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Lord SJ, Daniels B, O'Connell DL, Kiely BE, Beith J, Smith AL, Pearson SA, Chiew KL, Bulsara MK, Houssami N. Decline in the Incidence of Distant Recurrence of Breast Cancer: A Population-Based Health Record Linkage Study, Australia 2001-2016. Cancer Epidemiol Biomarkers Prev 2024; 33:314-324. [PMID: 38015752 DOI: 10.1158/1055-9965.epi-23-0942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/29/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND We investigated differences in cumulative incidence of first distant recurrence (DR) following non-metastatic breast cancer over a time period when new adjuvant therapies became available in Australia. METHODS We conducted a health record linkage study of females with localized (T1-3N0) or regional (T4 or N+) breast cancer in the New South Wales Cancer Registry in 2001 to 2002 and 2006 to 2007. We linked cancer registry records with administrative records from hospitals, dispensed medicines, radiotherapy services, and death registrations to estimate the 9-year cumulative incidence of DR and describe use of adjuvant treatment. RESULTS The study included 13,170 women (2001-2002 n = 6,338, 2006-2007 n = 6,832). The 9-year cumulative incidence of DR was 3.6% [95% confidence interval (CI), 2.3%-4.9%] lower for 2006-2007 diagnoses (15.0%) than 2001-2002 (18.6%). Differences in the annual hazard of DR between cohorts were largest in year two. DR incidence declined for localized and regional disease. Decline was largest for ages <40 years (absolute difference, 14.4%; 95% CI, 8.3%-20.6%), whereas their use of adjuvant chemotherapy (2001-2002 49%, 2006-2007 75%) and HER2-targeted therapy (2001-2002 0%, 2006-2007 16%) increased. DR did not decline for ages ≥70 years (absolute difference, 0.9%; 95% CI, -3.6%-1.8%) who had low use of adjuvant chemotherapy and HER2-targeted therapy. CONCLUSIONS This whole-of-population study suggests that DR incidence declined over time. Decline was largest for younger ages, coinciding with changes to adjuvant breast cancer therapy. IMPACT Study findings support the need for trials addressing questions relevant to older people and cancer registry surveillance of DR to inform cancer control programs.
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Affiliation(s)
- Sarah J Lord
- The National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Camperdown, Australia
- The School of Medicine, University of Notre Dame Australia, Darlinghurst, Australia
- NHMRC Centre of Research Excellence in Medicines Intelligence, UNSW Sydney, Australia
| | - Benjamin Daniels
- NHMRC Centre of Research Excellence in Medicines Intelligence, UNSW Sydney, Australia
- Health Systems Research, School of Population Health, UNSW Sydney, Australia
| | - Dianne L O'Connell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Australia
| | - Belinda E Kiely
- The National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Camperdown, Australia
| | - Jane Beith
- Chris O'Brien Lifehouse, Camperdown, The University of Sydney, Camperdown, Australia
| | - Andrea L Smith
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Sallie-Anne Pearson
- NHMRC Centre of Research Excellence in Medicines Intelligence, UNSW Sydney, Australia
- Health Systems Research, School of Population Health, UNSW Sydney, Australia
| | - Kim-Lin Chiew
- Cancer Services Division, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Max K Bulsara
- The Institute of Health Research and the School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Nehmat Houssami
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
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Ahmad A, Khan P, Rehman AU, Batra SK, Nasser MW. Immunotherapy: an emerging modality to checkmate brain metastasis. Mol Cancer 2023; 22:111. [PMID: 37454123 PMCID: PMC10349473 DOI: 10.1186/s12943-023-01818-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
The diagnosis of brain metastasis (BrM) has historically been a dooming diagnosis that is nothing less than a death sentence, with few treatment options for palliation or prolonging life. Among the few treatment options available, brain radiotherapy (RT) and surgical resection have been the backbone of therapy. Within the past couple of years, immunotherapy (IT), alone and in combination with traditional treatments, has emerged as a reckoning force to combat the spread of BrM and shrink tumor burden. This review compiles recent reports describing the potential role of IT in the treatment of BrM in various cancers. It also examines the impact of the tumor microenvironment of BrM on regulating the spread of cancer and the role IT can play in mitigating that spread. Lastly, this review also focuses on the future of IT and new clinical trials pushing the boundaries of IT in BrM.
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Affiliation(s)
- Aatiya Ahmad
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE-68198, USA
| | - Parvez Khan
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE-68198, USA
| | - Asad Ur Rehman
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE-68198, USA
| | - Surinder Kumar Batra
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE-68198, USA
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, 68198, USA
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE-68198, USA
| | - Mohd Wasim Nasser
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE-68198, USA.
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
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Kim H, Wirasaputra A, Mohammadi F, Kundu AN, Esteves JAE, Heiser LM, Meyer AS, Peyton SR. Live Cell Lineage Tracing of Dormant Cancer Cells. Adv Healthc Mater 2023; 12:e2202275. [PMID: 36625629 PMCID: PMC10238615 DOI: 10.1002/adhm.202202275] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/02/2022] [Indexed: 01/11/2023]
Abstract
Breast cancer is a leading cause of global cancer-related deaths, and metastasis is the overwhelming culprit of poor patient prognosis. The most nefarious aspect of metastasis is dormancy, a prolonged period between primary tumor resection and relapse. Current therapies are insufficient at killing dormant cells; thus, they can remain quiescent in the body for decades until eventually undergoing a phenotypic switch, resulting in metastases that are more adaptable and drug resistant. Unfortunately, dormancy has few in vitro models, largely because lab-derived cell lines are highly proliferative. Existing models address tumor dormancy, not cellular dormancy, because tracking individual cells is technically challenging. To combat this problem, a live cell lineage approach to find and track individual dormant cells, distinguishing them from proliferative and dying cells over multiple days, is adapted. This approach is applied across a range of different in vitro microenvironments. This approach reveals that the proportion of cells that exhibit long-term quiescence is regulated by both cell intrinsic and extrinsic factors, with the most dormant cells found in 3D collagen gels. This paper envisions that this approach will prove useful to biologists and bioengineers in the dormancy community to identify, quantify, and study dormant tumor cells.
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Affiliation(s)
- Hyuna Kim
- Molecular and Cell Biology Graduate Program, University of Massachusetts, Amherst, MA, 01002, USA
| | - Anna Wirasaputra
- Department of Chemical Engineering, University of Massachusetts, Amherst, MA, 01002, USA
| | - Farnaz Mohammadi
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
| | - Aritra Nath Kundu
- Department of Chemical Engineering, University of Massachusetts, Amherst, MA, 01002, USA
| | - Jennifer A E Esteves
- Department of Biomedical Engineering, University of Massachusetts, Amherst, MA, 01002, USA
| | - Laura M Heiser
- Department of Biomedical Engineering, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Aaron S Meyer
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, 90095, USA
| | - Shelly R Peyton
- Molecular and Cell Biology Graduate Program, University of Massachusetts, Amherst, MA, 01002, USA
- Department of Chemical Engineering, University of Massachusetts, Amherst, MA, 01002, USA
- Department of Biomedical Engineering, University of Massachusetts, Amherst, MA, 01002, USA
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4
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Konopka-Filippow M, Hempel D, Sierko E. Actual, Personalized Approaches to Preserve Cognitive Functions in Brain Metastases Breast Cancer Patients. Cancers (Basel) 2022; 14:3119. [PMID: 35804894 PMCID: PMC9265102 DOI: 10.3390/cancers14133119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/24/2022] Open
Abstract
Breast cancer (BC) is the most often diagnosed cancer among women worldwide and second most common cause of brain metastases (BMs) among solid malignancies being responsible for 10-16% of all BMs in oncological patients. Moreover, BMs are associated with worse prognosis than systemic metastases. The quality of life (QoL) among brain metastases breast cancer (BMBC) patients is significantly influenced by cognitive functions. Cancer-related cognitive deficits and the underlying neural deficits in BMBC patients can be caused via BMs per se, chemotherapy administration, brain irradiation, postmenopausal status, or comorbidities. Brain RT often leads to cognitive function impairment by damage of neural progenitor cells of the hippocampus and hence decreased QoL. Sparing the hippocampal region of the brain during RT provides protective covering of the centrally located hippocampi according to the patient's clinical requirements. This article discusses the personalized strategies for treatment options to protect cognitive functions in BMBC patients, with special emphasis on the innovative techniques of radiation therapy.
