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Fatima GN, Fatma H, Saraf SK. Vaccines in Breast Cancer: Challenges and Breakthroughs. Diagnostics (Basel) 2023; 13:2175. [PMID: 37443570 DOI: 10.3390/diagnostics13132175] [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: 04/17/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Breast cancer is a problem for women's health globally. Early detection techniques come in a variety of forms ranging from local to systemic and from non-invasive to invasive. The treatment of cancer has always been challenging despite the availability of a wide range of therapeutics. This is either due to the variable behaviour and heterogeneity of the proliferating cells and/or the individual's response towards the treatment applied. However, advancements in cancer biology and scientific technology have changed the course of the cancer treatment approach. This current review briefly encompasses the diagnostics, the latest and most recent breakthrough strategies and challenges, and the limitations in fighting breast cancer, emphasising the development of breast cancer vaccines. It also includes the filed/granted patents referring to the same aspects.
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Affiliation(s)
- Gul Naz Fatima
- Division of Pharmaceutical Chemistry, Faculty of Pharmacy, Babu Banarasi Das Northern India Institute of Technology, Lucknow 226028, Uttar Pradesh, India
| | - Hera Fatma
- Division of Pharmaceutical Chemistry, Faculty of Pharmacy, Babu Banarasi Das Northern India Institute of Technology, Lucknow 226028, Uttar Pradesh, India
| | - Shailendra K Saraf
- Division of Pharmaceutical Chemistry, Faculty of Pharmacy, Babu Banarasi Das Northern India Institute of Technology, Lucknow 226028, Uttar Pradesh, India
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Regan MM, Walley BA, Francis PA, Fleming GF, Láng I, Gómez HL, Colleoni M, Tondini C, Pinotti G, Salim M, Spazzapan S, Parmar V, Ruhstaller T, Abdi EA, Gelber RD, Coates AS, Goldhirsch A, Pagani O. Concurrent and sequential initiation of ovarian function suppression with chemotherapy in premenopausal women with endocrine-responsive early breast cancer: an exploratory analysis of TEXT and SOFT. Ann Oncol 2017; 28:2225-2232. [PMID: 28911092 PMCID: PMC5834112 DOI: 10.1093/annonc/mdx285] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recent breast cancer treatment guidelines recommend that higher-risk premenopausal patients should receive ovarian function suppression (OFS) as part of adjuvant endocrine therapy. If chemotherapy is also given, it is uncertain whether to select concurrent or sequential OFS initiation. DESIGN AND METHODS We analyzed 1872 patients enrolled in the randomized phase III TEXT and SOFT trials who received adjuvant chemotherapy for hormone receptor-positive, HER2-negative breast cancer and upon randomization to an OFS-containing adjuvant endocrine therapy, initiated gonadotropin-releasing-hormone-agonist triptorelin. Breast cancer-free interval (BCFI) was compared between patients who received OFS concurrently with chemotherapy in TEXT (n = 1242) versus sequentially post-chemotherapy in SOFT (n = 630). Because timing of trial enrollment relative to adjuvant chemotherapy differed, we implemented landmark analysis re-defining BCFI beginning 1 year after final dose of chemotherapy (median, 15.5 and 8.1 months from enrollment to landmark in TEXT and SOFT, respectively). As a non-randomized treatment comparison, we implemented comparative-effectiveness propensity score methodology with weighted Cox modeling. RESULTS Distributions of several clinico-pathologic characteristics differed between groups. Patients who were premenopausal post-chemotherapy in SOFT were younger on average. The median duration of adjuvant chemotherapy was 18 weeks in both groups. There were 231 (12%) BC events after post-landmark median follow-up of about 5 years. Concurrent use of triptorelin with chemotherapy was not associated with a significant difference in post-landmark BCFI compared with sequential triptorelin post-chemotherapy, either in the overall population (HR = 1.11, 95% CI 0.72-1.72; P = 0.72; 4-year BCFI 89% in both groups), or in the subgroup of 692 women <40 years at diagnosis (HR = 1.13, 95% CI 0.69-1.84) who are less likely to develop chemotherapy-induced amenorrhea. CONCLUSION Based on comparative-effectiveness modeling of TEXT and SOFT after about 5 years median follow-up, with limited statistical power especially for the subgroup <40 years, neither detrimental nor beneficial effect of concurrent administration of OFS with chemotherapy on the efficacy of adjuvant therapy that includes chemotherapy was detected. CLINICALTRIALS.GOV NCT00066690 and NCT00066703.
