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Anthracycline in breast cancer

Ami N Shah, William J Gradishar
Anthracyclines have been a mainstay of breast cancer therapy for decades, with strong evidence demonstrating their impact on breast cancer survival. However, concerns regarding rare but serious long-term toxicities including cardiotoxicity and hematologic malignancies have driven interest in alternative adjuvant therapy options with more favorable toxicity profiles. This article provides an update of data that help inform clinicians of the role anthracyclines should play in adjuvant breast cancer therapy. Two recently reported large randomized trials-the Anthracycline in Early Breast Cancer and Western German Study Plan B studies-compared a taxane and cyclophosphamide regimen with an anthracycline, taxane, and cyclophosphamide regimen...
August 17, 2018: Oncologist
Courtney P Williams, Kelly M Kenzik, Andres Azuero, Grant R Williams, Maria Pisu, Karina I Halilova, Stacey A Ingram, Supriya K Yagnik, Andres Forero, Smita Bhatia, Gabrielle B Rocque
BACKGROUND: National Comprehensive Cancer Network (NCCN) guideline-based treatment is a marker of high-quality care. The impact of guideline discordance on cost and health care utilization is unclear. MATERIALS AND METHODS: This retrospective cohort study of Medicare claims data from 2012 to 2015 included women age ≥65 with stage I-III breast cancer receiving care within the University of Alabama at Birmingham Cancer Community Network. Concordance with NCCN guidelines was assessed for treatment regimens...
August 17, 2018: Oncologist
N LeVasseur, C Stober, M Ibrahim, S Gertler, J Hilton, A Robinson, S McDiarmid, D Fergusson, S Mazzarello, B Hutton, A A Joy, M McInnes, M Clemons
Background: The choice of vascular access for systemic therapy administration in breast cancer remains an area of clinical equipoise, and patient preference is not consistently acknowledged. Using a patient survey, we evaluated the patient experience with vascular access during treatment for early-stage breast cancer and explored perceived risk factors for lymphedema. Methods: Patients who had received systemic therapy for early-stage breast cancer were surveyed at 2 Canadian cancer centres...
August 2018: Current Oncology
N LeVasseur, C Stober, K Daigle, A Robinson, S McDiarmid, S Mazzarello, B Hutton, A Joy, D Fergusson, J Hilton, M McInnes, M Clemons
Background: Despite advances in systemic therapy choices for patients with early-stage breast cancer, optimal practices for intravenous (IV) access remain unknown. That lack of knowledge holds particularly true for the use of central venous access devices (cvads) such as peripherally inserted central catheters (piccs) and implanted vascular access devices (ports). Methods: Using a survey of Canadian oncologists and oncology nurses responsible for the care of breast cancer patients, we evaluated current access practices, perceptions of complications, and perceptions of risk, and we estimated complication rates and evaluated perceived risk factors for lymphedema...
August 2018: Current Oncology
Zhipeng Wang, Lei Xu, Han Wang, Zhenzhi Li, Lu Lu, Xiaojia Li, Qingyuan Zhang
The goal of this study was to assess the antitumor efficacy and safety of lobaplatin-based regimens as the second line of treatment in patients with metastatic breast cancer (MBC) resistant to anthracyclines and taxanes, compared with that of cisplatin-based regimens. During August 2012 to April 2015, 87 patients who received lobaplatin-based regimens or cisplatin-based regimens were included. Medical records of the patients noted that lobaplatin (30 mg/m2 ) or cisplatin (25 mg/m2 ), combined with another chemotherapeutic agent such as Gemcitabine (1000 mg/m2 ) or Vinorelbine (25 mg/m2 ), was intravenously given to the patients on a basis of twenty-one days as one treatment cycle...
July 2018: Saudi Journal of Biological Sciences
Chagkrit Ditsatham, Imjai Chitapanarux, Areewan Somwangprasert, Kirati Watcharachan, Panchaporn Wongmaneerung, Chaiyut Charoentum, Busyamas Chewaskulyong, Somvilai Chakrabandhu, Wimrak Onchan, Anongnart Teeyasuntranonn, Patumrat Sripan
Background: We report the safety and efficacy of eribulin as a late treatment line in Thai metastatic breast cancer (MBC) patients. Patients and methods: A total of 30 MBC patients treated with eribulin between January 2014 and January 2017 were retrospectively analyzed. The patients were scheduled to receive 1.4 mg/m2 of eribulin on day 1, day 8 and subsequently every 21 days. All patients had previously received at least three chemotherapy regimens including anthracycline and taxane...
