scholarly journals Association of Obesity with Breast Cancer Outcome in Relation to Cancer Subtypes: A Meta-Analysis

2021 ◽  
Author(s):  
Ana Elisa Lohmann ◽  
Sara V Soldera ◽  
Isabel Pimentel ◽  
Domen Ribnikar ◽  
Marguerite Ennis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Meta Analysis ◽  
Obese Women ◽  
Her2 Positive ◽  
Random Effects Models ◽  
Cancer Subtypes ◽  
Hormone Receptor Positive ◽  
Hazard Ratios ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

Abstract Background Obesity at breast cancer (BC) diagnosis has been associated with poor outcome, although the magnitude of effect in different BC subtypes is uncertain. We report on the association of obesity/overweight at diagnosis of non-metastatic BC with disease-free (DFS) and overall survival (OS) in the following defined subtypes: hormone receptor positive/HER2 negative (HR+HER2-), HER2 positive (HER2+), and triple negative (TNBC). Methods We searched MEDLINE, EMBASE and COCHRANE databases until January 1, 2019. Study eligibility were performed independently by two authors. Studies reporting hazard ratios (HR) of OS and/or DFS for obesity/overweight in BC subtypes were included. Pooled HR were computed and weighted using generic inverse variance and random effects models. Results 27 studies were included. Obese, compared to non-obese, women, had worse DFS in all subtypes: the hazard ratios were 1.26 (95% confidence interval [CI] = 1.13 to 1.41, P < .001) for HR+HER2-BC, 1.16 (95%CI = 1.06 to 1.26, P < .001) for HER2+ BC, and 1.17 (95%CI = 1.06 to 1.29, P = .001) for TNBC. OS was also worse in obese vs non-obese women (HR+HER2-BC HR = 1.39, 95%CI = 1.20 to 1.62, P < .001; HER2+BC HR = 1.18, 95%CI = 1.05 to 1.33, P = .006 and TNBC HR = 1.32, 95%CI = 1.13 to 1.53, P < .001). As opposed to obesity, overweight was not associated with either DFS or OS in HER2+BC (HR = 1.02, 95%CI = 0.81 to 1.28, P = .85; and HR = 0.96, 95%CI = 0.76 to 1.21, P = .99, respectively) or TNBC (HR = 1.04, 95%CI = 0.93 to 1.18, P = .49; and HR = 1.08, 95%CI = 0.81 to 1.44, P = .17), respectively. In HR+HER2-BC, being overweight was associated with worse OS (HR = 1.14, 95%CI = 1.07 to 1.22, P < .001). Conclusions Obesity was associated with modestly worse DFS and OS in all BC subtypes.

Association of obesity with breast cancer outcome in relation to cancer subtypes.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11557-11557
Author(s):  
Ana Elisa Lohmann ◽  
Sara V. Soldera ◽  
Isabel Pimentel ◽  
Domen Ribnikar ◽  
Marguerite Ennis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Random Effects ◽  
Random Effects Models ◽  
Cancer Subtypes ◽  
Hazard Ratios ◽  
Inverse Variance ◽  
Breast Cancer Outcome ◽  
Fixed And Random Effects ◽  
Cancer Outcome ◽  
Intervention Trials

11557 Background: Obesity at breast cancer (BC) diagnosis is associated with poor outcome, although the magnitude of effect in different BC subtypes is uncertain. Here we report on the association of obesity at BC diagnosis with disease-free (DFS) and overall survival (OS) in the following subtypes: (i) hormone receptor (ER/PgR) +ve, HER2-ve, (ii) HER2+ve, any ER/PgR and (iii) triple negative (TN). Methods: We searched MEDLINE, EMBASE and COCHRANE databases to December 31, 2018 and meeting presentations (past 5 years) using predefined search terms. Study eligibility, data abstraction were performed independently by two authors; those reporting hazard ratios (HR) for obesity and DFS/OS in BC subtypes were included. Using Review Manager pooled HRs were computed and weighted using generic inverse variance in fixed and random effects models (results were similar, random effects are presented). Results: Of 10,702 titles, 26 studies (108,793 patients) were included. Pooled HR for DFS for obese vs non-obese were (i) ER/PgR+ve HER2-ve 1.21 (95% Confidence interval, CI; 1.12-1.31, p < 0.00001), (ii) HER2+ve, any ER/PgR 1.16 (95%CI, 1.06-1.26; p = 0.0006) and (iii) TN, 1.13 (95%CI; 1.05-1.22 p = 0.002). Pooled HRs for OS were (i) ER/PgR+ve, HER2-ve 1.45 (95%CI; 1.30-1.62 p < 0.00001), (ii) HER2+ve any ER/PgR 1.21 (95%CI; 1.10-1.34 p = 0.0001) and (iii) TN 1.13 (95%CI, 1.04-1.23, p = 0.003).PooledHR for OS (but not DFS) were somewhat higher in observational vs interventional studies in (i) ER/PgR+ve, HER2-ve 1.57 vs 1.36, HER2+ve any ER/PgR (ii) 1.37 vs 1.09 but not (iii) TN 1.12 vs 1.22 (p = 0.21, 0.03 and 0.48, respectively). Conclusions: Obesity was associated with a worse outcome in all BC subtypes. Higher HR for OS in observational studies in (i) ER/PgR+ve, HER2- and (ii) HER2+ve any ER/PgR BC may reflect selection of healthier patients for intervention trials.

