scholarly journals The Role of Electrochemotherapy in the Cutaneous and Subcutaneous Metastases From Breast Cancer: Analysis of Predictive Factors to Treatment From an Italian Cohort of Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Francesco Russano ◽  
Paolo Del Fiore ◽  
Claudia Di Prata ◽  
Andrea Pasqual ◽  
Roberto Marconato ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Predictive Factors ◽  
Radiation Treatment ◽  
Operative Procedure ◽  
Evaluation Criteria ◽  
Complete Response ◽  
Cellular Membrane ◽  
P Value ◽  
Reduced Body ◽  
Subcutaneous Metastases

The treatment of cutaneous and subcutaneous localizations from breast cancer (BC) is still a therapeutic challenge. Electrochemotherapy (ECT) is one of the available options, and it is characterized by the association between the administration of a chemotherapic agent (Bleomycin) with the temporary raise of permeability of the cellular membrane induced by the local administration of electrical impulses (electroporation). ECT represents an effective therapy for loco-regional control of this disease. This study aimed to investigate the predictive factors of response in cutaneous and subcutaneous localizations from breast cancer treated with ECT. We decided to evaluate the response to this treatment in 55 patients who underwent ECT between January 2013 and March 2020 at our Institute. We performed a monocentric retrospective cohort study. ECT was administered following the ESOPE (European Standard Operative Procedure of Electrochemotherapy) guidelines, a set of criteria updated in 2018 by a panel of European experts on ECT who defined the indications for selecting the patients who can benefit from the ECT treatment and the ones for technically performing the procedure. The responses were evaluated with the RECIST criteria (Response Evaluation Criteria in Solid Tumor). We found after 12 weeks of treatment a complete response (CR) in 64% of our patients. From the analysis divided for subgroups of covariates is emerged that lower BMI, reduced body surface, and absence of previous radiation treatment could be predictive for a better complete response. This study suggests that the efficacy of the ECT treatment is related to the concurrent systemic therapies while administering ECT. The association between ECT and immunotherapy has offered better results than the association between ECT and chemotherapy (p-value = 0.0463). So, ECT is a valuable tool in the treatment of cutaneous and subcutaneous metastases from breast cancer and its efficacy in local control of these lesions improves when it is well planned in a therapeutic scenario.

Predictive factors associated with a pathologic complete response in a Mexican HER2+ breast cancer population.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12630-e12630
Author(s):  
Raul Alejandro Andrade Moreno ◽  
José Fabián Martínez-Herrera ◽  
Geovani Amador ◽  
Raquel Gerson Cwilich ◽  
Juan Alberto Serrano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Predictive Factors ◽  
Hormone Receptor ◽  
Locally Advanced ◽  
Complete Response ◽  
Receptor Expression ◽  
Proliferation Index ◽  
Comprehensive Cancer Center ◽  
Lymph Node Status ◽  
Her2 Breast Cancer

e12630 Background: The current standard of treatment for locally advanced and early HER2+ breast cancer is the use of neoadjuvant chemotherapy (NAC) in combination with trastuzumab and pertuzumab. Mexican reports about its efficacy and predictive factors leading to pathological complete response (pCR) are scarce and few statistics are known. Methods: We performed a retrospective review of medical records of locally advanced and early HER2+ breast cancer patients who were treated with NAC in association with pertuzumab and trastuzumab. pCR was defined as the absence of residual invasive cancer cells in the breast and lymph nodes (ypT0/ypN0). Other histopathological features included Tumor type, estrogen, and progesterone receptor expression, HER2 status and Ki67. Clinical data included age, body mass index and number of metastatic nodes. Results: Thirty-five patients with early or locally advanced HER2+ breast cancer diagnosed and treated in a Comprehensive Cancer Center between January 2014 to June 2020 were included. The median age in the population was 47 years (range 28-79) with 20 patients under 50 years (57% of the total population). 40% of the patients were classified as overweight or obese at the time of diagnosis. The predominant histology was infiltrating ductal carcinoma (91%). The most frequent clinical stages were IIA, (34.2%) IIB (31.4%) and IIIA (22.8%). The population included patients with N0 (21.7%), N1 (56.5%), N2 (13%) and N3 (8.7%). Most tumors were larger than 2 centimeters at the time of diagnosis. T1 (17.4%), T2 (60.9%), T3 (17.4%) and T4 (4.3%). Most of the patients (77%) had a high proliferation index (Ki67 > 20). A total of 12 patients (34.3%) were hormone receptor (HR) negative and the rest (65.7%) were categorized as Triple Positive. The chemotherapy schemes used for NAC treatment were AC/THP (57.5%), THP (22.8%), TCHP (17.1%) and FEC/THP (2.7%) pCR was achieved in 60% of the patients. Patients with HR (-) achieved a pCR in 83% of the cases (10/12 patients) against 47.8% (11/23 patients) of the triple positive population. The Odds ratio (OR) for residual disease was 6.6 (95%CI 1.17-37.02) in the HR+ population. HR-/HER2+ tumors (p = 0.49) were independent predictors of pCR at multivariate logistic regression. No other variables including Ki67, BMI, age, tumor size, type of chemotherapy administered, and lymph node status were statistically significant. Conclusions: In this Mexican population there is a significant difference between the percentage of patients who achieve pCR in relation to the status of hormone receptors, favoring those patients with hormone receptor negative tumors. Nevertheless, most of the population achieves this benefit regardless of their hormone status, as HER2+ tumors showed sensitivity to chemotherapy and to the humanized anti-HER2 therapies. No other clinical or pathological variables were associated with pCR.

