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Pathological response in breast cancer

Andreas Schneeweiss, Volker Möbus, Hans Tesch, Claus Hanusch, Carsten Denkert, Kristina Lübbe, Jens Huober, Peter Klare, Sherko Kümmel, Michael Untch, Karin Kast, Christian Jackisch, Jörg Thomalla, Barbara Ingold-Heppner, Jens-Uwe Blohmer, Mahdi Rezai, Matthias Frank, Knut Engels, Kerstin Rhiem, Peter Andreas Fasching, Valentina Nekljudova, Gunter von Minckwitz, Sibylle Loibl
BACKGROUND: GeparOcto compared efficacy and safety of two chemotherapy regimens in high-risk early breast cancer (BC): sequential treatment with intense dose-dense epirubicin, paclitaxel, and cyclophosphamide (iddEPC) and weekly treatment with paclitaxel plus non-pegylated liposomal doxorubicin (M, Myocet®) with additional carboplatin (PM(Cb)) in triple-negative BC (TNBC). PATIENTS AND METHODS: Patients with cT1c-cT4a-d and centrally assessed human epidermal growth factor receptor (HER)2-positive BC or TNBC were eligible, irrespective of nodal status, luminal B-like tumours only if pN+...
December 4, 2018: European Journal of Cancer
Aura Muntasell, Federico Rojo, Sonia Servitja, Carlota Rubio-Perez, Mariona Cabo, David Tamborero, Marcel Costa-Garcia, Maria Martinez-Garcia, Silvia Menéndez, Ivonne Vazquez, Ana Lluch, Abel Gonzalez-Perez, Ana Rovira, Miguel Lopez-Botet, Joan Albanell
PURPOSE: We investigated the value of tumor-infiltrating NK cells (TI-NK) and HLA class I tumor expression as biomarkers of response to neoadjuvant anti-HER2 antibody-based treatment in breast cancer. EXPERIMENTAL DESIGN: TI-NK cells and HLA-I were determined by immunohistochemistry in pre-treatment tumor biopsies from two cohorts of HER2-positive breast cancer patients [discovery cohort (n=42) and validation cohort (n=71)]. TIL were scored according to international guidelines...
December 6, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Soizic Garaud, Pawel Zayakin, Laurence Buisseret, Undine Rulle, Karina Silina, Alexandre de Wind, Gert Van den Eyden, Denis Larsimont, Karen Willard-Gallo, Aija Linē
An important role for tumor infiltrating B lymphocytes (TIL-B) in the immune response to cancer is emerging; however, very little is known about the antigen specificity of antibodies produced in situ . The presence of IgA antibodies in the tumor microenvironment has been noted although their biological functions and clinical significance are unknown. This study used a 91-antigen microarray to examine the IgG and IgA autoantibody repertoires in breast cancer (BC). Tumor and adjacent breast tissue supernatants and plasma from BC patients together with normal breast tissue supernatants and plasma from healthy controls (patients undergoing mammary reduction and healthy blood donors) were analyzed to investigate relationships between autoantibodies and the clinical, histological and immunological features of tumors...
2018: Frontiers in Immunology
William T Tran, Charmaine Childs, Heidi Probst, Golnaz Farhat, Gregory J Czarnota
Guidelines from the American National Comprehensive Cancer Network recommend neoadjuvant chemotherapy to patients with locally advanced breast cancer (LABC) to downstage tumours before surgery. However, only a small fraction (15%-17%) of LABC patients achieve pathological complete response (pCR); that is, no residual tumour in the breast, after treatment. Measuring tumour response during neoadjuvant chemotherapy can potentially help physicians adapt treatment, thus potentially improving the pCR rate. Recently, imaging biomarkers that are used to measure the tumour's functional and biological features have been studied as pretreatment markers for pCR or as an indicator for intratreatment tumour response...
