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Neoadjuvant endocrine therapy

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https://www.readbyqxmd.com/read/29344722/benefit-of-the-addition-of-hormone-therapy-to-neoadjuvant-anthracycline-based-chemotherapy-for-breast-cancer-comparison-of-predicted-and-observed-pcr
#1
Daniele Generali, Silvia Paola Corona, Lajos Pusztai, Roman Rouzier, Giovanni Allevi, Sergio Aguggini, Manuela Milani, Carla Strina, Albane Frati
INTRODUCTION: Neoadjuvant hormonal therapy is generally considered a valid option for hormone receptor positive breast cancer (BC) patients who are unfit for chemotherapy or surgery. AIMS: Whilst numerous studies analyzed efficacy of neoadjuvant chemotherapy (CT) or endocrine therapy (HT) alone in hormone receptor positive patients, there is a lack of research looking at the usefulness of a preoperative combinatorial approach of CT and HT in this patient subgroup...
January 17, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29344106/overall-survival-and-progression-free-survival-with-endocrine-therapy-for-hormone-receptor-positive-her2-negative-advanced-breast-cancer-review
#2
REVIEW
Tomás Reinert, Carlos H Barrios
We reviewed randomized phase II/III trials comparing first- or second-line endocrine therapy as monotherapy or in combination with targeted therapies for treatment of postmenopausal patients with hormone receptor-positive advanced breast cancer. First-line was defined as treatment for endocrine therapy-naïve advanced breast cancer or advanced disease treated with endocrine therapy in the adjuvant/neoadjuvant setting. Second-line was defined as endocrine therapy for advanced breast cancer following disease progression on endocrine therapy for advanced disease...
November 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/29250202/asco-2017-highlights-in-breast-cancer
#3
REVIEW
Rupert Bartsch, Elisabeth Bergen
At the 2017 ASCO Annual Meeting, several pertinent studies in the field of breast cancer were presented and some are deemed as being potentially practice changing. BrighTNess was the first phase III study to investigate the addition of carboplatin to standard neoadjuvant chemotherapy in triple-negative breast cancer; while toxicity was increased in the experimental group, a significantly higher pathologic complete remission (pCR) rate was observed as well suggesting that adding carboplatin to neoadjuvant anthracycline, cyclophosphamide and taxane-containing regimens is efficacious in otherwise healthy patients...
2017: Memo
https://www.readbyqxmd.com/read/29233559/tumour-infiltrating-lymphocytes-and-prognosis-in-different-subtypes-of-breast-cancer-a-pooled-analysis-of-3771-patients-treated-with-neoadjuvant-therapy
#4
Carsten Denkert, Gunter von Minckwitz, Silvia Darb-Esfahani, Bianca Lederer, Barbara I Heppner, Karsten E Weber, Jan Budczies, Jens Huober, Frederick Klauschen, Jenny Furlanetto, Wolfgang D Schmitt, Jens-Uwe Blohmer, Thomas Karn, Berit M Pfitzner, Sherko Kümmel, Knut Engels, Andreas Schneeweiss, Arndt Hartmann, Aurelia Noske, Peter A Fasching, Christian Jackisch, Marion van Mackelenbergh, Peter Sinn, Christian Schem, Claus Hanusch, Michael Untch, Sibylle Loibl
BACKGROUND: Tumour-infiltrating lymphocytes (TILs) are predictive for response to neoadjuvant chemotherapy in triple-negative breast cancer (TNBC) and HER2-positive breast cancer, but their role in luminal breast cancer and the effect of TILs on prognosis in all subtypes is less clear. Here, we assessed the relevance of TILs for chemotherapy response and prognosis in patients with TNBC, HER2-positive breast cancer, and luminal-HER2-negative breast cancer. METHODS: Patients with primary breast cancer who were treated with neoadjuvant combination chemotherapy were included from six randomised trials done by the German Breast Cancer Group...
December 7, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29201277/pre-operative-endocrine-therapy
#5
REVIEW
Laura M Arthur, Arran K Turnbull, Lucy R Khan, J Michael Dixon
Purpose of Review: Pre-operative endocrine therapy can be used to down-stage large or locally advanced breast cancers in ER+ disease. In the last four decades, it has evolved from a treatment perceived as an alternative to surgery for those too unfit to undergo surgery or chemotherapy, to the present day where it is a valuable and valid option in the treatment of postmenopausal women with ER-rich (Allred score 7-8, or > 50% staining for ER) breast cancer. Recent Findings: Emerging data from the metastatic setting is translating into neoadjuvant trials, utilising dual endocrine targeting or combinations of endocrine agents and other targeted drugs, including those acting against components of the PI3K pathway and the cell cycle...
