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Neoadjuvant endocrine therapy

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https://www.readbyqxmd.com/read/28922685/neoadjuvant-systemic-therapy-for-breast-cancer-the-westmead-experience
#1
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
#2
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...
September 16, 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
#3
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-mk2206-an-akt-inhibitor-with-anastrozole-in-clinical-stage-2-or-3-pik3ca-mutant-er%C3%A2-positive-and-her2-negative-breast-cancer
#4
Cynthia X Ma, Vera Suman, Matthew P Goetz, Donald W Northfelt, Mark E Burkard, Foluso Ademuyiwa, Michael J Naughton, Julie Margenthaler, Rebecca Aft, Richard J Gray, Amye J Tevaarwerk, Lee G Wilke, Tufia C Haddad, Timothy Moynihan, Charles Loprenzi, Tina Hieken, Erica K Barnell, Zachary L Skidmore, Yan-Yang Feng, Kilannin Krysiak, Jeremy Hoog, Zhanfang Guo, Leslie Nehring, Kari B Wisinski, Elaine R Mardis, Ian S Hagemann, Kiran Vij, Souzan Sanati, Hussam Al-Kateb, Obi L Griffith, Malachi Griffith, Austin Doyle, Charles Erlichman, Matthew J Ellis
PURPOSE: Hyper-activation 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 pre-registered 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
#5
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...
September 1, 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/28862111/how-can-we-improve-education-of-breast-surgeons-across-europe
#6
Agnieszka Kolacinska
The proposed global curriculum developed by the American Society of Surgical Oncology (SSO) and the European Society of Surgical Oncology (ESSO) and the textbook: provides a state-of- the- art of breast cancer surgery, complements the syllabus and curriculum of the Union Europeenne des Medecins Specialistes (UEMS) examination in breast surgery/ European Board of Surgery Qualification in Breast Surgery (EBSQinBS) administered by ESSO (1) Knowledge and understanding of the principles of breast cancer incidence, aetiology, risk factors, genetics, premalignant and high-risk lesions, pathology, prognostic and predictive factors, risk prediction models, screening, diagnosis and imaging, breast cancer, oncoplastic, reconstructive breast surgery, axillary surgery and future perspective for this, radiation therapy, neoadjuvant and adjuvant systemic treatment- endocrine-, immuno- and chemotherapy, side effects and toxicities of treatment, locoregional recurrence, follow-up, locally advanced breast cancer, metastatic breast cancer, breast cancer in young and elderly patients, survivor issues, lymphedema, palliative care, chroni pain, body image and sexuality, fertility issues, cognitive functions, etc...
July 2017: Chirurgia
https://www.readbyqxmd.com/read/28838210/de-escalating-and-escalating-treatments-for-early-stage-breast-cancer-the-st-gallen-international-expert-consensus-conference-on-the-primary-therapy-of-early-breast-cancer-2017
#7
G Curigliano, H J Burstein, E P Winer, M Gnant, P Dubsky, S Loibl, M Colleoni, M M Regan, M Piccart-Gebhart, H-J Senn, B Thürlimann, F André, J Baselga, J Bergh, H Bonnefoi, S Y Brucker, F Cardoso, L Carey, E Ciruelos, J Cuzick, C Denkert, A Di Leo, B Ejlertsen, P Francis, V Galimberti, J Garber, B Gulluoglu, P Goodwin, N Harbeck, D F Hayes, C-S Huang, J Huober, K Hussein, J Jassem, Z Jiang, P Karlsson, M Morrow, R Orecchia, K C Osborne, O Pagani, A H Partridge, K Pritchard, J Ro, E J T Rutgers, F Sedlmayer, V Semiglazov, Z Shao, I Smith, M Toi, A Tutt, G Viale, T Watanabe, T J Whelan, B Xu
The 15th St. Gallen International Breast Cancer Conference 2017 in Vienna, Austria reviewed substantial new evidence on loco-regional and systemic therapies for early breast cancer. Treatments were assessed in light of their intensity, duration and side-effects, seeking where appropriate to escalate or de-escalate therapies based on likely benefits as predicted by tumor stage and tumor biology. The Panel favored several interventions that may reduce surgical morbidity, including acceptance of 2 mm margins for DCIS, the resection of residual cancer (but not baseline extent of cancer) in women undergoing neoadjuvant therapy, acceptance of sentinel node biopsy following neoadjuvant treatment of many patients, and the preference for neoadjuvant therapy in HER2 positive and triple-negative, stage II and III breast cancer...
