Factors affecting survival in upfront metastatic breast carcinoma patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11540-e11540
Author(s):  
Ummugul Uyeturk ◽  
Burcin Budakoglu ◽  
Ibrahim Turker ◽  
Kaan Helvaci ◽  
Ozlem Uysal Sonmez ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Survival Data ◽  
Ductal Carcinoma ◽  
Performance Status ◽  
Menopausal Status ◽  
Metastatic Breast ◽  
Her2 Status ◽  
Her2 Positive ◽  
Factors Affecting ◽  
Metastatic Breast Carcinoma

e11540 Background: Metastatic breast cancer is a heterogenous disease. There are several subgroups according to pathological, biological and molecular behaviours of the tumor. Recurrent metastatic breast carcinoma (RMBC) and upfront metastatic breast carcinoma (UMBC) may differ according to clinical and prognostic characteristics. Intrinsic genetic heterogeneity may be responsible for these differences. To date, little is known about the clinical features and outcome of patients with UMBC. Methods: Patients were considered to have UMBC if patients were admitted to the clinics with stage IV disease. Patients were considered to have RMBC if metastases had developed during followup for localized breast carcinoma. Between September 2007 and May 2011, 102 of 2478 (4.1%) UMBC patients who was admitted to Department of Medical Oncology Clinic, was included in this retrospective trial. Patients’ characteristics, treatment schedules and survival data were evaluated. Results: All patients were female. Median age was 50.0 (range: 26-90). More than half of patients (58.8%) were postmenopausal. Frequent histological type was invasive ductal carcinoma (89.2%). Most of the patients had grade 3 (57.8%) tumor. Hormone receptor (HR) and HER2 positivity were76.5% and 42.2%, respectively. Metastatic sites were visceral, isolated bone-soft tissue and combination in 20%, 42% and 37%, respectively. Most of visceral metastatic patients were HR negative and HER2 positive. Median PFS and OS were 30 and 66 months, respectively. Both PFS and OS were affected from HR status, HER2 status, sites of metastatic disease and chemotherapy (log-rank p=0.006, 0.04, 0.02, 0.004, 0.03 and log-rank p= 0.04, 0.04, 0.01, 0.03, 0.01 respectively). Both PFS and OS were not affected by age, menopausal status, performance status, histology and grade of the tumor. OS were longest in patients group who received chemotherapy (76 months) and shortest in patients group who received chemotherapy and targeted therapy combinations (23 months). Conclusions: Factors affecting survival were comparable to previous studies in UMBC patient population similiar to results RMBC studies. This finding should be confirmed with prospective trials in larger study populations.

scholarly journals 945 Characterization of the immune landscape of malignant pleural effusion composition from patients with metastatic breast carcinoma: a pilot study

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A993-A994
Author(s):  
Caddie Dy Laberiano ◽  
Edwin Parra ◽  
Qiong Gan ◽  
Heladio Ibarguen ◽  
Shanyu Zang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Ductal Carcinoma ◽  
Cytotoxic T Cells ◽  
Metastatic Breast ◽  
Absolute Number ◽  
List Type ◽  
Clinicopathologic Features ◽  
Metastatic Breast Carcinoma ◽  
Promising Tool

