Prognostic significance of PI3K pathway (PI3Kp) dysregulation in metastatic breast cancer (MBC) patients (pts).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 566-566
Author(s):  
Alejandro Navarro ◽  
Mafalda Oliveira ◽  
Leticia De Mattos-Arruda ◽  
Gessamí Sánchez-Ollé ◽  
Meritxell Bellet ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pik3ca Mutation ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Disease Recurrence ◽  
First Line ◽  
Free Survival ◽  
Test Kit ◽  
Disease Free

566 Background: PI3Kp dysregulation represents a potential target for therapies that are currently being tested in clinical trials. This observational retrospective study aims to evaluate the prognostic implications of PI3Kp dysregulation in MBC. Methods: MBC pts with PI3Kp status assessment from Sep09 to Sep11 were reviewed. PIK3CA mutation status analyzed in paraffin-embedded tissue by DxS PI3K Mutation Test Kit or Sequenom MassARRAY. PTEN status determined by IHC. PI3Kp status: (a) No dysregulation: PIK3CA wt and PTEN normal; (b) PI3Kp dysregulation: PIK3CA mutation (PIK3CAmut) or PTEN low (HScore≤50). Results: 232 MBC pts screened, median age 49.8 (22.9-83.1) and median MBC lines 4 (1-15). Distribution: HR+/HER2- 99 (43%), HER2+ 52 (22%), triple negative 35 (15%), unclassified 46 (20%). Sites of metastasis: visceral 173 (75%), only skin 10 (4%), only bone 49 (21%). PIK3CA status assessed in 174 pts, 53 (22.8%) bearing a mutation (21 exon9, 32 exon20). PTEN status assessed in 229 pts, PTEN low 61 (26.6%). PI3Kp dysregulation in 103/185 pts (55.6%). Time to progression to first line MBC treatment (TTP) and overall survival after MBC diagnosis (OS) are shown. Disease free survival (DFS) and distant-disease free survival (DDFS) in pts initially diagnosed with early breast cancer (n=193) has also been calculated. Conclusions: These results suggest that PI3Kp dysregulation, either by PIK3CA mutation or PTEN low, does not seem to have impact on disease recurrence, response to first line MBC treatment or overall MBC survival.[Table: see text]

Is It The Time That We Can Depend on Bioscore as a New Staging System in Non-Metastatic Breast Cancer to Predict the Disease-Free Survival?

2021 ◽  
Author(s):  
Rehab Farouk Mohamed ◽  
Donia Hussein Abd El Hameed ◽  
Mohamed Alaa Eldeen Hassan
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Prognostic Value ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Her2 Status ◽  
Free Survival ◽  
Disease Free

Abstract Purpose: Novel molecular characterization of breast cancer with cellular markers has allowed a new classification that offers prognostic value. This study investigates the prognostic value of the Bioscore among non-metastatic breast cancer patients with respect to disease free survival (DFS).Methods: This study included 317 patients with non-metastatic surgically treated breast cancer; they were identified in the period from January 2015 to December 2018 at Clinical Oncology Department of Assiut University Hospital. Many variables were used; pathologic stage (PS), T stage (T), nodal stage (N), grade (G), estrogen receptor (ER), progesterone receptors (PR), and human epidermal growth factor receptor (HER2) status. Univariate & two multivariate analyses were performed to identify which of these variables are associated with disease-free survival (DFS). Results: The only significant factors in the Univariate analysis were PS3, T2, T3, T4, N3, G2, G3, ER -ve, PR -ve, and HER2 –ve. The factors which were significant in the first multivariate analysis; PS3, G3, ER –ve, and in the second one were; T2, T4, N3, G3, and ER –ve. Two sets of models were built to determine the utility of combining variables. Models incorporating G and E status had the highest C-index (0.72) for T+N + G + ER in comparison with (0.69) for (PS+ G + ER) and the lowest AIC (953.01) for T + N + G + E and (966.9) for PS + G + E. Conclusions: This study confirms the prognostic significance of bioscore in non-metastatic breast cancer in concerning DFS.

scholarly journals Weight changes during chemotherapy for breast cancer

2002 ◽  
Vol 120 (4) ◽  
pp. 113-117 ◽  
Author(s):  
Luciano José Megale Costa ◽  
Paulo César Spotti Varella ◽  
Auro del Giglio
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Body Weight ◽  
Weight Gain ◽  
Weight Change ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Weight Changes ◽  
Free Survival ◽  
Disease Free