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Affiliation(s)
- M. M. Regan
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston
- International Breast Cancer Study Group Statistical Center, Boston, USA
| | - B. A. Walley
- University of Calgary and Canadian Cancer Trials Group, Calgary, Canada
| | - P. A. Francis
- Division of Cancer Medicine, Peter MacCallum Cancer Center, St Vincent’s Hospital, University of Melbourne, Melbourne
- Australia & New Zealand Breast Cancer Trials Group and International Breast Cancer Study Group, Melbourne, Australia
| | - G. F. Fleming
- The University of Chicago Medical Center and Alliance for Clinical Trials in Oncology, Chicago, USA
| | - I. Láng
- National Institute of Oncology and International Breast Cancer Study Group, Medical Oncology, Budapest, Hungary
| | - H. L. Gómez
- Division of Medicine, Instituto Nacional de Enfermedades Neoplásicas and International Breast Cancer Study Group, Lima, Peru
| | - M. Colleoni
- Division of Medical Senology, European Institute of Oncology and International Breast Cancer Study Group, Milan
| | - C. Tondini
- Medical Oncology, Ospedale Papa Giovanni XXIII and International Breast Cancer Study Group, Bergamo
| | - G. Pinotti
- Medical Oncology, ASST Sette Laghi-Ospedale di Circolo and Fondazione Macchi and International Breast Cancer Study Group, Varese, Italy
| | - M. Salim
- Allan Blair Cancer Center, Regina, Canada
| | - S. Spazzapan
- Medical Oncology, Centro di Riferimento Oncologico and International Breast Cancer Study Group, Aviano, Italy
| | - V. Parmar
- Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre and International Breast Cancer Study Group, Mumbai, India
| | - T. Ruhstaller
- Breast Center St. Gallen, Swiss Group for Clinical Cancer Research (SAKK) , St. Gallen
- International Breast Cancer Study Group, St. Gallen, Switzerland
| | - E. A. Abdi
- Australia & New Zealand Breast Cancer Trials Group and International Breast Cancer Study Group, The Tweed Hospital, Griffith University Gold Coast, Tweed Heads, Australia
| | - R. D. Gelber
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston
- Harvard T.H. Chan School of Public Health, Frontier Science and Technology Research Foundation, Boston, USA
| | - A. S. Coates
- International Breast Cancer Study Group and University of Sydney, Sydney, Australia
| | - A. Goldhirsch
- European Institute of Oncology and International Breast Cancer Study Group, Milan, Italy
| | - O. Pagani
- Oncology Institute of Southern Switzerland, Swiss Group for Clinical Cancer Research (SAKK), Bellinzona
- International Breast Cancer Study Group, Lugano, Viganello, Switzerland
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Bedognetti D, Sertoli MR, Pronzato P, Del Mastro L, Venturini M, Taveggia P, Zanardi E, Siffredi G, Pastorino S, Queirolo P, Gardin G, Wang E, Monzeglio C, Boccardo F, Bruzzi P. Concurrent vs sequential adjuvant chemotherapy and hormone therapy in breast cancer: a multicenter randomized phase III trial. J Natl Cancer Inst 2011; 103:1529-39. [PMID: 21921285 DOI: 10.1093/jnci/djr351] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The most appropriate timing of chemotherapy and hormone therapy administration is a critical issue in early breast cancer patients. The purpose of our study was to compare the efficacy of concurrent vs sequential administration of adjuvant chemotherapy and tamoxifen. METHODS Women with node-positive primary breast cancer were randomly assigned to receive tamoxifen (20 mg/d for 5 years) during (concurrent arm) or after (sequential arm) adjuvant chemotherapy. Chemotherapy consisted of alternating regimens of cyclophosphamide, epidoxorubicin, and 5-fluorouracil and cyclophosphamide, methotrexate, and 5-fluorouracil every 21 days for a total of 12 cycles. The primary endpoint was overall survival (OS), and secondary endpoints were toxic effects and disease-free survival (DFS). No provision for interim analyses was made in the original study protocol. Survival curves were estimated by the Kaplan-Meier method. Multivariable Cox regression models, adjusted for age, menopausal status, tumor stage, and lymph node and hormone receptor status, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. RESULTS From 1985 to 1992, 431 patients were randomly assigned and studied according to the intention-to-treat principle. After a maximum of 15.4 years of follow-up (median 12.3 years), the estimated actuarial 10-year OS was equivalent for the two study arms (concurrent arm: 111 patients, 66%, 95% CI = 59% to 72%; sequential arm: 114 patients, 65%, 95% CI = 59% to 72%, P = .86). No differences in DFS and toxic effects were evident. Four interim analyses were performed, but no alpha error adjustment was necessary because of the largely negative results of this final analysis (sequential vs concurrent arm: HR of death = 1.06, 95% CI = 0.78 to 1.44, P = .76; HR of relapse = 1.16, 95% CI = 0.88 to 1.52, P = .36). CONCLUSIONS No statistically significant differences in OS, DFS, and toxic effects between concurrent and sequential adjuvant chemo- and hormone therapies were observed. Our study does not support the superiority of one schedule of chemo- and hormone-therapy administration over the other. However, because of the limited statistical power of the study, these results must be considered with caution.
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Affiliation(s)
- Davide Bedognetti
- Infectious Disease and Immunogenetics Section (IDIS), Department of Transfusion Medicine, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
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Hara S, Ichikawa T, Akimoto S, Wakisaka M, Shimazaki J. Modalities of chemotherapy and endocrine therapy for growth inhibition of androgen-stimulated mouse carcinoma (Shionogi carcinoma 115). Prostate 1987; 11:107-15. [PMID: 3671190 DOI: 10.1002/pros.2990110202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Effects of chemotherapy and endocrine therapy applied individually or in combination on growth of an androgen-stimulated mouse tumor, Shionogi carcinoma 115 (SC 115), were examined. In the present study cyclophosphamide and castration were used as chemo- and endocrine therapy, respectively, and simultaneous combination of these two treatments was found to be the most effective in inhibiting tumor growth. When comparing the effect of castration alone with that of injection of cyclophosphamide alone, the former retarded the tumor growth more efficiently, but relapse occurred in both instances. Injection of cyclophosphamide to the relapsed tumor after castration caused a marked effect when compared with the effect of the drug on the untreated or the chemotherapy-relapsed tumors. Castration caused a retardation of growth in the chemotherapy-relapsed tumor, but the survival period was shorter than that observed in the mice that received castration followed by injection of cyclophosphamide. From these results, it was concluded that castration followed by chemotherapy was the preferred order among sequential treatments for the SC 115; however, the optimal treatment was produced by simultaneous combination of chemotherapy plus castration.
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Affiliation(s)
- S Hara
- Department of Urology, School of Medicine, Chiba University, Japan
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