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Singareeka Raghavendra A, Liu D, Shen Y, Barcenas CH, Ueno NT, Giordano S, Tripathy D, Sri Karuturi M. Outcomes of older adults with early-stage triple-negative breast cancer (TNBC) receiving chemotherapy: a single-institution experience. Breast Cancer Res Treat 2024; 207:81-90. [PMID: 38916821 DOI: 10.1007/s10549-024-07309-7] [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: 02/10/2024] [Accepted: 03/17/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Despite lower chemotherapy use in older triple-negative breast cancer (TNBC) patients, their outcomes match younger counterparts. We compared outcomes in early-stage TNBC patients by age receiving chemotherapy at a major cancer center with a national TNBC database. METHODS Retrospective study using institutional data on stage I-III TNBC (ER/PR < 10%) women with neoadjuvant/adjuvant chemotherapy. Based on their ages at diagnosis, patients were stratified into four categories: ≤40, 41-59, 60-69, and ≥ 70 years. Demographic and clinical characteristics recorded included race, disease stage, ER/PR positivity, treatment regimen, lymphatic or vascular invasion (LVI), histologic grade, Ki-67 level, body mass index (BMI), and pathologic complete response (pCR) following neoadjuvant treatment and are summarized using descriptive statistics. The primary endpoints were overall survival (OS), disease-free survival (DFS), and distant disease-free survival (DDFS); all were estimated using the Kaplan-Meier method. Both univariate and multivariate (MV) Cox regressions were applied to evaluate the impact of important covariates on these time-to-event endpoints. RESULTS Of the 2336 patients studied, 492 (21.1%) were ≤ 40 years old, 1239 (53.1%) were 41-59, 461 (19.7%) were 60-69, and 144 (6.2%) were ≥ 70. In the univariate regression model of OS/DFS/DDFS, age ≥ 70 was significantly associated with worse OS (p = 0.0217); other factors associated with worse OS were non-anthracycline-based chemotherapy, higher tumor stage, and neoadjuvant chemotherapy. The multivariate Cox regression model, adjusted for race and stage, showed no significant effects of age on OS; however, patients ≥ 70 years old who received non-anthracycline treatment combinations had worse DFS (hazard ratio = 0.349 vs. 1.049, p = 0.0293) and DDFS (hazard ratio = 0.317 vs. 1.016, p = 0.0251) than patients ≤ 40 years old. DFS from MV model after adjusting for age, race, and disease stage, the hazard ratio between anthracycline + taxane treatments and anthracycline + other treatments in patients ≥ 70 years old was statistically significantly lower than in patients ≤ 40 years old (hazard ratios [HRs] = 0.349 vs. 1.049, p = 0.0293). CONCLUSIONS Our findings indicate that outcomes such as DFS are less favorable in older compared to younger patients with early-stage TNBC, primarily in those who did not receive an anthracycline based chemotherapy regimen.
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Affiliation(s)
- Akshara Singareeka Raghavendra
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA
| | - Diane Liu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yu Shen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos H Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA
| | - Naoto T Ueno
- University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Sharon Giordano
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Debu Tripathy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA
| | - Meghan Sri Karuturi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.
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Song Y, Huang H, Jin M, Cheng B, Wang S, Yang X, Hu X. Dietary phytoestrogen intake and ovarian cancer risk: a prospective study in the prostate, lung, colorectal and ovarian (PLCO) cohort. Carcinogenesis 2024; 45:378-386. [PMID: 38375679 PMCID: PMC11164104 DOI: 10.1093/carcin/bgae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 01/12/2024] [Accepted: 02/17/2024] [Indexed: 02/21/2024] Open
Abstract
Estrogen plays a crucial role in ovarian tumorigenesis. Phytoestrogens (PEs) are a type of daily dietary nutrient for humans and possess a mild estrogenic characteristic. This study aimed to assess the correlation of the consumption of dietary PEs with ovarian cancer risk using data in the prostate, lung, colorectal and ovarian (PLCO) cancer screening trial. Participants were enrolled in PLCO from 1993 to 2001. Hazard ratios (HR) and 95% confidence intervals (CI) were utilized to determine the association between the intake of PEs and ovarian cancer occurrence, which were calculated by the Cox proportional hazards regression analysis. In total, 24 875 participants were identified upon completion of the initial dietary questionnaire (DQX). Furthermore, the analysis also included a total of 45 472 women who filled out the diet history questionnaire (DHQ). Overall, after adjustment for confounders, the dietary intake of total PEs was significantly associated with the risk of ovarian cancer in the DHQ group (HRQ4vsQ1 = 0.69, 95% CI: 0.50-0.95; P for trend = 0.066). Especially, individuals who consumed the highest quartile of isoflavones were found to have a decreased risk of ovarian cancer in the DHQ group (HRQ4vsQ1 = 0.68, 95% CI: 0.50-0.94; P for trend = 0.032). However, no such significant associations were observed for the DQX group. In summary, this study suggests that increased dietary intake of total PEs especially isoflavones was linked with a lower risk for developing ovarian cancer. More research is necessary to validate the findings and explore the potential mechanisms.
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Affiliation(s)
- Yizuo Song
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Huijun Huang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Mingmin Jin
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Binwei Cheng
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Shanshan Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Xinjun Yang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Xiaoli Hu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
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Zhang Z, Cheng J, Hou J, Niu M, Gao Y, Xu J, Zheng Q, Ji K, Zhang M, Hao T, Li N, Han X, Ma X, Kong J, Wang R, Zhao Y, Tian J, Hu X. Discrepancies in breast cancer guideline recommendations despite similar Cochrane systematic review conclusions. J Evid Based Med 2024; 17:17-25. [PMID: 38459781 DOI: 10.1111/jebm.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/03/2024] [Indexed: 03/10/2024]
Abstract
AIM This study aims to describe the citation patterns of Cochrane systematic reviews (CSR) in guidelines for managing breast cancer. METHODS We searched for systematic reviews on breast cancer in The Cochrane Library from the date of inception to November 15, 2023, and identified guidelines that cited them. We described how systematic reviews were cited by the guidelines in each database and each year. Additionally, we presented the relationships between the conclusions of the systematic reviews and guideline recommendations and compared the consistency of the recommendations on the same topic across different guidelines. RESULTS A total of 64 systematic reviews and 228 guidelines were included in this study. The average number of the 64 systematic reviews cited by the guidelines was 5.91. We found that the guideline recommendations were irrelevant or inconsistent with the conclusions of the systematic reviews in 56 (38.36%) cited entries. We grouped recommendations on the same topic across different guidelines into one group, of which only 5 groups (15.15%) had completely consistent recommendations, and the other 28 groups (84.85%) had inconsistent recommendations. CONCLUSION The average number of citations for CSR on breast cancer in the guidelines was 5.91. There were also situations in which the guideline recommendations were inconsistent with the conclusions of the included systematic reviews, and recommendations on the same topic across different guidelines were inconsistent.
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Affiliation(s)
- Zhigang Zhang
- Intensive Care Units, Lanzhou University First Affiliated Hospital, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Jie Cheng
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Nursing Department, Changzhi People's Hospital, Changzhi, China
| | - Jialu Hou
- Nursing Department, Changzhi People's Hospital, Changzhi, China
| | - Mingming Niu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Ya Gao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jianguo Xu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qingyong Zheng
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Kexin Ji
- Intensive Care Units, Lanzhou University First Affiliated Hospital, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Min Zhang
- Nursing Department, Changzhi People's Hospital, Changzhi, China
| | - Tian Hao
- Intensive Care Units, Lanzhou University First Affiliated Hospital, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Ning Li
- Nursing Department, Changzhi People's Hospital, Changzhi, China
| | - Xinyi Han
- Intensive Care Units, Lanzhou University First Affiliated Hospital, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Xiujuan Ma
- Intensive Care Units, Lanzhou University First Affiliated Hospital, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Jiajia Kong
- Intensive Care Units, Lanzhou University First Affiliated Hospital, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Rui Wang
- Intensive Care Units, Lanzhou University First Affiliated Hospital, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Ye Zhao
- Departments of Biochemistry and Molecular Biology, Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indianapolis, Indiana, USA
- First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Xiaofang Hu
- Nursing Department, Changzhi People's Hospital, Changzhi, China
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Arter ZL, Desmond D, Berenberg JL, Killeen JL, Bunch K, Merritt MA. Epithelial ovarian cancer survival by race and ethnicity in an equal-access healthcare population. Br J Cancer 2024; 130:108-113. [PMID: 38057396 PMCID: PMC10781944 DOI: 10.1038/s41416-023-02471-z] [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: 03/20/2023] [Revised: 09/27/2023] [Accepted: 10/17/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Previous studies in the general population observed that compared with non-Hispanic White women, Pacific Islander and Black women have higher age-adjusted mortality rates from epithelial ovarian cancer (EOC), while Asian American patients have lower mortality. We investigated whether race and ethnicity is associated with differences in EOC survival in a United States Military population where patients have equal access to healthcare. METHODS This retrospective study included women diagnosed with EOC between 2001 and 2018 among Department of Defense beneficiaries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models adjusting for age and year of diagnosis, histology and stage. RESULTS In our study population of 1230 invasive EOC cases (558 non-Hispanic White, 74 non-Hispanic Black, 73 Asian, 30 Pacific Islander and 36 Hispanic cases), 63% of the women died (all-cause death) after a mean = 4.8 years (SD = 4.1) of follow-up following diagnosis. Compared with non-Hispanic White cases, Asian cases had better overall survival, HR = 0.76 (95% CI = 0.58-0.98), whereas there were no differences in survival for other racial and ethnic groups. CONCLUSIONS These findings highlight the need to investigate how differences in access to healthcare may influence observed racial and ethnic disparities for EOC.
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Affiliation(s)
- Zhaohui L Arter
- University of California, Irvine Medical Center, Irvine, CA, USA
| | - Daniel Desmond
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Jeffrey L Berenberg
- Tripler Army Medical Center, Honolulu, HI, USA
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jeffrey L Killeen
- Department of Pathology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
- Kapiolani Medical Center for Women and Children, Honolulu, HI, USA
| | | | - Melissa A Merritt
- University of Hawaii Cancer Center, Honolulu, HI, USA.
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, NSW, Australia.
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Jalili M, Tavakoli S, Kargar K, Rafat M, Rad FR. Spotlight on the Expanding Role of miR-647 in Human Cancers. Adv Biomed Res 2023; 12:170. [PMID: 37564440 PMCID: PMC10410432 DOI: 10.4103/abr.abr_369_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 08/12/2023] Open
Abstract
MicroRNAs are a large group of small, non-coding ssRNAs (miRNAs) that have an epigenetically pivotal role in gene expression and other biological processes in cells and can be regarded as capable biomarkers for the early detection and management of cancer. The aim of the present review article is to summarize the evidence for recognizing the molecular mechanism, target genes, and clinical significance of miR-647 in different cancers. Multiple studies have demonstrated that aberrant expression of miR-647 could be found in a variety of malignancies, such as bladder cancer, cervical cancer, colorectal cancer, gastric cancer, glioma, hepatocellular carcinoma, non-small cell lung cancer, ovarian cancer, and prostate cancer have reported, notably, increase or decrease in expression of miR-647 so that it can function as a tumorigenic (oncomiR) or tumor suppressor gene. MiR-647 is effective in the proliferation, migration, and invasion of cancer cells by playing a function in cell cycle pathways. MiR-647 can be a valuable potential biomarker for assessing the extent of cancer, prognosis, and response to therapy and shows great therapeutic efficacy in different solid tumors. Moreover, serum concentrations of miR-647 are directly effective in decreasing overall survival and disease progression. So, an efficient therapeutic target can be the effect on miR-647 expression by antitumor drugs.