CONTEXT: Patients receiving adjuvant chemotherapy for breast cancer have a tendency to gain weight. This tendency has determining factors not completely defined and an unknown prognostic impact. OBJECTIVE: To evaluate weight change during chemotherapy for breast cancer in a defined population and to identify its predisposing factors and possible prognostic significance. DESIGN: Observational, retrospective cohort study. SETTING: Private clinical oncology service. PARTICIPANTS: 106 consecutive patients with breast cancer treated between June 1994 and April 2000, who received neoadjuvant (n = 8), adjuvant (n = 74) or palliative (n = 24) chemotherapy. INTERVETION: Review of medical records and gathering of clinical information, including patients’ body weights before treatment and at follow-up reviews. MAIN MEASUREMENTS: Body weight change, expressed as percentage of body weight per month in treatment; role of clinical data in weight change; and influence of weight change in overall survival and disease-free survival. RESULTS: There was a mean increase of 0.50 ± 1.42% (p = 0.21) of body weight per month of treatment. We noted a negative correlation between metastatic disease and weight gain (r = -0.447, p < 0.0001). In the adjuvant and neoadjuvant therapy groups there was a mean weight gain of 0.91 ± 1.19 % (p < 0.00001) per month, whereas in the metastatic (palliative) group, we observed a mean loss of 0.52 ± 1.21% (p = 0.11) of body weight per month during the treatment. We did not observe any statistically significant correlation between weight changes and disease-free survival or overall survival. CONCLUSIONS: Women with breast cancer undergoing adjuvant or neoadjuvant chemotherapy gain weight, whereas metastatic cancer patients will probably lose weight during palliative chemotherapy. Further studies are needed in order to evaluate the prognostic significance of weight changes during chemotherapy.

scholarly journals Rationale and description of a lifestyle intervention programme to achieve moderate weight loss in women with non-metastatic breast cancer: the lifestyle intervention part of the SUCCESS C Study

2020 ◽  
pp. bmjnph-2020-000119
Author(s):  
Dagmar Hauner ◽  
Brigitte Rack ◽  
Thomas Friedl ◽  
Philip Hepp ◽  
Wolfgang Janni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Phase Iii ◽  
Intervention Programme ◽  
Long Term Outcome ◽  
Free Survival ◽  
Disease Free

ObjectiveThere is growing evidence from observational studies that lifestyle factors such as obesity, an unhealthy diet and lack of physical activity are associated with poor long-term outcome in women with breast cancer. The primary objective of the lifestyle modification part of the Simultaneous Study of Docetaxel Based Anthracycline Free Adjuvant Treatment Evaluation, as well as Life Style Intervention Strategies (SUCCESS C) Trial is to investigate the effect of an individualised lifestyle intervention programme aiming at moderate weight loss on disease-free survival in women with HER2/neu-negative breast cancer. Secondary objectives include the effect of the intervention on body weight, cardiovascular risk and quality of life.MethodsThe SUCCESS C Trial is an open-label, multicentre, randomised controlled phase III study using a 2×2 factorial design in women with newly diagnosed HER2/neu-negative intermediate-risk to high-risk breast cancer. The first randomisation served to compare disease-free survival in patients treated with two different chemotherapy regimens (3642 participants). The second randomisation served to compare disease-free survival in patients with a body mass index of 24–40 kg/m² (2292 participants) receiving either a telephone-based individualised lifestyle intervention programme for moderate weight loss or general recommendations for a healthy lifestyle for 2 years. Outcome analyses will be conducted after 5 years of follow-up.PerspectiveThis study will provide information on the efficacy and safety of a comprehensive lifestyle intervention programme on disease-free survival in a large cohort of women with breast cancer. EU Clinical Trials Identifier: 2008-005453-38.

