scholarly journals Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types

2021 ◽  
Author(s):  
Tamami Morisaki ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Koji Takada ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Immune Response ◽  
Cancer Progression ◽  
Locally Advanced ◽  
Tumor Biology ◽  
Metastatic Breast ◽  
The Other ◽  
Other Hand ◽  
Significant Difference ◽  
Absolute Lymphocyte Counts

Abstract Background In the RECIST diagnostic criteria, the concepts of progression by pre-existing disease (PPL) and progression by new metastases (PNM) have been proposed to distinguish between the progression types of cancer refractory to treatment. According to the tumor biology of cancer progression forms, the "PPL" form indicates invasion and the "PNM" form indicates metastasis. On the other hand, recent studies have focused on the clinical importance of inflammatory markers as indicators of the systemic tumor immune response. In particular, absolute lymphocyte counts (ALC) is an indicator of the host’s immune response. Thus, we developed a new measure that combined progression form with ALC. In this study, we clinically validated the combined assessment of progression form and ALC in eribulin chemotherapy. Methods From August 2011 to April 2019, a total of 486 patients with locally advanced or metastatic breast cancer (MBC) underwent treatment. In this study, only 88 patients who underwent chemotherapy using eribulin were included. The antitumor effect was evaluated based on the RECIST criteria, version 1.1. To measure ALC, peripheral blood samples collected before eribulin treatment were used. The cut-off value for ALC in this study was 1,500 /µL, based on previous studies. Results The PPL group (71 patients, 80.7%) had significantly longer PFS (p = 0.022, log-rank) and OS (p < 0.001, log-rank) than the PNM group (17 patients,19.3%). In the 51 patients with ALC < 1500/µl, the PPL group had a significantly better prognosis than the PNM group (PFS: p = 0.035, OS: p < 0.001, log-rank, respectively). On the other hand, in the 37 patients with ALC ≥ 1500/µl, the PPL group had a better OS compared to the PNM group (p = 0.055, log-rank), but there was no significant difference in PFS between the two groups (p = 0.541, log-rank). Furthermore, multivariate analysis that validated the effect of OS showed that high ORR and “high-ALC and PPL” were factors for a good prognosis (p < 0.001, HR = 0.321) (p = 0.036, HR = 0.290). Conclusions In breast cancer patients with eribulin chemotherapy, good systemic immune status, such as ALC ≥ 1500/µl, was associated with less progression, particularly metastasis, and better prognosis. Furthermore, the biomarker "high-ALC and PPL" was particularly useful as a prognostic marker following eribulin chemotherapy.

scholarly journals Prediction of Survival after Eribulin Chemotherapy for Breast Cancer by Absolute Lymphocyte Counts and Progression Types

2020 ◽  
Author(s):  
Tamami Morisaki ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Koji Takada ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Immune Response ◽  
Cancer Progression ◽  
Locally Advanced ◽  
Tumor Biology ◽  
Metastatic Breast ◽  
The Other ◽  
Other Hand ◽  
Significant Difference ◽  
Absolute Lymphocyte Counts

Abstract Background: In the RECIST diagnostic criteria, the concepts of progression by pre-existing disease (PPL) and progression by new metastases (PNM) have been proposed to distinguish between the progression types of cancer refractory to treatment. According to the tumor biology of cancer progression forms, the "PPL" form indicates invasion and the "PNM" form indicates metastasis. On the other hand, recent studies have focused on the clinical importance of inflammatory markers as indicators of the systemic tumor immune response. In particular, absolute lymphocyte counts (ALC) is an indicator of the host’s immune response. Thus, we developed a new measure that combined progression form with ALC. In this study, we clinically validated the combined assessment of progression form and ALC in eribulin chemotherapy.Methods: From August 2011 to April 2019, a total of 486 patients with locally advanced or metastatic breast cancer (MBC) underwent treatment. In this study, only 88 patients who underwent chemotherapy using eribulin were included. The antitumor effect was evaluated based on the RECIST criteria, version 1.1. To measure ALC, peripheral blood samples collected before eribulin treatment were used. The cut-off value for ALC in this study was 1,500 /μL, based on previous studies.Results: The PPL group (71 patients, 80.7%) had significantly longer PFS (p=0.022, log-rank) and OS (p<0.001, log-rank) than the PNM group (17 patients,19.3%). In the 51 patients with ALC <1500/μl, the PPL group had a significantly better prognosis than the PNM group (PFS: p=0.035, OS: p<0.001, log-rank, respectively). On the other hand, in the 37 patients with ALC≥1500/μl, the PPL group had a better OS compared to the PNM group (p=0.055, log-rank), but there was no significant difference in PFS between the two groups (p=0.541, log-rank). Furthermore, multivariate analysis that validated the effect of OS showed that high ORR and “high-ALC and PPL” were factors for a good prognosis (p<0.001, HR=0.321) (p=0.036, HR=0.290).Conclusions: In breast cancer patients with eribulin chemotherapy, good systemic immune status, such as ALC≥1500/μl, was associated with less progression, particularly metastasis, and better prognosis. Furthermore, the biomarker "high-ALC and PPL" was particularly useful as a prognostic marker following eribulin chemotherapy.

