Neoadjuvant therapy in early-stage breast cancer

Moreno-Aspitia, Alvaro

doi:10.1016/j.critrevonc.2011.04.013

Cited by 22 publications

(15 citation statements)

References 76 publications

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“…Commonly accepted indications for NAC include the treatment of patients presenting with inflammatory breast cancer or T4 lesions (direct invasion of tumor into chest wall or skin) as well as treatment of women with initially operable tumors (T1c-3, N0-2, M0) who desire BCT but would be considered ineligible based on tumor size or tumor to breast size ratio [15,16]. A significant amount of clinical research has demonstrated the efficacy and safety of NAC in allowing patients initially considered ineligible for BCT to successfully undergo BCT without compromising patient overall survival.…”

Section: Introductionmentioning

confidence: 99%

Utilization of Neoadjuvant Chemotherapy Varies in the Treatment of Women with Invasive Breast Cancer

Onitilo

Onesti²,

Single

et al. 2013

PLoS ONE

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BackgroundTreatment with neoadjuvant chemotherapy (NAC) has made it possible for some women to be successfully treated with breast conservation therapy (BCT ) who were initially considered ineligible. Factors related to current practice patterns of NAC use are important to understand particularly as the surgical treatment of invasive breast cancer has changed. The goal of this study was to determine variations in neoadjuvant chemotherapy use in a large multi-center national database of patients with breast cancer. MethodsWe evaluated NAC use in patients with initially operable invasive breast cancer and potential impact on breast conservation rates. Records of 2871 women ages 18-years and older diagnosed with 2907 invasive breast cancers from January 2003 to December 2008 at four institutions across the United States were examined using the Breast Cancer Surgical Outcomes (BRCASO) database. Main outcome measures included NAC use and association with pre-operatively identified clinical factors, surgical approach (partial mastectomy [PM] or total mastectomy [TM]), and BCT failure (initial PM followed by subsequent TM). ResultsOverall, NAC utilization was 3.8%l. Factors associated with NAC use included younger age, pre-operatively known positive nodal status, and increasing clinical tumor size. NAC use and BCT failure rates increased with clinical tumor size, and there was significant variation in NAC use across institutions. Initial TM frequency approached initial PM frequency for tumors >30-40mm; BCT failure rate was 22.7% for tumors >40mm. Only 2.7% of patients undergoing initial PM and 7.2% undergoing initial TM received NAC. ConclusionsNAC use in this study was infrequent and varied among institutions. Infrequent NAC use in patients suggests that NAC may be underutilized in eligible patients desiring breast conservation.

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Section: Introductionmentioning

confidence: 99%

Utilization of Neoadjuvant Chemotherapy Varies in the Treatment of Women with Invasive Breast Cancer

Onitilo

Onesti²,

Single

et al. 2013

PLoS ONE

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“…Dogs and humans have similarities in breast cancer tumor types and in the distribution of the tumor types. Approximately two-thirds of human breast cancers are steroid hormone receptor (ER/PR) positive and treated with combinations of selective estrogen receptor modulators, gonadotropin-releasing hormone agonists, and/or aromatase inhibitors (131–133), either alone or in combination with third-generation cytotoxic or biological therapies (134, 135). Of the hormone-receptor negative tumors, some 20% are characterized by HER2 amplification and overexpression leading to a dependency on the family of EGF or related growth factors.…”

Section: Her and The Interaction Of Pathwaysmentioning

confidence: 99%

Molecular Signaling of Progesterone, Growth Hormone, Wnt, and HER in Mammary Glands of Dogs, Rodents, and Humans: New Treatment Target Identification

2017

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Mammary tumors are the most common form of neoplasia in the bitch. Female dogs are protected when they are spayed before the first estrus cycle, but this effect readily disappears and is already absent when dogs are spayed after the second heat. As the ovaries are removed during spaying, ovarian steroids are assumed to play an essential role in tumor development. The sensitivity toward tumor development is already present during early life, which may be caused by early mutations in stem cells during the first estrus cycles. Later on in life, tumors arise that are mostly steroid-receptor positive, although a small subset of tumors overexpressing human epidermal growth factor 2 (HER2) and some lacking estrogen receptor, progesterone receptor (PR), and HER2 (triple negative) are present, as is the situation in humans. Progesterone (P4), acting through PR, is the major steroid involved in outgrowth of mammary tissue. PRs are expressed in two forms, the progesterone receptor A (PRA) and progesterone receptor B (PRB) isoforms derived from splice variants from a single gene. The dog and the whole family of canids have only a functional PRA isoform, whereas the PRB isoform, if expressed at all, is devoid of intrinsic biological activity. In human breast cancer, overexpression of the PRA isoform is related to more aggressive carcinomas making the dog a unique model to study PRA-related mammary cancer. Administration of P4 to adult dogs results in local mammary expression of growth hormone (GH) and wing less-type mouse mammary tumor virus integration site family 4 (Wnt4). Both proteins play a role in activation of mammary stem cells. In this review, we summarize what is known on P4, GH, and Wnt signaling in canine mammary cancer, how the family of HER receptors could interact with this signaling, and what this means for comparative and translational oncological aspects of human breast cancer development.

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“…About two/third of human breast cancers are steroid hormone receptor (ER/PR) positive and treated with combinations of selective estrogen receptor modulators (SERMs), GnRH agonists and/or aromatase inhibitors [2][3][4], alone or in combination with third-generation cytotoxic or biological therapies [5,6]. A significant part of women treated by adjuvant hormonal therapies become ultimately therapy resistant [7,8] showing a relapse and development of distant metastasis.…”

Section: Introductionmentioning

confidence: 99%

Marginal activity of progesterone receptor B (PR-B) in dogs but high incidence of mammary cancer

Gračanin

Voorwald

Wolferen

et al. 2014

The Journal of Steroid Biochemistry and Molecular Biology

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Neoadjuvant therapy in early-stage breast cancer

Cited by 22 publications

References 76 publications

Utilization of Neoadjuvant Chemotherapy Varies in the Treatment of Women with Invasive Breast Cancer

Utilization of Neoadjuvant Chemotherapy Varies in the Treatment of Women with Invasive Breast Cancer

Molecular Signaling of Progesterone, Growth Hormone, Wnt, and HER in Mammary Glands of Dogs, Rodents, and Humans: New Treatment Target Identification

Marginal activity of progesterone receptor B (PR-B) in dogs but high incidence of mammary cancer

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