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Affiliation(s)
| | - Setayesh Tavakoli
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamran Kargar
- Department of Prosthodontics, Shahed Medical University, Tehran, Iran
| | - Milad Rafat
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh R. Rad
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Sia TY, Tew WP, Purdy C, Chi DS, Menzin AW, Lovecchio JL, Bookman MA, Cohn DE, Teoh DG, Friedlander M, Bender D, Mutch DG, Gershenson DM, Tewari KS, Wenham RM, Wahner Hendrickson AE, Lee RB, Gray HJ, Secord AA, Van Le L, Lichtman SM. The effect of older age on treatment outcomes in women with advanced ovarian cancer receiving chemotherapy: An NRG-Oncology/Gynecologic Oncology Group (GOG-0182-ICON5) ancillary study. Gynecol Oncol 2023; 173:130-137. [PMID: 37148580 PMCID: PMC10414765 DOI: 10.1016/j.ygyno.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/12/2023] [Accepted: 03/23/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To assess the effect of age on overall survival (OS) in women with ovarian cancer receiving chemotherapy. Secondary objectives were to describe the effect of age on treatment compliance, toxicities, progression free survival (PFS), time from surgery to chemotherapy, and rates of optimal cytoreduction. METHODS Women enrolled in GOG 0182-ICON5 with stage III or IV epithelial ovarian cancer (EOC) who underwent surgery and chemotherapy between 2001 and 2004 were included. Patients were divided into ages <70 and ≥ 70 years. Baseline characteristics, treatment compliance, toxicities, and clinical outcomes were compared. RESULTS We included a total of 3686 patients, with 620 patients (16.8%) ≥ 70 years. OS was 37.2 months in older compared to 45.0 months in younger patients (HR 1.21, 95% CI, 1.09-1.34, p < 0.001). Older patients had an increased risk of cancer-specific-death (HR 1.16, 95% CI, 1.04-1.29) as well as non-cancer related deaths (HR 2.78, 95% CI, 2.00-3.87). Median PFS was 15.1 months in older compared to 16.0 months in younger patients (HR 1.10, 95% CI, 1.00-1.20, p = 0.056). In the carboplatin/paclitaxel arm, older patients were just as likely to complete therapy and more likely to develop grade ≥ 2 peripheral neuropathy (35.7 vs 19.7%, p < 0.001). Risk of other toxicities remained equal between groups. CONCLUSIONS In women with advanced EOC receiving chemotherapy, age ≥ 70 was associated with shorter OS and cancer specific survival. Older patients receiving carboplatin and paclitaxel reported higher rates of grade ≥ 2 neuropathy but were not more likely to suffer from other chemotherapy related toxicities. Clintrials.gov: NCT00011986.
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Affiliation(s)
- Tiffany Y Sia
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
| | - William P Tew
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
| | - Christopher Purdy
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America.
| | - Dennis S Chi
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
| | - Andrew W Menzin
- North Shore-Long Island Jewish Medical Center, Manhasset, NY, United States of America.
| | - John L Lovecchio
- North Shore-Long Island Jewish Medical Center, Manhasset, NY, United States of America.
| | - Michael A Bookman
- Gynecologic Oncology Therapeutics, Kaiser Permanente, San Francisco, CA, United States of America.
| | - David E Cohn
- Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America.
| | - Deanna G Teoh
- University of Minnesota Medical Center, Minneapolis, MN, United States of America.
| | - Michael Friedlander
- Department of Medical Oncology, Prince of Wales Hospital and Prince of Wales Clinical School, UNSW, Sydney, New South Wales, Australia.
| | - David Bender
- University of Iowa Hospitals, Iowa City, IA, United States of America.
| | - David G Mutch
- Washington University, St. Louis, MO, United States of America.
| | | | | | - Robert M Wenham
- Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America.
| | | | - Roger B Lee
- Tacoma General Hospital, Tacoma, WA, United States of America.
| | - Heidi J Gray
- Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America.
| | | | - Linda Van Le
- University of North Carolina, Chapel Hill, NC, United States of America.
| | - Stuart M Lichtman
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
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Rafat M, Kohsarian M, Bahiraei M, Nikpoor AR. A Comprehensive Study on Signal Transduction and Therapeutic Role of miR-877 in Human Cancers. Adv Biomed Res 2023; 12:118. [PMID: 37434921 PMCID: PMC10331537 DOI: 10.4103/abr.abr_412_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 05/07/2022] [Accepted: 05/16/2022] [Indexed: 07/13/2023] Open
Abstract
MicroRNAs are a group of short non-coding RNAs (miRNAs), which are epigenetically involved in gene expression and other cellular biological processes and can be considered as potential biomarkers for cancer detection and support for treatment management. This review aims to amass the evidence in order to reach the molecular mechanism and clinical significance of miR-877 in different types of cancer. Dysregulation of miR-877 level in various types of malignancies as bladder cancer, cervical cancer, cholangiocarcinoma, colorectal cancer (CRC), gastric cancer, glioblastoma, head and neck squamous cell carcinoma (HNSCC), hepatocellular carcinoma, laryngeal squamous cell carcinoma, melanoma, non-small cell lung cancer (NSCLC), oral squamous cell carcinoma, ovarian cancer (OC), pancreatic ductal adenocarcinoma, and renal cell carcinoma (RCC) have reported, significantly increase or decrease in its level, which can be indicated to its function as oncogene or tumor suppressor. MiR-877 is involved in cell proliferation, migration, and invasion through cell cycle pathways in cancer. MiR-877 could be potential a candidate as a valuable biomarker for prognosis in various cancers. Through this study, we proposed that miR-877 can potentially be a candidate as a prognostic marker for early detection of tumor development, progression, as well as metastasis.
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Affiliation(s)
- Milad Rafat
- Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mahdis Kohsarian
- Department of Biology, Faculty of Science, Guilan University, Rasht, Iran
| | - Mohamad Bahiraei
- Department of Radiology, Besat Hospital, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Amin R. Nikpoor
- Department of Medical Genetics, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Itani Y, Sakai H, Hamano T, Asai-Sato M, Futagami M, Fujimura M, Aoki Y, Suzuki N, Yoshida Y, Enomoto T. Comparison of older and younger patients with ovarian cancer: A post hoc study (JGOG3016-A3) of the treatment strength and prognostic outcomes of conventional or dose-dense chemotherapy. J Obstet Gynaecol Res 2023; 49:1400-1411. [PMID: 36859635 DOI: 10.1111/jog.15620] [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: 09/05/2022] [Accepted: 02/09/2023] [Indexed: 03/03/2023]
Abstract
AIM To evaluate changes of treatment strength and its impact on prognosis in older patients with ovarian cancer. METHODS We compared relative dose intensity (RDI) as a representative of treatment strength, prognosis, and other features between older (≥65 years) and younger patients (<65 years) retrospectively. Seventy-seven older patients of 301 who received dose-dense-paclitaxel-carboplatin (dTC) and 93 older patients of 304 who received conventional-paclitaxel-carboplatin (cTC) from the Japanese Gynecologic Oncology Group (JGOG) 3016 clinical trial were analyzed. RESULTS The RDI of older patients was lower than that of younger patients in cTC (87.4% vs. 90.8%, p = 0.009) but not in dTC (79.0% vs. 81.2%, p = 0.205). In both regimens, older patients had worse overall survival than younger patients: hazard ratio [HR] = 1.80; 95% confidence interval [CI]: 1.25-2.59; p = 0.001 for dTC, and HR = 1.59; 95% CI: 1.15-2.19; p = 0.04 for cTC. However, the RDI was not determined as a prognostic factor statistically. The prognostic factors identified by multivariate analysis for both regimens were clinical stage and residual disease; for dTC were age, performance status, and serum albumin; and for cTC was white blood cell count. There was no difference in neutropenia observed between age groups in either regimen. CONCLUSIONS The RDI of older patients varies according to the administered schedule and is not always lower than that of younger patients. Older patients with comparable treatment strength to younger patients in the dTC group did not accomplish the same level of prognosis as younger patients. Other biologic factors attributable to aging may affect prognosis.
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Affiliation(s)
- Yoshio Itani
- Yao Municipal Hospital Palliative Care Center, Yao-Shi, Japan
| | - Hitomi Sakai
- Advanced Cancer Translational Research Institute (ACT), Showa University, Tokyo, Japan
| | | | - Mikiko Asai-Sato
- Department of Obstetrics and Gynecology, Nihon University School of Medicine, Itabashiku, Japan
| | - Masayuki Futagami
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Masaki Fujimura
- Tokyo Medical University Ibaraki Medical Center, Inashikigun, Japan
| | | | - Nao Suzuki
- St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | | | - Takayuki Enomoto
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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9
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Development and validation a survival prediction model and a risk stratification for elderly locally advanced breast cancer. Clin Breast Cancer 2022; 22:681-689. [DOI: 10.1016/j.clbc.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/23/2022] [Accepted: 06/20/2022] [Indexed: 11/23/2022]
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10
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Karuturi MS, Giordano SH, Hoover DS, Volk RJ, Housten AJ. Exploring and supporting older women's chemotherapy decision-making in early-stage breast cancer. J Geriatr Oncol 2022; 13:170-175. [PMID: 34955445 PMCID: PMC9045544 DOI: 10.1016/j.jgo.2021.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/29/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Few studies have focused on the therapeutic decision-making process in older adults with breast cancer. This study investigated older adult breast cancer patients' perspectives on neo/adjuvant chemotherapy, thereby identifying informational needs and preferences as patients navigate the treatment decision-making process. MATERIALS AND METHODS Women ≥65 years diagnosed with early-stage breast cancer were recruited from an academic cancer center after deciding whether or not to receive neo/adjuvant chemotherapy. Participants completed surveys assessing sociodemographic characteristics, health literacy/numeracy, and shared decision making. They took part in individual semi-structured interviews to explore their perspectives, experiences, and values regarding treatment. Interviews were audio-recorded and transcribed. Transcripts were analyzed using the Sort and Sift, Think and Shift qualitative approach. Quantitative data was summarized using descriptive statistics. RESULTS Of the 26 participants (age range 65-92 years; 81% non-Hispanic White; 72% ≥ college degree; 50% unmarried), 58% elected to undergo chemotherapy and 42% declined. The majority of participants had adequate health literacy/numeracy and engaged in shared decision-making. Thematic analysis revealed several commonalities regardless of the decision to undergo chemotherapy. Participants sought information regarding their disease/treatment. They referenced subjective experiences of friends/family members with cancer. Self-perception of health and the side effects of chemotherapy were also key factors. Participants placed importance on the maintenance of quality of life throughout treatment. CONCLUSIONS Decision-making strategies in older patients were shaped by knowledge, values, and the anecdotal experiences of others. Results can inform the development of decision support tools for older patients and physicians to better facilitate the shared decision-making process.
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Affiliation(s)
- Meghan S Karuturi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
| | - Sharon H Giordano
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Diana S Hoover
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Robert J Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ashley J Housten
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, United States
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11
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Rafat M, Yadegar N, Dadashi Z, Shams K, Mohammadi M, Abyar M. The prominent role of miR-942 in carcinogenesis of tumors. Adv Biomed Res 2022; 11:63. [PMID: 36133499 PMCID: PMC9483553 DOI: 10.4103/abr.abr_226_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/14/2021] [Accepted: 10/27/2021] [Indexed: 12/04/2022] Open
Abstract
As a family of short noncoding RNAs, MicroRNAs have been identified as possible biomarkers for cancer discovery and assist in therapy control due to their epigenetic involvement in gene expression and other cellular biological processes. In the present review, the evidence for reaching the clinical effect and the molecular mechanism of miR-942 in various kinds of cancer is amassed. Dysregulation of miR-942 amounts in different kinds of malignancies, as bladder cancer, esophageal squamous cell carcinoma, breast cancer, cervical cancer, gastric cancer, colorectal cancer, Kaposi's sarcoma, melanoma, Hepatocellular carcinoma, nonsmall-cell lung cancer, oral squamous cell carcinoma, osteosarcoma, ovarian cancer, pancreatic ductal adenocarcinoma, renal cell carcinoma, and prostate cancer has stated a considerable increase or decrease in its level indicating its function as oncogene or tumor suppressor. MiR-942 is included in cell proliferation, migration, and invasion through cell cycle pathways, including pathways of transforming growth factor-beta signaling pathways, Wnt pathway, JAK/STAT pathway, PI3K/AKT pathway, apoptosis pathway, hippo signaling pathway, lectin pathway, interferon-gamma signaling, signaling by G-protein coupled receptor, developmental genes, nuclear factor-kappa B pathway, Mesodermal commitment pathway, and T-cell receptor signaling in cancer. An important biomarker, MiR-942 is a potential candidate for prediction in several cancers. The present investigation introduced miR-942 as a prognostic marker for early discovery of tumor progression, metastasis, and development.