scholarly journals Prediction of survival after eribulin chemotherapy for breast cancer by absolute lymphocyte counts and progression types

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tamami Morisaki ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Koji Takada ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Immune Response ◽  
Cancer Progression ◽  
Locally Advanced ◽  
Tumor Biology ◽  
Metastatic Breast ◽  
The Other ◽  
Breast Cancer Patients ◽  
Other Hand ◽  
Significant Difference

Abstract Background In the Response Evaluation Criteria for Solid Tumors (RECIST) diagnostic criteria, the concepts of progression by preexisting disease (PPL) and progression by new metastases (PNM) have been proposed to distinguish between the progression types of cancer refractory to treatment. According to the tumor biology of cancer progression forms, the “PPL” form indicates invasion, and the “PNM” form indicates metastasis. On the other hand, recent studies have focused on the clinical importance of inflammatory markers as indicators of the systemic tumor immune response. In particular, absolute lymphocyte count (ALC) is an indicator of the host’s immune response. Thus, we developed a new measure that combined progression form with ALC. In this study, we clinically validated the combined assessment of progression form and ALC in eribulin chemotherapy. Methods From August 2011 to April 2019, a total of 486 patients with locally advanced or metastatic breast cancer (MBC) underwent treatment. In this study, only 88 patients who underwent chemotherapy using eribulin were included. The antitumor effect was evaluated based on the RECIST criteria, version 1.1. To measure ALC, peripheral blood samples collected before eribulin treatment were used. The cut-off value for ALC in this study was 1500/μl, based on previous studies. Results The PPL group (71 patients, 80.7%) had significantly longer progression-free survival (PFS) (p = 0.022, log-rank) and overall survival (OS) (p < 0.001, log-rank) than the PNM group (17 patients, 19.3%). In the 51 patients with ALC < 1500/μl, the PPL group had a significantly better prognosis than the PNM group (PFS: p = 0.035, OS: p < 0.001, log-rank, respectively). On the other hand, in the 37 patients with ALC ≥ 1500/μl, the PPL group had a better OS compared with the PNM group (p = 0.055, log-rank), but there was no significant difference in PFS between the two groups (p = 0.541, log-rank). Furthermore, multivariate analysis that validated the effect of OS showed that high ORR and “high-ALC and PPL” were factors for a good prognosis (p < 0.001, HR = 0.321; p = 0.036, HR = 0.290). Conclusions The progression form of PNM had a worse prognosis than PPL in patients treated with eribulin. In breast cancer patients with eribulin chemotherapy, good systemic immune status, such as ALC ≥ 1500/μl, was associated with less progression, particularly metastasis, and better prognosis. Furthermore, the biomarker “high-ALC (ALC ≥ 1500/μl) and PPL” was particularly useful as a prognostic marker following eribulin chemotherapy.

Therapeutic Place of Fulvestrant in the Management of Hormone-receptor Positive Breast Cancer

2016 ◽  
Vol 12 (01) ◽  
pp. 44 ◽  
Author(s):  
Yogesh R Belagali ◽  
Hanmant V Barkate ◽  
Jaykumar J Sejpal ◽  
Bhavesh B Parekh ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Oestrogen Receptor ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
First Line Therapy ◽  
Hormone Receptor Positive ◽  
Significant Difference ◽  
Turnover Markers ◽  
Positive Breast Cancer

