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Kim SH, Im SA, Suh KJ, Lee KH, Kim MH, Sohn J, Park YH, Kim JY, Jeong JH, Lee KE, Choi IS, Park KH, Kim HJ, Cho EK, Park SY, Kim M, Kim JH. Clinical activity of nivolumab in combination with eribulin in HER2-negative metastatic breast cancer: A phase IB/II study (KCSG BR18-16). Eur J Cancer 2023; 195:113386. [PMID: 37890351 DOI: 10.1016/j.ejca.2023.113386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/13/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023]
Abstract
AIM We evaluated the efficacy and safety of nivolumab and eribulin combination therapy for metastatic breast cancer (BC) in Asian populations. METHODS In this parallel phase II study, adult patients with histologically confirmed recurrent/metastatic hormone receptor-positive/HER2-negative (HR+HER2-) or triple-negative BC (TNBC) were prospectively enroled from 10 academic hospitals in Korea (ClinicalTrials.gov Identifier: NCT04061863). They received nivolumab (360 mg) on day 1 plus eribulin (1.4 mg/m2) on days 1 and 8 every 3 weeks until disease progression or intolerable toxicity. The primary endpoint was the investigator-assessed 6-month progression-free survival (PFS) rate in each subtype. Secondary endpoints included investigator-assessed objective response rate (ORR) as per Response Evaluation Criteria in Advanced Solid Tumors version 1.1, disease control rate, overall survival, and treatment toxicity. The association between PD-L1 expression and efficacy was investigated. RESULTS Forty-five patients with HR+HER2- BC and 45 with TNBC were enroled. Their median age was 51 (range, 31-71) years, and 74 (82.2%) received one or two prior treatments before enrolment. Six-month PFS was 47.2% and 25.1% in the HR+HER2- and TNBC cohorts, respectively. Median PFS was 5.6 (95% confidence interval [CI]: 5.3-7.4) and 3.0 (95% CI: 2.1-5.2) months in the HR+HER2- and TNBC groups, respectively. ORRs were 53.3% (complete response [CR]: 0, partial response [PR]: 24) and 28.9% (CR: 1, PR: 12). Patients with PD-L1+ tumours (PD-L1 expression ≥1%) and PD-L1- tumours (ORR 50% versus 53.8% in HR+HER2-, 30.8% versus 29.0% in TNBC) had similar ORRs. Neutropenia was the most common grade 3/4 adverse event; the most common immune-related adverse events (AEs) were grades 1/2 hypothyroidism and pruritus. Five patients discontinued therapy because of immune-related AEs. CONCLUSION Nivolumab plus eribulin showed promising efficacy and tolerable safety in previously treated HER2- metastatic BC. TRIAL REGISTRATION NCT04061863.
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Affiliation(s)
- Se Hyun Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, South Korea
| | - Koung Jin Suh
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, South Korea
| | - Min Hwan Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Joohyuk Sohn
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Yeon Hee Park
- Hematology-Oncology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji-Yeon Kim
- Hematology-Oncology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Ho Jeong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyoung Eun Lee
- Department of Hematology and Oncology, Ewha Womans University Hospital, Seoul, South Korea
| | - In Sil Choi
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Kyong Hwa Park
- Division of Medical Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Hee-Jun Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Eun Kyung Cho
- Division of Medical Oncology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - So Yeon Park
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Milim Kim
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea; Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jee Hyun Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
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Justo AFO, Collaço RDC, Lescano CH, de Oliveira IP. Malignant neoplasm of breast in Brazilian women: A cross-sectional study from 2008 to 2019. J Natl Med Assoc 2023; 115:38-45. [PMID: 36577555 DOI: 10.1016/j.jnma.2022.12.003] [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: 07/12/2022] [Revised: 09/16/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Breast cancer is the most lethal malignancy for women worldwide. Developed countries, such as Portugal, Spain, and the United States, have declining mortality rates due to breast cancer; however, in developing countries, the epidemiological reports are scarce. In this context, the aims of this study are to describe and discuss the female breast cancer profile of hospitalization and mortality according to age and geographic region in Brazil from 2008 to 2019. METHODS Data were obtained from the National Health System Department of Informatics (DATASUS), maintained by the Brazilian Ministry of Health, which includes the registers of hospitalization and mortality by malignant neoplasm of breast (code C50, ICD-10). Proportional rates of hospitalization and deaths were estimated per 100,000 inhabitants according to respective subjects' age, region, and year of the occurrence. RESULTS From 2008 to 2019, 643,822 hospital admissions due to malignant neoplasm of breast were reported in Brazil, of which the South and Southeast regions were the most prevalent. Higher hospitalization rates were seen in subjects aged 50-79-years-old. Regarding mortality, 53,480 deaths by breast cancer were reported; similarly to hospitalization, the Southeast and South were the most affected regions. Mortality rates have increased over time in different magnitudes depending on subjects' age. CONCLUSION We have shown an increase in morbidity and mortality over time, which is dependent on patients' age and region. The results presented here may contribute to the ongoing discussion about the role and future perspectives of the Brazilian health care system, especially regarding to the strategies for the prevention, control, and treatment of breast cancer.
