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Rotem O, Peretz I, Leviov M, Kuchuk I, Itay A, Tokar M, Paluch-Shimon S, Maimon O, Yerushalmi R, Drumea K, Evron E, Sonnenblick A, Gal-Yam E, Goldvaser H, Yosef S, Merose R, Bareket-Samish A, Soussan-Gutman L, Stemmer S. P169 Clinical outcomes in patients (pts) with estrogen receptor (ER)+ stage I breast cancer (BC) and Recurrence Score (RS) 26–30: Real-world data. Breast 2023. [DOI: 10.1016/s0960-9776(23)00286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
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Waissengrin B, Zahavi T, Salmon-Divon M, Goldberg A, Wolf I, Rubinek T, Winkler T, Farkash O, Grinshpun A, Zubkov A, Khatib M, Shachar S, Keren N, Carmi-Levy I, Ben-David U, Sonnenblick A. The effect of non-oncology drugs on clinical and genomic risk in early luminal breast cancer. ESMO Open 2022; 7:100648. [PMID: 36462463 PMCID: PMC9808449 DOI: 10.1016/j.esmoop.2022.100648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND An effect of non-oncology medications on cancer outcome has been proposed. In this study, we aimed to systematically examine the impact of commonly prescribed non-oncology drugs on clinical risk and on the genomic risk [based on the Oncotype DX recurrence score (RS)] in early breast cancer (BC). EXPERIMENTAL DESIGN We collected data on clinical risk (stage and grade), genomic risk (Oncotype DX RS), and on non-oncology medications administered to 1423 patients with estrogen receptor-positive human epidermal growth factor receptor 2-negative BC during the month of their surgery. The influence of various medications on clinical and genomic risks was evaluated by statistical analysis. RESULTS Out of the multiple drugs we examined, levothyroxine was significantly associated with a high Oncotype DX RS (mean 24.78; P < 0.0001) and metformin with a low Oncotype DX RS (mean 14.87; P < 0.01) compared with patients not receiving other non-oncology drugs (mean 18.7). By contrast, there were no differences in the clinical risk between patients receiving metformin, levothyroxine, or no other non-oncology drugs. Notably, there was no association between the consumption of levothyroxine and metformin and proliferation marker (Ki67) levels, but both drugs were significantly associated with progesterone-related features, suggesting that they influence genomic risk through estrogen-dependent signaling. CONCLUSIONS The results of this study indicate a significant impact of metformin and levothyroxine on clinical decisions in luminal BC, with potential impact on the clinical course of these patients.
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Affiliation(s)
- B. Waissengrin
- The Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv,Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - T. Zahavi
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel
| | - M. Salmon-Divon
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel
| | - A. Goldberg
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel
| | - I. Wolf
- The Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv,Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - T. Rubinek
- The Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv,Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - T. Winkler
- Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - O. Farkash
- The Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv
| | - A. Grinshpun
- Breast Oncology Center, Department of Medical Oncology, Dana Farber Cancer Institute, Boston, USA
| | - A. Zubkov
- Pathology Department, Pathology Institute, Tel Aviv Medical Center, Tel Aviv
| | - M. Khatib
- Division of General Surgery, Tel Aviv Medical Center, Tel Aviv
| | - S.S. Shachar
- The Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv,Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - N. Keren