2018: OncoTargets and Therapy
Norbert Marschner, Christoph Salat, Ulrike Söling, Richard Hansen, Sina Grebhardt, Johanna Harde, Arnd Nusch, Karin Potthoff
BACKGROUND: One of the most effective chemotherapies for metastatic breast cancer (MBC) is nab-paclitaxel (nab-P), which is approved for treatment of MBC after failure of first-line therapy and when anthracyclines are not indicated. Randomized clinical trials have shown high efficacy and acceptable toxicity. Real-world data of nab-P in MBC, however, are still limited. PATIENTS AND METHODS: The prospective multicenter noninterventional study NABUCCO collected data on the routine treatment of patients with MBC receiving nab-P in 128 sites across Germany...
August 9, 2018: Clinical Breast Cancer
Wafaa S El-Sherbeny, Nesreen M Sabry, Radwa M Sharbay
BACKGROUND: Adjuvant trastuzumab improved overall survival and reduced the risk for disease recurrence in women with breast cancers, because of its potential cardiotoxicity, careful monitoring of left ventricular (LV) function during treatment is required. METHODS: This study investigates, whether myocardial strain imaging and level of N-terminal pro-brain natriuretic peptide (NT-pro BNP) could predict subsequent reduction in LVEF in breast cancer patients received adjuvant trastuzumab...
August 11, 2018: Journal of Echocardiography
Anna Sofie Kappel Buhl, Troels Dreier Christensen, Ib Jarle Christensen, Knud Mejer Nelausen, Eva Balslev, Ann Søegaard Knoop, Eva Harder Brix, Else Svensson, Vesna Glavicic, Adam Luczak, Sven Tyge Langkjer, Søren Linnet, Erik Hugger Jakobsen, Jurij Bogovic, Bent Ejlertsen, Annie Rasmussen, Anker Hansen, Steen Knudsen, Dorte Nielsen, Peter Buhl Jensen
PURPOSE: Anthracyclines remain a cornerstone in the treatment of primary and advanced breast cancer (BC). This study has evaluated the predictive value of a multigene mRNA-based drug response predictor (DRP) in the treatment of advanced BC with epirubicin. The DRP is a mathematical method combining in vitro sensitivity and gene expression with clinical genetic information from > 3000 clinical tumor samples. METHODS: From a DBCG cohort, 140 consecutive patients were treated with epirubicin between May 1997 and November 2016...
August 11, 2018: Breast Cancer Research and Treatment
Mariana L Henry, Jiangong Niu, Ning Zhang, Sharon H Giordano, Mariana Chavez-MacGregor
OBJECTIVES: This study sought to determine the rate of chemotherapy-related cardiotoxicity and to estimate adherence to recommendations for cardiac monitoring among breast cancer patients treated with chemotherapy. BACKGROUND: Heart failure (HF) is a known complication associated with cancer therapies. Little is known regarding the rate of chemotherapy-related cardiotoxicity and adherence to recommendations for cardiac monitoring among chemotherapy-treated breast cancer patients...
August 2018: JACC. Cardiovascular Imaging
Thiago Ferreira de Souza, Thiago Quinaglia A C Silva, Felipe Osorio Costa, Ravi Shah, Tomas G Neilan, Lício Velloso, Wilson Nadruz, Fabricio Brenelli, Andrei Carvalho Sposito, Jose Roberto Matos-Souza, Fernando Cendes, Otávio Rizzi Coelho, Michael Jerosch-Herold, Otavio Rizzi Coelho-Filho
OBJECTIVES: The goal of this study was to demonstrate that cardiac magnetic resonance could reveal anthracycline-induced early tissue remodeling and its relation to cardiac dysfunction and left ventricular (LV) atrophy. BACKGROUND: Serum biomarkers of cardiac dysfunction, although elevated after chemotherapy, lack specificity for the mechanism of myocardial tissue alterations. METHODS: A total of 27 women with breast cancer (mean age 51.8 ± 8...
