First results of a prospective registry in unresectable locally advanced or metastatic breast cancer patients: GEICAM/2014-03 (RegistEM).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1077-1077
Author(s):  
Carlos Jara ◽  
Isabel Alvarez ◽  
Mireia Margeli Vila ◽  
Cesar Augusto Rodriguez ◽  
Purificacion Martinez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Advanced Disease ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Primary Breast Tumor ◽  
Luminal A ◽  
Luminal B ◽  
First Diagnosis

1077 Background: In Spain there is limited prospective data for unresectable locally advanced breast cancer (ULABC) or metastatic breast cancer (MBC) patients (pts) treated as per clinical practice. RegistEM study will provide epidemiological, pathological and clinical data, including treatments given for different disease stages. Understanding the real distribution of the different BC subtypes is the primary objective. Methods: This is a non-interventional cohort study enrolling approximately 1,400 pts with advanced disease diagnosed from January 2016 to December 2018, either after recurrence or as first diagnosis, in 38 Spanish sites. Biological samples (primary tumor, metastatic lesions, blood) are currently being collected. In this first analysis, we include 489 pts who met study criteria before October 31, 2017. All data are described in two subgroups: on the most recent tumor lesion or on the primary breast tumor. Results: At first diagnosis, 67.9%, 31.5% and 0.6% of pts had early BC (EBC), MBC and ULABC, respectively. In the total analysis population, median age at diagnosis of advanced disease was 59.6 years, most of pts were white (98.2%), female (99.4%) and postmenopausal (70%). Family history of BC and ovarian cancer was reported in 5.7% pts. In ~390 pts BC clinical subtypes distribution was luminal B(HER2-)-like (~55%), luminal B(HER2+)-like (~16%), luminal A-like or triple negative (TN) (~10% each) and HER2 enriched-like (~8%). Median time to recurrence (years) in EBC pts was: luminal A-like 5.8, luminal B(HER2-)-like 5.1, luminal B(HER2+)-like 3.9, HER2 enriched-like 2.7 and TN 1.7. Bone (59%), visceral (58%) and lymph node (27%) lesions were the most frequent metastatic locations. The two most frequent therapies in first line consisted in: endocrine therapy (ET) (47%) and ET+biological therapy (BT) (29%) for luminal A-like; ET (32%) and ET+BT (32%) for luminal B(HER2-)-like; chemotherapy (CT)+ET+BT (43%) and CT+BT (24%) for luminal B(HER2+)-like; CT+BT (68%) and CT (16%) for HER2 enriched-like; CT (59%) and CT+BT (34%) for TN. Conclusions: These first data confirm that luminal B (HER2-)-like subtype is the most predominant in MBC.

Association between molecular subtype of local advanced breast cancer with Ca 15-3 level

2021 ◽  
pp. 1-4
Author(s):  
Dony Ruswendro ◽  
Salman Ardi Syamsu ◽  
Rudy Thabry ◽  
Arifin Seweng ◽  
Andi Nilawati Usman
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Tumor Marker ◽  
Molecular Subtypes ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Tissue Growth ◽  
Advanced Breast ◽  
Luminal A ◽  
Luminal B

BACKGROUND: Neoplasm is an abnormal mass of tissue that grows excessively and not coordinated with normal tissue growth and continues to do so even though the stimulation that triggered the change has stopped. Breast cancer can be known by using tumor marker, which has been used is mucin-like glycoprotein Carcinoma Antigen (CA 15-3) which is a tumor marker that is specific to breast cancer. METHOD: This study is a cross-sectional study to determine the association between molecular subtypes of locally advanced breast cancer with CA 15-3 level at Abdul Wahab Sjahranie Samarinda Hospital. The population in this study were all breast cancer patients that were confirmed by histopathological examination. RESULTS: A total of 75 patients were included for this study, 29 patients (38.7%) known as Overexpression HER2, 18 patients (24.0%) were Luminal B with HER2 (+), 11 patients (14.7%) were Luminal B with HER2 (−), 11 patients (14.7%) were Basal-like/TNBC, and 6 patients (8,0%) were Luminal A. From the ANOVA test, the value of p = 0.045 (p < 0.05) means there was an association between Ca 15-3 level and molecular subtypes in patients with locally advanced breast cancer at the Abdul Wahab Sjahranie Hospital in Samarinda 2017. In this study Ca 15-3 levels were obtained on average for Luminal A 16.98 U/mL, Luminal B with HER2 (−) 42.41 U/mL, Luminal B with HER2 (+) 73.75 U/mL, Overexpression HER2 47.73 U/mL, and Basal Like /TNBC 63.50 U/mL. CONCLUSION: Statistically, it was found that there was an association between Ca 15-3 levels and molecular subtypes in patients with locally advanced breast cancer at the Abdul Wahab Sjahranie Hospital in Samarinda 2017.

