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Chakraborty S, Mir KB, Seligson ND, Nayak D, Kumar R, Goswami A. Integration of EMT and cellular survival instincts in reprogramming of programmed cell death to anastasis. Cancer Metastasis Rev 2021; 39:553-566. [PMID: 32020420 DOI: 10.1007/s10555-020-09866-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Apoptosis is a tightly controlled, coordinated cellular event responsible for inducing programmed cell death to rid the body of defective or unfit cells. Inhibition of apoptosis is, therefore, an essential process for cancer cells to harness. Genomic variants in apoptotic-controlling genes are highly prevalent in cancer and have been identified to induce pro-proliferation and pro-survival pathways, rendering cancer cells resistant to apoptosis. Traditional understanding of apoptosis defines it as an irreversible process; however, growing evidence suggests that apoptosis is a reversible process from which cells can escape, even after the activation of its most committed stages. The mechanism invoked to reverse apoptosis has been termed anastasis and poses challenges for the development and utilization of chemotherapeutic agents. Anastasis has also been identified as a mechanism by which cells can recover from apoptotic lesions and revert back to its previous functioning state. In this review, we intend to focus the attention of the reader on the comprehensive role of survival, metastasis, and epithelial mesenchymal transition (EMT), as well as DNA damage repair mechanisms in promoting anastasis. Additionally, we will emphasize the mechanistic consequences of anastasis on drug resistance and recent rational therapeutic approaches designed to combat this resistance.
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Affiliation(s)
- Souneek Chakraborty
- Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, 180001, India.,Academy of Scientific & Innovative Research (AcSIR), CSIR- Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India
| | - Khalid Bashir Mir
- Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, 180001, India.,Academy of Scientific & Innovative Research (AcSIR), CSIR- Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India
| | - Nathan D Seligson
- Department of Pharmacotherapy and Translational Research, The University of Florida, Jacksonville, FL, USA.,Department of Hematology and Oncology, Nemours Children's Specialty Care, Jacksonville, FL, USA
| | - Debasis Nayak
- College of Pharmacy, The Ohio State University, 540 Riffe Building, 496 West 12th Ave, Columbus, OH, 43210, USA
| | - Rakesh Kumar
- School of Biotechnology, Shri Mata Vaishno Devi University, Katra, 182320, India
| | - Anindya Goswami
- Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, 180001, India. .,Academy of Scientific & Innovative Research (AcSIR), CSIR- Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, India.
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Lee CK, Hudson M, Simes J, Ribi K, Bernhard J, Coates AS. When do patient reported quality of life indicators become prognostic in breast cancer? Health Qual Life Outcomes 2018; 16:13. [PMID: 29329582 PMCID: PMC5767023 DOI: 10.1186/s12955-017-0834-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 12/26/2017] [Indexed: 01/26/2023] Open
Abstract
Background Various patient reported quality-of-life indicators are independently prognostic for survival in metastatic breast cancer and other cancers. The same measures recorded at first diagnosis of early breast cancer carry no corresponding prognostic information. The present study aims to assess at what time in the disease evolution the prognostic association appears. Methods Among 8024 patients enrolled in one of seven randomized controlled trials in early-stage breast cancer 3247 had a breast cancer relapse after a median follow-up of 12.1 years. Of these 677 had completed QL indicator assessments within defined windows 1, 2 or 3 months prior to relapse. We performed Cox regression analyses using these assessments and using identical instruments after relapse. All analyses were stratified by trial and adjusted for baseline clinicopathologic factors. Results QL indicators in the months before relapse were not significantly prognostic for subsequent survival with the possibly chance exception of mood at the second month before relapse. After relapse, physical well-being was statistically significantly associated with survival (P < 0.001). This prognostic significance increased in later post-relapse assessments. Similar findings were observed using patient-reported indicators for nausea and vomiting, appetite, coping effort, and health perception. Conclusions Before cancer relapse, QL indicators were not generally prognostic for subsequent survival. After relapse, QL indicators substantially predicted OS, with a stronger association later in the course of relapsed disease. Simple patient perception of disease burden seems unlikely to explain this sudden change: rather the patient’s awareness of disease relapse must contribute.
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Affiliation(s)
- Chee Khoon Lee
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Locked Bag 7, Camperdown, NSW, 1450, Australia
| | - Malcolm Hudson
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Locked Bag 7, Camperdown, NSW, 1450, Australia
| | - John Simes
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Locked Bag 7, Camperdown, NSW, 1450, Australia
| | - Karin Ribi
- International Breast Cancer Study Group, Bern, Switzerland
| | - Jürg Bernhard
- International Breast Cancer Study Group, Bern, Switzerland.,International Breast Cancer Study Group and Inselspital, Bern University Hospital, Bern, Switzerland
| | - Alan S Coates
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Locked Bag 7, Camperdown, NSW, 1450, Australia. .,International Breast Cancer Study Group, Bern, Switzerland.
