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Pathological response in breast cancer

Janine M Simons, Thiemo J A van Nijnatten, Carmen C van der Pol, Ernest J T Luiten, Linetta B Koppert, Marjolein L Smidt
OBJECTIVE: The aim of this study was to perform a systematic review and meta-analysis to assess the accuracy of different surgical axillary staging procedures compared with ALND. SUMMARY OF BACKGROUND DATA: Optimal axillary staging after neoadjuvant systemic therapy (NST) in node-positive breast cancer is an area of controversy. Several less invasive procedures, such as sentinel lymph node biopsy (SLNB), marking axillary lymph node with radioactive iodine seed (MARI), and targeted axillary dissection (a combination of SLNB and a MARI-like procedure), have been proposed to replace the conventional axillary lymph node dissection (ALND) with its concomitant morbidity...
October 11, 2018: Annals of Surgery
S R Tee, L A Devane, D Evoy, J Rothwell, J Geraghty, R S Prichard, E W McDermott
BACKGROUND: Neoadjuvant chemotherapy for breast cancer has the potential to achieve a pathological complete response in up to 40 per cent of patients, converting disease that was initially node-positive to node-negative. This has raised the question of whether sentinel lymph node biopsy could be an alternative to axillary lymph node dissection in these patients. The aim was to undertake a systematic review and meta-analysis of the accuracy and reliability of sentinel lymph node biopsy after neoadjuvant chemotherapy in patients with initial biopsy-proven node-positive breast cancer...
November 2018: British Journal of Surgery
Yu-Tuan Wu, Zhou Xu, Ke Zhang, Jiu-Song Wu, Xin Li, Bilal Arshad, Ying-Cun Li, Zhong-Liang Wang, Hong-Yuan Li, Kai-Nan Wu, Ling-Quan Kong
The concurrent use of trastuzumab and anthracycline-based neoadjuvant chemotherapy (NAC) has been proposed to improve the pathologic complete response (pCR) rate, although there are conflicting views about its efficacy and safety. The purpose of this study was to evaluate the efficacy and cardiac safety of the concurrent use of trastuzumab and anthracycline-based NAC for human epidermal growth factor receptor 2 (HER2)-positive locally advanced breast cancer. We systematically searched PubMed, Embase, and Cochrane databases from inception until July 1, 2017, for relevant articles...
2018: Therapeutics and Clinical Risk Management
P Cottu, V D'Hondt, S Dureau, F Lerebours, I Desmoulins, P-E Heudel, F P Duhoux, C Levy, M-A Mouret-Reynier, F Dalenc, J-S Frenel, C Jouannaud, L Venat-Bouvet, S Nguyen, J-M Ferrero, J-L Canon, J Grenier, C Callens, D Gentien, J Lemonnier, A Vincent-Salomon, S Delaloge
Background: Palbociclib is a CDK4/6 inhibitor with demonstrated efficacy and safety in combination with endocrine therapy in advanced luminal breast cancer (LBC). We evaluated the respective efficacy and safety of chemotherapy and letrozole-palbociclib (LETPAL) combination as neoadjuvant treatment in patients with high-risk LBC. Patients and Methods: NeoPAL (UCBG10/4, NCT02400567) is a randomised, parallel, non-comparative phase II study. Patients with ER-positive, HER2-negative, Prosigna®-defined luminal B, or luminal A and node-positive, stage II-III breast cancer, not candidate for breast-conserving surgery, were randomly assigned to either letrozole (2...
October 11, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Andrea Nicolini, Paola Ferrari, Giuseppe Rossi, Angelo Carpi
It has become clearer that advanced cancer, especially advanced breast cancer, is an entirely displayed pathological system that is much more complex than previously considered. However, the direct relationship between tumour growth and immune evasion can represent a general rule governing the pathological cancer system from the initial cancer cells to when the system is entirely displayed. Accordingly, a refined pathobiological model and a novel therapeutic strategy are proposed. The novel therapeutic strategy is based on therapeutically induced conditions (undetectable tumour burden and/or a prolonged tumour ‘resting state’), which enable an efficacious immune response in advanced breast and other types of solid cancers...
November 1, 2018: Endocrine-related Cancer
Fouzia Guestini, Katsuhiko Ono, Minoru Miyashita, Takanori Ishida, Noriaki Ohuchi, Saki Nakagawa, Hisashi Hirakawa, Kentaro Tamaki, Yasuyo Ohi, Yoshiaki Rai, Yasuaki Sagara, Hironobu Sasano, Keely May McNamara
PURPOSE: Triple-negative breast cancer (TNBC) patients with residual disease following neoadjuvant chemotherapy (NAC) harbor higher risk of relapse, and eventual demise compared to those who achieve pathologic complete response. Therefore, in this study, we assessed a panel of molecules involved in key pathways of drug resistance and tumor progression before and after NAC in TNBC patients, in order to clarify the underlying mechanisms. METHODS: We studied 148 TNBC Japanese patients treated with anthracycline/taxane-based NAC...
