scholarly journals Outcome of Patients With Early-Stage Breast Cancer Treated With Doxorubicin-Based Adjuvant Chemotherapy As a Function ofHER2andTOP2AStatus

2009 ◽  
Vol 27 (24) ◽  
pp. 3881-3886 ◽  
Author(s):  
Raymond Tubbs ◽  
William E. Barlow ◽  
G. Thomas Budd ◽  
Eric Swain ◽  
Peggy Porter ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Univariate Analysis ◽  
Menopausal Status ◽  
Disease Free Survival ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Her2 Amplification ◽  
Amplification Ratio

PurposeAmplification and deletion of the TOP2A gene have been reported as positive predictive markers of response to anthracycline-based therapy. We determined the status of the HER2 and TOP2A genes in a large cohort of breast cancer patients treated with adjuvant doxorubicin (A) and cyclophosphamide (C).Patients and MethodsTOP2A/CEP17 and HER2/CEP17 fluorescent in situ hybridization (FISH) were performed on tissue microarrays (TMAs) constructed from 2,123 of the 3,125 women with moderate-risk primary breast cancer who received equivalent doses of either concurrent adjuvant chemotherapy with A plus C (n = 1,592) or sequential A followed by C (n = 1,533).ResultsAn abnormal TOP2A genotype was identified for 153 (9.4%) of 1,626 patients (4.0% amplified; 5.4% deleted). An abnormal HER2 genotype was identified for 303 (20.4%) of 1,483 patients (18.8% amplified; 1.6% deleted). No significant differences in either overall survival (OS) or disease-free survival (DFS) were identified for TOP2A. In univariate analysis, OS and DFS rates were strongly and adversely associated only with higher levels of HER2 amplification (ratio ≥ 4.0). Survival was not associated with low-level HER2 amplification (ratio ≥ 2; OS hazard ratio [HR], 1.14; P = .39; DFS HR, 1.07; P = .62), but it was associated for a ratio ≥ 4 (OS HR, 1.45; P = .03; DFS HR, 1.38; P = .033), in which analysis was adjusted for menopausal status, hormone receptor status, treatment, number of positive nodes, and tumor size.ConclusionIn this population of patients with early-stage breast cancer who were treated with adjuvant AC chemotherapy, TOP2A abnormalities were not associated with outcome. HER2 high-level amplification was a prognostic marker in anthracycline-treated patients.

Cardiovascular risk profile of breast cancer patients treated with anthracycline-taxane containing adjuvant chemotherapy and/or trastuzumab

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 666-666 ◽  
Author(s):  
L. W. Jones ◽  
M. Haykowsky ◽  
C. J. Peddle ◽  
A. A. Joy ◽  
E. N. Pituskin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Sinus Tachycardia ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Cvd Risk Factors ◽  
Cvd Risk

666 Background: With improving longevity, post-treatment cardiovascular disorders will become an increasingly important indicator of competing mortality in early-stage breast cancer. As such, we conducted a pilot study to comprehensively evaluate the CVD profile of a subset of early-stage breast cancer patients treated with adjuvant taxane-anthracycline containing chemotherapy and/or trastuzumab. Methods: Twenty-six breast cancer patients (mean 20 months post chemotherapy) who participated in Breast Cancer International Research Group 006 clinical trial and 10 healthy age-matched women were studied. We measured 14 metabolic and vascular established CVD risk factors, BMI, VO2peak and left ventricular systolic function. All assessments were performed within a 14-day period. Results: Cardiac abnormalities were suggested by LVEF <50% in 10% of patients, LVEF remained >10% below pre-treatment values in 38% while 50% presented with resting sinus tachycardia. BNP was significantly elevated in 40% and was correlated with LVEF (r = -0.72, p=<.001). For the majority of CVD risk factors, similar proportions of patients and controls (35% to 60%) were classified as ‘undesirable.’ A significantly higher proportion of patients were classified with low VO2peak (46% vs. 0%, p<0.01), being overweight/obese (72% vs. 50%, p<0.05), and having resting sinus tachycardia (50% vs. 0%, p<0.01) compared with controls. VO2peak and BMI were correlated with CV risk factors (r = -0.64 to 0.63, p<0.05; r = -0.63 to 0.67, p<0.05, respectively). Exploratory analyses revealed several differences between CVD risk factors based on chemotherapy regimen. Conclusions: Breast cancer survivors treated with adjuvant chemotherapy are at a higher risk of developing late-occurring CVD than age matched controls due to direct and indirect treatment-related toxicity. No significant financial relationships to disclose.

