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Saharkhiz S, Nasri N, Naderi N, Dini G, Ghalehshahi SS, Firoozbakht F. Evaluating a targeted Palbociclib-Trastuzumab loaded smart niosome platform for treating HER2 positive breast cancer cells. Int J Pharm X 2024; 7:100237. [PMID: 38516198 PMCID: PMC10955288 DOI: 10.1016/j.ijpx.2024.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024] Open
Abstract
In this study, we present a targeted and pH-sensitive niosomal (pHSN) formulation, incorporating quantum dot (QD)-labeled Trastuzumab (Trz) molecules for the specific delivery of Palbociclib (Pal) to cells overexpressing human epidermal growth factor receptor 2 (HER2). FTIR analyses confirmed the successful preparation of the pHSNs and their bioconjugation. The labeled Trz-conjugated Pal-pHSNs (Trz-Pal-pHSNs) exhibited a size of approximately 170 nm, displaying a spherical shape with a neutral surface charge of -1.2 mV. Pal encapsulation reached ∼86%, and the release pattern followed a two-phase pH-dependent mechanism. MTT assessments demonstrated enhanced apoptosis induction, particularly in HER2-positive cells, by Trz-Pal-pHSNs. Fluorescence imaging further validated the internalization of particles into cells. In conclusion, Trz-Pal-pHSNs emerge as a promising platform for personalized medicine in the treatment of HER2-positive breast cancer.
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Affiliation(s)
- Shaghayegh Saharkhiz
- Department of Biotechnology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan 81746-73441, Iran
| | - Negar Nasri
- Department of Biotechnology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan 81746-73441, Iran
| | - Nazanin Naderi
- Department of Cell and Molecular Biology, Faculty of Life Science and Biotechnology, Shahid Beheshti University, Tehran 19839-69411, Iran
| | - Ghasem Dini
- Department of Nanotechnology, Faculty of Chemistry, University of Isfahan, Isfahan 81746-73441, Iran
| | - Saeid Shirzadi Ghalehshahi
- Department of Biotechnology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan 81746-73441, Iran
| | - Fateme Firoozbakht
- Department of Nanotechnology, Faculty of Chemistry, University of Isfahan, Isfahan 81746-73441, Iran
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Visser A, van de Ven EMW, Ruczynski LIA, Blaisse RJB, van Halteren HK, Aben K, van Laarhoven HWM. Cardiac monitoring during adjuvant trastuzumab therapy: Guideline adherence in clinical practice. Acta Oncol 2015. [PMID: 26217988 DOI: 10.3109/0284186x.2015.1068444] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cardiotoxicity is an important adverse effect of adjuvant breast cancer treatment with trastuzumab and three monthly left ventricular ejection fraction (LVEF) monitoring is considered mandatory. The purpose of this study was to gain insight into LVEF monitoring during adjuvant trastuzumab treatment in clinical practice. MATERIAL AND METHODS In a multicenter retrospective study encompassing 328 patients, of which 171 patients were actually treated with trastuzumab, we analyzed the frequency and mode of LVEF monitoring and compared it with LVEF monitoring guidelines. RESULTS The results indicated poor guideline adherence. In 9% of patients trastuzumab was started in spite of a low LVEF (< 55%). In 24% of patients no valid baseline LVEF value was available. LVEF measurements during treatment at three, six and 12 months were only performed in, respectively, 53%, 40% and 30% of patients. CONCLUSION A significant proportion of patients are treated with trastuzumab, while LVEF monitoring is not adequately performed. More attention should be paid to the implementation of (cardiac assessment) guidelines in clinical practice.