August 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28741274/cyclin-dependent-kinase-4-6-inhibitors-in-breast-cancer-palbociclib-ribociclib-and-abemaciclib
#8
REVIEW
Dorota Kwapisz
PURPOSE: The cyclin D-cyclin dependent kinase (CDK) 4/6-inhibitor of CDK4 (INK4)-retinoblastoma (Rb) pathway plays a crucial role in cell cycle progression and its dysregulation is an important contributor to endocrine therapy resistance. CDK4/6 inhibitors trigger cell cycle arrest in Rb protein (pRb)-competent cells. Recent years have seen the development of selective CDK4/6 inhibitors, which have delivered promising results of efficacy and manageable safety profiles. The main objective of this review is to discuss preclinical and clinical data to date, and ongoing clinical trials with palbociclib, ribociclib, and abemaciclib in breast cancer...
July 24, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28730768/modulatory-effect-of-neoadjuvant-chemotherapy-on-the-prognosis-of-patients-with-breast-cancer
#9
Jasna Trifunovic, Numa Memisevic, Borislava Nikolin, Svetlana Salma, Tihomir Dugandzija, Vladimir Vidovic
PURPOSE: To evaluate the changes in biological markers ER, PR, HER2 and Ki67 in residual tumor after surgery for locally advanced breast cancer (LABC), and also to evaluate the outcome of breast cancer patients treated with neoadjuvant chemotherapy (NAC). METHODS: 144 breast cancer patients treated with NAC at the Oncology Institute of Vojvodina, Serbia from 2011 to 2015 were included in this study. Changes in biologic markers ER,PR, HER2/neu and Ki-67 were evaluated at diagnostic core biopsy and at the final surgery tissue specimens...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28717399/fulvestrant-in-advanced-breast-cancer-evidence-to-date-and-place-in-therapy
#10
REVIEW
Katalin Boér
Breast cancer is a classical hormone-dependent tumour; therefore, endocrine therapy is the mainstay of treatment for hormone receptor-positive, human epidermal growth factor 2-negative advanced breast cancer. Until recently, classical endocrine agents such as tamoxifen, steroidal and nonsteroidal aromatase inhibitors and fulvestrant have been widely used in postmenopausal patients to treat locally advanced or metastatic disease. However, for patients with this subtype of breast cancer, the landscape of endocrine therapy is rapidly changing...
July 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/28698832/acute-inflammatory-response-during-neoadjuvant-chemotherapy-for-locally-advanced-breast-cancer-a-case-report
#11
Xiaolan Feng, Tanya Berrang, John Paul McGhie, Peter Watson, R Petter Tonseth, Pauline T Truong
We report on a 56-year-old Caucasian female, diagnosed with locally advanced, hormone-receptor-positive, and human epidermal growth factor receptor 2 (HER2)-positive cancer of the left breast. The patient received neoadjuvant chemotherapy with adriamycin/cyclophosphamide (AC) followed by docetaxel/trastuzumab. A partial clinical and radiographical response was documented after four cycles of AC. Approximately one week after the first cycle of docetaxel and trastuzumab, the patient presented with diffuse edema, erythema, and induration involving the entire left breast...
June 10, 2017: Curēus
https://www.readbyqxmd.com/read/28690648/recent-advances-in-the-neoadjuvant-treatment-of-breast-cancer
#12
REVIEW
Gábor Rubovszky, Zsolt Horváth
In the last few decades, neoadjuvant therapy for breast cancer has gained considerable therapeutic importance. Despite extensive clinical investigations, it has not yet been clarified whether neoadjuvant therapy would result in improved survival in comparison with the standard adjuvant setting in any subgroups of patients with breast cancer. Chemotherapy is especially effective in the treatment of endocrine insensitive tumors, and such ther-apeutic benefit can be assumed for patients with triple-negative, or hormone receptor-negative and human epidermal growth factor receptor 2 (HER2)-positive breast cancer...
