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neoadjuvant breast cancer therapy

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https://www.readbyqxmd.com/read/29168427/neoadjuvant-letrozole-for-postmenopausal-estrogen-receptor-positive-her2-negative-breast-cancer-patients-a-study-from-the-danish-breast-cancer-cooperative-group-dbcg
#1
Signe Korsgaard Skriver, Anne-Vibeke Laenkholm, Birgitte Bruun Rasmussen, Jürgen Handler, Bo Grundtmann, Tove Filtenborg Tvedskov, Peer Christiansen, Ann S Knoop, Maj-Britt Jensen, Bent Ejlertsen
INTRODUCTION: Neoadjuvant endocrine treatment (NET) is a low-toxicity approach to achieve operability in locally advanced breast cancer, and to facilitate breast conservation in early breast cancer, particular in patients with highly estrogen receptor (ER) positive and HER2-negative disease. Here, we report the results obtained by neoadjuvant letrozole in patients with early breast cancer in a phase-II design. MATERIAL AND METHODS: A total of 119 postmenopausal women with ER-positive, HER2-negative operable breast cancer were assigned to four months of neoadjuvant letrozole before definitive surgery...
November 23, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/29158285/neoadjuvant-palbociclib-on-er-breast-cancer-n007-clinical-response-and-endopredict-value
#2
Louis Wc Chow, Satoshi Morita, Christopher Yc Chow, Wai Kuen Ng, Masakazu Toi
To test the efficacy of neoadjuvant palbociclib therapy and to evaluate its impact on cell cycle arrest and changes in EndoPredict (EP) scores before and after treatment. Postmenopausal women with histologically proven ER+ve, HER2-ve invasive breast cancer, 2cm or greater, were enrolled in an open-label, single arm study. Twenty eligible patients were given letrozole 2.5mg per day together with palbociclib 125mg per day for 3 out of 4 weeks in repeated cycles for 16 weeks (4 cycles) before surgery. The primary end-points were clinical response rates (cRR) and preoperative endocrine prognostic index (PEPI)...
November 20, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29146401/neratinib-after-trastuzumab-based-adjuvant-therapy-in-her2-positive-breast-cancer-extenet-5-year-analysis-of-a-randomised-double-blind-placebo-controlled-phase-3-trial
#3
Miguel Martin, Frankie A Holmes, Bent Ejlertsen, Suzette Delaloge, Beverly Moy, Hiroji Iwata, Gunter von Minckwitz, Stephen K L Chia, Janine Mansi, Carlos H Barrios, Michael Gnant, Zorica Tomašević, Neelima Denduluri, Robert Šeparović, Erhan Gokmen, Anna Bashford, Manuel Ruiz Borrego, Sung-Bae Kim, Erik Hugger Jakobsen, Audrone Ciceniene, Kenichi Inoue, Friedrich Overkamp, Joan B Heijns, Anne C Armstrong, John S Link, Anil Abraham Joy, Richard Bryce, Alvin Wong, Susan Moran, Bin Yao, Feng Xu, Alan Auerbach, Marc Buyse, Arlene Chan
BACKGROUND: ExteNET showed that 1 year of neratinib, an irreversible pan-HER tyrosine kinase inhibitor, significantly improves 2-year invasive disease-free survival after trastuzumab-based adjuvant therapy in women with HER2-positive breast cancer. We report updated efficacy outcomes from a protocol-defined 5-year follow-up sensitivity analysis and long-term toxicity findings. METHODS: In this ongoing randomised, double-blind, placebo-controlled, phase 3 trial, eligible women aged 18 years or older (≥20 years in Japan) with stage 1-3c (modified to stage 2-3c in February, 2010) operable breast cancer, who had completed neoadjuvant and adjuvant chemotherapy plus trastuzumab with no evidence of disease recurrence or metastatic disease at study entry...
November 13, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29145974/immunotherapy-for-triple-negative-breast-cancer-existing-challenges-and-exciting-prospects
#4
Hongyan Jia, Cristina I Truica, Bin Wang, Yanhong Wang, Xingcong Ren, Harold A Harvey, Jianxun Song, Jin-Ming Yang
Patients with breast tumors that do not express the estrogen receptor, the progesterone receptor, nor Her-2/neu are hence termed "triple negatives", and generally have a poor prognosis, with high rates of systemic recurrence and refractoriness to conventional therapy regardless of the choice of adjuvant treatment. Thus, more effective therapeutic options are sorely needed for triple-negative breast cancer (TNBC), which occurs in approximately 20% of diagnosed breast cancers. In recent years, exploiting intrinsic mechanisms of the host immune system to eradicate cancer cells has achieved impressive success, and the advances in immunotherapy have yielded potential new therapeutic strategies for the treatment of this devastating subtype of breast cancer...