BackgroundBreast cancer(BC) is the second most common cause after lung cancer of malignant pleural effusions(MPEs),in approximately one third of all MPEs.Although,MPEs are relativity easy to be collated are still not well characterized in their cellular compositions. This opens new avenues to characterize the cellular milieu comprising the MPE, as it has the potential to be highly informative about mutational markers and immune response –ultimately guiding targeted therapy and predicting therapeutic outcomes with their study. The proposed study will characterize immune landscape of the cellular composition of MPE from patients with metastatic breast carcinoma and characterize their relationship with clinicopathologic features in these patients.Abstract 945 Figure 1Comparison between the cell block in H-E and mIF expression CK, CD68 and CD3Abstract 945 Figure 2Composite image in mIF expressing 8 markers. In higher magnification is possible to observe the co expression of CK+Ki67+, CK PDL1, CD3+Foxp3+ and CD3+CD8+Abstract 945 Table 1Results: cell phenotypes in percentage in the six cases analyzedAbstract 945 Table 2Clinical data of the six patients. L: left . R: right , BR : Breast cáncer, CRC: Colorrectal cáncer, NE: No evaluable , IDC : Invasive ductal carcinoma , CT: chemotherapy and BT : biotherapy* Last appointment of the patient.MethodsFive microns thickness paraffin cell pellet blocks from six cases randomly selected of breast carcinoma MPE were stained using a quantitative multiplex immunofluorescence(mIF) panel containing 8 markers against pancytokeratin(CK), PD-L1, PD-1, CD3, CD8, Foxp3, CD68, Ki67, and DAPI (figure 1). Representative regions of interest were scanned using a multispectral scanner (Vectra Polaris) in high magnification (20x) to capture different cell populations. Markers co-expression were processed and analyzed using a quantitative image analysis software (InForm). The final results were obtained as absolute number of cells from each phenotype and were characterized with clinicopathologic features.ResultsWe analyzed and stained six breast cancer MPE cases with previously optimized and validated mIF panel for formalin fixed and paraffin embedded (FFPE) tumor tissues against CK, CD3, CD68, CD8, Foxp3, Ki67, PD1 and PD-L1 (figure 2). The median cellular density was 5870.53 cells. Median for each marker: CK+ was presented in 75.9% (between malignant cells and reactive mesothelial cells) in these cells the expression of Ki67 was 8% and PD-L1+ was present in 0.2%.CD3+ was 0.72% and being the cytotoxic T-cells CD3+CD8+ was 12.13% of these cells and it expression for CD3+PD1+ was in 1.14% without concomitant expression for PD-L1. The median of the macrophages CD68+ was 8.1% of the total cells (table 2).ConclusionsmIF is a promising tool to study diverse corporal effusion from different origin. Although more studies are needed, this new perspective can help us to resolve some clues and possible prognosis in advanced stages of BC.ReferenceNicholas D T, Matthew A. S. Diagnosis and Management of Pleural Metastases and Malignant Effusion in Breast Cancer.En: Kirby I B, Edward M C, V. Suzanne K, William J. G. The Breast (Fifth Edition): Elsevier; 2018. P 934.

Comparison of Radiation With or Without Concurrent Trastuzumab for HER2-Positive Ductal Carcinoma In Situ Resected by Lumpectomy: A Phase III Clinical Trial

2021 ◽  
pp. JCO.20.02824
Author(s):  
Melody A. Cobleigh ◽  
Stewart J. Anderson ◽  
Kalliopi P. Siziopikou ◽  
Douglas W. Arthur ◽  
Rachel Rabinovitch ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Menopausal Status ◽  
Eastern Cooperative Oncology Group ◽  
Phase Iii ◽  
Her2 Status ◽  
P Value ◽  
Her2 Positive

PURPOSE Preclinical studies report that trastuzumab (T) can boost radiotherapy (RT) effectiveness. The primary aim of the B-43 trial was to assess the efficacy of RT alone vs concurrent RT plus T in preventing recurrence of ipsilateral breast cancer (IBTR) in women with ductal carcinoma in situ (DCIS). PATIENTS AND METHODS Eligibility: Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1, DCIS resected by lumpectomy, known estrogen receptor (ER) and/or progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) status by centralized testing. Whole-breast RT was given concurrently with T. Stratification was by menopausal status, adjuvant endocrine therapy plan, and nuclear grade. Definitive intent-to-treat primary analysis was to be conducted when either 163 IBTR events occurred or all accrued patients were on study ≥ 5 years. RESULTS There were 2,014 participants who were randomly assigned. Median follow-up time as of December 31, 2019, was 79.2 months. At primary definitive analysis, 114 IBTR events occurred: RT arm, 63 and RT plus T arm, 51 (hazard ratio [HR], 0.81; 95% CI, 0.56 to 1.17; P value = .26). There were 34 who were invasive: RT arm, 18 and RT plus T arm, 20 (HR, 1.11; 95% CI, 0.59 to 2.10; P value = .71). Seventy-six were DCIS: RT arm, 45 and RT plus T arm, 31 (HR, 0.68; 95% CI, 0.43 to 1.08; P value = .11). Annual IBTR event rates were: RT arm, 0.99%/y and RT plus T arm, 0.79%/y. The study did not reach the 163 protocol-specified events, so the definitive analysis was triggered by all patients having been on study for ≥ 5 years. CONCLUSION Addition of T to RT did not achieve the objective of 36% reduction in IBTR rate but did achieve a modest but statistically nonsignificant reduction of 19%. Nonetheless, this trial had negative results. Further exploration of RT plus T is needed in HER2-positive DCIS before its routine delivery in patients with DCIS resected by lumpectomy.

