Adjuvant and Neoadjuvant Treatment of Triple-Negative Breast Cancer With Chemotherapy
Triple-negative breast cancer (TNBC) accounts for 15% to 20% of all invasive breast carcinomas and is defined by the lack of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. Although TNBC is characterized by high rates of disease recurrence and worse survival, it is significantly more sensitive to chemotherapy as compared with other breast cancer subtypes. Accordingly, despite great efforts in the genomic characterization of TNBC, chemotherapy still represents the cornerstone of treatment. For the majority of patients with early-stage TNBC, sequential anthracycline- and taxane-based n...
Source: The Cancer Journal - January 1, 2021 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Local Treatment of Triple-Negative Breast Cancer
Triple-negative breast cancer, compared with other molecular subtypes, poses particular challenges for optimizing the timing and the extent of locoregional treatments. In the past, the combination of increased rates of both locoregional and distant recurrences led to a preference of radical surgery and extensive radiation therapy; however, since the introduction of more effective chemotherapy, a sharp de-escalation in the extent of locoregional treatments followed. Current evidence confirms that less aggressive surgery in combination with tailored radiation therapy offers improved oncological outcomes combined with better ...
Source: The Cancer Journal - January 1, 2021 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Tumor-Infiltrating Lymphocyctes in Triple-Negative Breast Cancer: Update for 2020
Triple-negative breast cancer (TNBC) continues to represent an unmet need because of its significantly poorer outcomes, including higher relapse rates following early-stage disease and dismal survival times in the advanced setting, when compared with other breast cancer subtypes (Cancer 2012;118:5463–5472). Furthermore, there remains a lack of established systemic treatment options beyond conventional cytotoxic chemotherapy, with the exception of PARP inhibitors in the small subset of patients who harbor a BRCA mutation (N Engl J Med 2018;379:753; Lancet Oncol 2020;21:1269–1282; Ann Oncol 2019;30:558–566) and recentl...
Source: The Cancer Journal - January 1, 2021 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Obesity and Energy Balance Considerations in Triple-Negative Breast Cancer
Obesity is an increasingly prevalent state of energy imbalance that contributes to breast cancer risk and outcomes. The effects of obesity differ by breast cancer subtype and menopause. While most studies have focused on postmenopausal hormone receptor–positive disease, less is known about the relationship between obesity and triple-negative breast cancer (TNBC). Here we will review the observations linking obesity to TNBC, the socioeconomic disparities that contribute to obesity-related TNBC, and putative biologic mechanisms. Finally, we will consider the impact of obesity on surgical and medical treatment of TNBC and n...
Source: The Cancer Journal - January 1, 2021 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Epidemiology of Triple-Negative Breast Cancer: A Review
Triple-negative breast cancer accounted for 12% of breast cancers diagnosed in the United States from 2012 to 2016, with a 5-year survival 8% to 16% lower than hormone receptor–positive disease. However, preventive and screening strategies remain tailored to the demographics of less lethal luminal cancers. This review examines the ethnic, genetic, and modifiable risk factors associated with triple-negative breast cancer, which providers must recognize to address the societal disparities of this deadly disease. Most notable is that triple-negative cancers disproportionately affect African American women and carriers of ge...
Source: The Cancer Journal - January 1, 2021 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Triple-Negative Breast Cancer: Breast Tumors With an Identity Crisis
Triple-negative breast cancer (TNBC) is pathologically defined by lack of expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 amplification and portends an aggressive clinical course with worse outcomes compared with other breast cancers. Until recently, standard treatment options consisted of sequential cytotoxic chemotherapies for both early and metastatic disease. Advances in sequencing technology have led to the identification of 4 main subtypes of TNBC based on recurrent genetic alterations, transcriptional patterns, and molecular features: basal-like 1 (BL1), basal...
Source: The Cancer Journal - January 1, 2021 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Triple-Negative Breast Cancer: One Size Does Not Fit All
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - January 1, 2021 Category: Cancer & Oncology Tags: From the Guest Editor Source Type: research
Erratum
No abstract available (Source: The Cancer Journal)
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Erratum Source Type: research
What Is on the Horizon for Novel Immunotherapies in Lung Cancer?
