Current status of adjuvant systemic therapy for primary breast cancer: progress and controversy

Hortobágyi, Gabriel N.; Buzdar, Aman U.

doi:10.3322/canjclin.45.4.199

Cited by 71 publications

(37 citation statements)

References 83 publications

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“…Anthracyclines (doxorubicin or the 4-epimer epirubicin), considered the most effective drugs in advanced carcinomas, have been now introduced in the adjuvant setting and clinical data indicated that the inclusion of anthracyclines in adjuvant CT regimens produces a small but statistically significant improvement in survival over non-anthracycline-containing regimens (2). Unfortunately most patients will develop an acquired resistance during treatment and die of progressive disease (3). For this reason several studies have been devoted to the development of preclinical models aimed at understanding the molecular mechanisms producing treatmentresistant tumors.…”

Section: Introductionmentioning

confidence: 99%

Altered Expression of FAS System Is Related to Adverse Clinical Outcome in Stage I-II Breast Cancer Patients Treated with Adjuvant Anthracycline-Based Chemotherapy

Botti¹,

Buglioni²,

Benevolo³

et al. 2004

Clinical Cancer Research

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Purpose: To determine the prognostic value of Fas receptor and Fas ligand (FasL) as apoptosis-related biomarkers in the context of chemoresponsiveness in breast cancer (BC) patients submitted to anthracycline-based adjuvant therapy.Experimental Design: Fas and FasL were investigated by immunohistochemistry in surgical samples collected from 167 stage I-IIa-b BC patients enrolled in a prospective clinical trial using epirubicin plus cyclophosphamide in the adjuvant setting.Results: Fas and FasL were significantly associated with tumor stage (P < 0.0001). Multivariate analysis indicated that stage, loss of Fas (relative risk, 8.5 and 9.12; P < 0.0001) and FasL up-regulation (relative risk, 2.38 and 2.88; P ‫؍‬ 0.01) were independent prognostic variables influencing both disease-free survival (DFS) and overall survival (OS). A Cox analysis using a four-category Fas/FasL phenotype (؉/؊, ؉/؉, ؊/؉, ؊/؊) as a stratification factor evidenced a highly positive association between Fas/FasL phenotype and the cumulative hazard of relapse and death in the entire series of patients. We also estimated the DFS and OS for different combinations of the pathological-tumor-nodemetastasis (TNM) stage and Fas/FasL by using the K sample log-rank exact test demonstrating that significantly shorter DFS and OS were observed in Fas-negative and FasLpositive patients in both stage I-IIa and IIb.Conclusions: Data presented herein demonstrated that, according to a number of in vitro studies, the prognosis for BC patients receiving adjuvant anthracycline-based chemotherapy strongly depends on the Fas/FasL status. Therefore, a concomitant altered pattern of Fas/FasL expression seems to configure an aggressive tumor phenotype linked to disease progression.

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Section: Introductionmentioning

confidence: 99%

Altered Expression of FAS System Is Related to Adverse Clinical Outcome in Stage I-II Breast Cancer Patients Treated with Adjuvant Anthracycline-Based Chemotherapy

Botti¹,

Buglioni²,

Benevolo³

et al. 2004

Clinical Cancer Research

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“…1 The incidence of breast cancer has been steadily increasing, while the mortality rates for breast cancer have not changed significantly for the last 50 years. 2 A major characteristic of tumor malignancy and the primary cause of mortality in patients with breast cancer is the ability of the tumor cells to metastasize to distant sites. Breast cancer mortality is related to the capacity of the tumor cell to invade, metastasize, and proliferate.…”

mentioning

confidence: 99%

Treatment of human breast cancer cells with antisense RNA to the type I insulin-like growth factor receptor inhibits cell growth, suppresses tumorigenesis, alters the metastatic potential, and prolongs survival in vivo