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12
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Hiramoto S, Asano H, Miyamoto T, Takegami M, Kawabata A. Risk factors and pharmacotherapy for chemotherapy-induced peripheral neuropathy in paclitaxel-treated female cancer survivors: A retrospective study in Japan. PLoS One 2021; 16:e0261473. [PMID: 34972132 PMCID: PMC8719717 DOI: 10.1371/journal.pone.0261473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/02/2021] [Indexed: 01/09/2023] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting adverse reaction in cancer patients treated with several cytotoxic anticancer agents including paclitaxel. Duloxetine, an antidepressant known as a serotonin-noradrenalin reuptake inhibitor, is the only agent that has moderate evidence for the use to treat painful CIPN. The present retrospective cohort study aimed to analyze risk factors for paclitaxel-induced peripheral neuropathy (PIPN), and investigate ongoing prescription drug use for PIPN in Japan. Female breast and gynecologic cancer patients who underwent paclitaxel-based chemotherapy at a single center in Japan between January 2016 and December 2019 were enrolled in this study. Patients' information obtained from electronic medical records were statistically analyzed to test possible risk factors on PIPN diagnosis. Patients' age, total paclitaxel dose, the history of female hormone-related diseases, hypertension and body mass index (BMI), but not additional platinum agents, were significantly associated with increased PIPN diagnosis. Drugs prescribed for PIPN included duloxetine, pregabalin, mecobalamin and Goshajinkigan, a polyherbal medicine, regardless of poor evidence for their effectiveness against CIPN, and were greatly different between breast and gynecologic cancer patients diagnosed with PIPN at the departments of Surgery and Gynecology, respectively. Thus, older age, greater total paclitaxel dose, the history of estrogen-related diseases, hypertension and BMI are considered risk factors for PIPN in paclitaxel-based chemotherapy of female cancer patients. It appears an urgent need to establish a guideline of evidence-based pharmacotherapy for PIPN.
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Affiliation(s)
- Shiori Hiramoto
- Division of Pharmacology and Pathophysiology Faculty of Pharmacy, Kindai University, Higashi-Osaka, Japan
- Division of Pharmacy, Kindai University Hospital, Osakasayama, Japan
| | - Hajime Asano
- Division of Pharmacy, Kindai University Hospital, Osakasayama, Japan
| | - Tomoyoshi Miyamoto
- Division of Pharmacology and Pathophysiology Faculty of Pharmacy, Kindai University, Higashi-Osaka, Japan
| | - Manabu Takegami
- Division of Pharmacy, Kindai University Hospital, Osakasayama, Japan
| | - Atsufumi Kawabata
- Division of Pharmacology and Pathophysiology Faculty of Pharmacy, Kindai University, Higashi-Osaka, Japan
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13
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Tymon-Rosario J, Adjei NN, Roque DM, Santin AD. Microtubule-Interfering Drugs: Current and Future Roles in Epithelial Ovarian Cancer Treatment. Cancers (Basel) 2021; 13:6239. [PMID: 34944858 PMCID: PMC8699494 DOI: 10.3390/cancers13246239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
Taxanes and epothilones are chemotherapeutic agents that ultimately lead to cell death through inhibition of normal microtubular function. This review summarizes the literature demonstrating their current use and potential promise as therapeutic agents in the treatment of epithelial ovarian cancer (EOC), as well as putative mechanisms of resistance. Historically, taxanes have become the standard of care in the front-line and recurrent treatment of epithelial ovarian cancer. In the past few years, epothilones (i.e., ixabepilone) have become of interest as they may retain activity in taxane-treated patients since they harbor several features that may overcome mechanisms of taxane resistance. Clinical data now support the use of ixabepilone in the treatment of platinum-resistant or refractory ovarian cancer. Clinical data strongly support the use of microtubule-interfering drugs alone or in combination in the treatment of epithelial ovarian cancer. Ongoing clinical trials will shed further light into the potential of making these drugs part of current standard practice.
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Affiliation(s)
- Joan Tymon-Rosario
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA; (J.T.-R.); (N.N.A.)
| | - Naomi N. Adjei
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA; (J.T.-R.); (N.N.A.)
| | - Dana M. Roque
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Alessandro D. Santin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA; (J.T.-R.); (N.N.A.)
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14
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Thomaier L, Darst BF, Jewett P, Hoffmann C, Brown K, Makaram A, Blaes A, Argenta P, Teoh D, Vogel RI. Genetic variants predictive of chemotherapy-induced peripheral neuropathy symptoms in gynecologic cancer survivors. Gynecol Oncol 2021; 163:578-582. [PMID: 34674889 DOI: 10.1016/j.ygyno.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To identify genetic variants associated with chemotherapy-induced peripheral neuropathy (CIPN) symptoms among gynecologic cancer survivors and determine the variants' predictive power in addition to age and clinical factors at time of diagnosis. METHODS Participants of a prospective cohort study on gynecologic cancers provided a DNA saliva sample and reported CIPN symptoms (FACT/GOG-Ntx). Genotyping of 23 single nucleotide polymorphisms (SNPs) previously identified as related to platinum- or taxane-induced neuropathy was performed using iPLEX Gold method. Risk allele carrier frequencies of 19 SNPs that passed quality checks were compared between those with/without high CIPN symptoms using logistic regression, adjusting for age. Receiver operating characteristic (ROC) curves using clinical risk factors (age, diabetes, BMI, Charlson Comorbidity Index, previous cancer diagnosis) with and without the identified SNPs were compared. RESULTS 107 individuals received platinum or taxane-based chemotherapy and provided sufficient DNA for analysis. Median age was 65.1 years; 39.6% had obesity and 8.4% diabetes; most had ovarian (58.9%) or uterine cancer (29.0%). Two SNPs were significantly associated with high CIPN symptomatology: rs3753753 in GPX7, OR = 2.55 (1.13, 5.72) and rs139887 in SOX10, 2.66 (1.18, 6.00). Including these two SNPs in a model with clinical characteristics led to an improved AUC for CIPN symptomatology (0.65 vs. 0.74, p = 0.04). CONCLUSIONS Genetic and clinical characteristics were predictive of higher CIPN symptomatology in gynecologic cancer survivors, and combining these factors resulted in superior predictive power compared with a model with clinical factors only. Prospective validation and assessment of clinical utility are warranted.
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Affiliation(s)
- Lauren Thomaier
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America.
| | - Burcu F Darst
- University of Southern California, Center for Genetic Epidemiology, Keck School of Medicine, Los Angeles, CA, United States of America
| | - Patricia Jewett
- University of Minnesota, Division of Hematology and Oncology, Minneapolis, MN, United States of America
| | - Cody Hoffmann
- University of Minnesota Genomics Center, University of Minnesota, Minneapolis, MN, United States of America
| | - Katherine Brown
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America
| | - Aditi Makaram
- University of Minnesota, College of Biological Sciences, Minneapolis, MN, United States of America
| | - Anne Blaes
- University of Minnesota, Division of Hematology and Oncology, Minneapolis, MN, United States of America
| | - Peter Argenta
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America
| | - Deanna Teoh
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America
| | - Rachel I Vogel
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America
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15
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Jung CS, Jung YJ, Kim DI, Lee S, Kang SK, Nam SB, Kim HY. A comparative study of the clinical characteristics and outcomes of HR-positive HER2-negative breast cancer patients over and under 65 years old. KOREAN JOURNAL OF CLINICAL ONCOLOGY 2021; 17:1-7. [PMID: 36945204 PMCID: PMC9942741 DOI: 10.14216/kjco.21001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 11/07/2022]
Abstract
Purpose The purpose of this study was to compare the clinical characteristics and outcomes of hormone receptor-positive (HR+) human epidermal growth factor 2-negative (HER2-) breast cancer among elderly patients (over 65 years old) and younger patients. Methods This was a retrospective cohort study of 328 patients who were treated for breast cancer at Pusan National University Yangsan Hospital between January 2009 and December 2014. Tumor characteristics, surgical methods, and survival outcomes were compared between the two age groups (<65 and ≥65 years old). Kaplan-Meier curves for disease-free survival (DFS) and overall survival (OS) were also constructed according to the age groups. Results Among the 328 patients with HR+ HER2- breast cancer, 184 (56.1%) were <65 years old and 144 (43.9%) were ≥65 years old. Breast cancer stages were similar between the two age groups, but the older patients were treated less often with chemotherapy (81% vs. 66%, P=0.002). During the follow-up period, 17 deaths and 36 cases of recurrence or metastasis were reported. There was no difference in DFS between the two groups (P=0.840); however, the OS of the older age group was significantly lower than that of the younger age group (P=0.015). Conclusion This study suggested that HR+ HER2- breast cancer patients belonging to the two age groups had no significant difference in DFS. However, older age is an independent factor affecting OS rate. Therefore, even if patients are old, but their physical condition is satisfactory, standard and active treatment may be necessary, similar to that given to younger patients.
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Affiliation(s)
- Chang Shin Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dong Il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seungju Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seok Kyung Kang
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su Bong Nam
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
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Mallen A, Todd S, Robertson SE, Kim J, Sehovic M, Wenham RM, Extermann M, Chon HS. Impact of age, comorbidity, and treatment characteristics on survival in older women with advanced high grade epithelial ovarian cancer. Gynecol Oncol 2021; 161:693-699. [PMID: 33812698 DOI: 10.1016/j.ygyno.2021.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/03/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Older women have a worse prognosis with advanced epithelial ovarian cancer (EOC) and comorbidities likely contribute to poor outcomes. We sought to identify comorbid conditions and treatment-related factors in older women. METHODS A retrospective chart review identified 351 patients who underwent cytoreductive surgery (CRS). 100/351 (28.5%) were ≥ 70 years old. Demographic and clinicopathologic information was collected. Crude progression-free (PFS) and overall survival (OS) estimates were calculated using Kaplan-Meier method. Cox proportional hazards regression model was used to estimate hazard ratios and adjustments for confounders. RESULTS Study subjects ≥70 years old had significantly: higher Cumulative Illness Rating Scale-Geriatric (CIRS-G) score (5.9 vs 4.3; p = 0.0001), less completion of adjuvant chemotherapy (24% vs 15.1%; p = 0.049), less intraperitoneal (IP) therapy (18.2% vs 35.5%; p = 0.002), less clinical trial participation (16% vs 26.3%; p = 0.040), decreased platinum sensitivity (60% vs 73.7%; p = 0.012) and lacked BRCA mutations (0% vs 12%; p = 0.0006). They were less likely to have optimal CRS (75% vs 86.9%; p = 0.007) with same surgical complexity (p = 0.89). Patients ≥70 had significantly worse PFS and OS. In a multivariate analysis, better OS was associated with younger age (<70 years old), any IP therapy, completion of adjuvant chemotherapy, and platinum sensitivity. CONCLUSION The older cohort had worse CIRS-G scores (5.9 vs 4.3; p = 0.0001), but no strong associations between comorbidities and treatment characteristics, but less optimal CRS rates (75% vs 86.9%; p = 0.007) with similar surgical complexity and less platinum sensitivity. Our results show comorbid conditions in older patients with advanced EOC may have less impact than tumor biology.
