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Jung SU, Jung M, Choi JH, Jeon CW. Palbociclib with letrozole as second-line neo-systemic therapy after failure of neo-adjuvant chemotherapy for luminal type breast cancer: A case report. Medicine (Baltimore) 2021; 100:e25175. [PMID: 33832078 PMCID: PMC8036054 DOI: 10.1097/md.0000000000025175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Neo-adjuvant systemic therapy includes endocrine therapy and chemotherapy, which is widely used. Luminal breast cancer is resistant to chemotherapy and is more likely to not respond to chemotherapy before surgery. Palbociclib is a cyclin-dependent kinase 4 and 6 inhibitor. Palbociclib with letrozole combination therapy was an effective chemotherapy in metastatic luminal type breast cancer and had fewer side effects; however, the benefit of palbociclib in neoadjuvant systemic therapy is unclear. PATIENT CONCERNS A 50-year-old female patient visited our hospital with palpable lump in the right breast. The lymph nodes fixed in the ipsilateral axilla. DIAGNOSIS The patient was diagnosed with invasive ductal carcinoma of the right breast; the nuclear grade was moderate. The ipsilateral fixed lymph node was diagnosed as metastasis. The breast cancer subtype was luminal A type and was positive for estrogen receptor and progesterone receptor, and negative for HER2/neu and Ki-67 marker index <10% on immunohistochemistry. INTERVENTIONS Neo-systemic therapy was performed with 3 cycles of adriamycin with docetaxel. After follow-up study, the breast and axillary lesions progressed. Palbociclib with letrozole was administered as second neo-systemic therapy for 10 months. Subsequently, breast-conserving surgery with sentinel lymph node biopsy was performed. OUTCOMES In the postoperative pathologic result, 4 mm invasive lesion remained, and the sentinel lymph node biopsy was negative. The results achieved a residual cancer burden classification class 1. CONCLUSION Second-line neo-systemic therapy can further reduce the size of the tumor and increase the likelihood of avoiding the side effects of surgery. Palbociclib with letrozole may be a good treatment in the preoperative stage for luminal breast cancer that is resistant to chemotherapy.
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MESH Headings
- Antineoplastic Agents/administration & dosage
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Chemotherapy, Adjuvant/methods
- Female
- Humans
- Letrozole/administration & dosage
- Lymphatic Metastasis/pathology
- Mastectomy, Segmental
- Middle Aged
- Neoadjuvant Therapy/adverse effects
- Piperazines/administration & dosage
- Protein Kinase Inhibitors/administration & dosage
- Pyridines/administration & dosage
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Affiliation(s)
- Sung Ui Jung
- Division of Breast Surgery, Department of Surgery
| | - Minjung Jung
- Division of Breast Surgery, Department of Pathology, University of Kosin College of Medicine, Kosin University Gospel Hospital, Busan, Korea
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Kim YS, Kim HS, Park EJ, Kim HY, Kim HI, Park JH, Jeon CW, Yi HS. Predictive factors of drainage volume and drain duration after the inframammary approach to nipple-areolar-complex sparing mastectomy and implant-based breast reconstruction. Arch Aesthetic Plast Surg 2021. [DOI: 10.14730/aaps.2020.02348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Choi JH, Jeon CW, Kim YO, Jung S. Pathological complete response to neoadjuvant trastuzumab and pertuzumab therapy is related to human epidermal growth factor receptor 2 (HER2) amplification level in HER2-amplified breast cancer. Medicine (Baltimore) 2020; 99:e23053. [PMID: 33181670 PMCID: PMC7668516 DOI: 10.1097/md.0000000000023053] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The human epidermal growth factor receptor 2 (HER2) is amplified in approximately 20% of breast cancers, and HER2 receptor targeting therapy is associated with a significant improvement in disease-free and overall survival. In several clinical trials, the pathologic complete response (pCR) rate was significantly increased with combined pertuzumab and trastuzumab treatment in HER2-amplified