Breast Cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology

Gradishar, William J.; Anderson, Benjamin O.; Abraham, Jame; Aft, Rebecca; Agnese, Doreen M.; Allison, Kimberly H.; Blair, Sarah L.; Burstein, Harold J.; Dang, Chau T.; Elias, Anthony; Giordano, Sharon H.; Goetz, Matthew P.; Goldstein, Lori J.; Isakoff, Steven J.; Krishnamurthy, Jairam; Lyons, Janice A.; Marcom, P. Kelly; Matro, Jennifer M.; Mayer, Ingrid A.; Moran, Meena S.; Mortimer, Joanne; O’Regan, Ruth; Patel, Sameer A.; Pierce, Lori J.; Rugo, Hope S.; Sitapati, Amy M.; Smith, Karen L.; Smith, Mary Lou; Soliman, Hatem; Stringer-Reasor, Erica; Telli, Melinda L.; Ward, John H.; Young, Joseph C.; Burns, Jennifer L.; Kumar, Rashmi

doi:10.6004/jnccn.2020.0016

Cited by 1,016 publications

(694 citation statements)

References 180 publications

(250 reference statements)

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“…Cancer November 15, 2019 effects, 33,34 but studies of these treatments have not yet reported improvements in adherence. Differences between physicians and patients in perceptions of medicines may also pose important barriers to adherence: patients in 1 large AET study reported that an important barrier to continuing AET was "I was not sure if it (the medication) was helping," 35 and a meta-analysis of 5 randomized studies showed that educational interventions to address such issues had little impact on adherence.…”

Section: Discussionmentioning

confidence: 99%

The association of pharmacy fill synchronization with breast cancer endocrine therapy adherence

Neuner

Fergestrom

Laud

et al. 2019

Cancer

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Background One‐third to one‐half of patients prescribed adjuvant endocrine therapy are nonadherent during the recommended 5‐year endocrine therapy course. This study investigated whether poor pharmacy synchronization of medication fills (requiring refills on different days) acts as a barrier to adherence. Methods A cohort of older women with stage 0 to III endocrine receptor–positive breast cancer in 2011 was identified from the Surveillance, Epidemiology, and End Result–Medicare claims‐linked cancer registry. Women with endocrine therapy and at least 1 other medication fill were identified, and the 3‐month synchronization of their fills was calculated as 1 minus the quotient of the number of pharmacy visits and the number of filled medications. Regression models were used to examine the association between synchronization (in quartiles adjusted for the number of medications) and adherence to endocrine therapy (defined as a medication possession ratio ≥80%) over the subsequent year. Results During the 3 months after the first endocrine therapy prescription, the study cohort of 3212 women had a mean of 8.6 pharmacy visits (standard deviation, 4.7) with a mean synchronization of 0.3 (standard deviation, 0.2). Those in the third (odds ratio, 1.29; 95% confidence interval, 1.04‐1.59) and fourth (most) medication number–adjusted synchronization quartiles (odds ratio, 1.49; 95% confidence interval, 1.19‐1.86) were more likely to be adherent than those in the least. Multivariate model predictions showed that the proportion of patients who were adherent over 1 year varied from 68.9% in the least synchronized quartile to 76.6% in the most synchronized one. Conclusions Prescription refill synchronization is strongly associated with adherence to endocrine therapy. Efforts to improve adherence should address this.

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Section: Discussionmentioning

confidence: 99%

The association of pharmacy fill synchronization with breast cancer endocrine therapy adherence

Neuner

Fergestrom

Laud

et al. 2019

Cancer

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“…The resource‐stratified guidelines for breast cancer treatment describe the laboratory testing components needed to treat breast cancer 18,19 . For maximally resourced settings, this includes the traditional prognostic factors and the biomarkers and molecular tests mentioned above 20 . For the basic level of essential pathology, the list includes the traditional prognostic factors and ER/PR testing, but it excludes HER2 testing because the cost of therapy is very high.…”

Section: Resource‐stratified Guidelines For Breast Pathology Evaluationmentioning

confidence: 99%

Can pathology diagnostic services for cancer be stratified and serve global health?