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Affiliation(s)
- Adrianne Mallen
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Sarah Todd
- Department of Obstetrics and Gynecology, University of Louisville, Louisville, KY, USA
| | - Sharon E Robertson
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, USA
| | - Jongphil Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Marina Sehovic
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Robert M Wenham
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Martine Extermann
- Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Hye Sook Chon
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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17
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Exploring Older Women's Attitudes to and Experience of Treatment for Advanced Ovarian Cancer: A Qualitative Phenomenological Study. Cancers (Basel) 2021; 13:cancers13061207. [PMID: 33801991 PMCID: PMC8001330 DOI: 10.3390/cancers13061207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 11/28/2022] Open
Abstract
Simple Summary Older women with ovarian cancer often receive less anti-cancer treatment than younger women despite evidence showing they may benefit from similar levels of treatment. Little is known, however, about older women’s preferences toward chemotherapy and treatment experience. We aimed to understand the lived experience of older women with ovarian cancer undergoing chemotherapy though interviews and focus groups. Participants expressed a strong desire to undergo full treatment to improve survival for themselves and for their families. Women did not see their age as a reason to have less intensive treatment. Despite feeling overwhelmed with information and daily tasks due to fatigue, participants did not want cancer to interfere with their daily lives. Women felt distressed by logistical issues with transportation and communication between healthcare providers; however, they still felt positive about their care experience and desire for treatment. Older women may benefit from additional help to support effective communication around treatment preferences. Abstract Older women with ovarian cancer more often receive less intensive treatment and early discontinuation compared to younger women. There is little understanding of older women’s treatment experience and whether this contributes to declining intensive treatment. We aimed to explore the lived experience of older patients with advanced ovarian cancer undergoing chemotherapy, their treatment preferences and treatment burden. We conducted a phenomenological qualitative study with 15 women who had completed at least three cycles of first-line chemotherapy for advanced epithelial ovarian cancer, aged 65 years or older at the first cycle, at one tertiary cancer centre. We conducted interviews and focus groups and analysed the transcripts using inductive thematic analysis. Women reported a strong preference for active treatment despite treatment burden and toxicities. Participants undertook treatment to lengthen their lives for themselves and their families. Participants did not see age as a barrier to treatment. Patients expressed determination not to let cancer interfere with daily life. Women felt overwhelmed with information and struggled with daily tasks due to fatigue. Logistical issues, such as transportation and ineffective communication between healthcare providers, caused substantial distress. Despite these logistical burdens and toxicities, participants were positive about their care experience and desire for anticancer treatment. Older women may benefit from additional support to facilitate effective communication during the early stages of treatment.
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Shintani D, Yoshida H, Yabuno A, Fujiwara K. Tolerability and Efficacy of Bevacizumab Monotherapy in Older Patients With Recurrent Ovarian Cancer. In Vivo 2021; 34:1451-1457. [PMID: 32354945 DOI: 10.21873/invivo.11928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The aim of this study was to compare the tolerability and efficacy of bevacizumab monotherapy between older and younger patients with recurrent ovarian cancer. PATIENTS AND METHODS We enrolled 32 patients with recurrent ovarian cancer who were treated with bevacizumab monotherapy and divided them into those who were 65 years and older (n=12) and those younger than 65 years (n=20). RESULTS Except for grade ≥3 proteinuria, incidences of adverse events did not differ significantly between the groups. Although older patients exhibited more frequently cycle delay caused by non-hematological toxicities, this difference was not significant. There was no significant difference in tumor response and survival between the groups. CONCLUSION Bevacizumab monotherapy was tolerable and effective for older patients with recurrent ovarian cancer compared with younger patients.
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Affiliation(s)
- Daisuke Shintani
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroyuki Yoshida
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akira Yabuno
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan
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Alami Merrouni I, Elachouri M. Anticancer medicinal plants used by Moroccan people: Ethnobotanical, preclinical, phytochemical and clinical evidence. JOURNAL OF ETHNOPHARMACOLOGY 2021; 266:113435. [PMID: 33022340 DOI: 10.1016/j.jep.2020.113435] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 05/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cancer is a major health problem worldwide. Drugs' side effects and high cost of treatment remain the main limitations of conventional therapy. Nowadays, developing new therapeutic strategies is necessary. Therefore, medicinal plants can be used to promote novel, safe, and potent anticancer drugs through their natural compounds. AIM OF THE STUDY This review aims to provide scientific evidence related to the anticancer activities of medicinal plants used by Moroccan people as well as approving their efficiency as an alternative cancer therapy. METHODS An ethnopharmacological review approach was conducted by analyzing Moroccan published ethnobotanical surveys from 1991 to 2019 and consulting peer-reviewed articles worldwide to investigate the pharmacological, phytochemical, and clinical effects related to the anticancer activities. Plants with anticancer proprieties were classified into four groups: (a) plants only cited as anticancer, (b) plants pharmacologically investigated, (c) plants with bioactive compounds tested as anticancer, and (d) plants clinically investigated. RESULTS A total of 103 plant species belonging to 47 botanical families used by Moroccans to treat cancer have been recorded. Aristolochia fontanesii Boiss. & Reut, Marrubium vulgare L., and Allium sativum L. are the most referred species in Morocco. Medicinal plants used for cancer treatment were classified into four groups: 48 species were used traditionally as anticancer (group a), 41 species pharmacologically investigated for their anticancer activities (group b), 32 plants with bioactive compounds tested against cancer (group c), and eight plants were clinically investigated for their anticancer effects (group d). Out of 82 plants' extracts pharmacologically tested (from plants of group b), only 24 ones show a significant cytotoxic effect. A total of seventy-seven compounds are isolated from plants of group (c). However, only six ones were clinically evaluated, and most of them exhibit a beneficial effect on cancerous patients with few side effects. CONCLUSION Medicinal plants can be a promising candidate for alternative cancer therapy. Nevertheless, it is critical to increasing the clinical trials to confirm their beneficial effect on patients with cancer. Overall, this review can serve as a database for further studies.
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Affiliation(s)
- Ilyass Alami Merrouni
- Laboratory of Physiology, Genetics, and Ethnopharmacology, Faculty of Sciences, Mohammed First University, Oujda, Morocco.
| | - Mostafa Elachouri
- Laboratory of Physiology, Genetics, and Ethnopharmacology, Faculty of Sciences, Mohammed First University, Oujda, Morocco.
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20
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Charo LM, Jou J, Binder P, Hohmann SF, Saenz C, McHale M, Eskander RN, Plaxe S. Current status of hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer in the United States. Gynecol Oncol 2020; 159:681-686. [PMID: 32977989 DOI: 10.1016/j.ygyno.2020.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES 1.) To compare frequency of HIPEC use in ovarian cancer treatment before and after publication of the phase III study by van Driel et al. in January 2018. 2.) To compare associated rates of hospital-based outcomes, including length of stay, intensive care unit (ICU) admission, complications, and costs in ovarian cancer surgery with or without HIPEC. METHODS We queried Vizient's administrative claims database of 550 US hospitals for ovarian cancer surgeries from January 2016-January 2020 using ICD-10 diagnosis and procedure codes. Sodium thiosulfate administration was used to identify HIPEC cases according to the published protocol. Student t-tests and relative risk (RR) were used to compare continuous variables and contingency tables, respectively. RESULTS 152 ovarian cancer patients had HIPEC at 39 hospitals, and 20,014 ovarian cancer patients had surgery without HIPEC at 256 hospitals. Following the trial publication, 97% of HIPEC cases occurred. During the index admission, HIPEC patients had longer median length of stay (8.4 vs. 5.7 days, p < 0.001) and higher percentage of ICU admissions (63.1% vs. 11.0%, p < 0.001) and complication rates (RR = 1.87, p = 0.002). Index admission direct costs ($21,825 vs. $12,038, p < 0.001) and direct cost index (observed/expected costs) (1.87 vs. 1.11, p < 0.001) were also greater in the HIPEC patients. No inpatient deaths or 30-day readmissions were identified after HIPEC. CONCLUSIONS Use of HIPEC for ovarian cancer increased in the US after publication of a phase III clinical trial in a high-impact journal, though the absolute number of cases remains modest. Incorporation of HIPEC was associated with increased cost, hospital length of stay, ICU admission, and hospital-acquired complication rates. Further studies are needed in order to evaluate long-term outcomes, including morbidity and survival.
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Affiliation(s)
- Lindsey M Charo
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, Reproductive Sciences, University of California San Diego, Moores Cancer Center, La Jolla, CA 92093, USA.
| | - Jessica Jou
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, Reproductive Sciences, University of California San Diego, Moores Cancer Center, La Jolla, CA 92093, USA
| | - Pratibha Binder
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, Reproductive Sciences, University of California San Diego, Moores Cancer Center, La Jolla, CA 92093, USA
| | | | - Cheryl Saenz
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, Reproductive Sciences, University of California San Diego, Moores Cancer Center, La Jolla, CA 92093, USA
| | - Michael McHale
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, Reproductive Sciences, University of California San Diego, Moores Cancer Center, La Jolla, CA 92093, USA
| | - Ramez N Eskander
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, Reproductive Sciences, University of California San Diego, Moores Cancer Center, La Jolla, CA 92093, USA
| | - Steven Plaxe
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, Reproductive Sciences, University of California San Diego, Moores Cancer Center, La Jolla, CA 92093, USA
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21
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Du Z, Wang L, Xia Y. Circ_0015756 promotes the progression of ovarian cancer by regulating miR-942-5p/CUL4B pathway. Cancer Cell Int 2020; 20:572. [PMID: 33292255 PMCID: PMC7694308 DOI: 10.1186/s12935-020-01666-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/19/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ovarian cancer (OC) is the gynecologic cancer with the highest mortality. Circular RNAs (circRNAs) play a vital role in the development and progression of cancer. This study aimed to explore the potential role of circ_0015756 in OC and its molecular mechanism. METHODS The levels of circ_0015756, microRNA-942-5p (miR-942-5p) and Cullin 4B (CUL4B) were determined by quantitative real-time PCR (qRT-PCR) or Western blot assay. Cell proliferation, apoptosis, migration and invasion were assessed by Cell Counting Kit-8 (CCK-8), colony formation assay, flow cytometry and transwell assay. The levels of proliferation-related and metastasis-related proteins were measured by Western blot assay. The relationship between miR-942-5p and circ_0015756 or CUL4B was verified by dual-luciferase reporter assay, RNA immunoprecipitation assay and RNA pull-down assay. Xenograft assay was used to analyze tumor growth in vivo. RESULTS Circ_0015756 and CUL4B levels were increased, while miR-942-5p level was decreased in OC tissues and cells. Depletion of circ_0015756 suppressed proliferation, migration and invasion and promoted apoptosis in OC cells. Down-regulation of circ_0015756 hindered OC cell progression via modulating miR-942-5p. Also, up-regulation of miR-942-5p impeded OC cell development by targeting CUL4B. Mechanistically, circ_0015756 up-regulated CUL4B via sponging miR-942-5p. Moreover, circ_0015756 silencing inhibited tumor growth in vivo. CONCLUSION Knockdown of circ_0015756 suppressed OC progression via regulating miR-942-5p/CUL4B axis, suggesting that circ_0015756 might be a potential therapeutic target for ovarian cancer.