May 2017: Drug Resistance Updates: Reviews and Commentaries in Antimicrobial and Anticancer Chemotherapy
https://www.readbyqxmd.com/read/29144790/evaluation-of-ki-67-index-in-core-needle-biopsies-and-matched-breast-cancer-surgical-specimens
#5
Soomin Ahn, Junghye Lee, Min-Sun Cho, Sanghui Park, Sun Hee Sung
CONTEXT: - The Ki-67 index is strongly prognostic and is used as a surrogate marker to distinguish luminal A from luminal B breast cancer types. OBJECTIVE: - To investigate differences in Ki-67 index between core needle biopsy samples and matched surgical samples in breast cancer. DESIGN: - We included patients with invasive breast cancer who did not receive neoadjuvant therapy. A total of 89 pairs of core needle biopsies and surgical specimens were collected, and the Ki-67 index was assessed in hot spot areas using an image analyzer...
November 16, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/29138989/sexual-function-and-sex-hormones-in-breast-cancer-patients
#6
Antonio Gambardella, Daniela Esposito, Giacomo Accardo, Marianna Taddeo, Antonietta Letizia, Rossella Tagliafierro, Katherine Esposito, Daniela Pasquali
PURPOSE: Breast cancer patients (BCP) are at risk of female sexual dysfunction (FSD). Our aim was to clarify the effects of treatment strategies, and steroid hormones levels on FSD. METHODS: We enrolled 136 BCP (46.9 ± 0.8 years), and 122 completed questionnaires. BCP were divided into four groups: 22 women with advanced breast cancer on neoadjuvant therapy (NAT), 48 on adjuvant therapy (AT), 30 taking hormonal therapy (HT) and 22 with metastatic cancer on first line chemotherapy (FLT)...
November 14, 2017: Endocrine
https://www.readbyqxmd.com/read/29132557/triple-negative-breast-cancer-who-should-receive-neoadjuvant-chemotherapy
#7
REVIEW
Lubna N Chaudhary, K Hope Wilkinson, Amanda Kong
Progress in the treatment of triple-negative breast cancer remains an important challenge. Given the aggressive biology and high risk of distant recurrence, systemic chemotherapy is warranted in most patients. Neaodjuvant chemotherapy benefits patients with locally advanced disease by downsizing the tumor and increasing the probability of breast-conserving surgery. Clinical and pathologic responses provide important prognostic information, which makes neoadjuvant therapy an attractive approach for all patients with triple-negative breast cancer...
January 2018: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/29132326/association-between-gene-expression-profile-of-the-primary-tumor-and-chemotherapy-response-of-metastatic-breast-cancer
#8
Cemile Dilara Savci-Heijink, Hans Halfwerk, Jan Koster, Marc Joan Van de Vijver
BACKGROUND: To better predict the likelihood of response to chemotherapy, we have conducted a study comparing the gene expression patterns of primary tumours with their corresponding response to systemic chemotherapy in the metastatic setting. METHODS: mRNA expression profiles of breast carcinomas of patients that later developed distant metastases were analyzed using supervised and non-supervised classification techniques to identify predictors of response to chemotherapy...
November 13, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29127857/the-updated-network-meta-analysis-of-neoadjuvant-therapy-for-her2-positive-breast-cancer
#9
REVIEW
Ayako Nakashoji, Tetsu Hayashida, Takamichi Yokoe, Hinako Maeda, Tomoka Toyota, Masayuki Kikuchi, Rurina Watanuki, Aiko Nagayama, Tomoko Seki, Maiko Takahashi, Takayuki Abe, Yuko Kitagawa
BACKGROUND: We previously described a systematic assessment of the neoadjuvant therapies for human epidermal growth factor receptor-2 (HER2) positive breast cancer, using network meta-analysis. Accumulation of new clinical data has compelled us to update the analysis. METHODS: Randomized trials comparing different anti-HER2 regimens in the neoadjuvant setting were included, and odds ratio for pathologic complete response (pCR) in seven treatment arms were assessed by pooling effect sizes...
October 31, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29127538/the-shifting-paradigm-for-breast-cancer-surgery-in-patients-undergoing-neoadjuvant-chemotherapy
#10
Olga Kantor, Gaurav Ajmani, Chi-Hsiung Wang, Avisek Datta, Katharine Yao
INTRODUCTION: Surgical therapy for newly diagnosed breast cancer has changed over the past decade, but these trends have not been well documented in patients undergoing neoadjuvant therapy (NAC). METHODS: In a retrospective cohort study of the National Cancer Database (NCDB), we selected 285,514 women with clinical stage I-III breast cancer who underwent NAC or adjuvant therapy (AC) from 2006 to 2014. Breast-conserving surgery (BCS), unilateral mastectomy (UM), and bilateral mastectomy (BM) rates were compared between patients undergoing NAC and AC...
