Neoadjuvant or adjuvant chemotherapy in early breast cancer?

Neoadjuvant or adjuvant chemotherapy in early breast cancer? Expert Opin Pharmacother. 2020 Apr 01;:1-12 Authors: Montemurro F, Nuzzolese I, Ponzone R Abstract Introduction: The administration of chemotherapy before (neoadjuvant), rather than after surgery (adjuvant) in early breast cancer has been considered an optional strategy for patients with operable breast cancer. We reviewed this concept considering recent results in the field.Areas covered: Herein, the authors cover neoadjuvant chemotherapy with or without biologics in triple-negative and HER2-positive operable breast cancer with a focus on rates of complete pathological remission (pCR) in the breast and axilla. The impact of the CREATE X and KATERINE randomized clinical trials of post-surgical treatments in patients with residual disease after neoadjuvant chemotherapy is also discussed.Expert opinion: The CREATE X and KATERINE clinical trials show for the first time and with methodological strengths that, in TNBC and HER2-positive breast cancer patients, post-surgical capecitabine and T-DM1, respectively, can improve prognosis when the disease persists after neoadjuvant chemotherapy. Therefore, the role of pCR as a treatment endpoint and a guide for further treatment decisions is now demonstrated. On account of these results, neoadjuvant chemotherapy becomes not an option, but rather the preferred treatment strategy for more and more TNBC and HER2-positive breast cancer patients in clinical prac...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

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il;ois Bertucci Exquisitely exploiting defects in homologous recombination process, poly(ADP-ribose) polymerase (PARP) inhibitors have recently emerged as a promising class of therapeutics in human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer with germline breast cancer 1 (BRCA1) or breast cancer 2 (BRCA2) mutations (gBRCA1/2m). In this setting, PARP inhibitors, either as single agent or in combination with platinum-based chemotherapy, significantly increased progression-free survival, as compared to conventional chemotherapy. Accordingly, further therapeutic advances are expected at an ear...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
Condition:   Breast Cancer Invasive Interventions:   Drug: Pyrotinib;   Drug: Trastuzumab;   Drug: Pertuzumab;   Drug: Nab-paclitaxel;   Drug: EC chemotherapy;   Drug: Physician's choice;   Drug: T-DM1;   Procedure: Surgery Sponsors:   Shanghai Jiao Tong University School of Medicine;   Jiangsu HengRui Medicine Co., Ltd. Not yet recruiting
Source: - Category: Research Source Type: clinical trials
CONCLUSIONS: A delay in NSC initiation of more than 61 days after BC diagnosis was associated with an increased risk of death. Early initiation of NSC should be a priority; multidisciplinary teams must focus in coordination of care and patient-centered timely treatment planning and delivery. IMPLICATIONS FOR PRACTICE: As we demonstrated that a delay in neoadjuvant systemic chemotherapy initiation of more than 61 days after breast cancer diagnosis is associated with an increased risk of death, efforts must focus on early initiation of therapy, which should be a priority; multidisciplinary teams must enhance coor...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research
This article will serve as reference guide to pathologists on what we do and why we do the same.
Source: Indian Journal of Cancer - Category: Cancer & Oncology Authors: Source Type: research
To the Editor The main claim of the authors of the secondary analysis of the BrighTNess randomized clinical trial is that “patients with stages II to III TNBC who are not eligible for breast-conserving therapy (BCT) at presentation have an approximately 50% likelihood of converting to BCT eligible with neoadjuvant systemic therapy (NST).” This resulted in an overall increase in BCT eligibility of 7% (from 76.5% to 83.5%). However, the actual BCT rate after NST in 599 patients with pre- NST and post-NST evaluations for BCT eligibility was 57%, which is about 20% less than initially planned, and in agreement with...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Conclusions: An early MRI assessment after two NACT cycles, specifically of the tumour's axillary lymph nodes, has the potential to predict short-term BCSS in patients with locally advanced HER2-negative breast cancers. PMID: 32394761 [PubMed - as supplied by publisher]
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
This study aims to show the non-inferiority of eribulin, a non-taxane microtubule inhibitor, against taxane, as a partner for dual HER2 blockade.Methods/designThis multicenter, randomized, open-label, parallel-group, phase III study will involve a total of 480 Japanese women with HER2+ mBC who meet the following requirements: (1) age 20 –70 years; (2) no prior cytotoxic chemotherapy (excluding trastuzumab-emtansine) for mBC; (3) ≥ 6 months after prior neoadjuvant or adjuvant cytotoxic chemotherapy; (4) presence of any radiologically evaluable lesion; (5) left ventricular ejection fraction ≥...
Source: Trials - Category: Research Source Type: clinical trials
CONCLUSIONS: The expression level of ERBB2, ESR1, and few other genomic markers was highly predictive of pCR after trastuzumab-containing regimens. These findings need to be validated and calibrated in future studies. PMID: 32371537 [PubMed - as supplied by publisher]
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research
Endo Takabe We generated a 4-gene score with genes upregulated in LM2-4, a metastatic variant of MDA-MB-231 (DOK 4, HCCS, PGF, and SHCBP1) that was strongly associated with disease-free survival (DFS) in TCGA cohort (hazard ratio [HR]>1.2, p < 0.02). The 4-gene score correlated with overall survival of TCGA (HR = 1 .44, p < 0 .001), which was validated with DFS and disease-specific survival of METABRIC cohort. The 4-gene score was able to predict worse survival or clinically aggressive tumors, such as high Nottingham pathological grade and advanced cancer staging. High score was associated wit...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
llagher Determining which patients with early-stage breast cancer should receive chemotherapy is an important clinical issue. Chemotherapy has several adverse side effects, impacting on quality of life, along with significant economic consequences. There are a number of multi-gene prognostic signatures for breast cancer recurrence but there is less evidence that these prognostic signatures are predictive of therapy benefit. Biomarkers that can predict patient response to chemotherapy can help avoid ineffective over-treatment. The aim of this work was to assess if the OncoMasTR prognostic signature can predict pathologi...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
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