New paradigms in adjuvant systemic therapy of breast cancer.

2003 ◽  
pp. 75-89 ◽  
Author(s):  
E Thomas ◽  
G N Hortobagyi
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Hormone Therapy ◽  
Current Practice ◽  
Tumor Stage ◽  
Substantial Effect ◽  
Published Data ◽  
Adjuvant Hormone Therapy ◽  
Prognostic Features ◽  
Made In

Since the initial studies of adjuvant therapy in the 1970s, it has become increasingly clear that chemotherapy and hormone therapy have had a substantial effect on the survival of women with early breast cancer. It was originally assumed that only women with high-risk features would derive benefit from adjuvant therapy, but it is now apparent from numerous studies that adjuvant therapy improves survival in all subgroups of women with invasive breast cancer, although the absolute benefit varies depending on tumor stage and other prognostic features. Considerable progress has been made in elucidating effective adjuvant therapy regimens, but there continue to be many unanswered questions that are being addressed in ongoing clinical trials of adjuvant hormone therapy and chemotherapy. This paper reviews the current paradigms in adjuvant therapy, the published data that have affected current practice patterns, and the current controversies.

Early-stage breast cancer patients reporting difficulty sleeping, mood issues, or pain are more likely to refuse adjuvant hormone therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12065-e12065
Author(s):  
Christian A. Thomas
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Stage I ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Adjuvant Hormone Therapy

e12065 Background: Adjuvant hormone therapy is a crucial part of the treatment for patients with early stage breast cancer and an important quality measure for programs such as QOPI and the oncology care model (OCM). However, it is not known which factors influence some patients with early stage breast cancer to decline adjuvant hormone therapy. We hypothesized that specific self-reported symptoms might impact a patient’s decision to accept or decline adjuvant hormone therapy. Methods: Patients with stage 0 or I breast cancer were identified by chart review from 2011-2016 and de-identified. On the day patients received a recommendation for adjuvant treatment the following patient reported outcome measures (PROs) were analyzed: difficulty sleeping (DS), fatigue (F), mood (M such as anxiety and depression), and pain (P) on a 0-4 symptom scale based on CTCAE v. 4. PROs were then linked with a patient’s decision to accept or decline adjuvant therapy. Results: A total of 287 patients with stage 0 (n = 80) or stage I (n = 207) breast cancer were identified. 38 stage O and 103 stage I patients had evaluable PROs on the same day a recommendation for adjuvant hormone therapy was made. Overall 18/38 (47.4%) of stage 0 patients and 90 of 103 (87.4%) of stage I patients accepted adjuvant treatment. Stage 0 patients declining adjuvant therapy reported any grade of PROs: DS (40%, n = 8), F (35%, n = 7), M (35%, n = 7), P (20%, n = 4). Stage 0 patients accepting treatment reported: DS (22%, n = 4), F (44%, n = 8), M (6%, n = 1), P (20%, n = 4). Stage I patients who declined treatment reported: DS (54%, n = 7), F (46%, n = 6), M (38%, n = 5), P (62%, n = 8). Stage I patients accepting treatment reported: DS (41%, n = 37), F (49%, n = 44), M (31%, n = 28), P (36%, n = 32). Conclusions: Early stage breast cancer patients declining adjuvant hormone therapy are more likely to self report symptoms such as difficulty sleeping, mood disturbances (anxiety, depression), and pain than those accepting treatment.

scholarly journals Socioeconomic factors associated with adjuvant hormone therapy use in older breast cancer survivors

Cancer ◽  
2010 ◽  
Vol 117 (2) ◽  
pp. 398-405 ◽  
Author(s):  
Tina W. F. Yen ◽  
Linda K. Czypinski ◽  
Rodney A. Sparapani ◽  
Changbin Guo ◽  
Purushottam W. Laud ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Socioeconomic Factors ◽  
Hormone Therapy ◽  
Breast Cancer Survivors ◽  
Adjuvant Hormone Therapy ◽  
Factors Associated

Adjuvant Hormone Therapy for Breast Cancer

2019 ◽  
pp. 479-487
Author(s):  
Andrea K. Shimada ◽  
João Victor Machado Alessi ◽  
Bruna Zucchetti ◽  
Artur Katz
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Adjuvant Hormone Therapy

Randomized Trial of Observation Versus Adjuvant Therapy With Cyclophosphamide, Fluorouracil, Prednisone With or Without Tamoxifen Following Mastectomy in Postmenopausal Women With Node-Positive Breast Cancer

1989 ◽  
Vol 7 (1) ◽  
pp. 145-145
Author(s):  
James N. Ingle ◽  
Lloyd K. Everson ◽  
H. Sam Wieand ◽  
J. Kirk Martin ◽  
Henry J. Votava ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Randomized Trial ◽  
Clin Oncol ◽  
Postmenopausal Women ◽  
Median Dose ◽  
The Mean ◽  
Made In ◽  
September Issue ◽  
Positive Breast Cancer