November 10, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29116313/solitary-pancreatic-metastasis-from-breast-cancer-case-report-and-review-of-literature
#11
Márcio Apodaca-Rueda, Fábio Henrique Mendonça Chaim, Milena da Silva Garcia, Helena Paes de Almeida de Saito, Martinho Antonio Gestic, Murillo Pimentel Utrini, Francisco Callejas-Neto, Elinton Adami Chaim, Everton Cazzo
ABSTRACT: HASH(0x4b1f388) CONTEXT: Pancreatic metastases from primary malignant tumors at other sites are rare, constituting about 2% of the neoplasms that affect the pancreas. Pancreatic metastasis from breast cancer is extremely rare and difficult to diagnose, because its clinical and radiological presentation is similar to that of a primary pancreatic tumor. CASE REPORT: A 64-year-old female developed a lesion in the pancreatic tail 24 months after neoadjuvant therapy, surgery and adjuvant radiation therapy for right-side breast cancer (ductal carcinoma)...
November 6, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/29112227/trends-and-variations-in-postmastectomy-radiation-therapy-for-breast-cancer-in-patients-with-1-to-3-positive-lymph-nodes-a-national-cancer-data-base-analysis
#12
Nisha Ohri, Mark P Sittig, Chiaojung Jillian Tsai, Eun-Sil Shelley Hwang, Elizabeth Ann Mittendorf, Weiji Shi, Zhigang Zhang, Alice Y Ho
BACKGROUND: High-level evidence is lacking to guide treatment decisions about postmastectomy radiation therapy (PMRT) in patients who have breast cancer with 1 to 3 positive lymph nodes who receive contemporary systemic therapies, leading to potential variations in PMRT delivery. The objective of this study was to examine nationwide trends in PMRT use in this group. METHODS: The National Cancer Data Base (NCDB) was used to identify 93,372 women who had T1-T2N1 breast cancer diagnosed between 2003 and 2012...
November 7, 2017: Cancer
https://www.readbyqxmd.com/read/29110152/low-pten-levels-and-pik3ca-mutations-predict-resistance-to-neoadjuvant-lapatinib-and-trastuzumab-without-chemotherapy-in-patients-with-her2-over-expressing-breast-cancer
#13
Mothaffar F Rimawi, Carmine De Angelis, Alejandro Contreras, Fresia Pareja, Felipe C Geyer, Kathleen A Burke, Sabrina Herrera, Tao Wang, Ingrid A Mayer, Andres Forero, Rita Nanda, Matthew P Goetz, Jenny C Chang, Ian E Krop, Antonio C Wolff, Anne C Pavlick, Suzanne A W Fuqua, Carolina Gutierrez, Susan G Hilsenbeck, Marilyn M Li, Britta Weigelt, Jorge S Reis-Filho, C Kent Osborne, Rachel Schiff
PURPOSE: Aberrant activation of the PI3K pathway has been implicated in resistance to HER2-targeted therapy, but results of clinical trials are confounded by the co-administration of chemotherapy. We investigated the effect of perturbations of this pathway in breast cancers from patients treated with neoadjuvant anti-HER2-targeted therapy without chemotherapy. PATIENTS AND METHODS: Baseline tumor samples from patients with HER2-positive breast cancer enrolled in TBCRC006 (NCT00548184), a 12-week neoadjuvant clinical trial with lapatinib plus trastuzumab [plus endocrine therapy for estrogen receptor (ER)-positive tumors], were assessed for PTEN status by immunohistochemistry and PIK3CA mutations by sequencing...
November 7, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29103853/adherence-to-adjuvant-endocrine-therapy-in-christchurch-women-with-early-breast-cancer
#14
B Robinson, B Dijkstra, V Davey, S Tomlinson, C Frampton
AIMS: To assess adherence to adjuvant endocrine therapy by a real-world cohort of women in Christchurch and to determine any associated factors. MATERIALS AND METHODS: Records were retrieved of all women newly diagnosed with early breast cancer and registered on the Christchurch Breast Cancer Patient Register over 4 years from June 2009. Demographic and pathological factors, dates of starting and stopping endocrine therapies and reported side-effects were collected...