Prognostic Role of Estrogen Receptor Determination in Breast Cancer

1983 ◽  
Vol 69 (6) ◽  
pp. 527-530 ◽  
Author(s):  
Stefano Ciatto ◽  
Patrizia Bravetti ◽  
Gaetano Cardona ◽  
Luigi Cataliotti ◽  
Roberto Crescioli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Recent Literature ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Prognostic Role ◽  
Free Survival ◽  
The Difference ◽  
Disease Free ◽  
Actuarial Method

The authors report on 283 primary, non-metastatic, breast cancer cases consecutively referred after surgery and followed-up from a minimum of 10 months to a maximum of 3.5 years. All cases were studied according to the presence of estrogen receptors (ER). ER presence was correlated with age and menstrual status, with ER+ cases more frequent in older patients. No correlation was found between ER and nodal status. Prognosis was evaluated in terms of disease-free survival at 2 years (actuarial method). No correlation between ER and survival was evident for N– cases, whereas a better prognosis was recorded for ER+N+ patients compared to ER-N+, although the difference was not statistically significant. The observed results are compared with recent literature data and agree with other recent reports, which did not confirm the previously undiscussed statement regarding the prognostic role of ER determination. According to these studies and to the present study, the prognostic role of ER determination seems at least questionable and particularly the postoperative adjuvant treatment of ER-N– cases should be reconsidered.

Prognostic significance of NANOG and KLF4 for breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e12028-e12028
Author(s):  
Takuya Nagata
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Es Cells ◽  
Prognostic Significance ◽  
Embryonic Stem ◽  
Disease Free Survival ◽  
Free Survival ◽  
Strong Expression ◽  
Inducing Factors ◽  
Disease Free

e12028 Background: iPS cell inducing factors (Oct3/4, Sox2, Klf4, c-Myc, and Nanog ) are reported that they appears not only in ES cells(Embryonic stem cell), but also in normal cell or carcinoma cell, including breast carcinoma. We evaluated the expression of iPS inducing factors in the human breast cancer specimen with immunohistochemistry, and analyze the relativity of the relapse and the prognosis after the operation. Methods: 200 cases of breast cancer that were performed the surgical operation in this department were examined. Expression of c-MYC, KLF4, NANOG, OCT4 and SOX2 were determined by immunohistochemistry using a tissue microarray. Results: The average of the patient's age was 55.2 years old (29 - 87), and the advanced breast cancers in stage II or more were 122 cases (61%). About the hormone receptor and the HER2 appearance, Hormone receptor positively (HR+) types were 162 cases (81%), 10 cases (5%) were HER2 positively (HER2+) type, and 28 cases (14%) were triple negative (TN) type. During the following period from operation, the relapse was found in 48 cases (24%), and 18 cases (9%) were died. The average of survival time after the operation was 80.7 months (4 - 162). Patients with strong expression of NANOG had significantly lower disease-free survival and overall survival rates than those with weak expression of NANOG (p=0.004 and P=0.033, respectively). In contrast, patients with strong expression of KLF4 had better disease-free survival (p=0.014). Conclusions: Strong expression of NANOG was an indicator of a poor prognosis for breast cancer patients, while KLF4 was a favorable prognostic indicator. Our results suggest that NANOG stimulates the growth and metastasis of breast cancer cells, whereas KLF4 inhibits these processes.

Incidence and Prognostic Significance of Complete Axillary Downstaging After Primary Chemotherapy in Breast Cancer Patients With T1 to T3 Tumors and Cytologically Proven Axillary Metastatic Lymph Nodes

2002 ◽  
Vol 20 (5) ◽  
pp. 1304-1310 ◽  
Author(s):  
Roman Rouzier ◽  
Jean-Marc Extra ◽  
Jerzy Klijanienko ◽  
Marie-Christine Falcou ◽  
Bernard Asselain ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Primary Chemotherapy ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Distant Disease ◽  
Free Survival ◽  
Disease Free

