scholarly journals Higher efficacy and reduced adverse reactions in neoadjuvant chemotherapy for breast cancer by using pegylated liposomal doxorubicin compared with pirarubicin

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Weifang Liu ◽  
Wei Chen ◽  
Xiuxiang Zhang ◽  
Peng Zhao ◽  
Zhimin Fan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Reactions ◽  
Liposomal Doxorubicin ◽  
Molecular Subtype ◽  
Pathologic Complete Response ◽  
Pegylated Liposomal Doxorubicin ◽  
Control Group ◽  
Observation Group ◽  
Cardiac Side Effects

AbstractThe present study aimed to investigate the efficacy and toxicity of pegylated liposomal doxorubicin (PLD) in preoperative neoadjuvant chemotherapy for patients with breast cancer by comparing with conventional anthracycline. This study is a non-randomized controlled trial. Prospective analysis was conducted after matching as required. A total of 146 patients with confirmed diagnosis of breast cancer by histopathological examinations were enrolled into the observation group and control group in 1:1 ratio. Each of the cases in the observation group was required to correspond to another in the control group according to the requirements including age, molecular subtype, axillary node status, and regimen of the preoperative neoadjuvant chemotherapy. The chemotherapy was based on regimens consisting of anthracyclines, paclitaxel or docetaxel, and/or platinum. PLD was used at least twice in the observation group, with traditional anthracycline as a contrast in the control group. Clinical responses as well as cardiac side effects and other adverse reactions were evaluated by clinical and imaging examinations such as electrocardiogram (ECG) and color Doppler ultrasound during the chemotherapy. Pathologic examinations were performed following the surgeries after preoperative neoadjuvant chemotherapy. All the patients in both groups completed the preoperative neoadjuvant chemotherapy according to their original regimens. The postoperative pathological evaluation revealed a higher pathologic complete response (PCR) rate and significantly more patients of grade V of the Miller-Payne grading system in the observation group as compared to the control group (p = 0.047). In addition, the observation group recorded an evidently lower occurrence of the adverse cardiac events (p = 0.014), ECG changes (p = 0.048), and the relatively severe adverse reactions such as myelosuppression. Compared with conventional anthracycline drugs, PLD has a better pathologic response and safety performance, as well as a similar clinical effectiveness in preoperative neoadjuvant chemotherapy for breast cancer.

scholarly journals Efficacy Of Pegylated Liposomal Doxorubicin-based Neoadjuvant Chemotherapy In Breast Cancer: A Single Center Experience

2021 ◽  
Vol 44 (1) ◽  
pp. E7-14
Author(s):  
I-Chen Tsai ◽  
Chih-Chiang Hung Hung
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Recurrence Rate ◽  
Liposomal Doxorubicin ◽  
Histological Grade ◽  
Therapeutic Option ◽  
Pathologic Complete Response ◽  
Pegylated Liposomal Doxorubicin ◽  
Operable Breast Cancer ◽  
Breast Cancer Patients

Purpose: Neoadjuvant chemotherapy using a doxorubicin-based regimen has recently become a common therapeutic option for operable breast cancer. This study aimed to investigate the efficacy of polyethylene glycol-coated liposomal doxorubicin (PLD)-based chemotherapy for breast cancer in neoadjuvant settings. Methods: A total of 227 female operable breast cancer patients who were diagnosed between January 2009 and December 2017 and completed neoadjuvant PLD-based chemotherapy were retrospectively included. The logistic regression analysis was used to determine the associations between pathologic complete response (pCR) and preoperative clinicopathological characteristics. The breast cancer recurrence rate was estimated using the survival analysis. Results: A higher pCR rate was found in the patients with clinically negative lymph nodes and HER2-enriched patients. Moreover, the patients who achieved pCR also had a better prognosis outcome. A recurrence rate of 11.5% (n=26) was observed during a median follow-up of 11.63 months, and the recurrence rate of the pCR group (2.04%; 95% CI = 0.29-13.62) was lower than the non-pCR group (14.62%; 95% CI = 10.12-20.87). Higher histological grade was also associated high pCR rate (52.0% vs 40.0%). Conclusion: The use of PLD-containing chemotherapeutics in neoadjuvant settings might have benefits for non-metastatic operable breast cancer in Taiwanese females.

scholarly journals Effectiveness and safety of pegylated liposomal doxorubicin versus epirubicin as neoadjuvant or adjuvant chemotherapy for breast cancer: a real-world study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jin Zhang ◽  
Hongchuan Jiang ◽  
Jian Zhang ◽  
Guoqiang Bao ◽  
Guoqiang Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Lower Limit ◽  
Adjuvant Treatment ◽  
Real World ◽  
Liposomal Doxorubicin ◽  
Pegylated Liposomal Doxorubicin ◽  
Secondary Outcome ◽  
Rate Difference