October 10, 2018: Breast Cancer Research and Treatment
Ines Stevic, Volkmar Müller, Karsten Weber, Peter A Fasching, Thomas Karn, Frederic Marmé, Christian Schem, Elmar Stickeler, Carsten Denkert, Marion van Mackelenbergh, Christoph Salat, Andreas Schneeweiss, Klaus Pantel, Sibylle Loibl, Michael Untch, Heidi Schwarzenbach
BACKGROUND: The focus of this study is to identify particular microRNA (miRNA) signatures in exosomes derived from plasma of 435 human epidermal growth factor receptor 2 (HER2)-positive and triple-negative (TN) subtypes of breast cancer (BC). METHODS: First, miRNA expression profiles were determined in exosomes derived from the plasma of 15 TNBC patients before neoadjuvant therapy using a quantitative TaqMan real-time PCR-based microRNA array card containing 384 different miRNAs...
October 10, 2018: BMC Medicine
Margherita Leonardi, Eluisa Perna, Serena Tronnolone, David Colecchia, Mario Chiariello
Macroautophagy/autophagy is one of the major responses to stress in eukaryotic cells and is implicated in several pathological conditions such as infections, neurodegenerative diseases and cancer. Interestingly, cancer cells take full advantage of autophagy both to support tumor growth in adverse microenvironments and to oppose damages induced by anti-neoplastic therapies. Importantly, different human oncogenes are able to modulate this survival mechanism to support the transformation process, ultimately leading to 'autophagy addiction'...
October 5, 2018: Autophagy
Xinyi Zhu, Tian Tian, Miao Ruan, Jia Rao, Wentao Yang, Xu Cai, Menghong Sun, Guangqi Qin, Zhonghua Zhao, Jiong Wu, Zhimin Shao, Ruohong Shui, Zhen Hu
Purpose: The characteristic expression of DNA damage response proteins in familial breast cancers with BRCA1 , BRCA2 , or non- BRCA1/2 mutations has not been analyzed in Chinese patients. Our study aimed to assess the differential expression of microcephalin 1 (BRIT1), ATM serine/threonine kinase (ATM), checkpoint kinase 2 (CHEK2), BRCA1, RAD51 recombinase (RAD51), and poly (ADP-ribose) polymerase 1 (PARP-1) and establish the profile of Chinese familial breast cancers with different mutation status...
September 2018: Journal of Breast Cancer
Si Li, Wei Wei, Yi Jiang, Qiuyun Li, Qinghua Huang, Huawei Yang, Jianlun Liu
Purpose: The objective of this research was to compare the short- and long-term efficacy of the following four neoadjuvant chemotherapy (NAC) regimens: docetaxel/carboplatin/trastuzumab (TCH), docetaxel/epirubicin/cyclophosphamide (TEC), Xeloda/epirubicin/cyclophosphamide followed by Xeloda/docetaxel (XEC-XT), and 5-fluorouracil/epirubicin/cyclophosphamide followed by docetaxel (FEC-T) in human epidermal growth factor receptor-2-positive (Her-2-positive) breast cancer. Patients and methods: According to treatment preferences, 139 patients with Her-2-positive breast cancer were divided into the following four groups: 39 patients in the TCH group, 35 patients in the TEC group, 33 patients in the XEC-XT group, and 32 patients in the FEC-T group...
2018: Drug Design, Development and Therapy
Jianxin Yuan, Shuwei Zhang, Yiguo Zhang
Transcription factor Nrf1 acts as a unique vital player in maintaining cellular homeostasis and organ integrity during normal development and growth throughout the life process. Loss-of-function of Nrf1 results in severe oxidative stress, genomic instability, embryonic lethality, developmental disorders, and adult diseases such as non-alcoholic steatohepatitis, hepatocellular carcinoma, diabetes and neurogenerative diseases. Thereby, Nrf1 is critically implicated in a variety of important physio-pathological processes by governing robust target genes in order to reinforce antioxidant, detoxification and cytoprotective responses to cellular stress...
September 26, 2018: Toxicology and Applied Pharmacology
Judah Abberbock, Stewart Anderson, Priya Rastogi, Gong Tang
A strategy for early-stage breast cancer trials in recent years consists of a neoadjuvant trial with pathological complete response (pCR) at time of surgery as the efficacy endpoint, followed by the collection of long-term data to show efficacy in survival. To calculate an appropriate sample size to detect a survival difference based upon pCR data, it is necessary to relate the effect size in pCR with the effect size in survival. Here, we propose an exponential mixture model for survival time with parameters for the neoadjuvant pCR rates and an estimated benefit of achieving pCR to determine the treatment effect size...
September 27, 2018: Statistics in Medicine
Concetta Elisa Onesti, Claire Josse, Aurélie Poncin, Pierre Frères, Christophe Poulet, Vincent Bours, Guy Jerusalem
In current clinical practices, up to 27% of all breast cancer patients receive neoadjuvant chemotherapy. High pathological complete response rate is frequently associated with tumor-infiltrating lymphocytes. Additionally, circulating immune cells are also often linked to chemotherapy response. We performed a retrospective analysis on a cohort of 112 breast cancer patients (79 triple-negative, 33 hormone receptor-negative/HER2-positive) treated with standard neoadjuvant chemotherapy. Eosinophil and lymphocyte counts were collected from whole blood at baseline and during follow-ups and their associations with pathological complete response, relapse, disease-free and breast cancer-specific survival were analyzed...
