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Jibiki N, Nakazawa T, Nogami M, Yoshida K, Hasegawa A, Guo F, Hiroshima K. Prognostic Evaluation of HER2-positive Early Breast Cancers Using Clinico-pathological Criteria. CANCER DIAGNOSIS & PROGNOSIS 2024; 4:326-332. [PMID: 38707735 PMCID: PMC11062154 DOI: 10.21873/cdp.10328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/12/2024] [Indexed: 05/07/2024]
Abstract
Background/Aim HER2-positive breast carcinomas (BCs) generally behave more aggressively and show higher cytological and histological grade than HER2-negative BCs. However, the clinical properties of HER2-positive early BCs have not been studied extensively. Hence, the therapeutic significance of neoadjuvant chemotherapy (NAC) for this BC remains debatable. Patients and Methods We retrospectively examined the clinicopathological features of 94 HER2-positive early BCs who perioperatively received anti-HER2 drugs, without undergoing NAC prior to surgery. Results The patients' five year-disease free survival (DFS) and overall survival (OS) rates were 95.6% and 100%, respectively. Univariate analysis demonstrated significant differences in distant metastasis-free survival (DMFS) between clinical and pathological tumor stages (T stages). Pathological T1 stage and clinical T1 stage tumors showed significantly higher DMSF than pT2-3 and cT2-3 (p=0.0002 and 0.0294). Multivariate analysis disclosed no significant differences in DFS, OS, and DMFS with respect to preoperative clinical tumor stage, patient age, type of surgery, postoperative therapy, and pathological factors. Recurrences occurred in nine patients: four (4.3%) and five (5.3%) patients showed local and distant recurrences, respectively. One patient with cT2 BC died of disease. Interestingly, four of the five BCs with distant recurrence pathologically demonstrated lymph vessel invasion. The prognoses of patients with HER2-positive stage cT1/2N0M0 BC were highly favorable. Conclusion The indications for NAC in small, localized, and node-negative HER2-positive BC should be carefully assessed based on the presence of a larger tumor size, postoperative pathological evaluation of tumor size, and lymph vessel invasion.
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Affiliation(s)
- Norie Jibiki
- Department of Breast and Endocrine Surgery, Tokyo Woman's Medical University Yachiyo Medical Center (TYMC), Chiba, Japan
| | - Tadao Nakazawa
- Department of Pathology, Tokyo Woman's Medical University Yachiyo Medical Center (TYMC), Chiba, Japan
| | - Mako Nogami
- Department of Breast and Endocrine Surgery, Tokyo Woman's Medical University Yachiyo Medical Center (TYMC), Chiba, Japan
| | - Keita Yoshida
- Department of Pathology, Tokyo Woman's Medical University Yachiyo Medical Center (TYMC), Chiba, Japan
| | - Atsuko Hasegawa
- Department of Pathology, Tokyo Woman's Medical University Yachiyo Medical Center (TYMC), Chiba, Japan
| | - Feng Guo
- Department of Pathology, Tokyo Woman's Medical University Yachiyo Medical Center (TYMC), Chiba, Japan
| | - Kenzo Hiroshima
- Department of Pathology, Tokyo Woman's Medical University Yachiyo Medical Center (TYMC), Chiba, Japan
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Suba Z. DNA Damage Responses in Tumors Are Not Proliferative Stimuli, but Rather They Are DNA Repair Actions Requiring Supportive Medical Care. Cancers (Basel) 2024; 16:1573. [PMID: 38672654 PMCID: PMC11049279 DOI: 10.3390/cancers16081573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND In tumors, somatic mutagenesis presumably drives the DNA damage response (DDR) via altered regulatory pathways, increasing genomic instability and proliferative activity. These considerations led to the standard therapeutic strategy against cancer: the disruption of mutation-activated DNA repair pathways of tumors. PURPOSE Justifying that cancer cells are not enemies to be killed, but rather that they are ill human cells which have the remnants of physiologic regulatory pathways. RESULTS 1. Genomic instability and cancer development may be originated from a flaw in estrogen signaling rather than excessive estrogen signaling; 2. Healthy cells with genomic instability exhibit somatic mutations, helping DNA restitution; 3. Somatic mutations in tumor cells aim for the restoration of DNA damage, rather than further genomic derangement; 4. In tumors, estrogen signaling drives the pathways of DNA stabilization, leading to apoptotic death; 5. In peritumoral cellular infiltration, the genomic damage of the tumor induces inflammatory cytokine secretion and increased estrogen synthesis. In the inflammatory cells, an increased growth factor receptor (GFR) signaling confers the unliganded activation of estrogen receptors (ERs); 6. In breast cancer cells responsive to genotoxic therapy, constitutive mutations help the upregulation of estrogen signaling and consequential apoptosis. In breast tumors non-responsive to genotoxic therapy, the possibilities for ER activation via either liganded or unliganded pathways are exhausted, leading to farther genomic instability and unrestrained proliferation. CONCLUSIONS Understanding the real character and behavior of human tumors at the molecular level suggests that we should learn the genome repairing methods of tumors and follow them by supportive therapy, rather than provoking additional genomic damages.
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Affiliation(s)
- Zsuzsanna Suba
- Department of Molecular Pathology, National Institute of Oncology, Ráth György Str. 7-9, H-1122 Budapest, Hungary
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Chen P, Mao X, Ma N, Wang C, Yao G, Ye G, Zhou D. Dynamic changes in intrinsic subtype, immunity status, and risk score before and after neoadjuvant chemo- and HER2-targeted therapy without pCR in HER2-positive breast cancers: A cross-sectional analysis. Medicine (Baltimore) 2022; 101:e29877. [PMID: 35945759 PMCID: PMC9351872 DOI: 10.1097/md.0000000000029877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Very few studies have been done in HER2 positive patients without complete pathological response (pCR) after combined neoadjuvant chemo- and HER2-target therapy to investigate changes in intrinsic subtype, risk of recurrence (ROR) score, and immunity status before and after treatment. Patients with nonmetastatic HER2-positive breast cancer failed to achieve pCR after neoadjuvant chemotherapy plus trastuzumab were included in current study. We examined the distribution of PAM50 subtypes, ROR score and immunity score in 25 paired baseline and surgical samples. The Miller-Payne grading system was used to evaluate the efficacy of the neoadjuvant therapy. It was observed that the distribution of intrinsic subtype, ROR category and immunity subgroup varied according to hormone receptor (HR) status. HER2-enriched and basal-like subtypes, median-high ROR categories and immunity-weak subgroup were dominant in baseline tumors. Compared to baseline samples, conversion of intrinsic subtype, ROR categories and immunity subgroups were found in 15 (60.0%), 13(52.0%), and 11(44.0%) surgical samples, respectively. The PAM50 subtype, ROR category, and immunity subgroup were concordant between baseline and surgical samples where nonluminal subtypes, median-high ROR categories and i-weak subgroup were still common. In conclusion, the HER2-positive breast cancer is highly heterogeneous with a distribution of 72-gene expression varying according to HR co-expression. The dynamics of the 72-gene expression pre- and posttreatment may become novel biomarker for guiding adjuvant therapy and hence warrant further investigation.
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Affiliation(s)
- Peixian Chen
- Department of Breast Surgery, The First People’s Hospital of Foshan, Guangdong, China
| | - Xiaofan Mao
- Clinical Research Institute, The First People’s Hospital of Foshan, Guangdong, China
| | - Na Ma
- Department of Pathology, The First People’s Hospital of Foshan, Guangdong, China
| | - Chuan Wang
- The First People’s Hospital of Foshan, Guangdong, China
| | - Guangyu Yao
- Breast Center, Department of General Surgery, Nanfang Hospital, Southern Medical University, Province, hina
| | - Guolin Ye
- Department of Breast Surgery, The First People’s Hospital of Foshan, Guangdong, China
| | - Dan Zhou
- Department of Breast Surgery, The First People’s Hospital of Foshan, Guangdong, China
- * Correspondence: Dan Zhou, MD, Department of Breast Surgery, The First People’s Hospital of Foshan, #81, North Lingnan Avenue, Chancheng, Foshan, Guangdong, China (e-mail: )
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Handayani S, Susidarti RA, Utomo RY, Meiyanto E, Jenie RI. Synergistic Cytotoxic and Antimigratory Effect of Brazilein and Doxorubicin on HER2-Overexpressing Cells. Asian Pac J Cancer Prev 2022; 23:2623-2632. [PMID: 36037115 PMCID: PMC9741888 DOI: 10.31557/apjcp.2022.23.8.2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE The present research aims to report cytotoxic and antimigratory activities of the oxidized form of brazilin, i.e., brazilein, and the effects of the combination of brazilein-doxorubicin on MCF-7/HER2 cells. METHODS The MTT assay was conducted to test the cytotoxic activity, while flow cytometry with PI and PI-annexin V staining were respectively performed for cell cycle and apoptosis analyses. Migration and invasion analyses were assessed via Boyden chamber assay, while HER2, Rac1, p120, MMP2, and MMP9 protein levels were determined by immunoblotting and gelatin zymography. Molecular docking of ligands with HER2, Src, PI3Kα, PI3KΔ, and PI3Kγ proteins was evaluated using MOE 2010. RESULTS The MTT assay showed that the IC50 value of brazilein against MCF-7/HER2 cells was 51 ± 2.1 µM. Moreover, brazilein and its combination with doxorubicin-induced G2/M accumulation and apoptosis. Combination of brazilein-doxorubicin inhibited cell migration and tended to decrease HER2, Rac1, p120, MMP2, and MMP9 protein expression levels. Based on our molecular docking study, the docking score of brazilein with PI3Kγ is comparable to that of the native ligand. CONCLUSION Taken together, a combination of brazilein-doxorubicin exhibited synergistic cytotoxic and antimigratory effects on MCF-7/HER2 cells.<br />.