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Affiliation(s)
| | - Rita de Cássia Collaço
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Caroline Honaiser Lescano
- Department of Pharmacology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Ivan Pires de Oliveira
- Institute of Agricultural Sciences, Federal University of Minas Gerais, Minas Gerais, Brazil
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Colombo J, Moschetta-Pinheiro MG, Novais AA, Stoppe BR, Bonini ED, Gonçalves FM, Fukumasu H, Coutinho LL, Chuffa LGDA, Zuccari DAPDC. Liquid Biopsy as a Diagnostic and Prognostic Tool for Women and Female Dogs with Breast Cancer. Cancers (Basel) 2021; 13:5233. [PMID: 34680380 PMCID: PMC8533706 DOI: 10.3390/cancers13205233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Breast cancer (BC) is the malignant neoplasm with the highest mortality rate in women and female dogs are good models to study BC. OBJECTIVE We investigated the efficacy of liquid biopsy to detect gene mutations in the diagnosis and follow-up of women and female dogs with BC. MATERIALS AND METHODS In this study, 57 and 37 BC samples were collected from women and female dogs, respectively. After core biopsy and plasma samples were collected, the DNA and ctDNA of the tumor fragments and plasma were processed for next generation sequencing (NGS) assay. After preprocessing of the data, they were submitted to the Genome Analysis ToolKit (GATK). RESULTS In women, 1788 variants were identified in tumor fragments and 221 variants in plasma; 66 variants were simultaneously detected in tumors and plasma. Conversely, in female dogs, 1430 variants were found in plasma and 695 variants in tumor fragments; 59 variants were simultaneously identified in tumors and plasma. The most frequently mutated genes in the tumor fragments of women were USH2A, ATM, and IGF2R; in female dogs, they were USH2A, BRCA2, and RRM2. Plasma of women showed the most frequent genetic variations in the MAP3K1, BRCA1, and GRB7 genes, whereas plasma from female dogs had variations in the NF1, ERBB2, and KRT17 genes. Mutations in the AKT1, PIK3CA, and BRIP genes were associated with tumor recurrence, with a highly pathogenic variant in PIK3CA being particularly prominent. We also detected a gain-of-function mutation in the GRB7, MAP3K1, and MLH1 genes. CONCLUSION Liquid biopsy is useful to identify specific genetic variations at the beginning of BC manifestation and may be accompanied over the entire follow-up period, thereby supporting the clinicians in refining interventions.
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Affiliation(s)
- Jucimara Colombo
- Laboratory of Molecular Investigation in Cancer (LIMC), Department of Molecular Biology, Faculdade de Medicina de São José, São José do Rio Preto 15090-000, Brazil; (J.C.); (M.G.M.-P.); (A.A.N.); (B.R.S.); (E.D.B.); (F.M.G.)
| | - Marina Gobbe Moschetta-Pinheiro
- Laboratory of Molecular Investigation in Cancer (LIMC), Department of Molecular Biology, Faculdade de Medicina de São José, São José do Rio Preto 15090-000, Brazil; (J.C.); (M.G.M.-P.); (A.A.N.); (B.R.S.); (E.D.B.); (F.M.G.)
| | - Adriana Alonso Novais
- Laboratory of Molecular Investigation in Cancer (LIMC), Department of Molecular Biology, Faculdade de Medicina de São José, São José do Rio Preto 15090-000, Brazil; (J.C.); (M.G.M.-P.); (A.A.N.); (B.R.S.); (E.D.B.); (F.M.G.)
| | - Bruna Ribeiro Stoppe
- Laboratory of Molecular Investigation in Cancer (LIMC), Department of Molecular Biology, Faculdade de Medicina de São José, São José do Rio Preto 15090-000, Brazil; (J.C.); (M.G.M.-P.); (A.A.N.); (B.R.S.); (E.D.B.); (F.M.G.)
| | - Enrico Dumbra Bonini
- Laboratory of Molecular Investigation in Cancer (LIMC), Department of Molecular Biology, Faculdade de Medicina de São José, São José do Rio Preto 15090-000, Brazil; (J.C.); (M.G.M.-P.); (A.A.N.); (B.R.S.); (E.D.B.); (F.M.G.)
| | - Francine Moraes Gonçalves
- Laboratory of Molecular Investigation in Cancer (LIMC), Department of Molecular Biology, Faculdade de Medicina de São José, São José do Rio Preto 15090-000, Brazil; (J.C.); (M.G.M.-P.); (A.A.N.); (B.R.S.); (E.D.B.); (F.M.G.)
| | - Heidge Fukumasu
- Laboratory of Comparative and Translational Oncology (LOCT), Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil;
| | - Luiz Lehmann Coutinho
- Luiz de Queiroz College of Agriculture (ESALQ), University of São Paulo, Piracicaba 13418-900, Brazil;
| | - Luiz Gustavo de Almeida Chuffa
- Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, Universidade Estadual Paulista, Botucatu 18618-689, Brazil;
| | - Debora Aparecida Pires de Campos Zuccari
- Laboratory of Molecular Investigation in Cancer (LIMC), Department of Molecular Biology, Faculdade de Medicina de São José, São José do Rio Preto 15090-000, Brazil; (J.C.); (M.G.M.-P.); (A.A.N.); (B.R.S.); (E.D.B.); (F.M.G.)
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