Management of early-stage breast cancer: Are we headed in the right direction?

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 284-284
Author(s):  
U. Zurawska ◽  
D. A. Baribeau ◽  
C. Victor ◽  
S. Giilck ◽  
A. Florescu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Histological Grade ◽  
Growth Factor Receptor ◽  
Early Stage Breast Cancer ◽  
Her2 Positive ◽  
Cancer Subtypes ◽  
Excellent Outcome ◽  
Hormone Receptor Positive ◽  
The Right

284 Background: The understanding of breast cancer (BC) as a heterogeneous disease consisting of distinct subtypes based on variation in expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) has led to more personalized treatment. We postulated that with increased adoption of chemotherapy and targeted therapy for HER2 positive patients, the outcomes of ER/PR+, HER2- and of HER2+ subtypes of breast cancer would be similar. Methods: A chart review was performed of female patients >18 years old seen by a medical oncologist at an academic cancer centre in Toronto, Canada, between January 1, 2005 and December 31, 2006, for stage I-III invasive breast cancer. Clinical features, 5-year overall (OS) and relapse-free survival (RFS) of three BC subtypes were compared: ER/PR+, HER2- (hormone receptor positive, HR), HER2+ (HER2), and ER/PR-, HER2- (triple negative, TN). Results: Of 870 patient charts reviewed, 525 were analysed. There were 341 HR, 101 HER2 and 83 TN patients. TN patients were younger (p<0.001), and had higher stage (p<0.001) and higher histological grade tumors (p<0.001). The 5-year RFS and OS were: HR: 88.2% and 96.6%, HER2: 76.7% and 92%, TN: 79.8% and 83.9%. Chemotherapy was used in 41.1%, 84.2% and 83.1% of HR, HER2 and TN patients. Anthracycline plus taxane regimens were used in 48.6%, 52.9% and 68.1% of HR, HER2 and TN patients, respectively. Among HER2 patients, only 74.3% received trastuzumab. The 5-year RFS and OS for HER2 patients who received trastuzumab were 79.9% and 91.8%, and for those who did not: 69% and 91.6%. Conclusions: HR+ patients have an excellent outcome. Despite significant improvement in outcomes of HER2+ patients with early stage breast cancer, they still remain at higher risk of recurrence along with TN patients. Trastuzumab was underutilized among HER2+ patients in this cohort, which may have contributed to decreased 5 year RFS. Ongoing prospective follow up of early BC outcomes by breast cancer subtypes is important.

Preoperative lymphocyte-to-monocyte ratio predicts breast cancer outcome: A meta-analysis

2018 ◽  
Vol 484 ◽  
pp. 1-6 ◽  
Author(s):  
Ru-jin Hu ◽  
Qin Liu ◽  
Jian-ying Ma ◽  
Jing Zhou ◽  
Gang Liu
Keyword(s):  
Breast Cancer ◽  
Meta Analysis ◽  
Lymphocyte To Monocyte Ratio ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

Tumor-infiltrating lymphocytes to predict survival to anthracycline/taxane-based adjuvant chemotherapy in triple negative breast cancer.

2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 1-1
Author(s):  
Qiyun Ou ◽  
Yunfang Yu ◽  
Xiaoyun Xiao ◽  
Baoming Luo
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Breast Cancer Subtypes ◽  
Her2 Positive ◽  
Cancer Subtypes ◽  
Infiltrating Lymphocytes