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Affiliation(s)
- Annemiek Visser
- Department of Medical Psychology, Radboud university medical center, Nijmegen, The Netherlands
| | - Eline M. W. van de Ven
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Larissa I. A. Ruczynski
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | | | | | - Katja Aben
- Comprehensive Cancer Centre The Netherlands, Utrecht, The Netherlands
- Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
In anatomic pathology, the current state encompassing the pre-analytic processes of tissue collection, handling, examination, preparation, processing, and storage are largely uncontrolled, inconsistently performed, and/or not standardized according to the sound scientific data. Pre-analytic defects result in nearly three-quarters of the problems in laboratory diagnostics. This is evident in quality surveys from well-respected institutions that document high miss rates in the required basics of information related to patient and tissue identity, let alone parameters documenting quality aspects related to the surgical specimen and its preservation. This talk will describe the historical approach to tissue processing and identify gaps from worldwide observations in current laboratory practices. It will also offer potential methodological and technological solutions and process improvements that laboratories may consider in serving the ultimate users of pathology information: the clinician and the patient. It illustrates the need for scientifically validated specimen guidelines and a performance based, standardized and documented "chain of custody" of the pre-analytical steps from the patient's body through fixation. For thought leaders and professional standard setters, opportunities for optimizing molecular studies exist in specimen collection, transfer, grossing, fixation, and decalcification protocols. In this evolving era of molecular profiling and personalized therapeutic decision-making, a well-reasoned and coordinated focus on pre-analytic processes that optimizes specimens for subsequent testing will result in: Improved specimen quality for molecular testing Improved accuracy of diagnostic and molecular test results Reduced Turnaroundtimes for same-day diagnosis Enhanced satisfaction of clinicians and patients.
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Affiliation(s)
- Franco Visinoni
- Milestone Srl, Via Fatebenefratelli 1/5, 24010, Sorisole Bergamo, Italy,
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Vucicevic D, Carey EJ, Karlin NJ. Trastuzumab-induced hepatotoxicity: a case report. ACTA ACUST UNITED AC 2014; 8:146-8. [PMID: 24419371 DOI: 10.1159/000346844] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Trastuzumab is a humanized monoclonal antibody approved for the treatment of breast cancer with HER2 amplification and/or overexpression. There are only 2 prior cases of trastuzumab-related hepatotoxicity reported in the literature. CASE REPORT We report the case of a 60-year-old woman who was treated with trastuzumab for stage I invasive ductal carcinoma of the right breast. She successfully completed 6 months of therapy when an increase in liver transaminases was noted on routine examination. A full work-up for causes of acute and chronic liver disease was negative. After review of the patient's medication list, trastuzumab was thought to be the most likely culprit for the liver injury, based on timing of administration and rise in liver enzymes.
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Affiliation(s)
- Darko Vucicevic
- Department of Internal Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | | | - Nina J Karlin
- Division of Hematology/Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
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LIU CHUNGHSIEN, LIN CHINGJU, TSAI KANJEN, CHUANG YICHING, HUANG YALING, LEE TSUNGHSIEN, HUANG LIJIAU, CHAN HSUCHIN. Biological evaluation of 9-[(6-chloropyridin-4-yl)methyl]-9H-carbazole-3-carbinol as an anticancer agent. Oncol Rep 2013; 29:1501-9. [DOI: 10.3892/or.2013.2255] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 11/19/2012] [Indexed: 11/06/2022] Open
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Groenen PJTA, Blokx WAM, Diepenbroek C, Burgers L, Visinoni F, Wesseling P, van Krieken JHJM. Preparing pathology for personalized medicine: possibilities for improvement of the pre-analytical phase. Histopathology 2011; 59:1-7. [DOI: 10.1111/j.1365-2559.2010.03711.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Aldrich MB, Wang X, Hart A, Sampath L, Marshall MV, Sevick-Muraca EM. Assessment of free dye in solutions of dual-labeled antibody conjugates for in vivo molecular imaging. Mol Imaging Biol 2011; 13:32-42. [PMID: 20458634 PMCID: PMC5312670 DOI: 10.1007/s11307-010-0328-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Recent preclinical and clinical studies show that dyes that excite and fluoresce in the near-infrared range may be used for tracking and detecting disease targets in vivo. A method for quantifying free dye molecules in antibody conjugate preparations is required for agent batch release and for translation into the clinic. PROCEDURES Herein, we developed and validated a SDS-PAGE method to determine the percentage of free IRDye 800 CW in (DTPA)(n)-trastuzumab-(IRDye 800)(m) conjugate sample preparations in which high-performance liquid chromatography (HPLC) assessment of free dye was not possible. RESULTS The SDS-PAGE assay was accurate and valid for free IRDye 800 CW amounts between 38 and 4 mol% of total dye. Gel sample preparation reagent affected the specificity of the assay, and lower and upper limits of quantitation and detection were determined. CONCLUSION This method may be applicable to other near-infrared dye-conjugated antibody-based imaging agents in which HPLC assessment of purity is not feasible. This validated method for quality assurance will facilitate the translation of dual-labeled antibody conjugates for nuclear and optical imaging.