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Affiliation(s)
- Sri Handayani
- Research Center for Food Technology and Processing, National Research and Innovation Agency (BRIN), JL. Jogja - Wonosari, km 31.5, Yogyakarta, Indonesia.
- Cancer Chemoprevention Research Center, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Ratna Asmah Susidarti
- Cancer Chemoprevention Research Center, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Rohmad Yudi Utomo
- Cancer Chemoprevention Research Center, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Edy Meiyanto
- Cancer Chemoprevention Research Center, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Riris Istighfari Jenie
- Cancer Chemoprevention Research Center, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
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Han D, Shen R, Yue M, Zhao M, Yu Y, Yao J, Liu Y. Relationship between the changes of positivity rate of HER2 expression and the diameter of invasive lesions in early breast cancer and its clinical significance. Pathol Res Pract 2022; 233:153877. [DOI: 10.1016/j.prp.2022.153877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/27/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
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Dual targeting micelles loaded with paclitaxel and lapatinib for combinational therapy of brain metastases from breast cancer. Sci Rep 2022; 12:2610. [PMID: 35173243 PMCID: PMC8850478 DOI: 10.1038/s41598-022-06677-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 02/01/2022] [Indexed: 11/11/2022] Open
Abstract
Due to the presence of the blood–brain barrier (BBB), the delivery of general drugs into the brain tissue remains to be a tricky problem. For patients with brain metastases from breast cancer, drug delivery systems must overcome this physical barrier. Targeted nano vehicles arise as a promising alternative to deliver drugs to brain tissues successively. Herein, a dual targeting micelle drug delivery system loaded with paclitaxel (PTX) and lapatinib (LPTN) was developed for combinational therapy of brain metastases. In our study, it was shown the micelles modified with Angiopep-2 had high loading efficiency of paclitaxel and lapatinib (Ang-MIC-PTX/LP). In addition, Ang-MIC-PTX/LP could transport across the in vitro BBB model and accumulate in breast cancer cells. After intravenous injection, Ang-MIC significantly accumulated in the brain metastasis. Ang-MIC-PTX/LP could also extend the life span of brain metastasis mouse models. Overall, this study provided a promising method for treatment of brain metastases from breast cancer.
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Salama M, Khater A, Adel I, Selim M. National Cancer Institute Experience in Micro-invasive Breast Carcinoma Treatment and Outcome. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AbstractBackground: Significant relationship between breast cancer immunophenotype and risk of recurrence either local and/or distant may help determine which patients might benefit more from axillary staging and whether axillary staging is warranted in all cases or not. Patients with microinvasive carcinoma can present with axillary LN. metastasis, with incidence ranges from 0% to 20% . Thus, sentinel node biopsies are considered for patients with microinvasive carcinoma. The role of axillary staging in MIBC is not well defined, with the rate of axillary L.N. metastases ranging 0–11 %. Current studies focus on the clinical characteristics of MIBC. However, only a few studies have evaluated the survival and treatment, especially adjuvant chemotherapy after surgery, for patients with MIBC.Methods: This is a retrospective study of 139 cases diagnosed with microinvasive breast carcinoma from 2011 to 2015 who were identified in the National Cancer Institute, Cairo University. The pathologic database of our hospital was searched to identify patients with a pathologic diagnosis of MIBC on surgical specimens. The clinical features, sonographic and mammographic images and pathology records were reviewed.Results: There is increased incidence of MIBC over the past decade. Patients with MIBC were managed surgically with BCS. MIBC have the good prognosis. However, patients who are negative hormonal receptors have relatively substantial risk of relapse within the first 5 years after surgical operation. Adjuvant chemotherapy can only improve the outcomes of patients with negative hormonal receptors. Further studies with prolonged follow-up of large cohort are warranted to assess the prognostic significance and treatment of this lesion.Keywords: MIBC, CIS, DCIS, BC
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Villasco A, Actis S, Bounous VE, Borella F, D’Alonzo M, Ponzone R, De Sanctis C, Benedetto C, Biglia N. The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study. Cancers (Basel) 2021; 13:cancers13225836. [PMID: 34830989 PMCID: PMC8616482 DOI: 10.3390/cancers13225836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Treatment of small HER2+ breast cancers with adjuvant Trastuzumab is still controversial. This study aims to measure the effect of Trastuzumab in early stages of breast cancer (pT1mic/a pN0/1mi) in terms of disease recurrence and to identify which factors most affect the prognosis of small HER2+ tumors. We retrospectively selected and reviewed 100 HER2+ pT1mic-pT1a breast cancer patients with a median follow-up of 86 months. In our study the primary outcome was the disease recurrence rate, which appeared to be significantly lower among patients who received adjuvant Trastuzumab. Among the patients who did not receive adjuvant Trastuzumab, HR− HER2+ tumors showed a risk seven times higher of relapse. The results of our study indicate that adjuvant Trastuzumab reduces the risk of developing a disease recurrence even in small HER2+ tumors. Adjuvant targeted therapy should be considered in patients with HR− HER2+ tumors, the category with the highest risk of recurrence. Abstract The treatment with adjuvant Trastuzumab in patients diagnosed with HER2+ small breast cancers is controversial: limited prospective data from randomized trials is available. This study aims to measure the effect of Trastuzumab in the early stages of breast cancer (pT1mic/a pN0/1mi) in terms of disease recurrence and to identify which are the factors that most affect the prognosis of small HER2+ tumors. One hundred HER2+ pT1mic-pT1a breast cancer patients who were treated in three Turin Breast Units between January 1998 and December 2018 were retrospectively selected and reviewed. Trastuzumab was administered to 23 patients. Clinicopathological features and disease-free survival (DFS) were compared between different subgroups. The primary outcome was the disease recurrence rate. Median follow-up time was 86 months. Compared to pT1a tumors, pT1mic lesions had a higher tumor grade (84% of pT1mic vs. 55% of pT1a; p = 0.003), a higher Ki-67 index (81% vs. 46%; p = 0.007) and were more frequently hormone receptor (HR) negative (69% vs. 36%, p = 0.001). Disease recurrence rate was significantly lower among patients who received adjuvant Trastuzumab (p = 0.02), with this therapy conferring an 85% reduction in the risk of relapse (HR 0.15; p = 0.02). Among the patients who did not receive adjuvant Trastuzumab, the only factor significantly associated with an increased risk of developing a recurrence was the immunohistochemical (IHC) subtype: in fact, HR− HER2+ tumors showed a risk seven times higher of relapsing (HR 7.29; p = 0.003). Adjuvant Trastuzumab appears to reduce the risk of disease recurrence even in small HER2+ tumors. The adjuvant targeted therapy should be considered in patients with HR− HER2+ tumors since they have the highest risk of recurrence, independently from size and grade.
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Affiliation(s)
- Andrea Villasco
- Academic Division of Obstetrics and Gynaecology-A.O. Ordine Mauriziano, University of Turin, 10128 Turin, Italy; (A.V.); (S.A.); (V.E.B.); (M.D.)
| | - Silvia Actis
- Academic Division of Obstetrics and Gynaecology-A.O. Ordine Mauriziano, University of Turin, 10128 Turin, Italy; (A.V.); (S.A.); (V.E.B.); (M.D.)
| | - Valentina Elisabetta Bounous
- Academic Division of Obstetrics and Gynaecology-A.O. Ordine Mauriziano, University of Turin, 10128 Turin, Italy; (A.V.); (S.A.); (V.E.B.); (M.D.)
| | - Fulvio Borella
- Gynaecology and Obstetrics 1-City of Health and Science, University of Turin, 10126 Turin, Italy; (F.B.); (C.B.)
| | - Marta D’Alonzo
- Academic Division of Obstetrics and Gynaecology-A.O. Ordine Mauriziano, University of Turin, 10128 Turin, Italy; (A.V.); (S.A.); (V.E.B.); (M.D.)
| | - Riccardo Ponzone
- Gynecological Oncology, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy;
| | - Corrado De Sanctis
- Breast Unit, Department of Gynecology and Obstetrics, City of Health and Science, University of Turin, 10126 Turin, Italy;
| | - Chiara Benedetto
- Gynaecology and Obstetrics 1-City of Health and Science, University of Turin, 10126 Turin, Italy; (F.B.); (C.B.)
| | - Nicoletta Biglia
- Academic Division of Obstetrics and Gynaecology-A.O. Ordine Mauriziano, University of Turin, 10128 Turin, Italy; (A.V.); (S.A.); (V.E.B.); (M.D.)