2017: Current Breast Cancer Reports
https://www.readbyqxmd.com/read/29168427/neoadjuvant-letrozole-for-postmenopausal-estrogen-receptor-positive-her2-negative-breast-cancer-patients-a-study-from-the-danish-breast-cancer-cooperative-group-dbcg
#6
Signe Korsgaard Skriver, Anne-Vibeke Laenkholm, Birgitte Bruun Rasmussen, Jürgen Handler, Bo Grundtmann, Tove Filtenborg Tvedskov, Peer Christiansen, Ann S Knoop, Maj-Britt Jensen, Bent Ejlertsen
INTRODUCTION: Neoadjuvant endocrine treatment (NET) is a low-toxicity approach to achieve operability in locally advanced breast cancer, and to facilitate breast conservation in early breast cancer, particular in patients with highly estrogen receptor (ER) positive and HER2-negative disease. Here, we report the results obtained by neoadjuvant letrozole in patients with early breast cancer in a phase-II design. MATERIAL AND METHODS: A total of 119 postmenopausal women with ER-positive, HER2-negative operable breast cancer were assigned to four months of neoadjuvant letrozole before definitive surgery...
November 23, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/29158285/neoadjuvant-palbociclib-on-er-breast-cancer-n007-clinical-response-and-endopredict-value
#7
Louis Wc Chow, Satoshi Morita, Christopher Yc Chow, Wai Kuen Ng, Masakazu Toi
To test the efficacy of neoadjuvant palbociclib therapy and to evaluate its impact on cell cycle arrest and changes in EndoPredict (EP) scores before and after treatment. Postmenopausal women with histologically proven ER+ve, HER2-ve invasive breast cancer, 2cm or greater, were enrolled in an open-label, single arm study. Twenty eligible patients were given letrozole 2.5mg per day together with palbociclib 125mg per day for 3 out of 4 weeks in repeated cycles for 16 weeks (4 cycles) before surgery. The primary end-points were clinical response rates (cRR) and preoperative endocrine prognostic index (PEPI)...
November 20, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29132556/neoadjuvant-endocrine-therapy-who-benefits-most
#8
REVIEW
Julie Grossman, Cynthia Ma, Rebecca Aft
Neoadjuvant endocrine therapy (NET) can be effective at downstaging patients with estrogen receptor-positive tumors and identifying those tumors that are endocrine sensitive and resistant. The optimal prognostic markers for stratification are under investigation. Use of NET will allow the identification of patients with estrogen receptor-positive tumors who might benefit from additional treatment and allow better understanding of endocrine resistance.
January 2018: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/29110152/low-pten-levels-and-pik3ca-mutations-predict-resistance-to-neoadjuvant-lapatinib-and-trastuzumab-without-chemotherapy-in-patients-with-her2-over-expressing-breast-cancer
#9
Mothaffar F Rimawi, Carmine De Angelis, Alejandro Contreras, Fresia Pareja, Felipe C Geyer, Kathleen A Burke, Sabrina Herrera, Tao Wang, Ingrid A Mayer, Andres Forero, Rita Nanda, Matthew P Goetz, Jenny C Chang, Ian E Krop, Antonio C Wolff, Anne C Pavlick, Suzanne A W Fuqua, Carolina Gutierrez, Susan G Hilsenbeck, Marilyn M Li, Britta Weigelt, Jorge S Reis-Filho, C Kent Osborne, Rachel Schiff
PURPOSE: Aberrant activation of the PI3K pathway has been implicated in resistance to HER2-targeted therapy, but results of clinical trials are confounded by the co-administration of chemotherapy. We investigated the effect of perturbations of this pathway in breast cancers from patients treated with neoadjuvant anti-HER2-targeted therapy without chemotherapy. PATIENTS AND METHODS: Baseline tumor samples from patients with HER2-positive breast cancer enrolled in TBCRC006 (NCT00548184), a 12-week neoadjuvant clinical trial with lapatinib plus trastuzumab [plus endocrine therapy for estrogen receptor (ER)-positive tumors], were assessed for PTEN status by immunohistochemistry and PIK3CA mutations by sequencing...
November 7, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29103853/adherence-to-adjuvant-endocrine-therapy-in-christchurch-women-with-early-breast-cancer
#10
B Robinson, B Dijkstra, V Davey, S Tomlinson, C Frampton
AIMS: To assess adherence to adjuvant endocrine therapy by a real-world cohort of women in Christchurch and to determine any associated factors. MATERIALS AND METHODS: Records were retrieved of all women newly diagnosed with early breast cancer and registered on the Christchurch Breast Cancer Patient Register over 4 years from June 2009. Demographic and pathological factors, dates of starting and stopping endocrine therapies and reported side-effects were collected...