- The Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv,Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | | | - U. Ben-David
- Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - A. Sonnenblick
- The Oncology Division, Tel Aviv Sourasky Medical Center, Tel Aviv,Sackler School of Medicine, Tel Aviv University, Tel Aviv,Correspondence to: Dr Amir Sonnenblik, MD, Tel Aviv Sourasky Medical Center, 6 Waizman Street, Tel Aviv 64239, Israel; Tel: +972-3-6972446
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Rotem O, Peretz I, Leviov M, Kuchuk I, Itay A, Tokar M, Paluch-Shimon S, Maimon O, Yerushalmi R, Drumea K, Evron E, Sonnenblick A, Nili Gal Yam E, Goldvaser H, Yosef S, Merose R, Bareket-Samish A, Soussan-Gutman L, Stemmer S. 149P Clinical outcomes in ER+ breast cancer patients with recurrence score 26-30-guided therapy: Real-world data. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Condorelli M, Bruzzone M, Ceppi M, Ferrari A, Grinshpun A, Hamy AS, de Azambuja E, Carrasco E, Peccatori FA, Di Meglio A, Paluch-Shimon S, Poorvu PD, Venturelli M, Rousset-Jablonski C, Senechal C, Livraghi L, Ponzone R, De Marchis L, Pogoda K, Sonnenblick A, Villarreal-Garza C, Córdoba O, Teixeira L, Clatot F, Punie K, Graffeo R, Dieci MV, Pérez-Fidalgo JA, Duhoux FP, Puglisi F, Ferreira AR, Blondeaux E, Peretz-Yablonski T, Caron O, Saule C, Ameye L, Balmaña J, Partridge AH, Azim HA, Demeestere I, Lambertini M. Safety of assisted reproductive techniques in young women harboring germline pathogenic variants in BRCA1/2 with a pregnancy after prior history of breast cancer. ESMO Open 2021; 6:100300. [PMID: 34775302 PMCID: PMC8593447 DOI: 10.1016/j.esmoop.2021.100300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Knowledge is growing on the safety of assisted reproductive techniques (ART) in cancer survivors. No data exist, however, for the specific population of breast cancer patients harboring germline BRCA1/2 pathogenic variants. PATIENTS AND METHODS This is a multicenter retrospective cohort study across 30 centers worldwide including women diagnosed at ≤40 years with stage I-III breast cancer, between January 2000 and December 2012, harboring known germline BRCA1/2 pathogenic variants. Patients included in this analysis had a post-treatment pregnancy either achieved through use of ART (ART group) or naturally (non-ART group). ART procedures included ovulation induction, ovarian stimulation for in vitro fertilization or intracytoplasmic sperm injection, and embryo transfer under hormonal replacement therapy. RESULTS Among the 1424 patients registered in the study, 168 were eligible for inclusion in the present analysis, of whom 22 were in the ART group and 146 in the non-ART group. Survivors in the ART group conceived at an older age compared with those in the non-ART group (median age: 39.7 versus 35.4 years, respectively). Women in the ART group experienced more delivery complications compared with those in the non-ART group (22.1% versus 4.1%, respectively). No other apparent differences in obstetrical outcomes were observed between cohorts. The median follow-up from pregnancy was 3.4 years (range: 0.8-8.6 years) in the ART group and 5.0 years (range: 0.8-17.6 years) in the non-ART group. Two patients (9.1%) in the ART group experienced a disease-free survival event (specifically, a locoregional recurrence) compared with 40 patients (27.4%) in the non-ART group. In the ART group, no patients deceased compared with 10 patients (6.9%) in the non-ART group. CONCLUSION This study provides encouraging safety data on the use of ART in breast cancer survivors harboring germline pathogenic variants in BRCA1/2, when natural conception fails or when they opt for ART in order to carry out preimplantation genetic testing.
