Recent advances in the medical treatment of breast cancer

Over the past few decades, the systemic therapy of breast cancer (early and advanced) has changed considerably. For the past 40–50 years, and since the discovery and further therapeutic use of tamoxifen, a selective estrogen receptor modulator, breast cancer treatment has become the model for the development and success of tailored medical treatment. Much still needs to be done in improving outcomes for all patients with breast cancer, and especially for those who have advanced breast cancer, a challenging area for medical oncologists. Ongoing international clinical trials are currently evaluating new therapeutic approaches and identifying specific biological subsets that could determine a patient’s ability to respond to particular chemotherapeutic drugs.

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Antiphospholipid Antibody Syndrome and Infertility

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1697982 ◽

2019 ◽

Vol 41 (10) ◽

pp. 621-627

Author(s):

Vivian de Oliveira Rodrigues ◽

Adriana de Góes e Silva Soligo ◽

Gabriel Duque Pannain

Keyword(s):

Antiphospholipid Antibodies ◽

Fetal Loss ◽

Female Infertility ◽

Antiphospholipid Antibody ◽

Antiphospholipid Antibody Syndrome ◽

Therapeutic Approaches ◽

Negative Effects ◽

The Past ◽

New Therapeutic Approaches ◽

Abortion Complications

AbstractAntiphospholipid antibody syndrome (APS) is a systemic, autoimmune, prothrombotic disease characterized by persistent antiphospholipid antibodies (aPLs), thrombosis, recurrent abortion, complications during pregnancy, and occasionally thrombocytopenia. The objective of the present study was to review the pathophysiology of APS and its association with female infertility. A bibliographic review of articles of the past 20 years was performed at the PubMed, Scielo, and Bireme databases. Antiphospholipid antibody syndrome may be associated with primary infertility, interfering with endometrial decidualization and with decreased ovarian reserve. Antiphospholipid antibodies also have direct negative effects on placentation, when they bind to the trophoblast, reducing their capacity for invasion, and proinflammatory effects, such as complement activation and neutrophil recruitment, contributing to placental insufficiency, restricted intrauterine growth, and fetal loss. In relation to thrombosis, APS results in a diffuse thrombotic diathesis, with global and diffuse dysregulation of the homeostatic balance. Knowing the pathophysiology of APS, which is closely linked to female infertility, is essential for new therapeutic approaches, specialized in immunomodulation and inflammatory signaling pathways, to provide important advances in its treatment.

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Diagnosis and Therapy of Triple-Negative Breast Cancer (TNBC) – Recommendations for Daily Routine Practice

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-0887-0285 ◽

2019 ◽

Vol 79 (06) ◽

pp. 605-617 ◽

Cited By ~ 12

Author(s):

Andreas Schneeweiss ◽

Carsten Denkert ◽

Peter A. Fasching ◽

Carlo Fremd ◽

Oleg Gluz ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Therapeutic Strategies ◽

Routine Practice ◽

Daily Routine ◽

Therapeutic Approaches ◽

New Therapeutic Approaches ◽

Tumour Biology ◽

Therapeutic Concepts

AbstractThe rapid increase in knowledge in tumour biology and tumour pathogenesis of triple-negative breast cancer (TNBC) has resulted in new therapeutic approaches and new therapeutic concepts for treatment. For years, TNBC has been considered to be a difficult-to-treat tumour due to its generally aggressive tumour biology and in view of limited therapeutic options. The risk of recurrence and metastasis is higher than in the case of other breast cancer subtypes of the same stage. In addition to surgery and radiation in the curative situation, systemic chemotherapy with anthracyclines and/or taxanes is still the therapy of choice. New therapeutic approaches are based on the knowledge that TNBC is a molecularly very heterogeneous disease. Research groups are working to classify TNBC better and better on a molecular level and use this molecular subtyping as the basis for new therapeutic strategies. The most promising new approaches and considerations regarding the therapy of TNBCs are shown below. In addition, the current therapeutic strategies are discussed using a fictitious case history, taking the current data and the resultant therapeutic consequence into account.

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Sorafenib in breast cancer treatment: A systematic review and overview of clinical trials

World Journal of Clinical Oncology ◽

10.5306/wjco.v7.i4.331 ◽

2016 ◽

Vol 7 (4) ◽

pp. 331 ◽

Cited By ~ 18

Author(s):

Menelaos Zafrakas ◽

Panayiota Papasozomenou ◽

Christos Emmanouilides

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Clinical Trials ◽

Cancer Treatment ◽

Breast Cancer Treatment

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Fifty Years of Experience with Chordomas in Southeast Scotland

Neurosurgery ◽

10.1227/00006123-198502000-00007 ◽

1985 ◽

Vol 16 (2) ◽

pp. 166-170 ◽

Cited By ~ 51

Author(s):

P. O'Neill ◽

B.A. Bell ◽

J.D. Miller ◽

I. Jacobson ◽

W. Guthrie

Keyword(s):