Chernicky

Tan

et al. 2000

Cancer Gene Ther

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The type I insulin-like growth factor receptor (IGF-IR) plays an important role in the growth and transformation of breast cancer cells. In this study, we investigated the effects of treatment with an antisense IGF-IR construct on cells from the highly metastatic estrogen receptor-negative human breast cancer cell line MDA-MB-435s. The cells carrying the antisense IGF-IR had a markedly reduced expression of IGF-IR, had a significant decrease in cell proliferation, and lost the ability to form colonies in soft agar. There was a delay in tumor formation and a dramatic reduction in tumor size when cells carrying the antisense IGF-IR were injected into either nude or severe combined immunodeficient (scid) beige mice. We have also provided data that show that the scid beige mouse is a more suitable model for studying metastasis of the MDA-MB-435s cells. All of the scid beige mice injected with cells carrying the control construct had metastasis to the lungs, whereas lungs from the nude mice had no apparent metastatic sites after 11 weeks. When cells carrying antisense IGF-IR were injected subcutaneously in scid beige mice, the animals had a significant increase in survival compared with mice injected with cells carrying the control construct. Taken together, these results indicate that the IGF-IR can play a critical role in the progression of breast cancer. Our studies provide a basis for the development of future treatment strategies targeting the IGF-IR in metastatic breast cancer. Cancer Gene Therapy (2000) 7, 384 -395

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“…It is the most common type of cancer worldwide, with more than one million new cases every year. In spite of an increased incidence, mortality related to this condition has decreased in developed countries 1,2 . The probability for developing invasive cancer in women is 12.03% during their lifetime (one in every eight women) 3 .…”

Section: Introductionmentioning

confidence: 99%

Latissimus Dorsi Myocutaneous Extended Flap in the Reconstruction of Large Chest Wall Defects after Extensive Resections in Breast Pathology

Said-Lemus¹,

Peralta-Castillo²,

Salazar-Andrade³

et al. 2022

GAMO

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Locally advanced breast cancer remains a major problem in developing countries and it is a common presentation of this condition worldwide. In Mexico, 45% of breast cancer cases are diagnosed at locally advanced stages. Cutaneous coverage of the chest wall after extensive resection in breast cancer patients has always been a challenge for the surgical team, and latissimus dorsi flap is therefore widely used for chest wall reconstruction. With the classic technique, the size of the skin flap is usually not larger than 10 cm. For this reason, the use of latissimus dorsi extended flap has been implemented in our institution with the purpose to cover large defects of up to 40 cm. A retrospective study was carried out of all latissimus dorsi extended flap cases over a five-year period. A total of 30 patients have undergone reconstruction with a latissimus dorsi flap, out of which 15 were treated with the extended technique, with tumor resections of up to 30 cm being achieved. Mean age was 42.6 years. Recorded tumor dimensions were as large as 30 cm. There was a low rate of complications requiring surgical re-intervention (6.6%) throughout an average 15.8-month follow-up. This technique is reproducible and is carried out in a single surgical procedure, and can be considered for partial or total reconstruction of large esthetical defects for purely palliative or curative purposes. The success of this technique depends on adequate patient selection and multidisciplinary treatment coordinated between breast and plastic surgeons.(creativecommons.org/licenses/ by-nc-nd/4.0/).

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Current status of adjuvant systemic therapy for primary breast cancer: progress and controversy

Cited by 71 publications

References 83 publications

Altered Expression of FAS System Is Related to Adverse Clinical Outcome in Stage I-II Breast Cancer Patients Treated with Adjuvant Anthracycline-Based Chemotherapy

Altered Expression of FAS System Is Related to Adverse Clinical Outcome in Stage I-II Breast Cancer Patients Treated with Adjuvant Anthracycline-Based Chemotherapy

Treatment of human breast cancer cells with antisense RNA to the type I insulin-like growth factor receptor inhibits cell growth, suppresses tumorigenesis, alters the metastatic potential, and prolongs survival in vivo

Latissimus Dorsi Myocutaneous Extended Flap in the Reconstruction of Large Chest Wall Defects after Extensive Resections in Breast Pathology

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