September 14, 2018: Oncotarget
Azra Rašić, Amela Sofić, Semir Bešlija, Ismar Rašić, Berisa Hasanbegović
Aim To compare the effect of neoadjuvant chemotherapy based on taxane and/or anthracycline to the extent of an objective response in female patients with unresectable breast cancer with evaluation of the toxic profile of applied chemotherapy. Methods One hundred patients with histologically verified breast cancer, treated with neoadjuvant chemotherapy were divided into two groups: a study group A (50 patients), who had received 4 to 6 cycles of taxane-based chemotherapy, and control group B (50 patients), who had received 4 to 6 cycles of anthracyclines-based chemotherapy...
February 1, 2019: Medicinski Glasnik
Pegah Sasanpour, Saleh Sandoughdaran, Alireza Mosavi-Jarrahi, Mona Malekzadeh
Background: Achievement of pathologic complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy (NAC) is associated with both overall survival and disease-free survival. The aim of present study was to identify clinical and pathological factors associated with achieving pCR in Iranian breast cancer patients receiving NAC. Methods: A retrospective review of all breast cancer patients treated with neoadjuvant chemotherapy between April 2012 and September 2016 at our institution was performed; 207 cases were evaluable for analysis...
September 26, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Denise A Yardley, Dianna Shipley, John Zubkus, Gail L Wright, Patrick J Ward, Aruna Mani, Mythili Shastry, Lindsey Finney, Laura DeBusk, John D Hainsworth
BACKGROUND: Eribulin mesylate is a non-taxane microtubule inhibitor effective in the treatment of metastatic breast cancer refractory to anthracyclines and taxanes. In preclinical studies, additional mechanisms of eribulin included reversal of epithelial mesenchymal transition and tumor vascular remodeling. The present study compared the safety and efficacy of eribulin plus cyclophosphamide (ErC) to docetaxel plus cyclophosphamide (TC) as neoadjuvant therapy for operable HER2- breast cancer...
August 23, 2018: Clinical Breast Cancer
Ruo-Xi Wang, Sheng Chen, Liang Huang, Zhi-Ming Shao
BACKGROUND: This study aimed to investigate the clinical utility of serum and histological MMP-9 detection during neoadjuvant chemotherapy (NAC) for triple-negative breast cancer (TNBC). METHODS: A total of 303 TNBC patients who underwent weekly paclitaxel plus carboplatin treatments followed by surgical resection were included in this study. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum level of Matrix metalloproteinase-9 (sMMP-9) at baseline and prior to surgery...
September 21, 2018: BMC Cancer
Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, Guldarbogh Sadonshoeva, Saleem Sayani, Aliya Aminmuhammad, Farin Amersi, Sheemain Asaria, Mansoor Saleh, Zohray Talib
PURPOSE: To promote a systems-based approach for the early detection and downstaging of breast cancer at presentation in the remote mountainous region of Gorno Badakhshan Autonomous Oblast (GBAO), Tajikistan, by introducing breast cancer awareness into the community and training health care professionals in clinical breast evaluation (CBE). METHODS: Through a public-private partnership between the Ministry of Health, the Aga Khan Health Services, Tajikistan, and the Aga Khan Health Board, we organized breast cancer screening in the community and trained family medicine doctors (FMDs) and family medicine nurses (FMNs) in CBE...
September 2018: Journal of Global Oncology
Wanting Feng, Yongfei Li, Jiahui Chu, Jun Li, Yanhong Zhang, Xiaorong Ding, Ziyi Fu, Wei Li, Xiang Huang, Yongmei Yin
Triple-negative breast cancer (TNBC), an intrinsic subtype of breast cancer, is characterized by aggressive pathology and shorter overall survival. Yet there is no effective therapy for these patients. Breast cancer stem cells (BCSCs) in TNBC may account for treatment failure. It is urgent to identify new therapeutic targets for TNBC. tRNA-derived small noncoding RNAs (tDRs) represent a new class of small noncoding RNAs (sncRNA), which have been reported in some human diseases and biological processes. However, there is no detailed information about the relationship between tDRs and BCSCs...
September 21, 2018: Cancer Medicine
Kanako Nishiyama, Yoshiaki Kamei, Erina Kusakabe, Haruna Yamasawa, Reina Aoki, Saaya Komatsu, Kana Taguchi, Akari Murakami, Michiko Yamashita
Case 1 involved a 75-year-old woman with breast cancer and diffuse large B-cell lymphoma(DLBCL).Although we initially administered the R-CHOP regimen, the breast tumor increased in size and surgery had to be performed.After surgery, the R-CHOP regimen was re-initiated and DLBCL achieved clinical complete response.Case 2 involved a 74-year-old woman with breast cancer and gastric MALT lymphoma.After administration of rituximab and H. pylori eradication, a therapeutic effect was achieved in the lymphoma.A docetaxel and FEC regimen was continuously administered and surgery was performed...
September 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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