MicroRNA Expression Profiles and Breast Cancer Chemotherapy

Breast cancer is the most common malignancy diagnosed in women. Traditionally, radical surgical resection was the cornerstone of breast cancer management, with limited exceptions. In recent times, our enhanced appreciation of the biomolecular characteristics of breast cancer has transformed the treatment paradigm to include prescription of chemotherapeutical agents, radiotherapies, targeted therapies, as well as more refined surgical approaches. While treatments with such modalities have enhanced clinico-oncological outcomes for breast cancer patients, the efforts of oncological and translational research have concentrated on the identification of novel biomarkers which may successfully inform prognosis and response to therapies, improve current therapeutic strategies, and enhance prognostication. Mi(cro)RNAs are small, non-coding molecules which are known to play regulatory roles in governing gene expression and cellular activity. Measurement of miRNA expression profiles have been illustrated to inform the response to therapies, such as conventional chemotherapy, and are currently undergoing assessment as means of enhancing treatment strategies with these cytotoxic agents. Herein, this review outlines how chemotherapy prescription has revolutionised breast cancer treatment and illustrates the novel role of miRNAs as biomarkers capable of enhancing current therapeutic strategies using chemotherapy in patients being treated with curative intent for breast cancer.

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Involvement of Breast Cancer-Associated Fibroblasts in Tumor Development, Therapy Resistance and Evaluation of Potential Therapeutic Strategies

Current Medicinal Chemistry ◽

10.2174/0929867325666180309120746 ◽

2018 ◽

Vol 25 (29) ◽

pp. 3414-3434 ◽

Cited By ~ 11

Author(s):

Maria Rosaria Ruocco ◽

Angelica Avagliano ◽

Giuseppina Granato ◽

Valeria Imparato ◽

Stefania Masone ◽

...

Keyword(s):

Breast Cancer ◽

Chemotherapy Resistance ◽

Tumor Development ◽

Therapy Resistance ◽

Therapeutic Strategies ◽

Activation Process ◽

Cancer Therapies ◽

Cancer Associated Fibroblasts ◽

Breast Cancer Patients ◽

Cancer Management

Breast cancer is the most common cancer in women, which incidence has increased in recent years. It is constituted by very heterogeneous tissue characterized by an abnormal microenvironment regulating tumor progression and providing evasion from cancer therapies. Breast cancer-associated fibroblasts (BCAFs) are the main cell type of breast cancer microenvironment and can represent up to 80% of the tumor mass. In particular, BCAFs induce cancer initiation, proliferation, invasion and metastasis by undergoing an activation process associated with the secretion of growth factors, cytokines, and paracrine interactions. Therapy resistance is the main cause of poor therapeutic results or even failure in breast cancer patients. Despite recent advances in breast cancer management, there is a need for new prognostic markers and novel agents for targeting key signalling pathways to either improve the efficacy of the current therapies, or reduce toxicity. In this view, BCAFs represent markers useful to clinical diagnosis, therapy, and prognosis of breast cancer. This review focuses on the role of BCAFs in cancer, and describes the processes of endocrine/chemotherapy resistance linked to BCAFs action. Moreover, it points to molecules and pathways regulating therapy resistance induced by BCAFs. Finally, potential therapeutic strategies targeting BCAFs and offering new tools in breast cancer therapy are highlighted.

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ANALYSIS OF TOTAL COSTS OF BREAST CANCER CEMOTHERAPY PATIENTS BASED ON USE OF CHEMOTHERAPY REGIMEN ON JKN PATIENTS IN SANGLAH RSUP

Jurnal Endurance ◽

10.22216/jen.v2i3.2121 ◽

2017 ◽

Vol 2 (3) ◽

pp. 383

Author(s):

Ni Putu Wintariani ◽

Ni Made Okadwicandra ◽

Abdul Khodir Jaelani

Keyword(s):