breast cancer. Although the efficacy and safety of anti-HER2 dual blockade therapy has been reported, the markers that predict the response are still unclear. This study aimed to investigate the relationship between the level of HER2 amplification and the pCR in trastuzumab and pertuzumab neoadjuvant therapy.Twenty-two HER2-amplified early breast cancer patients who had received neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP) therapy were included in this study. HER2/CEP17 ratio and average HER2 copy number were measured by fluorescence in situ hybridization analysis. The relationship between level of HER2 amplification and tumor pCR status was investigated.The median age was 47.5 years (range, 36-62). 31.8% of the patients were hormone receptor (HR) positive and 68.2%% of the patients were HR negative. The pCR (ypN0/is ypN0) rate in the breast and axilla was 68.2%. The patients who experienced a pCR had a median HER2/CEP17 ratio of 7.08 (range, 3.16-10.40) and average HER2 copy number of 17.00 (range, 5.85-37.50). The patients who did not experience a pCR had a median ratio of 4.70 (range, 1.06-9.00) and median HER2 copy number of 12.00 (range, 5.85-20.95) (P = .030, P = .174), respectively.pCR was highly correlated with HER2/CEP17 ratio in neoadjuvant anti-HER2 dual blockade. This suggests that the HER2/CEP17 ratio can be used as a predictive marker for pCR in neoadjuvant trastuzumab and pertuzumab therapy.
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Affiliation(s)
| | | | - Young Ok Kim
- Department of Pathology, Kosin University Gospel Hospital, Busan, Republic of Korea
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Park MH, Lee SJ, Noh WC, Jeon CW, Lee SW, Son GS, Moon BI, Lee JS, Kang SS, Suh YJ, Gwak G, Kim TH, Yoo YB, Kim HA, Kim MY, Kim JY, Jeong J. A nationwide, multicenter retrospective study on the effectiveness and safety of eribulin in Korean breast cancer patients (REMARK). Breast 2020; 54:121-126. [PMID: 32980648 PMCID: PMC7519365 DOI: 10.1016/j.breast.2020.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/01/2020] [Revised: 08/07/2020] [Accepted: 09/04/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose Approval of eribulin for metastatic breast cancer was based on data primarily from Western patients, and there is a paucity of data on the effectiveness and safety of eribulin for Asian patients. To determine the effectiveness and safety of eribulin in Korean women with breast cancer in a real-world setting, we conducted a nationwide, multicenter, retrospective study. Methods Patients with locally advanced or metastatic breast cancer who were treated with eribulin in 14 centers throughout Korea were included in this study. Eribulin was generally administered at a dose of 1.23 mg/m2 (equivalent to 1.4 mg/m2 eribulin mesylate) by intravenous infusion for 2–5 min, or as a diluted solution, on Days 1 and 8 of every 21-day cycle. The primary endpoint was progression-free survival (PFS) rate at 6 months. Secondary endpoints included median PFS, overall survival (OS), time-to-treatment failure (TTF), tumor response rate, and incidence of hematologic treatment-emergent adverse events (TEAEs). Results The safety and full analysis populations included 398 and 360 (38 had no efficacy data) patients, respectively. The PFS rate at 6 months was 37.8%. Median PFS, OS, and TTF were 134, 631, and 120 days, respectively. Objective response rate, clinical benefit rate, and disease control rate were 18.1%, 50.6%, and 49.4%, respectively. Hematologic TEAEs were reported in 65.1% of patients; neutropenia (56.8%) and anemia (11.3%) were most common. Conclusion Real-world effectiveness and safety of eribulin in Korean breast cancer patients were consistent with previous reports; no new safety concerns were identified. Metastatic breast cancer patients were treated with eribulin (1.23 mg/m2, IV). Progression-free survival rate at 6 months was 37.8% in eribulin-treated patients. Median progression-free and overall survivals were 134 and 631 days, respectively. Hematologic treatment-emergent adverse events were reported in 65.1% of patients. Effectiveness and safety of eribulin were consistent with previous reports.