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Affiliation(s)
- Zhenhua Du
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, NO. 36 Sanhao Street, Heping District, Shenyang City, 110021, Liaoning Province, China.
| | - Lei Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, NO. 36 Sanhao Street, Heping District, Shenyang City, 110021, Liaoning Province, China
| | - Yu Xia
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, NO. 36 Sanhao Street, Heping District, Shenyang City, 110021, Liaoning Province, China
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Thomaier L, Jewett P, Brown K, Gotlieb R, Teoh D, Blaes AH, Argenta P, Vogel RI. The associations between physical activity, neuropathy symptoms and health-related quality of life among gynecologic cancer survivors. Gynecol Oncol 2020; 158:361-365. [PMID: 32499071 DOI: 10.1016/j.ygyno.2020.05.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/17/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Physical activity may mitigate the effects of cancer treatment. We sought to evaluate the association between self-reported physical activity, neuropathy symptomatology, and emotional health in gynecologic cancer survivors. METHODS Patients were recruited from an academic gynecologic oncology practice to a prospective cohort study. Participants completed semiannual surveys on quality of life (QOL), neuropathy symptoms, depression, distress, and health behaviors. Abstracted clinical data included cancer type, FIGO stage at diagnosis and treatments received (chemotherapy, surgery, radiation). Physical activity [no: moderate physical activity <150 min/week, yes: ≥150 min/week] and neuropathy symptomatology [high (FACT/GOG-Ntx ≥11; upper quartile); low (<11)] were dichotomized. Linear regression models assessed the associations between physical activity, neuropathy and psychosocial outcomes. RESULTS A total of 194 participants were included in this analysis. We identified significant interactions between physical activity and neuropathy in the depression (p = 0.0006) and QOL (p = 0.007) models. Greater physical activity and lower neuropathy scores were independently associated with fewer depressive symptoms (p = 0.02 and p < 0.0001, respectively) and greater QOL (p = 0.005 and p < 0.0001). Low neuropathy scores were associated with lower distress (p < 0.0001). Women with high neuropathy scores had larger beneficial associations between being physically active and depression and QOL. In the distress model, interaction between neuropathy and physical activity was suggested (p = 0.05). CONCLUSIONS Physical activity was associated with favorable psychosocial outcomes in gynecologic cancer survivors, most notably among those with worse neuropathy. These data suggest prescriptive exercise should be evaluated as a means of mitigating cancer-associated neuropathies and their effect on emotional health.
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Affiliation(s)
- Lauren Thomaier
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America.
| | - Patricia Jewett
- University of Minnesota, Division of Hematology and Oncology, Minneapolis, MN, United States of America
| | - Katherine Brown
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America
| | - Rachael Gotlieb
- University of Minnesota Medical School, Minneapolis, MN, United States of America; University of Minnesota, Division of Hematology and Oncology, Minneapolis, MN, United States of America
| | - Deanna Teoh
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America
| | - Anne H Blaes
- University of Minnesota, Division of Hematology and Oncology, Minneapolis, MN, United States of America
| | - Peter Argenta
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America
| | - Rachel I Vogel
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, MN, United States of America
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A Natural Quinazoline Derivative from Marine Sponge Hyrtios erectus Induces Apoptosis of Breast Cancer Cells via ROS Production and Intrinsic or Extrinsic Apoptosis Pathways. Mar Drugs 2019; 17:md17120658. [PMID: 31771152 PMCID: PMC6950652 DOI: 10.3390/md17120658] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 12/20/2022] Open
Abstract
Here, we report the therapeutic potential of a natural quinazoline derivative (2-chloro-6-phenyl-8H-quinazolino[4,3-b]quinazolin-8-one) isolated from marine sponge Hyrtios erectus against human breast cancer. The cytotoxicity of the compound was investigated on a human breast carcinoma cell line (MCF-7). Antiproliferative activity of the compound was estimated by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. MTT assay showed significant inhibition of MCF-7 cells viability with the IC50 value of 13.04 ± 1.03 µg/mL after 48 h. The compound induced down-regulation of anti-apoptotic Bcl-2 protein and increase in the pro-apoptotic Bax/Bcl-2 ratio in MCF-7 cells. The compound activated the expression of Caspases-9 and stimulated downstream signal transducer Caspase-7. In addition, Caspase-8 showed remarkable up-regulation in MCF-7 cells treated with the compound. Moreover, the compound was found to promote oxidative stress in MCF-7 cells that led to cell death. In conclusion, the compound could induce apoptosis of breast carcinoma cells via a mechanism that involves ROS production and either extrinsic or intrinsic apoptosis pathways. The systemic toxic potential of the compound was evaluated in an in vivo mouse model, and it was found non-toxic to the major organs.
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Salyer C, Kobelka C, Barrie A, Weintraub MR, Powell CB. Clinical characteristics and outcomes in elderly women with BRCA1 and BRCA2 mutations. Gynecol Oncol 2019; 154:374-378. [PMID: 31160070 DOI: 10.1016/j.ygyno.2019.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Describe clinical characteristics and risk reducing strategies utilized among women with a BRCA mutation who lived to age 75 and above. METHODS A retrospective study of women with BRCA mutations identified from 1995 to 2015 in a California health care system. From a database of 1189 women, 69 participants were identified who lived to age 75 or older. Demographic and clinical characteristics were recorded, as well as cancer history and risk-reducing strategies utilized. Descriptive and bivariate analyses were used to analyze the cohort. RESULTS The median age of the cohort at study entry was 78 (IQR: 76-84) and the median age at time of genetic testing was 73 (IQR 68-79). Fifty (72%) women had a prior history of breast cancer and 27 (39%) had a history of ovarian cancer. Three of 19 (16%) women with no history of breast cancer elected to undergo a risk-reducing mastectomy (RRM) after their positive genetic test. Among 30 women with ovaries still in place, 14 (47%) underwent a risk-reducing salpingo-oophorectomy (RRSO); six were age 70 or older at the time of surgery. Four (6%) women in the cohort developed BRCA-related cancer after testing, one developed breast cancer and three developed pancreatic cancer. CONCLUSIONS Most women with BRCA mutations surviving beyond age 75 received their genetic test result at an older age and had a history of BRCA-related cancer. Women continued surveillance and risk reducing surgeries at an older age. Pancreatic cancer was the most common new cancer diagnosed in older BRCA mutation carriers.
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Affiliation(s)
- Chelsea Salyer
- Kaiser Permanente Obstetrics and Gynecology Residency Program, Oakland, CA, United States of America; Kaiser Permanente Genetics Department, San Francisco, CA, United States of America; Rebecca and John Moores Cancer Center, Department of Reproductive Medicine, Division of Gynecologic Oncology, University of California, San Diego, La Jolla, CA, United States of America; Kaiser Permanente Oakland Department of Graduate Medical Education, Oakland, CA, United States of America; Kaiser Permanente Northern California Gynecologic Oncology Program, San Francisco, CA, United States of America
| | - Christine Kobelka
- Kaiser Permanente Obstetrics and Gynecology Residency Program, Oakland, CA, United States of America; Kaiser Permanente Genetics Department, San Francisco, CA, United States of America; Rebecca and John Moores Cancer Center, Department of Reproductive Medicine, Division of Gynecologic Oncology, University of California, San Diego, La Jolla, CA, United States of America; Kaiser Permanente Oakland Department of Graduate Medical Education, Oakland, CA, United States of America; Kaiser Permanente Northern California Gynecologic Oncology Program, San Francisco, CA, United States of America
| | - Allison Barrie
- Kaiser Permanente Obstetrics and Gynecology Residency Program, Oakland, CA, United States of America; Kaiser Permanente Genetics Department, San Francisco, CA, United States of America; Rebecca and John Moores Cancer Center, Department of Reproductive Medicine, Division of Gynecologic Oncology, University of California, San Diego, La Jolla, CA, United States of America; Kaiser Permanente Oakland Department of Graduate Medical Education, Oakland, CA, United States of America; Kaiser Permanente Northern California Gynecologic Oncology Program, San Francisco, CA, United States of America
| | - Miranda Ritterman Weintraub
- Kaiser Permanente Obstetrics and Gynecology Residency Program, Oakland, CA, United States of America; Kaiser Permanente Genetics Department, San Francisco, CA, United States of America; Rebecca and John Moores Cancer Center, Department of Reproductive Medicine, Division of Gynecologic Oncology, University of California, San Diego, La Jolla, CA, United States of America; Kaiser Permanente Oakland Department of Graduate Medical Education, Oakland, CA, United States of America; Kaiser Permanente Northern California Gynecologic Oncology Program, San Francisco, CA, United States of America
| | - C Bethan Powell
- Kaiser Permanente Obstetrics and Gynecology Residency Program, Oakland, CA, United States of America; Kaiser Permanente Genetics Department, San Francisco, CA, United States of America; Rebecca and John Moores Cancer Center, Department of Reproductive Medicine, Division of Gynecologic Oncology, University of California, San Diego, La Jolla, CA, United States of America; Kaiser Permanente Oakland Department of Graduate Medical Education, Oakland, CA, United States of America; Kaiser Permanente Northern California Gynecologic Oncology Program, San Francisco, CA, United States of America; Division of Research, Kaiser Permanente Northern California, Oakland CA, United States of America.
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Karuturi MS, Lei X, Shen Y, Giordano SH, Swanick CW, Smith BD. Long-term decision regret surrounding systemic therapy in older breast cancer survivors: A population-based survey study. J Geriatr Oncol 2019; 10:973-979. [PMID: 30940493 DOI: 10.1016/j.jgo.2019.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/01/2018] [Accepted: 03/20/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Little is known regarding regret experienced by older breast cancer survivors surrounding the choice for adjuvant systemic therapy, which limits providers' ability to optimally engage in the shared decision-making process. To address this, we evaluated endocrine therapy and chemotherapy decisional regret in a population-based cohort of older breast cancer survivors. MATERIALS AND METHODS Nationally comprehensive Medicare claims identified women age ≥67 living in the US with non-metastatic breast cancer diagnosed in 2009 and still alive in 2015. The Decision Regret Scale, a validated index that assesses regret regarding treatment decisions on a scale of 0 (no regret) to 100, was used to measure regret for endocrine therapy and chemotherapy approximately 6 years after diagnosis and was adjusted for sampling weight. Multivariable logistic regression adjusted for patient, demographic, and treatment characteristics identified predictors of endocrine therapy and chemotherapy decision regret. RESULTS Of the 480 respondents, 299 patients (61.1%) reported receiving endocrine therapy and 133 (27%) chemotherapy. The overall weighted decision-regret score was 17.2 (95%CI 13.6-20.8) for endocrine therapy and 17.7 (95%CI 12.1-23.3) for chemotherapy. Risk factors for higher endocrine therapy regret included white race (referent non-white race; estimate 12.8, 95%CI 3.0-22.7; P = 0.01) and post-graduate educational attainment (referent college education; 11.6, 95%CI 1.9-21.3; P = 0.02). The only risk factor for chemotherapy regret, albeit marginal, was age ≥75 (referent age 67-74; 12.0, 95%CI -0.1-24.2; P = 0.05) CONCLUSION: Overall, decision regret levels regarding systemic therapy in older breast cancer survivors are reassuringly low. However, further studies are needed to explore drivers of regret in certain vulnerable subgroups of patients.