December 2018: Journal of Medical Imaging and Radiation Sciences
Irma Soldevilla-Gallardo, Sevastian S Medina-Ornelas, Cynthia Villarreal-Garza, Enrique Bargalló-Rocha, Claudia Hs Caro-Sánchez, Rodrigo Hernández-Ramírez, Enrique Estrada-Lobato
Our study examines the association between two Positron Emission Mammography (PEM) semi-quantitative parameters: PUVmax (maximum uptake value) and LTB (lesion to background) baseline and the end of Neoadjuvant chemotherapy (NAC) with pathologic response in each of the following breast cancer subtype: Triple negative breast cancer (TPN), HER2-positive, and ER-positive/HER2-negative cancers. One-hundred and eight patients, 71 with invasive ductal carcinoma and 37 with infiltrating lobular carcinoma were evaluate with 18 F-FDG-PEM scans before and after of NAC...
2018: American Journal of Nuclear Medicine and Molecular Imaging
Evgeny N Imyanitov, Grigoriy A Yanus
Neoadjuvant therapy (NAT) is widely utilized in the routine management of cancer patients and various clinical trials for the treatment of breast, ovarian, rectal, esophageal, head and neck, lung, prostate and many other cancer types. There is a number of potential benefits of applying systemic treatment before the operation. NAT may significantly reduce the tumor burden thus allowing less traumatic surgery. NAT is often considered as personalized in vivo drug sensitivity test, as it allows rapid evaluation of tumor response to a given therapy and consequent adjustment of further treatment planning...
December 2018: Chinese Clinical Oncology
Mark K Farrugia, Sinjen Wen, Geraldine M Jacobson, Mohamad Adham Salkeni
Neoadjuvant chemotherapy (NAC) is a significant modality in breast cancer therapy. We sought to characterize prognostic factors in patients scheduled for NAC who had a pretreatment positron-emission tomography paired with diagnostic quality contrast-enhanced computed tomography (CT) (positron-emission tomography/CT [PET/CT]). A total of 118 breast cancer patients were analyzed through chart review who underwent pretreatment PET/CT imaging and received NAC from 2008 to 2014. We collected information on molecular markers, PET/CT, pathologic complete response (pCR), survival, and disease status...
October 2018: World Journal of Nuclear Medicine
Steven A Buechler, Yesim Gökmen-Polar, Sunil S Badve
BACKGROUND: EarlyR gene signature uses ESPL1, SPAG5, MKI67, PLK1 and PGR to classify ER+ breast cancer (ER+ BC) into EarlyR-Low, EarlyR-Int, and EarlyR-High risk strata and is prognostic in patients treated with adjuvant chemotherapy. The ability of EarlyR to predict pathological complete response (pCR) and long-term survival following neoadjuvant chemotherapy (NACT) is evaluated herein. MATERIALS: The ability of EarlyR gene signature to predict pCR was assessed in publicly available Affymetrix microarray datasets (Cohort A; n = 659; 74 pCR events) derived from NACT-treated ER+ BC patients...
November 17, 2018: Breast: Official Journal of the European Society of Mastology
Luis A Riba, Teresa Russell, Amulya Alapati, Roger B Davis, Ted A James
BACKGROUND: Pathological complete response (pCR) after neoadjuvant chemotherapy (NCT) for breast cancer is associated with improved survival and facilitates conservative surgical strategies. Invasive lobular carcinoma (ILC) has been observed to have decreased response to NCT compared with invasive ductal carcinoma (IDC). This study seeks to evaluate national trends in the use of NCT for ILC compared with IDC, and determine if there is a subset of ILC patients who demonstrate favorable response rates...
January 2019: Journal of Surgical Research
Yanjie Shuai, Li Ma
Neoadjuvant chemotherapy(NCT) has become the standard treatment for breast cancer. The information about the tumor's sensitivity to chemotherapy and prognostic significance based on response to therapy can be provided after individualized neoadjuvant treatment. The biomarkers are key factors in the decision-making process regarding treatment as well as important prognostic indicators. Studies have shown that patients who achieve pathological complete response(pCR) after NCT have a better prognosis. For patients who do not achieve pCR, the pathological characteristics of the residual tumor can make an effect on the survival...
