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Neoadjuvant endocrine therapy

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https://www.readbyqxmd.com/read/28612227/development-of-a-ki-67-based-clinical-trial-assay-for-neoadjuvant-endocrine-therapy-response-monitoring-in-breast-cancer
#1
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...
June 13, 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
#2
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...
June 3, 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
#3
Kate Ryan Kuhlman, Michael R Irwin, Patricia A Ganz, Catherine M Crespi, Laura Petersen, Arash Asher, Julienne E Bower
OBJECTIVE: 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 cancer patients and survivors have been identified, yet neurobiological risk factors in this population remain largely unexamined...
May 31, 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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28466123/the-role-of-quantitative-estrogen-receptor-status-in-predicting-tumor-response-at-surgery-in-breast-cancer-patients-treated-with-neoadjuvant-chemotherapy
#7
REVIEW
Jacques Raphael, Sonal Gandhi, Nim Li, Fang-I Lu, Maureen Trudeau
PURPOSE: Estrogen receptor (ER) negative (-) breast cancer (BC) patients have better tumor response rates than ER-positive (+) patients after neoadjuvant chemotherapy (NCT). We conducted a retrospective review using the institutional database "Biomatrix" to assess the value of quantitative ER status in predicting tumor response at surgery and to identify potential predictors of survival outcomes. METHODS: Univariate followed by multivariable regression analyses were conducted to assess the association between quantitative ER and tumor response assessed as tumor size reduction and pathologic complete response (pCR)...
May 2, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28327615/neoadjuvant-chemotherapy-creates-surgery-opportunities-for-inoperable-locally-advanced-breast-cancer
#8
Minghao Wang, Lingmi Hou, Maoshan Chen, Yan Zhou, Yueyang Liang, Shushu Wang, Jun Jiang, Yi Zhang
Neoadjuvant chemotherapy (NAC), the systematic chemotherapy given to patients with locally advanced and inoperable breast caner, has been proven to be of great clinical values. Many scientific reports confirmed NAC could effectively eliminate sub-clinical disseminated lesions of tumor, and improve long-term and disease-free survival rate of patients with locally advanced breast cancer (LABC); however, up to now, LABC is still a serious clinical issue given improved screening and early diagnosis. This study, with main focus on inoperable LABC, investigated the values of NAC in converting inoperable LABC into operable status and assessed the prognosis...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28289852/tumor-infiltrating-lymphocytes-and-molecular-response-after-neoadjuvant-therapy-for-hr-her2-%C3%A2-breast-cancer-results-from-two-prospective-trials
#9
M V Dieci, A Frassoldati, D Generali, G Bisagni, F Piacentini, L Cavanna, K Cagossi, F Puglisi, A Michelotti, R Berardi, G Banna, A Goubar, G Ficarra, G Griguolo, Pierfranco Conte, V Guarneri
PURPOSE: The aim was to evaluate the role of tumor-infiltrating lymphocytes (TIL) in predicting molecular response after preoperative endocrine or cytotoxic treatment for HR+/HER2- patients who do not achieve a pathological complete response. METHODS: Stromal (Str) TIL were centrally evaluated on samples from diagnostic core-biopsies of HR+/HER2- patients included in two prospective randomized trials: the LETLOB trial (neoadjuvant endocrine-based treatment) and the GIOB trial (neoadjuvant chemotherapy-based treatment)...
June 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28247605/-efficacy-of-adjuvant-endocrine-therapy-in-breast-cancer-patients-with-a-positive-to-negative-switch-of-hormone-receptor-status-after-neoadjuvant-chemotherapy
#10
Guangfa Xia, Juanying Zhu, Jun Yuan, Bo Cao, Jie Tang, Yiding Chen
Objective: To evaluate the efficacy of adjuvant endocrine therapy (AET) in breast cancer patients with a positive-to-negative switch of hormone receptor status after neoadjuvant chemotherapy (NAC). Methods: One hundred and six patients who presented with hormone receptor (HR)-positive breast cancer at diagnosis and turned to HR-negative after NAC during December 2000 and December 2013 in Jiaxing Maternity and Child Health Care Hospital were retrospectively identified. Kaplan-Meier analysis and log-rank test were used for univariate analyses of factors related to disease free survival (DFS) and overall survival (OS)...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28197838/the-growing-role-of-cdk4-6-inhibitors-in-treating-hormone-receptor-positive-advanced-breast-cancer
#11
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
#12
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
#13
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
#14
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...
April 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
#15
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...
March 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28128984/implementing-neoadjuvant-endocrine-strategies-in-er-positive-her2-negative-breast-cancer
#16
REVIEW
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...
April 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
#17
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
#18
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...
April 1, 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
#19
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
#20
(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
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