Clinical Presentation ◽

Surgical Intervention ◽

Slow Growth ◽

Multicenter Trial ◽

Treatment Modalities ◽

Therapeutic Approaches ◽

Slow Growth Rate ◽

The Past ◽

New Therapeutic Approaches

Abstract We report the clinical presentation and management of 34 patients with a histologically proven chordoma, treated in the neurosurgical departments in Edinburgh and Dundee, over the past 50 years. Although these tumors are commonly regarded as being locally invasive with a variable, but generally slow growth rate, they can metastasize, and this may precede surgical intervention, as in one of our patients. Our cases are compared to those in previously published series, and a comprehensive review of the treatment modalities for tumors at various sites is presented. The optimal treatment to be recommended from our own experience, and that of others, is aggressive operation and radiotherapy. A combination of hyperthermia and chemotherapy has shown some promise, but remains untested, and highlights the need for a multicenter trial with long follow-up to allow the evaluation of new therapeutic approaches.

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The Quality of Reporting Harms-Related Data in Clinical Trials of Adjuvant Trastuzumab in Early-Stage Breast Cancer Treatment

Therapeutic Innovation & Regulatory Science ◽

10.1177/2168479013509383 ◽

2014 ◽

Vol 48 (3) ◽

pp. 299-304 ◽

Cited By ~ 1

Author(s):

Ali Mahinbakht ◽

Sayeh M. Lavasani ◽

Micheal Guirguis

Keyword(s):

Breast Cancer ◽

Clinical Trials ◽

Cancer Treatment ◽

Early Stage ◽

Breast Cancer Treatment ◽

Early Stage Breast Cancer ◽

Quality Of Reporting ◽

Adjuvant Trastuzumab ◽

Related Data

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PI3Kinase Inhibition in Hormone Receptor-Positive Breast Cancer

International Journal of Molecular Sciences ◽

10.3390/ijms222111878 ◽

2021 ◽

Vol 22 (21) ◽

pp. 11878

Author(s):

Ajay Dhakal ◽

Luna Acharya ◽

Ruth O’Regan ◽

Shipra Gandhi ◽

Carla Falkson

Keyword(s):

Breast Cancer ◽

Clinical Trials ◽

Pi3k Pathway ◽

Molecular Target ◽

Breast Cancer Treatment ◽

Breast Cancers ◽

Phosphatidylinositol 3 Kinase ◽

Pi3k Inhibitors ◽

Hormone Receptor Positive ◽

Positive Breast Cancer

Derangement of the phosphatidylinositol-3 kinase (PI3K) pathway is implicated in several subtypes of breast cancers. Mutation or upregulation of PI3K enhances cancer cells’ survival, proliferation, and ability to metastasize, making it an attractive molecular target for systemic therapy. PI3K has four isoforms, and several drugs targeting individual isoforms or pan-PI3K have been or are currently being investigated in clinical trials. However, the search for an effective PI3K inhibitor with a robust therapeutic effect and reasonable safety profile for breast cancer treatment remains elusive. This review focuses on the recently completed and ongoing clinical trials involving PI3K inhibitors as mono- or combination therapy in breast cancer. We review the salient findings of clinical trials, the therapeutic efficacy of PI3K inhibitors, and reported adverse effects leading to treatment discontinuation. Lastly, we discuss the challenges and potential opportunities associated with adopting PI3K inhibitors in the clinic.

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Lack of consideration of sex and gender in clinical trials for COVID-19

10.1101/2020.09.13.20193680 ◽

2020 ◽

Author(s):

Emer Brady ◽

Mathias Wullum Nielsen ◽

Jens Peter Andersen ◽

Sabine Oertelt-Prigione

Keyword(s):

Clinical Trials ◽

Side Effects ◽

Sex And Gender ◽

Therapeutic Approaches ◽

Planning Stage ◽

New Therapeutic Approaches ◽

Analysis Phase ◽

Potential Risks ◽

And Gender ◽

Sex And Gender Differences

Sex and gender differences impact the incidence of SARS-CoV-2 infection and COVID-19 mortality. Furthermore, sex differences characterize the frequency and severity of pharmacological side effects. A large number of clinical trials are ongoing to develop new therapeutic approaches and vaccines for COVID-19. We investigated the inclusion of sex and/or gender in currently registered studies on ClinicalTrials.gov. Only 416 (16.7%) of the 2,484 registered SARS-CoV-2/COVID-19 trials mention sex/gender as recruitment criterion and only 103 (4.1%) allude to sex/gender in the description of the analysis phase. None of the 11 clinical trials published in scientific journals on June 2020 reported sex-disaggregated results. Hence, lack of consideration upon registration does not seem to be corrected during trial execution and reporting. Given the biological relevance and the potential risks of unwanted side effects, we urge researchers to focus on sex-disaggregated analyses already at the planning stage of COVID-19 trials.

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