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Affiliation(s)
- Melissa B. Aldrich
- Division of Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center-Houston, Houston, Texas
| | - XueJuan Wang
- Division of Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center-Houston, Houston, Texas
| | - Amy Hart
- Division of Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center-Houston, Houston, Texas
| | - Lakshmi Sampath
- Division of Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center-Houston, Houston, Texas
| | - Milton V. Marshall
- Division of Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center-Houston, Houston, Texas
| | - Eva M. Sevick-Muraca
- Division of Molecular Imaging, The Brown Foundation Institute of Molecular Medicine, University of Texas Health Sciences Center-Houston, Houston, Texas
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Vogel UF. Confirmation of a low HER2 positivity rate of breast carcinomas - limitations of immunohistochemistry and in situ hybridization. Diagn Pathol 2010; 5:50. [PMID: 20670419 PMCID: PMC2923103 DOI: 10.1186/1746-1596-5-50] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2010] [Accepted: 07/29/2010] [Indexed: 01/08/2023] Open
Abstract
Background Accurate assessment of the human epidermal growth factor receptor 2 (HER2) of invasive breast cancer is essential to treatment decisions since the advent of targeted therapy with the humanized monoclonal antibody trastuzumab and the dual tyrosine kinase inhibitor lapatinib. In the literature, the percentage of HER2-overexpressed/amplified breast carcinomas range from 3% to 30%. The routinely assigned low rate of 9% of HER2-overexpressed breast carcinomas alarmed one of our gynecologists who requested to confirm our HER2 test results. Methods A small study of 83 patients with breast carcinoma was designed to reexamine the routinely assessed HER2 status using immunohistochemistry and fluorescence in situ hybridization. Results The low rate of 9% of HER2-overexpressed/amplified breast tumors (DIN1C-3, invasive carcinoma) could be confirmed. However, FISH revealed two false positive cases and one false negative case. Moreover a case with an equivocal result in FISH was detected. Conclusion The HER2 positivity rate may be as low as 9%. The novel ASCO/CAP criteria for assessing immunohistochemical results in HER 2 testing reduce the false positive rate of HER2. First-line testing with immunohistochemistry may obscure false positive and false negative test results. In heterogeneous carcinomas even fluorescence in situ hybridization may not succeed in a correct evaluation of HER2.
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Affiliation(s)
- Ulrich F Vogel
- Institute of Pathology, University Hospital, Eberhard-Karls-University, Liebermeisterstrasse 8, 72076 Tuebingen, Germany.
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9
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Inhibition of phosphatidylcholine-specific phospholipase C downregulates HER2 overexpression on plasma membrane of breast cancer cells. Breast Cancer Res 2010; 12:R27. [PMID: 20462431 PMCID: PMC2917016 DOI: 10.1186/bcr2575] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 03/18/2010] [Accepted: 05/12/2010] [Indexed: 12/21/2022] Open
Abstract
Introduction Overexpression on plasma membrane of human epidermal growth factor receptor 2 (HER2) is reported in 25% to 30% of breast cancers. Heterodimer formation with cognate members of the epidermal growth factor receptor (EGFR) family, such as HER3 and EGFR, activates abnormal cell-signalling cascades responsible for tumorigenesis and further transcriptional HER2 gene upregulation. Targeting the molecular mechanisms controlling HER2 overexpression and recycling may effectively deactivate this feedback-amplification loop. We recently showed that inactivation of phosphatidylcholine-specific phospholipase C (PC-PLC) may exert a pivotal role in selectively modulating the expression on the membrane of specific receptors or proteins relevant to cell function. In the present study, we investigated the capability of PC-PLC inhibition to target the molecular mechanisms controlling HER2 overexpression on the membrane of breast cancer cells by altering the rates of its endocytosis and lysosomal degradation. Methods Localization on the membrane and interaction of PC-PLC with HER2, EGFR, and HER3 were investigated on HER2-overexpressing and HER2-low breast cancer cell lines, by using confocal laser scanning microscopy, flow cytometry, cell-surface biotinylation, isolation of lipid rafts, and immunoprecipitation experiments. The effects of the PC-PLC inhibitor tricyclodecan-9-yl-potassium xanthate (D609) on HER2 expression on the membrane and on the levels of overall HER2, HER2-HER3, and HER2-EGFR contents were monitored in the HER2-overexpressing SKBr3 cells, after either transient or continuous receptor engagement with anti-HER2 monoclonal antibodies, including trastuzumab. Changes of HER2 expression and cell proliferation were examined in SKBr3, BT-474, and MDA-MB-453 cells continuously exposed to D609 alone or combined with trastuzumab. Results PC-PLC selectively accumulates on the plasma membrane of HER2-overexpressing cells, where it colocalizes and associates with HER2 in raft domains. PC-PLC inhibition resulted in enhanced HER2 internalization and lysosomal degradation, inducing downmodulation of HER2 expression on the membrane. Moreover, PC-PLC inhibition resulted in strong retardation of HER2 reexpression on the membrane and a decrease in the overall cellular contents of HER2, HER2-HER3, and HER2-EGFR heterodimers. The PC-PLC inhibitor also induced antiproliferative effects, especially in trastuzumab-resistant cells. Conclusions The results pointed to PC-PLC inhibition as a potential means to counteract the tumorigenic effects of HER2 amplification and complement the effectiveness of current HER2-targeting therapies.