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Current advances in endocrine therapy options for premenopausal women with hormone receptor positive breast cancer. Gynecol Oncol 2017; 147:153-157. [PMID: 28662774 DOI: 10.1016/j.ygyno.2017.06.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/15/2017] [Accepted: 06/17/2017] [Indexed: 01/13/2023]
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Colleoni M, Munzone E. Picking the optimal endocrine adjuvant treatment for pre-menopausal women. Breast 2015; 24 Suppl 2:S11-4. [PMID: 26249119 DOI: 10.1016/j.breast.2015.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Endocrine treatments are key component of the adjuvant strategy for pre-menopausal patients with luminal tumors. Treatment options should be based not only upon the risk of relapse and level of endocrine responsiveness, but also on co-morbidities, preferences of the patient and degree of side effects. Tamoxifen should still be considered as an appropriate endocrine therapy in a large group of premenopausal patients (e.g. lower risk patient, presence of co-morbidities, patient preference). However, the results of the SOFT and TEXT trials, evaluating the value of ovarian function suppression (OFS) as well as the role of adjuvant aromatase inhibitor (AI), raised questions about the use of tamoxifen alone in selected higher risk patient. In the SOFT study, premenopausal patients did not benefit from the addition of OFS, but for those women at sufficient risk of recurrence to deserve adjuvant chemotherapy and who maintained pre-menopausal estradiol, the addition of OFS to tamoxifen reduced the risk of recurrence. Moreover, in the TEXT trial, adjuvant treatment with exemestane plus OFS, as compared with tamoxifen plus OFS, significantly improved disease-free survival, breast cancer-free interval and distant disease-free survival, thus representing a new treatment option. Recent available information on endocrine options for younger patients with luminal tumors support the use of tailored endocrine treatments. Issues specific for younger patients related to pregnancies desire, family planning, safety, quality of life and subjective side effects should be a priority in the therapeutic algorithm.
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Affiliation(s)
- Marco Colleoni
- Division of Medical Senology, European Institute of Oncology, Italy; International Breast Cancer Study Group, Italy.
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Colleoni M, Munzone E. Extended adjuvant chemotherapy in endocrine non-responsive disease. Breast 2014; 22 Suppl 2:S161-4. [PMID: 24074780 DOI: 10.1016/j.breast.2013.07.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION AND AIMS There is a biological rationale for expecting benefit from longer duration therapy in the subpopulation of patients with endocrine non-responsive disease. Such tumors have a rapid cell proliferation and are associated with a high risk of relapse despite adjuvant chemotherapy. Moreover, prolonged duration of chemotherapy may be particularly relevant for patients with triple negative disease to inhibit the growth of tumors that are not susceptible to the effects of endocrine therapies due to lack of steroid hormone receptors, or to the effects of anti-HER2 target treatment. METHODS AND RESULTS The question of duration of adjuvant chemotherapy for breast cancer has been directly addressed in several trials herein presented. Most of these were small and, therefore, unsuitable for detecting differences of modest magnitude in intrinsic biological subtypes. In addition, a number of trials examine regimens which differ in duration of therapy, but also in the drugs given. In these trials the effects of duration and choice of drug are inextricably confounded. However incremental chemotherapy strategies, compared with less extensive therapies, were more effective in past studies particularly in patients with endocrine non-responsive disease. CONCLUSIONS The evidence resulting from past trials indicates that conventional-dose chemotherapy for 4-6 months is an adequate option in patients whose tumors present a low or no expression of steroid hormone receptors. These tumor subtypes are part of a highly heterogeneous subgroup (e.g., basal-like, molecular apocrine, claudin-low, HER-enriched). Tailored research through international cooperation is key to solidify consensus on how to treat individual patients with endocrine non-responsive breast cancer.