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Affiliation(s)
- M Condorelli
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Fertility Clinic, Brussels, Belgium; Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - M Bruzzone
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - M Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - A Ferrari
- Department of Surgical Sciences, General Surgery III-Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical Surgical Sciences, University of Pavia, Pavia, Italy
| | - A Grinshpun
- Breast Oncology Unit Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - A S Hamy
- Department of Medical Oncology, Institut Curie, Paris, France
| | - E de Azambuja
- Department of Medicine, Institut Jules Bordet and Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - E Carrasco
- Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - F A Peccatori
- Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy
| | - A Di Meglio
- Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - S Paluch-Shimon
- Breast Oncology Unit Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - P D Poorvu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - M Venturelli
- Department of Oncology and Haematology, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - C Rousset-Jablonski
- Department of Surgery, Centre Léon Bérard and INSERM U1290 RESHAPE, Université Claude Bernard Lyon 1, Lyon, France
| | - C Senechal
- Cancer Genetics Unit, Bergonie Institute, Bordeaux, France
| | - L Livraghi
- Medical Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy; University of Siena, Siena, Italy
| | - R Ponzone
- Gynecological Oncology, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, Turin, Italy
| | - L De Marchis
- Division of Medical Oncology, Department of Radiological, Oncological and Pathological Sciences, "La Sapienza" University of Rome, Rome, Italy
| | - K Pogoda
- Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A Sonnenblick
- Oncology Division, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv, Israel
| | - C Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - O Córdoba
- Obstetrics and Gynecology Department, Hospital Universitari Son Espases, Palma, Spain
| | - L Teixeira
- Breast Disease Unit, Saint-Louis Hospital, APHP, Université de Paris, INSERM U976, Paris, France
| | - F Clatot
- Department of Medical Oncology, Centre Henri Becquerel, Rouen, France
| | - K Punie
- Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - R Graffeo
- Breast Unit of Southern Switzerland (CSSI), Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - M V Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Medical Oncology 2, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - J A Pérez-Fidalgo
- Department of Medical Oncology, INCLIVA University Hospital of Valencia, CIBERONC, Valencia, Spain
| | - F P Duhoux
- Department of Medical Oncology, Breast Clinic, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - F Puglisi
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Department of Medicine, University of Udine, Udine, Italy
| | - A R Ferreira
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - E Blondeaux
- Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - T Peretz-Yablonski
- Breast Oncology Unit Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - O Caron
- Department of Medical Oncology, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - C Saule
- Department of Genetics, Institut Curie, Paris, France
| | - L Ameye
- Data Centre, Institut Jules Bordet and Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - J Balmaña
- Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - H A Azim
- Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - I Demeestere
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Fertility Clinic, Brussels, Belgium; Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy; Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
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Peleg Hasson S, Brezis MR, Shachar E, Shachar SS, Wolf I, Sonnenblick A. Erratum to 'Adjuvant endocrine therapy in HER2-positive breast cancer patients: systematic review and meta-analysis': [ESMO Open Volume 6, Issue 2, April 2021, 100088]. ESMO Open 2021; 6:100158. [PMID: 34144779 PMCID: PMC8233645 DOI: 10.1016/j.esmoop.2021.100158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- S Peleg Hasson
- Oncology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M R Brezis
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Shachar
- Oncology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S S Shachar
- Oncology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - I Wolf
- Oncology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Sonnenblick
- Oncology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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6
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Sonnenblick A, Bailey A, Uziely B, Untch M, Smith I, Gianni L, Baselga J, Jackisch C, Cameron D, Bell R, Zardavas D, Al-Sakaff N, Gelber R, Dowsett M, Leyland-jones B, Piccart M, de Azambuja E. Autoimmunity and benefit from trastuzumab treatment in breast cancer: Results from the HERA phase III trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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7
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Sonnenblick A, Salgado R, Peretz T, Francis P, Crown J, Azambuja E, Lieveke A, Piccart M, Bromberg J, Sotiriou C. pSTAT3 in luminal breast cancer. Integrated RNA-protein pooled analysis and results from the BIG 2-98 phase III trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx138.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sonnenblick A, Brohée S, Pondé N, Venet D, Sotiriou C. Dissecting the Akt/mTOR pathway in estrogen receptor positive breast cancers identifies phosphorylated Akt signature to be associated with luminal A and good prognosis in contrast to phosphorylated mTOR. Breast 2017. [DOI: 10.1016/s0960-9776(17)30328-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Zick A, Peretz T, Lotem M, Hubert A, Katz D, Temper M, Rottenberg Y, Uziely B, Nechushtan H, Meirovitz A, Sonnenblick A, Sapir E, Edelman D, Goldberg Y, Lossos A, Rosenberg S, Fried I, Finklstein R, Pikarsky E, Goldshmidt H. Treatment inferred from mutations identified using massive parallel sequencing leads to clinical benefit in some heavily pretreated cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sonnenblick A, Pondé N, Piccart M. Metastatic breast cancer: The Odyssey of personalization. Mol Oncol 2016; 10:1147-59. [PMID: 27430154 PMCID: PMC5423195 DOI: 10.1016/j.molonc.2016.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 06/27/2016] [Accepted: 07/05/2016] [Indexed: 12/31/2022] Open
Abstract
Metastatic breast cancer is the most frequent cause of cancer death for women worldwide. In the last 15 years, a large number of new agents have entered clinical use, a result of the dramatic increase in our understanding of the molecular underpinnings of metastatic breast cancer. However, while these agents have led to better outcomes, they are also at the root cause of increasing financial pressure on healthcare systems. Moreover, decision making in an era where every year new agents are added to the therapeutic armamentarium has also become a significant challenge for medical oncologists. In the present article, we will provide an ample review on the most recent developments in the field of treatment of the different subtypes of metastatic breast cancer with a critical discussion on the slow progress made in identifying response biomarkers. New hopes in the form of ctDNA monitoring and functional imaging will be presented.