Breast Cancer ◽

Chemotherapy Regimen ◽

Cost Of Care ◽

Test Method ◽

Breast Cancer Patients ◽

Cost Component ◽

Breast Cancer Chemotherapy ◽

Real Cost ◽

Therapy Regimen ◽

Levene Test

<p><em>Breast cancer is the first sequence of most attacking women in Indonesia. The high cost of care and old services is a major problem in the prevention of breast cancer. This study aims to determine the relationship between the total cost of the Sanglah Denpasar hospital with the chemotherapy regimen of breast cancer of JKN patients at Sanglah Hospital Denpasar. Test homogeneity using Levene test method. Test normality using Kolmogorov-Smirnov. One way ANOVA test results showed a significant relationship between chemotherapy therapy regimen (FAC, FAC + PAXUS, FEC, AC, AC + PAXUS) with total real cost in breast cancer chemotherapy patients (p = 0.001). The total rill cost was greater in the group receiving FAC + PAXUS, FEC, and AC + PAXUS regimens than the group receiving FAC and AC therapy regimens. This can be caused by a large pharmaceutical cost component in the FAC + PAXUS, FEC, and AC + PAXUS groups. Pharmaceutical costs account for 76.84-85.80% of the total real cost of breast cancer patients receiving chemotherapy. More drug combination factors can lead to higher total rill costs in patients receiving FAC + PAXUS, FEC, and AC + PAXUS.</em></p>

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The feasibility of same day pegfilgrastim-cbqv administration in breast cancer patients receiving myelosuppressive chemotherapy regimens at a northern Virginia cancer center.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18687 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18687-e18687

Author(s):

Maya Leiva ◽

Angela Pennisi ◽

Kathleen Kiernan Harnden ◽

Patricia Conrad Rizzo ◽

Lauren Ann Mauro

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Small Sample Size ◽

Standard Of Care ◽

Secondary Prophylaxis ◽

Small Sample ◽

Cancer Center ◽

Breast Cancer Patients ◽

Curative Intent ◽

Myelosuppressive Chemotherapy

e18687 Background: The long-acting injectable G-CSF, pegfilgrastim and its biosimilars have historically been given to patients 24 hours following the administration of myelosuppressive chemotherapy for either primary or secondary prophylaxis of febrile neutropenia (FN). Previous literature has indicated that pegfilgrastim administration prior to 24 hours post chemotherapy, may result in a deepened and prolonged neutropenia due to the increase in circulating granulocytes exposed to chemotherapy. With the onset of the COVID-19 pandemic and to reduce potential SAR-CoV-2 exposure to cancer patients on therapy, we implemented same day administration of injectable pegfilgrastim-cbqv among select breast cancer patients receiving myelosuppressive chemotherapy regimens from March 2020 – February 2021. Methods: Utilizing retrospective EHR chart reviews, 55 patients among 4 medical oncologists in our breast cancer group were identified as meeting the criteria of same day pegfilgrastim-cbqv administration. Inclusion was based on completion of at least 2 consecutive cycles of same day pegfilgrastim-cbqv 6 mg subcutaneous injection for primary or secondary prophylaxis. The selected patient charts were reviewed for the incidence and severity of FN. Among the patients who had documented FN, further subgroup analyses were done regarding baseline characteristics, timing of neutropenia, regimens, regimen sequence, and reported ADRs associated with pegfilgrastim-cbqv. Results: 9 (16.4%) of the 55 patients experienced FN (Grades 3-4) and 6 (10.9%) patients were hospitalized. There were no Grade 5 events and none had therapy discontinued due to FN. 8 (88.9%) of the patients experienced FN between cycles 1 and 2. Of note, there were no cases of COVID-19 among the 9 patients who had an episode of FN. 52 (94.5%) of the 55 patients received treatment with curative intent and 3 (5.5%) had metastatic disease on a subsequent line of therapy. The median age was 49.1 years (range 29-71) and patients were 56.4% Caucasian, 18.1% Black or African American, 12.7% Asian, and 12.7% Hispanic/Latina. Conclusions: Based on the retrospective data analysis, same day pegfilgrastim-cbqv appears to be a safe and effective option in the primary and secondary prophylaxis of FN with myelosuppressive standard of care chemotherapy used in breast cancer treatment. Though our review was limited by a relatively small sample size and confined to younger (49.1 median age) breast cancer patients, this opens the door to further re-evaluation of same day pegfilgrastim-cbqv administration in other patient populations. In a post pandemic treatment world, this slight change in practice has the potential to reduce patient financial toxicity associated with multiple medical visits, provide an alternative to on-body injector formulations, and ensure treatment adherence.