August 2018: JACC. Cardiovascular Imaging
Xiaoyu Liu, Xiping Han, Xu Wan, Chao He, Yan Wang, Aiqin Mao, Fan Yu, Tingting Zhou, Lei Feng, Peng Zhang, Jian Jin, Xin Ma
It is believed that chemotherapeutic agents can enhance the malignancy of treated cancer cells in clinical situations, which is a major problem for chemotherapy. However, the underlying molecular mechanisms are still not fully understood. Here, we demonstrated that chemotherapy up-regulates the levels of spermatogenic bHLH transcription factor zip 1 (SPZ1), and knockdown of SPZ1 in drug resistant breast cancers showed that SPZ1 is critical for regulating the chemoresistance, migration, invasion and epithelial-mesenchymal transition (EMT) in a Twist1-dependent manner...
August 1, 2018: Biochemical Pharmacology
Naomi B Boekel, Judy N Jacobse, Michael Schaapveld, Maartje J Hooning, Jourik A Gietema, Frances K Duane, Carolyn W Taylor, Sarah C Darby, Michael Hauptmann, Caroline M Seynaeve, Margreet H A Baaijens, Gabe S Sonke, Emiel J T Rutgers, Nicola S Russell, Berthe M P Aleman, Flora E van Leeuwen
BACKGROUND: Improved breast cancer (BC) survival and evidence showing beneficial effects of internal mammary chain (IMC) irradiation underscore the importance of studying late cardiovascular effects of BC treatment. METHODS: We assessed cardiovascular disease (CVD) incidence in 14,645 Dutch BC patients aged <62 years, treated during 1970-2009. Analyses included proportional hazards models and general population comparisons. RESULTS: CVD rate-ratio for left-versus-right breast irradiation without IMC was 1...
August 1, 2018: British Journal of Cancer
Anna Goussia, Nafsika Simou, Flora Zagouri, Kyriaki Manousou, Georgios Lazaridis, Helen Gogas, Angelos Koutras, Maria Sotiropoulou, George Pentheroudakis, Dimitrios Bafaloukos, Christos Markopoulos, Helen Patsea, Christos Christodoulou, Pavlos Papakostas, Thomas Zaramboukas, Epaminontas Samantas, Paris Kosmidis, Vasileios Venizelos, Charisios Karanikiotis, George Papatsibas, Grigorios Xepapadakis, Konstantine T Kalogeras, Christina Bamia, Meletios-Athanassios Dimopoulos, Vassiliki Malamou-Mitsi, George Fountzilas, Anna Batistatou
Several studies support an important role of angiogenesis in breast cancer growth and metastasis. The main objectives of the study were to investigate the immunohistochemical expression of vascular endothelial growth factor (VEGF) family ligands (VEGF-A and VEGF-C) and receptors (VEGFR1, VEGFR2 and VEGFR3) in breast cancer and their associations with clinicopathological parameters, cancer subtypes/subgroups and patient outcome. Formalin-fixed paraffin-embedded tumor tissue samples were collected from early-stage breast cancer patients treated with anthracycline-based chemotherapy within a randomized trial...
2018: PloS One
Priyanka Sharma, Sara López-Tarruella, Jose A Garcia-Saenz, Qamar J Khan, Henry Gomez, Aleix Prat, Fernando Moreno, Yolanda Jerez-Gilarranz, Agustí Barnadas, Antoni C Picornell, Maria Del Monte-Millán, Milagros Gonzalez-Rivera, Tatiana Massarrah, Beatriz Pelaez-Lorenzo, María Isabel Palomero, Ricardo González Del Val, Javier Cortes, Hugo Fuentes Rivera, Denisse Bretel Morales, Ivan Marquez-Rodas, Charles M Perou, Carolyn Lehn, Yen Y Wang, Jennifer R Klemp, Joshua M Mammen, Jamie Wagner, Amanda Amin, Anne P O'Dea, Jaimie Heldstab, Roy A Jensen, Bruce F Kimler, Andrew K Godwin, Miguel Martín
PURPOSE: Prognostic value of pCR and extent of pathological response attained with anthracycline-free platinum plus taxane neoadjuvant chemotherapy (NAC) in TNBC is unknown. We report recurrence-free survival (RFS) and overall survival (OS) according to degree of pathological response in patients treated with carboplatin (Cb) plus docetaxel (D) NAC. EXPERIMENTAL DESIGN: 190 patients with stage I-III TNBC were treated with neoadjuvant Cb(AUC6) plus D(75mg/m2 ) every 21 days x 6 cycles...