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10
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Shih YCT, Elting LS, Pavluck AL, Stewart A, Halpern MT. Immunotherapy in the Initial Treatment of Newly Diagnosed Cancer Patients: Utilization Trend and Cost Projections for Non-Hodgkin's Lymphoma, Metastatic Breast Cancer, and Metastatic Colorectal Cancer. Cancer Invest 2009; 28:46-53. [DOI: 10.3109/07357900902783187] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Fiúza M. Cardiotoxicity associated with trastuzumab treatment of HER2+ breast cancer. Adv Ther 2009; 26 Suppl 1:S9-17. [PMID: 19669637 DOI: 10.1007/s12325-009-0048-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Although having high clinical efficacy in the treatment of human epidermal growth factor receptor-2 (HER2+) metastatic breast cancer, trastuzumab has been associated with cardiotoxicity, and the etiology and pathogenesis of this condition is currently under investigation. METHODS This paper reviews the cardiotoxicity, associated with trastuzumab use and discusses the risk assessment and management of cardiac dysfunction. RESULTS The increased risk of cardiotoxicity is lower when trastuzumab is given as monotherapy (3%-7%) compared with anthracyclines + trastuzumab therapy (27%). Type II cardiac changes occur in trastuzumab-treated patients, which do not appear to be dose-related, are not associated with histological changes, and are generally reversible. Several risk factors for cardiac events have been identified and assessing levels of troponin I and N-terminal pro-brain B-type natriuretic peptide before and after treatment with trastuzumab may allow early detection of cardiotoxicity. A symptomatic and functional evaluation scheme for patients indicated for treatment with trastuzumab has also been proposed to work alongside therapeutic options for the treatment of heart failure. CONCLUSION The risk of cardiac dysfunction associated with trastuzumab can be justified given the increase in overall survival. This risk is lower when trastuzumab is given as monotherapy. The paradigm for cardiologists remains the same: treat the cancer effectively whilst preventing cardiotoxicity.
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Affiliation(s)
- Manuela Fiúza
- Cardiology Service, Hospital of Santa Maria, University Clinic of Cardiology, Lisbon, Portugal.
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12
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Vicente C, Serrano N, Agustín M, Alonso V, Palomo P, Huarte R. Cardiotoxicidad asociada a trastuzumab en la práctica clínica asistencial. FARMACIA HOSPITALARIA 2009. [DOI: 10.1016/s1130-6343(09)72165-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Orlando FA, Brown KD. Unraveling breast cancer heterogeneity through transcriptomic and epigenomic analysis. Ann Surg Oncol 2009; 16:2270-9. [PMID: 19452229 DOI: 10.1245/s10434-009-0500-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 03/31/2009] [Accepted: 04/19/2009] [Indexed: 12/31/2022]
Abstract
Breast cancer diversity is histologically evident as various proliferative benign lesions, in situ carcinomas, and invasive carcinomas that may develop into distant metastases. Breast tumor molecular subtypes have been defined by genome-wide expression microarray technology and reveal associations between genetic alterations and the malignant phenotype. Early work has been conducted to use subtype-specific biomarkers to elucidate targeted treatment options early in the course of breast cancer progression. Additionally, DNA methylation is an epigenetic modification that contributes to breast cancer progression by transcriptionally silencing certain tumor suppressor genes. Among the genes characterized as targets for silencing are well-established tumor suppressors such as RASSF1A, RARB, SFN, and TGM2. Measuring elevated gene copy number and aberrant gene promoter methylation can further facilitate characterization of breast tumor molecular subtype; however, profiling of breast tumors based on epigenetic criteria has yet to be established. Epigenomic analysis has been investigated for clinical applicability, and it has great promise when used in combination with minimally invasive techniques for both diagnostic and prognostic purposes.