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Complications following breast cancer therapy in the adult spina bifida population: A case report

Canadian Urological Association Journal ◽

10.5489/cuaj.503 ◽

2013 ◽

Vol 7 (11-12) ◽

pp. 761

Author(s):

Nathan Y Hoy ◽

Peter Metcalfe

Keyword(s):

Breast Cancer ◽

Case Report ◽

Spina Bifida ◽

Ileal Conduit ◽

Subsequent Treatment ◽

Breast Cancer Chemotherapy ◽

Cancer Management ◽

First Case ◽

Breast Cancer Management ◽

Neurogenic Bowel

Survival to adulthood in spina bifida has greatly increased with the advent of modern therapies. With this prolonging of life expectancy, patients are exposed to the risk of adult onset malignancies and the complications of subsequent treatment. We present the case of a 66-year-old woman born with a terminal lipomyelomeningocele, presenting with new fecal incontinence and a desire to undivert her ileal conduit. The deterioration was attributed to chemotherapy for breast cancer. We highlight the urologic challenges of breast cancer management in the neurogenic bowel population, as well as the utility of an adult spina bifida clinic. To the best of our knowledge, this is the first case report of a spina bifida patient presenting with fecal and urinary complications from breast cancer chemotherapy.

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Exosomes: A Forthcoming Era of Breast Cancer Therapeutics

Cancers ◽

10.3390/cancers13184672 ◽

2021 ◽

Vol 13 (18) ◽

pp. 4672

Author(s):

Banashree Bondhopadhyay ◽

Sandeep Sisodiya ◽

Faisal Abdulrahman Alzahrani ◽

Muhammed A. Bakhrebah ◽

Atul Chikara ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Therapeutics ◽

Therapeutic Strategies ◽

Breast Cancer Patients ◽

Liquid Biopsies ◽

Non Invasive ◽

Tumor Tissues ◽

Circulating Markers

Despite the recent advancements in therapeutics and personalized medicine, breast cancer remains one of the most lethal cancers among women. The prognostic and diagnostic aids mainly include assessment of tumor tissues with conventional methods towards better therapeutic strategies. However, current era of gene-based research may influence the treatment outcome particularly as an adjunct to diagnostics by exploring the role of non-invasive liquid biopsies or circulating markers. The characterization of tumor milieu for physiological fluids has been central to identifying the role of exosomes or small extracellular vesicles (sEVs). These exosomes provide necessary communication between tumor cells in the tumor microenvironment (TME). The manipulation of exosomes in TME may provide promising diagnostic/therapeutic strategies, particularly in triple-negative breast cancer patients. This review has described and highlighted the role of exosomes in breast carcinogenesis and how they could be used or targeted by recent immunotherapeutics to achieve promising intervention strategies.

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Factors affecting radiotherapy prescribing patterns in the post-mastectomy setting

Current Oncology ◽

10.3747/co.25.3773 ◽

2018 ◽

Vol 25 (2) ◽

pp. 146 ◽

Cited By ~ 2

Author(s):

T.A. Koulis ◽

A. Dang ◽

C. Speers ◽

R.A. Olson

Keyword(s):

Breast Cancer ◽

Background Radiation ◽

Prescribing Patterns ◽

Autologous Reconstruction ◽

Breast Cancer Patients ◽

Prescribing Practices ◽

Curative Intent ◽

Factors Affecting ◽

Treatment Information ◽

Treatment Centre

Background Radiation therapy (rt) after mastectomy for breast cancer can improve survival outcomes, but has been associated with inferior cosmesis after breast reconstruction. In the literature, rt dose and fractionation schedules are inconsistently reported. We sought to determine the pattern of rt prescribing practices in a provincial rt program for patients treated with mastectomy and reconstruction.Methods Women diagnosed with stages 0–iii breast cancer between January 2012 and December 2013 and treated with curative-intent rt were identified from a clinicopathology database. Patient demographic, tumour, and treatment information were extracted. Of the identified patients, those undergoing mastectomy were the focus of the present analysis.Results Of 4016 patients identified, 1143 (28%) underwent mastectomy. The patients treated with mastectomy had a median age of 57 years, and 37% of them underwent reconstruction. Treatment with more than 16 fractions of rt was associated with autologous reconstruction [odds ratio (or): 37.2; 95% confidence interval (ci): 11.2 to 123.7; p < 0.001], implant reconstruction (or: 93.3; 95% ci: 45.3 to 192.2; p < 0.001), and treating centre. Hypofractionated treatment was associated with older age (or: 0.94; 95% ci: 0.92 to 0.96; p < 0.001), and living more than 400 km from a treatment centre (or: 0.37; 95% ci: 0.16 to 0.86; p = 0.02).Conclusions Prescribing practices in breast cancer patients undergoing mastectomy are influenced by reconstruction intent, age, nodal status, and distance from the treatment centre. Those factors should be considered when making treatment decisions.