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Affiliation(s)
- Marco Colleoni
- Division of Medical Senology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
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Huober J, Gelber S, Goldhirsch A, Coates AS, Viale G, Öhlschlegel C, Price KN, Gelber RD, Regan MM, Thürlimann B. Prognosis of medullary breast cancer: analysis of 13 International Breast Cancer Study Group (IBCSG) trials. Ann Oncol 2012; 23:2843-2851. [PMID: 22707751 PMCID: PMC3477879 DOI: 10.1093/annonc/mds105] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 01/03/2012] [Accepted: 02/27/2012] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To evaluate whether medullary breast cancer has a better prognosis compared with invasive ductal tumors. METHODS Among 12,409 patients, 127 were recorded as invasive medullary tumors and 8096 invasive ductal tumors. Medullary and ductal invasive tumors were compared with regard to stage, age at diagnosis, grade, hormone receptor status, peritumoral vascular invasion, and local and systemic treatment. Pattern of relapse, distant recurrence-free interval (DRFI), and overall survival (OS) were determined for both histological groups. Two cohorts were investigated: a full cohort including the pathologist-determined medullary histology without regard to any other tumor features and a cohort restricted to patients with ER-negative grade 3 tumors. RESULTS Fourteen-year DRFI and OS percents for medullary tumors (n = 127) and invasive ductal tumors (n = 8096) of the full cohort were 76% and 64% [hazard ratio (HR) 0.52, P = 0.0005] and 66% and 57% (HR = 0.75, P = 0.03), respectively. For the restricted cohort, 14-year DRFI and OS percents for the medullary (n = 47) and invasive ductal tumors (n = 1407) were 89% and 63% (HR 0.24, P = 0.002) and 74% and 54% (HR = 0.55, P = 0.01), respectively. Competing risk analysis for DRFI favored medullary tumors (HR medullary/ductal = 0.32; 95% confidence interval = 0.13-0.78, P = 0.01). CONCLUSION Medullary tumors have a favorable prognosis compared with invasive ductal tumors.
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MESH Headings
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Medullary/mortality
- Carcinoma, Medullary/pathology
- Carcinoma, Medullary/therapy
- ErbB Receptors/analysis
- Female
- Humans
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local
- Neoplasm Staging
- Prognosis
- Receptors, Estrogen/analysis
- Receptors, Progesterone/analysis
- Risk Factors
- Survival Rate
- Treatment Outcome
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Affiliation(s)
- J. Huober
- Breast Center, Kantonsspital, St Gallen
- Swiss Group for Clinical Cancer Research (SAKK), Berne, Switzerland
| | - S. Gelber
- IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston
- Frontier Science and Technology Research Foundation, Boston, USA
| | - A. Goldhirsch
- Department of Medicine, European Institute of Oncology, Milan, Italy
- Swiss Center for Breast Health, Sant'Anna Clinics, Lugano-Sorengo, Switzerland
| | - A. S. Coates
- International Breast Cancer Study Group and Australian New Zealand Breast Cancer Trials Group, University of Sydney, Sydney, Australia
| | - G. Viale
- Division of Pathology and Laboratory Medicine, IBCSG Central Pathology Office, European Institute of Oncology, University of Milan, Milan, Italy
| | - C. Öhlschlegel
- Swiss Group for Clinical Cancer Research (SAKK), Berne, Switzerland
- Department of Pathology, Kantonsspital, St Gallen, Switzerland
| | - K. N. Price
- Frontier Science and Technology Research Foundation, Boston, USA
| | - R. D. Gelber
- IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston
- Frontier Science and Technology Research Foundation, Boston, USA
- Department of Biostatistics, Harvard School of Public Health, Harvard Medical School, Boston, USA
| | - M. M. Regan
- IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston
- Department of Biostatistics, Harvard School of Public Health, Harvard Medical School, Boston, USA
| | - B. Thürlimann
- Breast Center, Kantonsspital, St Gallen
- Swiss Group for Clinical Cancer Research (SAKK), Berne, Switzerland
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Karlsson P, Cole BF, Chua BH, Price KN, Lindtner J, Collins JP, Kovács A, Thürlimann B, Crivellari D, Castiglione-Gertsch M, Forbes JF, Gelber RD, Goldhirsch A, Gruber G. Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report. Ann Oncol 2012; 23:2852-2858. [PMID: 22776708 PMCID: PMC3477880 DOI: 10.1093/annonc/mds118] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 01/04/2012] [Accepted: 03/20/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Rates and risk factors of local, axillary and supraclavicular recurrences can guide patient selection and target for postmastectomy radiotherapy (PMRT). PATIENTS AND METHODS Local, axillary and supraclavicular recurrences were evaluated in 8106 patients enrolled in 13 randomized trials. Patients received chemotherapy and/or endocrine therapy and mastectomy without radiotherapy. Median follow-up was 15.2 years. RESULTS Ten-year cumulative incidence for chest wall recurrence of >15% was seen in patients aged <40 years (16.1%), with ≥4 positive nodes (16.5%) or 0-7 uninvolved nodes (15.1%); for supraclavicular failures >10%: ≥4 positive nodes (10.2%); for axillary failures of >5%: aged <40 years (5.1%), unknown primary tumor size (5.2%), 0-7 uninvolved nodes (5.2%). In patients with 1-3 positive nodes, 10-year cumulative incidence for chest wall recurrence of >15% were age <40, peritumoral vessel invasion or 0-7 uninvolved nodes. Age, number of positive nodes and number of uninvolved nodes were significant parameters for each locoregional relapse site. CONCLUSION PMRT to the chest wall and supraclavicular fossa is supported in patients with ≥4 positive nodes. With 1-3 positive nodes, chest wall PMRT may be considered in patients aged <40 years, with 0-7 uninvolved nodes or with vascular invasion. The findings do not support PMRT to the dissected axilla.