Primary results of NRG Oncology / NSABP B-43: Phase III trial comparing concurrent trastuzumab (T) and radiation therapy (RT) with RT alone for women with HER2-positive ductal carcinoma in situ (DCIS) after lumpectomy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 508-508
Author(s):  
Melody A. Cobleigh ◽  
Stewart J. Anderson ◽  
Kalliopi P. Siziopikou ◽  
Douglas W Arthur ◽  
Thomas B. Julian ◽  
...  
Keyword(s):  
Ductal Carcinoma ◽  
Performance Status ◽  
Menopausal Status ◽  
Phase Iii ◽  
P Value ◽  
Primary Analysis ◽  
Her2 Positive ◽  
Ecog Performance Status ◽  
Intent To Treat

508 Background: Preclinical studies report that T can boost RT effectiveness. The primary aim of this trial assessed the efficacy of concurrent T + RT vs RT alone in preventing recurrence of ipsilateral breast cancer, ipsilateral skin cancer, or ipsilateral DCIS (IBTR) in women with DCIS. Methods: Eligibility: Women ≥18 yrs, ECOG performance status 0 or 1, DCIS resected by lumpectomy, and clear margins. Whole-breast RT after randomization was with 25+ fractions or accelerated with 16-17 fractions. RT boost was allowed. Centralized HER2 testing and ER and/or PR were required before entry. Stratification was by menopausal status, adjuvant endocrine therapy plan, and nuclear grade. T was given at 8 mg/kg IV within 1 wk before and 5 days after RT began (Dose 1) and at 6 mg/kg IV 3 wks after Dose 1 (Dose 2). Definitive intent-to-treat primary analysis was to be conducted when either 163 IBTR events were recorded or when all accrued pts were on study for ≥5 yrs. Results: 2014 pts were randomized (11/9/08 to 12/8/14);1998 (99.2%) had follow-up information. Median follow-up time on 12/31/19 was 79.2 mos. 2001 pts had RT information, 1965 (98.2%) completed RT: 988 (98.3%) in the RT arm and 977 (98.1%) in the RT+T arm. 996 pts had T compliance information in the RT+T arm, 939 (94.3%) completed two doses of T, 25 (2.5%) had one dose of T, and 32 (3.2%) did not receive T. At primary definitive analysis, 114 IBTR events occurred: 63 in the RT arm and 51 in the RT+T arm (HR = 0.81 [95% CI: 0.56-1.17], p-value = 0.26). 38 were invasive: 18 in the RT arm and 20 in the RT+T arm (HR = 1.11 [95% CI: 0.59-2.10], p-value = 0.74). 76 were DCIS: 45 in the RT arm and 31 in the RT+T arm (HR = 0.68 [95% CI: 0.43-1.08], p-value = 0.10). Annual IBTR event rates were 0.99%/yr in the RT group and 0.80%/yr in the RT+T group. There were 288 events of any kind [iDFS-DCIS] (DFS): 155 in the RT arm and 133 in the RT+T arm (HR = 0.84 [95% CI: 0.66-1.05], p-value = 0.13) and 48 deaths: 26 in the RT arm and 22 in the RT+T arm (OS HR = 0.85 [95% CI: 0.48-1.51], p = 0.59). The study did not reach the 163 protocol-specified events, so the definitive analysis was triggered by all pts having been on study for ≥5 years. Conclusions: The addition of T to RT did not achieve the protocol objective of 36% reduction in the IBTR rate but did achieve a modest, statistically non-significant reduction of 19%. Support: U10-180868, -180822, UG1-189867; Genentech. The authors thank Elaina Harper and Marlon Jones for data management. Clinical trial information: NCT00769379 .

