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Iakimova TM, Bubley AA, Boychenko OP, Guk DA, Vaneev AN, Prusov AN, Erofeev AS, Gorelkin PV, Krasnovskaya OO, Klyachko NL, Vlasova KY. Liposomal form of 2-alkylthioimidazolone-based copper complexes for combined cancer therapy. Nanomedicine (Lond) 2023; 18:2105-2123. [PMID: 38127591 DOI: 10.2217/nnm-2023-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Aim: To develop an optimized approach for encapsulating a 2-alkylthioimidazolone-based copper coordination compound within liposomes, which could offer treatment of cancer and bacterial infections by reactive oxygen species generation toxicity mechanisms. Materials & methods: For drug-loaded liposome preparation, lipids and drug mixture in organic solvents was injected into copper salt solution, forming a coordination compound simultaneously embedded in the lipid bilayer. In vitro tests were performed on MCF7 and MDA-MB-231 breast cancer cells. Results: Liposomes had a loading capacity of up to 1.75% (molar drug-to-lipid ratio). In vitro tests showed increased viability and accumulation of the liposomal formulation compared with free drug as well as lack of cytotoxicity in hepatocytes. Conclusion: This optimized technique for encapsulating large copper complexes in liposomes could be used to improve their delivery and better treat cancer and bacterial infections.
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Affiliation(s)
- Tamara M Iakimova
- Faculty of Materials Science, Lomonosov Moscow State University, Moscow, 119991, Russia
- School of Chemistry, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Anna A Bubley
- School of Chemistry, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Olga P Boychenko
- School of Chemistry, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Dmitry A Guk
- School of Chemistry, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Alexander N Vaneev
- School of Chemistry, Lomonosov Moscow State University, Moscow, 119991, Russia
- Research Laboratory of Biophysics, National University of Science & Technology, Moscow, 119049, Russia
| | | | - Alexander S Erofeev
- Research Laboratory of Biophysics, National University of Science & Technology, Moscow, 119049, Russia
- Research Laboratory of Scanning Probe Microscopy, Moscow Polytechnical University, Moscow, 107023, Russia
| | - Petr V Gorelkin
- Research Laboratory of Biophysics, National University of Science & Technology, Moscow, 119049, Russia
| | - Olga O Krasnovskaya
- School of Chemistry, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Natalia L Klyachko
- School of Chemistry, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - Kseniia Yu Vlasova
- School of Chemistry, Lomonosov Moscow State University, Moscow, 119991, Russia
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Ferraro MG, Bocchetti M, Riccardi C, Trifuoggi M, Paduano L, Montesarchio D, Misso G, Santamaria R, Piccolo M, Irace C. Triple Negative Breast Cancer Preclinical Therapeutic Management by a Cationic Ruthenium-Based Nucleolipid Nanosystem. Int J Mol Sci 2023; 24:ijms24076473. [PMID: 37047448 PMCID: PMC10094725 DOI: 10.3390/ijms24076473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
Based on compelling preclinical evidence concerning the progress of our novel ruthenium-based metallotherapeutics, we are focusing research efforts on challenging indications for the treatment of invasive neoplasms such as the triple-negative breast cancer (TNBC). This malignancy mainly afflicts younger women, who are black, or who have a BRCA1 mutation. Because of faster growing and spreading, TNBC differs from other invasive breast cancers having fewer treatment options and worse prognosis, where existing therapies are mostly ineffective, resulting in a large unmet biomedical need. In this context, we benefited from an experimental model of TNBC both in vitro and in vivo to explore the effects of a biocompatible cationic liposomal nanoformulation, named HoThyRu/DOTAP, able to effectively deliver the antiproliferative ruthenium(III) complex AziRu, thus resulting in a prospective candidate drug. As part of the multitargeting mechanisms featuring metal-based therapeutics other than platinum-containing agents, we herein validate the potential of HoThyRu/DOTAP liposomes to act as a multimodal anticancer agent through inhibition of TNBC cell growth and proliferation, as well as migration and invasion. The here-obtained preclinical findings suggest a potential targeting of the complex pathways network controlling invasive and migratory cancer phenotypes. Overall, in the field of alternative chemotherapy to platinum-based drugs, these outcomes suggest prospective brand-new settings for the nanostructured AziRu complex to get promising goals for the treatment of metastatic TNBC.
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Steenbrugge J, Bellemans J, Vander Elst N, Demeyere K, De Vliegher J, Perera T, De Wever O, Van Den Broeck W, De Spiegelaere W, Sanders NN, Meyer E. One cisplatin dose provides durable stimulation of anti-tumor immunity and alleviates anti-PD-1 resistance in an intraductal model for triple-negative breast cancer. Oncoimmunology 2022; 11:2103277. [PMID: 35898705 PMCID: PMC9311321 DOI: 10.1080/2162402x.2022.2103277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aggressive triple-negative breast cancer (TNBC) is classically treated with chemotherapy. Besides direct tumor cell killing, some chemotherapeutics such as cisplatin provide additional disease reduction through stimulation of anti-tumor immunity. The cisplatin-induced immunomodulation in TNBC was here investigated in-depth using immunocompetent intraductal mouse models. Upon primary tumor transition to invasive carcinoma, cisplatin was injected systemically and significantly reduced tumor progression. Flow cytometric immunophenotyping was corroborated by immunohistochemical analyses and revealed both differential immune cell compositions and positivity for their programmed death (PD)-1 and PD-ligand (L)1 markers across body compartments, including the primary tumor, axillary lymph nodes and spleen. As key findings, a significant decrease in immunosuppressive and a concomitant increase in anti-tumor lymphocytic cell numbers were observed in the axillary lymph nodes and spleen, highlighting their importance in cisplatin-stimulated anti-tumor immunity. These immunomodulatory effects were already established following the first cisplatin dose, indicating that early cisplatin-mediated events may determine (immuno)therapeutic outcome. Furthermore, a single cisplatin dose sufficed to alleviate anti-PD-1 resistance in a 4T1-based model, providing add-on disease reduction without toxic side effects as seen upon multiple cisplatin dosing. Overall, these results highlight cisplatin as immunotherapeutic ally in TNBC, providing durable immunostimulation, even after a single dose.