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Affiliation(s)
- A Sonnenblick
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Boulevard de Waterloo 125, B 1000 Brussels, Belgium; Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - N Pondé
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Boulevard de Waterloo 125, B 1000 Brussels, Belgium
| | - M Piccart
- Department of Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Boulevard de Waterloo 125, B 1000 Brussels, Belgium.
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Gingras I, Sonnenblick A, de Azambuja E, Paesmans M, Delaloge S, Aftimos P, Piccart MJ, Sotiriou C, Ignatiadis M, Azim HA. The current use and attitudes towards tumor genome sequencing in breast cancer. Sci Rep 2016; 6:22517. [PMID: 26931736 PMCID: PMC4773754 DOI: 10.1038/srep22517] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 02/09/2016] [Indexed: 12/24/2022] Open
Abstract
There is increasing availability of technologies that can interrogate the genomic landscape of an individual tumor; however, their impact on daily practice remains uncertain. We conducted a 28-item survey to investigate the current attitudes towards the integration of tumor genome sequencing in breast cancer management. A link to the survey was communicated via newsletters of several oncological societies, and dedicated mailing by academic research groups. Multivariable logistic regression modeling was carried out to determine the relationship between predictors and outcomes. 215 physicians participated to the survey. The majority were medical oncologists (88%), practicing in Europe (70%) and working in academic institutions (66%). Tumor genome sequencing was requested by 82 participants (38%), of whom 21% reported low confidence in their genomic knowledge, and 56% considered tumor genome sequencing to be poorly accessible. In multivariable analysis, having time allocated to research (OR 3.37, 95% CI 1.84–6.15, p < 0.0001), working in Asia (OR 5.76, 95% CI 1.57 – 21.15, p = 0.01) and having institutional guidelines for molecular sequencing (OR 2.09, 95% 0.99–4.42, p = 0.05) were associated with a higher probability of use. In conclusion, our survey indicates that tumor genome sequencing is sometimes used, albeit not widely, in guiding management of breast cancer patients.
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Affiliation(s)
- I Gingras
- Department of Hematology and Oncology, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - A Sonnenblick
- Department of Medicine, BrEAST Data Centre, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium.,Breast Cancer Translational Research Laboratory J. C. Heuson, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium
| | - E de Azambuja
- Department of Medicine, BrEAST Data Centre, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium.,Medical Oncology Clinic, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium
| | - M Paesmans
- Data Centre, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium
| | - S Delaloge
- Department of Medical Oncology, Institut Gustave-Roussy, Villejuif, France
| | - Philippe Aftimos
- Medical Oncology Clinic, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium
| | - M J Piccart
- Department of Medicine, BrEAST Data Centre, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium.,Medical Oncology Clinic, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium
| | - C Sotiriou
- Breast Cancer Translational Research Laboratory J. C. Heuson, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium.,Medical Oncology Clinic, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium
| | - M Ignatiadis
- Breast Cancer Translational Research Laboratory J. C. Heuson, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium.,Medical Oncology Clinic, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium
| | - H A Azim
- Department of Medicine, BrEAST Data Centre, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium.,Breast Cancer Translational Research Laboratory J. C. Heuson, Institut Jules Bordet/Université libre de Bruxelles, Brussels, Belgium
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12
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Azim HA, Sonnenblick A, Agbor-Tarh D, Bradbury I, Daly F, Huang Y, Dueck AC, Pritchard K, Wolff AC, Jackisch C, Lang I, Untch M, Smith I, Boyle F, Xu B, Gomez H, Perez E, Piccart M, de Azambuja E. Abstract PD5-07: The impact of early lapatinib-induced rash on disease-free and overall survival in patients treated within the ALTTO phase III randomized trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-pd5-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We have previously shown in a phase III neoadjuvant trial that early development of lapatinib-induced rash (i.e. within 6 weeks after lapatinib initiation) is independently associated with a higher chance of obtaining a pathological complete response (Azim et al; JCO 2013). In the current study, we aimed to investigate whether early lapatinib-induced rash is associated with improved survival in the context of a large phase III adjuvant trial.
