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González-Fernández S, Fernández-Rodríguez C, Mota-Alonso MJ, García-Teijido P, Pedrosa I, Pérez-Álvarez M. Emotional state and psychological flexibility in breast cancer survivors. Eur J Oncol Nurs 2017; 30:75-83. [PMID: 29031317 DOI: 10.1016/j.ejon.2017.08.006] [Citation(s) in RCA: 19] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 08/04/2017] [Accepted: 08/18/2017] [Indexed: 11/12/2022]
Abstract
PURPOSE This study analyses the premise that less time spent carrying out valuable activities and inflexible avoidance of thoughts, feelings and memories related to the oncological process may play an important role in the emotional problems of cancer survivors. METHODS Emotional state was evaluated, as was quality of life and psychological flexibility in a sample of 122 breast cancer survivors (Mage = 52.40; SDage = 7.26). The analysis was carried out using a cross-sectional predictive study. RESULTS Approximately half of those in the sample suffered from clinically significant emotional distress. The predictor variables selected explained a high percentage of the variability in emotional problems and quality of life (51.10-77.10%). CONCLUSION Avoidance explained a high percentage of the variance in anxiety, depression and general distress. A lower degree of participation in valuable activities contributed, more specifically, to explaining variability in depression. The quantity and availability of environmental reinforcement was closely related to quality of life. A decisive contribution towards promoting emotional well-being and quality of life can be made by nursing action aimed at diminishing those avoidance strategies related to the oncological experience which may distance patients from daily activities which are gratifying and congruent with their values.
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Affiliation(s)
| | | | | | | | - Ignacio Pedrosa
- Department of Psychology, University of Oviedo, Oviedo, Asturias, Spain
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Benavides M, Abad A, Carrato A, Gravalos C, Fernández-Montes A, Falcó E, González-Flores E, Garcia Garcia T, Martin-Valades J, Gallego Plazas J, Valladares-Ayerbes M, García-Girón C, Dueñas R, García-Tapiador A, Pericay C, Losa F, Viudez A, García-Teijido P, Diaz Rubio E, Aranda Aguilar E. Benefits of upfront primary tumour resection (UPTR) according to sidedness in mCRC: Retrospective analyses of TTD MACRO-2 and PLANET randomised trials. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.019] [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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García-Teijido P, Cabal ML, Fernández IP, Pérez YF. Tumor-Infiltrating Lymphocytes in Triple Negative Breast Cancer: The Future of Immune Targeting. Clin Med Insights Oncol 2016; 10:31-9. [PMID: 27081325 PMCID: PMC4822722 DOI: 10.4137/cmo.s34540] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 12/13/2022]
Abstract
Triple negative breast cancer (TNBC) is a highly heterogeneous tumor. There is increasing evidence of the role of tumor lymphocytic immune infiltrates in this subtype of breast cancer. Robust levels of tumor infiltrating lymphocytes (TILs) have been associated with improved disease-free and overall survival rates in TNBC patients with and without any treatment. Recent efforts have been made to develop a standardized methodology for evaluating TILs. The presence of TILs in the breast tumor microenvironment can also predict responses not only to neoadjuvant but also to adjuvant chemotherapy treatments. High numbers of TILs correlate with increased pathological complete responses (pCR) in TNBC. TILs are prognostic and predictive of response to standard therapies; thus, the immune system appears to play an active role in a subgroup of breast cancer. There is an increasing interest in directly targeting the immune system as part of breast cancer therapy, mainly in patients with TNBC. New immune modulatory agents, including immune checkpoints inhibitors, have shown promising activity in a subgroup of metastatic TNBC. Increased programmed cell death protein 1 ligand (PD-L1) expression on the surface of TNBC provides the rationale for implementing therapeutic strategies targeting the PD-1/PD-L1 axis in TNBC. The programmed cell death protein 1 (PD-1) inhibitor pembrolizumab, and the PD-L1 inhibitor atezolizumab have shown promising results in clinical trials.
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Affiliation(s)
- Paula García-Teijido
- Department of Medical Oncology, Hospital San Agustín, C/Camino de Heros 6, Asturias, Spain
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Luque-Cabal M, García-Teijido P, Fernández-Pérez Y, Sánchez-Lorenzo L, Palacio-Vázquez I. Mechanisms Behind the Resistance to Trastuzumab in HER2-Amplified Breast Cancer and Strategies to Overcome It. Clin Med Insights Oncol 2016; 10:21-30. [PMID: 27042153 PMCID: PMC4811269 DOI: 10.4137/cmo.s34537] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/10/2016] [Accepted: 02/11/2016] [Indexed: 12/15/2022]
Abstract
The introduction of trastuzumab therapy markedly improved the poor prognosis associated with HER2-amplified breast cancers. Despite this, the presence of primary and acquired resistance to trastuzumab treatment remains a significant common challenge. The identification of resistance mechanisms and the incorporation of new drugs that achieve a better blockade of HER family receptors signaling have resulted in improved outcomes. The phosphatidylinositol 3′-kinase/protein kinase B/mammalian target of rapamycin pathway, cross-talk with estrogen receptors, immune response, cell cycle control mechanisms, and other tyrosine kinase receptors such as insulin-like growth factor I receptor are potential pathways involved in trastuzumab resistance. Different therapeutic interventions targeting these pathways are currently under evaluation.