Programmed death (ligand) 1 checkpoint inhibitors have become standard treatment in patients with non–small cell lung cancer. Recently, combinations of nivolumab and ipilimumab have entered the clinic based on regulatory approval. Oftentimes, these checkpoint inhibitors are given in conjunction with chemotherapy. Through increased understanding of checkpoint evasion by cancer cells, many promising studies using combination therapies have continued to develop that aim to attack cancer cells by eliciting immunogenic responses through different modalities. Novel approaches include (1) using vaccines to trigger immune respon...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Immunotherapy for Lung Cancer—Improving Outcomes in Patients With Locally Advanced Non–Small Cell Lung Cancer With Immunotherapy
Patients with locally advanced non–small cell lung cancer (NSCLC), a heterogenous group encompassing stage IIIA–IIIC disease, often have surgically unresectable cancer and are managed with concurrent chemoradiation. Since the establishment of platinum-based chemoradiation as standard of care for unresectable locally advanced NSCLC, various strategies including escalating radiation dose, targeted therapies, antiangiogenic agents, and induction or consolidation chemotherapy have failed to show improvement in outcomes. However, recently, use of consolidation immunotherapy with durvalumab following concurrent chemoradiatio...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Moving Immunotherapy Into Early-Stage Lung Cancer
Blockade of the programmed cell death 1 immune inhibitory pathway has revolutionized the treatment of advanced non–small cell lung cancer and led to significant improvements in overall survival. In contrast, early-stage surgically resectable lung cancer has had few treatment advances in many years and continues to be associated with a high risk of relapse despite apparent curative resection. In this review, we discuss the many ongoing efforts to incorporate programmed cell death 1 pathway blockade into the treatment paradigm for surgically resectable lung cancer both as adjuvant and neoadjuvant therapy. We review the ear...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Optimizing Care for Patients With Adverse Events From Immunotherapeutics
Immune-related adverse events (irAEs) are a common occurrence in patients treated with immune checkpoint inhibitors. Fortunately, the majority of irAEs are mild and easily managed with steroids. As the use of immune checkpoint inhibitors and other immune therapies continues to increase across indications, so too will the need for managing irAEs. Optimal care for irAEs should include surveillance and early detection, guideline-driven management of standard irAEs, multidisciplinary expert involvement in complicated or steroid-refractory cases, and concurrent research to define predictive biomarkers and delineate the populati...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Immunotherapy Use in Patients With Lung Cancer and Comorbidities
Immune checkpoint inhibitor (ICI) therapy is now in widespread clinical use for the treatment of lung cancer. Although patients with autoimmune disease and other comorbidities were excluded from initial clinical trials, emerging real-world experience suggests that these promising treatments may be administered safely to individuals with inactive low-risk autoimmune disease such as rheumatoid arthritis or psoriasis, mild to moderate renal and hepatic dysfunction, and certain chronic viral infections. Considerations for ICI in autoimmune disease populations include exacerbations of the underlying autoimmune disease, increase...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Immunotherapy in EGFR-Mutant and ALK-Positive Lung Cancer: Implications for Oncogene-Driven Lung Cancer
Non–small cell lung cancer (NSCLC) is a heterogeneous disease, commonly defined by genetic alterations in oncogenic drivers. Targeted therapies have transformed the management of oncogene-driven lung cancers, with targeted agents now approved in the United States for 7 distinct molecular alterations. Nonetheless, acquired resistance remains an ongoing challenge, underscoring the need for alternative therapeutic approaches. Immune checkpoint inhibitors targeting the programmed cell death 1 (PD-1) axis have emerged as important therapies in the management of advanced NSCLC, but the role of these agents in patients with onc...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
Predictive Biomarkers for Immune Checkpoint Inhibitors in Advanced Non–Small Cell Lung Cancer: Current Status and Future Directions
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment paradigm for advanced non–small cell lung cancer (NSCLC). Although certain patients achieve significant, long-lasting responses from checkpoint blockade, the majority of patients with NSCLC do not and may be unnecessarily exposed to inadequate therapies and immune-related toxicities. Therefore, there is a critical need to identify biomarkers predictive of immunotherapy response. While tumor and immune cell expression of programmed death ligand-1 and, more recently, tumor mutational burden are used in clinical practice and may correlate with immunothera...
Source: The Cancer Journal - November 1, 2020 Category: Cancer & Oncology Tags: Review Articles Source Type: research