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Affiliation(s)
- Monika Konopka-Filippow
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
| | - Dominika Hempel
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
| | - Ewa Sierko
- Department of Oncology, Medical University of Bialystok, 15-274 Bialystok, Poland; (M.K.-F.); (D.H.)
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Centre, 15-027 Bialystok, Poland
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5
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Ecology and evolution of dormant metastasis. Trends Cancer 2022; 8:570-582. [DOI: 10.1016/j.trecan.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/25/2022]
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Lord SJ, Bahlmann K, O'Connell DL, Kiely BE, Daniels B, Pearson SA, Beith J, Bulsara MK, Houssami N. De novo and recurrent metastatic breast cancer - A systematic review of population-level changes in survival since 1995. EClinicalMedicine 2022; 44:101282. [PMID: 35128368 PMCID: PMC8804182 DOI: 10.1016/j.eclinm.2022.101282] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/04/2022] [Accepted: 01/17/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Advances in breast cancer (BC) care have reduced mortality, but their impact on survival once diagnosed with metastasis is less well described. This systematic review aimed to describe population-level survival since 1995 for de novo metastatic BC (dnMBC) and recurrent MBC (rMBC). METHODS We searched MEDLINE 01/01/1995-12/04/2021 to identify population-based cohort studies of MBC reporting overall (OS) or BC-specific survival (BCSS) over time. We appraised risk-of-bias and summarised survival descriptively for MBC diagnoses in 5-year periods from 1995 until 2014; and for age, hormone receptor and HER2 subgroups. FINDINGS We identified 20 eligible studies (14 dnMBC, 1 rMBC, 5 combined). Potential sources of bias in these studies were confounding and shorter follow-up for the latest diagnosis period.For dnMBC, 13 of 14 studies reported improved OS or BCSS since 1995. In 2005-2009, the median OS was 26 months (range 24-30), a median gain of 6 months since 1995-1999 (range 0-9, 4 studies). Median 5-year OS was 23% in 2005-2009, a median gain of 7% since 1995-1999 (range -2 to 14%, 4 studies). For women ≥70 years, the median and 5-year OS was unchanged (1 study) with no to modest difference in relative survival (range: -1·9% (p = 0.71) to +2·1% (p = 0.045), 3 studies). For rMBC, one study reported no change in survival between 1998 and 2006 and 2007-2013 (median OS 23 months). For combined MBC, 76-89% had rMBC. Three of four studies observed no change in median OS after 2000. Of these, one study reported median OS improved for women ≤60 years (1995-1999 19·1; 2000-2004 22·3 months) but not >60 years (12·7, 11·6 months). INTERPRETATION Population-level improvements in OS for dnMBC have not been consistently observed in rMBC cohorts nor older women. These findings have implications for counselling patients about prognosis, planning cancer services and trial stratification. FUNDING SL was funded in part by a National Health and Medical Research Council (NHMRC) Project Grant ID: 1125433. NH was funded by the NBCF Chair in Breast Cancer Prevention grant (EC-21-001) and a NHMRC Investigator (Leader) grant (194410). BD and SAP were funded in part by the NHMRC Centre of Research Excellence in Medicines Intelligence (1196900).
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Affiliation(s)
- SJ Lord
- The School of Medicine, University of Notre Dame Australia, Darlinghurst, Australia
- The National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Camperdown, Australia
- NHMRC Centre of Research Excellence in Medicines Intelligence, Australia
- Corresponding author at: School of Medicine, University of Notre Dame Australia, Darlinghurst, NSW 2011, Australia.
| | - K Bahlmann
- The School of Medicine, University of Notre Dame Australia, Darlinghurst, Australia
| | - DL O'Connell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Australia
| | - BE Kiely
- The National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Camperdown, Australia
| | - B Daniels
- NHMRC Centre of Research Excellence in Medicines Intelligence, Australia
- Medicines Policy Research Unit, Centre for Big Data Research in Health, UNSW Sydney, Australia
| | - SA Pearson
- NHMRC Centre of Research Excellence in Medicines Intelligence, Australia
- Medicines Policy Research Unit, Centre for Big Data Research in Health, UNSW Sydney, Australia
| | - J Beith
- Chris O'Brien Lifehouse, Camperdown, The University of Sydney, Camperdown, Australia
| | - MK Bulsara
- The Institute of Health Research and the School of Medicine, University of Notre Dame, Fremantle, Australia
| | - N Houssami
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
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Brain metastases in de novo breast cancer: An updated population-level study from SEER database. Asian J Surg 2022; 45:2259-2267. [PMID: 35012859 DOI: 10.1016/j.asjsur.2021.12.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/12/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Although there are current studies on breast cancer brain metastasis, population-level analysis is still lacking. As treatment for metastatic breast cancer has improved, an updated population-level analysis is necessary. Our aim was to use the SEER database to characterize the incidence and survival of patients with brain metastases at the initial diagnosis of breast cancer. PATIENTS AND METHODS Patients with breast cancer from 2010 to 2018 were identified using the SEER database. The stratified incidence and median survival of patients with BM at diagnosis were described. Multivariate logistic and Cox regression were performed to determine the covariates associated with brain metastasis and survival outcomes, respectively. Multiple comparisons based on Cox proportional hazards model were performed for the analysis of interactive effects on overall survival. RESULTS A total of 2,248 patients with brain metastases at the initial diagnosis of breast cancer were identified, accounting for 0.40% of all patients with breast cancer, and 7.26% of patients with metastatic disease. Incidence proportions were highest, and survival outcomes were worst among patients with hormone receptor (HR)-negative human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes. For patients with brain metastases, the prognostic differences among different molecular subtypes have been gradually narrowing, and the survival benefits from various treatment methods have been all increased over time. CONCLUSION Our study provides an updated population-level estimate of the incidence and survival for patients with brain metastases at the diagnosis of breast cancer, thus may help early identification, prognostic stratification and treatment planning for such patients.
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Effect of molecular subtypes on radiotherapy response in patients with breast cancer brain metastasis. MARMARA MEDICAL JOURNAL 2022. [DOI: 10.5472/marumj.1089686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Schlam I, Gatti-Mays ME. OUP accepted manuscript. Oncologist 2022; 27:538-547. [PMID: 35598254 PMCID: PMC9256020 DOI: 10.1093/oncolo/oyac064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/04/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ilana Schlam
- Division of Hematology and Oncology, Tufts Medical Center, Boston, MA, USA
| | - Margaret E Gatti-Mays
- Corresponding author: Margaret E. Gatti-Mays, MD, MPH, 1800 Cannon Drive, 1300A Lincoln Tower, Columbus, OH 43210, USA. Tel: +1 614 366 2698;
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Corti C, Antonarelli G, Criscitiello C, Lin NU, Carey LA, Cortés J, Poortmans P, Curigliano G. Targeting brain metastases in breast cancer. Cancer Treat Rev 2021; 103:102324. [PMID: 34953200 DOI: 10.1016/j.ctrv.2021.102324] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 12/19/2022]
Abstract
Brain metastases (BMs) are an important source of morbidity and mortality in patients with metastatic breast cancer (BC). As survival of patients with advanced BC considerably improved thanks to research advancements and new therapeutic approaches, the apparent incidence of BMs is increasing. Local interventions, in the form of either surgical resection or radiation therapy, remain the mainstay in the management of BMs. Systemic treatments are typically used to complement local strategies to further improve and maintain control of central nervous system (CNS) disease. Although high-level evidence data about the impact of the blood-brain barrier (BBB), as well as the efficacy of anti-cancer agents on BMs and differentials between the systemic compartment and CNS are still scant, our understanding of the activity of systemic treatments with impact on BMs is rapidly evolving. Novel anti-HER2 agents, such as tucatinib, ado-trastuzumab emtansine, trastuzumab deruxtecan and neratinib, have shown intracranial efficacy. Current research efforts are ongoing not only to clarify the activity of existing treatments on the CNS, as well as to develop new drugs and innovative multi-modality approaches. This review will encompass the current treatment landscape of BMs arising from BC, with a focus on recent advancements in the field and investigational approaches.