- Correspondence:
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Guven DC, Kaya MB, Fedai B, Ozden M, Yildirim HC, Kosemehmetoglu K, Kertmen N, Dizdar O, Uner A, Aksoy S. HER2-low breast cancer could be associated with an increased risk of brain metastasis. Int J Clin Oncol 2021; 27:332-339. [PMID: 34661778 DOI: 10.1007/s10147-021-02049-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/03/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE The HER2-low breast cancer is a newly recognized entity with the clinical characteristics is yet to be defined. We hypothesized that HER2-low breast cancer could lead to an increased rate of brain metastases in patients with localized breast cancer. We tested this hypothesis in a large cohort of breast cancer patients with long follow-up. METHODS We included 2686 adult breast cancer patients followed up in Hacettepe University Cancer Center. Patients with 1 + positive HER2 expression and 2 + HER2 expression with a negative FISH were categorized as HER2-low disease. We evaluated the brain metastasis risk with binary logistic regression analyses and reported odds ratios (OR) with 95% confidence intervals (CI). RESULTS During a median 95.4 (IQR 72.6-123.1) month follow-up, 184 patients developed brain metastasis (6.9%). The brain metastases were developed in 5.1% of the patients with HER2-negative disease, 8.5% of the patients with HER2-low disease, and 10.1% of the patients with HER2-positive disease. A multivariable binary logistic regression model demonstrated an increased risk of brain metastasis in patients with HER2-low disease (OR: 1.611, 95% CI 1.055-2.460, p = 0.027) and in HER2-positive patients (OR: 1.837, 95% CI 1.308-2.580, p < 0.001). Additionally, HR + -HER2-low disease was associated with a decreased DFS compared to HR + -HER2-negative disease (p = 0.008). CONCLUSION In this study, we observed an increased risk of brain metastasis in localized breast cancer patients with HER2-low disease. We think that a high level of vigilance and a low threshold for brain imaging could benefit HER2-low breast cancer patients similar to the patients with HER-positive disease.
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Affiliation(s)
- Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Hacettepe University Oncology Hospital, 06100, Sıhhıye, Ankara, Turkey.
| | - Mehmet Burak Kaya
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burak Fedai
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mucahit Ozden
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hasan Cagri Yildirim
- Department of Medical Oncology, Hacettepe University Cancer Institute, Hacettepe University Oncology Hospital, 06100, Sıhhıye, Ankara, Turkey
| | - Kemal Kosemehmetoglu
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Neyran Kertmen
- Department of Medical Oncology, Hacettepe University Cancer Institute, Hacettepe University Oncology Hospital, 06100, Sıhhıye, Ankara, Turkey
| | - Omer Dizdar
- Department of Medical Oncology, Hacettepe University Cancer Institute, Hacettepe University Oncology Hospital, 06100, Sıhhıye, Ankara, Turkey
| | - Aysegul Uner
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sercan Aksoy
- Department of Medical Oncology, Hacettepe University Cancer Institute, Hacettepe University Oncology Hospital, 06100, Sıhhıye, Ankara, Turkey
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Narayanankutty A. Phytochemicals as PI3K/ Akt/ mTOR Inhibitors and Their Role in Breast Cancer Treatment. Recent Pat Anticancer Drug Discov 2021; 15:188-199. [PMID: 32914720 DOI: 10.2174/1574892815666200910164641] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Breast cancer is the predominant form of cancer in women; various cellular pathways are involved in the initiation and progression of breast cancer. Among the various types of breast cancer that differ in their growth factor receptor status, PI3K/Akt signaling is a common pathway where all these converge. Thus, the PI3K signaling is of great interest as a target for breast cancer prevention; however, it is less explored. OBJECTIVE The present review is aimed to provide a concise outline of the role of PI3K/Akt/mTOR pathway in breast carcinogenesis and its progression events, including metastasis, drug resistance and stemness. The review emphasizes the role of natural and synthetic inhibitors of PI3K/Akt/m- TOR pathway in breast cancer prevention. METHODS The data were obtained from PubMed/Medline databases, Scopus and Google patent literature. RESULTS PI3K/Akt/mTOR signaling plays an important role in human breast carcinogenesis; it acts on the initiation and progression events associated with it. Numerous molecules have been isolated and identified as promising drug candidates by targeting the signaling pathway. Results from clinical studies confirm their application in the treatment of human breast cancer alone and in combination with classical chemotherapeutics as well as monoclonal antibodies. CONCLUSION PI3K/mTOR signaling blockers have evolved as promising anticancer agents by interfering breast cancer development and progression at various stages. Natural products and bioactive components are emerging as novel inhibitors of PI3K signaling and more research in this area may yield numerous drug candidates.
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Affiliation(s)
- Arunaksharan Narayanankutty
- Division of Cell and Molecular Biology, Post Graduate & Research Department of Zoology, St. Joseph's College (Autonomous), Devagiri, Kerala, India
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11
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Zhang H, Moisini I, Turner BM, Wang X, Dhakal A, Yang Q, Kovar S, Schiffhauer LM, Hicks DG. Significance of HER2 in Microinvasive Breast Carcinoma. Am J Clin Pathol 2021; 156:155-165. [PMID: 33491064 DOI: 10.1093/ajcp/aqaa222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES We compared the clinicopathologic features, clinical management, and outcomes of human epidermal growth factor receptor 2 (HER2)-expressing and nonexpressing microinvasive breast carcinomas (MiBC) to explore the significance of HER2 in MiBC. METHODS Clinicopathologic and follow-up information of cases with final diagnosis of MiBC with known HER2 status between 2007 and 2019 were analyzed. RESULTS Nineteen (41.3%) HER2-positive (HER2+) and 27 (58.7%) HER2-negative (HER2-) MiBCs were identified. HER2 positivity was likely to be associated with high nuclear grade, presence of tumor-infiltrating lymphocytes, hormonal receptor negativity, and increased Ki-67 in both microinvasive and associated in situ carcinomas. Nodal metastases were found in 2 ER+/HER2- cases (5.3%). One HER2+ case was found to have isolated tumor cells in the axillary node. The majority of patients with HER2+ MiBCs (76.5%) did not receive HER2-targeted therapy. All patients with available follow-up were alive without recurrence or distant metastasis, with a median follow-up of 38 months. CONCLUSIONS Similar to the larger size of invasive breast carcinomas, HER2 positivity is associated with high-grade morphologic features in MiBCs. However, HER2 overexpression in MiBCs does not appear to be associated with nodal metastasis or worse outcome in our study cohort. The role of HER2-targeted therapy in this clinical setting merits additional study.
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Affiliation(s)
- Huina Zhang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Ioana Moisini
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Bradley M Turner
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Xi Wang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Ajay Dhakal
- Department of Hematology and Oncology, University of Rochester Medical Center, Rochester, NY
| | - Qi Yang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Sierra Kovar
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Linda M Schiffhauer
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - David G Hicks
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
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Kang YJ, Oh SJ, Choi H, Cho S, Shin CH, Kim C, Woo J, Lee J, Park HK, Lee HB, Noh WC, Kim YS. Clinical significance of HER2 status in T1bN0 breast cancer: a nationwide study from the Korean Breast Cancer Society. Breast Cancer Res Treat 2021; 186:125-134. [PMID: 33389401 DOI: 10.1007/s10549-020-06017-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The prognosis of patients with node-negative T1b tumors according to human epidermal growth factor receptor 2 (HER2) status is not known. This group of patients has not been studied in the available randomized trials. The objective of this study was to evaluate the survival of patients in a monoethnic group diagnosed with T1b lymph node-negative breast cancer depending on HER2 status. METHODS We analyzed 3110 patients with T1bN0M0 breast cancer whose data were deposited into the Korean Breast Cancer Society Registry database between 2000 and 2009. Overall survival (OS) and breast cancer-specific survival (BCSS) were compared according to HER2 status. RESULTS Among all patients, 494 (15.9%) had HER2-positive breast cancer. At a mean follow-up of 93 months, 108 deaths and 86 breast cancer-specific deaths were noted among all patients. There was no significant difference in OS between the HER2-negative and HER2-positive groups (p = 0.103). The same result was observed for BCSS. However, in the subgroup of estrogen receptor (ER)-positive women, HER2-negative patients had a better BCSS prognosis than HER2-positive patients (p = 0.025). Multivariate analysis also indicated a significant difference in BCSS in the ER-positive subgroup (HR 2.60; 95% CI 1.15-5.87; p = 0.021). CONCLUSION This study analyzed a large nationwide and monoethnic cohort and found a significant difference only in BCSS in the ER-positive subgroup according to HER2 status. Anti-HER2 therapy may be considered in HER2-positive and ER-positive patients with small, node-negative breast cancer.
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Affiliation(s)
- Young-Joon Kang
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Se Jeong Oh
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hoon Choi
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Shijin Cho
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang-Hyun Shin
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chaiwon Kim
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271, Cheonbo-Ro, Uijeongbu-si, Gyeonggi-do, 11765, Republic of Korea
| | - Joohyun Woo
- Department of Surgery, Ewha Cancer Center for Women, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - JungSun Lee
- Department of Surgery, Inje University, College of Medicine, Haeundae-Paik Hospital, Busan, Republic of Korea
| | - Heung Kyu Park
- Department of Surgery, Breast Cancer Center, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Han-Byoel Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Yong-Seok Kim
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271, Cheonbo-Ro, Uijeongbu-si, Gyeonggi-do, 11765, Republic of Korea.
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Şahin S, Caglayan MO, Üstündağ Z. Recent advances in aptamer-based sensors for breast cancer diagnosis: special cases for nanomaterial-based VEGF, HER2, and MUC1 aptasensors. Mikrochim Acta 2020; 187:549. [PMID: 32888061 DOI: 10.1007/s00604-020-04526-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/20/2020] [Indexed: 02/07/2023]
Abstract
Cancer is one of the most common and important diseases with a high mortality rate. Breast cancer is among the three most common types of cancer in women, and the mortality rate has reached 0.024% in some countries. For early-stage preclinical diagnosis of breast cancer, sensitive and reliable tools are needed. Today, there are many types of biomarkers that have been identified for cancer diagnosis. A wide variety of detection strategies have also been developed for the detection of these biomarkers from serum or other body fluids at physiological concentrations. Aptamers are single-stranded DNA or RNA oligonucleotides and promising in the production of more sensitive and reliable biosensor platforms in combination with a wide range of nanomaterials. Conformational changes triggered by the target analyte have been successfully applied in fluorometric, colorimetric, plasmonic, and electrochemical-based detection strategies. This review article presents aptasensor approaches used in the detection of vascular endothelial growth factor (VEGF), human epidermal growth factor receptor 2 (HER2), and mucin-1 glycoprotein (MUC1) biomarkers, which are frequently studied in the diagnosis of breast cancer. The focus of this review article is on developments of the last decade for detecting these biomarkers using various sensitivity enhancement techniques and nanomaterials.