scholarly journals The Relationship between Recurrence Rate and Molecular Subtypes of Breast Cancer in Locally Advance Breast Cancer (LABC) Post Mastectomy: Focus on Comparison of Luminal A and Luminal B

2021 ◽  
Vol 5 (4) ◽  
pp. 877-881
Author(s):  
Eric Hartoyo Salim ◽  
Eddy Herman Tanggo ◽  
Dwi Hari Susilo
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Recurrence Rate ◽  
Molecular Subtype ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Luminal A ◽  
Luminal B ◽  
The Relationship

Background. Breast cancer is the highest prevalence of malignancy for women in Indonesia and important national health problem. Estimated 2 million women developed breast cancer in 2018 with a mortality rate of 14.1 in every 100,000 women. Regarding the relationship between subtypes and breast cancer recurrence Several studies on gene expression have shown several subtypes of breast cancer, including the two most important subtypes, estrogen receptor (ER) positive (Luminal A and Luminal B) and ER negative (Triple negative and Her2 positive). Based on the explanation above, currently there is no data in Soetomo Hospital that discusses the role of breast cancer subtypes as a prognostic factor in determining the recurrence rate in locally advanced breast cancer.Methods. The research design is an associative test using a retrospective cohort observational analytical study design, associating the relationship between tumor subtypes with recurrence in locally advanced breast cancer patients after mastectomy and has received additional therapy according to standard procedures at Dr. Soetomo Surabaya This study used secondary data from the medical records of the Oncology Polyclinic, RSUD Dr. Soetomo Surabaya from 2014 to 2019.Results. The research subjects who have been selected according to inclusion criteria are 214 people, with the proportion in the population of luminal A and luminal B subtypes of 107 people each. Based on this study, it was found that the subtype was positively correlated with recurrence in LABC patients who had undergonecmastectomy with a significance value of p = 0.000 (p <0.05; 99% CI).Conclusion. There is a relationship between the recurrence rate and the molecular subtype of breast cancer in locally advanced breast cancer (LABC) patients after mastectomy at Dr Soetomo Hospital.

scholarly journals Real-world treatment of patients with palbociclib for HR+/HER2-advanced/metastatic breast cancer: the Europe IRIS study

2021 ◽  
Author(s):  
Katie Mycock ◽  
Lin Zhan ◽  
Kieran Hart ◽  
Gavin Taylor-Stokes ◽  
Gary Milligan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Real World ◽  
Clinical Characteristics ◽  
Low Dose ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Survival Rates ◽  
Metastatic Breast ◽  
Kaplan Meier

Aim: To report the Europe Ibrance Real World Insights study findings. Methods: Physicians abstracted demographic/clinical characteristics, treatment and outcomes data for women with HR+/HER2- locally advanced breast cancer (ABC) or metastatic  breast cancer (MBC) receiving palbociclib + aromatase inhibitor (AI) or palbociclib + fulvestrant. Kaplan–Meier analysis estimated progression-free rates (PFRs) and survival rates (SRs). Results: 238 physicians abstracted data for 1723 patients. For patients (>90%) initiating at 125 mg/day, dose was reduced in 18.9% of palbociclib + AI and 12.3% of palbociclib + fulvestrant patients. At 12 months, PFR for palbociclib + AI was 88.1%, and SR was 97.3%; PFR for palbociclib + fulvestrant was 79.8%, and SR was 97.5%. Conclusion: Low dose-reduction rates and favorable PFRs and SRs suggest that palbociclib + AI/fulvestrant is well tolerated and effective for HR+/HER2– ABC/MBC in real-world clinical practice.