Abstract Background Pegylated liposomal doxorubicin (PLD) is an improved formulation of doxorubicin with comparable effectiveness but significantly lower cardiotoxicity than conventional anthracycline. This study aimed to evaluate the real-world effectiveness and safety of PLD versus epirubicin as neoadjuvant or adjuvant treatment for breast cancer. Methods Clinical data of invasive breast cancer patients who received neoadjuvant or adjuvant chemotherapy with PLD or epirubicin were retrospectively collected. Propensity score matching (PSM) was performed to reduce the risk of selection bias. The molecular typing of these patients included Luminal A, Luminal B, HER2-positive, and basal-like/triple-negative. The primary outcome was pathological complete response (pCR) rate for neoadjuvant chemotherapy and 3-year disease-free survival (DFS) rate for adjuvant chemotherapy. Noninferiority was suggested if the lower limit of the 95% CI for the 3-year DFS rate difference was greater than − 10%. The secondary outcome was adverse reactions. Results A total of 1213 patients were included (neoadjuvant, n = 274; adjuvant, n = 939). pCR (ypT0/Tis ypN0) rates of patients who received neoadjuvant chemotherapy were 11.6% for the PLD group and 7.0% for the epirubicin group, but the difference was not statistically significant (P = 0.4578). The 3-year DFS rate of patients who received adjuvant chemotherapy was 94.9% [95%CI, 91.1–98.6%] for the PLD group and 95.4% [95%CI, 93.0–97.9%] for the epirubicin group (P = 0.5684). Rate difference between the two groups and its 95% CI was - 0.55 [− 5.02, 3.92]. The lower limit of the 95% CI was − 5.0% > − 10.0%, suggesting that PLD is not be inferior to epirubicin in adjuvant chemotherapy for breast cancer. The incidences of myelosuppression, decreased appetite, alopecia, gastrointestinal reactions, and cardiotoxicity were lower in the PLD group than in the epirubicin group, while the incidence of nausea was higher in the PLD group. Conclusions In the neoadjuvant and adjuvant treatment of breast cancer, effectiveness is similar but toxicities are different between the PLD-containing regimen and epirubicin-containing regimen. Therefore, further study is warranted to explore PLD-based neoadjuvant and adjuvant chemotherapy for breast cancer.

Clinicopathologic profile of breast cancer patients treated with neoadjuvant chemotherapy at HUCFF/UFRJ

Mastology ◽  
2021 ◽  
Author(s):  
Luís Claudio Belo Amendola ◽  
Maria de Fatima Dias Gaui ◽  
Ana Helena Pereira Correia Carneiro ◽  
Nathalie Henriques Silva Canedo
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Molecular Subtype ◽  
Pathologic Complete Response ◽  
Real Life ◽  
Public University ◽  
Public Institution ◽  
Breast Cancer Patients ◽  
Response To Chemotherapy

Introduction: The objective of this study is to describe the profile of patients from a public institution, submitted to neoadjuvant chemotherapy (NACT), comparing the verified pathological response with literature data. Methods: Observational retrospective cohort study on breast cancer patients diagnosed between September 2001 and October 2018 and treated with NACT at Hospital Universitário Clementino Fraga Filho (HUCFF/UFRJ), located in Rio de Janeiro, Brazil. The adopted neoadjuvant chemotherapy regimen was based on anthracycline and docetaxel. Results: A total of 133 patients were evaluated. The average age in this group was 54 years (28-86), 49 women (37%) were under 50 years old. The following distribution by molecular subtype was observed: overexpression or amplification of the human epidermal growth factor receptor 2 (HER2+) (13 women, 26.6%), Luminal (19 women, 38.8%), and Triple-negative (TN) (17 women, 34.6%). The HER2+ and TN subtypes had a higher incidence of cases between 40-49 years and 50-59 years. As for the initial staging, 34% were IIIA; 26%, IIB; and 19%, IIIB. Only one patient did not undergo surgery after NACT, 33 (24.8%) underwent conservative surgery, and 99 patients (74.4%) underwent mastectomy. Regarding the axillary approach, 41 (31%) underwent sentinel lymph node biopsy and 88 (66%) had an indication for lymphadenectomy. In the anatomopathological evaluation of the surgery, 12 (9.1%) patients obtained a pathologic complete response (pCR) and 113 (84.9%), partial or no response to chemotherapy. Conclusion: This research enabled the identification of clinicopathologic characteristics and outcome of patients who received neoadjuvant chemotherapy in a public university service. The predominance of advanced tumors was observed, stressing the need for public health policies for the screening of breast cancer as well as the guarantee of timely treatment for diagnosed cases. The data somewhat reflect the difficulty that the public sector encounters to carry out the most appropriate treatment. The authors expect that this article, by analyzing the profile and the adopted treatment in real-life cases and in a public university institution, can contribute to the improvement of breast cancer treatment in Brazil.

scholarly journals Non-Pegylated Liposomal Doxorubicin-Cyclophosphamide in Sequential Regimens with Taxanes as Neoadjuvant Chemotherapy in Breast Cancer Patients