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Affiliation(s)
- Jonas Steenbrugge
- Laboratory of Biochemistry, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Julie Bellemans
- Laboratory of Biochemistry, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Niels Vander Elst
- Laboratory of Biochemistry, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Kristel Demeyere
- Laboratory of Biochemistry, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Josephine De Vliegher
- Laboratory of Biochemistry, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Olivier De Wever
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Laboratory of Experimental Cancer Research, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Wim Van Den Broeck
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Ward De Spiegelaere
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Niek N. Sanders
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Laboratory of Gene Therapy, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Evelyne Meyer
- Laboratory of Biochemistry, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
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Korde LA, Somerfield MR, Carey LA, Crews JR, Denduluri N, Hwang ES, Khan SA, Loibl S, Morris EA, Perez A, Regan MM, Spears PA, Sudheendra PK, Symmans WF, Yung RL, Harvey BE, Hershman DL. Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline. J Clin Oncol 2021; 39:1485-1505. [PMID: 33507815 DOI: 10.1200/jco.20.03399] [Citation(s) in RCA: 376] [Impact Index Per Article: 125.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To develop guideline recommendations concerning optimal neoadjuvant therapy for breast cancer. METHODS ASCO convened an Expert Panel to conduct a systematic review of the literature on neoadjuvant therapy for breast cancer and provide recommended care options. RESULTS A total of 41 articles met eligibility criteria and form the evidentiary basis for the guideline recommendations. RECOMMENDATIONS Patients undergoing neoadjuvant therapy should be managed by a multidisciplinary care team. Appropriate candidates for neoadjuvant therapy include patients with inflammatory breast cancer and those in whom residual disease may prompt a change in therapy. Neoadjuvant therapy can also be used to reduce the extent of local therapy or reduce delays in initiating therapy. Although tumor histology, grade, stage, and estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) expression should routinely be used to guide clinical decisions, there is insufficient evidence to support the use of other markers or genomic profiles. Patients with triple-negative breast cancer (TNBC) who have clinically node-positive and/or at least T1c disease should be offered an anthracycline- and taxane-containing regimen; those with cT1a or cT1bN0 TNBC should not routinely be offered neoadjuvant therapy. Carboplatin may be offered to patients with TNBC to increase pathologic complete response. There is currently insufficient evidence to support adding immune checkpoint inhibitors to standard chemotherapy. In patients with hormone receptor (HR)-positive (HR-positive), HER2-negative tumors, neoadjuvant chemotherapy can be used when a treatment decision can be made without surgical information. Among postmenopausal patients with HR-positive, HER2-negative disease, hormone therapy can be used to downstage disease. Patients with node-positive or high-risk node-negative, HER2-positive disease should be offered neoadjuvant therapy in combination with anti-HER2-positive therapy. Patients with T1aN0 and T1bN0, HER2-positive disease should not be routinely offered neoadjuvant therapy.Additional information is available at www.asco.org/breast-cancer-guidelines.
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Affiliation(s)
- Larissa A Korde
- Clinical Investigations Branch, CTEP, DCTD, National Cancer Institute, Bethesda, MD
| | | | - Lisa A Carey
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | | | | | | | | | | | - Alejandra Perez
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Plantation, FL
| | | | - Patricia A Spears
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | | | | | | | - Dawn L Hershman
- Herbert Irving Comprehensive Cancer Center at Columbia University, New York, NY
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Li ZY, Zhang Z, Cao XZ, Feng Y, Ren SS. Platinum-based neoadjuvant chemotherapy for triple-negative breast cancer: a systematic review and meta-analysis. J Int Med Res 2020; 48:300060520964340. [PMID: 33100072 PMCID: PMC7645412 DOI: 10.1177/0300060520964340] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Triple-negative breast cancer (TNBC) is associated with higher aggressiveness and mortality than hormone-positive breast cancer because of the lack of approved therapeutic targets. Patients with TNBC who attain a pathological complete response (pCR) after neoadjuvant chemotherapy have improved survival. Platinum-based agents show promising activity in TNBC; however, their use remains controversial. We conducted a meta-analysis to assess the role of platinum-based agents in neoadjuvant chemotherapy in patients with TNBC. Methods We performed an extensive literature search of the Pubmed, Embase, and Cochrane databases. We calculated pooled odds ratios (OR) with 95% confidence intervals (CI) for the identified studies. Results Eight randomized controlled trials with 1345 patients were included in the analysis. The addition of platinum-based agents improved pCR compared with neoadjuvant therapy based on anthracyclines, cyclophosphamide, taxanes, and fluorouracil (49.1% vs. 35.9%; OR: 1.87, 95% CI: 1.23–2.86). Hematological adverse events were similar in both groups, except for more thrombocytopenia in the platinum-based group (OR: 7.96, 95% CI: 3.18–19.93). Conclusion The addition of platinum-based agents to neoadjuvant chemotherapy improved pCR rates in patients with TNBC, with a slight increase in hematological toxicities. Platinum-based agents might thus be an accessible and economically viable option in patients with TNBC.
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Affiliation(s)
- Zhen-Yu Li
- Department of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
| | - Zhen Zhang
- Department of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
| | - Xiao-Zhong Cao
- Department of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
| | - Yun Feng
- Department of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
| | - Sha-Sha Ren
- Department of Breast Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
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Egger SJ, Chan MMK, Luo Q, Wilcken N. Platinum-containing regimens for triple-negative metastatic breast cancer. Cochrane Database Syst Rev 2020; 10:CD013750. [PMID: 33084020 PMCID: PMC8092567 DOI: 10.1002/14651858.cd013750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND In a previous Cochrane Review, we found that for women with metastatic breast cancer unselected for triple-negative disease, there is little or no survival benefit and excess toxicity from platinum-based regimens. In subgroup analyses, however, we found preliminary low-quality evidence of a survival benefit from platinum-based regimens for women with metastatic triple-negative breast cancer (mTNBC). This review updates the evidence from the mTNBC subgroup analyses in the previous Cochrane Review. OBJECTIVES To assess the effects of platinum-containing chemotherapy regimens with regimens not containing platinum in the management of women with mTNBC. SEARCH METHODS We obtained relevant studies published prior to 2015 and their extracted results from the mTNBC subgroup analysis in the previous Cochrane Review. We searched the Cochrane Breast Cancer Group's Specialised Register, CENTRAL, MEDLINE, Embase, the World Health Organization's International Clinical Trials Registry Platform and ClinicalTrials.gov between 2015 and 27 September 2019. We identified further potentially relevant studies from previous trial reports, systematic reviews, and meta-analyses. SELECTION CRITERIA Randomised trials comparing platinum-containing chemotherapy regimens with regimens not containing platinum in women with mTNBC. Individual trials could compare one or more platinum-based regimens to one or more non-platinum regimens; hence there could be more 'treatment-comparisons' (i.e. platinum regimen versus non-platinum regimen comparison) than trials. Trial participants may have been purposely selected for mTNBC or inadvertently selected as a subgroup. DATA COLLECTION AND ANALYSIS At least two independent reviewers assessed studies for eligibility and quality, and extracted all relevant data from each study. We derived hazard ratios (HRs) for time-to-event outcomes, where possible, and used fixed-effect models for meta-analyses. We analysed objective tumour response rates (OTRRs) and toxicities as binary (dichotomous) outcomes with risk ratios (RRs) used as measures of effects. We extracted quality of life data, if available. We used GRADE to rate the quality of evidence for time-to-event and tumour response outcomes. MAIN RESULTS This review includes 13 treatment-comparisons involving 1349 women from 10 studies. Twelve of the 13 treatment-comparisons were included in one or more meta-analyses. Of the 13 treatment-comparisons, six and eight had published or provided time-to-event data on overall survival (OS) or progression-free survival/time to progression (PFS/TTP), respectively, that could be included in meta-analyses. Ten treatment-comparisons published or provided OTRR data that could be included in meta-analyses. Eight of the 13 treatment-comparisons were from studies that selected participants on the basis of mTNBC status, while the other five treatment-comparisons were from studies that reported mTNBC results as part of subgroup analyses. Analysis of six treatment-comparisons indicated that platinum-containing regimens may have provided a small survival benefit to mTNBC patients (HR 0.85, 95% CI 0.73 to 1.00; 958 women; moderate-quality evidence) with no evidence of heterogeneity (P = 0.41; I2 = 1%). Data from eight treatment-comparisons showed that platinum regimens may improve PFS/TTP (HR 0.77, 95% CI 0.68 to 0.88; 1077 women; very low-quality evidence). There was marked evidence of heterogeneity (P < 0.0001; I2 = 80%). There was also low-quality evidence of better tumour response for platinum recipients (RR 1.40, 95% CI 1.22 to 1.59; 1205 women) with some evidence of heterogeneity (P = 0.01; I2 = 58%). The observed heterogeneity for the PFS/TTP and OTRR outcomes may reflect between-study differences and general difficulties in assessing tumour response, as well as the varying potencies of the comparators. Compared with women receiving non-platinum regimens: rates of grade 3 and 4 nausea/vomiting were higher for platinum recipients (RR 4.77, 95% CI 1.93 to 11.81; 655 women; low-quality evidence) and rates of grade 3 and 4 anaemia were higher for platinum recipients (RR 3.80, 95% CI 2.25 to 6.42; 843 women; low-quality evidence). In general, however, relatively few intervention-comparisons could be included in meta-analyses for adverse events. None of the studies reported quality of life. AUTHORS' CONCLUSIONS For women with mTNBC, there was moderate-quality evidence of a small survival benefit from platinum-based regimens compared to non-platinum regimens. This finding is consistent with findings of a PFS/TTP benefit and improved tumour response from platinum-based regimens. These potential benefits, however, should be weighed against previously identified excess toxicities from platinum-based regimens, particularly regimens containing cisplatin. Further randomised trials of platinum-based regimens among women with mTNBC are required.