Correlate effects of local therapy for the primary tumor in metastatic breast cancer at diagnosis with molecular subtypes.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11502-e11502
Author(s):  
Fatima Zahra Hijri ◽  
Samia Arifi ◽  
Sami Aziz Brahmi ◽  
Nezar Bouyahia ◽  
Zineb Benbrahim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Primary Tumor ◽  
Molecular Subtypes ◽  
Metastatic Breast ◽  
Local Therapy ◽  
Axillary Lymph ◽  
Luminal A ◽  
Her2 Positive ◽  
Luminal B

e11502 Background: Few studies demonstrated that surgical resection of the primary tumor in patients with metastatic breast cancer at diagnosis is associated with significant improvement of survival. The aim of this study is to evaluate the correlation impact of local surgery in metastatic breast cancer at diagnosis with molecular subtypes. Methods: A retrospective study was conducted from 2007 to 2011 in our institution, of all stage IV breast cancer patients; who undergo breast surgery. Clinical , tumor characteristics, molecular subtypes, prognostic factors, therapeutic results data were analyzed. Results: We selected 59 cases. The mean age was 36 years (range: 22-44). 55 % women presented with locally advanced breast cancer with 13% T4 d . All patients underwent mastectomy except 4 who underwent conservative surgery .41 patients had axillary lymph node dissection. 63% were luminal A, 17% were luminal B, 7% were Her2-positive and 13% were basal-like . All patients received anthracycline based regimen and only 33% received taxanes. Loco regional radiotherapy (RT) was given to 6 women. Average follow-up was 13 months: - 20 patients represented partial response : 15 patients in luminal A , 3 patients in luminal B ,1 patients in basal-like and 1 patient in HER2-positive. - 11 patients (19%) were stable : 9 patients in luminal A and 2 patient in luminal B . -24 patients represented a progressive disease including 11 patients presented locoregional recurrence : 75 % in HER-positive, 40 % in basal-like, 50% in luminal B and 30% in luminal A (p=0.4). - 4 patients died in basal-like. The median local recurrence-free survival was 19 months and the median progression-free survival was 20 months. The local relapse is less observed in patients who: have a small tumor size (p = 0.003), had axillary lymph node dissection (p = 0.02) and loco regional radiotherapy (p = 0.03). The metastatic progression is less observed in patients with small tumor size (p = 0.01). Conclusions: Local Therapy of the primary tumor improves local control of disease, particularly in women with Small tumors. However, no significant correlation between impact of locale therapy and Molecular Subtypes was observed.

Prognostic biomarker candidates of neoadjuvant chemotherapy for luminal B-positive locally advanced breast cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12638-e12638
Author(s):  
Zhaoyun Liu ◽  
Jinjin Wang ◽  
Chenxi Yuan ◽  
Zhiyong Yu ◽  
Wendy Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Advanced Breast ◽  
Luminal A ◽  
Her2 Positive ◽  
Luminal B

e12638 Background: In the last decade, the treatment approach for locally advanced breast cancer (BC) patients has partly shifted from adjuvant treatment to neoadjuvant treatment. Systemic neoadjuvant treatment can downstage the tumor for less extensive surgery and improve cosmetic outcomes. Differential subtypes of BC responded unevenly to neoadjuvant chemotherapy. Luminal B type with the relatively higher prevalence (40% in all 4 subtypes) had better therapeutic effect to neoadjuvant treatment than luminal A type, but worse than HER2-positive patients. Methods: We enrolled 87 BC patients for genotyping with multiple cancer-related genes. Among them, 17 patients were luminal A, 21 were HER2-negative luminal B, 23 were HER2-positive luminal B, 17 were HER2-positive and 9 were triple-negative. According to the RECIST, the patients were divided into 1-4 and 5 grades. Fisher test was used to analyze the difference of SNV and CNV between the two primary tumors, as well as TMB difference between post-neoadjuvant chemotherapy and past-neoadjuvant chemotherapy. Results: Base mutations in all patients showed discrepant preference between 1-4 grades and 5 grade groups, G-to-A in 1-4 grades, while A-to-G, A-to-T and G-to-T in 5 grade. In luminal B group (combine liminal B-negative and luminal B-positive groups), FLT4 gene mutation occurred more frequent in 5 grade than 1-4 grades (4/16 vs 0/28, P = 0.01). CNV analysis in NFKBIA and ZNF217 distinguished the two therapeutic efficiency groups in luminal B-positive group. The amplification of NFKBIA and ZNF217 was higher in 1-4 grades than 5 grade (8/14 vs 1/9, P = 0.036; 9/14 vs 1/9, P = 0.017). TMB difference between post and past neoadjuvant chemotherapy in luminal B-positive group was also significant in 5 grade (4.36 vs 1.99, P = 0.002). Conclusions: NFKBIA and ZNF217 amplification notably differentiated the 1-4 grades and 5 grade groups in luminal B-positive patients, suggesting the potential prognostic biomarkers of neoadjuvant chemotherapy in this locally advanced breast cancer subtype, which would be improved by further large-scale cohort study. The differences of TMB and FLT4 gene mutation were also found between the two therapeutic efficiency groups.