Fulvestrant is an oestrogen-receptor antagonist that exerts selective oestrogen receptor downregulation, antiproliferative activity and induction of apoptosis. It is indicated for the treatment of postmenopausal women with locally advanced or metastatic breast cancer for disease relapse or progression on or after adjuvant anti-oestrogen therapy. Fulvestrant was initially approved at a dose of 250 mg, however, the results of the CONFIRM trial led to approval of 500 mg dose (i.e. 500 mg on days 0, 14 and 28, then 500 mg every 28 days). Fulvestrant has also shown superiority over anastrozole as first-line therapy in the phase II trial. There are contrasting data for its efficacy when used in combination with anastrozole. It is well tolerated, with no significant difference with respect to the toxicity profile of other hormonal therapies. Treatment with fulvestrant is not associated with any clinically significant effects on sex hormone levels, bone-specific turnover markers or endometrial thickening. Fulvestrant has been recommended by the National Comprehensive Cancer Network and the European School of Oncology guidelines as a treatment option in first- and second-line management of hormone-receptor positive breast cancer.

scholarly journals Investigation of the change in the biological structure of the tumor in metastatic breast cancer

2021 ◽  
Vol 8 (3) ◽  
pp. 171-174
Author(s):  
Veysel Haksoyler ◽  
Tolga Koseci ◽  
Timucin Cil ◽  
Berna Bozkurt Duman ◽  
Polat Olgun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Hormone Receptors ◽  
Tumor Biology ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Metastatic Site ◽  
Significant Difference ◽  
Her 2

Objective: When metastasis develops in some breast cancer patients, hormone receptors (HR) and Human Epidermal Growth Factor-2 (Her-2) status can change and the tumor alters its character. We tried to determine the rate of these changes in tumor biology in 110 patients that we followed in our clinic and performed the change of the biopsy from the metastatic site (re-bx). We aimed to determine the biological changes of tumors and, contribute to the literature by examining the relationship of these changes with the adjuvant endocrine treatments (ET) or chemotherapy type (CT). Material and Methods: We included 110 metastatic breast cancer patients in our study. These patients had previously completed their local treatments followed by CT, and those with positive HR completed ET. After the first metastasis developed in the patients, we performed metastasectomy or biopsy from the metastatic site. Results: The median ki-67 value was 25% at the time of primary diagnosis and 30% in re-bx. 20.9% of patients estrogen receptor (ER), 31.8%  of patients progesterone receptor (PR) and 26.3% of patients Her-2 changed when metastasis developed. Conclusions: We found that the metastatic tumor has more aggressive properties than the primary tumor. Adjuvant chemotherapy and endocrine treatments or the location of metastasis did not make a significant difference in tumor biology.

scholarly journals Multi-institutional prospective observational study of the effectiveness of eribulin in first-line or second-line chemotherapy for HER2-negative hormone-resistant advanced or metastatic breast cancer: The KBCRN A001: E-SPEC Study

2021 ◽  
Author(s):  
Yuichiro Kikawa ◽  
Takeshi Kotake ◽  
Shigeru Tsuyuki ◽  
Yookija Kang ◽  
Sachiko Takahara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
The Other ◽  
Second Line ◽  
First Line ◽  
Second Line Chemotherapy ◽  
Significant Difference ◽  
Er Positive ◽  
Line Chemotherapy

Abstract PurposeTo investigate the survival impact of eribulin use in first-line and second-line chemotherapy for patients with endocrine-resistant advanced or metastatic breast cancer (AMBC) in the real-world clinical setting. MethodsThis multi-institutional prospective cohort study enrolled patients with triple-negative AMBC or estrogen receptor (ER)-positive AMBC refractory to at least one previous endocrine therapy selected at the physician’s discretion. The overall survival from the start of first-line (OS1) and second-line chemotherapy (OS2) were assessed. Adjusted hazard ratio (HR) between eribulin and the other regimens (oral 5-fluorouracil [5-FU] and anthracycline/taxane) was calculated using a stratified proportional hazards model that included prespecified prognostic factors. ResultsOf the 201 patients enrolled, 180 were included in the final analysis. Baseline patient characteristics were quite diverse among regimens. The median OS1 was 2.25, 3.49, and 2.62 years for eribulin (n=46), oral 5-FU (n=57), and anthracycline/taxane (n=71), and the median OS2 was 1.75, 2.33, and 1.69 years for eribulin (n=70), oral 5-FU (n=26), and anthracycline/taxane (n=44), respectively. First-line eribulin had a worse adjusted HR for OS than the other regimens in the ER-negative cohort; second-line oral 5-FU had a better adjusted HR for OS than eribulin in the ER-positive cohort. There was no significant difference between regimens in the other subgroups.ConclusionsEribulin and anthracycline/taxane resulted in similar point estimates for OS, while oral 5-FU led to relatively longer survival. Adjusted HRs differed based on treatment line and ER status. However, caution should be exercised when interpreting the results due to the heterogamies in patient background.Trial registration number and date of registrationClinical Trials.gov (NCT 02551263), July 22, 2015.