PURPOSE: To determine the incidence and prognostic significance of eradication of cytologically proven axillary lymph node metastases in breast cancer patients treated with primary chemotherapy. PATIENTS AND METHODS: Between January 1985 and December 1994, 152 breast cancer patients with invasive T1 to T3 tumors and axillary metastases cytologically proven by fine-needle sampling underwent primary chemotherapy followed by lumpectomy or mastectomy, level I and II axillary lymph node dissection, and irradiation. We studied pathologic complete responses (pCRs) of axillary nodes and breast tumors, as well as predictors of distant metastases. RESULTS: Thirty-five patients (23%) had axillary pCRs, and 20 patients (13.2%) had pCRs of primary breast tumors. Scarff-Bloom-Richardson grade 3 tumors (P = .04) and a clinical response to chemotherapy ≥ 50% (P = .003) were associated with negative axillary status at dissection. An initial tumor size ≤ 3 cm (63 patients) was associated with pCR of the primary tumor (P = .02) but not with complete histologic clearance of axillary lymph nodes. The median length of follow-up was 75 months. In the univariate analysis, age greater than 40 years (P = .003), absence of residual nodal disease (P = .01), and pCR of the tumor (P = .05) were associated with better distant disease-free survival. Five-year distant disease-free survival rates were 73.5% ± 14.9% among patients with no involved nodes at the time of surgery and 48.7% ± 9.2% among patients with residual nodal disease. In the multivariate Cox regression analysis, parameters associated with poor distant disease-free survival were age ≤ 40 years (P = .002), persistence of nodal involvement (P = .03), and S-phase fraction greater than 4% (P = .02). CONCLUSION: Our results suggest that axillary status is a better prognostic factor than response of the primary tumor to primary chemotherapy.

Generation of adaptive HER2-specific immunity in HER2 breast cancer patients by addition of trastuzumab to chemotherapy in the adjuvant setting: NCCTG (Alliance) study N9831.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 522-522 ◽  
Author(s):  
Keith L. Knutson ◽  
Edith A. Perez ◽  
Karla V. Ballman ◽  
Courtney L. Erskine ◽  
Nicholas Fox ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Response To Therapy ◽  
Breast Cancer Patients ◽  
Adjuvant Setting ◽  
Free Survival ◽  
Specific Immunity ◽  
Her2 Breast Cancer ◽  
Disease Free

522 Background: In the adjuvant setting, patients with HER2 breast cancer treated with trastuzumab and chemotherapy have superior survival compared to patients treated with chemotherapy alone. We previously showed that trastuzumab and chemotherapy induces HER2-specific antibodies which correlate with response to therapy in patients with HER2+ metastatic breast cancer. It remained unclear from those studies, however, whether the HER2-specific immunity played a role and if antibody immunity was associated with improved disease free survival in the adjuvant setting. In the present study, we addressed these questions by analyzing sera samples from a subset of patients enrolled in the NCCTG adjuvant trial, N9831, which includes an arm (Arm A) in which trastuzumab was not used. Arms B and C received trastuzumab sequentially or concurrently to chemotherapy, respectively. Methods: Pre-and post-treatment initiation sera were obtained from 50 women enrolled in N9831 (22 Arm A; 14 Arm B, and 14 Arm C). Lambda IgG antibodies (to avoid detection of trastuzumab) to HER2 were measured and presented as an index (>0.2 was considered a positive response). Results: Prior to therapy, across all three arms, N9831 patients had similar mean HER2 IgG levels (0.19 units in Arm A, 0.14 in Arm B, and 0.23 in Arm C, P=0.85). Following treatment, the mean levels of antibodies increased in Arm B to 0.35 units and in Arm C to 0.56 units and were higher (p<0.001) than in Arm A where levels did not increase. The proportion of patients who demonstrated antibody immunity increased by 9% in Arm A, 50% in Arm B and 28% in Arm C (P=0.026). Although the event rate was low in this cohort, Cox modeling suggested that larger increases in antibodies were associated with improved disease free survival (HR=0.23; p=0.04). Conclusions: These results show that the increased antibody immunity observed in adjuvant patients treated with combination trastuzumab and chemotherapy is clinically significant and results from the inclusion of trastuzumab. The findings may have important implications for improving treatment outcomes in patients treated with trastuzumab.

scholarly journals The Prognostic Significance of Modified Lymph Node Ratio and LODDS in HER-2(+) Breast Cancer

2021 ◽  
Author(s):  
Fatma Özkan ◽  
Ilkay Tugba Unek ◽  
Olçun Ümit Ünal ◽  
Mustafa Emiroğlu ◽  
Asım Leblebici ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node Ratio ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Risk Groups ◽  
Free Survival ◽  
Node Ratio ◽  
Her 2 ◽  
The Mean ◽  
Disease Free

