scholarly journals Bilateral Salpingo-Oophorectomy Versus GnRH Analogue in the Adjuvant Treatment of Premenopausal Breast Cancer Patients: Cost-Effectiveness Evaluation of Breast Cancer Outcome, Ovarian Cancer Prevention and Treatment

2017 ◽  
Vol 37 (11) ◽  
pp. 1093-1102 ◽  
Author(s):  
Gabriella Ferrandina ◽  
Giulia Amadio ◽  
Andrea Marcellusi ◽  
Elena Azzolini ◽  
Anna Puggina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Effectiveness Evaluation ◽  
Gnrh Analogue ◽  
Breast Cancer Patients ◽  
Premenopausal Breast Cancer ◽  
Breast Cancer Outcome ◽  
Prevention And Treatment ◽  
Cancer Outcome

scholarly journals The Cost-Effectiveness of Multigene Panel Testing for Hereditary Breast and Ovarian Cancer in Norway

2019 ◽  
Vol 4 (1) ◽  
pp. 238146831882110 ◽  
Author(s):  
Lars Asphaug ◽  
Hans Olav Melberg
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Gene Panel ◽  
Breast Cancer Patients ◽  
Brca Testing ◽  
Early Onset Breast Cancer ◽  
Breast And Ovarian Cancer ◽  
Quality Adjusted Life ◽  
Multigene Panel

Background. Expansion of routine genetic testing for hereditary breast and ovarian cancer from conventional BRCA testing to a multigene test could improve diagnostic yield and increase the opportunity for cancer prevention in both identified carriers and their relatives. We use an economic decision model to assess whether the current knowledge on non- BRCA mutation prevalence, cancer risk, and patient preferences justifies switching to a multigene panel for testing of early-onset breast cancer patients. Methods. We evaluated routine testing by BRCA testing, a 7-gene panel, and a 14-gene panel using individual-level simulations of annual health state transitions over a lifetime perspective. Breast and ovarian cancer incidence is reduced and posttreatment survival is improved when high-risk mutations are detected and risk-reducing treatment offered. Most model inputs were synthesized from published literature. Intermediate health outcomes included breast and ovarian cancer incidence rates, along with organ-specific cancer mortality. Cost-effectiveness outcomes were health sector costs and quality-adjusted life years. Results. Intermediate health outcomes improved by testing with multigene panels. At a cost-effectiveness threshold of $77,000, a 7-gene panel test with five non- BRCA genes was the optimal strategy with an incremental cost-effectiveness ratio of $53,310 per quality-adjusted life year compared to BRCA-only testing. Limitations. Unable to stratify carriers to specific mutations within genes, we can only make predictions on the gene level, with combined risk estimates for known variants. As mutation prevalence is the absolute upper bound of returns to more expansive testing, the rarity of modelled mutations makes analysis outcomes sensitive to model implementation. Conclusions. A 7-gene panel to diagnose hereditary breast and ovarian cancer in early-onset breast cancer patients can be a cost-effective alternative to current BRCA-only testing in Norway.

scholarly journals Familial aggregation of breast/ovarian cancer: age of onset along subsequent generations in Brazil

1998 ◽  
Vol 14 (suppl 3) ◽  
pp. S181-S185 ◽  
Author(s):  
Rosalina Jorge Koifman ◽  
Sergio Koifman ◽  
Roberto José da Silva Vieira
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Age Of Onset ◽  
Familial Aggregation ◽  
Brca1 And Brca2 ◽  
Breast Cancer Outcome ◽  
Environmental Agents ◽  
Risks Factors ◽  
The Mean ◽  
Cancer Outcome