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Affiliation(s)
- Meghan Sri Karuturi
- Department of Breast Medical Oncology, The University of Texas, MD Anderson Cancer Center, United States of America.
| | - Xiudong Lei
- Department of Health Services, The University of Texas, MD Anderson Cancer Center, United States of America
| | - Yu Shen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, United States of America
| | - Sharon H Giordano
- Department of Breast Medical Oncology, The University of Texas, MD Anderson Cancer Center, United States of America; Department of Health Services, The University of Texas, MD Anderson Cancer Center, United States of America
| | - Cameron W Swanick
- Department of Radiation Oncology, Orlando Health UF Health Cancer Center, United States of America
| | - Benjamin D Smith
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, United States of America
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Feng J, Wen W, Jia YG, Liu S, Guo J. pH-Responsive Micelles Assembled by Three-Armed Degradable Block Copolymers with a Cholic Acid Core for Drug Controlled-Release. Polymers (Basel) 2019; 11:E511. [PMID: 30960495 PMCID: PMC6473676 DOI: 10.3390/polym11030511] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 02/06/2023] Open
Abstract
One of the most famous anticancer drugs, paclitaxel (PTX), has often been used in drug controlled-release studies. The polymers derived from bio-compound bile acids and degradable poly(ε-caprolactone) (PCL) form a reservoir and have been used as a drug delivery system with great advantages. Herein, we grafted poly(N,N-diethylaminoethyl methacrylate) and poly(poly(ethylene glycol) methyl ether methacrylate) into the bile acid-derived three-armed macroinitiator CA-(PCL)₃, resulting in the amphiphilic block copolymers CA-(PCL-b-PDEAEMA-b-PPEGMA)₃. These pH-responsive three-armed block copolymers self-assembled into micelles in aqueous solution and PTX was encapsulated into the micellar core to form PTX-loaded micelles with a drug loading of 29.92 wt %. The micelles were stable in PBS at pH 7.4 and showed a pH-triggered release behavior of PTX under acidic environments, in which 55% of PTX was released at pH 5.0 in 80 h. These cholic acid-based functionalized three-armed block polymers present good biocompatibility, showing great potential for drug controlled-release.
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Affiliation(s)
- Jingjie Feng
- School of Chemical Engineering & Light Industry, Guangdong University of Technology, Guangzhou 510006, China.
| | - Weiqiu Wen
- School of Chemical Engineering & Light Industry, Guangdong University of Technology, Guangzhou 510006, China.
| | - Yong-Guang Jia
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510641, China.
| | - Sa Liu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou 510641, China.
| | - Jianwei Guo
- School of Chemical Engineering & Light Industry, Guangdong University of Technology, Guangzhou 510006, China.
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You SH, Kim JS, Kim YS. Apoptosis and Cell Cycle Arrest in Two Human Breast Cancer Cell Lines by Dieckol Isolated from <i>Ecklonia cava</i>. ACTA ACUST UNITED AC 2018. [DOI: 10.14449/jbd.2018.6.2.39] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Buscariollo DL, Cronin AM, Borstelmann NA, Punglia RS. Impact of pre-diagnosis depressive symptoms and health-related quality of life on treatment choice for ductal carcinoma in situ and stage I breast cancer in older women. Breast Cancer Res Treat 2018; 173:709-717. [PMID: 30406869 DOI: 10.1007/s10549-018-5006-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 10/09/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine whether pre-diagnosis patient-reported health-related quality of life (HRQOL) and depressive symptoms are associated with local treatment for older women with ductal carcinoma in situ (DCIS) and stage I breast cancer (BC). METHODS Using the SEER-MHOS dataset, we identified women ≥ 65 years old with DCIS or stage I BC diagnosed 1998-2011 who completed surveys ≤ 24 months before diagnosis. Depressive symptoms were measured by major depressive disorder (MDD) risk and HRQOL was measured by Physical and Mental Component Summary scores (PCS and MCS, respectively) of the SF-36/VR-12. Associations with treatment choice (breast-conserving surgery [BCS] and radiation therapy [RT], BCS alone, mastectomy) were assessed with multivariable multinomial logistic regression, controlling for patient characteristics. RESULTS We identified 425 women with DCIS and 982 with stage I BC. Overall, 20.4% endorsed depressive symptoms placing them at risk for MDD pre-diagnosis; mean MCS and PCS scores were 52.3 (SD = 10.1) and 40.5 (SD = 11.5), respectively. Among women with DCIS, those at risk for MDD were more likely to receive BCS (adjusted odds ratio [AOR] 2.04, 95% CI 1.04-4.00, p = 0.04) or mastectomy (AOR 1.88, 95% CI 0.91-3.86, p = 0.09) compared to BCS + RT. For DCIS, MCS score was not associated with treatment; higher PCS score was associated with decreased likelihood of receiving mastectomy versus BCS + RT (AOR 0.71 per 10-point increase, 95% CI 0.54-0.95, p = 0.02). For BC, none of the measures were significantly associated with treatment. CONCLUSION Older women at risk for MDD before DCIS diagnosis were less likely to receive RT after BCS, compared to BCS alone or mastectomy.
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Affiliation(s)
- Daniela L Buscariollo
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Angel M Cronin
- Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Nancy A Borstelmann
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rinaa S Punglia
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.
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Chen S, Liu Y, Zhu S, Chen C, Xie W, Xiao L, Zhu Y, Hao L, Wang Z, Sun J, Chang S. Dual-mode imaging and therapeutic effects of drug-loaded phase-transition nanoparticles combined with near-infrared laser and low-intensity ultrasound on ovarian cancer. Drug Deliv 2018; 25:1683-1693. [PMID: 30343601 PMCID: PMC6201789 DOI: 10.1080/10717544.2018.1507062] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/26/2018] [Accepted: 07/29/2018] [Indexed: 12/29/2022] Open
Abstract
Chemotherapy and photo-sonodynamic therapy (PSDT) can be combined through drug delivery nano-platforms to enhance the anti-tumor efficacy, however, which is limited by hypoxia in tumor, thereby causing chemotherapy resistance. Perfluoropentane (PFP) has the ability to carry oxygen and to enhance ultrasound or photoacoustic imaging after vaporization. Herein, we constructed a kind of nanoparticles (PTX/ICG and oxygen loaded PLGA nanoparticles (PIO_NPs)), which had PFP core carrying oxygen and PLGA shell loaded indocyanine green (ICG) and paclitaxel (PTX). PIO_NPs harbored good optical stability and the ability to transit phase. Moreover, it could rapidly release PTX and generate ROS under the mediation by near-infrared laser and low-intensity ultrasound. The PIO_NPs enhanced contrast of the ultrasound and PA imaging. In particular, PIO_NPs may be used to monitor and guide treatment for the accumulation of PIO_NPs at tumor site can be observed by PA imaging. Compared with PTX or other nanoparticles, PIO_NPs combined with laser and ultrasound (L.U) significantly induced apoptosis of SKOV3 cells and inhibited SKOV3 tumor growth. Therefore, PIO_NPs are of great potential in cancer imaging and therapy.
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Affiliation(s)
- Shuning Chen
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
- Institute of Ultrasound Imaging, Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Yujiao Liu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Shenyin Zhu
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Chunyan Chen
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Wan Xie
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Linlin Xiao
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Yi Zhu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Lan Hao
- Institute of Ultrasound Imaging, Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Zhigang Wang
- Institute of Ultrasound Imaging, Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Jiangchuan Sun
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Shufang Chang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
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Efird JT, Hunter S, Chan S, Jeong S, Thomas SL, Jindal C, Biswas T. The Association between Age, Comorbidities and Use of Radiotherapy in Women with Breast Cancer: Implications for Survival. MEDICINES (BASEL, SWITZERLAND) 2018; 5:E62. [PMID: 29941817 PMCID: PMC6163280 DOI: 10.3390/medicines5030062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/18/2018] [Accepted: 06/23/2018] [Indexed: 01/22/2023]
Abstract
Background: Radiotherapy (RT) plays an important role in the management and survival of patients with breast cancer. The aim of this study was to examine the association between age, comorbidities and use of RT in this population. Methods: Patients diagnosed with breast cancer from 2004⁻2013 were identified from the American College of Surgeons National Cancer Database (NCDB). Follow-up time was measured from the date of diagnosis (baseline) to the date of death or censoring. Adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) were used as the measure of association. Results: Independently of comorbidities and other important outcome-related factors, patients >65 years of age who received RT survived significantly longer than those who did not receive RT (aHR = 0.53, 95% CI = 0.52⁻0.54). However, as women aged, those with comorbidities were less likely to receive RT (adjusted p-trend by age < 0.0001). Conclusions: The development of decision-making tools to assist clinicians, and older women with breast cancer and comorbidities, are needed to facilitate personalized treatment plans regarding RT. This is particularly relevant as the population ages and the number of women with breast cancer is expected to increase in the near future.
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Affiliation(s)
- Jimmy T Efird
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, The University of Newcastle (UoN), Newcastle 2308, Australia.
- Priority Research Centre for Generational Health and Ageing (PRCGHA), School of Medicine and Public Health, the University of Newcastle (UoN), Newcastle 2308, Australia.
| | - Sharyn Hunter
- School of Nursing and Midwifery, the University of Newcastle (UoN), Callaghan 2308, Australia.
| | - Sally Chan
- School of Nursing and Midwifery, the University of Newcastle (UoN), Callaghan 2308, Australia.
| | - Sarah Jeong
- School of Nursing and Midwifery, the University of Newcastle (UoN), Callaghan 2308, Australia.
| | - Susan L Thomas
- School of Nursing and Midwifery, the University of Newcastle (UoN), Callaghan 2308, Australia.
| | - Charulata Jindal
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, The University of Newcastle (UoN), Newcastle 2308, Australia.
| | - Tithi Biswas
- Department of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, OH 44106, USA.
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Quinten C, Kenis C, Hamaker M, Coolbrandt A, Brouwers B, Dal Lago L, Neven P, Vuylsteke P, Debrock G, Van Den Bulck H, Smeets A, Schöffski P, Bottomley A, Wedding U, Wildiers H. The effect of adjuvant chemotherapy on symptom burden and quality of life over time; a preliminary prospective observational study using individual data of patients aged ≥ 70 with early stage invasive breast cancer. J Geriatr Oncol 2018; 9:152-162. [DOI: 10.1016/j.jgo.2017.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/29/2017] [Accepted: 10/13/2017] [Indexed: 12/27/2022]
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Rottenberg Y, Naeim A, Uziely B, Peretz T, Jacobs JM. Breast cancer among older women: The influence of age and cancer stage on survival. Arch Gerontol Geriatr 2018; 76:60-64. [PMID: 29459246 DOI: 10.1016/j.archger.2018.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 02/03/2018] [Accepted: 02/05/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE OF STUDY To describe the association between increasing age and survival among women aged over 65 years, diagnosed with breast cancer. MATERIALS AND METHODS A historical prospective cohort study, comparing 3270 breast cancer patients to 13,163 non cancer age matched controls. Baseline characteristics and cancer data gathered from the Israeli Central Bureau of Statistics (1995), the Israel Cancer Registry (2000-2010). Baseline measurements included age, socioeconomic status. Cancer stage at diagnosis was clustered as stage I, stage II-III and metastatic. Cox Proportional Hazards regression models were used to determine Hazards Ratios (HR) for mortality. RESULTS Between ages 65-69 and ≥85, metastatic disease rose from 3.9% to 23.4% and stage I disease declined from 58.6% to 30.1%. At age 80-84, 50% life expectancy among controls, stage I, and stage II-III disease was 95,92 and 90 months respectively, compared to 2 months for metastatic disease. Compared to controls, between the age 65-69 to ≥85, adjusted HR's progressively decreased among subjects with stage I from HR 0.96 (95% CI 0.69-1.33) to 0.60 (95%CI 0.36-1.01), stage II-III from HR 3.26 (95%CI2.58-4.12) to HR 1.60 (95%CI 1.22-2.09), and metastatic disease from HR 57.40 (95%CI 39.56-83.29) to HR 20.76 (95%CI 14.73-29.24). CONCLUSIONS This study describes the increasingly poor prognosis and short life expectancy observed among women aged ≥80 diagnosed with metastatic breast. In contrast, our findings confirm the positive prognosis associated with rising age, among older women presenting with stage I breast cancer, among whom survival was similar, if not slightly better, than non-cancer age matched controls.
