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neoadjuvant breast cancer therapy

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https://www.readbyqxmd.com/read/28213781/swedish-prospective-multicenter-trial-on-the-accuracy-and-clinical-relevance-of-sentinel-lymph-node-biopsy-before-neoadjuvant-systemic-therapy-in-breast-cancer
#1
Linda Zetterlund, Fuat Celebioglu, Rimma Axelsson, Jana de Boniface, Jan Frisell
PURPOSE: The timing of sentinel lymph node biopsy (SLNB) in the context of neoadjuvant systemic therapy (NAST) in breast cancer is still controversial. SLNB before NAST has been evaluated in few single-institution studies in which axillary lymph node dissection (ALND), however, was commonly not performed in case of a negative SLNB. We investigated the potential clinical relevance of SLNB before NAST by performing ALND in all patients after NAST. METHODS: This national multicenter trial prospectively enrolled clinically node-negative breast cancer patients planned for NAST at 13 recruiting Swedish hospitals between October 2010 and December 2015...
February 17, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28210563/neoadjuvant-therapy-for-treatment-of-breast-cancer-the-way-forward-or-simply-a-convenient-option-for-patients
#2
COMMENT
Abhishek Chatterjee, John K Erban
The complexity of managing early stage breast cancer is well known. Optimal treatment is increasingly multidisciplinary and in the modern era informed by sophisticated molecular tools to help select and guide therapy. Major phase III trials have determined that the order of systemic therapy relative to surgery does not influence important endpoints such as event free survival and overall survival (OS), but questions remain as to how best to utilize these most essential services. For example, there is still uncertainty regarding the ideal timing, intensity, and duration of proposed therapy...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28205193/new-therapeutic-strategies-for-triple-negative-breast-cancer
#3
REVIEW
Borbála Székely, Andrea L M Silber, Lajos Pusztai
Relatively few clinically important therapeutic advances have occurred in the treatment of triple-negative breast cancer (TNBC) since the introduction of taxanes as adjuvant therapy over 20 years ago. However, this is rapidly changing due to a variety of conceptually important clinical trials and emerging new options such as immune checkpoint inhibitors and antibody-drug conjugates. Evidence also increasingly supports that platinum drugs and inhibitors of poly (ADP-ribose) polymerase, or PARP, are particularly effective in the treatment of germline BRCA-mutant cancers, including TNBC...
February 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28197838/the-growing-role-of-cdk4-6-inhibitors-in-treating-hormone-receptor-positive-advanced-breast-cancer
#4
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/28196771/liver-metastases-from-breast-cancer-what-role-for-surgery-indications-and-results
#5
REVIEW
Nicolas Golse, René Adam
Liver metastases from breast cancer (LMBC) have long been considered as a systemic disease because of the hematological route of dissemination, requiring noncurative management. In fact, despite recent advances in drug therapies personalized to tumor phenotype, the chances of a cure are nil and there is little hope of long-term survivors after nonsurgical management alone. By contrast, there is a growing evidence in the literature for satisfactory long-term results after a combination of chemotherapy and liver resection, with 5-year survival reaching >40% in some series...
January 9, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28195993/subcutaneous-testosterone-letrozole-therapy-before-and-concurrent-with-neoadjuvant-breast-chemotherapy-clinical-response-and-therapeutic-implications
#6
Rebecca L Glaser, Anne E York, Constantine Dimitrakakis
OBJECTIVE: Hormone receptor-positive breast cancers respond favorably to subcutaneous testosterone combined with an aromatase inhibitor. However, the effect of testosterone combined with an aromatase inhibitor on tumor response to chemotherapy was unknown. This study investigated the effect of testosterone-letrozole implants on breast cancer tumor response before and during neoadjuvant chemotherapy. METHODS: A 51-year-old woman on testosterone replacement therapy was diagnosed with hormone receptor-positive invasive breast cancer...
February 13, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28193571/outcomes-and-utilization-of-postmastectomy-radiotherapy-for-t3n0-breast-cancers
#7
Samual R Francis, Jonathan Frandsen, Kristine E Kokeny, David K Gaffney, Matthew M Poppe
BACKGROUND: The role of postmastectomy radiotherapy (PMRT) for women with pT3N0M0 breast cancer is controversial. We sought to determine the benefit of PMRT in this cohort using the National Cancer Database (NCDB). METHODS: We analyzed women with pT3N0M0 breast cancer who received mastectomy with or without PMRT between 2004 and 2012. We excluded men, women ≤18 years, neoadjuvant or unknown radiation or chemotherapy status, unknown estrogen or progesterone receptor status, unknown surgical margin status, histology other than invasive ductal or lobular carcinoma, and if death occurred <3 months after diagnosis...