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Getting It Wrong Most of The Time: Comparing Trialists’ Choice of Primary Outcome With What Patients And Health Professionals Want

10.21203/rs.3.rs-1084868/v1 ◽

2021 ◽

Author(s):

Shaun Treweek ◽

Viviane Miyakoda ◽

Dylan Burke ◽

Frances Shiely

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Health Care Professionals ◽

Primary Outcome ◽

Healthcare Professionals ◽

Breast Cancer Patients ◽

Additional Information ◽

Cancer Management ◽

Breast Cancer Management ◽

Secondary Outcomes

Abstract Background: Randomised trials support improved decision-making through the data they collect. One important piece of data is the primary outcome – so called because it is what the investigators decide is the most important. Secondary outcomes provide additional information to support decision-making. We were interested in knowing how important patients and healthcare professionals consider the outcomes (especially the primary outcome) measured in a selection of published trials. Methods: The work had three stages: 1. We identified a body of late-stage trials in two clinical areas, breast cancer management and nephrology. 2. We identified the primary and secondary outcomes for these trials. 3. We randomly ordered these outcomes and presented them to patients and healthcare professionals (with experience of the clinical area), and we asked them to rank the importance of the outcomes. They were not told which outcomes trial authors considered primary and secondary. Results: In our sample of 44 trials with 46 primary outcomes, 29 patients, one patient representative and 12 healthcare professionals together ranked the primary outcome as the most important outcome 13/46 times, or 30%. Breast cancer patients and health care professionals considered the primary outcome to be the most important outcome for 8/21 primary outcomes chosen by trialists. For nephrology, the equivalent figure was 5/25. The primary outcome appeared in a respondent’s top 5 ranked outcomes 151/178 (85%) times for breast cancer and 225/259 (87%) times for nephrology even if the primary wasn’t considered the most important outcome. Conclusions: The primary outcome in a trial is the most important piece of data collected. It is used to determine how many participants are required, and it is the main piece of information used to judge whether the intervention is effective or not. Our study found that in the view of patients and healthcare professionals, teams doing trials in breast cancer management and nephrology got their choice of primary outcome wrong 70% of the time.

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Suggested modifications in the management of breast cancer patients in the era of COVID-19 pandemic: a web-based survey. (Preprint)

10.2196/preprints.27073 ◽

2021 ◽

Author(s):

Shereef Elsamany ◽

Mohamed Elbaiomy ◽

Ahmed Zeeneldin ◽

Emad Tashkandi ◽

Fayza Hassanin ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

United Arab Emirates ◽

Hormonal Therapy ◽

Breast Cancer Patients ◽

Her2 Positive ◽

Web Based ◽

Cancer Management ◽

Breast Cancer Management ◽

Positive Breast Cancer

BACKGROUND Management of cancer patients in the current era of COVID-19 pandemic poses a significant challenge on health care systems. OBJECTIVE We explored the views of oncologists for the management of breast cancer patients during COVID-19 pandemic. METHODS A web-based questionnaire using SurveyMonkey was submitted to licensed oncologists involved in breast cancer management in Saudi Arabia, Egypt and United Arab Emirates. The survey focused on characteristics of participants, infection risk among cancer patients and possible treatment modifications related to different types of breast cancer RESULTS The survey was completed by 82 participants. For early HR positive, HER2-negative breast cancer,74.4% supported using neoadjuvant hormonal therapy in selected patients, and 58.0% preferred giving 6 over 8 cycles of adjuvant chemotherapy when indicated. Only 42.7% preferred CDK4/6 inhibitor with hormonal therapy as first line in all patients with metastatic HR-positive disease. 67.1% of participants supported using adjuvant trastuzumab for 6 instead of 12 months in selected patients with HER2-positive breast cancer. For metastatic HER2-positive, HR-positive breast cancer, 80.5% of participants supported the use of hormonal therapy with dual anti-HER2 blockade in selected patients. The preferred choice of 1st line treatment in metastatic triple negative patients with BRCA mutation and PDL1<1%, was PARP inhibitor according to 42.5% of the participants, and atezolizumab with nabpaclitaxel if the PDL1>1% according to 70.4% of the participants. CONCLUSIONS Several modifications in breast cancer management is supported by the survey participants. These modifications need to be discussed on local basis taking into account the local infrastructure and available resources. CLINICALTRIAL none