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Affiliation(s)
- Yakir Rottenberg
- The Department of Oncology, Hadassah-Hebrew University Medical Center, Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel; The Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center Mount Scopus, Hebrew University-Hadassah Medical School, Mount Scopus, Jerusalem, Israel.
| | - Arash Naeim
- Divisions of Hematology-Oncology and Geriatric Medicine, Department of Medicine and Jonsson Comprehensive Cancer Center, David Geffen UCLA School of Medicine, 10911 Weyburn Avenue, Los Angeles, CA 90095, United States
| | - Beatrice Uziely
- The Department of Oncology, Hadassah-Hebrew University Medical Center, Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Tamar Peretz
- The Department of Oncology, Hadassah-Hebrew University Medical Center, Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel
| | - Jeremy M Jacobs
- The Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center Mount Scopus, Hebrew University-Hadassah Medical School, Mount Scopus, Jerusalem, Israel; The Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center Mount Scopus, Hebrew University-Hadassah Medical School, Mount Scopus, Jerusalem, Israel.
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Karam A, Ledermann J, Kim JW, Sehouli J, Lu K, Gourley C, Katsumata N, Burger R, Nam BH, Bacon M, Ng C, Pfisterer J, Bekkers R, Casado Herráez A, Redondo A, Fujiwara H, Gleeson N, Rosengarten O, Scambia G, Zhu J, Okamoto A, Stuart G, Ochiai K. Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: first-line interventions. Ann Oncol 2017; 28:711-717. [DOI: 10.1093/annonc/mdx011] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Indexed: 11/13/2022] Open
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von Gruenigen VE, Huang HQ, Beumer JH, Lankes HA, Tew W, Herzog T, Hurria A, Mannel RS, Rizack T, Landrum LM, Rose PG, Salani R, Bradley WH, Rutherford TJ, Higgins RV, Secord AA, Fleming G. Chemotherapy completion in elderly women with ovarian, primary peritoneal or fallopian tube cancer - An NRG oncology/Gynecologic Oncology Group study. Gynecol Oncol 2017; 144:459-467. [PMID: 28089376 PMCID: PMC5570471 DOI: 10.1016/j.ygyno.2016.11.033] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/16/2016] [Accepted: 11/20/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE A simple measure to predict chemotherapy tolerance in elderly patients would be useful. We prospectively tested the association of baseline Instrumental Activities of Daily Living (IADL) score with ability to complete 4 cycles of first line chemotherapy without dose reductions or >7days delay in elderly ovarian cancer patients. PATIENTS AND METHODS Patients' age ≥70 along with their physicians chose between two regimens: CP (Carboplatin AUC 5, Paclitaxel 135mg/m2) or C (Carboplatin AUC 5), both given every 3weeks either after primary surgery or as neoadjuvant chemotherapy (NACT) with IADL and quality of life assessments performed at baseline, pre-cycle 3, and post-cycle 4. RESULTS Two-hundred-twelve women were enrolled, 152 selecting CP and 60 selecting C. Those who selected CP had higher baseline IADL scores (p<0.001). After adjusting for age and PS, baseline IADL was independently associated with the choice of regimen (p=0.035). The baseline IADL score was not found to be associated with completion of 4 cycles of chemotherapy without dose reduction or delays (p=0.21), but was associated with completion of 4 cycles of chemotherapy regardless of dose reduction and delay (p=0.008) and toxicity, with the odds ratio (OR) of grade 3+ toxicity decreasing 17% (OR: 0.83; 95%CI: 0.72-0.96; p=0.013) for each additional activity in which the patient was independent. After adjustment for chemotherapy regimen, IADL was also associated with overall survival (p=0.019) for patients receiving CP. CONCLUSION Patients with a higher baseline IADL score (more independent) were more likely to complete 4 cycles of chemotherapy and less likely to experience grade 3 or higher toxicity.
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Affiliation(s)
- Vivian E von Gruenigen
- Division of Gynecologic Oncology, Summa Akron City Hospital, NEOMED, Akron, OH 44304, United States.
| | - Helen Q Huang
- NRG Oncology Statistics & Data Center, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
| | - Jan H Beumer
- Cancer Therapeutics Program, University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, PA 15213, United States; Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15213, United States; Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United States.
| | - Heather A Lankes
- NRG Oncology Statistics & Data Center, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
| | - William Tew
- Memorial Sloan Kettering Cancer Center, Department of Medicine, Gynecologic Medical Oncology Service, New York, NY 10065, United States.
| | - Thomas Herzog
- Department of Obstetrics and Gynecology, Columbia University Cancer Center, New York NY, 10032, United States.
| | - Arti Hurria
- Department of Obstetrics and Gynecology, Columbia University Cancer Center, New York NY, 10032, United States.
| | - Robert S Mannel
- Division of Obstetrics & Gynecology, The Peggy and Charles Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States.
| | - Tina Rizack
- Dept. of Gynecologic Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States.
| | - Lisa M Landrum
- Division of Obstetrics & Gynecology, The Peggy and Charles Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States.
| | - Peter G Rose
- Dept. of Gynecologic Oncology, Cleveland Clinic Foundation, Cleveland, OH 44109, United States
| | - Ritu Salani
- Dept. of Gynecologic Oncology, Ohio State University Medical Center, Columbus, OH 43210, United States.
| | - William H Bradley
- Dept. of OB/GYN, Medical College of Wisconsin, Milwaukee, WI 53226, United States.
| | - Thomas J Rutherford
- Dept. of OB/GYN, Western Connecticut Health Network, Norwalk, CT 06856, United States.
| | - Robert V Higgins
- Dept. of Gynecologic Oncology, Carolinas Medical Center, Blumenthal Cancer Center, Charlotte, NC 28203, United States.
| | - Angeles Alvarez Secord
- Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC 27710, United States; Dept. of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, United States.
| | - Gini Fleming
- Section of Hematology-Oncology, Department of Medicine, The University of Chicago, Chicago, IL 60637, United States.
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Chen Y, Song G, Dong Z, Yi X, Chao Y, Liang C, Yang K, Cheng L, Liu Z. Drug-Loaded Mesoporous Tantalum Oxide Nanoparticles for Enhanced Synergetic Chemoradiotherapy with Reduced Systemic Toxicity. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2017; 13:1602869. [PMID: 27957802 DOI: 10.1002/smll.201602869] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 09/29/2016] [Indexed: 06/06/2023]
Abstract
Combining chemotherapy and radiotherapy (chemoradiotherapy) has been widely applied in many clinical practices, showing promises in enhancing therapeutic outcomes. Nontoxic nanocarriers that not only are able to deliver chemotherapeutics into tumors, but could also act as radiosensitizers to enhance radiotherapy would thus be of great interest in the development of chemoradiotherapies. To achieve this aim, herein mesoporous tantalum oxide (mTa2 O5 ) nanoparticles with polyethylene glycol (PEG) modification are fabricated. Those mTa2 O5 -PEG nanoparticles could serve as a drug delivery vehicle to allow efficient loading of chemotherapeutics such as doxorubicin (DOX), whose release appears to be pH responsive. Meanwhile, owing to the interaction of Ta with X-ray, mTa2 O5 -PEG nanoparticles could offer an intrinsic radiosensitization effect to increase X-ray-induced DNA damages during radiotherapy. As a result, DOX-loaded mTa2 O5 -PEG (mTa2 O5 -PEG/DOX) nanoparticles can offer a strong synergistic therapeutic effect during the combined chemoradiotherapy. Furthermore, in chemoradiotherapy, such mTa2 O5 -PEG/DOX shows remarkably reduced side effects compared to free DOX, which at the same dose appears to be lethal to animals. This work thus presents a new type of mesoporous nanocarrier particularly useful for the delivery of safe and effective chemoradiotherapy.
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Affiliation(s)
- Yuyan Chen
- Institute of Functional Nano and Soft Materials (FUNSOM), Collaborative Innovation Center of Suzhou Nano Science and Technology, the Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Guosheng Song
- Institute of Functional Nano and Soft Materials (FUNSOM), Collaborative Innovation Center of Suzhou Nano Science and Technology, the Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Ziliang Dong
- Institute of Functional Nano and Soft Materials (FUNSOM), Collaborative Innovation Center of Suzhou Nano Science and Technology, the Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Xuan Yi
- School of Radiation Medicine and Protection and School for Radiological and Interdisciplinary Sciences (RAD-X), Medical College of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Yu Chao
- Institute of Functional Nano and Soft Materials (FUNSOM), Collaborative Innovation Center of Suzhou Nano Science and Technology, the Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Chao Liang
- Institute of Functional Nano and Soft Materials (FUNSOM), Collaborative Innovation Center of Suzhou Nano Science and Technology, the Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Kai Yang
- School of Radiation Medicine and Protection and School for Radiological and Interdisciplinary Sciences (RAD-X), Medical College of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Liang Cheng
- Institute of Functional Nano and Soft Materials (FUNSOM), Collaborative Innovation Center of Suzhou Nano Science and Technology, the Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou, Jiangsu, 215123, China
| | - Zhuang Liu
- Institute of Functional Nano and Soft Materials (FUNSOM), Collaborative Innovation Center of Suzhou Nano Science and Technology, the Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices, Soochow University, Suzhou, Jiangsu, 215123, China
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Sorio R, Roemer-Becuwe C, Hilpert F, Gibbs E, García Y, Kaern J, Huizing M, Witteveen P, Zagouri F, Coeffic D, Lück HJ, González-Martín A, Kristensen G, Levaché CB, Lee CK, Gebski V, Pujade-Lauraine E. Safety and efficacy of single-agent bevacizumab-containing therapy in elderly patients with platinum-resistant recurrent ovarian cancer: Subgroup analysis of the randomised phase III AURELIA trial. Gynecol Oncol 2017; 144:65-71. [DOI: 10.1016/j.ygyno.2016.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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Jolly TA, Williams GR, Bushan S, Pergolotti M, Nyrop KA, Jones EL, Muss HB. Adjuvant treatment for older women with invasive breast cancer. ACTA ACUST UNITED AC 2016; 12:129-45; quiz 145-6. [PMID: 26767315 DOI: 10.2217/whe.15.92] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Older women experience a large share of breast cancer incidence and death. With the projected rise in the number of older cancer patients, adjuvant chemo-, radiation and endocrine therapy management will become a key component of breast cancer treatment in older women. Many factors influence adjuvant treatment decisions including patient preferences, life expectancy and tumor biology. Geriatric assessment predicts important outcomes, identifies key deficits, and can aid in the decision making process. This review utilizes clinical vignettes to illustrate core principles in adjuvant management of breast cancer in older women and suggests an approach incorporating life expectancy and geriatric assessment.
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Affiliation(s)
- Trevor A Jolly
- Hematology & Oncology Division, University of North Carolina, Chapel Hill, NC 27599, USA.,Division of Geriatric Medicine & Center for Aging & Health, University of North Carolina, Chapel Hill, NC 27599, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Grant R Williams
- Hematology & Oncology Division, University of North Carolina, Chapel Hill, NC 27599, USA.,Division of Geriatric Medicine & Center for Aging & Health, University of North Carolina, Chapel Hill, NC 27599, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Sita Bushan
- Department of Medicine/School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Mackenzi Pergolotti
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kirsten A Nyrop
- Hematology & Oncology Division, University of North Carolina, Chapel Hill, NC 27599, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Ellen L Jones
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Hyman B Muss
- Hematology & Oncology Division, University of North Carolina, Chapel Hill, NC 27599, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27514, USA
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Peng MT, Chen SC, Shen WC, Lin YC, Chang HK. The adherence and tolerance of adjuvant endocrine therapy in geriatric breast cancer patients. JOURNAL OF CANCER RESEARCH AND PRACTICE 2016. [DOI: 10.1016/j.jcrpr.2016.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Tew WP. Ovarian cancer in the older woman. J Geriatr Oncol 2016; 7:354-61. [PMID: 27499341 DOI: 10.1016/j.jgo.2016.07.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/02/2016] [Accepted: 07/18/2016] [Indexed: 02/08/2023]
Abstract
Ovarian cancer is the seventh most common cancer in women worldwide and accounts for nearly 4% of all new cases of cancer in women. Almost half of all patients with ovarian cancer are over the age of 65 at diagnosis, and over 70% of deaths from ovarian cancer occur in this same age group. As the population ages, the number of older women with ovarian cancer is increasing. Compared to younger women, older women with ovarian cancer receive less surgery and chemotherapy, develop worse toxicity, and have poorer outcomes. They are also significantly under-represented in clinical trials and thus application of standard treatment regimens can be challenging. Performance status alone has been shown to be an inadequate tool to predict toxicity of older patients from chemotherapy. Use of formal geriatric assessment tools is a promising direction for stratifying older patients on trials. Elderly-specific trials, adjustments to the eligibility criteria, modified treatment regimens, and interventions to decrease morbidities in the vulnerable older population should be encouraged.