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Affiliation(s)
- Sam J Egger
- Cancer Research Division, Cancer Council NSW, Sydney, Australia
| | - Matthew Ming Ki Chan
- Department of Medical Oncology, Central Coast Cancer Centre, Gosford Hospital, Gosford, Australia
| | - Qingwei Luo
- Cancer Research Division, Cancer Council NSW, Sydney, Australia
| | - Nicholas Wilcken
- Medical Oncology, Crown Princess Mary Cancer Centre, Westmead, Australia
- Sydney Medical School, The University of Sydney, Sydney, Australia
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Caramelo O, Silva C, Caramelo F, Frutuoso C, Almeida-Santos T. The effect of neoadjuvant platinum-based chemotherapy in BRCA mutated triple negative breast cancers -systematic review and meta-analysis. Hered Cancer Clin Pract 2019; 17:11. [PMID: 30962858 PMCID: PMC6434625 DOI: 10.1186/s13053-019-0111-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/14/2019] [Indexed: 12/17/2022] Open
Abstract
Background Triple negative breast cancers (TNBC) are associated with an aggressive clinical course, earlier recurrence and short survival. BRCA – mutated tumours represent up to 25% of all TNBC. BRCA status is being studied as a predictive biomarker of response to platinum agents. However, the predictive role of BRCA status is still uncertain in this setting. Since TNBC is a very heterogeneous group of diseases, it is important to identify subsets of TNBC patients that may benefit from platinum-based therapy. This study aims to establish if the presence of a germline BRCA mutation in women with TNBC improves the pathologic complete response (pCR) after neoadjuvant chemotherapy with platinum compounds. Methods An extensive literature search was performed in MEDLINE, EMBASE and LILACS databases, WHO (WHO International Clinical Trials Registry Platform) and the Cochrane Controlled Trials Register Database, for online trial registries and conference proceedings. The measurement of pCR was assessed by pathology review of breast specimen and lymph nodes. Results The overall OR was computed using random effects models. Seven studies were included, comprising a total of 808 TNBC patients, among which 159 were BRCA mutated. Among mutated TNBC patients, 93 (93/159; 58.4%) achieved pCR, while 410 wildtype patients (410/808; 50.7%) showed pCR (OR 1.459 CI 95% [0.953–2.34] p = 0.082) although this result did not reach statistical significance. Conclusions This meta-analysis shows that the addition of platinum to chemotherapy regimens in the neoadjuvant setting increases pCR rate in BRCA – mutated as compared to wild-type TNBC patients. However, this trend did not achieve statistical significance. Trial registration CRD42018092341
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Affiliation(s)
- Olga Caramelo
- 1Gynecology Department, Coimbra Hospital and University Centre (CHUC), EPE, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Cristina Silva
- 2Faculty of Pharmacy of the University of Coimbra, Rua Filipe Simões n° 33, 3000-186 Coimbra, Portugal
| | - Francisco Caramelo
- 3Laboratory of Biostatistics and Medical Informatics, iCBR - Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Cristina Frutuoso
- 1Gynecology Department, Coimbra Hospital and University Centre (CHUC), EPE, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal
| | - Teresa Almeida-Santos
- 4Centre for Fertility Preservation, Human Reproduction Department, Coimbra Hospital and University Centre (CHUC), EPE, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal.,5Faculty of Medicine of the University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548 Coimbra, Portugal
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Xiao Q, Zhao Z, Lin K, Wang J. A phosphorescent cyclometalated iridium(III) complex as mitochondria-targeted theranostic anticancer agent. INORG CHEM COMMUN 2018. [DOI: 10.1016/j.inoche.2018.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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9
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Wang Z, Xu L, Wang H, Li Z, Lu L, Li X, Zhang Q. Lobaplatin-based regimens outperform cisplatin for metastatic breast cancer after anthracyclines and taxanes treatment. Saudi J Biol Sci 2018; 25:909-916. [PMID: 30108440 PMCID: PMC6087814 DOI: 10.1016/j.sjbs.2018.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/14/2018] [Accepted: 01/15/2018] [Indexed: 12/21/2022] Open
Abstract
The goal of this study was to assess the antitumor efficacy and safety of lobaplatin-based regimens as the second line of treatment in patients with metastatic breast cancer (MBC) resistant to anthracyclines and taxanes, compared with that of cisplatin-based regimens. During August 2012 to April 2015, 87 patients who received lobaplatin-based regimens or cisplatin-based regimens were included. Medical records of the patients noted that lobaplatin (30 mg/m2) or cisplatin (25 mg/m2), combined with another chemotherapeutic agent such as Gemcitabine (1000 mg/m2) or Vinorelbine (25 mg/m2), was intravenously given to the patients on a basis of twenty-one days as one treatment cycle. All the patients were followed until August 2017. The endpoint of this study was progression-free survival (PFS), overall survival (OS), and estimated objective response rate (RR). Safety and drug tolerability data were also obtained. Lobaplatin-based regimens prolonged PFS compared to cisplatin-based regimens (median 13.2 vs 4.7 months, hazard ratio = 0.37, 95% confidence intervals: 0.21-0.67, P = .0007), while OS was not significantly different between the two groups (hazard ratio = 0.72, 95% confidence intervals: 0.40-1.30, P = .2767), as was objective RR (37.8% vs 33.4%, x 2 = 0.19, P = .6653). Nausea/vomiting and renal injury were more frequent with cisplatin-based regimens. Our results show that lobaplatin-based regimens are superior to cisplatin in terms of efficacy and are better tolerated.