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Cognitive impairment after cytotoxic chemotherapy

Neuro-Oncology Practice ◽

10.1093/nop/npz052 ◽

2019 ◽

Vol 7 (1) ◽

pp. 11-21 ◽

Cited By ~ 2

Author(s):

Petra Huehnchen ◽

Antonia van Kampen ◽

Wolfgang Boehmerle ◽

Matthias Endres

Keyword(s):

Breast Cancer ◽

Colon Cancer ◽

Cognitive Impairment ◽

Cancer Patients ◽

Cytotoxic Chemotherapy ◽

Cytotoxic Drugs ◽

Cytotoxic Agents ◽

Cancer Type ◽

Breast Cancer Patients ◽

The Impact

Abstract Background Neurotoxicity is a frequent side effect of cytotoxic chemotherapy and affects a large number of patients. Despite the high medical need, few research efforts have addressed the impact of cytotoxic agents on cognition (ie, postchemotherapy cognitive impairment; PCCI). One unsolved question is whether individual cytotoxic drugs have differential effects on cognition. We thus examine the current state of research regarding PCCI. Neurological symptoms after targeted therapies and immunotherapies are not part of this review. Methods A literature search was conducted in the PubMed database, and 1215 articles were reviewed for predefined inclusion and exclusion criteria. Thirty articles were included in the systematic review. Results Twenty-five of the included studies report significant cognitive impairment. Of these, 21 studies investigated patients with breast cancer. Patients mainly received combinations of 5-fluorouracil, epirubicin, cyclophosphamide, doxorubicin, and taxanes (FEC/FEC-T). Five studies found no significant cognitive impairment in chemotherapy patients. Of these, 2 studies investigated patients with colon cancer receiving 5-fluorouracil and oxaliplatin (FOLFOX). Independent risk factors for PCCI were patient age, mood alterations, cognitive reserve, and the presence of apolipoprotein E e4 alleles. Conclusions There is evidence that certain chemotherapy regimens cause PCCI more frequently than others as evidenced by 21 out of 23 studies in breast cancer patients (mainly FEC-T), whereas 2 out of 3 studies with colon cancer patients (FOLFOX) did not observe significant changes. Further studies are needed defining patient cohorts by treatment protocol in addition to cancer type to elucidate the effects of individual cytotoxic drugs on cognitive functions.

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Systemic Treatment Options for HER2-Positive Breast Cancer Patients with Brain Metastases beyond Trastuzumab: A Literature Review

Breast Care ◽

10.1159/000467387 ◽

2017 ◽

Vol 12 (3) ◽

pp. 168-171 ◽

Cited By ~ 12

Author(s):

Elena Laakmann ◽

Volkmar Müller ◽

Marcus Schmidt ◽

Isabell Witzel

Keyword(s):

Breast Cancer ◽

Brain Metastases ◽

Cancer Patients ◽

Systemic Treatment ◽

Treatment Options ◽

Cytotoxic Agents ◽

Breast Cancer Patients ◽

Her2 Positive ◽

Her2 Positive Breast Cancer ◽

Positive Breast Cancer

Background: The incidence of brain metastases (BM) in breast cancer patients has increased. Many retrospective analyses have shown that first-line treatment with trastuzumab prolongs survival in patients with HER2-positive BM. In contrast, the evidence for other therapies targeting HER2 for patients with BM is rare. Methods: The aim of this review is to update the reader about current systemic treatment options in patients with HER2-positive metastatic breast cancer with BM who had already received trastuzumab. A literature search was performed in the PubMed database in June 2016. 30 relevant reports concerning the efficacy of trastuzumab emtansine (T-DM1), lapatinib and its combination with other cytotoxic agents, pertuzumab and novel HER2-targeting substances were identified. Results: There is limited but promising evidence for the use of T-DM1 and pertuzumab in the treatment of BM. Up to now, most reported studies used lapatinib as treatment of HER2-positive breast cancer with BM, a treatment with only a modest effect and a high toxicity profile. The combination of lapatinib with cytotoxic agents seems to result in better response rates. Conclusion: Further prospective investigations are needed to investigate the efficacy of the established and novel HER2-targeting agents on BM in HER2-positive breast cancer patients.

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