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Affiliation(s)
- Frank A Orlando
- Department of Surgery, University of Florida College of Medicine and UF Shands Cancer Center, Gainesville, FL, USA.
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14
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Adjuvant chemotherapy for early breast cancer in the elderly. Curr Treat Options Oncol 2009; 10:144-58. [PMID: 19360475 DOI: 10.1007/s11864-009-0092-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 03/04/2009] [Indexed: 10/20/2022]
Abstract
The use of cytotoxic therapy in the fit elderly breast cancer patient has been tempered with concerns of age, physical function, and co-morbid illness. In the appropriate patient with biologically aggressive disease, such as receptor poor breast cancer, it is reasonable to consider combination chemotherapy as part of an adjuvant program. If this approach is to be employed, the physician must also consider the patient's co-morbid conditions and status of function in society as potential indicators of toxicity or lack of benefit. In this case, a formal geriatric assessment is of value. A Cancer and Leukemia Group B (CALGB) trial of monotherapy vs combination cytotoxic therapy as adjuvant treatment for localized breast cancer patients over 65 years of age has determined that the combination approach is superior to single agent therapy. In an unplanned analysis of receptor rich and receptor poor tumors, the patients with receptor poor tumors seemed to achieve the greatest benefit from combination cytotoxic therapy. Adjuvant chemotherapy can also be considered for patients with high-risk receptor rich breast cancers. However, the use of chemotherapy in the elderly patient with breast cancer is largely based upon data emerging from trials in younger patients. Studies specifically for patients over 65 years of age are urgently needed in this population to provide evidence-based proof of the current approach.
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15
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Ross JS, Slodkowska EA, Symmans WF, Pusztai L, Ravdin PM, Hortobagyi GN. The HER-2 receptor and breast cancer: ten years of targeted anti-HER-2 therapy and personalized medicine. Oncologist 2009; 14:320-68. [PMID: 19346299 DOI: 10.1634/theoncologist.2008-0230] [Citation(s) in RCA: 836] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The human epidermal growth factor receptor (HER-2) oncogene encodes a transmembrane tyrosine kinase receptor that has evolved as a major classifier of invasive breast cancer and target of therapy for the disease. The validation of the general prognostic significance of HER-2 gene amplification and protein overexpression in the absence of anti-HER-2 targeted therapy is discussed in a study of 107 published studies involving 39,730 patients, which produced an overall HER-2-positive rate of 22.2% and a mean relative risk for overall survival (OS) of 2.74. The issue of HER-2 status in primary versus metastatic breast cancer is considered along with a section on the features of metastatic HER-2-positive disease. The major marketed slide-based HER-2 testing approaches, immunohistochemistry, fluorescence in situ hybridization, and chromogenic in situ hybridization, are presented and contrasted in detail against the background of the published American Society of Clinical Oncology-College of American Pathologists guidelines for HER-2 testing. Testing issues, such as the impact of chromosome 17 polysomy and local versus central HER-2 testing, are also discussed. Emerging novel HER-2 testing techniques, including mRNA-based testing by real-time polymerase chain reaction and DNA microarray methods, HER-2 receptor dimerization, phosphorylated HER-2 receptors, and HER-2 status in circulating tumor cells, are also considered. A series of biomarkers potentially associated with resistance to trastuzumab is discussed with emphasis on the phosphatase and tensin homologue deleted on chromosome ten/Akt and insulin-like growth factor receptor pathways. The efficacy results for the more recently approved small molecule HER-1/HER-2 kinase inhibitor lapatinib are also presented along with a more limited review of markers of resistance for this agent. Additional topics in this section include combinations of both anti-HER-2 targeted therapies together as well as with novel agents including bevacizumab, everolimus, and tenespimycin. A series of novel HER-2-targeting agents is also presented, including pertuzumab, ertumaxomab, HER-2 vaccines, and recently discovered tyrosine kinase inhibitors. Biomarkers predictive of HER-2 targeted therapy toxicity are included, and the review concludes with a consideration of HER-2 status in the prediction of response to non-HER-2 targeted treatments including hormonal therapy, anthracyclines, and taxanes.
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Affiliation(s)
- Jeffrey S Ross
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY 12208, USA.