November 17, 2018: Pathology, Research and Practice
Thorsten Kühn, Jean-Marc Classe, Oreste David Gentilini, Corrado Tinterri, Florentia Peintinger, Jana de Boniface
Axillary surgery has undergone considerable changes in recent years, especially in relation to patients who undergo neoadjuvant chemotherapy (NACT). Due to constantly decreasing rates of recurrence and death from breast cancer, modern surgical strategies aim at de-escalating the extent of local treatment and avoiding unnecessary procedures. This relates especially to lymph node surgery which is associated with considerable morbidity. In patients who initially present with clinically node-negative disease, sentinel lymph node biopsy (SLNB) is increasingly performed after NACT...
October 2018: Breast Care
Elaine M Walsh, Aliaa Shalaby, Mark O'Loughlin, Nessa Keane, Mark J Webber, Michael J Kerin, Maccon M Keane, Sharon A Glynn, Grace M Callagy
PURPOSE: The rate of pathological complete response (pCR) for patients with triple negative breast cancer (TNBC) is increased when carboplatin is added to neo-adjuvant chemotherapy (NACT). However, while phase III trial data showing a survival benefit are awaited, carboplatin is not yet standard-of-care for TNBC. The aim of this study was to examine the rate of pCR and the outcome for those treated with carboplatin and to examine the predictors of response to therapy. METHODS: The retrospective series comprised 333 consecutive patients with TNBC (median follow-up time, 43 months)...
November 28, 2018: Breast Cancer Research and Treatment
Tamás Zombori, Gábor Cserni
Despite national guidelines, the evaluation of effects of primary systemic treatment (PST) in breast cancer is a complex challenge. Our aims were to evaluate the response patterns focusing on correlations of radiological and pathological tumor size, regression heterogeneity in different molecular subtypes, cellularity changes and the incidence of enlarged, multinucleated neoplastic cells related to therapy. Slides of pretreatment biopsies and resection specimens of consecutive cases were reevaluated focusing on heterogeneity of regression per whole slide, and 40x or 100x magnification fields...
November 27, 2018: Pathology Oncology Research: POR
Tomer Cooks, Sofia Dp Theodorou, Eleni Paparouna, Sophia V Rizou, Vassilios Myrianthopoulos, Vassilis G Gorgoulis, Ioannis S Pateras
In the era of precision medicine immunohistochemistry (IHC) and immunocytochemistry (ICC) share some of the highlights in personalized treatment. Survival data obtained from clinical trials shape the cut-offs and IHC scoring that serve as recommendations for patient selection both for targeted and conventional therapies. Assessment of Estrogen and Progesterone Receptors along with HER2 status has been among the first approved immunostaining assays revolutionizing breast cancer treatment. Similarly, ALK positivity predicts the efficacy of ALK inhibitors in patients with non-small cell lung cancer (NSCLC)...
November 27, 2018: Histology and Histopathology
Begoña Martin-Castillo, Sonia Pernas, Joan Dorca, Isabel Álvarez, Susana Martínez, Jose Manuel Pérez-Garcia, Norberto Batista-López, César A Rodríguez-Sánchez, Kepa Amillano, Severina Domínguez, Maria Luque, Agostina Stradella, Idoia Morilla, Gemma Viñas, Javier Cortés, Elisabet Cuyàs, Sara Verdura, Álvaro Fernández-Ochoa, Salvador Fernández-Arroyo, Antonio Segura-Carretero, Jorge Joven, Elsa Pérez, Neus Bosch, Margarita Garcia, Eugeni López-Bonet, Samiha Saidani, Maria Buxó, Javier A Menendez
The METTEN study assessed the efficacy, tolerability, and safety of adding metformin to neoadjuvant chemotherapy plus trastuzumab in early HER2-positive breast cancer (BC). Women with primary, non-metastatic HER2-positive BC were randomized (1:1) to receive metformin (850 mg twice-daily) for 24 weeks concurrently with 12 cycles of weekly paclitaxel plus trastuzumab, followed by four cycles of 3-weekly FE75C plus trastuzumab (arm A), or equivalent regimen without metformin (arm B), followed by surgery. Primary endpoint was the rate of pathological complete response (pCR) in the per-protocol efficacy population...
