scholarly journals A large-cohort retrospective study of metastatic patterns and prognostic outcomes between inflammatory and non-inflammatory breast cancer

2020 ◽  
Vol 12 ◽  
pp. 175883592093267
Author(s):  
Zheng Wang ◽  
Hui Wang ◽  
Xinyuan Ding ◽  
Xiaosong Chen ◽  
Kunwei Shen
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Lymph Node ◽  
Inflammatory Breast Cancer ◽  
Regression Models ◽  
Cox Regression ◽  
Growth Factor Receptor ◽  
Kaplan Meier ◽  
Metastatic Patterns ◽  
Epidermal Growth

Background and aims: Breast cancer-related death is attributable mainly to metastasis. Inflammatory breast cancer (IBC) is an infrequent subtype of breast cancer that shows a relatively high rate of metastasis. In this study, we aimed to compare the metastatic patterns and prognostic outcomes of IBC and non-inflammatory breast cancer (non-IBC). Methods: We extracted data between 2010 and 2014 from the Surveillance, Epidemiology and End Results (SEER) database. The Chi-square test and Fisher’s exact test were used to compare the categorical parameters among different groups. Logistic regression was applied for multivariate analysis. The Kaplan–Meier method and multivariate Cox regression models were performed to analyze prognosis. Results: We enrolled 233,686 breast cancer patients between 2010 and 2014 in our research, including 2806 IBC and 230,880 non-IBC patients. Compared with the non-IBC group, the IBC group tended to have a higher incidence of the human epidermal growth factor receptor 2 positive (HER2+) and triple-negative breast cancer (TNBC) subtypes, older age, a higher rate of unmarried status, a lower incidence of black race, poorer tumor differentiation, larger tumor sizes, and a higher frequency of regional lymph node invasion. IBC and non-IBC shared similar trends in molecular subtypes among different metastatic organs. The percentage of the hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2–) subtype decreased gradually in patients with lung (IBC 42.5%, non-IBC 55.7%), distant lymph node (IBC 41.5%, non-IBC 54.6%), liver (IBC 31.1%, non-IBC 46.7%), and brain (IBC 30.6%, non-IBC 47.9%) metastases compared with that in patients with bone (IBC 50.8%, non-IBC 69.0%) metastasis in both cohorts. In both the IBC and non-IBC cases, the proportion of visceral metastases increased in the TNBC subtype, especially brain metastasis (IBC 26.4%, non-IBC 21.2%), which had the largest increase. The frequencies of all sites (bone, lung, liver, brain, and distant lymph node) in IBC were much higher than those in non-IBC (bone: IBC 21.1%, non-IBC 3.0%; lung: IBC 11.4%, non-IBC 1.4%; liver: IBC 9.6%, non-IBC 1.2%; brain: IBC 2.6%, non-IBC 0.3%; distant lymph node: IBC 12.9%, non-IBC 1.0%). The most frequent bi-site metastasis was the bone and liver (IBC 2.5%, non-IBC 0.3%), and the most frequent tri-site combination was the bone, lung, and liver (IBC 1.1%, non-IBC 0.2%). Kaplan–Meier curves and multivariate Cox regression models suggested that the IBC cohort had poorer overall survival [hazard ratio (HR) 1.602, 95% confidence interval (CI) 1.496–1.716, p < 0.001] and breast cancer-specific survival (HR 1.511, 95% CI 1.402–1.628, p < 0.001) than the non-IBC cohort. Furthermore, univariate and multivariate analyses indicated that IBC was an independent prognostic factor in patients with different metastatic sites. Conclusion: IBC and non-IBC patients presented with different metastatic frequencies, clinical features and prognostic outcomes. Our findings provide more information for therapeutic decision making and clinical study designs.

Phase II Study to Evaluate the Efficacy and Safety of Neoadjuvant Lapatinib Plus Paclitaxel in Patients With Inflammatory Breast Cancer

2010 ◽  
Vol 28 (20) ◽  
pp. 3248-3255 ◽  
Author(s):  
Hamouda Boussen ◽  
Massimo Cristofanilli ◽  
Tal Zaks ◽  
Michelle DeSilvio ◽  
Vanessa Salazar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Inflammatory Breast Cancer ◽  
Response Rate ◽  
Growth Factor Receptor ◽  
Clinical Response Rate ◽  
Her2 Positive ◽  
Epidermal Growth

PurposeWe conducted a phase II, open-label, multicenter study to evaluate the efficacy, safety, and tolerability of daily lapatinib plus weekly paclitaxel in treatment-naïve patients with inflammatory breast cancer (IBC).Patients and MethodsThe primary end point was pathologic complete response (pCR). Secondary end points included combined clinical response rate (based on Response Evaluation Criteria in Solid Tumors (RECIST) criteria and clinically evaluable skin disease criteria). Patients were assigned to either cohort A (human epidermal growth factor receptor 2 [HER2] 2+ or 3+ by immunohistochemistry [IHC] or fluorescent in situ hybridization [FISH] –amplified ± epidermal growth factor receptor [EGFR] expression) or cohort B (HER2-negative/EGFR-positive). A subpopulation of cohort A considered HER2-positive by the current definition of overexpression (3+ by IHC or FISH-amplified) was also analyzed. Patients received lapatinib at 1,500 mg/d for 14 days, then lapatinib at 1,500 mg/d plus weekly paclitaxel (80 mg/m2) for 12 weeks, followed by surgical resection or additional chemotherapy.ResultsForty-nine women were enrolled (cohort A, n = 42; cohort B, n = 7). Cohort B was terminated because of slow accrual and lack of efficacy observed in IBC patients with HER2-negative/EGFR-positive tumors enrolled onto the parallel study, EGF103009. pCR occurred in 18.2% (95% CI, 5.2% to 40.3%) of cohort A patients. Combined clinical response rate was 78.6% (95% CI, 63.2% to 89.7%) in all cohort A patients and 78.1% (95% CI, 60.0% to 90.7%) in the HER2-positive subset. Common adverse events included diarrhea, rash, alopecia, and nausea (> 50% of patients in both cohorts). The incidence of grade 3 diarrhea was 55%.ConclusionLapatinib monotherapy for 14 days followed by lapatinib plus paclitaxel for 12 weeks provided clinical benefit in IBC patients with HER2-overexpressing tumors without unexpected toxicity.

