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Connolly RM, Miller KD. Back to the Beginning: The Role of Ovarian Suppression in Management of Hormone Sensitive Breast Cancer in Premenopausal Women. J Clin Oncol 2023; 41:1339-1341. [PMID: 36521079 DOI: 10.1200/jco.22.02319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Roisin M Connolly
- Cancer Research @UCC, College of Medicine & Health, University College Cork, Cork, Ireland
| | - Kathy D Miller
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Bloomington, IN
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Khan F, Rojas K, Schlumbrecht M, Jeudin P. Oophorectomy in Premenopausal Patients with Estrogen Receptor-Positive Breast Cancer: New Insights into Long-Term Effects. Curr Oncol 2023; 30:1794-1804. [PMID: 36826100 PMCID: PMC9954995 DOI: 10.3390/curroncol30020139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/19/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
Approximately 80% of breast cancers are estrogen receptor-positive (ER+), and 68-80% of those occur in premenopausal or perimenopausal women. Since the introduction of tamoxifen for adjuvant endocrine therapy in women with non-metastatic ER+ breast cancer, subsequent trials have demonstrated an oncologic benefit with the addition of ovarian function suppression (OFS) to adjuvant endocrine therapy. Subsequently, therapies to either suppress or ablate ovarian function may be included in the treatment plan for patients that remain premenopausal or perimenopausal after upfront or adjuvant chemotherapy and primary surgery. One strategy for OFS, bilateral salpingo-oophorectomy (BSO), has lasting implications, and the routine recommendation for this strategy warrants a critical analysis in this population. The following is a narrative review of the utility of ovarian suppression or ablation (through either bilateral oophorectomy or radiation) in the context of adjuvant endocrine therapy, including selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). The long-term sequelae of bilateral oophorectomy include cardiovascular and bone density morbidity along with sexual dysfunction, negatively impacting overall quality of life. As gynecologists are the providers consulted to perform bilateral oophorectomies in this population, careful consideration of each patient's oncologic prognosis, cardiovascular risk, and psychosocial factors should be included in the preoperative assessment to assist in shared decision-making and prevent the lifelong adverse effects that may result from overtreatment.
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Affiliation(s)
- Fatima Khan
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 N.W. 14th Street, Miami, FL 33136, USA
| | - Kristin Rojas
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 N.W. 14th Street, Miami, FL 33136, USA
- Dewitt Daughtry Department of Surgery, University of Miami, Miami, FL 33136, USA
| | - Matthew Schlumbrecht
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 N.W. 14th Street, Miami, FL 33136, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA
- Division of Gynecologic Oncology, University of Miami, Miami, FL 33136, USA
| | - Patricia Jeudin
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, 1120 N.W. 14th Street, Miami, FL 33136, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA
- Division of Gynecologic Oncology, University of Miami, Miami, FL 33136, USA
- Correspondence:
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Huang L, Huang J, Nie H, Li Y, Song L, Wu F. Design, synthesis and biological evaluation of combretastatin A-4 sulfamate derivatives as potential anti-cancer agents. RSC Med Chem 2021; 12:1374-1380. [PMID: 34458740 PMCID: PMC8372205 DOI: 10.1039/d0md00372g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/17/2021] [Indexed: 01/20/2023] Open
Abstract
A series of combretastatin A-4 (CA-4) sulfamate derivatives were synthesized and their structure-activity relationship on tubulin, arylsulfatase and tumor cell antiproliferation inhibition was studied. Among them, compound 16a showed excellent potency as well as CA-4 under the same conditions against six tumor cells including HTC-116, HeLa, HepG2, MGC803, MKN45 and MCF-7 cells, respectively. Molecular docking revealed that several important hydrogen bond interactions were formed between the sulfamate group of 16a and the colchicine binding site of tubulin and steroid sulfatase respectively. Although compound 16a was less active than CA-4 in regard to its in vitro activity as an inhibitor of tubulin polymerization, it was effective as an inhibitor of arylsulfatase. This novel combretastatin A-4 sulfamate derivative has the potential to be developed as a dual inhibitor of tubulin polymerization and arylsulfatase for cancer therapy.