February 9, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28193205/comparison-of-immunohistochemistry-with-pcr-for-assessment-of-er-pr-and-ki-67-and-prediction-of-pathological-complete-response-in-breast-cancer
#8
Hans-Peter Sinn, Andreas Schneeweiss, Marius Keller, Kornelia Schlombs, Mark Laible, Julia Seitz, Sotirios Lakis, Elke Veltrup, Peter Altevogt, Sebastian Eidt, Ralph M Wirtz, Frederik Marmé
BACKGROUND: Proliferation may predict response to neoadjuvant therapy of breast cancer and is commonly assessed by manual scoring of slides stained by immunohistochemistry (IHC) for Ki-67 similar to ER and PgR. This method carries significant intra- and inter-observer variability. Automatic scoring of Ki-67 with digital image analysis (qIHC) or assessment of MKI67 gene expression with RT-qPCR may improve diagnostic accuracy. METHODS: Ki-67 IHC visual assessment was compared to the IHC nuclear tool (AperioTM) on core biopsies from a randomized neoadjuvant clinical trial...
February 13, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28191807/neo-adjuvant-chemotherapy-in-locally-advanced-breast-cancer-a-retrospective-analysis-from-tertiary-care-centre
#9
Deepti Sharma, Garima Singh
INTRODUCTION: Breast cancer is the most common cancer in women in India. The incidence of LABC is 30%-40% in developing countries as compared to developed countries, lack of awareness and screening programmes in developing countries are supposed to be main contributor of this increase incidence. The use of neoadjuvant chemotherapy in locally advanced breast cancer has shown benefits in down staging of tumors, and increases the rate of breast conserving surgeries. AIM: The aim was to compare response rate (clinical and pathological), the disease free survival, and overall survival in two chemotherapy regime...
September 2016: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28191801/evaluation-of-clinicopathological-findings-on-255-cases-of-inoperable-locally-advanced-breast-carcinoma-a-tertiary-care-experience
#10
Shah Naveed, Hasina Quari, Ghanish Panjawani, Ankit Shah, B B Panday
INTRODUCTION: Breast cancer is the second most common cancer in the Indian female population. LABC and metastatic breast cancer are the most common stages at presentation in most low-resource countries. Although the incidence of LABC has decreased significantly in countries with enhanced resources thanks to widespread education and screening programs, it remains a daily encounter for surgeons and oncologists in low-resource countries. Neoadjuvant therapy has been studied widely for the treatment of LABC and is followed by locoregional therapy...
September 2016: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28187033/prognostic-significance-of-stromal-versus-intratumoral-infiltrating-lymphocytes-in-different-subtypes-of-breast-cancer-treated-with-cytotoxic-neoadjuvant-chemotherapy
#11
Thaer Khoury, Vidya Nagrale, Mateusz Opyrchal, Xuan Peng, Dan Wang, Song Yao
BACKGROUND: The aim of the study was to investigate if there were differences in associations of stromal versus intratumoral tumor infiltrating lymphocytes (TILs) with pathology complete response (pCR) among breast cancer (BC) subtypes treated with neoadjuvant therapy. MATERIALS AND METHODS: The hematoxylin and eosin slides of BC-core biopsy consecutive cases (n=331) were reviewed from a single institution between 2000 and 2014. TIL-stroma (TIL-str) was scored from 0% to 100%...
February 9, 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
https://www.readbyqxmd.com/read/28183138/overall-survival-and-clinical-characteristics-of-brca-mutation-carriers-with-stage-i-ii-pancreatic-cancer
#12
Talia Golan, Tal Sella, Eileen M O'Reilly, Matthew H G Katz, Ron Epelbaum, David P Kelsen, Ayelet Borgida, Hannah Maynard, Hedy Kindler, Eitan Friedmen, Milind Javle, Steven Gallinger
BACKGROUND: BRCA1/BRCA2 germ line (GL) mutation carriers with pancreatic adenocarcinoma (PDAC) may have distinct outcomes. We recently described an apparent more favourable prognosis of surgically resected BRCA-associated PDAC patients in a single-arm, uncontrolled, retrospective study. However, the prognostic impact of GL BRCA1/2 mutations in surgically resected PDAC has not been compared with a matched control population. METHODS: A larger multi-centre, case-control retrospective analysis was performed...