2014 ◽  
Vol 5 (6) ◽  
pp. 398-405 ◽  
Author(s):  
Patrizia Vici ◽  
Laura Pizzuti ◽  
Teresa Gamucci ◽  
Domenico Sergi ◽  
Francesca Conti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Liposomal Doxorubicin ◽  
Pegylated Liposomal Doxorubicin ◽  
Breast Cancer Patients

scholarly journals Preoperative neoadjuvant chemotherapy on surgical condition and oncogene expression in advanced gastric cancer

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Guangyu Sun Sun ◽  
Shuyan Wang ◽  
Guangsheng Liu
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Adverse Reactions ◽  
Control Group ◽  
Observation Group ◽  
Oncogene Expression ◽  
Long Term Prognosis ◽  
Surgical Condition

Objective: To evaluate the effect of preoperative neoadjuvant chemotherapy regimen of XELOX (capecitabine combined with oxaliplatin) on surgical condition and oncogene expression in advanced gastric cancer. Methods: From January 2015 to July 2016, 124 patients with advanced gastric cancer who were admitted to our hospital were selected. Random number table method was used to divide them into an observation group and a control group, 62 each group. The observation group received two courses of neoadjuvant chemotherapy (XELOX) before operation, and the control group received surgery. The operation condition, expression of oncogenes in gastric cancer lesions, occurrence of adverse reactions and the long-term prognosis were compared between the two groups. Results: The R0 resection rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). The operation time of the observation group was shorter than that of the control group, the amount of intraoperative bleeding and the amount of postoperative drainage of the observation group were less than that of the control group, and the differences were statistically significant (P<0.05). The mRNA expression of gastrokine 1, multiple tumor suppressor protein, Wilms tumor gene on the X chromosome (WTX gene) and gene of phosphate and tension homology deleted on chromosome ten (PTEN gene) in the observation group after treatment was significantly higher than that in the control group before treatment, and the increase amplitude of the observation group was more obvious than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). In terms of long-term prognosis, the disease-free survival time and average survival time of the observation group during the two-year follow-up period were significantly better than those of the control group, and the recurrence rate of the observation group was significantly lower than that of the control group; the differences were statistically significant (P<0.05). Conclusion: Preoperative XELOX for advanced gastric cancer patients can effectively increase the proportion of radical surgery, reduce the risk of surgery, and significantly regulate the expression of oncogene, thus improving the long-term prognosis of patients. doi: https://doi.org/10.12669/pjms.36.3.1608 How to cite this:Sun G, Wang S, Liu G. Preoperative neoadjuvant chemotherapy on surgical condition and oncogene expression in advanced gastric cancer. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1608 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Efficacy of Combining Metformin with Neoadjuvant Chemotherapy on Pathologic Response in Non-diabetic Patients with Carcinoma Breast- A Randomized Controlled Trial

2021 ◽  
pp. 1-7
Author(s):  
Kadambari Dharanipragada ◽  
Niraj Ghimire ◽  
Kadambari Dharanipragada ◽  
Nisha Ghimire ◽  
Shanmugam Dasarathan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Progressive Disease ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Pathologic Response ◽  
Control Group ◽  
Study Group ◽  
Breast Cancer Patients ◽  
Metformin Group

Background: In India breast cancer forms the commonest malignancy after cervical cancer in females and is detected in 20 per 1,00,000 women. Metformin acts as oral hypoglycemia drug and anti-tumor drug. Mechanism of action of metformin is to inhibit cellular proliferation as well as to increases pathological Complete Response in breast cancer patients when used in addition to neoadjuvant chemotherapy. Methods: This randomized control trial study was conducted on 54 patients to assess the effect of adding metformin to neoadjuvant chemotherapy in pathologic response in Breast Cancer patients as well as to establish safety and tolerance of metformin as a neoadjuvant drug in Breast cancer and to measure the effect of metformin on sex hormones, tumor and insulin resistance dated from November 2016 to June 2018. Study group received metformin along with neoadjuvant chemotherapy and Control group received neoadjuvant chemotherapy only. In every visit, side effects of metformin were assessed like nausea, vomiting, abdominal discomfort, dizziness. Pre NACT-BMI and Post NACT- BMI were calculated and differences were assessed. Any post-operative complication was looked for post-surgery. Data was analysed by SPSS version 19. Results: Our study showed that DHEAS level decreased by 5.65 in study group while the fall in DHEAS in non-metformin arm was 2.1. 7.1% of participants in metformin group showed complete response, 78.6% participants showed partial response and 14.3% had progressive disease. In non-metformin group, complete, partial response and progressive disease were seen in 40.0%, 60.0% and 0.0% respectively. Patient in control group had higher complete response. However, the difference in pathologic complete response between metformin and non-metformin group has no statistical significance (p= 0.057). Conclusion: Our study supports the view that patient without insulin resistance treated with NACT alone has higher pathologic complete response than the patient treated with NACT with metformin. However, sample size of present study is small to support the results.

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