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Affiliation(s)
- Leilei Huang
- Department of Pharmaceutical Engineering, School of Chemical and Environmental Engineering, Shanghai Institute of Technology Shanghai China
| | - Jinwen Huang
- Department of Pharmaceutical Engineering, School of Chemical and Environmental Engineering, Shanghai Institute of Technology Shanghai China
- Shanghai Engineering Research Center of Green Fluoropharmaceutical Technology China
- Key Laboratory of Organofluorine Chemistry, Shanghai Institute of Organic Chemistry CAS China
| | - Hui Nie
- Department of Pharmaceutical Engineering, School of Chemical and Environmental Engineering, Shanghai Institute of Technology Shanghai China
| | - Yingzi Li
- Department of Pharmaceutical Engineering, School of Chemical and Environmental Engineering, Shanghai Institute of Technology Shanghai China
| | - Lixing Song
- Department of Pharmaceutical Engineering, School of Chemical and Environmental Engineering, Shanghai Institute of Technology Shanghai China
| | - Fanhong Wu
- Department of Pharmaceutical Engineering, School of Chemical and Environmental Engineering, Shanghai Institute of Technology Shanghai China
- Shanghai Engineering Research Center of Green Fluoropharmaceutical Technology China
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Lin TH, Gao HW, Liao GS, Yu JC, Dai MS, Ho JY, Yu CP. Amongst Women Stratified to Receive Endocrine Therapy on the Basis of Their Tumor Estrogen and Progesterone Receptor Levels, Those with Higher Tumor Progesterone Receptor Levels Had a Better Outcome Than Those with Lower Levels of Tumor Progesterone Receptor. Cancers (Basel) 2021; 13:cancers13040905. [PMID: 33670083 PMCID: PMC7926358 DOI: 10.3390/cancers13040905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death of women worldwide. Several cut-points for estrogen receptor (ER) and progesterone receptor (PgR) have been proposed as predictive effects of hormone therapy; while the cut-off values were inconsistent. The aim of our retrospective study was to propose better prognostic cut-off levels for ER and PgR, and their effects on breast cancer-specific survival (BCSS) and disease-free survival (DFS) over 5 and 10 years were evaluated in 1807 eligible patients. Subgroups were generated based on ER and PgR expression percentage and scoring from the Allred scoring system (Allred scores). After comparing the hazard ratios (event rates in each group to reference group) of BCSS and DFS using multivariate analyses, our results suggested that patients with PgR expression ≤50% or Allred score ≤5 revealed a poor prognosis and should be paid more attention during follow-up. Abstract Background: To realize the association between stratified expression levels of ER and PgR and long-term prognosis of breast cancer patients who received adjuvant hormone therapy, this study aimed to propose better prognostic cut-off levels for estrogen receptor (ER) and progesterone receptor (PgR). Methods: Patients who received adjuvant hormone therapy after surgical intervention were selected. The ER and PgR status and their effects on breast cancer-specific survival (BCSS) and disease-free survival (DFS) over 5 and 10 years were evaluated. Next, subgroups were generated based on ER and PgR expression percentage and Allred scores. Survival curves were constructed using the Kaplan–Meier method. Results: ER and PgR expression were significantly associated with better prognosis in 5 years, whereas only PgR expression was significantly associated during the 10-year follow-up. The optimal cut-off values for better 5-year BCSS were ER > 50%; ER Allred score > 7; PgR ≥ 1%; or PgR Allred score ≥ 3; the corresponding values for DFS were ER > 40%; ER Allred score > 6; PgR > 10%; or PgR Allred score ≥ 3. In the long-term follow-up, PgR of > 50% or Allred score of > 5 carriers revealed a better prognosis of both BCSS and DFS. Conclusion: Patients with a PgR expression > 50% or an Allred score > 5 exhibited better 10-year BCSS and DFS.
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Affiliation(s)
- Tai-Han Lin
- Department of Pathology and Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, No. 161, Section 6, Minquan E. Road, Neihu District, Taipei 114, Taiwan; (T.-H.L.); (H.-W.G.)
| | - Hong-Wei Gao
- Department of Pathology and Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, No. 161, Section 6, Minquan E. Road, Neihu District, Taipei 114, Taiwan; (T.-H.L.); (H.-W.G.)
| | - Guo-Shiou Liao
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (G.-S.L.); (J.-C.Y.)
| | - Jyh-Cherng Yu
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (G.-S.L.); (J.-C.Y.)
| | - Ming-Shen Dai
- Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
| | - Jar-Yi Ho
- Department of Pathology and Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, No. 161, Section 6, Minquan E. Road, Neihu District, Taipei 114, Taiwan; (T.-H.L.); (H.-W.G.)
- Graduate Institute of Life Sciences, National Defense Medical Center, No. 161, Section 6, Minquan E. Road, Neihu District, Taipei 114, Taiwan
- Correspondence: (J.-Y.H.); (C.-P.Y.)
| | - Cheng-Ping Yu
- Department of Pathology and Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, No. 161, Section 6, Minquan E. Road, Neihu District, Taipei 114, Taiwan; (T.-H.L.); (H.-W.G.)
- Graduate Institute of Life Sciences, National Defense Medical Center, No. 161, Section 6, Minquan E. Road, Neihu District, Taipei 114, Taiwan
- Correspondence: (J.-Y.H.); (C.-P.Y.)
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Lambertini M, Del Mastro L, Viglietti G, Pondé NF, Solinas C, de Azambuja E. Ovarian Function Suppression in Premenopausal Women with Early-Stage Breast Cancer. Curr Treat Options Oncol 2017; 18:4. [DOI: 10.1007/s11864-017-0442-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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