February 9, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28176175/safety-and-immunogenicity-of-neoadjuvant-treatment-using-wt1-immunotherapeutic-in-combination-with-standard-therapy-in-patients-with-wt1-positive-stage-ii-iii-breast-cancer-a-randomized-phase-i-study
#13
M Higgins, G Curigliano, V Dieras, S Kuemmel, G Kunz, P A Fasching, M Campone, T Bachelot, P Krivorotko, S Chan, A Ferro, L Schwartzberg, M Gillet, P M De Sousa Alves, V Wascotte, F F Lehmann, P Goss
PURPOSE: This Phase I, multicenter, randomized study (ClinicalTrials.gov NCT01220128) evaluated the safety and immunogenicity of recombinant Wilms' tumor 1 (WT1) protein combined with the immunostimulant AS15 (WT1-immunotherapeutic) as neoadjuvant therapy administered concurrently with standard treatments in WT1-positive breast cancer patients. METHODS: Patients were treated in 4 cohorts according to neoadjuvant treatment (A: post-menopausal, hormone receptor [HR]-positive patients receiving aromatase inhibitors; B: patients receiving chemotherapy; C: HER2-overexpressing patients on trastuzumab-chemotherapy combination; D: HR-positive/HER2-negative patients on chemotherapy)...
February 7, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28174294/trastuzumab-in-human-epidermal-growth-factor-receptor-2-positive-early-breast-cancer-results-of-a-prospective-noninterventional-study-on-routine-treatment-between-2006-and-2012-in-germany
#14
Peter Dall, Thorsten Koch, Thomas Göhler, Johannes Selbach, Andreas Ammon, Jochen Eggert, Nidal Gazawi, Daniela Rezek, Arthur Wischnik, Carsten Hielscher, Stella Keitel, Ursula Cirrincione, Axel Hinke, Gabriele Feisel-Schwickardi
PURPOSE: Trastuzumab is part of the standard treatment in patients with human epidermal growth factor receptor 2-positive early breast cancer in addition to (neo)adjuvant chemotherapy. This German prospective noninterventional study, which included major patient cohorts underrepresented in the pivotal randomized studies, examined the generalizability of the results of those studies. PATIENTS AND METHODS: Between 2006 and 2012, 4,027 patients were enrolled and treated with trastuzumab; they were unselected regarding age or concomitant/sequential adjuvant chemotherapy...
February 7, 2017: Oncologist
https://www.readbyqxmd.com/read/28167568/pathologic-complete-response-with-neoadjuvant-doxorubicin-and-cyclophosphamide-followed-by-paclitaxel-with-trastuzumab-and-pertuzumab-in-patients-with-her2-positive-early-stage-breast-cancer-a-single-center-experience
#15
Jasmeet C Singh, Anita Mamtani, Andrea Barrio, Monica Morrow, Steven Sugarman, Lee W Jones, Anthony F Yu, Daniel Argolo, Lilian M Smyth, Shanu Modi, Sarah Schweber, Camilla Boafo, Sujata Patil, Larry Norton, Jose Baselga, Clifford A Hudis, Chau Dang
OBJECTIVES: Trastuzumab (H) and pertuzumab (P) with standard chemotherapy is approved for use in the neoadjuvant setting for human epidermal growth receptor 2 -positive patients. A retrospective analysis was performed of patients treated with dose-dense (dd) doxorubicin and cyclophosphamide (AC) followed by paclitaxel (T), trastuzumab, and pertuzumab (THP) in the neoadjuvant setting. Here, the pathologic complete response (pCR) rates are reported. METHODS: An electronic medical record review was conducted of patients treated with HP-based therapy in the neoadjuvant setting from September 1, 2013, to March 1, 2015...
February 6, 2017: Oncologist
https://www.readbyqxmd.com/read/28164759/neoadjuvant-therapy-for-her2-positive-breast-cancer
#16
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
#17
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
#18
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...
February 2, 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
#19
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...
January 30, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28152746/preoperative-triage-and-multidisciplinary-consultation-for-patients-with-breast-cancer-a-pilot-study-between-surgery-and-medical-oncology
#20
Christine E Simmons, Maryam Eslami, Caroline Illmann, Rebecca Warburton, Elaine McKevitt
: 208 Background: Breast cancer management has become exceedingly collaborative across specialties. Preoperative multidisciplinary input in particular is increasingly needed as indications for neoadjuvant therapy (NAT) continue to expand. In British Columbia, as in many other regions, breast cancer surgery is typically performed by community surgeons working in settings away from medical and radiation oncologists, making preoperative multidisciplinary input challenging. METHODS: This prospective pilot study was designed to enhance and streamline preoperative breast cancer care at the BC Cancer Agency Vancouver Centre (BCCA) and Mount Saint Joseph's Hospital (MSJ)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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