July 30, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Yismeilin R Feliz-Mosquea, Ashley A Christensen, Adam S Wilson, Brian Westwood, Jasmina Varagic, Giselle C Meléndez, Anthony L Schwartz, Qing-Rong Chen, Lesley Mathews Griner, Rajarshi Guha, Craig J Thomas, Marc Ferrer, Maria J Merino, Katherine L Cook, David D Roberts, David R Soto-Pantoja
BACKGROUND: A perennial challenge in systemic cytotoxic cancer therapy is to eradicate primary tumors and metastatic disease while sparing normal tissue from off-target effects of chemotherapy. Anthracyclines such as doxorubicin are effective chemotherapeutic agents for which dosing is limited by development of cardiotoxicity. Our published evidence shows that targeting CD47 enhances radiation-induced growth delay of tumors while remarkably protecting soft tissues. The protection of cell viability observed with CD47 is mediated autonomously by activation of protective autophagy...
July 28, 2018: Breast Cancer Research and Treatment
Diana E Baxter, Baek Kim, Andrew M Hanby, Eldo T Verghese, Andrew H Sims, Thomas A Hughes
INTRODUCTION: Neoadjuvant treatments for primary breast cancer are becoming more common; however, little is known about how these impact on response to subsequent adjuvant therapies. Conveniently, neoadjuvant therapy provides opportunities to consider this question, by studying therapy-induced expression changes using comparisons between pre- and posttreatment samples. These data are relatively lacking in the context of neoadjuvant endocrine therapy, as opposed to the more common neoadjuvant chemotherapy...
July 6, 2018: Clinical Breast Cancer
Arlene Chan, Astrid Bauwens, Sally Pontre, Sally Jackson, Frances McGlone, Tracie Ernenwein, Jun Chih, Christopher Reid
INTRODUCTION: Hair loss as a result of chemotherapy for early breast cancer (EBC) is a frequent and distressing side effect. Minimising hair loss may improve mood and body image. Our aim was to determine scalp cooling (SC) efficacy in EBC patients receiving contemporary chemotherapy regimen, to inform future patients choice to use SC or not. METHODS AND RESULTS: Prospective cohort study of 60 stage 1-3 EBC patients recommended to receive taxane or anthracycline-taxane chemotherapy regimens...
July 18, 2018: Breast: Official Journal of the European Society of Mastology
Benjamin Daniels, Federico Girosi, Hanna Tervonen, Belinda E Kiely, Sarah J Lord, Nehmat Houssami, Sallie-Anne Pearson
BACKGROUND: Targeted cancer therapy is often complex, involving multiple agents and chemotherapeutic partners. In Australia, prescribing restrictions are put in place to reflect existing evidence of cost-effectiveness of these medicines. As therapeutic options continue to expand, these restrictions may not be perceived to align with best practice and it is not known if their use in the real-world clinic adheres to these restrictions. We examined the treatment of women receiving trastuzumab for HER2-positive metastatic breast cancer (HER2+MBC) to determine the extent to which treatment adhered to national prescribing restrictions...
2018: PloS One
B J Srinivasa, Bhanu Prakash Lalkota, Girish Badarke, Diganta Hazarika, Nasiruddin Mohammad, Sulav Sapkota, Mansi Khanderia, D Tousif, Raghavendra Rao, Amritanshu Ram, Shekar Patil, Radheshyam Naik
Background: Eribulin mesylate is a non-taxane microtubule inhibitor which can be used after anthracycline and taxane treatment in patients with metastatic breast cancer (MBC). The purpose of this study was to investigate the efficacy and safety of eribulin monotherapy in heavily pretreated patients with MBC. Methods: In this study, a total of 45 eligible patients with MBC who received eribulin in HCG Cancer Speciality Center from November 2014 to March 2016 were prospectively analyzed...
2018: Clinical Medicine Insights. Oncology
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