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16
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Schlotter CM, Vogt U, Allgayer H, Brandt B. Molecular targeted therapies for breast cancer treatment. Breast Cancer Res 2008; 10:211. [PMID: 18671839 PMCID: PMC2575526 DOI: 10.1186/bcr2112] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Targeting the oestrogen receptor, HER2 (human epidermal growth factor receptor 2) and vascular endothelial growth factor has markedly improved breast cancer therapy. New targeted therapeutic approaches to induction of apoptosis or inhibition of anti-apoptosis, cell cycle progression, signal transduction and angiogenesis are described. The molecular pathways and their inhibitory or repair mechanisms are discussed in the preclinical and clinical settings.
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Affiliation(s)
- Claus M Schlotter
- Department of Obstetrics and Gynecology, Breast Centre Klinikum Lüdenscheid, Academic Teaching Hospital of the University Bonn, Luedenscheid, Paulmannshoeher Str, 14 - 58515 Luedenscheid Germany
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Abstract
PURPOSE OF REVIEW Adenocarcinomas of the gallbladder are uncommon, aggressive tumors with poor survival. This review summarizes advances in understanding the biology of gallbladder cancer. RECENT FINDINGS Published response rates of adenocarcinomas of the gallbladder to chemotherapy are less than 30% and no survival benefit has been demonstrated from palliative systemic therapy. New information on the molecular carcinogenic mechanisms of these malignancies, combined with findings from animal models, may lead to improved treatment for patients. SUMMARY Improved understanding of the molecular carcinogenesis of adenocarcinomas of the gallbladder, coupled with the availability of novel molecularly 'targeted' chemotherapeutic agents, may improve outcome for patients.
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18
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Sengupta PP, Northfelt DW, Gentile F, Zamorano JL, Khandheria BK. Trastuzumab-induced cardiotoxicity: heart failure at the crossroads. Mayo Clin Proc 2008; 83:197-203. [PMID: 18241629 DOI: 10.4065/83.2.197] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Trastuzumab, a drug targeting human epidermal growth factor receptor 2, improves survival rate in women with metastatic breast cancer. Symptomatic heart failure, a serious adverse effect of trastuzumab, occurs in 1% to 4% of patients treated with the antibody, whereas left ventricular ejection fraction declines substantially in 10% of patients. The prevalence of cardiotoxic effects of trastuzumab appears to increase with exposure to anthracyclines. Serial assessment of left ventricular function with 2-dimensional echocardiography or radionuclide ventriculography is the most practical means of monitoring cardiotoxicity. Patients who develop cardiotoxicity while receiving trastuzumab therapy generally improve once use of the agent is discontinued.
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Affiliation(s)
- Partho P Sengupta
- Division of Cardiovascular Diseases, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA
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Clark JCM, Dass CR, Choong PFM. A review of clinical and molecular prognostic factors in osteosarcoma. J Cancer Res Clin Oncol 2007; 134:281-97. [PMID: 17965883 DOI: 10.1007/s00432-007-0330-x] [Citation(s) in RCA: 207] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Accepted: 10/08/2007] [Indexed: 12/11/2022]
Abstract
Traditional prognostic determinants in osteosarcoma have included demographics (age, sex), tumour size, site, stage, and the response to chemotherapy. Many of these are determined using varying techniques and units of measurement, which can make comparison between studies difficult. The absence of survival difference between limb sparing surgery and amputation has been repeatedly demonstrated in primary disease, and even in the setting of pathological fracture. On the other hand, there is still some controversy over the existence of increased local recurrence for limb-sparing surgery, and the implications of this. Commonly used prognostic determinants such as metastases, and response to chemotherapy enable a high degree of prognostic accuracy but usually at a late stage in the course of disease. Leading on from this, there is a need to uncover molecular pathways with specific influence over osteosarcoma progression to facilitate earlier treatment changes. Some important pathways are already being defined, for example the association of CXCR4 with metastases on presentation, the likelihood of doxorubicin resistance with positive P-glycoprotein, and the reduced survival prediction of over expressed survivin. It is anticipated that the future of osteosarcoma treatment will involve treatment tailored to the molecular profile of tumours at diagnosis, adjuvant therapy directed towards dysfunctional molecular pathways rather than the use of cytotoxics, and a more standardised approach to the measurement of clinical prognostic factors.
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Affiliation(s)
- Jonathan C M Clark
- Department of Orthopaedics, University of Melbourne, St. Vincent's Hospital, P.O. Box 2900, Fitzroy, Melbourne, VIC 3065, Australia
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