June 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/28682681/de-escalation-strategies-in-human-epidermal-growth-factor-receptor-2-her2-positive-early-breast-cancer-bc-final-analysis-of-the-west-german-study-group-adjuvant-dynamic-marker-adjusted-personalized-therapy-trial-optimizing-risk-assessment-and-therapy-response
#13
RANDOMIZED CONTROLLED TRIAL
Nadia Harbeck, Oleg Gluz, Matthias Christgen, Ronald Ernest Kates, Michael Braun, Sherko Küemmel, Claudia Schumacher, Jochem Potenberg, Stefan Kraemer, Anke Kleine-Tebbe, Doris Augustin, Bahriye Aktas, Helmut Forstbauer, Joke Tio, Raquel von Schumann, Cornelia Liedtke, Eva-Maria Grischke, Johannes Schumacher, Rachel Wuerstlein, Hans Heinrich Kreipe, Ulrike Anneliese Nitz
Purpose Human epidermal growth factor receptor 2 (HER2)-positive/hormone receptor (HR)-positive breast cancer is a distinct subgroup associated with lower chemotherapy sensitivity and slightly better outcome than HER2-positive/HR-negative disease. Little is known about the efficacy of the combination of endocrine therapy (ET) with trastuzumab or with the potent antibody-cytotoxic, anti-HER2 compound trastuzumab emtansine (T-DM1) with or without ET for this subgroup. The West German Study Group trial, ADAPT (Adjuvant Dynamic Marker-Adjusted Personalized Therapy Trial Optimizing Risk Assessment and Therapy Response Prediction in Early Breast Cancer) compares pathologic complete response (pCR) rates of T-DM1 versus trastuzumab with ET in early HER2-positive/HR-positive breast cancer...
September 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28669712/lessons-in-precision-oncology-from-neoadjuvant-endocrine-therapy-trials-in-er-breast-cancer
#14
Matthew J Ellis
For post-menopausal women with clinical stage II/III estrogen receptor positive (ER+) breast cancer neoadjuvant endocrine therapy (NET) is an under-utilized and low-toxicity alternative to chemotherapy for increasing breast conservation rates. Individual responses to endocrine therapy can also be used to tailor systemic treatment. The Preoperative Endocrine Prognostic Index (PEPI) was developed to identify patients at low risk of relapse after NET so that adjuvant chemotherapy can safely be avoided. In a recent validation study, patients with pathological stage 1 or 2A breast cancers with a Ki67 value of 2...
August 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28612227/development-of-a-ki-67-based-clinical-trial-assay-for-neoadjuvant-endocrine-therapy-response-monitoring-in-breast-cancer
#15
Rodrigo Goncalves, Katherine DeSchryver, Cynthia Ma, Yu Tao, Jeremy Hoog, Maggie Cheang, Erika Crouch, Neha Dahiya, Souzan Sanati, Michael Barnes, Luis Otávio Zanatta Sarian, John Olson, Donald Craig Allred, Matthew J Ellis
PURPOSE: The recent publication of the ACOSOG Z1031 trial results demonstrated that Ki-67 proliferation marker-based neoadjuvant endocrine therapy response monitoring could be used for tailoring the use of adjuvant chemotherapy in ER+HER2-negative breast cancer patients. In this paper, we describe the development of the Ki-67 clinical trial assay used for this study. METHODS: Ki-67 assay assessment focused on reproducing a 2.7% Ki-67 cut-point (CP) required for calculating the Preoperative Endocrine Prognostic Index and a 10% CP for poor endocrine therapy response identification within the first month of neoadjuvant endocrine treatment...