In Table 4 of the manuscript by Ingle et al published in the September issue (J Clin Oncol 6:1388–1396, 1988) an error was made in the dosage of tamoxifen. The planned dose should have read 140 mg/wk; the mean dose, 125 mg/wk; and the median dose, 140 mg/wk.

scholarly journals Sequential Adjuvant Hormone Therapy in Postmenopausal Breast Cancer: Rationale and Clinical Results

2006 ◽  
Vol 21 (2) ◽  
pp. 111-122
Author(s):  
R. Longo ◽  
M.R. D'Andrea ◽  
G. Gasparini
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Early Stage ◽  
Postmenopausal Breast Cancer ◽  
Clinical Results ◽  
Tamoxifen Treatment ◽  
Clinicopathological Parameters ◽  
Breast Cancer Patients ◽  
Adjuvant Hormone Therapy ◽  
Metastatic Setting

For the past 15 years tamoxifen has been the standard adjuvant hormone therapy for women with early-stage breast cancer and estrogen receptor (ER)-positive tumors, irrespective of nodal status and other clinicopathological parameters. Recent studies provided evidence that the optimal duration of tamoxifen treatment is 5 years. Based on the positive clinical results obtained with the administration of aromatase inhibitors (AIs) in the metastatic setting, several controlled clinical trials have evaluated the efficacy and side effects of AIs versus standard tamoxifen also as adjuvant therapy in postmenopausal breast cancer patients. The results of the above studies, suggest a therapeutic advantage of AIs over tamoxifen with regard to relapse-free survival and the risk of metachronous contralateral breast cancer. We review the rationale and the available clinical data on initial or sequential hormone treatment with AIs and we propose a novel scenario for possible therapeutic strategies based on the clinicopathological characteristics of the patients and on the biology of each single tumor.

A prediction model for breast cancer recurrence after adjuvant hormone therapy

2008 ◽  
Vol 23 (4) ◽  
pp. 199-206 ◽  
Author(s):  
P. Boracchi ◽  
D. Coradini ◽  
S. Antolini ◽  
S. Oriana ◽  
Ruggero Dittadi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prediction Model ◽  
Hormone Therapy ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Adjuvant Hormone Therapy

CDK2 and CDK1 specific activities: A novel prognostic indicator in early breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10592-10592
Author(s):  
S. Kim ◽  
N. Masuda ◽  
H. Inaji ◽  
K. Yoshidome ◽  
M. Tsujimoto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Specific Activity ◽  
Univariate Analysis ◽  
Menopausal Status ◽  
Prognostic Significance ◽  
Prognostic Indicator ◽  
Cycle Phase ◽  
Adjuvant Hormone Therapy ◽  
Node Negative

10592 Background: Cyclin-dependent kinases (CDKs) are expressed almost constantly but their activities change according to cell cycle phase. We studied the specific activity (SA; activity/expression) of CDKs to accurately evaluate their role in cell proliferation. We focused on the ratio of CDK2 SA to CDK1 SA because this ratio has been associated with rapid tumor growth in human breast cancer xenografts. Our goal was to investigate the prognostic significance of CDK2/1 ratio in node-negative breast cancer. Methods: We used a novel assay to measure SAs of CDK2 and CDK1 in 365 primary breast tumors. All tumors were histologically confirmed invasive breast cancer without lymph node involvement. The primary endpoint was relapse-free survival (RFS). Cut-off values for CDK2/1 ratio were defined as those points that best discriminated groups according to RFS. Tumors were grouped as low (136pts), intermediate (84pts), and high (145pts) CDK2/1 ratio. The median follow-up was 59 months (range 4–102). Results: Pts characteristics are described as follows: menopausal status: pre- 42%, post- 58%; tumor size: =20mm 48%, >20mm 52%; histologic grade (HG): I 28%, II 47%, III 23%; ER: (+) 57%, (-) 42%; PR: (+) 51%, (-) 48%. Pts with HG III or high CDK2/1 ratio showed significantly lower 5y-RFS rates than those with HG I/II or low/intermediate CDK2/1 ratio, respectively (HG: I 97%, II 91%, III 85%, P=0.040; CDK2/1 ratio: low 97%, intermediate 92%, high 85%, P=0.017). In univariate analysis, PR (- vs +, P=0.088) had a tendency to associate with relapse, and HG (III vs I, P=0.024) and CDK2/1 ratio (high vs low, P=0.011) also had a significant correlation with relapse. However, only CDK2/1 ratio showed a significant independent prognostic indicator in multivariate analysis (hazard ratio 2.86, 95% CI 1.25–6.58, P=0.01). More important, among women (n=185) with hormone receptor (HR) positive disease given adjuvant hormone therapy alone, who have had no useful factors to predict their outcomes, high CDK2/1 ratio was also associated with worse prognosis than low CDK2/1 ratio (5y-RFS 84% vs 100%, P=0.007). Conclusions: For patients with node- negative disease, especially those with HR positive tumors given adjuvant hormone therapy alone, the CDK2/1 ratio might be useful as a routine laboratory test to predict outcome. No significant financial relationships to disclose.

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