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Affiliation(s)
- Chiara Corti
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Haematology (DIPO), University of Milan, Milan, Italy.
| | - Gabriele Antonarelli
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Haematology (DIPO), University of Milan, Milan, Italy
| | - Carmen Criscitiello
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Haematology (DIPO), University of Milan, Milan, Italy
| | - Nancy U Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lisa A Carey
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Javier Cortés
- Oncology Department, International Breast Cancer Center (IBCC), Quiron Group, Barcelona, Spain; Medica Scientia Innovation Research (MedSIR), Barcelona, Spain; Medica Scientia Innovation Research (MedSIR), Ridgewood, NJ, USA; Breast Cancer Research program, Vall d́Hebron Institute of Oncology (VHIO), Barcelona, Spain; Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
| | - Philip Poortmans
- Iridium Netwerk and University of Antwerp, Wilrijk-Antwerp, Belgium
| | - Giuseppe Curigliano
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Haematology (DIPO), University of Milan, Milan, Italy
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11
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Sun MS, Liu YH, Ye JM, Liu Q, Cheng YJ, Xin L, Xu L. A nomogram for predicting brain metastasis in patients with de novo stage IV breast cancer. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:853. [PMID: 34164487 PMCID: PMC8184439 DOI: 10.21037/atm-21-1808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Brain metastasis (BM) is a very serious event in patients with breast cancer. The aim of this study was to establish a nomogram to predict the risk of BM in patients with de novo stage IV breast cancer. Methods We gathered female patients diagnosed with de novo stage IV breast cancer between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. After randomly allocating the patients to the training set and verification set, we used univariate and multivariate logistic regression to analyze the relationship between BM and clinicopathological features. Finally, we developed a nomogram which was validated by the analysis of calibration curve and receiver operating characteristic curve. Results Of 7,154 patients with de novo stage IV breast cancer, 422 developed BM. Age, tumor size, subtype, and the degree of lung involvement were significantly correlated with BM. The nomogram had discriminatory ability with an area under curve (AUC) of 0.640 [95% confidence interval (CI): 0.607 to 0.673] in the training set, and 0.644 (95% CI: 0.595 to 0.693) in the validation set. Conclusions Our study developed a nomogram to predict BM for de novo stage IV breast cancer, thus helping clinicians to identify patients at high-risk of BM and implement early preventive interventions to improve their prognoses.
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Affiliation(s)
- Ming-Shuai Sun
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yin-Hua Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Jing-Ming Ye
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Qian Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yuan-Jia Cheng
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Ling Xin
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Ling Xu
- Breast Disease Center, Peking University First Hospital, Beijing, China
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Li Y, Lu S, Zhang Y, Wang S, Liu H. Loco-regional recurrence trend and prognosis in young women with breast cancer according to molecular subtypes: analysis of 1099 cases. World J Surg Oncol 2021; 19:113. [PMID: 33849563 PMCID: PMC8042870 DOI: 10.1186/s12957-021-02214-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/26/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. METHODS A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤ 35 years of age with pathologically confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases (DM) were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastasis-free intervals. RESULTS We identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤ 35 years of age. The overall 5-year LR, RR, and DM rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P = 0.028 and P = 0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P = 0.004 and P = 0.007, respectively). Patients with HR-/HER2+ status had a significantly higher LR (HR 20.4; 95% CI, 11.8-35.4) and DM (HR 37.2; 95% CI, 24.6-56.3) at 10 years. Breast-conserving surgery (BCS) or mastectomy did not influence rates of LR and RR. In the overall population, the 5-year survival of YBC patients exceeded 90%. CONCLUSIONS The rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report the highest LR rates in this young population were associated with HR-/HER2+ tumors.
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Affiliation(s)
- Yang Li
- The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer & Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Su Lu
- The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer & Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Yuhan Zhang
- Oncology Department, Taikang Xianlin Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, 210046, Jiangsu Province, China
| | - Shuaibing Wang
- Oncology Department, Hebei PetroChina Central Hospital, Langfang, 065000, Hebei Province, China
| | - Hong Liu
- The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer & Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China.
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Herget G, Saravi B, Schwarzkopf E, Wigand M, Südkamp N, Schmal H, Uhl M, Lang G. Clinicopathologic characteristics, metastasis-free survival, and skeletal-related events in 628 patients with skeletal metastases in a tertiary orthopedic and trauma center. World J Surg Oncol 2021; 19:62. [PMID: 33632256 PMCID: PMC7908692 DOI: 10.1186/s12957-021-02169-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/10/2021] [Indexed: 12/22/2022] Open
Abstract
Background Skeletal-related events (SREs) due to bone metastases (BM) significantly impact the morbidity and mortality of cancer patients. The present study sought to investigate clinicopathological characteristics, metastasis-free survival (MFS), and SREs in patients referred to a tertiary orthopedic and trauma center. Methods Data were retrieved from electronic health records (n=628). Survival curves were estimated utilizing the Kaplan–Meier method. The Cox regression model was used to determine factors influencing MFS based on estimated hazard ratios (HRs). Results Breast (55.8%) and lung (18.2%), and lung (32.9%) and prostate (16.8%) cancer were the most common cancer types in our cohort in women and men, respectively. Fifteen percent of patients presented with BM as the first manifestation of tumor disease, 23% had metastasis diagnosis on the same day of primary tumor diagnosis or within 3 months, and 62% developed BM at least 3 months after primary tumor diagnosis. Osteolytic BM were predominant (72.3%) and most commonly affecting the spine (23%). Overall median MFS was 45 months (32 (men) vs. 53 (women) months). MFS was shortest in the lung (median 15 months, 95% CI 8.05–19) and longest in breast cancer (median 82 months, 95% CI 65.29–94). Age (≥ 60 vs. < 60 years) and primary cancer grading of ≥2 vs. 1 revealed prognostic relevance. Conclusion Women with breast or lung cancer, men with lung or prostate cancer, age ≥60 years, male sex, and primary cancer grading ≥2 are associated with increased risk for MBD. Intensified follow-up programs may reduce the risk of SREs and associated morbidity and mortality.
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Affiliation(s)
- Georg Herget
- Department of Orthopedics and Trauma Surgery, Medical Centre-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany
| | - Babak Saravi
- Department of Orthopedics and Trauma Surgery, Medical Centre-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany.