Antecedents of familial aggregation of breast and ovarian cancer are observed in only 5-8% of all breast cancer cases. Nevertheless, this variable displays one of the highest risk ratios associated to breast cancer outcome. Despite recent identification of genetic mutations associated with familial aggregation of these tumors, mainly at BRCA1 and BRCA2 genes, knowledge on the interaction between environmental agents in these families remains quite unclear. In this paper we ascertained the correlation among ages of the onset of breast/ovarian cancer in 260 Brazilian families with those cancer aggregation. Further we estimated the median age of the onset of breast cancer among four generations. We observed that the higher the number of family cancer cases, the highest is the correlation of ages for the onset of breast cancer. We also observed a 8-10 year decline in the mean age-of-onset of breast/ovarian cancer from one generation to another in the studied families. If these results could be confirmed elsewhere, we believe that the hypothesis of interaction between environmental risks factors in families indeed showing breast/ovarian cancer aggregation is reinforced.

scholarly journals THE COMPLEX OF INFORMATIVE IMMUNOLOGICAL PARAMETERS FOR BREAST CANCER OUTCOME PROGNOSIS

2015 ◽  
Vol 14 (3) ◽  
pp. 30-34
Author(s):  
M. N. Stakheyeva ◽  
A. P. Serykh ◽  
S. I. Karas ◽  
E. A. Perina
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Prognosis ◽  
Breast Cancer Patients ◽  
Immunological Parameters ◽  
Informative Parameters ◽  
Cell Immunity ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

Prognosis of disease outcome is important procedure for cancer patients treatment. The article presents the problem of elicitation of breast cancer prognosis criteria from immunological data as parameters complex.The aim is to identify necessary and sufficient amount of immunological parameters for accurate classification of breast cancer patients with various outcomes – clinical remission and hematogenous metastases.Material and methods. 36 immunological parameters were studied in 197 breast cancer patients T1–4N0–3M0. The “next neighbor” algorithm was used for identification of informative parameters. Detection of informative parameters complex was carried out by using ADD and DEL methods.Results. Two sets of informative immunological parameters were detected. The ADD method elicited parameters related to T-cell immunity, DEL – to humoral response.Conclusions. The complex of 17–19 immunological parameters characterizing different elements of immune system is necessary for accurate classification of breast cancer patients with different outcomes (presence/absence of hematogenous metastases).

scholarly journals Oncogene-mediated metabolic gene signature predicts breast cancer outcome

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Merve Aslan ◽  
En-Chi Hsu ◽  
Fernando J. Garcia-Marques ◽  
Abel Bermudez ◽  
Shiqin Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Gene Signature ◽  
The United States ◽  
Breast Cancer Patients ◽  
Metabolic Gene ◽  
Metabolic Signature ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

AbstractBreast cancer remains the second most lethal cancer among women in the United States and triple-negative breast cancer is the most aggressive subtype with limited treatment options. Trop2, a cell membrane glycoprotein, is overexpressed in almost all epithelial cancers. In this study, we demonstrate that Trop2 is overexpressed in triple-negative breast cancer (TNBC), and downregulation of Trop2 delays TNBC cell and tumor growth supporting the oncogenic role of Trop2 in breast cancer. Through proteomic profiling, we discovered a metabolic signature comprised of TALDO1, GPI, LDHA, SHMT2, and ADK proteins that were downregulated in Trop2-depleted breast cancer tumors. The identified oncogene-mediated metabolic gene signature is significantly upregulated in TNBC patients across multiple RNA-expression clinical datasets. Our study further reveals that the metabolic gene signature reliably predicts poor survival of breast cancer patients with early stages of the disease. Taken together, our study identified a new five-gene metabolic signature as an accurate predictor of breast cancer outcome.

scholarly journals Identification of candidate mediators of chemoresponse in breast cancer through therapy-driven selection of somatic variants

2020 ◽  
Vol 183 (3) ◽  
pp. 607-616
Author(s):  
Waleed S. Al Amri ◽  
Diana E. Baxter ◽  
Andrew M. Hanby ◽  
Lucy F. Stead ◽  
Eldo T. Verghese ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Candidate Genes ◽  
Genomic Analysis ◽  
Predictive Markers ◽  
Chemotherapy Response ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Breast Cancer Outcome ◽  
Before And After ◽  
Cancer Outcome