Methods: This analysis is based on the ALTTO trial (BIG 2-06, Alliance N063D), in which patients with HER2-positive early breast cancer were randomized to adjuvant trastuzumab, lapatinib, their sequence or their combination for a total duration of 1 year. In this sub-study, we evaluated whether the development of rash (any grade) within 6 weeks of lapatinib initiation was associated with disease-free (DFS) and overall survival (OS). All analyses were tested in a multivariate model adjusted for treatment arm, treatment completion and trial stratification factors.
Results: A total of 6,098 lapatinib-treated patients were included in the current analysis; of whom 2,006 patients (32.9%) developed early lapatinib-induced rash, 1,025 (16.8%) developed rash after 6 weeks and 3,067 (50.3%) did not develop rash. No differences in patient characteristics were observed between the three groups apart from a higher frequency of younger patients (≤ 50) in the early rash group (54% vs. 47% and 44%, p<0.0001). At a median follow-up of 4.5 years, 876 (14.37%) and 377 (6.18%) patients in the lapatinib containing arms experienced a DFS and OS event, respectively. In a multivariate analysis confined to patients randomized to the lapatinib containing arms, the development of early rash was associated with improved DFS (HR: 0.80; 95%CI: 0.69-0.93, p=0.004) and OS (HR: 0.61; 95%CI: 0.48 - 0.78, p<0.001) compared to patients who did not develop early rash, with no interaction according to patient's age (p=0.9). No significant association was observed between the development of rash after 6 weeks of lapatinib initiation and survival. Compared to patients randomized to the trastuzumab alone arm (n=2,076), patients who developed early rash in the sequence (n=580) or combination (n=704) arms of trastuzumab/lapatinib had superior DFS (Sequence: HR 0.75 [95% CI: 0.58 – 0.98], p=0.034; Combination: HR 0.69 [95% CI: 0.54 – 0.89], p=0.005) and OS (Sequence: HR 0.57 [95%CI: 0.36 – 0.88], p=0.012; Combination: HR 0.59 [95% CI: 0.39 – 0.89], p=0.011). On the other hand, patients randomized to the lapatinib only arm who developed early rash (n=722) still had inferior DFS (HR 1.28 [95% CI: 1.04 – 1.59], p=0.02) with no difference in OS (HR: 0.95; 95%CI: 0.67 – 1.35, p=0.79) compared to patients randomized to the trastuzumab alone arm.
Conclusions: The results support our previous findings in the neoadjuvant setting that early development of skin rash within the first 6 weeks can identify patients who derive superior benefit of lapatinib treatment.
Citation Format: Azim Jr HA, Sonnenblick A, Agbor-Tarh D, Bradbury I, Daly F, Huang Y, Dueck AC, Pritchard K, Wolff AC, Jackisch C, Lang I, Untch M, Smith I, Boyle F, Xu B, Gomez H, Perez E, Piccart M, de Azambuja E. The impact of early lapatinib-induced rash on disease-free and overall survival in patients treated within the ALTTO phase III randomized trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr PD5-07.