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Key Words
- Breast cancer
- Cisplatin
- Eastern Cooperative Oncology Group, ECOG
- Lobaplatin
- Metastatic
- National Cancer Institute Common Toxicity Criteria for Adverse Events, NCI-CTCAE
- Resistant
- Response Evaluation Criteria in Solid Tumors, RECIST
- cisplatin and gemcitabine, GP
- cisplatin and vinorelbine, NP
- complete response, CR
- confidence interval, CI
- estrogen receptor, ER
- granulocyte-colony stimulating factor, G-CSF
- hazard ratio, HR
- human epidermal growth factor receptor 2, HER-2
- lobaplatin and gemcitabine, GL
- lobaplatin and vinorelbine, NL
- lymph nodes, LN
- metastatic breast cancer, MBC
- non-small-cell lung cancer, NSCLC
- overall survival, OS
- partial response, PR
- performance scale, PS
- platinum-based compounds, PBCs
- progesterone receptor, PR
- progression-free survival, PFS
- progressive disease, PD
- response rate, RR
- stable disease, SD
- standard error, SE
- time to progression, TTP
- triple negative breast cancer, TNBC
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Affiliation(s)
- Zhipeng Wang
- Department of Medical Oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Lei Xu
- Genetics Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Han Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
| | - Zhenzhi Li
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Lu Lu
- Department of Medical Oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Xiaojia Li
- Department of Medical Oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150081, China
| | - Qingyuan Zhang
- Department of Medical Oncology, Tumor Hospital of Harbin Medical University, Harbin 150081, China
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Yu S, Zhang Y, Chen L, Li Q, Du J, Gao Y, Zhang L, Yang Y. Antitumor effects of carbon nanotube-drug complex against human breast cancer cells. Exp Ther Med 2018; 16:1103-1110. [PMID: 30116361 PMCID: PMC6090374 DOI: 10.3892/etm.2018.6334] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/27/2018] [Indexed: 12/21/2022] Open
Abstract
To improve the bio-solubility and sustained-release properties of a carbon nanotube (CNT)-drug complex, the present study used a hydrophilic polymer, polyethylene glycol (PEG), and β-estradiol (E2), which targets the estrogen receptor in human breast cancer cells (HBCCs), to modify CNTs carrying lobaplatin (LBP) to form E2-PEG-CNT-LBP. The in vitro inhibitory effects against HBCCs and the in vivo pharmacological effect of the complex on heart, liver and kidney tissues were also evaluated. The results indicated that the inhibitory effects of this complex against HBCCs reached 80.44% within 72 h. A blood biochemical test of normal mice indicated that this complex reduced platelet counts, while aspartate aminotransferase levels were increased compared with those in the control group. Histopathological analysis revealed no obvious adverse effects on the heart, liver and kidneys. The in vivo results indicated that the novel E2-PEG-CNT-LBP complex had no obvious toxic effects while exhibiting sustained-release properties. The clearance of E2-PEG-CNT-LBP by non-specific uptake systems was delayed and its clearance was increased compared with LBP alone.
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Affiliation(s)
- Shiping Yu
- Department of Interventional Therapy, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Yi Zhang
- Department of Radiology, Peace Hospital of Changzhi Medical University, Changzhi, Shanxi 046000, P.R. China
| | - Lin Chen
- Key Laboratory of Interface Science and Engineering in Advanced Materials, Ministry of Education, Taiyuan University of Technology, Taiyuan, Shanxi 030024, P.R. China
| | - Qiang Li
- Department of Interventional Therapy, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Jinglei Du
- Department of Medical Imageology, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Yuduan Gao
- Department of Ophthalmology, Shanxi Dayi Hospital, Taiyuan, Shanxi 030032, P.R. China
| | - Li Zhang
- Department of Urinary Surgery, Shanxi Dayi Hospital, Taiyuan, Shanxi 030032, P.R. China
| | - Yongzhen Yang
- Key Laboratory of Interface Science and Engineering in Advanced Materials, Ministry of Education, Taiyuan University of Technology, Taiyuan, Shanxi 030024, P.R. China
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Kaya V, Yildirim M, Yazici G, Gunduz S, Bozcuk H, Paydas S. Effectiveness of Platinum-Based Treatment for Triple Negative Metastatic Breast Cancer: a Meta-Analysis. Asian Pac J Cancer Prev 2018; 19:1169-1173. [PMID: 29801396 PMCID: PMC6031818 DOI: 10.22034/apjcp.2018.19.5.1169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: Triple-negative breast cancer (TNBC) is a sub-group of breast cancers with a particularly poor prognosis. The results of studies investigating the role of platinum-based chemotherapy (PBC) in metastatic TNBC (mTNBC) have been conflicting. In this meta-analysis, our aim was to assess the effectiveness of PBCs for mTNBCs. Methods: The PubMed, Cochrane Controlled Trials Register Databases, and EBSCOhost databases were accessed. The English language was used as the search language and only human studies were included. The Newcastle–Ottawa Quality Assessment Scale and the Jadad scoring system were used to evaluate the quality of the included randomized controlled studies. Results: Seven studies and 1,571 patients were included in this meta-analysis. The pooled hazard ratio (HR) for overall survival (OS), evaluated on the basis of six studies, showed the use of PBC regimes to be related to OS in mTNBCs (HR 0.620; 95% CI 0.513-0.749; p:<0.001). Four studies containing HR and abstract statistics used for HR calculation were included in the meta-analysis for progression-free survival (PFS). The pooled HR again indicated a significant relation (HR, 0.628; 95% CI, 0.501-0.786; p:<0.001). Conclusions: In this meta-analysis, we confirmed that PBC regimes provide OS and PFS advantages compared to non-PBC regimes. The use of PBC regimes could be a good choice in mTNBC patients for better quality of life and survival.
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Affiliation(s)
- Vildan Kaya
- Medstar Antalya Hospital, Department of Radiation Oncology, Antalya Education and Research Hospital, Antalya,Turkey.
