Breast cancer molecular profiles and tumor response of neoadjuvant doxorubicin and paclitaxel: The I-SPY TRIAL (CALGB 150007/150012, ACRIN 6657)

Esserman, Laura J.; Perou, CM; Cheang, Maggie C.U.; DeMichele, A.; Carey, LA; Veer, Laura J. van ’t; Gray, Joseph V.; Petricoin, EF; Conway, Kathleen; Hylton, N.; Berry, Diane

doi:10.1200/jco.2009.27.18s.lba515

Cited by 16 publications

(23 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have suggested that luminal-B breast cancer was relatively insensitive to endocrine therapy compared to luminal-A breast cancer and to paclitaxeland doxorubicin-containing preoperative chemotherapy compared with HER2-positive and basal-like breast cancers. However, luminal-B breast cancer responds better to neoadjuvant chemotherapy than luminal-A subtype, achieving higher pathological complete response rates [25][26][27][28][29] . Increased relapse rates observed in luminal-B tumors are limited to the first 5 years after diagnosis [30] .…”

Section: Luminal-bmentioning

confidence: 99%

Biological subtypes of breast cancer: Prognostic and therapeutic implications

Yersal

Barutça

2014

WJCO

796

578

View full text Add to dashboard Cite

show abstract

Section: Luminal-bmentioning

confidence: 99%

Biological subtypes of breast cancer: Prognostic and therapeutic implications

Yersal

Barutça

2014

WJCO

796

578

View full text Add to dashboard Cite

show abstract

“…This model is used to (multiply) impute pCR results for those patients who have not yet had surgery but who have had at least one post-randomization MRI. Longitudinal MRI volume measurements are predictive of outcomes at surgery [18-19]. The predictions are not perfect, but interim MRI measurements are informative and improve the performance of the adaptive design algorithm.…”

Section: I-spymentioning

confidence: 99%

Reports from the 2010 Clinical and Translational Cancer Research Think Tank Meeting: Design Strategies for Personalized Therapy Trials

Berry

Herbst

Rubin³

2012

Clinical Cancer Research

View full text Add to dashboard Cite

It has long been evident that cancer is a heterogeneous disease. But only relatively recently have we come to realize the extent of the heterogeneity. No single therapy is effective for every patient with tumors having the same histology. A clinical strategy based on a single-therapy approach results in overtreatment for the majority of patients. Biomarkers are knives slicing the disease ever more finely. The future of clinical research will be based on learning whether particular therapies are more appropriate for some biomarker-defined subsets than are other therapies. Therapies will eventually be tailored to narrow biomarker subsets. Determining which therapies are appropriate for which patients requires both biological science and empirical evidence from clinical trials. Neither aspect is easy. In this essay we describe some nascent approaches to designing clinical trials that are biomarker-based and adaptive. Our focus is on adaptive trials that address many questions at once. In a way these clinical experiments are themselves part of a much larger experiment: learning whether and how it is possible to design experiments that match patients in small subsets of disease with a therapies that are especially effective and possibly even curative for them.

show abstract

“…Fortunately, several studies have shown a marked chemosensitivity among these tumors, especially with regard to the neoadjuvant regimens. In fact, reports derived from diverse clinical trials, these subtypes of BC have demonstrated high response rates to neoadjuvant chemotherapy, including the schemes with anthracyclines and taxanes (Rouzier et al, 2005;Carey et al, 2007;Liedtke et al, 2008;Esserman et al, 2009). In these trials, the response of triple-negative BC is usually higher than those of other BC subtypes, but despite initial responsiveness, they show a poorer overall survival rate: such apparently surprising behavior is often referred to as "triple-negative BC paradox" (De Laurentiis et al, 2010).…”

Section: Wwwintechopencommentioning

confidence: 99%

Breast and Ovarian Cancer Treatment: Facing Forward Women's Health Care

Herlinger¹,

Madeira²,

Daltoé³

et al. 2011

Current Cancer Treatment - Novel Beyond Conventional Approaches

View full text Add to dashboard Cite

parameters guide tumor treatment decisions, as well as the disease prognosis evaluation (Arnone et al., 2010). It is likely that BC classification may require revision, as a recent cDNA microarray gene expression profiling study has classified BC into 5 distinct subtypes based on variations in gene expression patterns (Haupt, 2010). These 5 subtypes are luminal A and luminal B, normal breastlike, HER2 overexpressing, and basal-like subtypes (Nielsenet al., 2004;Haupt et al., 2010). BC treatment commonly follows combinatory schemes comprising surgery, radiotherapy, chemotherapy, and/or hormonotherapy. Surgical strategies of breast tumors vary according to the extent of the disease, which is evaluated as in situ carcinoma or invasive cancer. Lobular and ductal in situ carcinomas are treated, respectively, with excisional biopsy then prophylactic use of tamoxifen, or another hormonotherapy approach, for five years (depending on the tumor ER status), and mastectomy followed by radiotherapy. Partial mastectomy may also be considered. Although the discussion of BC surgery is beyond the scope of the present work, it is worthwhile to point that the decision to pursue with mastectomy, partial or radical, must consider that its curative benefit overpasses its mutilation impact on women's psychological health (Barros et al., 2009). On the other hand, invasive BC carcinomas are differentially treated depending on the tumor size, free surgical margins and residual post-surgical disease, skin damage, and the existence of metastasis. When BC is diagnosed as a tumor of 3 cm or less with free surgical margins, the recommendation is conservatory surgery, characterized by segmentar resection, followed by radiotherapy (Veronesi et al., 1995). Axillary linfadenectomy dissection is also advised whenever sentinel lymph node (SLN) tests positive for malignancy, as it indicates lymphoid drainage of the primary tumor micrometastasis (Fisher et al., 1997a). Nonetheless, invasive BC carcinomas larger than 3 cm at the disease diagnosis, both mastectomy and linfadenectomy are indicated. Breast reconstitution may be considered for patients presenting good clinical conditions (Barros et al., 2009). Regarding the conventional pharmacologic control of BC, there are several multidrug regimens preconized for neoadjuvant, adjuvant, or palliative chemotherapy approaches. As for any other antineoplastic approach, BC chemotherapy combines drugs with distinct cytotoxic mechanisms of action aiming the avoidance of drug resistant phenotype development by cancer cells. In this context, current BC chemotherapy schemes include drugs classified as anthracyclines, alkaloid taxanes, nitrogen mustard alkylating agents, antimetabolic drugs, and hormonotherapeutic agents. Of interest, the relevant pharmacodynamic aspects of the cited drugs will be briefly addressed [Drugs mechanisms of action have been reviewed by Brunton (2010)]. Anthracyclines, which include doxorubicin and epirrubicin, are considered cytotoxic antibiotics that comprise a tetracycline ring cou...

show abstract

Breast cancer molecular profiles and tumor response of neoadjuvant doxorubicin and paclitaxel: The I-SPY TRIAL (CALGB 150007/150012, ACRIN 6657)

Cited by 16 publications

References 0 publications

Biological subtypes of breast cancer: Prognostic and therapeutic implications

Biological subtypes of breast cancer: Prognostic and therapeutic implications

Reports from the 2010 Clinical and Translational Cancer Research Think Tank Meeting: Design Strategies for Personalized Therapy Trials

Breast and Ovarian Cancer Treatment: Facing Forward Women's Health Care

Contact Info

Product

Resources

About