scholarly journals Feasibility Trial of Letrozole in Combination With Bevacizumab in Patients With Metastatic Breast Cancer

2010 ◽  
Vol 28 (4) ◽  
pp. 628-633 ◽  
Author(s):  
Tiffany A. Traina ◽  
Hope S. Rugo ◽  
James F. Caravelli ◽  
Sujata Patil ◽  
Benjamin Yeh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Endocrine Therapy ◽  
Stable Disease ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Phase Iii ◽  
Feasibility Trial ◽  
Anti Vegf

Purpose Preclinical models suggest that the use of anti–vascular endothelial growth factor (anti-VEGF) therapy with antiestrogens may prevent or delay the development of endocrine therapy resistance. We therefore performed a feasibility study to evaluate the safety of letrozole plus bevacizumab in patients with hormone receptor–positive metastatic breast cancer (MBC). Methods Patients with locally advanced breast cancer or MBC were treated with the aromatase inhibitor (AI) letrozole (2.5 mg orally daily) and the anti-VEGF antibody bevacizumab (15 mg/kg intravenously every 3 weeks). The primary end point was safety, defined by grade 4 toxicity using the National Cancer Institute Common Toxicity Criteria, version 3.0. Secondary end points included response rate, clinical benefit rate, and progression-free survival (PFS). Prior nonsteroidal AIs (NSAIs) were permitted in the absence of progressive disease. Results Forty-three patients were treated. After a median of 13 cycles (range, 1 to 71 cycles), select treatment-related toxicities included hypertension (58%; grades 2 and 3 in 19% and 26%), proteinuria (67%; grades 2 and 3 in 14% and 19%), headache (51%; grades 2 and 3 in 16% and 7%), fatigue (74%; grades 2 and 3 in 19% and 2%), and joint pain (63%; grades 2 and 3 in 19% and 0%). Eighty-four percent of patients had at least stable disease on an NSAI, confounding efficacy results. Partial responses were seen in 9% of patients and stable disease ≥ 24 weeks was noted in 67%. Median PFS was 17.1 months. Conclusion Combination letrozole and bevacizumab was feasible with expected bevacizumab-related events of hypertension, headache, and proteinuria. Phase III proof-of-efficacy trials of endocrine therapy plus bevacizumab are in progress (Cancer and Leukemia Group B 40503).

scholarly journals Blood levels of growth and progression factors in patients with locally advanced breast cancer during neoadjuvant chemotherapy

2021 ◽  
Vol 2 (3) ◽  
pp. 6-12
Author(s):  
E. M. Frantsiyants ◽  
N. Yu. Samaneva ◽  
L. Yu. Vladimirova ◽  
A. E. Storozhakova ◽  
E. A. Kalabanova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Blood Levels ◽  
Luminal A ◽  
Luminal B ◽  
Tnf Α