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Affiliation(s)
- Samet Şahin
- Department of Bioengineering, Bilecik Şeyh Edebali University, 11230, Bilecik, Turkey.
| | | | - Zafer Üstündağ
- Department of Chemistry, Kütahya Dumlupınar University, 43100, Kütahya, Turkey
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14
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Lin H, Zheng H, Ge C, Wang Q, Tang W, Zhang X, Zhou S, Jin X, Xu X, Du J, Fu J. The Effect of Adjuvant Treatment in Small Node-negative HER2-positive Breast Cancer: Which Subgroup Will Benefit? Clin Breast Cancer 2020; 20:503-510. [PMID: 32653474 DOI: 10.1016/j.clbc.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND We conducted this study to evaluate whether patients with T1a/b, node-negative (N-), human epidermal growth factor receptor 2-positive (HER2+) breast cancers benefited from adjuvant therapy, and explored better treatment strategies for these patients. PATIENTS AND METHODS Patients with T1a/b, N-, HER2+ breast cancers during 2000 through 2004 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The Gray test was used to evaluate breast cancer-specific death (BCSD) and non-BCSD. To identify patients more suitable for chemotherapy, subgroup analyses were conducted according to tumor size and estrogen receptor (ER) status, and plots of hazard rate of death (HRD) were drawn to present the changes of BCSD. RESULTS A total of 2940 patients with T1a/b, N-, HER2+ breast cancers were included; more patients in the T1b group received chemotherapy compared with the T1a group (65.18% vs. 29.30%; P < .001). Patients receiving chemotherapy did not benefit from it (5-year incidences of BCSD: 1.00% in the non-chemotherapy group vs. 1.18% in the chemotherapy group; P = .853). Compared with those in the T1a group, patients in the T1b group had similar prognosis (P = .532), whereas ER status was significantly associated with survival (P = .048). HRD had a peak in years 2 to 5, which was more obvious in the ER- group. CONCLUSION Chemotherapy, which is mainly decided by tumor size, fails to render survival benefits for patients with T1a/b, N-, HER2+ breast cancers. ER status, rather than tumor size, is important for clinicians to make adjuvant treatment decisions. The peak of BCSD occurs 2 to 5 years after diagnosis, and an at least 5-year follow-up is recommended for these patients.
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Affiliation(s)
- Haiping Lin
- Department of Hepatobiliary Surgery, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Hongjuan Zheng
- Department of Medical Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Chenyang Ge
- Department of Colorectal Surgery, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Qinghua Wang
- Department of Medical Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Wanfen Tang
- Department of Medical Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Xia Zhang
- Department of Medical Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Shishi Zhou
- Department of Medical Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Xiayun Jin
- Department of Medical Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Xifeng Xu
- Department of Medical Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China
| | - Jinlin Du
- Department of Colorectal Surgery, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China.
| | - Jianfei Fu
- Department of Medical Oncology, Zhejiang University Jinhua Hospital, Jinhua, Zhejiang Province, China.
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Kang J, Yu Y, Jeong S, Lee H, Heo HJ, Park JJ, Na HS, Ko DS, Kim YH. Prognostic role of high cathepsin D expression in breast cancer: a systematic review and meta-analysis. Ther Adv Med Oncol 2020; 12:1758835920927838. [PMID: 32550865 PMCID: PMC7281710 DOI: 10.1177/1758835920927838] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 04/27/2020] [Indexed: 12/21/2022] Open
Abstract
Background: High cathepsin D has been associated with poor prognosis in breast cancer;
however, the results of many studies are controversial. Here, we assessed
the association between high cathepsin D levels and worse breast cancer
prognosis by conducting a meta-analysis. Methods: A comprehensive search strategy was used to search relevant literature in
PUBMED and EMBASE by September 2018. The meta-analysis was performed in
Review Manager 5.3 using hazard ratios (HRs) with 95% confidence intervals
(CIs). Results: A total of 15,355 breast cancer patients from 26 eligible studies were
included in this meta-analysis. Significant associations between elevated
high cathepsin D and poor overall survival (OS) (HR = 1.61, 95% CI:
1.35–1.92, p < 0.0001) and disease-free survival (DFS)
(HR = 1.52, 95% CI: 1.31–2.18, p < 0.001) were observed.
In the subgroup analysis for DFS, high cathepsin D was significantly
associated with poor prognosis in node-positive patients (HR = 1.38, 95% CI:
1.25–1.71, p < 0.00001), node-negative patients
(HR = 1.78, 95% CI: 1.39–2.27, p < 0.0001), early stage
patients (HR = 1.73, 95% CI: 1.34–2.23, p < 0.0001), and
treated with chemotherapy patients (HR = 1.60, 95% CI: 1.21–2.12,
p < 0.001). Interestingly, patients treated with
tamoxifen had a low risk of relapse when their cathepsin D levels were high
(HR = 0.71, 95% CI: 0.52–0.98, p = 0.04) and a high risk of
relapse when their cathepsin D levels were low (HR = 1.50, 95% CI:
1.22–1.85, p = 0.0001). Conclusions: Our meta-analysis suggests that high expression levels of cathepsin D are
associated with a poor prognosis in breast cancer. Based on our subgroup
analysis, we believe that cathepsin D can act as a marker for poor breast
cancer prognosis and also as a therapeutic target for breast cancer.
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Affiliation(s)
- Junho Kang
- Interdisciplinary Program of Genomic Data Science, Pusan National University, Yangsan, Republic of Korea
| | - Yeuni Yu
- Interdisciplinary Program of Genomic Data Science, Pusan National University, Yangsan, Republic of Korea
| | - Seongdo Jeong
- Interdisciplinary Program of Genomic Data Science, Pusan National University, Yangsan, Republic of Korea
| | - Hansong Lee
- Interdisciplinary Program of Genomic Data Science, Pusan National University, Yangsan, Republic of Korea
| | - Hye Jin Heo
- Departmment of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jeong Jun Park
- Departemt of Anesthesiology and Pain Medicine, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Hee Sam Na
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Dai Sik Ko
- Division of Vascular Surgery, Department of Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yun Hak Kim
- Department of Anatomy and Department of Biomedical Informatics, Pusan National University, 49 Busandaehak-ro, Yangsan 50612, Republic of Korea
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16
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Wang C, Zhou Y, Zhu H, Huang W, Chen Z, Mao F, Lin Y, Zhang X, Shen S, Zhong Y, Li Y, Sun Q. Would 1.0 cm be a more suitable cutoff to subdivide pT1 tumors in hormone receptor-negative and HER2-positive breast cancer? Cancer Med 2018; 7:5420-5430. [PMID: 30277006 PMCID: PMC6246936 DOI: 10.1002/cam4.1785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/11/2018] [Accepted: 08/29/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND HER2+ and hormone receptor (HoR)-negative breast cancer usually associated with poor outcome. However, it remained elusive for the prognosis of small (T1a-T1c) HER2+/HoR- breast cancer. The present study retrospectively analyzed the Surveillance, Epidemiology, and End Results (SEER) database to explore the clinicopathological characteristics and prognosis of T1a-T1c HER2+/HoR- breast cancer. MATERIAL AND METHODS Data for patients diagnosed with either HER2-/HoR+or HER2+/HoR- T1a-T1c breast cancer between 2010 and 2012 were obtained from SEER program. Survival analyses were conducted by Kaplan-Meier method and Cox proportion hazard regression. RESULTS Totally, 2648 HER2+/HoR- and 56387 HER2-/HoR+T1a-T1c breast cancer patients were enrolled. There was a clear trend that tumor size had a positive correlation with advanced AJCC stage (P < 0.001) and N-stage (P < 0.001). T1a and T1b HER2+/HoR- breast cancer had great homogeneity in that these two subgroups had comparable survival and both showed no significant survival difference with its counterpart of HER2-/HoR+subtype. Conversely, T1c HER2+/HoR- breast cancers revealed worse prognosis than T1a/T1b HER2+/HoR- and T1c HER2-/HoR+tumors (BCSS HR 3.847, P < 0.001; OS HR 2.055, P < 0.001). CONCLUSION T1a and T1b HER2+/HoR- breast cancer had favorable prognosis and great homogeneity, indicating 1.0 cm may be a suitable cutoff for subclassification of T1 cancer. Future randomized clinical trials were warranted to verify this hypothesis and elucidate the biological behavior of small T1 tumor to facilitate precise medicine.