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Affiliation(s)
- HA Azim
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - A Sonnenblick
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - D Agbor-Tarh
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - I Bradbury
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - F Daly
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - Y Huang
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - AC Dueck
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - K Pritchard
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - AC Wolff
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - C Jackisch
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - I Lang
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - M Untch
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - I Smith
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - F Boyle
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - B Xu
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - H Gomez
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - E Perez
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - M Piccart
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
| | - E de Azambuja
- Institut Jules Bordet, Belgium; Frontier Science Scotland, United Kingdom; Novartis; Mayo Clinic Cancer Center; Sunnybrook Odette Cancer Centre, Canada; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center; Sana Klinikum Offenbach, Germany; National Institute of Oncology, Hungary; Helios Klinikum Berlin-Buch, Germany; Royal Marsden Hospital, United Kingdom; Mater Hospital, Australia; Chinese Academy of Medical Sciences and Peking Union Medical College, China; Instituto Nacional de Enfermedades Neoplasicas Universidad Peruana Cayetano Heredia, Peru
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Gingras I, Sonnenblick A, Dolci S, de Azambuja E, Paesmans M, Delaloge S, Piccart MJ, Sotiriou C, Michail I, Azim HA. Abstract P6-04-13: The role of precision medicine in "real-life" management of breast cancer patients: A survey assessing the current use and attitudes towards tumor molecular sequencing in clinical practice. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-04-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Personalized medicine is a rising paradigm in cancer care. The identification of pathways involved in carcinogenesis along with the development of targeted therapies has revolutionized cancer treatment. There is increasing availability of technologies that can interrogate the genomic landscape of the tumor; however, it is still uncertain whether such platforms are used in clinical practice.
Methods: We conducted a 28-item survey to investigate the current use of tumor molecular sequencing in the management of breast cancer patients. A link to the online survey was communicated via various platforms such as the European Society for Medical Oncology (ESMO) and European School of Oncology (ESO) newsletter, and via a dedicated mailing by the Breast International Group (BIG) and other academic groups. Descriptive statistical analysis and Fisher's exact tests were applied to explore potential association between the demographic characteristics and responses.
Results: A total of 211 physicians from 35 countries participated to the study between the 9 March and 3 June 2015, with 92% fully completed questionnaires. The mean age of the participants was 45 years (range 27-77). The majority of responders were medical oncologists (88%), practicing in Europe (69%) and working in academic institutions (66%). 62% (130/211) of participants had never requested tumor molecular sequencing for breast cancer patients. Working in academic institutions and having more time allocated to research were associated with the use of tumor molecular sequencing (p = 0.007 and 0.009, respectively). For the 81 participants that used tumor molecular sequencing in the past (Table 1), there was a significant association between accessibility and frequency of use (p=0.02). 92% (181/211) of participants claimed that they would probably use tumor molecular sequencing more often if it was more accessible. Lack of funding and lack of access to the technology were the main reasons for poor endorsement. 89% of participants believe that tumor molecular sequencing will play a major role in the management of breast cancer patients in the future. Current weak evidence and poor access to matched targeted therapy are the main concerns against a wider use of these platforms in clinical practice.
Table 1. Summary of replies from the 81 participants that used tumor molecular sequencing for breast cancer patientsQuestionResponseN (%)In what percentage of your breast cancer patients has tumor molecular sequencing been performed at least once?≤5%55 (68%) >5%26 (32%)How often do the results lead to enrollment in a clinical trial?≤10%53 (65%) >10%28 (35%)How confident are you in interpreting tumor sequencing results?Not at all/A little17 (21%) Somewhat/Highly64 (79%)Do you consider molecular sequencing platforms accessible?Not at all/A little45 (55%) Somewhat/Highly36 (45%)
Conclusion: Our survey indicates that molecular sequencing platforms are sometimes used, albeit not widely in guiding management of breast cancer patients. Poor accessibility may contribute to the low frequency of use, but lack of evidence and poor access to matched targeted therapy are also major concerns.
Citation Format: Gingras I, Sonnenblick A, Dolci S, de Azambuja E, Paesmans M, Delaloge S, Piccart MJ, Sotiriou C, Michail I, Azim Jr HA. The role of precision medicine in "real-life" management of breast cancer patients: A survey assessing the current use and attitudes towards tumor molecular sequencing in clinical practice. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-04-13.