November 2, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29093602/fertility-preservation-in-female-patients-with-breast-cancer-a-current-overview
#11
Veronika Guenther, Ibrahim Alkatout, Wiebe Junkers, Dirk Bauerschlag, Nicolai Maass, Soeren von Otte
Many premenopausal patients who develop breast cancer have not yet completed their family planning, so measures of fertility protection to preserve their fertile potential would be beneficial. Polychemotherapy causes irreversible damage to the ovarian follicles - irrespective of whether in a neoadjuvant or adjuvant setting - and this can sometimes result in permanent infertility. Depending on which cytostatic agents are used and on the age-related ovarian reserve of the woman, gonadotoxic risk must be classified as low, moderate or high...
October 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29070044/neoadjuvant-everolimus-plus-letrozole-versus-fluorouracil-epirubicin-and-cyclophosphamide-for-er-positive-her2-negative-breast-cancer-study-protocol-for-a-randomized-pilot-trial
#12
Wei Wu, Heran Deng, Nanyan Rao, Na You, Yaping Yang, Minghui Cao, Jieqiong Liu
BACKGROUND: The response to neoadjuvant chemotherapy (NAC) varies by estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) statuses, with responses being lower in ER-positive, HER2-negative tumors as compared with ER-negative, HER2-positive or triple-negative tumors. Neoadjuvant endocrine therapy (NET) is an attractive alternative to NAC for ER-positive, HER2-negative cancer. However, a prior trial comparing NET with standard NAC in ER-positive tumor showed that the difference of response was not significant...
October 25, 2017: Trials
https://www.readbyqxmd.com/read/28984771/application-of-neoadjuvant-chemotherapy-in-occult-breast-cancer-five-case-reports
#13
Haisong Yang, Ling Li, Mengmeng Zhang, Shiyong Zhang, Shu Xu, Xiaoxia Ma
RATIONALE: Although rare, occult breast cancer (OBC) originates from breast tissue. Its primary lesions cannot be identified by clinical examination or imaging; therefore, the diagnosis, treatment, and prognosis remain controversial. PATIENT CONCERNS: This study comprised 5 female OBC patients who were admitted to the Affiliated Hospital of Guizhou Medical University for painless axillary lumps. DIAGNOSES: F-flurodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) indicated metastasis in the ipsilateral axillary lymph nodes...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28943062/the-success-of-sentinel-lymph-node-biopsy-after-neoadjuvant-therapy-a-single-institution-review
#14
James M Chang, Heidi E Kosiorek, Nabil Wasif, Richard J Gray, Chee-Chee H Stucky, Donald W Northfelt, Karen S Anderson, Ann E McCullough, Idris Tolgay Ocal, Barbara A Pockaj
BACKGROUND: The appropriate management of the axilla among women undergoing neoadjuvant therapy is in evolution. METHOD: A retrospective review of a prospective database of women with breast cancer who underwent neoadjuvant systemic therapy using endocrine/chemotherapy (NE/CT) from 2002 to 2015 was performed. RESULTS: We reviewed 253 women: triple negative breast cancer (30%), ER+HER2- (44%) breast cancer and HER2+ (25%) disease. The mean age was 55 years (SD = 12)...
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28937963/ki67-and-lymphocytes-in-the-pretherapeutic-core-biopsy-of-primary-invasive-breast-cancer-positive-markers-of-therapy-response-prediction-and-superior-survival
#15
REVIEW
Claus M Schlotter, Lothar Tietze, Ulf Vogt, Carlos Villena Heinsen, Antje Hahn
Background Core needle biopsy plays a crucial role as diagnostic tool for BC. Both Ki67 and likely tumor-infiltrating lymphocytes (TILs) in the near future are determining the kind of systemic therapy. The role of TILs in BC is still an issue for clinical research, albeit preliminary results of neoadjuvant and adjuvant clinical studies already now highlight the crucial impact of TILs on therapy response and survival. Methods Evaluation of related publications (pubmed) and meeting abstracts (ASCO, SABCS). Results The monoclonal antibody Ki67 recognizing a nuclear antigene in proliferating cells is a positive marker of therapy response and superior survival...
