Hormonothérapie du cancer du sein

Delozier, T.

doi:10.1016/j.jgyn.2010.10.004

Cited by 9 publications

(5 citation statements)

References 54 publications

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“…Ces chiffres sont cependant différents de ceux obtenus dans les études effectuées dans la zone européenne ou l'âge moyen au diagnostic semble être différent de celui de l'Afrique car plus de 50% des cancers du sein surviennent chez des femmes de 65 ans ou plus et seuls 25% surviennent avant l'âge de 50 ans avec un âge moyen au diagnostic de 61 ans [ Le dosage des récepteurs hormonaux permet de distinguer les tumeurs de bon pronostic avec des RH positifs de celles de mauvais pronostic RH négatifs. Les récepteurs hormonaux représentent un facteur pronostique et prédictif de la réponse à une hormonothérapie [12]. Dans l'étude de Delozier et al [12], il existerait une corrélation entre l'expression des récepteurs hormonaux et la réponse à la chimiothérapie et les tumeurs qui n'expriment pas les récepteurs hormonaux semblent plus chimio-sensibles.…”

Section: Discussionunclassified

“…Les récepteurs hormonaux représentent un facteur pronostique et prédictif de la réponse à une hormonothérapie [12]. Dans l'étude de Delozier et al [12], il existerait une corrélation entre l'expression des récepteurs hormonaux et la réponse à la chimiothérapie et les tumeurs qui n'expriment pas les récepteurs hormonaux semblent plus chimio-sensibles. Dans notre série, le dosage des récepteurs hormonaux (RH) était fait que chez 33 patientes (12%).…”

Section: Discussionunclassified

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Evaluation des facteurs pronostiques dans le cancer du sein chez la femme au Sénégal : à propos de 288 cas

Ndiaye¹,

Dieng²,

Thiam³

et al. 2021

Af J Oncol

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INTRODUCTION: In Senegal, breast cancer is the second female cancer and poses a major public health problem. The aim of this work was to assess prognostic factors in the progression of breast cancer in women. PATIENTS AND METHODS: This is a retrospective study carried out over a period of one year from January 1, 2008 to December 31, 2008 on all the women followed for breast cancer in the oncology department at the Joliot Curie Institute. Thus, 288 breast cancer patients were collected. RESULTS: The average age of our patients was 47.32 years. The average parity was 4.9 children per woman. Twenty-two or 7% of patients had a history of cancer. Clinically, the tumor size was classified as T4 in 180 patients, ie 81%. Lymph node involvement in 188 patients (65.2%). The most frequent histological type was invasive ductal carcinoma with 90.3% of cases. A predominance of grades SBRII and SBRIII was observed (respectively 41% and 46%). Hormone receptors (RH) were positive in eight cases (24%). Overexpression of the HER2 gene was found in only four out of 30 patients. The limits of the surgery were specified in 48 patients with invaded margins in seven patients (14.5%). The presence of vascular emboli was noted in 18 patients among the 29 whose research was carried out in 179 patients, ie 62%. At the time of the initial diagnosis, 45 patients or 19.7% of patients presented at least one distant metastasis. The majority of patients were received at an advanced stage (89%, classified between stage III and IV). Only one patient was received at stage I. Overall survival for breast cancer was 72% at 3 years and 30% at 5 years. The 5-year overall survival of patients with localized disease was 85% compared to 5% for patients with advanced stage. CONCLUSION: The prognostic factors are multiple and often pejorative in our patients with a predominance of young women, locally advanced cancers and aggressive biological forms.

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Section: Discussionunclassified

Evaluation des facteurs pronostiques dans le cancer du sein chez la femme au Sénégal : à propos de 288 cas

Ndiaye¹,

Dieng²,

Thiam³

et al. 2021

Af J Oncol

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“…For example, the hormone receptors for estrogen (ER+) and progesterone (P R+) are the first biomarkers used as predictive factors of response to hormone therapy in breast cancer patients. The expression of at least one of the two receptors allows the selection of patients who will benefit from tamoxifen or other hormonotherapy [2,3]. It is therefore important to identify biomarker-treatment interactions in RCTs [4,5] since this is a key point for improving precision medicine [1].…”