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Affiliation(s)
- I Gingras
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - A Sonnenblick
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - S Dolci
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - E de Azambuja
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - M Paesmans
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - S Delaloge
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - MJ Piccart
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - C Sotiriou
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - I Michail
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
| | - HA Azim
- Institut Jules Bordet, Brussels, Belgium; Institut Gustave-Roussy, Paris, France
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Sonnenblick A, Piccart M. Adjuvant systemic therapy in breast cancer: quo vadis? Ann Oncol 2015; 26:1629-34. [DOI: 10.1093/annonc/mdv108] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/16/2015] [Indexed: 11/13/2022] Open
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Sonnenblick A, Brohée S, Salgado R, Van den Eynden G, Neven P, Loibl S, Denkert C, Joensuu H, Piccart M, Sotiriou C. Constitutively activated STAT3 is predictive for trastuzumab resistance in primary HER2 positive breast cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv117.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sonnenblick A, Azim H, De Azambuja E, Francis P, Nordenskjöld B, Crown J, Gutiérez J, Quinaux E, Mastropasqua M, Ameye L, Anderson M, Lluch A, Goldhirsch A, Di Leo A, Barnadas A, Cortes-Funes H, Piccart M. Ten-Year Safety and Efficacy Analyses of the Big 02-98 Phase III Trial with an Exploratory Analysis on the Role of Ki67 in Predicting Benefit of Adjuvant Docetaxel in Er Positive Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Halpern N, Sonnenblick A, Kaduori L, Uziely B, Goldberg Y, Katz D, Allweis T, Divinsky L, Merlet I, Maly B, Sagi M, Hamburger T, Carmon E, Peretz T. Abstract P4-05-08: Oncotype Dx assay in BRCA positive ER positive breast cancer patients. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-05-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Oncotype DX is a 21-gene RT-PCR assay which quantifies the likelihood of breast cancer recurrence and the potential benefit of chemotherapy in patients with early stage, ER positive, Tamoxifen treated breast cancer. Breast cancer in BRCA carriers is considered more aggressive. The aim of our study was to evaluate whether Oncotype Dx recurrence score distribution is different in breast cancer patients with inherited BRCA mutation.
Methods:
The Oncotype DX assay has been used at Hadassah Medical Center since 2004 on specimens from over 450 patients. We analyzed and compared clinicopathological characteristics and Oncotype Dx recurrence scores of BRCA carriers versus non- BRCA or unknown status of BRCA patients.
Results:
Ten patients had validated inherited BRCA mutation, five of them are BRCA1 carriers and five BRCA2 carriers. There were no significant differences in the clinicopathological characteristics between the two groups. Oncotype Dx recurrence score distribution between low, intermediate and high risk groups was not significantly different. The mean recurrence score was 18.48 for the non- BRCA or unknown status of BRCA patients and 22.8 for the BRCA carriers patients. This difference was not statistically significant.
Conclusion:
Estrogen receptor positive breast cancer tumors from BRCA carriers does not display a significantly different Oncotype Dx recurrence score result distribution.
These preliminary data suggest Oncotype Dx assay might be used to help tailor treatment in this subset of patients, although further follow up is needed.
All patients evaluated for oncotype_DX All evaluated (except BRCA+) n = 456BRCA positiveP valueAgeMean57.4557.60.7 Median5857 Range56 (25-81)34 (42-76) T stageT167.7%70%0.9 T230.7%30% T31.6%0% Tumor sizeMean1.71.360.2 Median1.51.26 Range7.8 (0.2-8)1.3 (0.7-2) GradeGrade 1-278.8%60%0.15 Grade 321.2%40% RSLow50%40%0.57 Intermediate39.8%40% High10.2%20% RSMean18.4822.80.16 Median17.522.5 Range64 (0-64)27 (12-39)
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-05-08.
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Affiliation(s)
- N Halpern
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - A Sonnenblick
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - L Kaduori
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - B Uziely
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - Y Goldberg
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - D Katz
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - T Allweis
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - L Divinsky
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - I Merlet
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - B Maly
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - M Sagi
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - T Hamburger
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - E Carmon
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
| | - T Peretz
- Sharette Institute of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Hadassah Hebrew University Medical Center, Jerusalem, Israel; Sarah Markowitz Breast Center, Kaplan Medical Center, Rehovot, Israel
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