Laboratory indicators predict axillary nodal pathologic complete response after neoadjuvant therapy in breast cancer

2021 ◽  
Author(s):  
Peng Chen ◽  
Tong Zhao ◽  
Zhao Bi ◽  
Zhao-Peng Zhang ◽  
Li Xie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Neoadjuvant Therapy ◽  
Predictive Factors ◽  
Molecular Subtype ◽  
Treatment Options ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Logistic Analysis

 The purpose was to integrate clinicopathological and laboratory indicators to predict axillary nodal pathologic complete response (apCR) after neoadjuvant therapy (NAT). The pretreatment clinicopathological and laboratory indicators of 416 clinical nodal-positive breast cancer patients who underwent surgery after NAT were analyzed from April 2015 to 2020. Predictive factors of apCR were examined by logistic analysis. A nomogram was built according to logistic analysis. Among the 416 patients, 37.3% achieved apCR. Multivariate analysis showed that age, pathological grading, molecular subtype and neutrophil-to-lymphocyte ratio were independent predictors of apCR. A nomogram was established based on these four factors. The area under the curve (AUC) was 0.758 in the training set. The validation set showed good discrimination, with AUC of 0.732. In subtype analysis, apCR was 23.8, 47.1 and 50.8% in hormone receptor-positive/HER2-, HER2+ and triple-negative subgroups, respectively. According to the results of the multivariate analysis, pathological grade and fibrinogen level were independent predictors of apCR after NAT in HER2+ patients. Except for traditional clinicopathological factors, laboratory indicators could also be identified as predictive factors of apCR after NAT. The nomogram integrating pretreatment indicators demonstrated its distinguishing capability, with a high AUC, and could help to guide individualized treatment options.

Analysis of the pathological response to primary chemotherapy in patients with locally advanced breast cancer (LABC) grouped according to ER, PR and HER2 status

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 626-626 ◽  
Author(s):  
L. A. Fernandez-Morales ◽  
E. Dalmau ◽  
S. Martinez ◽  
A. Arcusa ◽  
C. Pericay ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptors ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Complete Response ◽  
Primary Chemotherapy ◽  
Response To Treatment ◽  
Her2 Status ◽  
P Value ◽  
Chi Squared

626 Background: The determination of ER and PR has a considerable importance when evaluating the prognosis and the response to treatment in breast cancer (BC). Assessment of HER2 status is also a standard for the management of BC. Hormone receptors (HR), HER2, and increasingly, genomic profiles distinguish at least four major classes of BC: HER2+; HER2-HR+, which can be divided into two classes, favorable and unfavorable; and basal-like that express neither HER2 nor HR. In the clinical practice is possible to divided BC according to ER, PR and HER2: ER-PR-HER2+, ER-PR-HER2-, ER+PR+HER2-, ER+RP+HER2+; and less frequently ER+PR-HER2-, ER+PR-HER2+, ER-PR+HER2+ and ER-PR+HER2-. In the neoadjuvant setting the pathological complete response (pCR) to primary chemotherapy (PC) is associated to negativity for ER and PR receptors, and in patients (pts) with HER2 + BC, the addition of trastuzumab to PC increasing the rate of pCR. The aims of this study were to determine the pCR of PC with anthracyclines (A) and taxanes (T) in pts with LABC grouped according to ER, PR and HER2 status. Methods: Pts with LABC treated with PC including A and T were grouped according to ER, PR and HER2 status, and the pCR rate were analyzed using the chi-squared test and correlations with a p value of ≤0,05 were considered statistically significant. Results: A total of 103 pts were treated. There were 14.6% of ER-PR-HER2+ BC, 23.3% ER-PR-HER2-, 35.0%ER+PR+HER2-, 8.7% ER+PR+HER2+, 11.7% ER+PR-HER2-, 2.9% ER+PR-HER2+, 1.9% ER-PR+HER2+, and 1.9% ER-PR+HER2-. For the analysis of pCR only 100 pts were included. There were18 pts who achieved a pCR. Of these pts, 9/18 (50.0%) were RE-RP-HER2-, 5/18 (27.8%) ER-PR-HER2+, 3/18 (16.7%) ER+PR+HER2+, and 1/18 (5.6%) ER+PR+HER2- (p≤0.01). The table 1 show the pCR rate for each subgroup of BC. Conclusions: In patients with LABC to group BC according to ER, PR and HER2 status can help to predict pCR to PC. [Table: see text] No significant financial relationships to disclose.