Abstract Purpose More than a third of primary breast cancer patients are treated with cytotoxic chemotherapy, typically without guidance from predictive markers. Increased use of neoadjuvant chemotherapy provides opportunities for identification of molecules associated with treatment response, by comparing matched tumour samples before and after therapy. Our hypothesis was that somatic variants of increased prevalence after therapy promote resistance, while variants with reduced prevalence cause sensitivity. Methods We performed systematic analyses of matched pairs of cancer exomes from primary oestrogen receptor-positive/HER2-negative breast cancers (n = 6) treated with neoadjuvant epirubicin/cyclophosphamide. We identified candidate genes as mediators of chemotherapy response by consistent subclonal changes in somatic variant prevalence through therapy, predicted variant impact on gene function, and enrichment of specific functional pathways. Influence of candidate genes on breast cancer outcome was tested using publicly available breast cancer expression data (n = 1903). Results We identified 14 genes as the strongest candidate mediators of chemoresponse: TCHH, MUC17, ARAP2, FLG2, ABL1, CENPF, COL6A3, DMBT1, ITGA7, PLXNA1, S100PBP, SYNE1, ZFHX4, and CACNA1C. Genes contained somatic variants showing prevalence changes in up to 4 patients, with up to 3 being predicted as damaging. Genes coding for extra-cellular matrix components or related signalling pathways were significantly over-represented among variants showing prevalence changes. Expression of 5 genes (TCHH, ABL1, CENPF, S100PBP, and ZFHX4) was significantly associated with patient survival. Conclusions Genomic analysis of paired pre- and post-therapy samples resulting from neoadjuvant therapy provides a powerful method for identification of mediators of response. Genes we identified should be assessed as predictive markers or targets in chemo-sensitization.

scholarly journals Cost-effectiveness of paclitaxel, doxorubicin, cyclophosphamide and trastuzumab versus docetaxel, cisplatin and trastuzumab in new adjuvant therapy of breast cancer in china

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qiaoping Xu ◽  
Li Yuanyuan ◽  
Zhu Jiejing ◽  
Liu Jian ◽  
Li Qingyu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Partial Response ◽  
Cancer Patients ◽  
Transition Probabilities ◽  
Complete Response ◽  
Sensitivity Analyses ◽  
Half Cycle ◽  
Breast Cancer Patients ◽  
Grade 3

Abstract Background Breast cancer is the most common cancer among women in China. Amplification of the Human epidermal growth factor receptor type 2 (HER2) gene is present and overexpressed in 18–20% of breast cancers and historically has been associated with inferior disease-related outcomes. There has been increasing interest in de-escalation of therapy for low-risk disease. This study analyzes the cost-effectiveness of Doxorubicin/ Cyclophosphamide/ Paclitaxel/ Trastuzumab (AC-TH) and Docetaxel/Carboplatin/Trastuzumab(TCH) from payer perspective over a 5 year time horizon. Methods A half-cycle corrected Markov model was built to simulate the process of breast cancer events and death occurred in both AC-TH and TCH armed patients. Cost data came from studies based on a Chinese hospital. One-way sensitivity analyses as well as second-order Monte Carlo and probabilistic sensitivity analyses were performed.The transition probabilities and utilities were extracted from published literature, and deterministic sensitivity analyses were conducted. Results We identified 41 breast cancer patients at Hangzhou First People’s Hospital, among whom 15 (60%) had a partial response for AC-TH treatment and 13 (81.25%) had a partial response for TCH treatment.No cardiac toxicity was observed. Hematologic grade 3 or 4 toxicities were observed in 1 of 28 patients.Nonhematologic grade 3 or 4 toxicities with a reverse pattern were observed in 6 of 29 patients. The mean QALY gain per patient compared with TCH was 0.25 with AC-TH, while the incremental costs were $US13,142. The incremental cost-effectiveness ratio (ICER) of AC-TH versus TCH was $US 52,565 per QALY gained. Conclusions This study concluded that TCH neoadjuvant chemotherapy was feasible and active in HER2-overexpressing breast cancer patients in terms of the pathological complete response, complete response, and partial response rates and manageable toxicities.

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