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Affiliation(s)
- Min Ho Park
- Department of Surgery, Chonnam National University Medical School, Gwangju, South Korea
| | - Soo Jung Lee
- Department of Surgery, Yeungnam University College of Medicine, Daegu, South Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Cancer Center Hospital, Seoul, South Korea
| | - Chang Wan Jeon
- Department of Surgery, Kosin University Gospel Hospital, Seoul, South Korea
| | - Seok Won Lee
- Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Gil Soo Son
- Department of Surgery, Korea University Ansan Hospital, Ansan, South Korea
| | - Byung-In Moon
- Department of Surgery, Ewha Women's University School of Medicine, Seoul, South Korea
| | - Jin Sun Lee
- Department of Surgery, Chungnam National University Hospital, Daejeon, South Korea
| | - Sung Soo Kang
- Department of Surgery, CHA University Ilsan Medical Center, Goyang, South Korea
| | - Young Jin Suh
- Department of Surgery, Catholic University of Korea, St. Vincent's Hospital, Suwon, South Korea
| | - Geumhee Gwak
- Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Tae Hyun Kim
- Department of Surgery, Inje University Busan Paik Hospital, Busan, South Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University Medical Center, Cheongju, South Korea
| | - Hyun-Ah Kim
- Department of Surgery, Korea Cancer Center Hospital, Seoul, South Korea
| | - Min Young Kim
- Medical Department, Eisai Korea Inc., Seoul, South Korea
| | - Ju Yeon Kim
- Medical Department, Eisai Korea Inc., Seoul, South Korea
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital Yonsei University, Seoul, South Korea.
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Jung SU, Jeon CW, Choi JH. Long-term survival with eribulin monotherapy after whole brain radiation therapy in a patient with brain metastasis from breast cancer. Asian J Surg 2020; 43:1008-1009. [PMID: 32631621 DOI: 10.1016/j.asjsur.2020.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/06/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sung Ui Jung
- Division of Breast Surgery, Department of Surgery, University of Kosin College of Medicine, Kosin Univ. Gospel Hospital, Busan, South Korea
| | - Chang Wan Jeon
- Division of Breast Surgery, Department of Surgery, University of Kosin College of Medicine, Kosin Univ. Gospel Hospital, Busan, South Korea
| | - Jin Hyuk Choi
- Division of Breast Surgery, Department of Surgery, University of Kosin College of Medicine, Kosin Univ. Gospel Hospital, Busan, South Korea.
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Yi HS, In SK, Kim HS, Park JH, Kim HI, Jeon CW, Kim HY. Factors affecting mastectomy specimen density in direct-to-implant breast reconstruction. Arch Aesthetic Plast Surg 2019. [DOI: 10.14730/aaps.2019.01774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Choo WG, Jeon CW, Ryu DW. Clinicopathological Factors Associated with Remnant or Regrowth of Benign Breast Tumor after Previous Vacuum-Assisted Core Biopsy. ACTA ACUST UNITED AC 2017. [DOI: 10.14449/jbd.2017.5.1.23] [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: 10/19/2022]
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Abstract
BACKGROUND Vacuum-assisted breast biopsy system (VAB) is an alternative modality to core needle biopsy for the diagnosis of breast lesions. MATERIAL AND METHODS Fifty-four patients who underwent ultrasound-guided VAB procedures were analyzed. Patients were categorized into two groups: The first 20 consecutive patients as group A and the next 34 consecutive patients as group B. RESULTS Fifty-two patients underwent excision, and two underwent biopsy only. Moving average curves showed a plateau phase for performing VAB procedures after the 20(th) patient. Total operation times of group B were significantly shorter than those of group A (p < 0.001). Complication rates in group B tended to be lower, and VAB probe position of group B tended to be better than that of group A, but these differences were not statistically significant. CONCLUSION Our data suggest the existence of a learning curve for ultrasound-guided VAB procedures. VAB procedures can be performed safely, even during the early learning period.