A feasibility study of [11C]choline for the molecular imaging of human breast cancer in vivo using positron emission tomography (PET)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 613-613
Author(s):  
L. M. Kenny ◽  
R. C. Coombes ◽  
A. Al-Nahhas ◽  
S. Osman ◽  
C. Lowdell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Dynamic Imaging ◽  
Choline Uptake ◽  
Tissue Uptake ◽  
Choline Pet ◽  
Arterial Blood ◽  
Significant Difference ◽  
Patlak Analysis

613 Background: [11C]Choline is a novel PET radiotracer. Preclinical studies suggest that it may be promising in breast cancer. [11C]Choline has been recently evaluated as a screening agent in prostate cancer, but no studies have yet investigated its potential in breast cancer. We report a pilot study evaluating the utility and reproducibility of [11C]Choline-PET in breast cancer. Methods: Dynamic imaging was performed on an ECAT962 HR+ PET scanner for 65 min after intravenous injection with 190–369 MBq [11C]choline. Patients with locally advanced and metastatic breast cancer were eligible. All histological subtypes were included (ductal, lobular, and inflammatory). Arterial blood samples were taken continuously for 10 min, with 8 discrete samples up to 60 min to measure [11C]choline and metabolites. Tissue uptake was determined by standardised uptake value at 60 min (SUV, dose and BSA corrected) and Ki (irreversible trapping) calculated using Patlak (corrected for [11C]choline metabolites in plasma) and modified Patlak analysis (corrected for plasma + tissue metabolites). Reproduciblilty scans were performed 2–17 days later in the absence of treatment. Results: Tumour [11C]choline uptake was observed in 10 out of 11 patients (12 out of 13 distinct lesions). There was a significant difference between tumour and normal tissue (breast/lung) in [11C]choline uptake for Ki (p<0.0001) and SUV (p<0.0001). Tissue uptake was of the order lung ≤ normal breast < tumour < liver ≤ spleen. [11C]choline was rapidly metabolised, at 60 min the mean ± S.E. plasma radioactivity due to [11C]choline was 16.4 ± 2.9%. [11C]Choline uptake was found to be reproducible for Ki (modified Patlak: r=0.93, p<0.0001, Patlak: r=0.85, p=0.002) and SUV (r=0.94, p<0.0001) - measured in 8 patients (median of 2 days after the 1st scan). Tumour Patlak Ki was 13.2% > Ki calculated using modified Patlak analysis. Conclusions: [11C]Choline-PET imaging of breast cancer is promising and warrants further evaluation. Tumour [11C]Choline uptake measured by Ki and SUV is reproducible. We plan to study the relationship between choline uptake measured by PET and immunoassays of tumour samples. Functional imaging could have a vital role to determine the efficacy of target-specific agents. No significant financial relationships to disclose.

scholarly journals The Evolution of Radiation Therapy in Metastatic Breast Cancer: From Local Therapy to Systemic Agent

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jessica M. S. Jutzy ◽  
Jeffrey M. Lemons ◽  
Jason J. Luke ◽  
Steven J. Chmura
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Metastatic Breast Cancer ◽  
Metastatic Disease ◽  
Locally Advanced ◽  
Tumor Biology ◽  
Metastatic Breast ◽  
Local Therapy ◽  
Metastatic Setting

Radiation therapy is a mainstay of treatment in early and locally advanced breast cancer but is typically reserved for palliation of symptomatic lesions in patients with metastatic breast cancer. With new advances in the field of tumor biology and immunology, the role of radiation in the metastatic setting is evolving to harness its immune-enhancing properties. Through the release of tumor antigens, tumor DNA, and cytokines into the tumor microenvironment, radiation augments the antitumoral immune response to affect both the targeted lesion and distant sites of metastatic disease. The use of immunotherapeutics to promote antitumoral immunity has resulted in improved treatment responses in patients with metastatic disease and the combination of radiation therapy and immunotherapy has become an area of intense investigation. In this article, we will review the emerging role of radiation in the treatment of metastatic disease and discuss the current state of the science and clinical trials investigating the combination of radiation and immunotherapy.

