Progress in adjuvant systemic therapy for breast cancer

Abstract

The prognosis of patients with early stage breast cancer has greatly improved in the past three decades. Following the first adjuvant endocrine therapy and chemotherapy trials, continuous improvements of clinical outcomes have been achieved through intense therapeutic escalation, albeit with increased health-care costs and treatment-related toxicities. In contrast to the advances achieved in surgery or radiotherapy, the identification of the patient subgroups that will derive clinical benefit from therapeutic escalation has proved to be a daunting process hindered by a lack of collaboration between scientific groups and by the pace of drug development. In the past few decades, initiatives towards de-escalation of systemic adjuvant treatment have achieved success. Herein, we summarize attempts to escalate and de-escalate adjuvant systemic treatment for patients with breast cancer and argue that new, creative trial designs focused on patients' actual needs rather than on maximizing drug market size are needed. Ultimately, the adoption of effective treatments that do not needlessly expose patients and health-care systems to harm demands extensive international collaboration between academic groups, governments, and pharmaceutical companies.

Antitumor functions and mechanisms of nitidine chloride in human cancers

“…Breast cancer is one of the leading causes of cancer-mediated deaths in female [8]. Currently, the treatments of breast cancer include surgery, radiotherapy, and chemotherapy.…”

“…Currently, the treatments of breast cancer include surgery, radiotherapy, and chemotherapy. However, due to metastasis and drug resistance, breast cancer patients have poor prognosis [8]. NC has been reported to Ivyspring International Publisher inhibit the metastasis of breast cancer cells via inactivation of the c-Src/FAK-associated pathway [3].…”

“…Accumulating evidence suggest that EMT plays an essential role in tumor metastasis due to that mesenchymal cells acquire more migratory feature [8]. EMT is a programme that epithelial cells transfer to mesenchymal cells, which is often happened in multiple biological processes such as fibrosis, wound healing, and tumor metastasis [10].…”

18F FDG-PET/CT evaluation of histological response after neoadjuvant treatment in patients with cancer of the esophagus or gastroesophageal junction

“…In selected cases the addition of adjuvant therapy in the form of radiotherapy, cytotoxic drugs, drugs targeting endocrine processes and anti-HER-2 drugs have improved the prognosis of patients with breast cancer (51).…”

Senescent stromal cells promote cancer resistance through SIRT1 loss-potentiated overproduction of small extracellular vesicles

“…Cytotoxic chemotherapy represents an effective modality for cancer treatment, inducing clinical responses associated with a significantly lowered risk of recurrence, but only in a limited fraction of patients [1][2][3] . As selection of genes accurately predicting therapeutic responses might improve cancer outcomes, gene signatures aimed at predicting responses to specific anticancer agents and minimizing drug resistance are being actively evaluated 4 .…”