September 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28580882/monarch-2-abemaciclib-in-combination-with-fulvestrant-in-women-with-hr-her2-advanced-breast-cancer-who-had-progressed-while-receiving-endocrine-therapy
#16
RANDOMIZED CONTROLLED TRIAL
George W Sledge, Masakazu Toi, Patrick Neven, Joohyuk Sohn, Kenichi Inoue, Xavier Pivot, Olga Burdaeva, Meena Okera, Norikazu Masuda, Peter A Kaufman, Han Koh, Eva-Maria Grischke, Martin Frenzel, Yong Lin, Susana Barriga, Ian C Smith, Nawel Bourayou, Antonio Llombart-Cussac
Purpose MONARCH 2 ( ClinicalTrials.gov identifier: NCT02107703) compared the efficacy and safety of abemaciclib, a selective cyclin-dependent kinase 4 and 6 inhibitor, plus fulvestrant with fulvestrant alone in patients with advanced breast cancer (ABC). Patients and Methods MONARCH 2 was a global, double-blind, phase III study of women with hormone receptor-positive and human epidermal growth factor receptor 2-negative ABC who had progressed while receiving neoadjuvant or adjuvant endocrine therapy (ET), ≤ 12 months from the end of adjuvant ET, or while receiving first-line ET for metastatic disease...
September 1, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28570439/cortisol-awakening-response-as-a-prospective-risk-factor-for-depressive-symptoms-in-women-after-treatment-for-breast-cancer
#17
Kate Ryan Kuhlman, Michael R Irwin, Patricia A Ganz, Catherine M Crespi, Laura Petersen, Arash Asher, Julienne E Bower
OBJECTIVE: The aim of the study was to investigate hypothalamic-pituitary-adrenal axis (HPA axis) functioning as a neurobiological risk factor for depressive symptoms in an ongoing longitudinal, observational study of women undergoing treatment and recovery from breast cancer. Many women with breast cancer experience depressive symptoms that interfere with their treatment, recovery, and quality of life. Psychosocial risk factors for depression among patients with cancer and survivors have been identified, yet neurobiological risk factors in this population remain largely unexamined...
September 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28516441/decision-making-in-the-surgical-management-of-invasive-breast-cancer-part-2-expanded-applications-for-breast-conserving-surgery
#18
REVIEW
Lisa A Newman
Treatment of early-stage invasive breast cancer with breast-conserving surgery plus radiation therapy (RT) yields overall survival outcomes equivalent to those achieved with mastectomy. Further, breast-conserving surgery is endorsed by the National Comprehensive Cancer Network as being supported by the highest-level, category 1 evidence. Advances in pathologic evaluation, management of multiple tumors, oncoplastic lumpectomy techniques, neoadjuvant chemotherapy, and hypofractionated RT can expand the pool of patients eligible for breast-conserving surgery...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28495849/neoadjuvant-trials-in-er-breast-cancer-a-tool-for-acceleration-of-drug-development-and-discovery
#19
REVIEW
Angel L Guerrero-Zotano, Carlos L Arteaga
Neoadjuvant therapy trials offer an excellent strategy for drug development and discovery in breast cancer, particularly in triple-negative and HER2-overexpressing subtypes, where pathologic complete response is a good surrogate of long-term patient benefit. For estrogen receptor-positive (ER(+)) breast cancers, however, use of this strategy has been challenging because of the lack of validated surrogates of long-term efficacy and the overall good prognosis of the majority of patients with this cancer subtype...
June 2017: Cancer Discovery
https://www.readbyqxmd.com/read/28478828/tidal-chemotherapy-in-premenopausal-patients-with-hormone-receptor-positive-breast-cancer
#20
Qing-Qing Luo, Jian-Bo Huang, Yu-Tuan Wu, Xin Li, Chun-Xia Zhao, He Wu, Wei Dai, Kai-Nan Wu, Ling-Quan Kong
Neoadjuvant chemotherapy remains an inseparable part of systemic therapy for hormone receptor positive (HR+) advanced breast cancer. However, efficacy of neoadjuvant chemotherapy in this subtype of patients is inferior to its hormone receptor negative counterpart. Several preclinical and clinical studies have suggested that it was growth rate rather than hormone receptor status that determined sensitivity to chemotherapy. In addition, estrogen was proved to recruit more HR+ breast cancer cells into actively dividing phase according to various studies...
May 2017: Medical Hypotheses
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