Comparison between Single Fraction versus Multiple Fraction Radiotherapy in Terms of Pain Control and Prevention of Skeletal Related Events in Patients with Bone Metastasis Candidates for Radiotherapy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Azmy ◽  
A M Adel ◽  
A A Nagy ◽  
S A Ibrahim
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Partial Response ◽  
Pain Score ◽  
Initial Response ◽  
Complete Response ◽  
P Value ◽  
Tumor Type ◽  
Single Fraction ◽  
Skeletal Related Events

Abstract Background Metastasis are the most common type of malignant tumor which involve bone, according to OSCER (Oncology Services Comprehensive Electronic Record) among 382,733 study patients, breast cancer (36 %), lunge cancer (60%), and colorectal cancer (12%) were the most common, incidence of bone metastasis was 2.9% at 30 days, 4.9% at 1 year, 5.6% at 2 years, 6.9% at 5 years, 8.4 % at 10 years. Incidence varied by tumor type with prostate cancer patients were at highest risk (18%-29%) followed by lunge, renal and breast cancer. Aim of the Work This study aim to prove the equivalency and the efficacy of single fraction radiotherapy (800cGY) and multiple fraction radiotherapy (10 fractions, 300 cGY / fraction, 1 fraction / day, 5 days per week over 2 weeks to a total of 3000cGy) in terms of pain relief and prevention of skeletal related events. Results In this study we collected data of 60 patients, 5 patients died and 55 patients received active treatment who were divided into 2 arms, Arm I represented 28 patients received single fraction radiotherapy on sites of bone metastasis (800cGY) and Arm II represented 27 patients received multiple fraction radiotherapy on sites of bone metastasis (total of 3000cGY in 10 fractions). Regarding to pain response, it was evaluated at zero, 2,4 weeks and 2,4 months using Visual Analogue Scale and Numeric Rating Scale or telephone interviews. Complete response was defined as no pain for 4 months, partial response was defined as at least 2 points lower than initial response, stable response was defined as 1 point change in pain score and progressive response was defined as pain score that’s at least 2 points higher than initial response. In our study, in Arm I patient achieving complete response represented 50% and in Arm II 40.7% which is non significant of P value 0.490, while partial response in Arm I represented 39.3% and 18.5 % in Arm II which is non significant of P value 0.090, stable response in Arm I represented 3.6% and 33.3% in Arm II which is highly significant of P value 0.004 and progressive response in Arm I represented 7.1% and in Arm II 7.4% which is non significant of P value 0.974. Conclusion Single fraction radiotherapy is equivalent to multiple fraction radiotherapy in terms of palliating pain of bone metastasis and prevention of skeletal related events.

scholarly journals Inflammatory Blood Markers as Prognostic and Predictive Factors in Early Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2666
Author(s):  
Ileana Corbeau ◽  
Simon Thezenas ◽  
Aurelie Maran-Gonzalez ◽  
Pierre-Emmanuel Colombo ◽  
William Jacot ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Febrile Neutropenia ◽  
Early Breast Cancer ◽  
Predictive Factors ◽  
Predictive Factor ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Independent Predictive Factor ◽  
Lymphocyte Ratio

Background: Inflammatory blood markers, such as neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), have been reported as putative prognostic factors for survival and predictive factors for pathological complete response and toxicity in cancers, however with conflicting results. Methods: We retrospectively analyzed data of 280 patients with early breast cancer receiving neo-adjuvant chemotherapy between 2005 and 2013 in our center. Neutrophil count, lymphocyte count and platelet count before treatment were collected as well as data on pathological complete response, toxicity, recurrence and survival. Results: In multivariate analysis, high PLR was an independent prognostic factor for relapse-free survival (hazard ratio [HR] = 1.91; 95%CI = 1.15–3.16; p = 0.012) and for shorter overall survival (HR = 1.83; 95%CI = 1.03–3.24; p = 0.039). NLR was an independent predictive factor for febrile neutropenia (HR = 0.28; 95%CI = 0.13–0.58; p = 0.001). In triple negative breast cancer molecular subtype, low white blood cell count (<6.75 G/L) was predictive for a higher pathological complete response rate (odds ratio [OR] = 0.29; 95%CI = 0.14–0.61; p < 0.01). Conclusion: In the present study, PLR was found as an independent prognostic factor for survival, while NLR was an independent predictive factor for febrile neutropenia.

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