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Bergamo A, Dyson PJ, Sava G. The mechanism of tumour cell death by metal-based anticancer drugs is not only a matter of DNA interactions. Coord Chem Rev 2018. [DOI: 10.1016/j.ccr.2018.01.009] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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13
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Absmaier M, Napieralski R, Schuster T, Aubele M, Walch A, Magdolen V, Dorn J, Gross E, Harbeck N, Noske A, Kiechle M, Schmitt M. PITX2 DNA-methylation predicts response to anthracycline-based adjuvant chemotherapy in triple-negative breast cancer patients. Int J Oncol 2018; 52:755-767. [PMID: 29328369 PMCID: PMC5807037 DOI: 10.3892/ijo.2018.4241] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/19/2017] [Indexed: 12/11/2022] Open
Abstract
Triple-negative breast cancer (TNBC) constitutes a heterogeneous breast cancer subgroup with poor prognosis; survival rates are likely to be lower with TNBC compared to other breast cancer subgroups. For this disease, systemic adjuvant chemotherapy regimens often yield suboptimal clinical results. To improve treatment regimens in TNBC, identification of molecular biomarkers may help to select patients for individualized adjuvant therapy. Evidence has accumulated that determination of the methylation status of the PITX2 gene provides a predictive value in various breast cancer subgroups, either treated with endocrine-based therapy or anthracycline-containing chemotherapy. To further explore the validity of this novel predictive candidate biomarker, in the present exploratory retrospective study, determination of the PITX2 DNA-methylation status was assessed for non-metastatic TNBC patients treated with adjuvant anthracycline-based chemotherapy by molecular analysis of breast cancer tissues. The PITX2 DNA-methylation status was determined in fresh-frozen tumor tissue specimens (n=56) by methylation-specific qRT-PCR (qMSP) and the data related to disease-free and overall survival, applying an optimized DNA-methylation score of 6.35%. For non-metastatic TNBC patients treated with adjuvant systemic anthracycline-based chemotherapy, a low PITX2 DNA-methylation status (<6.35) defines TNBC patients with poor disease-free and overall survival. Univariate and multivariate analyses demonstrate the statistically independent predictive value of PITX2 DNA-methylation. For non-metastatic TNBC patients, selective determination of the PITX2 DNA-methylation status may serve as a cancer biomarker for predicting response to anthracycline-based adjuvant chemotherapy. The assay based on methylation of the PIXT2 gene can be applied to frozen and routinely available formalin-fixed, paraffin-embedded (FFPE) breast cancer tumor tissues that will not only define those TNBC patients who may benefit from anthracycline-based chemotherapy but also those who should be spared the necessity of such potentially toxic treatment. Such patients should be allocated to alternative treatment options.
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Affiliation(s)
- Magdalena Absmaier
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Rudolf Napieralski
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Tibor Schuster
- Institute of Medical Statistics and Epidemiology, Technische Universität München, Munich, Germany
| | - Michaela Aubele
- Institute of Pathology, Helmholtz Zentrum Muenchen, Neuherberg, Germany
| | - Axel Walch
- Institute of Pathology, Helmholtz Zentrum Muenchen, Neuherberg, Germany
| | - Viktor Magdolen
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Julia Dorn
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Eva Gross
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Nadia Harbeck
- Breast Center, Klinikum der Ludwig Maximilians Universität München, Munich, Germany
| | - Aurelia Noske
- Department of Pathology and Pathological Anatomy, Technische Universität München, Munich, Germany
| | - Marion Kiechle
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Manfred Schmitt
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
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Wang J, Zhao Z, Zhou S, Zhang X, Bo H. The antitumor effect and toxicity of a ruthenium(II) complex in vivo. INORG CHEM COMMUN 2018. [DOI: 10.1016/j.inoche.2017.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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15
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Tian Q, Du P, Li S, Bai Z, Yang Y, Zeng J. Effect of antitumor treatments on triple-negative breast cancer patients: A PRISMA-compliant network meta-analysis of randomized controlled trials. Medicine (Baltimore) 2017; 96:e8389. [PMID: 29137021 PMCID: PMC5690714 DOI: 10.1097/md.0000000000008389] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) lacks the expression of the estrogen receptor, progesterone receptor, and receptor tyrosine-protein kinase erbB-2 (HER2/neu), which renders hormone-related endocrine and targeted therapy essentially futile. OBJECTIVE We performed a meta-analysis to assess the effects of antitumor regimens in the treatment of TNBC patients. METHODS We searched electronic databases, including PubMed, Embase, and the Cochrane Library, through January 2017 using the following keywords: "triple negative breast cancer," "TNBC," and "random*" without language restrictions. The major outcome in the present analysis was the overall response rate (ORR), and the secondary outcomes were progression-free survival (PFS) and overall survival (OS). A network meta-analysis and multilevel mixed-effects logistic regression were used to compare antitumor regimens. RESULTS We included 35 articles assessing a total of 8476 TNBC patients in our systematic review. The regimen of Bevacizumab, Carboplatin, and Paclitaxel (78.2%) was the most likely to improve the ORR in TNBC patients, followed by EndoTAG-1 and Paclitaxel (69.7%), Carboplatin and Paclitaxel (65.0%), and Bevacizumab and Paclitaxel (61.8%). In the patients without metastasis, the regimen of Bevacizumab, Carboplatin, and Paclitaxel (74.9%) remained the most likely to improve the ORR. We could not analyze the results for patients with metastasis or outcomes of PFS and OS because no >4 regimens formed a network. In the regression analysis, Bevacizumab (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.43-2.05; P < .001) and Carboplatin (OR, 2.07; 95% CI, 1.62-2.64; P < .001) correlated with superior ORR outcome, and Iniparib (OR, 1.51; 95% CI, 1.11-2.07; P = .009) correlated with superior OS outcome. CONCLUSION The regimen including Bevacizumab, Carboplatin, and Paclitaxel was the most likely to improve the ORR in TNBC patients and in advanced metastatic TNBC patients. The administration of Bevacizumab and Carboplatin provided greater benefit toward improved patient ORR.
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Affiliation(s)
| | - Peng Du
- Department of Surgery, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Sen Li
- Department of Surgery, First Affiliated Hospital of Nanchang University, Nanchang, China
| | | | | | - Jinsheng Zeng
- Department of Surgery, First Affiliated Hospital of Nanchang University, Nanchang, China
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Wang J, Zheng R, Wang Z, Yang Y, Wang M, Zou W. Efficacy and Safety of Vinorelbine Plus Cisplatin vs. Gemcitabine Plus Cisplatin for Treatment of Metastatic Triple-Negative Breast Cancer After Failure with Anthracyclines and Taxanes. Med Sci Monit 2017; 23:4657-4664. [PMID: 28957036 PMCID: PMC5629993 DOI: 10.12659/msm.905300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND This study aimed to compare the efficacy and safety of vinorelbine plus cisplatin (NP regimen) vs. gemcitabine plus cisplatin (GP regimen) for treatment of metastatic TNBC after failure with anthracyclines and taxanes. MATERIAL AND METHODS A total of 48 patients with metastatic TNBC that failed in anthracyclines and taxanes treatment were enrolled and randomly grouped. Patients in the NP group (n=22) were given 25 mg/m² vinorelbine on days 1 and 8 and 25 mg/m² cisplatin on days 2-4 of each 21-day cycle, while subjects in the GP group (n=26) were administered 1000 mg/m² gemcitabine on days 1 and 8 and 25 mg/m² cisplatin on days 2-4 of each 21-day cycle. The treatment response and adverse events were compared between the 2 groups every 2 cycles. RESULTS The ORR, DCR, and median TTP were 45.5%, 77.3%, and 5 months in the NP group, and 46.2%, 80.8%, and 5.2 months in the GP group, and no significant differences were observed in ORR, DCR, and median TTP between the 2 groups (P>0.05). The major adverse events included grade I-II bone marrow inhibition, gastrointestinal reactions, and phlebitis, and a lower incidence of thrombocytopenia and rash and a higher incidence of phlebitis was found in the NP group than in the GP group (P<0.05). CONCLUSIONS Either NP or GP regimen is active and tolerated in treatment of metastatic TNBC with anthracyclines and/or taxanes resistance, which may be used as a salvage treatment for metastatic TNBC.