1 Background: Previous clinical data suggested that the tumour-infiltrating lymphocytes (TILs) were predictive in breast cancer treated with adjuvant chemotherapy; however, clinical relevance has yet to be established. We hypothesized that TILs would be associated with overall survival (OS) and disease-free survival (DFS) after anthracycline/taxane-based adjuvant chemotherapy in breast cancer subtypes. Methods: PubMed and EMBASE were searched until March 2017 for studies that investigated the association of TILs with survival for anthracycline/taxane-based adjuvant chemotherapy in breast cancer. OS and DFS were combined using random-effects meta-analysis and calculated as combined hazard ratio (HR) with 95% credible intervals (CIs). The PROSPERO registry number is CRD42017072133. Results: Twelve studies comprising 9,023 patients were eligible for analysis. Six were prospective adjuvant trials (n = 7686) and six were retrospective studies (n = 1337). Pooled analysis indicated that high TILs have no significant predictive association in overall population (DFS, HR = 0.87, 95% CI, 0.70 – 1.08; OS, HR = 0.98, 95% CI, 0.89 – 1.07), Luminal A/B (DFS, HR = 0.99, 95% CI, 0.94 – 1.04; OS, HR = 1.01, 95% CI, 0.92 – 1.12), and HER2–positive patients (DFS, HR = 0.84, 95% CI, 0.71 – 1.00; OS, HR = 0.89, 95% CI, 0.77 – 1.02), but were related to improved DFS (HR, 0.81; 95% CI, 0.73 – 0.89) and OS (HR, 0.74; 95% CI, 0.66 – 0.84) in triple negative breast cancer (TNBC) patients. Additionally, increasing TILs were not significantly associated with reduced risk of relapse in HER2-positive patient through adjuvant trastuzumab (HR, 0.97; 95% CI, 0.93 – 1.01). Conclusions: This meta-analysis provides an evidence that TILs predicts survival to anthracycline/taxane-based adjuvant chemotherapy in TNBC patients and suggests that predictive benefit seemed to be influenced by breast cancer subtypes as well.

scholarly journals Tumor-infiltrating B cells as a favorable prognostic biomarker in breast cancer: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
You Qin ◽  
Fei Peng ◽  
Lisha Ai ◽  
Shidai Mu ◽  
Yuting Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Random Effects Models ◽  
Hazard Ratios ◽  
Novel Therapeutic Strategies ◽  
High Level

Abstract Background Tumor-infiltrating B lymphocytes (TIL-Bs) is a heterogeneous population of lymphocytes. The prognostic value of TIL-Bs in patients with breast cancer remains controversial. Here we conducted this meta-analysis to clarify the association of TIL-Bs with outcomes of patients with breast cancer. Methods We searched PubMed, Embase, and Web of Science to identify relevant studies assessing the prognostic significance of TIL-Bs in patients with breast cancer. Fixed- or random-effects models were used to evaluate the pooled hazard ratios (HRs) for overall survival (OS), breast cancer-specific survival (BCSS), disease-free survival (DFS), and relapse-free survival (RFS) in breast cancer. Results A total of 8 studies including 2628 patients were included in our study. Pooled analyses revealed that high level of TIL-Bs was associated with longer OS (pooled HR = 0.42, 95% CI 0.24–0.60), BCSS (pooled HR = 0.66, 95% CI 0.47–0.85), and DFS/RFS (pooled HR = 0.41, 95% CI 0.27–0.55). Conclusions This meta-analysis suggests that TIL-Bs could be a promising prognostic marker for breast cancer. Novel therapeutic strategies for breast cancer treatment could be developed by enhancement of B cell-mediated antitumor immunity.

scholarly journals Local and Systemic Therapy in Breast Cancer Patients with Central Nervous System Metastases

2021 ◽  
Author(s):  
Ninke Elisabeth Aster Wellerdieck ◽  
Peter Wessels ◽  
Maartje Los ◽  
Gabe S Sonke ◽  
Ellen Tromp ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Systemic Therapy ◽  
Median Overall Survival ◽  
Breast Cancer Patients ◽  
Cns Metastases ◽  
Her2 Positive ◽  
Cancer Subtypes ◽  
Hormone Receptor Positive

Abstract Purpose As survival of patients with central nervous system (CNS) metastases from breast cancer is poor and incidence rates are increasing, there is a growing need for better treatment strategies. In the current study, the efficacy of local and systemic therapies was analyzed in breast cancer patients with CNS metastases.Methods Medical records from patients with breast cancer and brain and/or leptomeningeal metastases treated at a tertiary referral center and a teaching hospital between 2010 and 2020 were retrospectively studied. Main outcomes of interest were overall survival and CNS progression free survival. Analyses were performed for the different systemic and local therapies for CNS metastases, and subgroups based on breast cancer subtypes and brain metastases vs leptomeningeal metastases were tested.Results We identified 155 patients, 44 HER2-positive, 68 hormone receptor positive/HER2-negative and 43 triple negative. Median overall survival was 5.9 months for all 155 analyzed patients. Survival differed significantly between breast cancer subtypes (HER2-positive 22.8 months, hormone receptor positive/HER2-negative 2.4 months, triple negative 4.2 months, P<0.001). Patients receiving a combination of local and systemic therapy demonstrated prolonged median overall survival (18.5 months) as compared to local therapy only (5.7 months) or systemic therapy only (4.3 months, P<0.001). No significant difference in overall survival was observed between different systemic treatment regimens.Conclusion Breast cancer patients with CNS metastases show longest median overall survival when the subtype is HER2-positive and when they are treated with both local and systemic therapy.