| | - Eugenia Schwarzkopf
- Department of Orthopedics and Trauma Surgery, Medical Centre-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany
| | - Mara Wigand
- Department of Orthopedics and Trauma Surgery, Medical Centre-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany
| | - Norbert Südkamp
- Department of Orthopedics and Trauma Surgery, Medical Centre-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany
| | - Hagen Schmal
- Department of Orthopedics and Trauma Surgery, Medical Centre-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany.,Department of Orthopaedic Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark
| | - Markus Uhl
- Department of Radiology, Pediatric Radiology, and Interventional Radiology, St. Josefskrankenhaus, Sautierstraße 1, 79104, Freiburg, Germany
| | - Gernot Lang
- Department of Orthopedics and Trauma Surgery, Medical Centre-Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany
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14
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Ventriculoperitoneal Shunt for CNS Metastasis in Breast Cancer: Clinical Outcomes Based on Intrinsic Subtype. Clin Breast Cancer 2021; 21:e402-e414. [PMID: 33526378 DOI: 10.1016/j.clbc.2020.12.013] [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: 03/18/2020] [Revised: 12/16/2020] [Accepted: 12/31/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Leptomeningeal metastasis (LM) is associated with a grave prognosis in breast cancer (BC) and can be controlled with a ventriculoperitoneal shunt (VPS). Information regarding LM and VPS based on intrinsic subtype is limited; thus, we investigated the clinical outcomes of BC treated with VPS. PATIENTS AND METHODS The present retrospective study comprised 70 patients diagnosed with LM who received a VPS. The patients were divided into 4 groups based on BC subtype: hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)-, HR+/HER2+, HR-/HER2+, and triple negative BC (TNBC). RESULTS The most common indications for VPS were uncontrolled intracranial pressure (57.1%) and uncontrolled headache (55.7%), which improved in 54 (77.1%) of 70 patients after VPS. The median overall survival (OS) after brain or LM and overall survival after VPS were 7.6 and 2.3 months, respectively. Anti-HER2 treatment was a significant prognostic factor for better OS after brain or LM based on multivariate analysis (hazard ratio, 0.15; 95% confidence interval, 0.04-0.57; P = .005), whereas TNBC was correlated with shorter OS after central nervous system metastasis (hazard ratio, 2.82; 95% confidence interval, 1.46-5.48; P = .002). CONCLUSIONS There were significant differences in clinical outcome based on the intrinsic subtype of patients with BC with LM who received a VPS. Anti-HER2 treatment in patients with HER2+ BC was associated with better survival in patients with metastatic BC with VPS insertion compared with those without. Survival of metastatic BC with VPS remained poor, especially in the TNBC subgroup.
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15
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Hexiao T, Yuquan B, Lecai X, Yanhong W, Li S, Weidong H, Ming X, Xuefeng Z, Gaofeng P, Li Z, Minglin Z, Zheng T, Zetian Y, Xiao Z, Yi C, Lanuti M, Jinping Z. Knockdown of CENPF inhibits the progression of lung adenocarcinoma mediated by ERβ2/5 pathway. Aging (Albany NY) 2021; 13:2604-2625. [PMID: 33428600 PMCID: PMC7880349 DOI: 10.18632/aging.202303] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/05/2020] [Indexed: 01/21/2023]
Abstract
Many studies have reported that estrogen (E2) promotes lung cancer by binding to nuclear estrogen receptors (ER), and altering ER related nuclear protein expressions. With the GEO database analysis, Human centromere protein F (CENPF) is highly expressed in lung adenocarcinoma (LUAD), and the co-expression of CENPF and ERβ was found in the nucleus of LUAD cells through immunofluorescence. We identified the nuclear protein CENPF and explored its relationship with the ER pathway. CENPF and ERβ2/5 were related with T stage and poor prognosis (P<0.05). CENPF knockout significantly inhibited LUAD cell growth, the tumor growth of mice and the expression of ERβ2/5 (P<0.05). The protein expression of CENPF and ERβ2/5 in the CENPF-Knockdown+Fulvestrant group was lower than CENPF- Negative Control +Fulvestrant group (P=0.002, 0.004, 0.001) in A549 cells. The tumor size and weight of the CENPF-Knockdown+Fulvestrant group were significantly lower than CENPF- Negative Control +Fulvestrant group (P=0.001, 0.039) in nude mice. All the results indicated that both CENPF and ERβ2/5 play important roles in the progression of LUAD, and knockdown CENPF can inhibit the progression of LUAD by inhibiting the expression of ER2/5. Thus, the development of inhibitors against ERβ2/5 and CENPF remained more effective in improving the therapeutic effect of LUAD.
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Affiliation(s)
- Tang Hexiao
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bai Yuquan
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiong Lecai
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei Yanhong
- Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shen Li
- Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Hu Weidong
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xu Ming
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhou Xuefeng
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Pan Gaofeng
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhang Li
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhu Minglin
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Tang Zheng
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yang Zetian
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhou Xiao
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Cai Yi
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Michael Lanuti
- Division of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Zhao Jinping
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
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16
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Huang JF, Shen J, Li X, Rengan R, Silvestris N, Wang M, Derosa L, Zheng X, Belli A, Zhang XL, Li YM, Wu A. Incidence of patients with bone metastases at diagnosis of solid tumors in adults: a large population-based study. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:482. [PMID: 32395526 PMCID: PMC7210217 DOI: 10.21037/atm.2020.03.55] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Bones are one of the most common metastatic sites for solid malignancies. Bone metastases can significantly increase mortality and decrease the quality of life of cancer patients. In the United States, around 350,000 people die each year from bone metastases. This study aimed to analyze and update the incidence and prognosis of bone metastases with solid tumors at the time of cancer diagnosis and its incidence rate for each solid cancer. Methods We used the Surveillance, Epidemiology, and End Results (SEER) database to find patients diagnosed with solid cancers originating from outside the bones and joints between 2010 and 2016. Data were stratified by age, sex, and race. Patients with a tumor in situ or with an unknown bone metastases stage were excluded. We then selected most of the sites where cancer often occurred, leaving 2,207,796 patients for the final incidence analysis. For the survival analysis, patients were excluded if they were diagnosed at their autopsy or on their death certificate, or had unknown follow-ups. The incidence of bone metastases and overall survival was compared between patients with different primary tumor sites. Results We identified 2,470,634 patients, including 426,594 patients with metastatic disease and 113,317 patients with bone metastases, for incidence analysis. The incidence of bone metastases among the metastatic subset was 88.74% in prostate cancer, 53.71% in breast cancer, and 38.65% in renal cancer. In descending order of incidence, there were patients with other cancers in the genitourinary system (except for renal, bladder, prostate, and testicular cancer) (37.91%), adenocarcinoma of the lung (ADC) (36.86%), other gynecologic cancers (36.02%), small-cell lung cancer (SCLC) (34.56%), non-small cell lung cancer not otherwise specified and others [NSCLC (NOS/others)] (33.55%), and bladder (31.08%) cancers. The rate of bone metastases is 23.19% in SCLC, 22.50% in NSCLC (NOS/others), 20.28% in ADC, 8.44% in squamous cell carcinoma of the lung (SCC), and 4.11% in bronchioloalveolar carcinoma [NSCLC (BAC)]. As for the digestive system, the overall bone metastases rate was 7.99% in the esophagus, 4.47% in the gastric cancer, 4.42% in the hepatobiliary cancer, 3.80% in the pancreas, 3.26% in other digestive organs, 1.24% in the colorectum, and 1.00% in the anus. Overall, the incidence rate of bone metastases among the entire cohort in breast and prostate cancer was 3.73% and 5.69%, respectively. Conclusions The results of this study provide population-based estimates for the incidence rates of patients with bone metastases at initial diagnosis of their solid tumor. The findings can help clinicians to early detect bone metastases by bone screening to anticipate the occurrence of symptoms and favorably improve the prognosis.