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Affiliation(s)
- Changjun Wang
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yidong Zhou
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Hanjiang Zhu
- Department of Dermatology, 90 Medical Center Way, Surge 110, University of California, San Francisco, California
| | - Wei Huang
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Ziyuan Chen
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Feng Mao
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yan Lin
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xiaohui Zhang
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Songjie Shen
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Ying Zhong
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yan Li
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Qiang Sun
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
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17
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Parikh M, Galkin M, Brunson A, Keegan T, Chew HK. Breast cancer-specific survival in patients with HER2-positive, node-negative T1a and T1b breast cancer. Cancer Treat Res Commun 2018; 16:38-44. [PMID: 31299001 DOI: 10.1016/j.ctarc.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/08/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE There is limited data on prognosis of node-negative (N0), HER2-positive (HER2+) small breast cancers. We evaluated breast cancer-specific survival (BCSS) among women diagnosed with T1a/T1b, N0 tumors in California between 2000-2004 and 2005-2012, eras before and after approval of adjuvant trastuzumab. PATIENTS AND METHODS 45,346 women diagnosed with T1a/b, N0 tumors between January 1, 2000 and December 31, 2012 were identified in the California Cancer Registry (CCR); approximately 10% were HER2 + , and 80% hormone receptor positive (ER and/or PR+). Primary outcome was BCSS, analyzed in 2000-2004 and 2005-2012. Multivariable Cox proportional hazards regression was used to calculate hazard ratios and 95% confidence intervals for mortality, and separately conducted for hormone receptor positive and negative tumors. Kaplan-Meier curves compared BCSS by HER2 status. RESULTS While BCSS in this cohort exceeded 90%, a significantly higher hazard of breast cancer death was observed in women with HER2+ tumors in the 2000-2004 era. There was no difference in outcomes between T1a and T1b tumors. Women with ER/PR+ tumors had lower hazards of death in both eras, but HER2+ tumors were associated with a higher hazard of death in the 2000-2004 era. Among women with hormone receptor negative tumors, HER2 positive disease was associated with a lower hazard of death in the 2005-2012 era. CONCLUSION Within this large cohort of T1a/b N0 breast cancers from the CCR, HER2+ tumors were associated with a significantly worse BCSS in the era before adjuvant trastuzumab. A balanced discussion regarding HER2-directed therapies is needed between patient and clinician.
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Affiliation(s)
- Mamta Parikh
- Department of Internal Medicine, Division of Hematology Oncology, UC Davis School of Medicine, United States
| | - Maria Galkin
- Department of Internal Medicine, UC Davis School of Medicine, United States
| | - Ann Brunson
- Center for Oncology and Hematology Outcomes Research and Training (COHORT), Division of Hematology Oncology, UC Davis School of Medicine, United States
| | - Theresa Keegan
- Center for Oncology and Hematology Outcomes Research and Training (COHORT), Division of Hematology Oncology, UC Davis School of Medicine, United States
| | - Helen K Chew
- Department of Internal Medicine, Division of Hematology Oncology, UC Davis School of Medicine, United States.
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Barroso-Sousa R, Exman P, Tolaney SM. De-escalating treatment in the adjuvant setting in HER2-positive breast cancer. Future Oncol 2018; 14:937-945. [DOI: 10.2217/fon-2017-2500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The decision to offer adjuvant therapy to patients with early-stage cancer relies on factors related to the risk of disease recurrence, degree of benefit with the proposed therapy and the associated risk of toxicities. For patients with stages II and III HER2-positive breast cancer, administering 1 year of trastuzumab plus comprehensive chemotherapy is the standard of care. However, the pivotal adjuvant trials had very few older patients and patients with small HER2-positive tumors. In this review, we will discuss the clinical data regarding strategies to de-escalate adjuvant systemic therapy in patients with early stage HER2-positive disease.
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Affiliation(s)
- Romualdo Barroso-Sousa
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Pedro Exman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Sara M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Harvard Medical School, Boston, MA 02115, USA
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19
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Pathobiology of HER 2 positive small invasive (T1a,b) breast cancer: “A wolf in sheep’s clothing”. Pathol Res Pract 2017; 213:1510-1514. [DOI: 10.1016/j.prp.2017.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/18/2017] [Accepted: 09/27/2017] [Indexed: 12/26/2022]
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Musolino A, Falcini F, Sikokis A, Boggiani D, Rimanti A, Pellegrino B, Silini EM, Campanini N, Barbieri E, Zamagni C, Degli Esposti R, Cortesi L, Bisagni G, Cavanna L, Frassoldati A, Sgargi P, Michiara M. Prognostic impact of interval breast cancer detection in women with pT1a N0M0 breast cancer with HER2-positive status: Results from a multicentre population-based cancer registry study. Eur J Cancer 2017; 88:10-20. [PMID: 29175735 DOI: 10.1016/j.ejca.2017.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/18/2017] [Accepted: 10/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although human epidermal growth factor receptor 2 (HER2) overexpression is associated with poor prognosis, patients (pts) with pT1a N0M0 breast cancers (BCs) have an excellent outcome across all subtypes. Interval cancers (ICs) have poorer survival than screen-detected (SD) tumours, and an association has been reported between ICs and HER2 overexpression. We aimed to determine, in a general population of pT1a N0M0 BCs with known screening status, whether HER2-positive ICs have a poorer outcome than HER2-positive SD cancers. METHODS We evaluated all incident pT1a N0M0 BCs (n = 874) collected in the Emilia-Romagna region (Italy) from 2003 to 2009 and diagnosed in women aged 50-69. Pts unexposed to screening, with unknown HER2 status and/or treated with adjuvant trastuzumab were excluded from analysis. RESULTS Sixty-one percent of the BCs were SD, whereas 19% were ICs. BCs with high histologic grade, hormone receptor-negative or HER2-positive status (odds ratio=1.7; 95% confidence interval [CI]: 1.1-2.7) were more likely ICs. Median follow-up was 115 months. The 10-year invasive disease-free survival (iDFS) for HER2-positive ICs was lower than that for HER2-positive SD cancers: 75.0% (95% CI: 55.5%-94.5%) versus 93.8% (95% CI: 86.5%-100%). An interaction between ICs and HER2-positive status was found for poorer iDFS after adjusting for prognostic variables (HR = 5.3; 95% CI: 1.6-16.7). CONCLUSIONS IC detection may identify pts with HER2-positive pT1a N0M0 tumours in whom the rate of recurrence justifies consideration for conventional, anti-HER2, adjuvant treatment.
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Affiliation(s)
- A Musolino
- Medical Oncology Unit and Cancer Registry of Parma Province, University Hospital of Parma, Italy.
| | - F Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Forlì, Italy; Azienda USL Della Romagna, Forlì, Italy
| | - A Sikokis
- Medical Oncology Unit and Cancer Registry of Parma Province, University Hospital of Parma, Italy
| | - D Boggiani
- Medical Oncology Unit and Cancer Registry of Parma Province, University Hospital of Parma, Italy
| | - A Rimanti
- Medical Oncology Unit and Cancer Registry of Parma Province, University Hospital of Parma, Italy
| | - B Pellegrino
- Medical Oncology Unit and Cancer Registry of Parma Province, University Hospital of Parma, Italy
| | - E M Silini
- Section of Anatomy and Pathology, University Hospital of Parma, Italy
| | - N Campanini
- Section of Anatomy and Pathology, University Hospital of Parma, Italy
| | - E Barbieri
- SSD Oncologia Medica Addarii, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - C Zamagni
- SSD Oncologia Medica Addarii, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - R Degli Esposti
- Medical Oncology Unit, Azienda USL-IRCCS Scienze Neurologiche, Bologna, Italy
| | - L Cortesi
- Department of Oncology, Hematology and Respiratory Diseases, University Hospital of Modena, Italy
| | - G Bisagni
- Department of Oncology and Advanced Technologies, Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - L Cavanna
- Department of Oncology-Hematology, G. da Saliceto Hospital, Piacenza, Italy
| | - A Frassoldati
- Division of Medical Oncology, University Hospital of Ferrara, Italy
| | - P Sgargi
- Medical Oncology Unit and Cancer Registry of Parma Province, University Hospital of Parma, Italy
| | - M Michiara
- Medical Oncology Unit and Cancer Registry of Parma Province, University Hospital of Parma, Italy
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de Nonneville A, Gonçalves A, Zemmour C, Cohen M, Classe JM, Reyal F, Colombo PE, Jouve E, Giard S, Barranger E, Sabatier R, Bertucci F, Boher JM, Houvenaeghel G. Adjuvant chemotherapy in pT1ab node-negative triple-negative breast carcinomas: Results of a national multi-institutional retrospective study. Eur J Cancer 2017; 84:34-43. [PMID: 28780480 DOI: 10.1016/j.ejca.2017.06.043] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/19/2017] [Accepted: 06/27/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Triple-negative breast cancers (TNBCs) are considered as associated with poor outcome, but prognosis of subcentimetric, node-negative disease remains controversial and evidence that adjuvant chemotherapy (CT) is effective in these small tumours remains limited. PATIENTS AND METHODS Our objective was to investigate the impact of CT on survival in pT1abN0M0 TNBC. Patients were retrospectively identified from a cohort of 22,475 patients who underwent primary surgery in 15 French centres between 1987 and 2013. As rare pathological types may display very particular prognoses in these tumours, we retained only the invasive ductal carcinomas of no special type according to the last World Health Organisation (WHO) classification which is the most common TNBC histological type. End-points were disease-free survival (DFS) and metastasis-free survival (MFS). A propensity score for receiving CT was estimated using a logistic regression including age, tumour size, Scarff Bloom and Richardson (SBR) grade and lymphovascular invasion. RESULTS Of a total of 284 patients with pT1abN0M0 ductal TNBC, 144 (51%) received CT and 140 (49%) did not. Patients receiving CT had more adverse prognostic features, such as tumour size, high grade, young age, and lymphovascular invasion. CT was not associated with a significant benefit for DFS (Hazard ratio, HR = 0.77 [0.40-1.46]; p = 0.419, log-rank test) or MFS (HR = 1.00 [0.46-2.19]; p = 0.997), with 5-year DFS and MFS in the group with CT versus without of 90% [81-94%] versus 84% [74-90%], and 90% [81-95%] versus 90% [83%-95%], respectively. Results were consistent in all supportive analyses including multivariate Cox model and the use of the propensity score for adjustment and as a matching factor for case-control analyses. CONCLUSIONS This study did not identify a significant DFS or MFS advantage for CT in subcentimetric, node-negative ductal TNBC. Although current consensus guidelines recommend consideration of CT in all TNBC larger than 5 mm, clinicians should carefully discuss benefit/risk ratio with patients, given the unproven benefits.