scholarly journals Impact of the line of treatment on progression-free survival in patients treated with T-DM1 for metastatic breast cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Migeotte ◽  
V. Dufour ◽  
A. van Maanen ◽  
M. Berliere ◽  
J. L. Canon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Prior Treatment ◽  
Her2 Positive ◽  
Free Survival ◽  
Significant Difference

Abstract Background Trastuzumab emtansine (T-DM1) is indicated as second-line treatment for human epidermal growth factor receptor 2 (HER2)-positive metastatic or unresectable locally advanced breast cancer, after progression on trastuzumab and a taxane-based chemotherapy. We wished to determine if the line of treatment in which T-DM1 is administered has an impact on progression-free survival (PFS) and in particular, if prior treatment with capecitabine/lapatinib or pertuzumab modifies PFS of further treatment with T-DM1. Patients and methods We performed a multicenter retrospective study in 3 Belgian institutions. We evaluated PFS with T-DM1 in patients treated for HER2 positive metastatic or locally advanced unresectable breast cancer between January 1, 2009 and December 31, 2016. Results We included 51 patients. The median PFS was 9.01 months. The line of treatment in which T-DM1 (1st line, 2nd line, 3rd line or 4+ lines) was administered had no influence on PFS (hazard ratio 0.979, CI95: 0.835–1.143). There was no significant difference in PFS whether or not patients had received prior treatment with capecitabine/lapatinib (9.17 vs 5.56 months, p-value 0.875). But, patients who received pertuzumab before T-DM1 tended to exhibit a shorter PFS (3.55 months for T-DM1 after pertuzumab vs 9.50 months for T-DM1 without pretreatment with pertuzumab), even if this difference was not statistically significant (p-value 0.144). Conclusion Unlike with conventional chemotherapy, the line of treatment in which T-DM1 is administered does not influence PFS in our cohort of patients with advanced HER2-positive breast cancer.

COMPARISON OF THE QUALITY OF LIFE OF PATIENTS IN THE LOCALY ADVANCED BREAST CANCER FORMS AFTER SYSTEM AND INTRALYMPHATIC POLYCHEMOTHERAPY

2018 ◽  
Vol 4 ◽  
pp. 3-13
Author(s):  
Yuriy Dumanskiy ◽  
Oleksandr Bondar ◽  
Oleksandr Tkachenko ◽  
Evhenii Stoliachuk ◽  
Vasilii Ermakov
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Locally Advanced ◽  
Developed Countries ◽  
Control Group ◽  
Preoperative Treatment ◽  
Discrete Elements ◽  
Important Indicator ◽  
Significant Difference

In recent years, breast cancer (BC) is the most common cancer pathology and the most common cause of disability among women in developed countries. Finding the most effective ways of interaction between the patient and the doctor creates the preconditions for the necessary analysis of the treatment process from an objective and subjective point of view. Therefore, an important indicator to be taken into account is the quality of life of a patient. To compare the indicators of a comprehensive assessment of the quality of life of patients to the adverse locally advanced forms (LA) of breast cancer before and after systemic intravenous polychemotherapy (SPCTx) and selective endolymphatic polychemotherapy (ELPCTx) in neoadjuvant mode. The study was conducted on the basis of a random analysis of outpatient cards from 112 patients with LA BC T4A-DN0-3M0 who received a comprehensive antitumor treatment on the basis of the Donetsk regional antitumor center and the University Clinic of the Odessa National Medical University from 2000 to 2017, which was proposed a questionnaire at various stages of preoperative treatment. The first (control) group consisted of 65 patients (58 %) with inoperable forms of LA BC, which was performed in neoadjuvant mode by SPCTx. The second (study group) included 47 patients (42 %) with inoperable forms of LA BC, which was performed as a neoadjuvant course ELPCTx. According to the integral indicators of quality of life and quality of health between patients in the control and study groups, there was no statistically significant difference. In a detailed analysis of the indicators of symptomatic scales, the difference between the groups did not exceed the critical. Based on the results of a study conducted among patients receiving endolymphatic chemotherapy in a neoadjuvant mode, the subjective evaluations of treatment in absolute numbers have better reference values without statistical superiority. The study of the integrative indicator of quality of life and its discrete elements is an ergonomic and economical means of heuristic assessment of the health of patients in order to further develop more rational and convenient ways of solving urgent issues of modern oncology by increasing compliance and finding a compromise between the physician and the patient.

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