Adamo, Mitch Dowsett, Eva M Carrasco, Miguel Martín, J Michael Dixon, Charles M Perou, Emilio Alba
PURPOSE: Hormone receptor-positive (HR+) breast cancer is clinically and biologically heterogeneous and subgroups with different prognostic and treatment sensitivities need to be identified. EXPERIMENTAL DESIGN: Research-based PAM50 subtyping and expression of additional genes was performed on 63 patients with HR+/HER2- disease randomized to neoadjuvant multi-agent chemotherapy versus endocrine therapy in a phase II trial. The biology associated with treatment response was used to derive a PAM50-based Chemo-Endocrine Score (CES)...
November 30, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/27903276/accurate-prediction-of-response-to-endocrine-therapy-in-breast-cancer-patients-current-and-future-biomarkers
#14
REVIEW
Cigdem Selli, J Michael Dixon, Andrew H Sims
Approximately 70% of patients have breast cancers that are oestrogen receptor alpha positive (ER+) and are therefore candidates for endocrine treatment. Many of these patients relapse in the years during or following completion of adjuvant endocrine therapy. Thus, many ER+ cancers have primary resistance or develop resistance to endocrine therapy during treatment. Recent improvements in our understanding of how tumours evolve during treatment with endocrine agents have identified both changes in gene expression and mutational profiles, in the primary cancer as well as in circulating tumour cells...
December 1, 2016: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/27866067/escalating-and-de-escalating-treatment-in-her2-positive-early-breast-cancer
#15
REVIEW
Heikki Joensuu
The current standard adjuvant systemic treatment of early HER2-positive breast cancer consists of chemotherapy plus 12months of trastuzumab, with or without endocrine therapy. Several trials have investigated modifications of the standard treatment that are shorter and less resource-demanding (de-escalation) or regimens that aim at dual HER2 inhibition or include longer than 12months of HER2-targeted treatment (escalation). Seven randomized trials investigate shorter than 12months of trastuzumab treatment duration...
January 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/27865536/breast-cancer
#16
REVIEW
Nadia Harbeck, Michael Gnant
Breast cancer is one of the three most common cancers worldwide. Early breast cancer is considered potentially curable. Therapy has progressed substantially over the past years with a reduction in therapy intensity, both for locoregional and systemic therapy; avoiding overtreatment but also undertreatment has become a major focus. Therapy concepts follow a curative intent and need to be decided in a multidisciplinary setting, taking molecular subtype and locoregional tumour load into account. Primary conventional surgery is not the optimal choice for all patients any more...
November 16, 2016: Lancet
https://www.readbyqxmd.com/read/27817858/-systemic-neoadjuvant-therapy-of-luminal-breast-cancer-in-2016
#17
REVIEW
Paul H Cottu
Neoadjuvant systemic therapies have been extensively evaluated in luminal breast cancer. Conventional cytotoxic chemotherapy increases breast conservation rate, albeit with a low level of complete pathological response of uncertain clinical significance. Endocrine therapies allow similar clinical results with much less side effects. Biological criteria of response to endocrine therapies are still being defined. The neoadjuvant setting must be used for early development of new compounds and to further document biological mechanisms of sensitivity and resistance to treatments...
January 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/27788894/neoadjuvant-systemic-therapy-use-for-younger-patients-with-breast-cancer-treated-in-different-types-of-cancer-centers-across-the-united-states
#18
Jahan J Mohiuddin, Allison M Deal, Lisa A Carey, Jennifer L Lund, Brock R Baker, Timothy M Zagar, Ellen L Jones, Lawrence B Marks, Ronald C Chen
BACKGROUND: Multiple clinical trials have shown that neoadjuvant systemic therapy has a benefit in women who are borderline lumpectomy candidates and in those with locally advanced breast cancers by reducing the mastectomy rate and making inoperable tumors operable. The study aim was to examine the patterns of neoadjuvant chemotherapy and endocrine therapy use among younger women in the United States treated at different types of cancer centers. STUDY DESIGN: Data from the National Cancer Data Base for 118,086 women younger than 65 years with clinical stage IIA (T2N0 only) to IIIC breast cancer...
November 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27770345/chemosensitivity-and-endocrine-sensitivity-in-clinical-luminal-breast-cancer-patients-in-the-prospective-neoadjuvant-breast-registry-symphony-trial-nbrst-predicted-by-molecular-subtyping
#19
Pat Whitworth, Peter Beitsch, Angela Mislowsky, James V Pellicane, Charles Nash, Mary Murray, Laura A Lee, Carrie L Dul, Michael Rotkis, Paul Baron, Lisette Stork-Sloots, Femke A de Snoo, Jennifer Beatty
PURPOSE: Hormone receptor-positive (HR+) tumors have heterogeneous biology and present a challenge for determining optimal treatment. In the Neoadjuvant Breast Registry Symphony Trial (NBRST) patients were classified according to MammaPrint/BluePrint subtyping to provide insight into the response to neoadjuvant endocrine therapy (NET) or neoadjuvant chemotherapy (NCT). OBJECTIVE: The purpose of this predefined substudy was to compare MammaPrint/BluePrint with conventional 'clinical' immunohistochemistry/fluorescence in situ hybridization (IHC/FISH) subtyping in 'clinical luminal' [HR+/human epidermal growth factor receptor 2-negative (HER2-)] breast cancer patients to predict treatment sensitivity...
October 21, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27757718/outcomes-of-patients-with-inflammatory-breast-cancer-treated-by-breast-conserving-surgery
#20
Monika Brzezinska, Linda J Williams, Jeremy Thomas, J Michael Dixon
PURPOSE: Inflammatory breast cancer (IBC) is rare and associated with a poor prognosis. Following neoadjuvant chemotherapy or endocrine therapy, the multidisciplinary team selected a small number of patients for breast-conservation therapy (BCT). The aim of this study was to determine the outcome of IBC patients treated with BCT in Edinburgh. METHODS: Between January 1999 and December 2013, thirty-five women with IBC were treated by BCT. The median follow-up was 80 months...
October 18, 2016: Breast Cancer Research and Treatment
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