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Affiliation(s)
- Junbin Wang
- Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
| | - Rongsheng Zheng
- Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
| | - Zishu Wang
- Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
| | - Yan Yang
- Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
| | - Mingxi Wang
- Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland)
| | - Weiyan Zou
- Department of Histology and Embryology, Bengbu Medical College, Bengbu, Anhui, China (mainland)
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BRCA1-like profile is not significantly associated with survival benefit of non-myeloablative intensified chemotherapy in the GAIN randomized controlled trial. Breast Cancer Res Treat 2017; 166:775-785. [PMID: 28822007 DOI: 10.1007/s10549-017-4444-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 08/05/2017] [Indexed: 01/06/2023]
Abstract
PURPOSE The BRCA1-like profile identifies tumors with a defect in homologous recombination due to inactivation of BRCA1. This profile has been shown to predict which stage III breast cancer patients benefit from myeloablative, DNA double-strand-break-inducing chemotherapy. We tested the predictive potential of the BRCA1-like profile for adjuvant non-myeloablative, intensified dose-dense chemotherapy in the GAIN trial. METHODS Lymph node positive breast cancer patients were randomized to 3 × 3 dose-dense cycles of intensified epirubicin, paclitaxel, and cyclophosphamide (ETC) or 4 cycles concurrent epirubicin and cyclophosphamide followed by 10 cycles of weekly paclitaxel combined with 4 cycles capecitabine (EC-TX). Only triple negative breast cancer patients (TNBC) for whom tissue was available were included in these planned analyses. BRCA1-like or non-BRCA1-like copy number profiles were derived from low coverage sequencing data. RESULTS 119 out of 163 TNBC patients (73%) had a BRCA1-like profile. After median follow-up of 83 months, disease free survival (DFS) was not significantly different between BRCA1-like and non-BRCA1-like patients [adjusted hazard ratio (adj.HR) 1.02; 95% confidence interval (CI) 0.55-1.86], neither was overall survival (OS; adj.HR 1.26; 95% CI 0.58-2.71). When split by BRCA1-like status, DFS and OS were not significantly different between treatments. However, EC-TX seemed to result in a trend to an improvement in DFS in patients with a BRCA1-like tumor, while the reverse accounted for ETC treatment in patients with a non-BRCA1-like tumor (p for interaction = 0.094). CONCLUSIONS The BRCA1-like profile is not associated with survival benefit for a non-myeloablative, intensified regimen in this study population. Considering the limited cohort size, capecitabine might have additional benefit for TNBC patients.
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18
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Irmejs A, Loza P, Skuja E, Gardovskis J. Platinum-Based Chemotherapy Secures Effective Local Control for Very Advanced Hereditary Triple-Negative Breast Cancer with Life-Threatening Bleeding. Cureus 2017; 9:e1455. [PMID: 28929039 PMCID: PMC5590706 DOI: 10.7759/cureus.1455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Here we report the case of a noncompliant 50-year-old female patient with high-grade, triple-negative breast cancer (TNBC) and strong family cancer history. She only agreed to start treatment after being admitted to the hospital with advanced stage disease and severe anaemia resulting from bulky, ulcerated, and actively bleeding tumor. Therapy was promptly started with platinum-based chemotherapy, resulting in extremely rapid clinical remission and complete control of local symptoms. In conclusion, we hypothesise that even a single course of platinum-based chemotherapy could bring under control life-threatening complications in hereditary TNBC and, therefore, it should be administered without hesitation in emergency circumstances if the patient can tolerate one dose of the medication.
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Affiliation(s)
- Arvids Irmejs
- Institute of Oncology, Continuing Education, Riga Stradins University, Latvia
| | - Peteris Loza
- Breast Unit, Riga Stradins University Hospital, Riga Stradins University, Latvia
| | - Elina Skuja
- Institute of Oncology, Continuing Education, Riga Stradins University, Latvia
| | - Janis Gardovskis
- Chief of Surgical Department, Riga Stradins University Hospital, Riga Stradins University, Latvia
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19
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Egger SJ, Willson ML, Morgan J, Walker HS, Carrick S, Ghersi D, Wilcken N. Platinum-containing regimens for metastatic breast cancer. Cochrane Database Syst Rev 2017; 2017:CD003374. [PMID: 28643430 PMCID: PMC6481538 DOI: 10.1002/14651858.cd003374.pub4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Studies have reported high tumour response rates for platinum-containing regimens in the treatment of women with metastatic breast cancer. Most of these studies were conducted prior to the 'intrinsic subtype' era, and did not specifically focus on metastatic triple-negative breast cancers (mTNBCs). OBJECTIVES To identify and review the evidence from randomised trials comparing platinum-containing chemotherapy regimens with regimens not containing platinum in the management of women with metastatic breast cancer. SEARCH METHODS For this review update, we searched the Cochrane Breast Cancer Group's Specialised Register, CENTRAL, MEDLINE, Embase, the World Health Organization's International Clinical Trials Registry Platform and ClinicalTrials.gov on 28 May 2015. We identified further potentially relevant studies from handsearching references of previous trials, systematic reviews, and meta-analyses. Prior to this review update, the most recent search for studies was conducted in May 2003 for the original 2004 review. SELECTION CRITERIA Randomised trials comparing platinum-containing chemotherapy regimens with regimens not containing platinum in women with metastatic breast cancer. DATA COLLECTION AND ANALYSIS At least two independent reviewers assessed studies for eligibility and quality, and extracted all relevant data from each study. Hazard ratios (HRs) were derived for time-to-event outcomes, where possible, and fixed-effect models were used for meta-analyses. Objective tumour response rates (OTRRs) and toxicities were analysed as binary (dichotomous) outcomes with risk ratios (RRs) used as measures of effects. Quality of life data were extracted where available. GRADE was used to rate the quality of evidence for survival and tumour response outcomes at the level of subgroups selected and unselected for mTNBC, and for toxicity outcomes based on combining data from selected and unselected populations. MAIN RESULTS This update includes 15 new eligible treatment-comparisons from 12 studies. In total, 28 treatment-comparisons, involving 4418 women, from 24 studies are now included in one or more meta-analyses. Of the 28 treatment-comparisons, 19 and 16 had published or provided extractable time-to-event data on overall survival (OS) or progression-free survival/time to progression (PFS/TTP), respectively. All 28 treatment-comparisons provided OTRR data that could be included in meta-analyses. Most women recruited to the studies were not selected on the basis of mTNBC status.In a subgroup of three treatment-comparisons assessing women with mTNBC, platinum-containing regimens may have provided a survival benefit (HR 0.75, 95% CI 0.57 to 1.00; low-quality evidence). In women unselected for intrinsic subtypes such as mTNBC, there was little or no effect on survival (HR 1.01, 95% CI 0.92 to 1.12; high-quality evidence). This effect was similar to the combined analysis of survival data for both populations (HR 0.98, 95% CI 0.89 to 1.07; I2 =39%, 1868 deaths, 2922 women; 19 trials). The difference in treatment effects between mTNBC women compared with unselected women was of borderline statistical significance (P = 0.05).Data from three treatment-comparisons with mTNBC participants showed that platinum regimens may improve PFS/TTP (HR 0.59, 95% CI 0.49 to 0.72; low-quality