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Affiliation(s)
- Jin-Feng Huang
- Department of Orthopaedics, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Jianfei Shen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
| | - Xiao Li
- Department of Urology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Ramesh Rengan
- Department of Radiation Oncology, University of Washington School of Medicine, Washington, USA
| | - Nicola Silvestris
- IRCCS Istituto Tumori "Giovanni Paolo II" of Bari, Bari, Italy.,Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Minqi Wang
- Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Lisa Derosa
- U1015, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, Villejuif, France
| | - Xuanqi Zheng
- Department of Orthopaedics, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Andrea Belli
- Department of Abdominal Oncology, National Cancer Institute-Fondazione "G Pascale", IRCCS, Naples, Italy
| | - Xiao-Lei Zhang
- Department of Orthopaedics, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Yan Michael Li
- Department of Neurosurgery and Oncology, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY, USA
| | - Aimin Wu
- Department of Orthopaedics, Zhejiang Provincial Key Laboratory of Orthopaedics, The Second Affiliated Hospital, and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
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17
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Le D, Speers C, Thompson L, Gondara L, Nichol A, Lohrisch C. The impact of new systemic therapies on survival and time on hormonal treatment in hormone receptor-positive, human epidermal growth factor receptor 2-negative metastatic breast cancer: A population-based study in British Columbia from 2003 to 2013. Cancer 2020; 126:971-977. [PMID: 31750938 DOI: 10.1002/cncr.32631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/02/2019] [Accepted: 10/15/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND The purpose of this study was to determine whether new systemic therapy regimens have resulted in improved survival and increased time on first- and second-line hormonal treatment for patients with hormone receptor (HR)-positive metastatic breast cancer (MBC) over time. METHODS Patients diagnosed with HR-positive, human epidermal growth factor receptor 2 (HER2)-negative MBC were identified across 3 time cohorts (2003-2005, 2007-2009, and 2011-2013). Data were prospectively collected. Cases with previous, synchronous, or subsequent contralateral breast cancer were excluded. The types of first- and second-line therapies, the times on first- and second-line hormonal treatment, and the median survival times were compared across the cohorts. RESULTS Within the time period analyzed, 9 new adjuvant systemic therapies (with or without neoadjuvant therapy) and 2 metastatic systemic therapies were approved at BC Cancer for the treatment of HR-positive, HER2-negative MBC. In the 3 time cohorts, 3953 patients diagnosed with MBC were identified. Among the 2432 patients (62%) who had HR-positive/HER2-negative disease, 2197 (90%) received at least 1 line of systemic therapy after the diagnosis of MBC, and 80% of these patients (1752 of 2197) received first- and/or second-line hormonal treatment. The median duration on hormonal treatment was 9.0 months for the first line and 6.1 months for the second line. The durations were similar across the time cohorts (range for the first line, 8.9-9.0 months; range for the second line, 6.0-6.1 months). The median survival for the entire study population was 2.0 years (95% confidence interval, 1.8-2.1 years), and there was no significant difference between the cohorts (range, 1.9-2.0 years). CONCLUSIONS Even though more adjuvant and metastatic systemic therapies have been approved since 2003, population-level gains in survival and the time on hormonal treatment for patients with HR-positive, HER2-negative MBC have not been made over the course of a decade.
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Affiliation(s)
- Dan Le
- Department of Medical Oncology, Fraser Valley Cancer Centre, BC Cancer, Surrey, British Columbia, Canada
| | - Caroline Speers
- Cancer Surveillance and Outcomes, BC Cancer, Vancouver, British Columbia, Canada
| | - Leigh Thompson
- Cancer Surveillance and Outcomes, BC Cancer, Vancouver, British Columbia, Canada
| | - Lovedeep Gondara
- Cancer Surveillance and Outcomes, BC Cancer, Vancouver, British Columbia, Canada
| | - Alan Nichol
- Department of Radiation Oncology, Vancouver Centre, BC Cancer, Vancouver, British Columbia, Canada
| | - Caroline Lohrisch
- Department of Medical Oncology, Vancouver Centre, BC Cancer, Vancouver, British Columbia, Canada
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18
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Salvador F, Llorente A, Gomis RR. From latency to overt bone metastasis in breast cancer: potential for treatment and prevention. J Pathol 2019; 249:6-18. [PMID: 31095738 PMCID: PMC6771808 DOI: 10.1002/path.5292] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 12/19/2022]
Abstract
Bone metastasis is present in a high percentage of breast cancer (BCa) patients with distant disease, especially in those with the estrogen receptor‐positive (ER+) subtype. Most cells that escape primary tumors are unable to establish metastatic lesions, which suggests that target organ microenvironments are hostile for tumor cells. This implies that BCa cells must achieve a process of speciation to adapt to the new conditions imposed in the new organ. Bone has unique characteristics that can be exploited by cancer cells: it undergoes constant remodeling and comprises diverse environments (including osteogenic, perivascular, and hematopoietic stem cell niches). This allows colonizing cells to take advantage of numerous adhesion molecules, matrix proteins, and soluble factors that facilitate homing, survival, and, eventually, metastatic outgrowth. However, in most cases, metastatic lesions enter into a latency state that can last months, years, or even decades, before forming a clinically detectable macrometastasis. This dormant state challenges the effectiveness of adjuvant chemotherapy. Detecting which tumors are more prone to metastasize to bone and developing new specific therapies that target bone metastasis represent urgent clinical needs. Here, we review the biological mechanisms of BCa bone metastasis and provide the latest options of treatments and predictive markers that are currently in clinical use or are being tested in clinical assays. © 2019 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Fernando Salvador
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Alicia Llorente
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Roger R Gomis
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain.,CIBERONC, Barcelona, Spain.,ICREA, Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain.,School of Medicine, Universitat de Barcelona, Barcelona, Spain
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19
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Lord SJ, Kiely BE, Pearson SA, Daniels B, O'Connell DL, Beith J, Bulsara MK, Houssami N. Metastatic breast cancer incidence, site and survival in Australia, 2001-2016: a population-based health record linkage study protocol. BMJ Open 2019; 9:e026414. [PMID: 30709862 PMCID: PMC6367965 DOI: 10.1136/bmjopen-2018-026414] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Advances in systemic therapy for early and metastatic breast cancer (BC) over the last two decades have improved patients' survival, but their impact on metastatic disease outcomes at a population level is not well described. The aim of this study is to investigate changes in the incidence, site and survival of metastatic disease for women with a first diagnosis of BC in 2001-2002 vs 2006-2007. METHODS AND ANALYSIS Population-based retrospective cohort study of women with first primary invasive BC registered in the New South Wales (NSW) Cancer Registry in 2001-2002 and 2006-2007. We will use linked records from NSW hospitals, dispensed medicines, outpatient services and death registrations to determine: women's demographic and tumour characteristics; treatments received; time to first distant metastasis; site of first metastasis and survival. We will use the Kaplan-Meier method to estimate cumulative incidence of distant metastasis, distant recurrence-free interval and postmetastasis survival by extent of disease at initial diagnosis, site of metastasis and treatment-defined tumour receptor type (hormone receptor-positive, human epidermal growth factor receptor-2-positive, triple negative). We will use Cox proportional hazards regression to estimate the relative effects of prognostic factors, and we will compare systemic therapy patterns by area-of-residence and area-level socioeconomic status to examine equity of access to healthcare. ETHICS AND DISSEMINATION Research ethics committee approval was granted by the Australian Institute of Health and Welfare (#EO2017/2/255), NSW Population and Health Services (#HREC/17/CIPHS/19) and University of Notre Dame Australia (#0 17 144S). We will disseminate research findings to oncology, BC consumer and epidemiology audiences through national and international conference presentations, lay summaries to BC consumer groups and publications in international peer-reviewed oncology and cancer epidemiology journals.