Section: Contentmentioning

confidence: 99%

“…Université Paris-Saclay, CESP, INSERM U1018 Oncostat, labeled Ligue Contre le Cancer, Villejuif, France 2. Bureau de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France 3. Department of Mathematics, University of Oslo, Oslo, Norway 4.…”

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Favoring the hierarchical constraint in penalized survival models for randomized trials in precision medicine

Belhechmi

Teuff

Bin

et al. 2022

Preprint

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Background: The research of biomarker-treatment interactions is commonly investigated in randomized clinical trials (RCT) for improving medicine precision. The hierarchical interaction constraint states that an interaction should only be in a model if its main effects are also in the model. However, this constraint is not guaranteed in the different penalized statistical approaches used for high-dimensional data selection. Results: To favor the property of the hierarchical interaction constraint, we proposed to create groups composed of the biomarker main effect and its interaction with treatment and to perform the bi-level selection on these groups. We proposed two weighting approaches (Single Wald (SW) and likelihood ratio test (LRT)) for the adaptive lasso method. The selection performance of these two approaches is compared to alternative lasso extensions (adaptive lasso with ridge-based weights, composite Minimax Concave Penalty, group exponential lasso and Sparse Group Lasso) through a simulation study. A RCT (NSABP B-31) randomizing 1574 patients (431 events) with early breast cancer aiming to evaluate the effect of adjuvant trastuzumab on distant-recurrence free survival with expression data from 462 genes measured in the tumour will serve for illustration. The simulation study illustrates that the adaptive lasso LRT and SW favored the hierarchical interaction constraint (with a ratio between the number of selected main effects and selected interactions greater than 50%). Overall, in the alternative scenarios, they had the best balance of false discovery and false negative rates for the main effects of the selected interactions. For NSABP B-31, 12 genes for which interaction with treatment was selected more than 20% were identified by the different methods. Among them, the adaptive lasso (SW) approach offered the best trade-off between a high number of selected gene-treatment interactions and a high proportion of selection of both the gene-treatment interaction and its main effect.Conclusions: Adaptive lasso with Single Wald and likelihood ratio test weighting approaches outperformed their competitors in favoring the hierarchical constraint of the biomarker-treatment interaction. However, the performance of the methods tends to decrease in the presence of prognostic biomarkers.

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“…However, in postmenopausal women, aromatase inhibitors are more effective than tamoxifen therapy and thus they are presently used as the first line of treatment and tamoxifen as the second line (10,11). In addition to SERMs, a new class of drugs called SERDs have emerged, which interact with and facilitate ER turnover in cells.…”

Section: Abstract: Breast Cancer Serms Tamoxifen Aromatase Inhibitmentioning

confidence: 99%

Immunomodulatory effects of anti-estrogenic drugs

Ray¹,

M²

2012

Acta Pharmaceutica

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Immunomodulatory effects of anti-estrogenic drugsThere are substantial experimental, epidemiological and clinical evidences that show that breast cancer pathology is influenced by endogenous estrogens. This knowledge is the foundation upon which endocrine deprivation therapy has been developed as a major modality for the management of breast cancer. Tamoxifen, which functions as a competitive partial agonist-inhibitor of estrogen at its receptor, has been widely used for more than three decades for adjuvant endocrine treatment in breast cancer. Currently, other effective drugs for endocrine therapy include raloxifene, different aromatase inhibitors (particularly third-generation agents) and luteinizing hormone-releasing hormone agonists. In recent years, a growing body of evidence suggests that these drugs can also act as immune modulators by altering the function of various leukocytes and the release of different cytokines. Moreover, there is evidence that anti-estrogens may prove to be beneficial in the treatment or prevention of some autoimmune diseases due to their effects on immune function. However, their immunopharmacological aspects in the present state of knowledge are not precisely comprehensible. Only a clear pathophysiological understanding could lead to an efficient strategy for breast cancer prevention and decrease in the mortality due to this disease.

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Hormonothérapie du cancer du sein

Cited by 9 publications

References 54 publications

Evaluation des facteurs pronostiques dans le cancer du sein chez la femme au Sénégal : à propos de 288 cas

Evaluation des facteurs pronostiques dans le cancer du sein chez la femme au Sénégal : à propos de 288 cas

Favoring the hierarchical constraint in penalized survival models for randomized trials in precision medicine

Immunomodulatory effects of anti-estrogenic drugs

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