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Tufail M, Hu JJ, Liang J, He CY, Wan WD, Huang YQ, Jiang CH, Wu H, Li N. Predictive, preventive, and personalized medicine in breast cancer: targeting the PI3K pathway. J Transl Med 2024; 22:15. [PMID: 38172946 PMCID: PMC10765967 DOI: 10.1186/s12967-023-04841-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
Breast cancer (BC) is a multifaceted disease characterized by distinct molecular subtypes and varying responses to treatment. In BC, the phosphatidylinositol 3-kinase (PI3K) pathway has emerged as a crucial contributor to the development, advancement, and resistance to treatment. This review article explores the implications of the PI3K pathway in predictive, preventive, and personalized medicine for BC. It emphasizes the identification of predictive biomarkers, such as PIK3CA mutations, and the utility of molecular profiling in guiding treatment decisions. The review also discusses the potential of targeting the PI3K pathway for preventive strategies and the customization of therapy based on tumor stage, molecular subtypes, and genetic alterations. Overcoming resistance to PI3K inhibitors and exploring combination therapies are addressed as important considerations. While this field holds promise in improving patient outcomes, further research and clinical trials are needed to validate these approaches and translate them into clinical practice.
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Affiliation(s)
- Muhammad Tufail
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
| | - Jia-Ju Hu
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Liang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
| | - Cai-Yun He
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
| | - Wen-Dong Wan
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu-Qi Huang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
| | - Can-Hua Jiang
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China
- Institute of Oral Precancerous Lesions, Central South University, Changsha, China
- Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hong Wu
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha, 410083, China
| | - Ning Li
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, China.
- Institute of Oral Precancerous Lesions, Central South University, Changsha, China.
- Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Geisler J, Karihtala P, Tuxen M, Valachis A, Holm B. Current treatment landscape of HR+/HER2- advanced breast cancer in the Nordics: a modified Delphi study. Acta Oncol 2023; 62:1680-1688. [PMID: 37713138 DOI: 10.1080/0284186x.2023.2254475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 08/06/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND This Delphi study aimed to assess current perspectives on hormone receptor-positive/human epidermal growth factor receptor 2-negative(HR+/HER2-) advanced breast cancer (aBC) treatment strategies across the Nordics, and to establish where consensus exists across the Nordics on HR+/HER2- aBC treatment. MATERIAL AND METHODS A modified, three-round Delphi method was followed. A steering committee was appointed for study coordination, panellist selection, and questionnaire development. The questionnaires covered relevant topics on HR+/HER2- aBC treatment: treatment patterns in different lines of therapy (first [1L], second [2L], and third [3L]), oligometastatic disease, de novo aBC, brain metastases, age as influential factor, visceral crisis, radiotherapy, diagnostics, and clinical guidelines. Both open and closed-ended questions were included. Consensus was defined as at least 70% agreement. RESULTS In total, 28 experienced BC oncologists participated in the study from all five Nordic countries. Overall, topics reaching consensus included: preferred treatment approach in 1L and 2L therapy, treatment of oligometastatic disease, visceral crisis, brain metastases, and age-related treatment considerations. No consensus was reached for 3L therapy and local treatment for primary tumour in de novo aBC. Endocrine therapy (ET) combined with a cyclin-dependent kinase (CDK)4/6 inhibitor was the treatment of choice for 1L and 2L therapy. Treatment patterns in clinical practice did not always follow recommendations in current Nordic guidelines, as seen in the case of recently approved treatments. DISCUSSION ET in combination with a CDK4/6 inhibitor is the preferred frontline treatment for HR+/HER2- aBC in the Nordics. The observed discrepancy between current guidelines and clinical practice could be due to differences in the reimbursement of novel treatments in the Nordics. Collaborative research efforts are warranted for topics that lack consensus.