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Affiliation(s)
- Sarah J Lord
- The School of Medicine, University of Notre Dame Australia - Darlinghurst, Darlinghurst, New South Wales, Australia
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Belinda E Kiely
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sallie-Anne Pearson
- The Centre for Big Data Research in Health, The University of NSW, Kensington, NSW, Australia
| | - Benjamin Daniels
- The Centre for Big Data Research in Health, The University of NSW, Kensington, NSW, Australia
| | - Dianne L O'Connell
- Cancer Research Division, Cancer Council NSW, Woolloomooloo, New South Wales, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia
| | - Jane Beith
- Chris O'Brien Lifehouse, Camperdown, The University of Sydney, Camperdown, New South Wales, Australia
| | - Max K Bulsara
- The Institute of Health Research and the School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Nehmat Houssami
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
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20
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Hernandez RK, Wade SW, Reich A, Pirolli M, Liede A, Lyman GH. Incidence of bone metastases in patients with solid tumors: analysis of oncology electronic medical records in the United States. BMC Cancer 2018; 18:44. [PMID: 29306325 PMCID: PMC5756362 DOI: 10.1186/s12885-017-3922-0] [Citation(s) in RCA: 193] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/14/2017] [Indexed: 12/21/2022] Open
Abstract
Background Bone metastases commonly occur in conjunction with solid tumors, and are associated with serious bone complications. Population-based estimates of bone metastasis incidence are limited, often based on autopsy data, and may not reflect current treatment patterns. Methods Electronic medical records (OSCER, Oncology Services Comprehensive Electronic Records, 569,000 patients, 52 US cancer centers) were used to identify patients ≥18 years with a solid tumor diagnosis recorded between 1/1/2004 and 12/31/2013, excluding patients with hematologic tumors or multiple primaries. Each patient’s index date was set to the date of his or her first solid tumor diagnosis in the selection period. Kaplan-Meier analyses were used to quantify the cumulative incidence of bone metastasis with follow-up for each patient from the index date to the earliest of the following events: last clinic visit in the OSCER database, occurrence of a new primary tumor or bone metastasis, end of study (12/31/2014). Incidence estimates and associated 95% confidence intervals (CI) are provided for up to 10 years of follow-up for all tumor types combined and stratified by tumor type and stage at diagnosis. Results Among 382,733 study patients (mean age 64 years; mean follow-up 940 days), breast (36%), lung (16), and colorectal (12%) tumors were most common. Mean time to bone metastasis was 400 days (1.1 years). Cumulative incidence of bone metastasis was 2.9% (2.9–3.0) at 30 days, 4.8% (4.7–4.8) at one year, 5.6% (5.5–5.6) at two years, 6.9% (6.8–7.0) at five years, and 8.4% (8.3–8.5) at ten years. Incidence varied substantially by tumor type with prostate cancer patients at highest risk (18% – 29%) followed by lung, renal or breast cancer. Cumulative incidence of bone metastasis increased by stage at diagnosis, with markedly higher incidence among patients diagnosed at Stage IV of whom11% had bone metastases diagnosed within 30 days. Conclusions These estimates of bone metastasis incidence represent the experience of a population with longer follow-up than previously published, and represent experience in the recent treatment landscape. Underestimation is possible given reliance on coded diagnoses but the clinical detail available in electronic medical records contributes to the accuracy of these estimates.
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Affiliation(s)
| | - Sally W Wade
- Wade Outcomes Research and Consulting, 358 South 700 East, Suite B432, Salt Lake City, UT, 84102, USA
| | - Adam Reich
- IMS Health, 1 IMS Drive, Plymouth Meeting, PA, 19462, USA
| | | | - Alexander Liede
- Amgen, Inc., 1120 Veterans Blvd, South San Francisco, CA, 94114, USA.
| | - Gary H Lyman
- Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, 1100 Fairview Ave N, Seattle, Washington, 98109, USA
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21
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Cronin-Fenton D, Kjærsgaard A, Nørgaard M, Amelio J, Liede A, Hernandez RK, Sørensen HT. Breast cancer recurrence, bone metastases, and visceral metastases in women with stage II and III breast cancer in Denmark. Breast Cancer Res Treat 2017; 167:517-528. [PMID: 28948396 DOI: 10.1007/s10549-017-4510-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE We developed and validated algorithms to identify metastases and breast cancer recurrence in Danish medical registries. We computed the incidence rate (IR) and hazard ratios (HRs) to evaluate predictors of these outcomes in stage II/III breast cancer patients. METHODS We included all women in Denmark diagnosed during 1999-2011 with regional or stage II/III breast cancer. Demographic, tumor, and treatment data were ascertained from population-based health registries. To facilitate diagnostic work-up of the primary cancer, follow-up began 180 days after diagnosis and continued until recurrence/metastases, death, or 31 December 2012, whichever occurred first. We computed the positive predictive values (PPVs) of recurrence, bone metastases, and visceral metastases using medical records as a gold standard. We calculated the cumulative incidence, IR per 10,000 person years, and used Cox regression to compute the HRs and associated 95% confidence intervals (95% CI) for each outcome. RESULTS Among 23,478 patients, 7073 had regional stage and 16,405 had stage II/III breast cancer. The PPV for recurrence was 72.6% (95% CI 59.3, 83.3%). The PPVs for bone and visceral metastases were 92.3% (95% CI 69.3-99.2%) and 70.8% (95% CI 51.1, 85.9%), but had low sensitivity. Five-year cumulative incidence of recurrence, bone metastases, and visceral metastases were 18.4, 2.2, and 5.2%, with corresponding 5-year IRs of 540 (95% CI 524, 557), 60 (95% CI 55, 65), and 144 (95% CI 136, 152), respectively. Predictors of recurrence and metastases included age, stage, hormone receptor status, and cancer treatment. CONCLUSION Our algorithms show moderate to high PPVs for recurrence and metastases. The IRs of metastases were lower compared with other registry-based cohort studies, so may be underestimated in Danish registries.
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Affiliation(s)
- Deirdre Cronin-Fenton
- Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200, Aarhus N, Denmark.
| | - Anders Kjærsgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200, Aarhus N, Denmark
| | - Mette Nørgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200, Aarhus N, Denmark
| | | | | | | | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200, Aarhus N, Denmark
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Aalders K, van Bommel A, van Dalen T, Sonke G, van Diest P, Boersma L, van der Heiden- van der Loo M. Contemporary risks of local and regional recurrence and contralateral breast cancer in patients treated for primary breast cancer. Eur J Cancer 2016; 63:118-26. [DOI: 10.1016/j.ejca.2016.05.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/08/2016] [Accepted: 05/09/2016] [Indexed: 12/17/2022]
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Aalders KC, Postma EL, Strobbe LJ, van der Heiden-van der Loo M, Sonke GS, Boersma LJ, van Diest PJ, Siesling S, van Dalen T. Contemporary Locoregional Recurrence Rates in Young Patients With Early-Stage Breast Cancer. J Clin Oncol 2016; 34:2107-14. [DOI: 10.1200/jco.2015.64.3536] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The aim of this study was to evaluate contemporary rates of local recurrence (LR) and regional recurrence (RR) in young patients with breast cancer in relation to tumor biology as expressed by biomarker subtypes. Patients and Methods Women < 35 years of age who underwent surgery for primary unilateral invasive breast cancer between 2003 and 2008 were selected from the Netherlands Cancer Registry. Patients were categorized according to biomarker subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year risks of developing LR and regional lymph node recurrence were estimated by using Kaplan-Meier statistics. Results A total of 1,000 patients were identified, of whom 59% had a known subtype: 39% HR-positive/HER2-negative; 17% HR-positive/HER2-positive; 10% HR-negative/HER2-positive; and 34% HR-negative/HER2-negative (triple negative). Overall 5-year LR and RR rates were 3.5% and 3.7%, respectively. A decreasing trend for both rates was observed over time and was accompanied by a significant decrease in the risk of distant metastases (DM). LR occurred in 4.2%, RR in 6.1%, and DM in 17.8% of patients in 2003, and in 3.2%, 4.4%, and 10.0%, respectively, in 2008. LR and RR rates varied with biomarker subtype. These differences were borderline significant when analyzed for the entire study period (P = .056 and P = .014, respectively) and leveled off after the introduction of trastuzumab after 2005 (P = .24 and P = .42, respectively). Patients with lymph node metastases at the time of diagnosis had an increased risk of RR. The type of surgery performed—breast-conserving or mastectomy—did not influence rates of LR and RR. Conclusion Overall, the rates of LR and RR in young patients with early-stage breast cancer were relatively low and varied by biomarker subtype.