Purpose of the study. An analysis of blood levels of TGF-β, TGFR2, TNF-α, TNF-αR1, TNF-αR2, CD44 and MMP9 in patients with various biological subtypes of breast cancer receiving neoadjuvant chemotherapy.Materials and methods. This article presents an analysis of levels of growth and progression factors (TGF-β, TGFR2, TNF-α, TNF-αR1, TNF-αR2, CD44 and MMP9) in the blood of 162 patients with various biological subtypes of locally advanced breast cancer receiving 8 cycles of neoadjuvant chemotherapy.Results. Levels of TGF-β, TGFR2, TNF, TNF-α, TNFR1, TNFR2, CD44, MMP9 in patients with all BC subtypes were high before the treatment. After chemotherapy cycles, the values decreased statistically significantly in all BC subtypes: CD44 decreased by 25.2 %, 30 % and 54.7 % in luminal A, luminal B and TNBC, respectively; TNFα– by 26.2 %, 48.3 % and 50.8 %, respectively; TNFα-R1 – by 52.1 %, 39.2 % and 50.3 % respectively; TNFα-R2 – by 31.7 %, 32.8 % and 41.9 % respectively; MMP9 – 35.3 %, 32.6 % and 43.3 % respectively.Conclusions. We identified a combination of growth and progression factors which determines the chemotherapy sensitivity and resistance in all subtypes of breast cancer; so, a decline in the levels of TGF-β, TNFα, MMP9 and CD44 after neoadjuvant chemotherapy predicts further remission for at least 3 years. On the contrary, stabilization or an increase of these indicators leads to the early tumor progression.

scholarly journals Network meta-analysis of eribulin versus other chemotherapies used as second- or later-line treatment in locally advanced or metastatic breast cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qi Zhao ◽  
Rachel Hughes ◽  
Binod Neupane ◽  
Kristin Mickle ◽  
Yun Su ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Metastatic Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Free Survival

Abstract Background Eribulin mesylate (ERI; Halaven®) is a microtubule inhibitor approved in the United States for metastatic breast cancer patients with at least two prior chemotherapy regimens for metastatic breast cancer, and in the European Union in locally advanced breast cancer or metastatic breast cancer patients who progressed after at least one chemotherapy for advanced disease. This network meta-analysis compared the efficacy and safety of ERI versus other chemotherapies in this setting. Methods Systematic searches conducted in MEDLINE, Embase, and the Cochrane Central Register of Clinical Trials identified randomized controlled trials of locally advanced breast cancer/metastatic breast cancer chemotherapies in second- or later-line settings. Efficacy assessment included pre-specified subgroup analysis of breast cancer subtypes. Included studies were assessed for quality using the Centre for Reviews and Dissemination tool. Bayesian network meta-analysis estimated primary outcomes of overall survival and progression-free survival using fixed-effect models. Comparators included: capecitabine (CAP), gemcitabine (GEM), ixabepilone (IXA), utidelone (UTI), treatment by physician’s choice (TPC), and vinorelbine (VIN). Results The network meta-analysis included seven trials. Results showed that second- or later-line patients treated with ERI had statistically longer overall survival versus TPC (hazard ratio [HR]: 0.81; credible interval [CrI]: 0.66–0.99) or GEM+VIN (0.62; 0.42–0.90) and statistically longer progression-free survival versus TPC (0.76; 0.64–0.90), but statistically shorter progression-free survival versus CAP+IXA (1.40; 1.17–1.67) and CAP+UTI (1.61; 1.23–2.12). In triple negative breast cancer, ERI had statistically longer overall survival versus CAP (0.70; 0.54–0.90); no statistical differences in progression-free survival were observed in triple negative breast cancer. Conclusions This network meta-analysis suggests that ERI may provide an overall survival benefit in the overall locally advanced breast cancer/metastatic breast cancer populations and triple negative breast cancer subgroup compared to standard treatments. These findings support the use of ERI in second- or later-line treatment of patients with locally advanced breast cancer/metastatic breast cancer.

Breast cancer

2007 ◽  
pp. 309-330
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Breast Reconstruction ◽  
Early Breast Cancer ◽  
Adjuvant Treatment ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Nursing Management ◽  
Non Invasive

Introduction 310 Diagnosis and staging 312 Management of non-invasive breast cancer 314 Management of early breast cancer 316 Adjuvant treatment of early breast cancer 318 Management of locally advanced breast cancer 320 Management of metastatic breast cancer 322 Breast reconstruction 324 Nursing management issues 328...

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