Objective: The overexpression of human epidermal growht factor-2 (HER-2) receptor is detected in 20% of patients with breast cancer. The prognosis is poor in patients with HER-2(+) breast cancer not receiving systemic therapy. Modified lymph node ratio (mLNR) and log odds of positive lymph nodes (LODDS) are the novel ratio-based classifications of lymph nodes in breast cancer. In literatüre, the data about the prognostic significance of mLNR ve LODDS is limited in patients with HER-2(+) breast cancer. The objective of the study was to evaluate the prognostic significance of mLNR and LODDS in patients with HER-2(+) breast cancer. Method: This study included 75 patients who were treated with adjuvant chemotherapy and trastuzumab for the diagnosis of HER-2(+) breast cancer between 2008-2013. The patients who received neoadjuvant chemotherapy or patients without axillary dissection were excluded from the study. Results: The mean disease-free survival and overall survival were 126.36±4.38 months (range: 117.78-134.95) and 128.87±3.32 months (range: 122.37-135.38), respectively. The mean disease-free survival was 127.30 months in patients with mLNR≤ 0.5 and 118.08 months in patients with mLNR> 0.5 (p=0.690). When the patients were classified into three groups according to LODDS values as LODDS1 (LODDS≤ -1.0), LODDS2 (-1.0<LODDS≤0) and LODDS3 (LODDS>0), the mean disease-free survival were 128.65 months, 114.07 months and 111.78 months, respectively (p=0.641). Conclusion: In this study, patients with HER-2(+) breast cancer were divided into risk groups according to mLNR and LODDS values, and a survival difference that could be clinically meaningful was observed between the groups, but was not statistically significant. There is a need for studies involving more patients on this subject. Our study highlights the prognostic significance of mLNR and LODDS in HER-2(+) breast cancer. Dividing HER-2(+) breast cancer into risk groups through mLNR and LODDS will help clinicians to develop optimal treatment and follow-up strategies.

Clinicopathological significance of Sox10 expression in triple-negative breast carcinoma

2020 ◽  
Author(s):  
Linfang Jin ◽  
Chenglin Qin ◽  
Xiaowei Qi ◽  
Tingting Hong ◽  
Xiaodong Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Invasive Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Free Survival ◽  
Primary Invasive Breast Cancer ◽  
Sox10 Expression ◽  
Disease Free

Abstract Purpose The present study aimed to investigate the Sox10 expression in the pathological diagnosis of triple-negative breast cancer (TNBC). Furthermore, its correlation with the clinicopathological characteristics and disease-free survival rate in patients with TNBC was also evaluated to identify the diagnostic utility of Sox10 as a reliable biomarker for diagnosis and prognosis of TNBC. Methods Using immunohistochemistry, we identified the expression of Sox10, GATA-3, FOXA1, GCDFP15 and MGB in 376 cases of primary invasive breast cancer, and 77 cases of metastatic breast cancer. The expression of Sox10 in different molecular subtypes of primary invasive breast cancer and metastatic breast cancer were also compared. Furthermore, the correlation between Sox10 expression and clinicopathological parameters and disease-free survival (DFS) of patients with primary TNBC were also analyzed. Results Expression of Sox10 was only detected in the myoepithelial cells of normal breast, but not in any other types of cells, including luminal cell and fibroblasts. The positive rate of Sox10 in primary and metastatic TNBC was significantly higher than that in the other two types (P < 0.001, P < 0.001, respectively). The sensitivity and specificity of Sox10 expression in primary TNBC and metastatic TNBC were significantly lower than GATA-3, significantly higher than FOXA1, GCDFP15, and MGB (P < 0.001, P = 0.0004, P = 0.0064, P = 0.0229, respectively). In 71 cases of primary TNBC, a higher expression rate of Sox10 was significantly associated with high-grade tumors, late-stage tumors, and tumors with involvement of four or more lymph node metastases (P = 0.0145, P = 0.0105, P = 0.0249, respectively). Conclusion Sox10 may be used as a novel reliable putative marker for the diagnosis of TNBC. Notably, Sox10 combined with GATA-3 expression may serve as a supplementary differential diagnostic biomarker for primary and metastatic TNBC. Besides, Sox10 may be a good predictor of the prognosis of primary and metastatic TNBC. This study also highlights the significance of targeting Sox10 as a promising potential therapeutic target gene for TNBC therapy.

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