Anglade¹,

Milner

Brock

2020

Cancer

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BACKGROUND: Before initiating cancer therapy, a diagnostic tumor tissue sample evaluated within a pathology laboratory by a pathologist is essential to confirm the malignancy type and provide key prognostic factors that direct the treatment offered. METHODS: Pathology evaluation includes multiple expensive reagents, complex equipment, and both laboratory and pathologist technical skills. By using breast cancer as an example, at a minimum, key tumor prognostic information required before the initiation of treatment includes subtype, tumor grade, tumor size, lymph node status when possible, and biomarker expression determined by immunohistochemistry for estrogen receptor. The additional determination of biomarker expression of progesterone receptor and human epidermal growth factor receptor (HER2) is the standard of care in high-resource settings, but assays may not be affordable in low-income and middleincome countries. RESULTS: With positive tests, patients are eligible for either tamoxifen (for estrogen receptor-positive/progesterone receptor-positive cancers) or monoclonal antibody therapy (for HER2-positive cancers). For settings in which endocrine therapy and/ or HER2-targeted therapy is unavailable, biomarker studies have no utility, and high-resource setting standards for pathology evaluation and reporting are unachievable. Resource-stratified pathology evaluation guidelines in cancer diagnosis have not been developed, in contrast to excellent comprehensive, resource-stratified clinical guidelines for use in low-income and middle-income countries, and these are long overdue. CONCLUSIONS: The challenges of pathology evaluation in the context of global health are being met by innovative solutions, which may change the face of pathology practice. Cancer 2020;126:2431-2438.

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“…Currently, neoadjuvant therapy for luminal A patients includes NAC and neoadjuvant endocrine therapy. NAC is still the preferred treatment [6,7]. The chemotherapy regimens of this type of patients are based on anthracycline and taxane, but the effective rate is only 13-14.1% [8,9],sometimes even lower than the effective rate of neoadjuvant endocrine therapy [10], and the adverse events of chemotherapy will cause unnecessary pain for patients who will not bene t from it.…”

Section: Introductionmentioning

confidence: 99%

ABTB2 regulatory variant as predictor of epirubicin-based neoadjuvant chemotherapy in luminal A breast cancer

Gong

et al. 2020

Preprint

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Background: Epirubicin combined with docetaxel is the cornerstone of neoadjuvant chemotherapy(NAC) for breast cancer. The efficacy of NAC for luminal A breast cancer patients is very limited, and single nucleotide polymorphism is one of the most important factor that influence the efficacy. Our study aimed to explore genetic markers for the efficacy of epirubicin combined with docetaxel for NAC in patients with luminal A breast cancer.Methods: A total of 421 patients with two stages of luminal A breast cancer were enrolled in this study from 2 centers. Among them 231 patients included in discovery cohort and 190 patients are in replication cohort. All patients received epirubicin 75mg/m2 and docetaxel 75mg/m2 on day 1, 21 days. a cycle for 2 to 6 cycles. Before treatment, 2ml of peripheral blood was collected from each patient to isolate genomic DNA. Fourteen functional variants potentially regulating epirubicin/docetaxel response genes were prioritized by CellMiner and bioinformatics approaches. Moreover, biological assays were performed to determine the effect of genetic variations on response to chemotherapy.Results: The patients carrying rs6484711 variant A allele suffered a poor response to epirubicin and docetaxel for NAC (OR=0.63, 95% CI: 0.44-0.89, P=0.010) in combined stage. Moreover, expression quantitative trait loci (eQTL) analyses and luciferase reporter assays revealed that rs6484711 A allele significantly increased the expression of ABTB2. Subsequent biological assays illustrated that upregulation of ABTB2 significantly reduced the apoptosis rate of breast cancer cells and enhanced the chemo-resistance to epirubicin. Conclusions: Our study demonstrated rs6484711 polymorphism regulating ABTB2 expression might predict efficacy to epirubicin based NAC in luminal A breast cancer patients. These results provided valuable information about potential role of genetic variations in individualized chemotherapy.

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Breast Cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology

Cited by 1,016 publications

References 180 publications

The association of pharmacy fill synchronization with breast cancer endocrine therapy adherence

The association of pharmacy fill synchronization with breast cancer endocrine therapy adherence

Can pathology diagnostic services for cancer be stratified and serve global health?

ABTB2 regulatory variant as predictor of epirubicin-based neoadjuvant chemotherapy in luminal A breast cancer

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