evidence). Thirteen treatment-comparisons of unselected metastatic participants showed that there was probably a small PFS/TTP benefit for platinum recipients, although the confidence interval included no difference (HR 0.92, 95% CI 0.84 to 1.01; moderate-quality evidence). Combined analysis of data from an estimated 1772 women who progressed or died out of 2136 women selected or unselected for mTNBC indicated that platinum-containing regimens improved PFS/TTP (HR 0.85, 95% CI 0.78 to 0.93). There was marked evidence of heterogeneity (P = 0.0004; I2 = 63%). The larger treatment benefit in mTNBC women compared with unselected women was statistically significant (P < 0.0001).There was low-quality evidence of better tumour response in both subgroups of women with mTNBC and unselected women (RR 1.33, 95% CI 1.13 to 1.56; RR 1.11, 95% CI 1.04 to 1.19, respectively). Combined analysis of both populations was closer to the effect in unselected women (RR 1.15, 95% CI 1.08 to 1.22; 4130 women). There was considerable evidence of heterogeneity (P < 0.0001; I2 = 64%), which may reflect between-study differences and general difficulties in assessing response, as well as the varying potencies of the comparators.Compared with women receiving non-platinum regimens: rates of grade 3 and 4 nausea/vomiting were probably higher among women receiving cisplatin- (RR 2.65, 95% CI 2.10 to 3.34; 1731 women; moderate-quality evidence) but the effect from carboplatin-containing regimens was less certain (RR 0.77, 95% CI 0.47 to 1.26; 1441 women; moderate-quality evidence); rates of grade 3 and 4 anaemia were higher among women receiving cisplatin- (RR 3.72, 95% CI 2.36 to 5.88; 1644 women; high-quality evidence) and carboplatin-containing regimens (RR 1.72, 95% CI 1.10 to 2.70; 1441 women; high-quality evidence); rates of grade 3 and 4 hair loss (RR 1.41, 95% CI 1.26 to 1.58; 1452 women; high-quality evidence) and leukopenia (RR 1.38, 95% CI 1.21 to 1.57; 3176 women; moderate-quality evidence) were higher among women receiving platinum-containing regimens (regardless of platinum agent). AUTHORS' CONCLUSIONS In women with metastatic breast cancer who do not have triple-negative disease, there is high-quality evidence of little or no survival benefit and excess toxicity from platinum-based regimens. There is preliminary low-quality evidence of a moderate survival benefit from platinum-based regimens for women with mTNBC. Further randomised trials of platinum-based regimens in this subpopulation of women with metastatic breast cancer are required.
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Affiliation(s)
- Sam J Egger
- Cancer Council NSWCancer Research Division153 Dowling StreetSydneyNSWAustralia2092
| | - Melina L Willson
- NHMRC Clinical Trials Centre, The University of SydneySystematic Reviews and Health Technology AssessmentsLocked Bag 77SydneyNSWAustralia1450
| | - Jenna Morgan
- University of SheffieldAcademic Unit of Surgical Oncology, Department of OncologySheffieldSouth YorkshireUKS10 2RX
| | - Harriet S Walker
- University of SheffieldAcademic Unit of Surgical Oncology, Department of OncologySheffieldSouth YorkshireUKS10 2RX
| | - Sue Carrick
- The University of MelbourneTwins Research Australia, Melbourne School of Population and Global HealthMelbourneVictoriaAustralia
- The University SydneyThe Hub, Charles Perkins CentreSydneyNSWAustralia
| | - Davina Ghersi
- National Health and Medical Research CouncilResearch Policy and Translation16 Marcus Clarke StreetCanberraACTAustralia2601
- The University of SydneyNHMRC Clinical Trials CentreSydneyAustralia
| | - Nicholas Wilcken
- Westmead HospitalMedical OncologyWestmeadNSWAustralia2145
- The University of SydneySydney Medical SchoolSydneyAustralia
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Fu D, Zuo Q, Huang Q, Su L, Ring HZ, Ring BZ. Molecular Classification of Lobular Carcinoma of the Breast. Sci Rep 2017; 7:43265. [PMID: 28303886 PMCID: PMC5355990 DOI: 10.1038/srep43265] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/20/2017] [Indexed: 12/15/2022] Open
Abstract
The morphology of breast tumors is complicated and diagnosis can be difficult. We present here a novel diagnostic model which we validate on both array-based and RNA sequencing platforms which reliably distinguishes this tumor type across multiple cohorts. We also examine how this molecular classification predicts sensitivity to common chemotherapeutics in cell-line based assays. A total of 1845 invasive breast cancer cases in six cohorts were collected, split into discovery and validation cohorts, and a classifier was created and compared to pathological diagnosis, grade and survival. In the validation cohorts the concordance of predicted diagnosis with a pathological diagnosis was 92%, and 97% when inconclusively classified cases were excluded. Tumor-derived cell lines were classified with the model as having predominantly ductal or lobular-like molecular physiologies, and sensitivity of these lines to relevant compounds was analyzed. A diagnostic tool can be created that reliably distinguishes lobular from ductal carcinoma and allows the classification of cell lines on the basis of molecular profiles associated with these tumor types. This tool may assist in improved diagnosis and aid in explorations of the response of lobular type breast tumor models to different compounds.
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Affiliation(s)
- Denggang Fu
- Institute of Genomic and Personalized Medicine, College of Life Science, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Qi Zuo
- Institute of Genomic and Personalized Medicine, College of Life Science, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Qi Huang
- Institute of Genomic and Personalized Medicine, College of Life Science, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Li Su
- Key Laboratory of Molecular Biophysics, Ministry of Education, College of Life Science, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Huijun Z. Ring
- Institute of Genomic and Personalized Medicine, College of Life Science, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Brian Z. Ring
- Institute of Genomic and Personalized Medicine, College of Life Science, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
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Petrelli F, Barni S, Bregni G, de Braud F, Di Cosimo S. Platinum salts in advanced breast cancer: a systematic review and meta-analysis of randomized clinical trials. Breast Cancer Res Treat 2016; 160:425-437. [PMID: 27770282 DOI: 10.1007/s10549-016-4025-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The interest in platinum salts in breast cancer (BC) therapy has been recently renewed as inhibition of DNA damage response may enhance the effects of DNA-damaging agents in BC tumors with high genomic instability. The present systematic review and meta-analysis of randomized trials were performed to assess the efficacy and safety of therapy with platinum salts in patients with locally advanced or metastatic (hereinafter advanced) BC. METHODS We searched PubMed, EMBASE, SCOPUS, Web of Science, the Cochrane Library, and CINAHL for phase II/III clinical trials that assessed efficacy of platinum-based therapy in patients with advanced BC. Pooled estimates of overall response rate (RR), median progression-free survival (PFS) and overall survival (OS) were computed using random or fixed effects models. RESULTS Data on 4625 patients from 23 phase II and III trials (11 with cisplatin, 11 with carboplatin, and 1 with either agents respectively) were analyzed. Estimates for RR, PFS, and OS were obtained from 23, 13, and 15 studies, respectively. Although at the cost of significantly increased fatigue, hematological and gastrointestinal toxicity, compared with non-platinum schemas, cisplatin, and carboplatin prolonged OS (HR 0.91; 95 % CI 0.83-1.00, p = 0.04), PFS (HR 0.84; 95 % CI 0.73-0.97, p = 0.01), and RR (HR 1.27; 95 % CI 1.03-1.57, p = 0.03). CONCLUSIONS Despite some limitations of the studies examined, including partial information on hormonal receptor and HER2 status, the use of platinum salts significantly prolonged OS, and PFS of patients with advanced BC with no unexpected toxicity.
