scholarly journals Chemotherapy and Targeted Therapy for Patients With Human Epidermal Growth Factor Receptor 2–Negative Metastatic Breast Cancer That is Either Endocrine-Pretreated or Hormone Receptor–Negative: ASCO Guideline Update

2021 ◽  
pp. JCO.21.01374
Author(s):  
Beverly Moy ◽  
R. Bryan Rumble ◽  
Steven E. Come ◽  
Nancy E. Davidson ◽  
Angelo Di Leo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Triple Negative ◽  
Single Agent ◽  
Growth Factor Receptor ◽  
Human Epidermal Growth Factor ◽  
Epidermal Growth ◽  
Single Agent Chemotherapy

PURPOSE This guideline updates recommendations of the ASCO guideline on chemotherapy and targeted therapy for patients with human epidermal growth factor receptor 2–negative metastatic breast cancer (MBC) that is either endocrine-pretreated or hormone receptor (HR)–negative. METHODS An Expert Panel conducted a targeted systematic literature review guided by a signals approach to identify new, potentially practice-changing data that might translate into revised guideline recommendations. RESULTS The Expert Panel reviewed abstracts from the literature review and retained 14 articles. RECOMMENDATIONS Patients with triple-negative, programmed cell death ligand-1–positive MBC may be offered the addition of immune checkpoint inhibitor to chemotherapy as first-line therapy. Patients with triple-negative, programmed cell death ligand-1–negative MBC should be offered single-agent chemotherapy rather than combination chemotherapy as first-line treatment, although combination regimens may be offered for life-threatening disease. Patients with triple-negative MBC who have received at least two prior therapies for MBC should be offered treatment with sacituzumab govitecan. Patients with triple-negative MBC with germline BRCA mutations previously treated with chemotherapy may be offered a poly (ADP-ribose) polymerase inhibitor rather than chemotherapy. Patients with HR-positive human epidermal growth factor receptor 2–negative MBC for whom chemotherapy is being considered should be offered single–agent chemotherapy rather than combination chemotherapy, although combination regimens may be offered for highly symptomatic or life-threatening disease. Patients with HR-positive MBC with disease progression on an endocrine agent may be offered treatment with either endocrine therapy with or without targeted therapy or single-agent chemotherapy. Patients with HR-positive MBC with germline BRCA mutations no longer benefiting from endocrine therapy may be offered a poly (ADP-ribose) polymerase inhibitor rather than chemotherapy. No recommendation regarding when a patient's care should be transitioned to hospice or best supportive care alone is possible. Additional information is available at www.asco.org/breast-cancer-guidelines .

Expression of Estrogen, Progesterone Receptors, and Human Epidermal Growth Factor Receptor 2 in Women With Breast Cancer

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S89-S89
Author(s):  
Angela Mlole
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Triple Negative ◽  
Growth Factor Receptor ◽  
Progesterone Receptors ◽  
Human Epidermal Growth Factor ◽  
Epidermal Growth ◽  
The Mean

Abstract Introduction Globally, breast cancer is a leading cause of female cancer-related mortality and most predominant in the premenopausal stage. Expression of hormone receptors and human epidermal growth factor receptor 2, HER2/neu, appears to be different in the premenopausal group. However, there are limited data on hormone receptor expressions among women in Uganda. Therefore, the objective of this study was to determine the expression of estrogen, progesterone receptors, and human epidermal growth factor receptor 2 in women with breast cancer. Methods This was a retrospective descriptive cross-sectional laboratory-based study conducted in the Department of Pathology, Makerere University. Paraffin-embedded tissue blocks were retrieved from the archive and stained with H&E for histological confirmation and establishment of histological grade and type. Immunohistochemistry staining using a mouse-derived monoclonal antibody for hormonal receptors and HER2/neu expression was also done. Data were analyzed using STATA version 13. Results A total of 103 patients’ tissue blocks were analyzed. The mean ± SD age of the cases was 49 ± 15 years. The majority, 55/103 (53.4%), had intermediate cancer grade and 39/103 (37.9%) had triple-negative breast cancer. The majority, 55/103 (53.4%), were positive for ER hormone expression, 48/103 (46.6%) showed positive PR hormone expression, and only 19/103 (18.5%) were HER2/neu positive. Age of the cases showed statistical significance with hormonal receptor expressions and triple-negative breast cancer (P < .05), with high-grade cancers being more common among premenopausal women. Conclusion The study found that the mean age of breast cancer was 49 years, invasive carcinoma of no special type (NST) was the commonest histological type, and the majority were of intermediate cancer grade. In total, 53.4% of patients were ER positive, 46.6% were PR positive, 18.5% were HER2/neu positive, and 37.9% were triple negative. Age was the only factor significantly associated with hormonal receptors and triple-negative breast cancers.

scholarly journals Hormonal Receptors, Human Epidermal Growth Factor Receptor-2 and Triple Negative Immunohistochemical Typing of Women Breast Cancer in Kampala, Uganda.