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Affiliation(s)
- Jürgen Geisler
- Department of Oncology, University of Oslo and Akershus University Hospital, Akershus, Norway
| | - Peeter Karihtala
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Centre and University of Helsinki, Helsinki, Finland
| | - Malgorzata Tuxen
- Department of Oncology, University of Copenhagen Herlev Hospital, Copenhagen, Denmark
| | - Antonis Valachis
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - Barbro Holm
- Department of Oncology, Novartis, Stockholm, Sweden
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Al-Shamsi HO, Abdelwahed N, Abyad A, Abu-Gheida I, Afrit M, Abu ElFuol T, Alasas R, Lababidi B, Dash P, Ahmad M, Dreier NW, ul Haq U, Joshua TLA, Otsmane S, Al-Nouri A, Al-Awadhi A, Tirmazy SH, Alterkait F, Elsabae S, Khan N, Albastaki NK, Sonawane Y, Jouda M, Perdawood F, Iqbal F, Jaafar H. Breast Cancer in the Arabian Gulf Countries. Cancers (Basel) 2023; 15:5398. [PMID: 38001658 PMCID: PMC10670541 DOI: 10.3390/cancers15225398] [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: 09/19/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Breast cancer stands as the prevailing malignancy across all six Gulf Cooperation Council (GCC) nations. In this literature review, we highlighted the incidence and trend of breast cancer in the GCC. Most of the studies reported a consistent increase in breast cancer incidence over the past decades, which was particularly attributed to the adoption of a Westernized lifestyle in the region and the implications of emerging risk factors and other environmental and societal factors, the increase in screening uptake, as well as the improvement in data collection and reporting in the GCC. The data on breast cancer risk factors in the GCC were limited. In this geographic region, breast cancer frequently manifests with distinctive characteristics, including an early onset, typically occurring before the age of 50; an advanced stage at presentation; and a higher pathological grade. Additionally, it often exhibits more aggressive features such as human epidermal growth factor receptor 2 (HER2) positivity or the presence of triple-negative (TN) attributes, particularly among younger patients. Despite the growing body of literature on breast cancer in the GCC, data pertaining to survival rates are, regrettably, meager. Reports on breast cancer survival rates emanating from the GCC region are largely confined to Saudi Arabia and the United Arab Emirates (UAE). In the UAE, predictive modeling reveals 2-year and 5-year survival rates of 97% and 89%, respectively, for the same period under scrutiny. These rates, when compared to Western counterparts such as Australia (89.5%) and Canada (88.2%), fall within the expected range. Conversely, Saudi Arabia reports a notably lower 5-year survival rate, standing at 72%. This disparity in survival rates underscores the need for further research directed toward elucidating risk factors and barriers that hinder early detection and screening. Additionally, there is a pressing need for expanded data reporting on survival outcomes within the GCC. In sum, a more comprehensive and nuanced understanding of breast cancer dynamics in this region is imperative to inform effective strategies for prevention, early detection, and improved patient outcomes.
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Affiliation(s)
- Humaid O. Al-Shamsi
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
- Department of Clinical Sciences, College of Medicine, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Nadia Abdelwahed
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Amin Abyad
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Ibrahim Abu-Gheida
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Mehdi Afrit
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Tasneem Abu ElFuol
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Ryad Alasas
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Bilal Lababidi
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Prasanta Dash
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Mudhasir Ahmad
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Norbert W. Dreier
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Urfan ul Haq
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Thanda Lucy Ann Joshua
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Sonia Otsmane
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Anwar Al-Nouri
- Kuwait Cancer Control Center, Kuwait City, Kuwait; (A.A.-N.); (F.A.)
| | - Aydah Al-Awadhi
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | | | - Faisal Alterkait
- Kuwait Cancer Control Center, Kuwait City, Kuwait; (A.A.-N.); (F.A.)
| | - Shimaa Elsabae
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Nyla Khan
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Nehad Kazim Albastaki
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Yoginee Sonawane
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Mohammed Jouda
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Frea Perdawood
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Faryal Iqbal
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Hassan Jaafar
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
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