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Affiliation(s)
- María Luque-Cabal
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | - Yolanda Fernández-Pérez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Luisa Sánchez-Lorenzo
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Isabel Palacio-Vázquez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Martínez-Jañez N, Chacón I, de Juan A, Cruz-Merino L, Del Barco S, Fernández I, García-Teijido P, Gómez-Bernal A, Plazaola A, Ponce J, Servitja S, Zamora P. Anti-HER2 Therapy Beyond Second-Line for HER2-Positive Metastatic Breast Cancer: A Short Review and Recommendations for Several Clinical Scenarios from a Spanish Expert Panel. Breast Care (Basel) 2016; 11:133-8. [PMID: 27239176 DOI: 10.1159/000443601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of this project was to provide an expert opinion regarding anti-human epidermal growth factor receptor 2 (HER2) therapy beyond second-line treatment of metastatic breast cancer (mBC). METHODS A group of experts discussed specific issues concerning anti-HER2 therapy in late-line settings in mBC. RESULTS Trastuzumab emtansine (T-DM1) or dual HER2 blockade appeared to be good options for HER2-positive mBC after ≥ 2 HER2-targeted therapies. Once an objective response has been achieved with anti-HER2-containing therapy, the anti-HER2 agent can be continued until progression of the disease, unacceptable toxicity or patient decision. mBC treated with ≥ 3 consecutive lines of anti-HER therapy, ≥ 1 being a dual HER2 blockade and with early progression of disease during a fourth or later-line treatment, are clinically resistant to anti-HER therapy. For progression of metastasis in the brain after anti-HER2 therapy, lapatinib and chemotherapy appear to be a good alternative after best local treatment. CONCLUSIONS Further clinical trials are needed to provide valuable knowledge about the best treatment options in the later settings of mBC.
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Affiliation(s)
| | - Ignacio Chacón
- Medical Oncology Department, Hospital Virgen de la Salud, Toledo, Spain
| | - Ana de Juan
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Luis Cruz-Merino
- Medical Oncology Department, Hospital Virgen de la Macarena, Sevilla, Spain
| | - Sònia Del Barco
- Instituto Catalán de Oncología, Hospital Universitario Doctor Josep Trueta, Gerona, Spain
| | | | | | | | | | - José Ponce
- Hospital General Universitario de Alicante, Alicante, Spain
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Luque M, Arranz F, Cueva JF, de Juan A, García-Teijido P, Calvo L, Peláez I, García-Palomo A, García-Mata J, Antolín S, García-Estévez L, Fernández Y. Breast cancer management in the elderly. Clin Transl Oncol 2013; 16:351-61. [PMID: 24085574 DOI: 10.1007/s12094-013-1113-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 09/15/2013] [Indexed: 01/02/2023]
Abstract
The increase in life expectancy in the western world means that we are faced with patients diagnosed with breast cancer in old age with increasing frequency. The management of these cases is a challenge for the oncologist, who must take into account the conditions associated with advanced age and the lack of trials in this population. In this review, we addressed the incorporation of geriatric assessment methods that may be useful in making decisions, the particular biological characteristics of breast cancer in elderly patients and their treatment in both localized and advanced disease. Finally, we collected recommendations based on scientific evidence regarding the monitoring and life-style after finishing treatment.
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Affiliation(s)
- M Luque
- Medical Oncology Department, Hospital Universitario Central de Asturias, C/Julian Clavería s/n, 33006, Oviedo, Spain,
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Fernández Y, Cueva J, Palomo AG, Ramos M, de Juan A, Calvo L, García-Mata J, García-Teijido P, Peláez I, García-Estévez L. Novel therapeutic approaches to the treatment of metastatic breast cancer. Cancer Treat Rev 2009; 36:33-42. [PMID: 19883980 DOI: 10.1016/j.ctrv.2009.10.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 09/30/2009] [Accepted: 10/02/2009] [Indexed: 01/22/2023]
Abstract
Metastatic breast cancer is ultimately an incurable disease, although recent data have shown that its incidence is decreasing and that patients with metastatic breast cancer live longer. This improvement in survival seems to be linked with the introduction of new therapeutic agents, novel combinations of existing therapies and targeted therapies. Our increasing understanding of the molecular biology of metastatic disease has allowed the development of therapies aimed at specific molecular targets. Some of these have already been approved for the treatment of metastatic breast cancer in combination with cytotoxics, and others have shown promising results regarding disease-free survival, overall response rates and time to disease progression. Given the enormous amount of information about drug discovery in cancer, it is important to be familiar with the present state of the treatment of metastatic breast cancer. The purpose of this review is to provide an update on the development of some of the most promising novel agents and treatment strategies in metastatic breast cancer.
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Buesa JM, García-Teijido P, Losa R, Fra J. Treatment of ifosfamide encephalopathy with intravenous thiamin. Clin Cancer Res 2003; 9:4636-7. [PMID: 14555540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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