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Affiliation(s)
- A de Nonneville
- Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, Department of Medical Oncology, CRCM, Marseille, France.
| | - A Gonçalves
- Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, Department of Medical Oncology, CRCM, Marseille, France.
| | - C Zemmour
- Department of Clinical Research and Investigation, Biostatistics and Methodology Unit, Institut Paoli-Calmettes, Aix Marseille University, INSERM, IRD, SESSTIM, Marseille, France
| | - M Cohen
- Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, Department of Surgical Oncology, CRCM, Marseille, France
| | - J M Classe
- Institut René Gauducheau, Saint-Herblain, France
| | - F Reyal
- Institut Curie, Paris, France
| | | | - E Jouve
- Institut Claudius Regaud, Toulouse, France
| | - S Giard
- Centre Oscar Lambret, Lille, France
| | | | - R Sabatier
- Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, Department of Medical Oncology, CRCM, Marseille, France
| | - F Bertucci
- Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, Department of Medical Oncology, CRCM, Marseille, France
| | - J M Boher
- Department of Clinical Research and Investigation, Biostatistics and Methodology Unit, Institut Paoli-Calmettes, Aix Marseille University, INSERM, IRD, SESSTIM, Marseille, France
| | - G Houvenaeghel
- Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, Department of Surgical Oncology, CRCM, Marseille, France
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22
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Shigemizu D, Iwase T, Yoshimoto M, Suzuki Y, Miya F, Boroevich KA, Katagiri T, Zembutsu H, Tsunoda T. The prediction models for postoperative overall survival and disease-free survival in patients with breast cancer. Cancer Med 2017; 6:1627-1638. [PMID: 28544536 PMCID: PMC5504310 DOI: 10.1002/cam4.1092] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/17/2017] [Accepted: 04/12/2017] [Indexed: 12/18/2022] Open
Abstract
The goal of this study is to establish a method for predicting overall survival (OS) and disease‐free survival (DFS) in breast cancer patients after surgical operation. The gene expression profiles of cancer tissues from the patients, who underwent complete surgical resection of breast cancer and were subsequently monitored for postoperative survival, were analyzed using cDNA microarrays. We detected seven and three probes/genes associated with the postoperative OS and DFS, respectively, from our discovery cohort data. By incorporating these genes associated with the postoperative survival into MammaPrint genes, often used to predict prognosis of patients with early‐stage breast cancer, we constructed postoperative OS and DFS prediction models from the discovery cohort data using a Cox proportional hazard model. The predictive ability of the models was evaluated in another independent cohort using Kaplan–Meier (KM) curves and the area under the receiver operating characteristic curve (AUC). The KM curves showed a statistically significant difference between the predicted high‐ and low‐risk groups in both OS (log‐rank trend test P = 0.0033) and DFS (log‐rank trend test P = 0.00030). The models also achieved high AUC scores of 0.71 in OS and of 0.60 in DFS. Furthermore, our models had improved KM curves when compared to the models using MammaPrint genes (OS: P = 0.0058, DFS: P = 0.00054). Similar results were observed when our model was tested in publicly available datasets. These observations indicate that there is still room for improvement in the current methods of predicting postoperative OS and DFS in breast cancer.
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Affiliation(s)
- Daichi Shigemizu
- Department of Medical Science Mathematics, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan.,Laboratory for Medical Science Mathematics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.,CREST, Japan Science and Technology Agency, Tokyo, Japan.,Department for Medical Genome Sciences, Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takuji Iwase
- Department of Breast Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Yasuyo Suzuki
- First Department of Surgery, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Fuyuki Miya
- Department of Medical Science Mathematics, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan.,Laboratory for Medical Science Mathematics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Keith A Boroevich
- Laboratory for Medical Science Mathematics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Toyomasa Katagiri
- Division of Genome Medicine, Institute for Genome Research, Tokushima University, Tokushima, Japan.,Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hitoshi Zembutsu
- Division of Genetics, National Cancer Center Research Institute, Tokyo, Japan
| | - Tatsuhiko Tsunoda
- Department of Medical Science Mathematics, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan.,Laboratory for Medical Science Mathematics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.,CREST, Japan Science and Technology Agency, Tokyo, Japan
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23
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Risk factors and state-of-the-art indications for boost irradiation in invasive breast carcinoma. Brachytherapy 2017; 16:552-564. [DOI: 10.1016/j.brachy.2017.03.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/27/2017] [Accepted: 03/01/2017] [Indexed: 12/14/2022]
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24
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Reix N, Malina C, Chenard MP, Bellocq JP, Delpous S, Molière S, Sevrin A, Neuberger K, Tomasetto C, Mathelin C. A prospective study to assess the clinical utility of serum HER2 extracellular domain in breast cancer with HER2 overexpression. Breast Cancer Res Treat 2016; 160:249-259. [PMID: 27709352 PMCID: PMC5065601 DOI: 10.1007/s10549-016-4000-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/23/2016] [Indexed: 12/31/2022]
Abstract
Purpose We explored the clinical utility of human epidermal growth factor receptor-2 extracellular domain (HER2/ECD) in patients treated for an invasive breast cancer with HER2 overexpression. Methods We prospectively studied HER2/ECD levels in the sera of 334 women included between 2007 and 2014, all treated with trastuzumab. HER2/ECD levels were measured at diagnosis, during treatments, and along the follow-up. We investigated the relationship of HER2/ECD with other clinicopathological parameters at diagnosis, its prognosis value, and its utility during the monitoring of a neoadjuvant treatment and the follow-up. Results Elevated HER2/ECD at diagnosis correlated positively with parameters associated with tumor aggressiveness. Disease-free survival of non-metastatic patients was significantly shorter in patients with high HER2/ECD at diagnosis (HR = 13.6, 95 % CI 1.6–113.6, P < 0.0001). Progression-free survival of metastatic patients was better for patients with low HER2/ECD (HR = 2.6, 95 % CI 1.2–5.3, P = 0.033). A multivariate analysis revealed that HER2/ECD level at diagnosis was an independent prognosis factor. During neoadjuvant therapy, a significant decrease in HER2/ECD was reported only for the complete histological response group (P = 0.031). During the follow-up, HER2/ECD helped predict relapse, disease progression, and metastases before imaging in 18.6 % cases of the studied cohort. Conclusions HER2/ECD is a prognosis factor that is valuable in evaluating the neoadjuvant treatment efficiency. HER2/ECD also appears to be a helpful surveillance biomarker for the early diagnosis of relapses and to predict the fate of metastases. This study brings evidences to support the use of HER2/ECD in the management of HER2-positive breast cancer.
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Affiliation(s)
- Nathalie Reix
- ICube UMR 7357, Université de Strasbourg/CNRS, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France. .,Laboratoire de Biochimie et Biologie Moléculaire, Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg, France.
| | - Charlotte Malina
- Unité de Sénologie, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France
| | - Marie-Pierre Chenard
- Service de Pathologie, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France
| | - Jean-Pierre Bellocq
- Service de Pathologie, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France
| | - Stéphanie Delpous
- Department of Functional Genomics and Cancer, Institut de Génétique et de Biologie Moléculaire et Cellulaire, CNRS UMR 7104, INSERM U964, Université de Strasbourg, Illkirch, France
| | - Sébastien Molière
- Department of Imaging, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France
| | | | | | - Catherine Tomasetto
- Department of Functional Genomics and Cancer, Institut de Génétique et de Biologie Moléculaire et Cellulaire, CNRS UMR 7104, INSERM U964, Université de Strasbourg, Illkirch, France
| | - Carole Mathelin
- Unité de Sénologie, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg, France.,Department of Functional Genomics and Cancer, Institut de Génétique et de Biologie Moléculaire et Cellulaire, CNRS UMR 7104, INSERM U964, Université de Strasbourg, Illkirch, France
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25
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Dalenc F, Penault-Llorca F, Cohen M, Houvenaeghel G, Piat JM, Liegeois P, Puyuelo L, Suchaud JP, Zouai M, Lacroix-Triki M, Radosevic-Robin N, Benkanoun C, Attar-Rabia H, Chauvet MP, Gligorov J, Belkacemi Y. Daily Practice Management of pT1a-b pN0 Breast Carcinoma: A Prospective French ODISSEE Cohort Study. Clin Breast Cancer 2016; 17:107-116. [PMID: 27856201 DOI: 10.1016/j.clbc.2016.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/29/2016] [Accepted: 08/20/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Most breast cancer (BC) tumors ≤10 mm have an excellent prognosis. The subgroups with a higher risk for distant recurrence requiring adjuvant systemic therapy are not precisely defined in current international guidelines. PATIENTS AND METHODS The OBSERVATOIRE DES PETITS CANCERS DU SEIN HER2 +/- (ODISSEE) study was a prospective, multicenter, cohort study that aimed to describe the daily adjuvant management and outcome of 616 patients with unifocal, invasive pT1a-b pN0 nonmetastatic BC who underwent surgery. RESULTS At the time of diagnosis, the median age of patients was 61 years. Tumor was detected on imaging or during a screening program in 397 patients (64.6%). Most patients (96%) underwent conservative surgery with sentinel node biopsy (89%), completed with axillary lymph node dissection in 15%. At inclusion, 82% of tumors were pT1b, 73% were pN0 (i-), 53% were Scarff-Bloom-Richardson Grade I, 91% were estrogen receptor (ER)-positive, 5% overexpressed/amplified HER2, and 5% were triple negative (TNBC). Adjuvant treatments were radiotherapy (95%), hormone therapy (82%), chemotherapy (7%), and trastuzumab (3.5%). In patients with TNBC and HER2-positive BC, chemotherapy and trastuzumab (if needed) were administered in 45% and 68%, respectively. After 5 years of follow-up, 7 patients had contralateral BC, 7 had locoregional recurrence, and 1 had distant metastasis. At 5 years, overall survival, disease-free survival, and recurrence-free survival were: 98.4% (96.9%-99.1%), 94.7% (92.4%-96.3%), and 97.1% (95.2%-98.2%), respectively. CONCLUSION This prospective cohort study showed that in France, the routine practice in pT1a-b pN0 breast cancers follows international standard guidelines for practice including conservative surgery followed by radiotherapy and endocrine therapy for ER-positive patients. Adjuvant chemotherapy with or without trastuzumab was used but their benefit in breast cancer of ≤10 mm remains controversial.