scholarly journals Evaluation of the prognostic value of CD3, CD8, and FOXP3 mRNA expression in early-stage breast cancer patients treated with anthracycline-based adjuvant chemotherapy

2018 ◽  
Vol 7 (10) ◽  
pp. 5066-5082 ◽  
Author(s):  
Marinos Tsiatas ◽  
Konstantine T. Kalogeras ◽  
Kyriaki Manousou ◽  
Ralph M. Wirtz ◽  
Helen Gogas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Mrna Expression ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Foxp3 Mrna

Accelerated Treatment of Breast Cancer

2001 ◽  
Vol 19 (7) ◽  
pp. 1993-2001 ◽  
Author(s):  
Frank A. Vicini ◽  
Kathy L. Baglan ◽  
Larry L. Kestin ◽  
Chris Mitchell ◽  
Peter Y. Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Time ◽  
Reference Group ◽  
Early Stage ◽  
Estrogen Receptor Status ◽  
Disease Free Survival ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Tumor Bed

PURPOSE: Radiation therapy (RT) restricted to the tumor bed, by means of an interstitial implant, and lasting 4 to 5 days after lumpectomy was prospectively evaluated in early-stage breast cancer patients treated with breast-conserving therapy (BCT). The goals of the study were to determine whether treatment time can be reduced and whether elective treatment of the entire breast is necessary. MATERIALS AND METHODS: Between January 1993 and January 2000, 174 cases of early-stage breast cancer were managed with lumpectomy followed by RT restricted to the tumor bed using an interstitial implant. Each brachytherapy patient was matched with one external-beam RT (ERT) patient derived from a reference group of 1,388 patients treated with standard BCT. Patients were matched for age, tumor size, histology, margins of excision, absence of an extensive intraductal component, nodal status, estrogen receptor status, and tamoxifen use. Median follow-up for both the ERT and brachytherapy groups was 36 months. RESULTS: No statistically significant differences were noted in the 5-year actuarial rates of ipsilateral breast treatment failure or locoregional failure between ERT and brachytherapy patients (1% v 0%, P = .31 and 2% v 1%, P = .63, respectively). In addition, there were no statistically significant differences noted in rates of distant metastasis (6% v 3%, P = .24), disease-free survival (87% v 91%, P = .55), overall survival (90% v 93%, P = .66), or cause-specific survival (97% v 99%, P = .28). CONCLUSION: Accelerated treatment of breast cancer using an interstitial implant to deliver radiation to the tumor bed alone over 4 to 5 days seems to produce 5-year results equivalent to those achieved with conventional ERT. Extended follow-up will be required to determine the long-term efficacy of this treatment approach.

Influences on Oncologists’ Adoption of New Agents in Adjuvant Chemotherapy of Breast Cancer

2001 ◽  
Vol 19 (4) ◽  
pp. 954-959 ◽  
Author(s):  
Gina M. Buban ◽  
Brian K. Link ◽  
William R. Doucette
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Early Stage ◽  
Social Systems ◽  
Communication Channels ◽  
Early Stage Breast Cancer ◽  
Phase Iii ◽  
Breast Cancer Patients ◽  
New Treatments