2020 ◽  
Author(s):  
Angela T Mlole ◽  
James Yahaya ◽  
Emmanuel Othieno ◽  
Sam Kalungi ◽  
Livex A Okwi
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Growth Factor Receptor ◽  
Progesterone Receptors ◽  
Human Epidermal Growth Factor ◽  
Epidermal Growth

Abstract Background: The expression of estrogen and progesterone receptors and human epidermal growth factor receptor-2 has been reported to have invaluable prognostic role. This study aimed at determining the expression ER, PR and HER2 in women with breast cancer in Kampala, Uganda.Methods: Expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) was determined immunohistochemically. Logistic regression was performed to determine the effect of the independent factors in predicting the risk of not expressing the breast markers. A two-tailed p<0.05 was regarded to be statistically significant.Results: ER, PR and HER2 were expressed in 53.4%, 46.6% and 18.5%, respectively. Co-expression of ER and PR and triple negative breast cancer was present in 42.7% and 37.9%, respectively. Age was an independent predictor of expression of ER (AOR = 0.18, 95% CI: 0.062-0.541, p = 0.002), PR (AOR = 0.35, 95% CI: 0.129-0.968, p = 0.043).Conclusion: Majority of patients in this study had less than 50 years and the majority of them had infiltrating ductal carcinoma of no special type with grade 2. Age predicted independently the expression of both ER and PR in our study.

scholarly journals Optimum duration of adjuvant trastuzumab in treatment of human epidermal growth factor receptor-2 positive early breast cancer: protocol for a network meta-analysis of randomised controlled trials

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e035802
Author(s):  
Qiancheng Hu ◽  
Xin Wang ◽  
Ye Chen ◽  
Xiaofen Li ◽  
Ting Luo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Early Breast Cancer ◽  
Meta Analysis ◽  
Growth Factor Receptor ◽  
Her2 Positive ◽  
Human Epidermal Growth Factor ◽  
Epidermal Growth

IntroductionControversy regarding optimum duration of trastuzumab treatment remains in patients with human epidermal growth factor receptor-2 (HER2) positive early breast cancer. The objective of applying network meta-analysis (NMA) is to integrate existing evidence based on direct and indirect comparisons of efficacy and safety, and then to determine the duration of trastuzumab treatments with the greatest impact on therapeutic outcomes in HER2-positive early breast cancers.Methods and analysisElectronic searching of trastuzumab treatments for early breast cancer by titles and abstracts will be conducted for the period from inception to 16 June 2019 in PubMed, Cochrane Library, Embase and ClinicalTrils.gov, as well as the annual meetings of San Antonio Breast Cancer Symposium (SABCS), European Society of Medical Oncology (ESMO) and American Society of Clinical Oncology (ASCO) online archives. The outcomes of interest are overall survival, disease-free survival, acceptability, cardiotoxicities and grade 3 to 4 non-haematological toxicities. Two independent reviewers will screen and extract eligible data based on the inclusion and exclusion criteria, and then assess the risk of bias and evidence quality of individual studies using Cochrane Collaboration’s tool and Grades of Recommendation, Assessment, Development and Evaluation (GRADE). The heterogeneity, transitivity and inconsistency of NMA will be evaluated. In addition, we will perform subgroup and sensitivity analyses to assess the robustness and reliability of findings in our NMA.Ethics and disseminationEthics approval is not required for our NMA. Findings from our NMA will be submitted as peer-reviewed journal manuscripts and international conference reports.Trial registration numberCRD42019139109.

Anti-Human Epidermal Growth Factor Receptor 2 Single-Chain Fv Fragment-Decorated DM1 Nanoparticles for Specific Targeting of Human Epidermal Growth Factor Receptor 2-Positive Breast Tumor Cells

2021 ◽  
Vol 17 (3) ◽  
pp. 447-455
Author(s):  
Ling Ni ◽  
You-Xin Li
Keyword(s):  
Breast Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Growth Factor Receptor ◽  
Single Chain ◽  
Human Epidermal Growth Factor ◽  
Single Chain Fv ◽  
Epidermal Growth ◽  
Single Chain Fv Fragment

Purpose: Although monoclonal antibodies are used to decorate nanoparticles to target specific cells, penetration of tumor tissues by monoclonal antibodies is limited by their large size. Therefore, we prepared DM1 nanoparticles decorated with the small anti-HER2 single-chain Fv fragment (scFvHER2) of trastuzumab (TMAB) for targeting to human epidermal growth factor receptor 2 (HER2) overexpressing in breast cancer effectively. Methods: ScFvHER2 fragment was coupled with DM1 nanoparticles (NPs) via covalent thiol-maleimide linkages. Their physicochemical properties, uptake by cells, and toxicity to tumor cells were investigated. Their vivo biodistribution was assessed employing liquid chromatographytandem mass spectrometry, while their antitumor activity was investigated in nude mice burdened with BT-474 tumor. Results: Viability of BT-474 cells incubated with scFvHER2-DM1-Nanoparticles (scFv-DM1-NPs) was significantly lower than that of BT-474 cell treated with TMAB-DM1-Nanoparticles (TMAB-DM1-NPs) (P < 0 05). Uptake by cells of scFvDM1-NPs was significantly higher than TMAB-DM1-NPs (P < 0 01). Accumulation of scFv-DM1-NPs in tumor tissue was notably higher than TMAB-DM1-NPs (P < 0 05). scFv-DM1-NPs exhibited improved antitumor effects compared to TMABDM1-NPs (P < 0 05), showing a tumor inhibition rate of more than 70%. Conclusions: ScFvHER2 fragment could serve as a more effective targeting ligand than TMAB, and scFv-DM1-NPs could be developed as a possible drug delivery system to target HER2-positive breast cancer.

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