November 2, 2018: Oncotarget
Gohar Hakobyan, Hasmik Davtyan, Kristine Harutyunyan, Knarik Alexanyan, Yelizaveta Amirkhanyan, Anna L Gharibyan, Liana Asatryan, Yuri Tadevosyan
Phospholipids (PLs), key elements of cellular membranes, are regulated reciprocally with membrane proteins and can act as sensors for alterations in physiological or pathological states of cells including initiation and development of cancer. On the other hand, peripheral blood mononuclear cells (MNCs) play an important role in antitumor immune response by reacting to cancerous modifications in distant organs. In the current study, we tested the hypothesis that tumor initiation and development are reflected in the alteration pattern of the MNC PL component...
November 23, 2018: Medical Sciences: Open Access Journal
Wataru Goto, Shinichiro Kashiwagi, Yuka Asano, Koji Takada, Katsuyuki Takahashi, Takaharu Hatano, Tsutomu Takashima, Shuhei Tomita, Hisashi Motomura, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: The lymphocyte-to-monocyte ratio (LMR) has been used as a parameter reflecting systemic inflammation in several tumors, and is reportedly associated with prognosis in cancer patients. In this study, we evaluated the predictive value of LMR for progression and chemosensitivity in breast cancer patients treated with preoperative chemotherapy. METHODS: LMR was evaluated in 239 patients with breast cancer treated with neoadjuvant chemotherapy (NAC) with 5-fluorouracil, epirubicin, and cyclophosphamide, followed by weekly paclitaxel with or without trastuzumab, and subsequent curative surgery...
November 19, 2018: BMC Cancer
Meritxell Arenas, Elisabet Rodríguez, Anabel García-Heredia, Salvador Fernández-Arroyo, Sebastià Sabater, Rogelio Robaina, Marina Gascón, Maria Rodríguez-Pla, Noemí Cabré, Fedra Luciano-Mateo, Anna Hernández-Aguilera, Isabel Fort-Gallifa, Jordi Camps, Jorge Joven
The aims of this study were to investigate changes in energy balance-associated metabolites associated with radiotherapy in patients with breast cancer, and to relate these changes to the clinical and pathological response-to-treatment. We studied 151 women with breast cancer who received radiotherapy following surgical excision of the tumor. Blood was obtained before and after the irradiation procedure. The control group was composed of 44 healthy women with a similar age distribution to that of the patients...
2018: PloS One
Javier Cuello-López, Ana Fidalgo-Zapata, Laura López-Agudelo, Elsa Vásquez-Trespalacios
Response to neoadjuvant chemotherapy in breast cancer patients is of prognostic value in determining short- and mid-term outcomes. Inflammatory biomarkers, such as platelet-to-lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR), have been proposed as predictive factors of response to neoadjuvant chemotherapy. Currently, there are no studies in Colombian patients reporting the role of inflammatory biomarkers as response predictors in patients receiving neoadjuvant chemotherapy. Therefore, in this study we performed a cross-sectional study and analyzed the association between inflammatory biomarkers and pCR (pathological complete response) in patients diagnosed with breast cancer-of different molecular subtypes- and treated with neoadjuvant chemotherapy...
2018: PloS One
Andreína Fernandes, Adriana Pesci-Feltri, Isabel García-Fleury, Marco López, Vincent Guida, Marisol De Macedo, María Correnti
AIM: To detect human papilloma virus (HPV) presence and to characterize cellular immune response in breast cancer patients. METHODS: A total of 74 women were included, of which 48 samples were from patients diagnosed with breast cancer and 26 patients with benign pathology of the breast. Molecular subtype classification was performed based on the immunohistochemical reports of the tumor piece. HPV genome detection and genotyping from fresh breast biopsies was performed using the INNO-LIPA HPV Genotyping Extra test (Innogenetics, Ghent, Belgium)...
November 10, 2018: World Journal of Clinical Oncology
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