New paradigms in adjuvant systemic therapy of breast cancer.

Abstract

Since the initial studies of adjuvant therapy in the 1970s, it has become increasingly clear that chemotherapy and hormone therapy have had a substantial effect on the survival of women with early breast cancer. It was originally assumed that only women with high-risk features would derive benefit from adjuvant therapy, but it is now apparent from numerous studies that adjuvant therapy improves survival in all subgroups of women with invasive breast cancer, although the absolute benefit varies depending on tumor stage and other prognostic features. Considerable progress has been made in elucidating effective adjuvant therapy regimens, but there continue to be many unanswered questions that are being addressed in ongoing clinical trials of adjuvant hormone therapy and chemotherapy. This paper reviews the current paradigms in adjuvant therapy, the published data that have affected current practice patterns, and the current controversies.

Securin is overexpressed in breast cancer

“…[17][18][19] A considerable challenge that remains is to identify those women who will best benefit from often intensive chemotherapeutic regimens, as absolute benefit varies depending on tumor stage and other prognostic features. 20 The premise that rapidly proliferating tumors are more dangerous than slowly dividing tumors is difficult to challenge, but the measurement of DNA content and/or S-phase fraction cannot always make this prediction. The use of proliferative markers such as Ki-67 can determine the proportion of actively dividing cells in a given tumor, but a potential disadvantage of Ki-67 is that it is expressed …”

Synthesis of texaphyrin conjugates

“…They rely on the use of methotrexate, 25, rather than cis-Pt, as the active chemotherapeutic group. Methotrexate is a cell cycle inhibitor that has a well-recognized role in oncology and is an agent that is used widely in conjunction with other cancer drugs [41][42][43]. Thus, potentiation of methotrexate by MGd might be anticipated, and has indeed been reported in in vitro models [44].…”