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Affiliation(s)
- P Karlsson
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - B F Cole
- Department of Mathematics and Statistics College of Engineering and Mathematical Sciences, University of Vermont, Burlington; IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA
| | - B H Chua
- Department of Radiation Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia
| | - K N Price
- IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA; Frontier Science and Technology Research Foundation, Boston, USA
| | - J Lindtner
- The Institute of Oncology, Ljubljana, Slovenia
| | - J P Collins
- Department of Surgery, Royal Melbourne Hospital, Victoria, Australia
| | - A Kovács
- Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - B Thürlimann
- The Breast Center, Kantonsspital, St Gallen, Switzerland and Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
| | - D Crivellari
- Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
| | | | - J F Forbes
- Australian New Zealand Breast Cancer Trials Group, University of Newcastle, Calvary Mater Newcastle, Newcastle, Australia
| | - R D Gelber
- IBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, USA; Frontier Science and Technology Research Foundation, Boston, USA; Harvard School of Public Health and Harvard Medical School, Boston, USA
| | - A Goldhirsch
- European Institute of Oncology, Milan, Italy; Swiss Center for Breast Health, Sant'Anna Clinics, Lugano-Sorengo
| | - G Gruber
- Institut fuer Radiotherapie, Klinik Hirslanden, Zürich, Switzerland
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Colleoni M, Cole BF, Viale G, Regan MM, Price KN, Maiorano E, Mastropasqua MG, Crivellari D, Gelber RD, Goldhirsch A, Coates AS, Gusterson BA. Classical cyclophosphamide, methotrexate, and fluorouracil chemotherapy is more effective in triple-negative, node-negative breast cancer: results from two randomized trials of adjuvant chemoendocrine therapy for node-negative breast cancer. J Clin Oncol 2010; 28:2966-73. [PMID: 20458051 DOI: 10.1200/jco.2009.25.9549] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Retrospective studies suggest that primary breast cancers lacking estrogen receptor (ER) and progesterone receptor (PR) and not overexpressing human epidermal growth factor receptor 2 (HER2; triple-negative tumors) are particularly sensitive to DNA-damaging chemotherapy with alkylating agents. PATIENTS AND METHODS Patients enrolled in International Breast Cancer Study Group Trials VIII and IX with node-negative, operable breast cancer and centrally assessed ER, PR, and HER2 were included (n = 2,257). The trials compared three or six courses of adjuvant classical cyclophosphamide, methotrexate, and fluorouracil (CMF) with or without endocrine therapy versus endocrine therapy alone. We explored patterns of recurrence by treatment according to three immunohistochemically defined tumor subtypes: triple negative, HER2 positive and endocrine receptor absent, and endocrine receptor present. RESULTS Patients with triple-negative tumors (303 patients; 13%) were significantly more likely to have tumors > 2 cm and grade 3 compared with those in the HER2-positive, endocrine receptor-absent, and endocrine receptor-present subtypes. No clear chemotherapy benefit was observed in endocrine receptor-present disease (hazard ratio [HR], 0.90; 95% CI, 0.74 to 1.11). A statistically significantly greater benefit for chemotherapy versus no chemotherapy was observed in triple-negative breast cancer (HR, 0.46; 95% CI, 0.29 to 0.73; interaction P = .009 v endocrine receptor-present disease). The magnitude of the chemotherapy effect was lower in HER2-positive endocrine receptor-absent disease (HR, 0.58; 95% CI, 0.29 to 1.17; interaction P = .24 v endocrine receptor-present disease). CONCLUSION The magnitude of benefit of CMF chemotherapy is largest in patients with triple-negative, node-negative breast cancer.
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Affiliation(s)
- Marco Colleoni
- Research Unit in Medical Senology, Department of Medicine, European Institute of Oncology, Università degli Studi di Milano, Milan, Italy.
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