scholarly journals Patient with metastatic breast cancer, HER2-positive, trastuzumab- and pertuzumab-resistant responding to lapatinib

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 66-68
Author(s):  
Daniela Cianniello ◽  
Roberta Caputo
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Breast Carcinoma ◽  
Tyrosine Kinase ◽  
Tyrosine Kinase Inhibitor ◽  
Kinase Inhibitor ◽  
Hepatic Metastases ◽  
Metastatic Breast ◽  
Her2 Positive ◽  
Metastatic Breast Carcinoma

Lapatinib is an intracellular tyrosine kinase inhibitor of EGFR (ErbB1) and HER2 (ErbB2) receptors, approved for the treatment of metastatic breast carcinoma pre-treated with anti-HER2 antibodies. We report the case of a 60-year-old woman diagnosed with metastatic breast neoplasm, HER2-positive, progressing after treatment with trastuzumab, pertuzumab and T-DM1, who obtained a regression of hepatic metastases after treatment with lapatinib-capecitabine (Oncology).

Metastatic breast carcinoma in pleural fluid: Correlation of receptor and HER2 status with the primary carcinoma-a pilot study

2016 ◽  
Vol 44 (12) ◽  
pp. 980-986 ◽  
Author(s):  
Issam M. Francis ◽  
Preeta Alath ◽  
Sara S. George ◽  
Mohammed Jaragh ◽  
Ayesha Al Jassar ◽  
...  
Keyword(s):  
Pilot Study ◽  
Breast Carcinoma ◽  
Pleural Fluid ◽  
Metastatic Breast ◽  
Primary Carcinoma ◽  
Her2 Status ◽  
Metastatic Breast Carcinoma

Folate Receptor Alpha Immunohistochemistry in Cytology Specimens of Metastatic Breast Carcinoma

2015 ◽  
Vol 59 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Umer N. Sheikh ◽  
Cynthia Cohen ◽  
Momin T. Siddiqui
Keyword(s):  
Breast Carcinoma ◽  
Clinical Significance ◽  
Ductal Carcinoma ◽  
Folate Receptor ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Breast Cancers ◽  
Folate Receptor Alpha ◽  
Metastatic Breast Carcinoma ◽  
Receptor Alpha

Background: Folate receptor alpha (FRA) is involved in folate accumulation and utilization, and is expressed in varying proportions in breast, ovary and parotid epithelial cells, among others. FRA overexpression by immunohistochemistry (IHC) has been shown in estrogen/progesterone receptor (ER/PR)-negative carcinoma (40-74%) and in triple-negative breast carcinoma (TNBC; 50-86%) in histological specimens of primary breast cancers. We assessed the feasibility of IHC in detecting FRA expression and its patterns and clinical significance in metastatic TNBC in fine-needle aspiration (FNA) cell blocks (CBs). Materials and Methods: Metastatic breast ductal carcinoma cases were retrospectively immunostained with FRA IHC on FNA CBs. FRA staining was scored qualitatively (+/-), by intensity (0-3) and by staining area (0-100%). Of these metastatic cases, a subset of primary breast carcinoma cases was also immunostained with FRA. The results were correlated with ER, PR and human epidermal growth factor receptor 2 (Her2/Neu) performed by routine IHC. Results: A total of 40 FNA CBs with metastatic disease were studied, including hormone (ER/PR) positive (n = 5), triple positive (n = 5), Her2/Neu-only positive (n = 5) and TNBC (n = 25). FRA IHC showed immunoreactivity with moderate positivity in only 1 (4%) TNBC. All the remaining 39 cases were negative for FRA expression. Five cases of primary TNBC were stained with FRA IHC and were negative for FRA expression. Conclusions: Our data suggest that FRA expression by IHC was rarely associated with ER/PR-negative tumors relative to ER/PR-positive tumors and, more importantly, with TNBC in FNA CBs. This finding may have a clinical significance and prognostic implications in metastatic breast carcinoma. Furthermore, 5 primary TNBC cases did not overexpress FRA by IHC. Hence, antifolate receptor therapies do not appear to be clinically relevant in TNBC based on immunostaining of FNA CBs of metastatic breast cancers.

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