Outcome without any adjuvant systemic treatment in stage I ER+/HER2- breast cancer patients included in the MINDACT trial

Over the last years, the incidence of brain metastases in HER2 breast cancer patients has increased. Surgery and radiotherapy are the current standard local therapies. Nevertheless, it is unclear which and when systemic treatment should be applied in addition to local treatment. This work aims to present an updated review of current systemic treatment options for patients with HER2+ metastatic breast cancer with brain metastases and to present a case study of clinical cases that occurred in a Portuguese population. The methodology of this work included a literature search in PubMed for the impact of HER2-targeting agents, such as pertuzumab, trastuzumab emtansine (T-DM1), lapatinib, neratinib, trastuzumab deruxtecan, and tucatinib in the treatment of patients with HER2+ breast cancer with brain metastases. Then, a cohort of Portuguese patients with HER2+ breast cancer (n=44) was analyzed. In this exploratory study, considering a follow-up of 23.9 months, three patients (6.8%) developed brain metastases despite having shown a complete pathological response. The role of systemic treatment for patients with HER2 breast cancer with brain metastases has rapidly evolved following recent successes in phase II and III clinical trials. The biggest challenge is how to integrate systemic and local treatment in the management of these patients.

Download Full-text

Abstract PS11-01: Outcome without adjuvant systemic treatment in breast cancer patients included in the MINDACT trial

10.1158/1538-7445.sabcs20-ps11-01 ◽

2021 ◽

Author(s):

Josephine MN Lopes Cardozo ◽

Danalyn Byng ◽

Caroline A Drukker ◽

Marjanka K Schmidt ◽

Laura J van 't Veer ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Systemic Treatment ◽

Breast Cancer Patients ◽

Adjuvant Systemic Treatment

Download Full-text

Long-term prognosis of young breast cancer patients (≤40 years) who did not receive adjuvant systemic treatment: protocol for the PARADIGM initiative cohort study

BMJ Open ◽

10.1136/bmjopen-2017-017842 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017842 ◽

Cited By ~ 4

Author(s):

Gwen MHE Dackus ◽

Natalie D ter Hoeve ◽

Mark Opdam ◽

Willem Vreuls ◽

Zsuzsanna Varga ◽

...

Keyword(s):

Breast Cancer ◽

The Netherlands ◽

Cancer Patients ◽

Cancer Registry ◽

Systemic Treatment ◽

Young Patients ◽

Breast Cancer Patients ◽

Adjuvant Systemic Treatment ◽

Netherlands Cancer Registry ◽

Young Breast Cancer

IntroductionCurrently used tools for breast cancer prognostication and prediction may not adequately reflect a young patient’s prognosis or likely treatment benefit because they were not adequately validated in young patients. Since breast cancers diagnosed at a young age are considered prognostically unfavourable, many treatment guidelines recommend adjuvant systemic treatment for all young patients. Patients cured by locoregional treatment alone are, therefore, overtreated. Lack of prognosticators for young breast cancer patients represents an unmet medical need and has led to the initiation of the PAtients with bReAst cancer DIaGnosed preMenopausally (PARADIGM) initiative. Our aim is to reduce overtreatment of women diagnosed with breast cancer aged≤40 years.Methods and analysisAll young, adjuvant systemic treatment naive breast cancer patients, who had no prior malignancy and were diagnosed between 1989 and 2000, were identified using the population based Netherlands Cancer Registry (n=3525). Archival tumour tissues were retrieved through linkage with the Dutch nationwide pathology registry. Tissue slides will be digitalised and placed on an online image database platform for clinicopathological revision by an international team of breast pathologists. Immunohistochemical subtype will be assessed using tissue microarrays. Tumour RNA will be isolated and subjected to next-generation sequencing. Differences in gene expression found between patients with a favourable and those with a less favourable prognosis will be used to establish a prognostic classifier, using the triple negative patients as proof of principle.Ethics and disseminationObservational data from the Netherlands Cancer Registry and left over archival patient material are used. Therefore, the Dutch law on Research Involving Human Subjects Act (WMO) is not applicable. The PARADIGM study received a ‘non-WMO’ declaration from the Medical Ethics Committee of the Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, waiving individual patient consent. All data and material used are stored in a coded way. Study results will be presented at international (breast cancer) conferences and published in peer-reviewed, open-access journals.

Download Full-text

The impact of the pathological lymph node status on adjuvant systemic treatment recommendations in clinically node negative breast cancer patients

Breast Cancer Research and Treatment ◽

10.1007/s10549-013-2822-5 ◽

2014 ◽

Vol 143 (3) ◽

pp. 469-476 ◽

Cited By ~ 13

Author(s):

L. M. van Roozendaal ◽

R. J. Schipper ◽

K. K. B. T. Van de Vijver ◽

C. M. Haekens ◽

M. B. I. Lobbes ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Systemic Treatment ◽

Lymph Node Status ◽

Breast Cancer Patients ◽

Node Negative ◽

Adjuvant Systemic Treatment ◽

Node Negative Breast Cancer ◽

The Impact

Download Full-text

Predictive Role of Leptin Receptor (Ob-R) Overexpression in Patients with Early Breast Cancer Receiving Neoadjuvant Systemic Treatment

Cancers ◽

10.3390/cancers13133269 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3269

Author(s):

Laura García-Estévez ◽

Isabel Calvo ◽

Silvia Pérez ◽

Isabel Gallegos ◽

Eva Díaz ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Early Breast Cancer ◽

Leptin Receptor ◽

Systemic Treatment ◽

Treatment Modalities ◽

Breast Cancer Patients ◽

Old Patients ◽

Her2 Breast Cancer ◽

Clinical Records

The primary aim of this retrospective study was to investigate the correlation between the immunohistochemical expression of Ob-R (leptin receptor) with pCR (pathological complete response) in early breast cancer patients receiving neoadjuvant systemic treatment (NST). A total of 100 women with breast cancer receiving NST (2017–2020) followed by surgical resection were retrospectively obtained. Demographic parameters and clinicopathological factors (e.g., treatment modalities, immunohistochemistry (IHC), and cancer subtype) were obtained from the patient’s clinical records. In the analyzed breast cancer cohort, high expression of Ob-R was found in 52% of tumors and there was a significantly higher incidence in the HER2+ and TNBC subgroups. Overall, a significantly greater percentage of patients with Ob-R positive tumors achieved pCR compared with Ob-R negative patients (57.7% vs. 27.1%; p = 0.002). This result was observed in most breast cancer subtypes. In patients with HER2+ breast cancer, there was no difference in Ob-R expression in relation to the HR status. Ob-R cell positivity was significantly higher in younger breast cancer patients (p = 0.008), those who were premenopausal (p = 0.011), and in those with a BMI > 25 kg/m2 (p = 0.019). A significantly greater percentage of early breast cancer patients with Ob-R positive tumors achieved pCR compared with Ob-R negative patients. Furthermore, breast cancer patients with positive Ob-R expression were significantly younger than those with negative Ob-R expression. This association was not explained by differences in BMI between young and old patients.

Download Full-text