Breast Cancer in Low- and Middle-Income Countries: Why We Need Pathology Capability to Solve This Challenge.
Breast Cancer in Low- and Middle-Income Countries: Why We Need Pathology Capability to Solve This Challenge. Clin Lab Med. 2018 Mar;38(1):161-173 Authors: Martei YM, Pace LE, Brock JE, Shulman LN Abstract Breast cancer is the leading cause of cancer mortality among women in developing countries. Timely and accurate histopathological diagnosis of breast cancer is critical to delivering high-quality breast cancer care to patients in low- and middle-income countries (LMIC). The most important prognostic factors in breast cancer along with tumor size and nodal status are tumor grade, estrogen receptor status, as well as HER2 status in countries where specific targeted therapies are available. In addition, detailed and complete cancer registry data are needed to assess a country's disease burden and guide disease prioritization and allocation of resources for breast cancer treatment. Innovations in leapfrog technology and low-cost point-of-care tests for molecular evaluations are needed to provide accurate and timely pathology, with the ultimate goal of improving survival outcomes for patients with breast cancer in LMIC. PMID: 29412880 [PubMed - in process]
In patients with HER2-positive breast cancer treated with anthracyclines plus trastuzumab, can adding lisinopril or carvedilol reduce the risk of cardiotoxicity?
Authors: Martínez-Pérez C, Turnbull AK, Dixon JM Abstract INTRODUCTION: In breast cancer, estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) are essential biomarkers to predict response to endocrine and anti-HER2 therapies, respectively. In metastatic breast cancer, the use of these receptors and targeted therapies present additional challenges: temporal heterogeneity, together with limited sampling methodologies, hinders receptor status assessment, and the constant evolution of the disease invariably leads to resistance to treatment. Areas covered: This review summarizes the g...
(ECOG-ACRIN Cancer Research Group) Before TAILORx, there was uncertainty about treatment for women with hormone receptor-positive, HER2-negative, node-negative breast cancer and a score of 11-25 on a tumor gene test. The trial was designed to address this question and provides a definitive answer: no benefit from chemotherapy for women over 50 with a score of 11-25; 50 years old or younger with a score of 11-15; and any age with a score of 0-10.
Conclusion: Contrary to popular belief, we demonstrate that DOTA-PRIT can be successfully adapted to an internalizing antigen-antibody system such as HER2, with sufficient TIs and absorbed tumor doses to achieve a high probability of cures of established human breast cancer xenografts while sparing critical organs of significant radiotoxicity.
Conclusion: The results suggest that the aptamer-based probe is a powerful tool for fast and highly sensitive subtyping of breast cancer both in vitro and in vivo and is also very promising for the identification, diagnosis, and targeted therapy of breast cancer molecular subtypes.
AbstractPurposeTo investigate the efficacy of metformin (M) plus chemotherapy versus chemotherapy alone in metastatic breast cancer (MBC).MethodsNon-diabetic women with HER2-negative MBC were randomized to receive non-pegylated liposomal doxorubicin (NPLD) 60 mg/m2 + cyclophosphamide (C) 600 mg/m2 × 8 cycles Q21 days plus M 2000 mg/day (arm A) versus NPLD/C (arm B). The primary endpoint was progression-free survival (PFS).ResultsOne-hundred-twenty-two patients were evaluable for PFS. At a median follow-up of 39.6 months (interquartile range [IQR] 24.6 –50.7 months), 112 P...
(American Association for Cancer Research) Circulating tumor-cell (CTC) count could be used to choose hormone therapy or chemotherapy as frontline treatment for patients with estrogen receptor-positive (ER+), HER2-negative (HER2-) metastatic breast cancer, according to data from the phase III STIC CTC clinical trial presented at the 2018 San Antonio Breast Cancer Symposium. In the case of discrepancy between CTC count-based treatment choice and physician's choice of treatment, frontline chemotherapy was associated with a significant gain in overall survival.
(American Association for Cancer Research) Even with equivalent treatments in women with hormone receptor-positive, HER2-negative breast cancer, black women had significantly higher breast cancer recurrence and increased overall mortality compared to white women in a large phase III clinical trial, TAILORx, according to data presented at the 2018 San Antonio Breast Cancer Symposium.
Conclusion: ER+PR-HER2- breast cancer consists of clinically and genomically distinct groups that may require different treatment strategies. The non-luminal-like subgroup was associated with reduced benefit from endocrine therapy.
' Practice-changing'results support adjuvant trastuzumab emtansine in patients with HER2+ early stage breast cancer who have residual disease following surgery.Medscape Medical News