September 22, 2017: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/28922685/neoadjuvant-systemic-therapy-for-breast-cancer-the-westmead-experience
#16
Annelise M Cocco, David Messer, Alexander Brown, Nina Sriram, Jenny Gilchrist, Loma Al-Mansouri, Richard Kefford, Farid Meybodi, James French, Jeremy Hsu, Elisabeth Elder
BACKGROUND: Neoadjuvant systemic therapy (NAST) can be used to treat breast cancer. Pathologic complete response (pCR) is a surrogate marker for improved survival. This study examined response in the breast and axilla to NAST and identified features associated with pCR. METHODS: Patients undergoing NAST and surgery between January 2012 and June 2016 by surgeons at Westmead Breast Cancer Institute were identified. Patients with inflammatory or metastatic disease were excluded...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28918496/recurrent-papillary-craniopharyngioma-with-brafv600e-mutation-treated-with-neoadjuvant-targeted-therapy
#17
Elham Rostami, Petra Witt Nyström, Sylwia Libard, Johan Wikström, Olivera Casar-Borota, Olafur Gudjonsson
Craniopharyngiomas are histologically benign but locally aggressive tumors in the sellar region that may cause devastating neurological and endocrine deficits. They tend to recur following surgery with high morbidity; hence, postoperative radiotherapy is recommended following sub-total resection. BRAFV600E mutation is the principal oncogenic driver in the papillary variant of craniopharyngiomas. Recently, a dramatic tumor reduction has been reported in a patient with BRAFV600E mutated, multiply recurrent papillary craniopharyngioma using a combination therapy of BRAF inhibitor dabrafenib and MEK inhibitor trametinib...
November 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28876590/surgery-post-neoadjuvant-therapy-for-breast-cancer-an-analysis-of-82-patients-treated-at-a-specialist-unit-in-johannesburg
#18
L Van Schalkwyk, C Benn, K Bergstrom
INTRODUCTION: Neoadjuvant therapy in the breast cancer setting not only provides an indication of response to systemic therapy, but also results in tumour downsizing/downstaging, which facilitates breast conservation therapy (BCT). The aim of this retrospective analysis is to examine the surgical management of patients who have received neoadjuvant therapy for breast cancer at the Netcare Breast Care Centre (NCBC) in Johannesburg. METHOD: All breast cancer patients managed surgically at the NCBC after neoadjuvant chemotherapy/primary endocrine therapy were identified from a database of 431 breast cancer patients presenting to this facility from June 2015 to June 2016...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28874413/a-phase-ii-trial-of-neoadjuvant-mk-2206-an-akt-inhibitor-with-anastrozole-in-clinical-stage-ii-or-iii-pik3ca-mutant-er-positive-and-her2-negative-breast-cancer
#19
Cynthia X Ma, Vera Suman, Matthew P Goetz, Donald Northfelt, Mark E Burkard, Foluso Ademuyiwa, Michael Naughton, Julie Margenthaler, Rebecca Aft, Richard Gray, Amye Tevaarwerk, Lee Wilke, Tufia Haddad, Timothy Moynihan, Charles Loprinzi, Tina Hieken, Erica K Barnell, Zachary L Skidmore, Yan-Yang Feng, Kilannin Krysiak, Jeremy Hoog, Zhanfang Guo, Leslie Nehring, Kari B Wisinski, Elaine Mardis, Ian S Hagemann, Kiran Vij, Souzan Sanati, Hussam Al-Kateb, Obi L Griffith, Malachi Griffith, Laurence Doyle, Charles Erlichman, Matthew J Ellis
Purpose: Hyperactivation of AKT is common and associated with endocrine resistance in estrogen receptor-positive (ER(+)) breast cancer. The allosteric pan-AKT inhibitor MK-2206 induced apoptosis in PIK3CA-mutant ER(+) breast cancer under estrogen-deprived condition in preclinical studies. This neoadjuvant phase II trial was therefore conducted to test the hypothesis that adding MK-2206 to anastrozole induces pathologic complete response (pCR) in PIK3CA mutant ER(+) breast cancer.Experimental Design: Potential eligible patients with clinical stage II/III ER(+)/HER2(-) breast cancer were preregistered and received anastrozole (goserelin if premenopausal) for 28 days in cycle 0 pending tumor PIK3CA sequencing...
September 5, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28872469/extending-indication-of-cyclin-dependent-kinase-4-6-inhibitors-in-the-adjuvant-and-neoadjuvant-setting
#20
REVIEW
Carmen Criscitiello, Giulia Viale, Giuseppe Curigliano
PURPOSE OF REVIEW: A burst of recent activity has surrounded the study of cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors for the treatment of metastatic breast cancer. The success of these drugs in the metastatic setting has pushed the evaluation of these agents in early-stage disease. The use of CDK 4/6 inhibitors as neoadjuvant and adjuvant therapy is a hot topic and several studies are underway. RECENT FINDINGS: Ongoing studies are exploring the addition of CDK 4/6 inhibitors to endocrine therapy in early breast cancer...
November 2017: Current Opinion in Oncology
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