PURPOSE: Little is known about how oncologists’ adopt new treatments for breast cancer. This study investigated influences on oncologists’ adoption of paclitaxel as adjuvant chemotherapy for early-stage breast cancer, 9 months after presentation of phase III data suggesting improved disease-free and overall survival when paclitaxel was added to doxorubicin and cyclophosphamide for such patients. METHODS: Self-reported data were collected with a mail survey of a random sample of 1,200 oncologists practicing in the United States. Using Rogers’ model, we measured four types of influences on adoption of innovation: (1) communication channels, (2) innovation characteristics, (3) a practitioner’s social system, and (4) physician characteristics. Multiple regression analysis assessed the associations between oncologist adoption of paclitaxel for early-stage breast cancer patients and variables representing the modeled influences on adoption. RESULTS: On average, respondents (n = 181) reported having adopted paclitaxel for 37% of their early-stage breast cancer patients. The overall model was significant, with seven variables associated (P ≤ .05) with adoption of paclitaxel. Significant influences on adoption included use of symposia as a therapy information source, physician experience with paclitaxel to treat late-stage breast cancer, and perceived advantage in efficacy of paclitaxel. CONCLUSION: As new modalities become available to treat cancer, it is vital to understand what factors influence oncologists and patients when choosing to use them. Those parties interested in fostering the adoption of new breast cancer treatments should address features of communication channels (eg, use of symposia), characteristics of new treatments (eg, perceived advantage in efficacy), physicians’ social systems (eg, patient requests), and characteristics of potential adopters (eg, previous experience with the treatment).

Adjuvant chemotherapy and survival outcome in node-negative breast cancer with a 21-gene recurrence score of 26–30

2021 ◽  
Author(s):  
Shi-Ping Yang ◽  
Jia Yao ◽  
Ping Zhou ◽  
Chen-Lu Lian ◽  
Jun Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Recurrence Score ◽  
Tumor Grade ◽  
Early Stage Breast Cancer ◽  
Sensitivity Analyses ◽  
Breast Cancer Patients ◽  
Cancer Specific Survival ◽  
Chemotherapy Patients

Aim: To investigate the benefit of chemotherapy among early-stage breast cancer patients with 21-gene recurrence scores of 26–30. Methods: We identified 3754 patients in the Surveillance, Epidemiology, and End Results database. Results: 57.6% of the patients received adjuvant chemotherapy. Patients with higher tumor grade, larger tumors and younger age were more likely to receive chemotherapy. The receipt of chemotherapy was independently associated with better breast cancer-specific survival than in patients without chemotherapy before (p = 0.016) and after (p = 0.043) propensity score matching. The sensitivity analyses showed that survival gain was pronounced in patients with poorly differentiated or undifferentiated disease. Conclusions: Adjuvant chemotherapy improves the outcome for early-stage breast cancer with 21-gene recurrence score of 26–30, especially for patients with high-grade tumors.

Cognitive Function in Breast Cancer Patients Receiving Adjuvant Chemotherapy

2000 ◽  
Vol 18 (14) ◽  
pp. 2695-2701 ◽  
Author(s):  
Christine B. Brezden ◽  
Kelly-Anne Phillips ◽  
Mohamed Abdolell ◽  
Terry Bunston ◽  
Ian F. Tannock
Keyword(s):  
Breast Cancer ◽  
Cognitive Function ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Standard Dose ◽  
Univariate Analysis ◽  
Menopausal Status ◽  
Mood Disturbance ◽  
Healthy Controls ◽  
Breast Cancer Patients

PURPOSE: Breast cancer patients receiving chemotherapy have complained of difficulties in their ability to remember, think, and concentrate. This study assessed whether there are differences in cognitive function between breast cancer patients treated with standard-dose adjuvant chemotherapy compared with healthy controls. PATIENTS AND METHODS: The High Sensitivity Cognitive Screen and the Profile of Mood States (POMS) were used to assess cognitive function and mood in a group of 107 women. The women consisted of 31 breast cancer patients receiving adjuvant chemotherapy (group A), 40 breast cancer patients who had completed adjuvant chemotherapy a median of 2 years earlier (group B), and 36 healthy controls (group C). RESULTS: Univariate analysis showed statistically significant differences (P = .009) in overall cognitive function scores between groups A and C, with poorer function in patients receiving adjuvant chemotherapy. These differences remained significant (P = .046) when controlling for age, education level, and menopausal status. More patients had moderate or severe cognitive impairment in groups A and B than in controls (P ≤ .002). There were no significant differences in POMS scores between the groups, suggesting that the differences seen in cognitive scores were unlikely to be because of mood disturbance. CONCLUSION: Cognitive differences were observed in breast cancer patients receiving adjuvant chemotherapy compared with healthy controls. These differences did not seem to be caused by significant differences in mood disturbance between the two groups. If confirmed, these results have substantial implications for informed consent, counseling, and psychosocial support of patients receiving adjuvant chemotherapy for breast cancer.

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