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Affiliation(s)
- Kim C. Aalders
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
| | - Emily L. Postma
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
| | - Luc J. Strobbe
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
| | - Margriet van der Heiden-van der Loo
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
| | - Gabe S. Sonke
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
| | - Liesbeth J. Boersma
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
| | - Paul J. van Diest
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
| | - Sabine Siesling
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
| | - Thijs van Dalen
- Kim C. Aalders, Emily L. Postma, and Thijs van Dalen, Diakonessenhuis; Margriet van der Heiden-van der Loo and Sabine Siesling, Netherlands Comprehensive Cancer Organization; Paul J. van Diest, University Medical Center Utrecht, Utrecht; Luc J. Strobbe, Canisius Wilhelmina Hospital, Nijmegen; Gabe S. Sonke, Netherlands Cancer Institute, Amsterdam; Liesbeth J. Boersma, University Hospital Maastricht, Maastricht; and Sabine Siesling, University of Twente, Enschede, the Netherlands
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Liede A, Jerzak KJ, Hernandez RK, Wade SW, Sun P, Narod SA. The incidence of bone metastasis after early-stage breast cancer in Canada. Breast Cancer Res Treat 2016; 156:587-595. [DOI: 10.1007/s10549-016-3782-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 04/02/2016] [Indexed: 12/12/2022]
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Changing molecular profile of brain metastases compared with matched breast primary cancers and impact on clinical outcomes. Br J Cancer 2016; 114:793-800. [PMID: 26908328 PMCID: PMC4984859 DOI: 10.1038/bjc.2016.34] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/12/2016] [Accepted: 01/22/2016] [Indexed: 12/21/2022] Open
Abstract
Background: Breast cancer commonly metastasises to the brain, but little is known about changes in the molecular profile of the brain secondaries and impact on clinical outcomes. Methods: Patients with samples from brain metastases and matched breast cancers were included. Immunohistochemical analysis for oestrogen receptor, progesterone receptor, p27kip1, cyclin D1, epidermal growth factor receptor, insulin like growth factor 1, insulin like growth factor 1 receptor, vascular endothelial growth factor A, transforming growth factor-β and HER2 receptor was performed. Borderline HER2 results were analysed by fluorescent in situ hybridisation. Levels of expression were compared, with review of effect on clinical outcomes. Results: A total of 41 patients were included. Of the patients, 20% had a change in oestrogen receptor or HER2 in their brain metastasis that could affect therapeutic decisions. There were statistically significant rises in brain metastases for p27kip1 (P=0.023) and cyclin D1 (P=0.030) and a fall in vascular endothelial growth factor A (P=0.012). Overall survival from the time of metastasis increased significantly with oestrogen receptor-positive (P=0.005) and progesterone receptor-positive (P=0.013) brain lesions and with a longer duration from diagnosis of the breast primary (P<0.001). Conclusions: In this cohort there were phenotypic differences in metastatic brain tumours compared with matched primary breast tumours. These could be relevant for aetiology, and have an impact on prognostication, current and future therapies.
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Pavlovic M, Arnal-Estapé A, Rojo F, Bellmunt A, Tarragona M, Guiu M, Planet E, Garcia-Albéniz X, Morales M, Urosevic J, Gawrzak S, Rovira A, Prat A, Nonell L, Lluch A, Jean-Mairet J, Coleman R, Albanell J, Gomis RR. Enhanced MAF Oncogene Expression and Breast Cancer Bone Metastasis. J Natl Cancer Inst 2015; 107:djv256. [PMID: 26376684 PMCID: PMC4681582 DOI: 10.1093/jnci/djv256] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 08/18/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There are currently no biomarkers for early breast cancer patient populations at risk of bone metastasis. Identification of mediators of bone metastasis could be of clinical interest. METHODS A de novo unbiased screening approach based on selection of highly bone metastatic breast cancer cells in vivo was used to determine copy number aberrations (CNAs) associated with bone metastasis. The CNAs associated with bone metastasis were examined in independent primary breast cancer datasets with annotated clinical follow-up. The MAF gene encoded within the CNA associated with bone metastasis was subjected to gain and loss of function validation in breast cancer cells (MCF7, T47D, ZR-75, and 4T1), its downstream mechanism validated, and tested in clinical samples. A multivariable Cox cause-specific hazard model with competing events (death) was used to test the association between 16q23 or MAF and bone metastasis. All statistical tests were two-sided. RESULTS 16q23 gain CNA encoding the transcription factor MAF mediates breast cancer bone metastasis through the control of PTHrP. 16q23 gain (hazard ratio (HR) for bone metastasis = 14.5, 95% confidence interval (CI) = 6.4 to 32.9, P < .001) as well as MAF overexpression (HR for bone metastasis = 2.5, 95% CI = 1.7 to 3.8, P < .001) in primary breast tumors were specifically associated with risk of metastasis to bone but not to other organs. CONCLUSIONS These results suggest that MAF is a mediator of breast cancer bone metastasis. 16q23 gain or MAF protein overexpression in tumors may help to select patients at risk of bone relapse.
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Affiliation(s)
- Milica Pavlovic
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Anna Arnal-Estapé
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Federico Rojo
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Anna Bellmunt
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Maria Tarragona
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Marc Guiu
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Evarist Planet
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Xabier Garcia-Albéniz
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Mónica Morales
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Jelena Urosevic
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Sylwia Gawrzak
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Ana Rovira
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Aleix Prat
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Lara Nonell
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Ana Lluch
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Joël Jean-Mairet
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Robert Coleman
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Joan Albanell
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG)
| | - Roger R Gomis
- Oncology Program (MP, AAE, AB, MT, MG, XGA, MM, JU, SG, RRG) and Biostatistics and Bioinformatics Unit (EP), Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Cancer Research Program (FR, AR, JA) and Microarray Analysis Service (LN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Pathology Department, IIS-Fundación Jimenez Diaz, Madrid, Spain (FR); Medical Oncology Service, Hospital del Mar, Barcelona, Spain (AR, JA); Department of Oncology and Hematology, Hospital Clínico Universitario, Valencia, Spain (AL); Valencia Central University, Spain (AL); Inbiomotion, Barcelona, Spain (JJM); Sheffield Cancer Research Centre, Sheffield, UK (RC); Universitat Pompeu Fabra, Barcelona, Spain (JA); Translational Genomics, Vall d'Hebron Insitute of Oncology, Barcelona, Spain (AP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (XGA); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain (RRG).
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27
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Kimbung S, Johansson I, Danielsson A, Veerla S, Egyhazi Brage S, Frostvik Stolt M, Skoog L, Carlsson L, Einbeigi Z, Lidbrink E, Linderholm B, Loman N, Malmström PO, Söderberg M, Walz TM, Fernö M, Hatschek T, Hedenfalk I. Transcriptional Profiling of Breast Cancer Metastases Identifies Liver Metastasis-Selective Genes Associated with Adverse Outcome in Luminal A Primary Breast Cancer. Clin Cancer Res 2015; 22:146-57. [PMID: 26276891 DOI: 10.1158/1078-0432.ccr-15-0487] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/26/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE The complete molecular basis of the organ-specificity of metastasis is elusive. This study aimed to provide an independent characterization of the transcriptional landscape of breast cancer metastases with the specific objective to identify liver metastasis-selective genes of prognostic importance following primary tumor diagnosis. EXPERIMENTAL DESIGN A cohort of 304 women with advanced breast cancer was studied. Associations between the site of recurrence and clinicopathologic features were investigated. Fine-needle aspirates of metastases (n = 91) were subjected to whole-genome transcriptional profiling. Liver metastasis-selective genes were identified by significance analysis of microarray (SAM) analyses and independently validated in external datasets. Finally, the prognostic relevance of the liver metastasis-selective genes in primary breast cancer was tested. RESULTS Liver relapse was associated with estrogen receptor (ER) expression (P = 0.002), luminal B subtype (P = 0.01), and was prognostic for an inferior postrelapse survival (P = 0.01). The major variation in the transcriptional landscape of metastases was also associated with ER expression and molecular subtype. However, liver metastases displayed unique transcriptional fingerprints, characterized by downregulation of extracellular matrix (i.e., stromal) genes. Importantly, we identified a 17-gene liver metastasis-selective signature, which was significantly and independently prognostic for shorter relapse-free (P < 0.001) and overall (P = 0.001) survival in ER-positive tumors. Remarkably, this signature remained independently prognostic for shorter relapse-free survival (P = 0.001) among luminal A tumors. CONCLUSIONS Extracellular matrix (stromal) genes can be used to partition breast cancer by site of relapse and may be used to further refine prognostication in ER positive primary breast cancer.