scholarly journals Phase II Study of Paclitaxel Given Once per Week Along With Trastuzumab and Pertuzumab in Patients With Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer

2015 ◽  
Vol 33 (5) ◽  
pp. 442-447 ◽  
Author(s):  
Chau Dang ◽  
Neil Iyengar ◽  
Farrah Datko ◽  
Gabriella D'Andrea ◽  
Maria Theodoulou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Phase Ii Study ◽  
Growth Factor Receptor ◽  
Loading Dose ◽  
Prior Therapy ◽  
Kaplan Meier ◽  
Epidermal Growth

Purpose The CLEOPATRA (Clinical Evaluation of Trastuzumab and Pertuzumab) study demonstrated superior progression-free survival (PFS) and overall survival when pertuzumab was added to trastuzumab and docetaxel. Paclitaxel given once per week is effective and less toxic than docetaxel. We performed a phase II study to evaluate the efficacy and safety of pertuzumab and trastuzumab with paclitaxel given once per week. Patients and Methods Patients with metastatic human epidermal growth factor receptor 2–positive breast cancer with zero to one prior therapy were enrolled. Treatment consisted of paclitaxel 80 mg/m2 once per week plus trastuzumab (8 mg/kg loading dose → 6 mg/kg) once every 3 weeks plus pertuzumab (840 mg loading dose → 420 mg) once every 3 weeks, all given intravenously. The primary end point was 6-month PFS assessed by Kaplan-Meier methods. Results From January 2011 to December 2013, we enrolled 69 patients: 51 (74%) and 18 (26%) treated in first- and second-line metastatic settings, respectively. At a median follow-up of 21 months (range, 3 to 38 months), 6-month PFS was 86% (95% CI, 75% to 92%). The median PFS was 19.5 months (95% CI, 14 to 26 months) overall. PFS was 24.2 months (95% CI, 14 months to not reached [NR]) and 16.4 months (95% CI, 8.5 months to NR) for those without and with prior treatment, respectively. At 1 year, Kaplan-Meier PFS was 70% (95% CI, 56% to 79%) overall, 71% (95% CI, 55% to 82%) for those without prior therapy, and 66% (95% CI, 40% to 83%) for those with prior therapy. Treatment was well-tolerated; there was no febrile neutropenia or symptomatic left ventricular systolic dysfunction. Conclusion Paclitaxel given once per week with trastuzumab and pertuzumab is highly active and well tolerated and seems to be an effective alternative to docetaxel-based combination therapy.

scholarly journals Correlation of Ki67 Expression with Hormone Receptors, Human Epidermal Growth Factor Receptor-2 (HER-2) Status, P53 Mutation and Clinicopathological Characteristics in Pathologic Specimens of Breast Cancer Patients

2016 ◽  
Vol 5 (2) ◽  
pp. 90-97
Author(s):  
Seyed Abbas Mirmalek ◽  
Maedeh Ghorbani ◽  
Ala Gholamrezaei Boushehrinejad ◽  
Masoud Salehi ◽  
Seyed Alireza Salimi-Tabatabaee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Lymph Node ◽  
Growth Factor ◽  
Tumor Size ◽  
Growth Factor Receptor ◽  
Breast Cancer Patients ◽  
Ki 67 ◽  
Her 2 ◽  
Epidermal Growth

Background: Breast cancer is the main cause of cancer in women and the second cause of ma­lignancy deaths. Ki-67 is one of the molecular markers used to evaluate cancer prognosis along with other factors such as age, tumor size, lymph node involvement, estrogen receptor (ER), progesterone receptor (PR), P53, human epidermal growth factor receptor-2 (HER-2), histolog­ical and nuclear grades. This study was aimed to evaluate the correlation of KI-67 expression with some biomarkers and clinico-pathological characteristics in breast cancer patients. Mate­rials and Methods: A total of 513 cases (all female) aged 40- 80 years, were randomly selected from patients who were admitted in two centers affiliated with Tehran University of Medical Sciences (Buo-alli and Kasra hospitals) over a 7-year period (2010-2015). Assessment of tumors for HER-2, P53, ER PR, pathological type and histologic grade was performed. Ki-67 labelling index (Ki-67LI) was defined as the percentage of MIB1-positive cells among a total number of 1,000 malignant cells at high-power magnification (×400). Results: Our study showed that age, ER and PR status were negatively correlated with Ki-67LI (P<0.05). Moreover, number of lymph nodes involved, HER-2, P53 and nuclear grades had a positive correlation with Ki-67LI (P<0.05), whereas, tumor size and histological grade showed no significant correlation with Ki-67LI (P =0.195 and P=0.721, respectively). Conclusion: Results of our study and other studies confirm that the expression of Ki-67 is significantly associated with ER, PR, HER-2 and P53 status. On the other hand, Ki-67 relationship with clinical characteristics such as age, tumor size and lymph node metastasis is not completely established and needs further research.[GMJ.2016;5(2):90-97]

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