scholarly journals Practical Consensus Recommendations for Optimizing Risk versus Benefit of Chemotherapy in Patients with HR Positive Her2 Negative Early Breast Cancer in India

2021 ◽  
Vol 10 (04) ◽  
pp. 213-219
Author(s):  
Purvish M. Parikh ◽  
Gouri Shankar Bhattacharyya ◽  
Ghanshyam Biswas ◽  
Arvind Krishnamurty ◽  
Dinesh Doval ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Practical Experience ◽  
Predictive Test ◽  
Opinion Poll ◽  
Breast Cancer Patients ◽  
Consensus Recommendation ◽  
Domain Experts ◽  
Geographical Variations ◽  
Genetic Features

AbstractBreast cancer is a public health challenge globally as well as in India. Improving outcome and cure requires appropriate biomarker testing to assign risk and plan treatment. Because it is documented that significant ethnic and geographical variations in biological and genetic features exist worldwide, such biomarkers need to be validated and approved by authorities in the region where these are intended to be used. The use of western guidelines, appropriate for the Caucasian population, can lead to inappropriate overtreatment or undertreatment in Asia and India. A virtual meeting of domain experts discussed the published literature, real-world practical experience, and results of opinion poll involving 185 oncologists treating breast cancer across 58 cities of India. They arrived at a practical consensus recommendation statement to guide community oncologists in the management of hormone positive (HR-positive) Her2-negative early breast cancer (EBC). India has a majority (about 50%) of breast cancer patients who are diagnosed in the premenopausal stage (less than 50 years of age). The only currently available predictive test for HR-positive Her2-negative EBC that has been validated in Indian patients is CanAssist Breast. If this test gives a score indicative of low risk (< 15.5), adjuvant chemotherapy will not increase the chance of metastasis-free survival and should not be given. This is applicable even during the ongoing COVID-19 pandemic.

CD1a- and CD83-positive dendritic cells as prognostic markers of metastasis development in early breast cancer patients

Breast Cancer ◽  
2021 ◽  
Author(s):  
María Belén Giorello ◽  
Ayelén Matas ◽  
Pablo Marenco ◽  
Kevin Mauro Davies ◽  
Francisco Raúl Borzone ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dendritic Cells ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Prognostic Markers ◽  
Breast Cancer Patients ◽  
Metastasis Development

Survival in Early Breast Cancer Patients Is Favorably Influenced by a Natural Humoral Immune Response to Polymorphic Epithelial Mucin

2000 ◽  
Vol 18 (3) ◽  
pp. 574-574 ◽  
Author(s):  
S. von Mensdorff-Pouilly ◽  
A.A. Verstraeten ◽  
P. Kenemans ◽  
F.G. M. Snijdewint ◽  
A. Kok ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Humoral Response ◽  
Disease Specific Survival ◽  
Breast Cancer Patients ◽  
Antibody Levels ◽  
Pretreatment Serum ◽  
Test Result ◽  
Disease Specific

PURPOSE: Polymorphic epithelial mucin (PEM or MUC1) is being studied as a vaccine substrate for the immunotherapy of patients with adenocarcinoma. The present study analyzes the incidence of naturally occurring MUC1 antibodies in early breast cancer patients and relates the presence of these antibodies in pretreatment serum to outcome of disease.MATERIALS AND METHODS: We measured immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to MUC1 with an enzyme-linked immunoassay (PEM.CIg), which uses a MUC1 triple-tandem repeat peptide conjugated to bovine serum albumin, in pretreatment serum samples obtained from 154 breast cancer patients (52 with stage I disease and 102 with stage II) and 302 controls. The median disease-specific survival time of breast cancer patients was 74 months (range, 15 to 118 months). A positive test result was defined as MUC1 IgG or IgM antibody levels equal to or greater than the corresponding rounded-up median results obtained in the total breast cancer population.RESULTS: A positive test result for both MUC1 IgG and IgM antibodies in pretreatment serum was associated with a significant benefit in disease-specific survival in stage I and II (P = .0116) breast cancer patients. Positive IgG and IgM MUC1 antibody levels had significant additional prognostic value to stage (P = .0437) in multivariate analysis. Disease-free survival probability did not differ significantly. However, stage II patients who tested positive for MUC1 IgG and IgM antibody and who relapsed had predominantly local recurrences or contralateral disease, as opposed to recurrences at distant sites in the patients with a negative humoral response (P = .026).CONCLUSION: Early breast cancer patients with a natural humoral response to MUC1 have a higher probability of freedom from distant failure and a better disease-specific survival. MUC1 antibodies may control hematogenic tumor dissemination and outgrowth by aiding the destruction of circulating or seeded MUC1-expressing tumor cells. Vaccination of breast cancer patients with MUC1-derived (glyco)peptides in an adjuvant setting may favorably influence the outcome of disease.

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