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Affiliation(s)
- Hyung Seok Park
- Department of Surgery, Yonsei University College of Medicine , Seoul , Korea
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Park S, Park BW, Kim TH, Jeon CW, Kang HS, Choi JE, Hwang KT, Kim IC. Lack of either estrogen or progesterone receptor expression is associated with poor survival outcome among luminal A breast cancer subtype. Ann Surg Oncol 2012. [PMID: 23192228 DOI: 10.1245/s10434-012-2772-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND This study was designed to evaluate the impact of lack of either estrogen receptor (ER) or progesterone receptor (PR) on characteristics and outcomes among luminal A breast cancer subtype treated with endocrine with or without chemotherapeutic agents. METHODS The luminal A subtype was categorized into three subgroups: ER+/PR+, ER+/PR-, and ER-/PR+. All tumors were human epidermal growth factor receptor 2 (HER2) negative. Clinicopathological features and survival were analyzed using the Severance Hospital dataset (n = 1,180) and were validated by the nationwide Korean Breast Cancer Society (KBCS) registry (n = 9,916). RESULTS Despite the different distribution of ER/PR status, tumor stage, grade, and local therapies between the two datasets, similarly ER+/PR+ showed smaller size and good differentiation, ER+/PR- patients had the oldest age at diagnosis, and ER-/PR+ was associated with the youngest age at onset and grade III tumor. Single hormone receptor-positive subgroups demonstrated worse disease-related outcomes than the ER+/PR+ subgroup. These associations were confirmed by the KBCS dataset. This trend was also demonstrated in the subpopulation of 1,944 patients with Ki-67 < 14 %. Inferior survival of single receptor-positive tumors was more definite among node-positive patients even when receiving both chemo-endocrine therapies. CONCLUSIONS Current results suggest that the luminal A subtype is also heterogeneous and each subgroup has unique clinicopathologic characteristics. Lack of either ER or PR expression is associated with worse survival, especially among node-positive luminal A subtype.
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Affiliation(s)
- Seho Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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Park WC, Kim LS, Kim TH, Park BW, Park HY, Song BJ, Lee JB, Jeon CW, Choi UJ. Molecular Targets for Treatment of Breast Cancer. J Breast Cancer 2009. [DOI: 10.4048/jbc.2009.12.4.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Woo-Chan Park
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
| | - Lee Su Kim
- Department of Surgery, College of Medicine, Hallym University, Seoul, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
| | - Tae Hyun Kim
- Department of Surgery, College of Medicine, Inje University, Busan, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
| | - Byeong-Woo Park
- Department of Surgery, College of Medicine, Yonsei University, Seoul, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
| | - Ho Yong Park
- Department of Surgery, College of Medicine, Kyungpook National University, Daegu, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
| | - Byung Joo Song
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
| | - Jae Bok Lee
- Department of Surgery, College of Medicine, Korea University, Seoul, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
| | - Chang Wan Jeon
- Department of Surgery, College of Medicine, Kosin Unversity, Busan, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
| | - Un-Jong Choi
- Department of Surgery, College of Medicine, Wonkwang University, Iksan, Korea
- Target Molecule Study Group of Korean Breast Cancer Society, Seoul, Korea
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Affiliation(s)
- Chul Min Lee
- Department of Surgery, Kosin University College of Medicine, Busan, Korea
| | - Seung Hyun Lee
- Department of Surgery, Kosin University College of Medicine, Busan, Korea
| | - Chang Wan Jeon
- Department of Surgery, Kosin University College of Medicine, Busan, Korea
| | - Byung Kwon Ahn
- Department of Surgery, Kosin University College of Medicine, Busan, Korea
| | - Sung Uhn Baek
- Department of Surgery, Kosin University College of Medicine, Busan, Korea
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Heliotis G, Gu E, Griffin C, Jeon CW, Stavrinou PN, Dawson MD, Bradley DDC. Wavelength-tunable and white-light emission from polymer-converted micropixellated InGaN ultraviolet light-emitting diodes. ACTA ACUST UNITED AC 2006. [DOI: 10.1088/1464-4258/8/7/s20] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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