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Affiliation(s)
- Florence Dalenc
- Claudius Regaud Institute, Institut Universitaire du Cancer de Toulouse (UICT)-Oncopole, Department of Medical Oncology and Inserm UMR 1037, Team "Cholesterol Metabolism and Therapeutic Innovations", Cancer Research Center, Toulouse, France
| | | | - Monique Cohen
- Department of Surgery, Private Institute, Aubagne, France
| | | | | | | | - Laurent Puyuelo
- Department of Breast and Gynecologic Surgery, Union Clinic, Saint Jean, France
| | | | - Mohammed Zouai
- Department of Radiotherapy, Marie Curie Institute, Valence, France
| | - Magali Lacroix-Triki
- Claudius Regaud Institute, Institut Universitaire du Cancer de Toulouse (UICT)-Oncopole, Department of Medical Oncology and Inserm UMR 1037, Team "Cholesterol Metabolism and Therapeutic Innovations", Cancer Research Center, Toulouse, France
| | | | | | | | - Marie-Pierre Chauvet
- Department of Breast Surgery, Oscar Lambret Anti-Cancer Center-UNICANCER, Lille, France
| | - Joseph Gligorov
- Assistance Publique Hôpitaux de Paris (AP-HP), Department of Medical Oncology, Tenon Hospital, and University of Pierre et Marie Curie (UPMC), Paris
| | - Yazid Belkacemi
- Assistance Publique Hôpitaux de Paris (AP-HP), Department of Radiation Oncology and Henri Mondor Breast Center, INSERM U955 E07, and University of Paris-Est Créteil (UPEC), France.
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26
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Gijs M, Penner G, Blackler GB, Impens NREN, Baatout S, Luxen A, Aerts AM. Improved Aptamers for the Diagnosis and Potential Treatment of HER2-Positive Cancer. Pharmaceuticals (Basel) 2016; 9:E29. [PMID: 27213406 PMCID: PMC4932547 DOI: 10.3390/ph9020029] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 02/07/2023] Open
Abstract
Aptamers provide a potential source of alternative targeting molecules for existing antibody diagnostics and therapeutics. In this work, we selected novel DNA aptamers targeting the HER2 receptor by an adherent whole-cell SELEX approach. Individual aptamers were identified by next generation sequencing and bioinformatics analysis. Two aptamers, HeA2_1 and HeA2_3, were shown to bind the HER2 protein with affinities in the nanomolar range. In addition, both aptamers were able to bind with high specificity to HER2-overexpressing cells and HER2-positive tumor tissue samples. Furthermore, we demonstrated that aptamer HeA2_3 is being internalized into cancer cells and has an inhibitory effect on cancer cell growth and viability. In the end, we selected novel DNA aptamers with great potential for the diagnosis and possible treatment of HER2-positive cancer.
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Affiliation(s)
- Marlies Gijs
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK•CEN), 2400 Mol, Belgium.
- Cyclotron Research Centre, University of Liège, 4000 Liège, Belgium.
| | - Gregory Penner
- NeoVentures Biotechnology Inc., London, N6A 1A1 ON, Canada.
| | | | | | - Sarah Baatout
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK•CEN), 2400 Mol, Belgium.
| | - André Luxen
- Cyclotron Research Centre, University of Liège, 4000 Liège, Belgium.
| | - An M Aerts
- Radiobiology Unit, Belgian Nuclear Research Centre (SCK•CEN), 2400 Mol, Belgium.
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27
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Ditsatham C, Somwangprasert A, Watcharachan K, Wongmaneerung P, Khorana J. Factors affecting local recurrence and distant metastases of invasive breast cancer after breast-conserving surgery in Chiang Mai University Hospital. BREAST CANCER-TARGETS AND THERAPY 2016; 8:47-52. [PMID: 27051315 PMCID: PMC4807892 DOI: 10.2147/bctt.s99184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The purpose of this study was to collect data regarding breast cancer profiles and factors that affect local recurrence and distant metastasis after breast-conserving surgery (BCS) in Chiang Mai University Hospital. MATERIALS AND METHODS This study was a retrospective review in a single institution of newly diagnosed invasive breast cancer patients who were treated with BCS between April 9, 2001 and December 25, 2011. RESULTS A total of 185 patients treated with BCS were included in this study, with an average age of 46.83 years. The average recurrence age was 41.1 years and the average nonrecurrence age was 47.48 years, with a recurrence rate of 10.27%. Premenopause was significant in recurrence (P=0.047), as well as non-estrogen-expression patients (P=0.001) and patients who did not receive antihormonal treatment (P=0.011). CONCLUSION The recurrence rate in our institute was 10.27%. Factors affecting recurrence after BCS included young age, premenopausal status, nonexpression of the estrogen receptor, and patients who had not received antihormonal treatment. The recurrence rate was higher in the first 90 postoperative months.
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Affiliation(s)
- Chagkrit Ditsatham
- Division of Head, Neck, and Breast Surgery, Chiang Mai University, Chiang Mai, Thailand
| | | | - Kirati Watcharachan
- Division of Head, Neck, and Breast Surgery, Chiang Mai University, Chiang Mai, Thailand
| | | | - Jiraporn Khorana
- Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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28
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Wolters R, Ebner F, Janni W, Novopashenny I, Wöckel A, Kreienberg R, Wischnewsky M, Schwentner L. Do T1a breast cancers profit from adjuvant systemic therapy? A multicenter retrospective cohort study of 325 T1a-patients. Arch Gynecol Obstet 2016; 294:377-84. [DOI: 10.1007/s00404-016-4016-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/05/2016] [Indexed: 01/02/2023]
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29
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Prognostic risk factors for treatment decision in pT1a,b N0M0 HER2-positive breast cancers. Cancer Treat Rev 2016; 43:1-7. [DOI: 10.1016/j.ctrv.2015.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/25/2015] [Accepted: 11/26/2015] [Indexed: 12/26/2022]
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30
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Wang WJ, Lei YY, Mei JH, Wang CL. Recent progress in HER2 associated breast cancer. Asian Pac J Cancer Prev 2016; 16:2591-600. [PMID: 25854334 DOI: 10.7314/apjcp.2015.16.7.2591] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Breast cancer is the most common cancer worldwide among women and the second most common cancer. Approximately 15-23% of breast cancers over-express human epidermal growth factor receptor2 (HER2), a 185-kDa transmembrane tyrosine kinase, which is mainly found at the cell surface of tumor cells. HER2-positive breast cancer, featuring amplification of HER2/neu and negative expression of ER and PR, has the three following characteristics: rapid tumor growth, lower survival rate, and better response to adjuvant therapies. Clinically, it is notable for its role in a pathogenesis that is associated with increased disease recurrence and acts as a worse prognosis. At the same time, it represents a good target for anti-cancer immunotherapy despite the prevalence of drug resistance. New treatments are a major topic of research, and a brighter future can be expected. This review discusses the role of HER2 in breast cancer, therapeutic modalities available and prognostic factors.
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Affiliation(s)
- Wei-Jia Wang
- Department of Pathology, the First Affiliated Hospital of Nanchang University, Nanchang, China E-mail : ;
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31
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Spielmann M, Dalenc F, Pointreau Y, Azria D, Classe JM, Dromain C, Facchini T, Gonçalves A, Liegeois P, Namer M, Pivot X, Vincent-Salomon A. [Perception of pT1a,b pN0 breast tumor prognosis by the French oncology community: Results of the EURISTIC national survey]. Bull Cancer 2015; 103:154-63. [PMID: 26652718 DOI: 10.1016/j.bulcan.2015.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 10/05/2015] [Accepted: 10/18/2015] [Indexed: 10/22/2022]
Abstract
The prognosis of infracentimetric breast cancers (BC) is heterogeneous. The EURISTIC survey describes how French oncology specialists perceive the prognosis of pT1a,b pN0 BCs. A self-administered questionnaire has been sent to over 2000 French BC specialists. Six hundred and sixty-three physicians responded. Fifty-eight percent do not consider tumor size as a key prognostic criterion. They consider that the cutoff for poor prognosis is 22mm, 10mm and 7mm for hormone receptors (HRs)+, HER2+ and triple-negative (TN) tumors respectively. Eighty-three percent of respondents consider that a HR+ pT1a,b tumor has a good prognosis (21% and 8% for HER2+ and TN respectively). Factors perceived as most detrimental are: HER2 overexpression (29% of respondents); HR- (20%); high grade (20%); TN status (14%); high KI67 (5%); presence of lymphovascular invasion (3%); young age (2%) and high mitotic index (1%). For French specialists, immunohistochemical characteristics, in particular hormone and HER2 status, are strong prognostic factors in BCs below 1cm.