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Affiliation(s)
- Fausto Petrelli
- Medical Oncology Unit, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy.
| | - Sandro Barni
- Medical Oncology Unit, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy
| | - Giacomo Bregni
- Department of Medical Oncology, IRCCS A.O.U. S.Martino-IST, Genoa, Italy
| | - Filippo de Braud
- University of Milan, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Serena Di Cosimo
- Division of Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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22
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Abstract
NEOADJUVANT CHEMOTHERAPY IN HER2-POSITIVE AND TRIPLE-NEGATIVE BREAST CANCER: Neoadjuvant chemotherapy is a standard option in the management of operable breast cancer, as effective as adjuvant chemotherapy in term of survival and with the potential to increase the rate of breast conservation. In HER2+ and triple-negative breast cancers, neoadjuvant chemotherapy is associated with a high probability of pathological complete response, which strongly predicts survival outcome. In HER2+ breast cancer, trastuzumab, in combination with neoadjuvant chemotherapy, mostly anthracyclines and taxane-based, demonstrated a significant increase in pathological complete response rate. Recently, dual HER2 blockade strategies (lapatinib-trastuzumab or pertuzumab-trastuzumab) demonstrated a significant improvement in terms of pathological complete response over trastuzumab. In triple-negative breast cancer, recent data indicate that incorporating platinum compounds to neoadjuvant chemotherapy also significantly improves this parameter. Yet, in both subtypes, whether these substantial improvements may lead to significant benefits in terms of survival and breast conserving surgery remains to be demonstrated.
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Affiliation(s)
- Anthony Gonçalves
- Département d'oncologie médicale, Institut Paoli-Calmettes, Marseille, 13009; Centre de recherche en cancérologie de Marseille (Institut Paoli-Calmettes, Inserm 1068, Cnrs 7258, Aix-Marseille Université), Marseille, 13009; Aix-Marseille Université, Marseille, 13006.
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23
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Rizzi A, Aroldi F, Bertocchi P, Prochilo T, Mutti S, Savelli G, Fraccon AP, Zaniboni A. GEMOX: An Active Regimen for the Treatment of Luminal and Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer. Chemotherapy 2016; 62:30-33. [PMID: 27287263 DOI: 10.1159/000445936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/04/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pretreated metastatic breast cancer (MBC) remains a formidable challenge with unmet needs both in terms of prolonged survival and quality-of-life-related issues. METHODS We collected data from 27 MBC patients treated with gemcitabine and oxaliplatin (GEMOX) at our institution between June 2009 and April 2015. The patients were heavily pretreated, and all had previously been exposed to anthracyclines and taxanes. RESULTS We achieved a complete response in 1 patient (4%), a partial response in 7 patients (26%) and stable disease in 12 patients (44%), while 6 patients (22%) experienced progressive disease. The response of 1 patient (4%) could not be evaluated because she interrupted her treatment during the first cycle due to a major reaction to oxaliplatin. We observed grade 4 hypertransaminasaemia in only 1 patient (4%) and grade 2 neuropathy in 16 patients (59%). Grade 3 leuconeutropenia was observed in 5 patients (18%). The median progression-free survival was 5.9 months and the median overall survival was 9.6 months. CONCLUSIONS GEMOX is an efficient and well-tolerated salvage regimen for MBC patients.
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Affiliation(s)
- Anna Rizzi
- Oncology Department, Fondazione Poliambulanza, Brescia, Italy
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24
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Potential targets for ovarian clear cell carcinoma: a review of updates and future perspectives. Cancer Cell Int 2015; 15:117. [PMID: 26675567 PMCID: PMC4678619 DOI: 10.1186/s12935-015-0267-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 12/01/2015] [Indexed: 12/16/2022] Open
Abstract
Advances in surgical and medical treatments for ovarian cancer have improved prognoses. Platinum drugs in particular are pivotal for the medical treatment of ovarian cancer. However, previous studies have revealed that some histological subtypes, such as clear cell carcinoma, are resistant to medical treatment, including that with platinum drugs. Consequently, the clinical prognosis of advanced clear cell carcinoma is remarkably inferior, primarily because of its chemoresistant behavior. The prevalence of clear cell carcinoma is approximately 5 % in the West, but in Japan, its prevalence is particularly high, at approximately 25 %. Current medical treatments for advanced clear cell carcinoma are difficult to administer, and they have poor efficacy, warranting the development of novel target-based therapies. In this review, we describe medical treatments for clear cell carcinoma and discuss future prospects for therapy. In particular, we focus on the mechanism of platinum resistance in clear cell carcinoma, including the role of annexin A4, one of the most investigated factors of platinum resistance, as well as the mutant genes and overexpressed proteins such as VEGF, PI3K/AKT/mTOR signaling pathway, ARID1A, hepatocyte nuclear factor-1β, ZNF217. We also review targeted molecular therapeutics for epithelial ovarian cancer and discuss their role in clear cell carcinoma treatment. We review the drugs targeting angiogenesis (bevacizumab, sorafenib, and pazopanib), growth factors (gefitinib, erlotinib, lapatinib, trastuzumab, and AMG479), and signaling pathways (temsirolimus, dasatinib, and imatinib), and other drugs (oregovomab, volociximab, and iniparib). This current review summarizes and discusses the clinical significance of these factors in ovarian clear cell carcinoma as well as their potential mechanisms of action. It may provide new integrative understanding for future studies on their exact role in ovarian clear cell carcinoma.
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25
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Abstract
Evidence has long demonstrated that premenopausal women obtain the greatest benefit from adjuvant chemotherapy overall, with risk reduction increasing with decreasing age. The chemoendocrine effect of chemotherapy has only more recently been documented as impacting on outcomes for women with hormone receptor-positive breast cancer, and recent data have elucidated the optimal strategies for manipulating the menopausal status to improve disease outcomes, without necessarily including cytotoxic chemotherapy. Still, many premenopausal women will require adjuvant cytotoxic chemotherapy, and the effects of treatment on women diagnosed with breast cancer in the premenopausal setting can have important implications both on their breast cancer outcomes and on comorbidities and psychosocial outcomes. This article describes the most recent information and issues surrounding the indications, effects, and special considerations for adjuvant chemotherapy in premenopausal women with breast cancer, in an effort to inform their care.
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Affiliation(s)
- Ann H Partridge
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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26
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Azim HA, Azim HA. Potential Therapeutic Targets in Triple Negative Breast Cancer. CURRENT BREAST CANCER REPORTS 2015. [DOI: 10.1007/s12609-015-0192-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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