November 2, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29101985/acr-appropriateness-criteria-%C3%A2-monitoring-response-to-neoadjuvant-systemic-therapy-for%C3%A2-breast-cancer
#15
Priscilla J Slanetz, Linda Moy, Paul Baron, Roberta M diFlorio, Edward D Green, Samantha L Heller, Anna I Holbrook, Su-Ju Lee, Alana A Lewin, Ana P Lourenco, Bethany Niell, Ashley R Stuckey, Sunita Trikha, Nina S Vincoff, Susan P Weinstein, Monica M Yepes, Mary S Newell
Patients with locally advanced invasive breast cancers are often treated with neoadjuvant chemotherapy prior to definitive surgical intervention. The primary aims of this approach are to: 1) reduce tumor burden thereby permitting breast conservation rather than mastectomy; 2) promptly treat possible metastatic disease, whether or not it is detectable on preoperative staging; and 3) potentially tailor future chemotherapeutic decisions by monitoring in-vivo tumor response. Accurate radiological assessment permits optimal management and planning in this population...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29100977/evaluation-of-weekly-paclitaxel-plus-carboplatin-followed-by-anthracycline-chemotherapy-on-the-neoadjuvant-treatment-of-patients-with-triple-negative-breast-cancer
#16
Aurelio B Castrellon
OBJECTIVE: To evaluate the effectiveness and tolerability of neoadjuvant chemotherapy with weekly paclitaxel in combination with weekly carboplatin area under curve 2 followed by anthracycline chemotherapy. PATIENTS AND METHODS: This is a retrospective review of electronic medical records of patients (N = 32) with stage 1c-III triple-negative breast cancer. Patients received neoadjuvant chemotherapy with paclitaxel 80 mg/m(2) once per week for 12 weeks in combination with carboplatin area under curve 2 once per week for 12 weeks (wP + wCb), followed by a standard anthracycline regimen including either doxorubicin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) every 2 or 3 weeks, or epirubicin 90 mg/m(2) and cyclophosphamide 600 mg/m(2) every 3 weeks for four cycles with myeloid growth factor support...
October 28, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/29100044/a-plea-for-appraisal-and-appreciation-of-immunohistochemistry-in-the-assessment-of-prognostic-and-predictive-markers-in-invasive-breast-cancer
#17
Mieke Van Bockstal, Giuseppe Floris, Christine Galant, Kathleen Lambein, Louis Libbrecht
This viewpoint is a personal reflection on the values and merits of immunohistochemistry in current breast cancer diagnosis. Immunohistochemistry is a validated mainstay in molecular subtyping of invasive breast cancer. Immunohistochemical assessment of hormone receptor status and HER2 expression is used to determine the clinico-pathological surrogate of breast cancer intrinsic subtypes, which guide neoadjuvant and adjuvant therapy. The advent of genomic prognostic signatures and qualitative mRNA-based assays makes some clinicians and researchers wonder whether immunohistochemistry should be abandoned...
October 31, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29093602/fertility-preservation-in-female-patients-with-breast-cancer-a-current-overview
#18
Veronika Guenther, Ibrahim Alkatout, Wiebe Junkers, Dirk Bauerschlag, Nicolai Maass, Soeren von Otte
Many premenopausal patients who develop breast cancer have not yet completed their family planning, so measures of fertility protection to preserve their fertile potential would be beneficial. Polychemotherapy causes irreversible damage to the ovarian follicles - irrespective of whether in a neoadjuvant or adjuvant setting - and this can sometimes result in permanent infertility. Depending on which cytostatic agents are used and on the age-related ovarian reserve of the woman, gonadotoxic risk must be classified as low, moderate or high...
October 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29093017/a-population-of-heterogeneous-breast-cancer-patient-derived-xenografts-demonstrate-broad-activity-of-parp-inhibitor-in-brca1-2-wild-type-tumors
#19
Kurt W Evans, Erkan Yuca, Argun Akcakanat, Stephen M Scott, Natalia Paez Arango, Xiaofeng Zheng, Ken Chen, Coya Tapia, Emily Tarco, Agda K Eterovic, Dalliah M Black, Jennifer K Litton, Timothy A Yap, Debu Tripathy, Gordon B Mills, Funda Meric-Bernstam
Background: Breast cancer patients who do not respond to neoadjuvant therapy have a poor prognosis. There is a pressing need for novel targets and models for preclinical testing. Here we report characterization of breast cancer patient-derived xenografts (PDX) largely generated from residual tumors following neoadjuvant chemotherapy.Experimental Design: PDXs were derived from surgical samples of primary or locally recurrent tumors. Normal and tumor DNA sequencing, RNASeq, and reverse phase protein arrays (RPPA) were performed...
November 1, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29089798/neoadjuvant-systemic-therapy-in-breast-cancer-use-and-trends-in-radiotherapy-practice
#20
T A Koulis, K Beecham, C Speers, S Tyldesley, D Voduc, C Simmons, R Olson
BACKGROUND: The use of neoadjuvant systemic therapy (nast) in the treatment of breast cancer is increasing, and the role of adjuvant radiation therapy (rt) in that setting is uncertain. We sought to review and report the use of nast, its trends over time, and its relationship with the prescribing patterns of locoregional rt in a provincial cancer system. METHODS: Patients with stages i-iii breast cancer diagnosed during 2007-2012 were identified using a provincial database...
October 2017: Current Oncology
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