scholarly journals Vav1 downmodulates Akt in different breast cancer subtypes: a new promising chance to improve breast cancer outcome

2018 ◽  
Vol 12 (7) ◽  
pp. 1012-1025 ◽  
Author(s):  
Silvia Grassilli ◽  
Federica Brugnoli ◽  
Rossano Lattanzio ◽  
Marco Marchisio ◽  
Letizia Perracchio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Subtypes ◽  
Cancer Subtypes ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

scholarly journals Molecular heterogeneity in breast carcinoma cells with increased invasive capacities

2020 ◽  
Vol 54 (1) ◽  
pp. 103-118
Author(s):  
Giulia Negro ◽  
Bertram Aschenbrenner ◽  
Simona Kranjc Brezar ◽  
Maja Cemazar ◽  
Andrej Coer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Hormone Receptor ◽  
Breast Cancer Cells ◽  
Triple Negative ◽  
Carcinoma Cells ◽  
Her2 Positive ◽  
Cancer Subtypes ◽  
Breast Carcinoma Cells ◽  
Hormone Receptor Positive

AbstractBackgroundMetastatic progression of breast cancer is still a challenge in clinical oncology. Therefore, an elucidation how carcinoma cells belonging to different breast cancer subtypes realize their metastatic capacities is needed. The aim of this study was to elucidate a similarity of activated molecular pathways underlying an enhancement of invasiveness of carcinoma cells belonging to different breast carcinoma subtypes.Materials and methodsIn order to reach this aim, parental and invasive (INV) MDA-MB-231 (triple-negative), T47D (hormone receptor-positive), and Au565 (Her2-positive) breast carcinoma cells were used and their molecular phenotypes were compared using a proteomic approach.ResultsIndependently from breast cancer subtypes, INV cells have demonstrated fibroblast-like morphology accompanied by enhancement of invasive and migratory capacities, increased expression of cancer stem cell markers, and delayed tumor growth in in vivo animal models. However, the global proteomic analysis has highlighted that INV cells were different in protein expressions from the parental cells, and Her2-positive Au565-INV cells showed the most pronounced molecular differences compared to the triple-negative MDA-MB-231-INV and hormone receptor-positive T47D-INV cells. Although Au565-INV breast carcinoma cells possessed the highest number of deregulated proteins, they had the lowest overlapping in proteins commonly expressed in MDA-MB-231-INV and T47D-INV cells.ConclusionsWe can conclude that hormone receptor-positive cells with increased invasiveness acquire the molecular characteristics of triple-negative breast cancer cells, whereas Her2-positive INV cells specifically changed their own molecular phenotype with very limited partaking in the involved pathways found in the MDA-MB-231-INV and T47D-INV cells. Since hormone receptor-positive invasive cells share their molecular properties with triple-negative breast cancer cells, we assume that these types of metastatic disease can be treated rather equally with an option to add anti-hormonal agents. In contrast, Her2-positive metastasis should be carefully evaluated for more effective therapeutic approaches which are distinct from the triple-negative and hormone-positive metastatic breast cancers.

scholarly journals Efficacy of tucatinib for HER2-positive metastatic breast cancer after HER2-targeted therapy: a network meta-analysis

2021 ◽  
Author(s):  
Kendra DeBusk ◽  
Shaun Abeysinghe ◽  
Adrian Vickers ◽  
Anubhav Nangia ◽  
Judith Bell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Meta Analysis ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Her2 Positive ◽  
Hazard Ratios ◽  
Targeted Treatments ◽  
Meta Analyses ◽  
Relative Differences

Aim: A systematic literature review and network meta-analysis of randomized controlled trials in patients receiving therapy for HER2+ unresectable/metastatic breast cancer after ≥1 HER2-directed therapy was conducted to compare progression-free survival (PFS) and overall survival (OS). Methods: Hazard ratios (HRs) and relative differences from fractional polynomials (FPs) for PFS and OS were assessed by Bayesian network meta-analyses. Results: For PFS, surface under the cumulative rankogram (SUCRA) ranked tucatinib plus trastuzumab with capecitabine as highest in both HR and FP analyses, followed by T-DM1 monotherapy and neratinib plus capecitabine. For OS, SUCRA ranked tucatinib plus trastuzumab with capecitabine as highest in both HR and FP analyses, followed by pertuzumab plus trastuzumab with capecitabine and T-DM1 monotherapy, with similar scores. Conclusion: Tucatinib plus trastuzumab with capecitabine, and T-DM1 monotherapy, consistently showed improved PFS and OS versus lapatinib/trastuzumab plus capecitabine and non-targeted treatments.

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