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Affiliation(s)
- Marc Spielmann
- Institut Gustave-Roussy, department of medical oncology, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
| | - Florence Dalenc
- Institut Claudius-Regaud, department of medical oncology, 20-24, rue du Pont-Saint-Pierre, 31052 Toulouse, France
| | - Yoann Pointreau
- Centre Jean-Bernard, clinique Victor-Hugo, department of radiation oncology, 18, rue Victor-Hugo, 72000 Le Mans, France; Centre hospitalier régional universitaire, department of radiation oncology, 37044 Tours cedex 9, France
| | - David Azria
- ICM centre Val-d'Aurelle, department of radiation oncology, 208, avenue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 5, France
| | - Jean-Marc Classe
- Site hospitalier Nord, centre René-Gauducheau, department of surgery, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France
| | - Clarisse Dromain
- Institut Gustave-Roussy, department of medical oncology, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - Thomas Facchini
- Clinique Courlancy, department of medical oncology, 38, rue de Courlancy, 51100 Reims, France
| | - Anthony Gonçalves
- Institut Paoli-Calmettes, department of medical oncology, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - Philippe Liegeois
- Institut du sein de l'Orangerie, department of surgery, 11, rue Silbermann, 67000 Strasbourg, France
| | - Moïse Namer
- Clinique Saint-Georges, department of medical oncology, 2, avenue de Rimiez, 06100 Nice cedex 2, France
| | - Xavier Pivot
- Centre hospitalier universitaire, department of medical oncology, 2, place Saint-Jacques, 25000 Besançon, France
| | - Anne Vincent-Salomon
- Institut Curie, department of pathology, 26, rue d'Ulm, 75248 Paris cedex 05, France
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Waks AG, Tolaney SM. The evolving understanding of small HER2-positive breast cancers: matching management to outcomes. Future Oncol 2015; 11:3261-71. [PMID: 26634944 DOI: 10.2217/fon.15.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Systemic therapy for small (stage I) HER2-positive breast cancers has long posed a dilemma for clinicians, as the majority of these patients were excluded from the large adjuvant trastuzumab trials. However in the decade since those trials were reported, data have accumulated to suggest that recurrence risk for these small but biologically aggressive tumors is nontrivial. In this review, we summarize data from numerous cohort studies describing the outcomes of small HER2-positive tumors, mostly in the absence of HER2-directed therapy. We then examine the potential impact of HER2-directed treatment in this population, culminating in the recently published prospective study of paclitaxel/trastuzumab therapy. The landscape of next generation anti-HER2 therapies is quickly evolving; a role for some of these agents in the small HER2-positive subpopulation may also be on the horizon.
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Affiliation(s)
- Adrienne G Waks
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Sara M Tolaney
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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Tot T. Early (<10 mm) HER2-Positive Invasive Breast Carcinomas are Associated with Extensive Diffuse High-Grade DCIS: Implications for Preoperative Mapping, Extent of Surgical Intervention, and Disease-Free Survival. Ann Surg Oncol 2015; 22:2532-9. [PMID: 25582746 DOI: 10.1245/s10434-015-4367-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND The few publications on <10-mm invasive breast carcinomas have reported worse outcomes for women with human epidermal growth factor receptor 2 (HER2)-positive cancer compared with HER2-negative cases and indicated that the high risk of recurrence in HER2-positive cases is related to the high grade, hormone receptor negativity, and high proliferation index of the invasive tumor component. METHODS We studied the subgross morphology of such tumors in a consecutive series of 203 cases documented in large-format histology slides and worked up with detailed radiological-pathological correlation. RESULTS The invasive component was associated with a diffuse in situ component in 78 % of the HER2-positive and 26 % of HER2-negative tumors <10 mm in size (odds ratio [OR], 11.3936; P < .0001). The in situ component was of high grade in 75 % of HER2-positive and 9 % of HER2-negative cases (OR, 29.6000; P < .0001). Significant associations were also found between the HER2 positivity of the invasive component and diffuse combined lesion distribution (P > .0001), invasive tumor grade 3 (P = .0004), presence of vascular invasion (P = .0026), extensive disease (P = .0170), "not special" (ductal) histological tumor type (P = .0302), estrogen receptor negativity (OR, 7.8846; P < .0001), and high Ki67 proliferation index (OR, 5.0000; P = .0007). The HER2-positive tumors tended to be multifocal (OR, 2.000) and lymph node-positive (OR, 3.0147), but the tendency was not statistically significant. CONCLUSIONS The vast majority of <10-mm HER2-positive breast carcinomas exhibited a high-grade, diffuse, and extensive in situ component, which may explain the high risk of recurrence among these tumors.
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Affiliation(s)
- Tibor Tot
- Department of Pathology and Clinical Cytology, Central Hospital Falun, Falun, Sweden,
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34
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Factors associated with the incidence of local recurrences of breast cancer in women who underwent conservative surgery. Int J Breast Cancer 2014; 2014:639534. [PMID: 25530886 PMCID: PMC4235109 DOI: 10.1155/2014/639534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 10/09/2014] [Indexed: 12/02/2022] Open
Abstract
Conservative surgery is considered the procedure of choice for women who are affected by early stage tumours. The local recurrence of cancer as a consequence of breast tissue conservation is a growing concern. This study aimed to describe the sociodemographic and clinical profiles of women who had local recurrences of breast cancer after conservative surgery and to examine the associations between sociodemographic and clinical variables and the incidence of tumour recurrence in these women. The retrospective cohort included 880 women who were diagnosed with breast cancer and underwent conservative surgery between January 2000 and December 2010. Recurrences occurred in 60 patients, and the mean age of the women at diagnosis was 48.8 years. Predictive factors for local recurrence were young age (<39 years) (P = 0.028 and OR = 10.93), surgical margin involvement (P = 0.001 and OR = 3.66), and Her-2 overexpression (P = 0.045 and OR = 1.94). The establishment of sociodemographic and clinical characteristics might help to select optimum treatments, which is a crucial challenge for public health in Brazil, especially with regard to reductions of surgery and hospitalisation expenditures in the Unified Health System (Sistema Único de Saúde—SUS).
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Long XH, Zhao K, Zhang GM, Zhou Y, Zhou RP, Liu ZL, Zhang ZH. Interaction between fatty acid synthase and human epidermal growth receptor 2 (HER2) in osteosarcoma cells. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:8777-8783. [PMID: 25674245 PMCID: PMC4313995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
Abstract
Elevated expression of fatty acid synthase (FASN) and human epidermal growth factor receptor-2 (HER2) are observed in human osteosarcoma (OS). The aim in this study is to investigate a possible connection between FASN expression and the activity of HER2. The immunohistochemistry staining was conducted on 24 OS specimens from patients, which revealed a significant positive correlation between FASN and HER2 as well as p-HER2 protein expression. Furthermore, the human OS cell lines MG-63 and U2-OS were treated with FASN-specific RNAi Plasmid or Lapatinib (an inhibitor of HER2). The mRNA of HER2 and FASN was measured using RT-PCR. Western blot was performed to detect the protein expression of HER2, p-HER2 and FASN. The results demonstrated that HER2 modulates FASN expression, inhibition of FASN resulted in down-regulation of HER2 and p-HER2 protein in OS cells. Our findings suggested that there was positive feedback regulation between FASN and HER2 expression and phosphorylation in OS cells.
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Affiliation(s)
- Xin Hua Long
- Department of Orthopedics, The First Affiliated Hospital of Nanchang UniversityJiangxi, P.R. China
| | - Kai Zhao
- Department of Orthopedics, The First Affiliated Hospital of Nanchang UniversityJiangxi, P.R. China
| | - Guo Mei Zhang
- Department of Orthopedics, The Second Affiliated Hospital of Nanchang UniversityJiangxi, P. R. China
| | - Yang Zhou
- Department of Orthopedics, The First Affiliated Hospital of Nanchang UniversityJiangxi, P.R. China
| | - Rong Ping Zhou
- Department of Orthopedics, The Second Affiliated Hospital of Nanchang UniversityJiangxi, P. R. China
| | - Zhi Li Liu
- Department of Orthopedics, The First Affiliated Hospital of Nanchang UniversityJiangxi, P.R. China
| | - Zhi Hong Zhang
- Department of Orthopedics, The First Affiliated Hospital of Nanchang UniversityJiangxi, P.R. China
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Paplomata E, Nahta R, O'Regan RM. Systemic therapy for early-stage HER2-positive breast cancers: time for a less-is-more approach? Cancer 2014; 121:517-26. [PMID: 25346473 DOI: 10.1002/cncr.29060] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 08/22/2014] [Accepted: 08/25/2014] [Indexed: 11/11/2022]
Abstract
Trastuzumab-based chemotherapy has dramatically improved outcomes for patients with all stages of human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Additional HER2-directed agents that have recently been approved are also expected to improve outcomes. Patients with small, lymph node-negative, HER2-positive breast cancers who are treated with trastuzumab-based chemotherapy demonstrate especially favorable responses, with 5-year recurrence rates of <5%. In this review, recent data regarding response rates among patients with early-stage HER2-positive breast cancer treated with trastuzumab-based chemotherapy are discussed. This review supports future studies of the possible omission of chemotherapy in a subset of patients with HER2-positive cancers, specifically those that coexpress hormone receptors.
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Affiliation(s)
- Elisavet Paplomata
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia; Department of Hematology and Medical Oncology, Emory University, Georgia Cancer Center for Excellence, Grady Memorial Hospital, Atlanta, Georgia
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Day-care for breast cancer: Ambulatory surgery and intra-operative radiation. Techniques and preliminary results of the Centre Val-d’Aurelle – Montpellier. J Visc Surg 2014; 151 Suppl 1:S3-10. [DOI: 10.1016/j.jviscsurg.2014.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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