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Affiliation(s)
- Siker Kimbung
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund, Lund University, Sweden. CREATE Health Strategic Center for Translational Cancer Research, Lund University, Lund, Sweden
| | - Ida Johansson
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund, Lund University, Sweden. CREATE Health Strategic Center for Translational Cancer Research, Lund University, Lund, Sweden
| | - Anna Danielsson
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Srinivas Veerla
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund, Lund University, Sweden. CREATE Health Strategic Center for Translational Cancer Research, Lund University, Lund, Sweden
| | - Suzanne Egyhazi Brage
- Department of Oncology and Pathology, Karolinska Institutet and Karolinska University Hospital, Sweden
| | - Marianne Frostvik Stolt
- Department of Oncology and Pathology, Karolinska Institutet and Karolinska University Hospital, Sweden
| | - Lambert Skoog
- Department of Oncology and Pathology, Karolinska Institutet and Karolinska University Hospital, Sweden
| | - Lena Carlsson
- Department of Oncology, Sundsvall Hospital, Sundsvall, Sweden
| | - Zakaria Einbeigi
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elisabet Lidbrink
- Department of Oncology and Pathology, Karolinska Institutet and Karolinska University Hospital, Sweden
| | - Barbro Linderholm
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Niklas Loman
- Department of Oncology, Skåne University Hospital, Lund/Malmö, Sweden
| | | | - Martin Söderberg
- Department of Oncology, Skåne University Hospital, Lund/Malmö, Sweden
| | - Thomas M Walz
- Division of Oncology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Mårten Fernö
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund, Lund University, Sweden
| | - Thomas Hatschek
- Department of Oncology and Pathology, Karolinska Institutet and Karolinska University Hospital, Sweden
| | - Ingrid Hedenfalk
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund, Lund University, Sweden. CREATE Health Strategic Center for Translational Cancer Research, Lund University, Lund, Sweden.
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28
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Senda N, Yamaguchi A, Nishimura H, Shiozaki T, Tsuyuki S. Pertuzumab, trastuzumab and docetaxel reduced the recurrence of brain metastasis from breast cancer: a case report. Breast Cancer 2015; 23:323-8. [PMID: 26116144 DOI: 10.1007/s12282-015-0623-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 06/17/2015] [Indexed: 01/16/2023]
Abstract
The CLEOPATRA trial reported the survival benefit of pertuzumab with trastuzumab plus docetaxel in HER2-positive metastatic breast cancer patients. However, there are a few case reports concerning the effects of a pertuzumab-containing regimen on brain metastases. A 55-year-old woman, who underwent curative surgery for breast cancer after neoadjuvant chemotherapy 5 years previously, developed repeated solitary brain metastasis in her right occipital lobe. Whole brain radiation therapy, stereotactic radiosurgery and 3 times of surgical resection were performed. Lapatinib and capecitabine plus tamoxifen were administered. The metastasis recurred in the stump of the previous surgery. Pertuzumab with trastuzumab plus docetaxel was initiated as second-line chemotherapy. A complete response of the brain metastasis was achieved, which persisted for 5 months. Pertuzumab with trastuzumab plus docetaxel was effective in reducing the brain metastases from breast cancer. Further studies are warranted to confirm the effect of this regimen on brain metastases.
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Affiliation(s)
- Noriko Senda
- Department of Breast Surgery, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, Osaka, 543-8555, Japan.
| | - Ayane Yamaguchi
- Department of Breast Surgery, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, Osaka, 543-8555, Japan.,Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Toshiki Shiozaki
- Department of Diagnostic Radiology, Osaka Red Cross Hospital, Osaka, Japan
| | - Shigeru Tsuyuki
- Department of Breast Surgery, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, Osaka, 543-8555, Japan
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29
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Tarhan MO, Demir L, Somali I, Yigit S, Erten C, Alacacioglu A, Ellidokuz H, Seseogullari O, Kucukzeybek Y, Can A, Dirican A, Bayoglu V, Akyol M. The clinicopathological evaluation of the breast cancer patients with brain metastases: predictors of survival. Clin Exp Metastasis 2012; 30:201-13. [PMID: 22915160 DOI: 10.1007/s10585-012-9528-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 08/10/2012] [Indexed: 10/28/2022]
Abstract
We aimed to define the clinicopathologic characteristics of breast cancer (BC) patients with brain metastasis (BM) and to investigate the effect of these parameters on survival. Seventy-nine patients diagnosed with BC and symptomatic BM between 1995 and 2011 were retrospectively evaluated. The relationship between clinicopathological features and outcome was investigated. Triple negative patients had the shortest overall survival (OS) while HR(+)HER2(-) patients had the longest (48.2 vs 88.2 months, 95 % CI; p = 0.33). Multivariate analysis demonstrated that luminal A subtype was the strongest positive predictor of prolonged OS (HR 0.48, 95 % CI 0.28-0.84; p = 0.01), while poor performance status (PS) (ECOG 3-4) at BM was the strongest predictor of shortened OS (HR 1.92, 95 % CI 1.21-3.06; p = 0.006). The patients with early-stage BC at diagnosis had BM later than the advanced-staged patients (47 months for Stage I-II disease, 23.2 months for Stage III-IV disease, 95 % CI; p = 0.002). Median survival after BM was 10.2 months (6.4-14 months, 95 % CI). The patients with liver or skin metastases had significantly shorter survival than the patients with only BM (4.8 vs 17 months, p < 0.001 for liver and 4.8 vs 11.1 months, p = 0.04 for skin). Multivariate analysis demonstrated that regardless of the BC subtype, lack of systemic therapy, and liver involvement were independent factors associated with increased risk of death (HR 4, 95 % CI 1.7-9.1; p = 0.001 and HR 2.2, 95 % CI 1.05-4.9; p = 0.036 respectively). Clinical outcome after BM mostly depends on the ECOG PS and the fact that whether the patient received systemic therapy or not. Systemic therapy prolongs survival especially in HER2 positive patients.
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Affiliation(s)
- Mustafa Oktay Tarhan
- Department of Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Basin Sitesi, Karabaglar, Izmir, Turkey
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30
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Unfavourable pattern of metastases in M0 breast cancer patients during 1978-2008: a population-based analysis of the Munich Cancer Registry. Breast Cancer Res Treat 2011; 128:795-805. [PMID: 21311969 DOI: 10.1007/s10549-011-1372-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 01/23/2011] [Indexed: 10/18/2022]
Abstract
Little is known about time trends in metastases in the patients treated in routine health care facilities without metastases at diagnosis (M0) and about survival after these metastases. Data on 33,771 M0 patients with primary breast cancer diagnosed between 1978 and 2003 were obtained from the Munich Cancer Registry. Survival analyses were restricted to the patients with metastases within 5 years of the initial diagnosis. The incident number of the patients approximately doubled each period and 5-year overall survival increased from 77% in the first to 82% percent in the last period. 5490 (16%) M0 patients developed metastases within 5 years after the initial diagnosis. The hazard of developing metastases was lowest in the most recent period compared to the first period (HR = 0.50, P < 0.001). The hazard of dying after metastases was equal for patients diagnosed between 1978-1984 and 1995-2003 (HR 1.08, P = 0.3). The percentage of the patients that developed bone metastases decreased each time period, but the percentage primary liver and CNS metastases increased. Exclusion of site of metastases in the multivariate analysis led to a 20% (P = 0.02) higher hazard of dying following metastases in the last versus the first period. In the period 1978-2008, unfavourable changes in the pattern of metastases were exhibited and no improvement was observed in survival of the patients after occurrence of metastases. An explanation might be the increased use of adjuvant systemic treatment, which has less effect on the highly lethal liver and CNS metastases than on bone metastases. The increased use also appeared to contribute to the overall prevention of metastases in breast cancer and therefore to improve overall survival.
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