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Cardiac toxicity of trastuzumab in elderly patients with breast cancer. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:355-63. [PMID: 27403145 PMCID: PMC4921548 DOI: 10.11909/j.issn.1671-5411.2016.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Breast cancer (BC) is diagnosed in ≥ 65 year old women in about half of cases. Experts currently recommend that systemic therapy is offered to elderly patients with BC, if, based on their overall conditions and life expectancy, it can be reasonably anticipated that the benefits will outweigh the risks of treatment. Like for young subjects, the monoclonal antibody against human epidermal growth factor receptor-2 (HER-2), trastuzumab, represents a valid therapeutic option when BC over-expresses this receptor. Unfortunately, administration of trastuzumab is associated with the occurrence of left ventricular dysfunction and chronic heart failure (CHF), possibly because of interference with the homeostatic functions of HER-2 in the heart. Registry-based, retrospective analyses have reported an incidence of CHF around 25% in elderly women receiving trastuzumab compared with 10%-15% in those not given any therapy for BC, and the risk of CHF has been estimated to be two-fold higher in > 60-65 year old trastuzumab users vs. non-users. Extremely advanced age and preexisting cardiac disease have been shown to predispose to trastuzumab cardiotoxicity. Therefore, selection of older patients for treatment with trastuzumab should be primarily based on their general status and the presence of comorbidities; previous chemotherapy, especially with anthracyclines, should be also taken into account. Once therapy has started, efforts should be made to ensure regular cardiac surveillance. The role of selected biomarkers, such as cardiac troponin, or new imaging techniques (three-dimension, tissue Doppler echocardiography, magnetic resonance imaging) is promising, but must be further investigated especially in the elderly. Moreover, additional studies are needed in order to better understand the mechanisms by which trastuzumab affects the old heart.
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Kim HK, Ham JS, Byeon S, Yoo KH, Jung KS, Song HN, Cho J, Lee JY, Lim SH, Kim HS, Kim JY, Lee JE, Kim SW, Nam SJ, Lee SK, Bae SY, Ahn JS, Im YH, Park YH. Clinicopathologic Features and Long-Term Outcomes of Elderly Breast Cancer Patients: Experiences at a Single Institution in Korea. Cancer Res Treat 2016; 48:1382-1388. [PMID: 26987392 PMCID: PMC5080825 DOI: 10.4143/crt.2015.423] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/03/2016] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the tumor characteristics and long-term clinical outcomes of adjuvant treatments after surgery with a curative aim for patients with breast cancer who are 65 years and older. MATERIALS AND METHODS Patients with breast cancer who underwent curative surgery from 2000 to 2009 were analyzed (n=4,388). Tumor characteristics and survival outcome were compared by dividing the patients into two age groups (< 65 and ≥ 65 years old). The Kaplan-Meier method was used for comparison of survival rates by log-rank test, and a Cox regression model was used to examine the effect of variables. RESULTS Among 4,388 patients with invasive breast cancer, 317 patients (7.2%) were 65 years or older and the median age of all patients was 47 years (range, 18 to 91 years). Tumor characteristics were similar between the two age groups, but the older patients were treated less often with adjuvant treatments. During a median follow-up period of 122 months, recurrence-free survival (RFS) was equivalent for patients 65 years and older compared to younger patients, but significantly worse in overall survival (OS) and breast cancer-specific survival (BCSS) (5-year OS, 94.3% vs. 90.5%; p < 0.001 and 5-year BCSS, 94.7% vs. 91.8%; p=0.031). In the multivariate model, age ≥ 65 years old was identified as an independent risk factor for OS and RFS. CONCLUSION Elderly breast cancer appeared to have worse outcomes with very low prevalence in Korea, despite similar tumor characteristics. More active adjuvant therapies would have a role for aggressive subtypes for fit, elderly patients.
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Affiliation(s)
- Hee Kyung Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Soo Ham
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seonggyu Byeon
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwai Han Yoo
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Sun Jung
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Haa-Na Song
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinhyun Cho
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Yun Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Hee Lim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hae Su Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Won Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Youn Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Seok Ahn
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Hyuck Im
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon Hee Park
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Jensen JD, Cold S, Nielsen MH, Jylling AMB, Søe KL, Larsen LB, Ewertz M. Trends in breast cancer in the elderly in Denmark, 1980-2012. Acta Oncol 2016; 55 Suppl 1:59-64. [PMID: 26781003 DOI: 10.3109/0284186x.2015.1115118] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Breast cancer is the most frequent malignancy among women worldwide and the second most common cause of cancer-related death in developed countries. The aim of the present analysis is to describe trends in incidence, mortality, prevalence, and relative survival in Denmark from 1980 to 2012 focusing on age, comparing persons aged 70 years or more with those aged less than 70 years. MATERIAL AND METHODS Cancer of the breast was defined as ICD-10 code C50. Data derived from the NORDCAN database with comparable data on cancer incidence, mortality, prevalence and relative survival in the Nordic countries, where the Danish data were delivered from the Danish Cancer Registry and the Danish Cause of Death Registry with follow-up for death or emigration until the end of 2013. RESULTS The proportion of patients diagnosed with breast cancer over the age of 70 years increased with time to 29% of women and 44% of men in 2012. Incidence rates increased with time and peaked around 2010 in all age groups except for those aged 90 years or more. Mortality rates were clearly separated by age with increasing mortality rates by increasing age group for both women and men. Relative survival increased over time in all age groups, but patients aged 70 years or more had a poorer relative survival than those aged less than 70 years. In 2012, 58 521 persons (all ages) were alive in Denmark after a diagnosis of breast cancer. CONCLUSION Poorer survival of Danish breast cancer patients over the age of 70 years is likely to be due to inferior treatment and non-adherence to treatment guidelines. There is a need for clinical trials focusing on patients over the age of 70 years.
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Affiliation(s)
- Jeanette D Jensen
- a Department of Oncology , Odense University Hospital, Institute of Clinical Research, University of Southern Denmark , Odense , Denmark
| | - Søren Cold
- a Department of Oncology , Odense University Hospital, Institute of Clinical Research, University of Southern Denmark , Odense , Denmark
| | - Mette H Nielsen
- a Department of Oncology , Odense University Hospital, Institute of Clinical Research, University of Southern Denmark , Odense , Denmark
| | - Anne Marie B Jylling
- b Department of Clinical Pathology , Odense University Hospital , Odense , Denmark
| | - Katrine L Søe
- c Department of Plastic Surgery , Odense University Hospital , Odense , Denmark
| | - Lisbet B Larsen
- d Department of Radiology , Odense University Hospital , Odense , Denmark
| | - Marianne Ewertz
- a Department of Oncology , Odense University Hospital, Institute of Clinical Research, University of Southern Denmark , Odense , Denmark
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Abstract
Epithelial ovarian cancer is primarily a disease of older women. Advanced age is risk factor for decreased survival. Optimal surgery and the safe and effective administration of chemotherapy are essential for prolonged progression-free and overall survival (OS). In this article, the available regimens in both the primary treatment and relapsed setting are reviewed.
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Affiliation(s)
| | - Stuart M Lichtman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 11725, USA
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Baird R, Banks I, Cameron D, Chester J, Earl H, Flannagan M, Januszewski A, Kennedy R, Payne S, Samuel E, Taylor H, Agarwal R, Ahmed S, Archer C, Board R, Carser J, Copson E, Cunningham D, Coleman R, Dangoor A, Dark G, Eccles D, Gallagher C, Glaser A, Griffiths R, Hall G, Hall M, Harari D, Hawkins M, Hill M, Johnson P, Jones A, Kalsi T, Karapanagiotou E, Kemp Z, Mansi J, Marshall E, Mitchell A, Moe M, Michie C, Neal R, Newsom-Davis T, Norton A, Osborne R, Patel G, Radford J, Ring A, Shaw E, Skinner R, Stark D, Turnbull S, Velikova G, White J, Young A, Joffe J, Selby P. An Association of Cancer Physicians' strategy for improving services and outcomes for cancer patients. Ecancermedicalscience 2016; 10:608. [PMID: 26913066 PMCID: PMC4762575 DOI: 10.3332/ecancer.2016.608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Indexed: 12/02/2022] Open
Abstract
The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members.
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Affiliation(s)
- Richard Baird
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Addenbrooke’s Hospital, Cambridge, UK
| | - Ian Banks
- ACP Strategy Drafting Group
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - David Cameron
- ACP Executive Member
- ACP Strategy Drafting Group
- Edinburgh Cancer Research Centre, UK
| | - John Chester
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Wales Cancer Research Centre, Cardiff, UK
| | - Helena Earl
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Addenbrooke’s Hospital, Cambridge, UK
| | - Mark Flannagan
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Beating Bowel Cancer, Harlequin House, 7 High St, Teddington, Middlesex TW11 8EE, UK
| | - Adam Januszewski
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- London Deanery, Stewart House, 32 Russell Square, London WC1B 5DN, UK
| | | | - Sarah Payne
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Guy’s and St Thomas’s Hospital, London, UK and Medical Affairs Manager, Pfizer
| | - Emlyn Samuel
- ACP Strategy Drafting Group
- Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
| | - Hannah Taylor
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Severn Deanery, Vantage Office Park Old Gloucester Road, Hambrook, Avon, Bristol BS16 1GW, UK
| | - Roshan Agarwal
- ACP Executive Member
- Northampton General Hospital, Cliftonville, Northampton NN1 5BD, UK
| | - Samreen Ahmed
- ACP Executive Member
- University Hospitals of Leicester, Infirmary Square, Leicester LE1 5WW, UK
| | - Caroline Archer
- ACP Executive Member
- Queen Alexandra Hospital, Portsmouth, UK
| | - Ruth Board
- ACP Executive Member
- Lancashire Teaching Hospitals, UK
| | - Judith Carser
- ACP Executive Member
- Southern Health and Social Care Trust, Southern College of Nursing, Craigavon Area Hospital, 68 Lurgan Road, Portadown, BT63 5QQ, UK
| | - Ellen Copson
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | - David Cunningham
- ACP Executive Member
- Supporting Chapter Author
- NIHR Biomedical Research Centre, Royal Marsden Hospital, London, UK
| | - Rob Coleman
- ACP Executive Member
- Weston Park Hospital, Sheffield, UK
| | - Adam Dangoor
- ACP Executive Member
- Supporting Chapter Author
- University Hospitals Bristol, Bristol, UK
| | - Graham Dark
- Supporting Chapter Author
- Freeman Hospital, Newcastle, UK
| | - Diana Eccles
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | | | - Adam Glaser
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - Richard Griffiths
- ACP Executive Member
- Supporting Chapter Author
- Clatterbridge Cancer Centre, Clatterbridge Health Park, Clatterbridge Rd, Wirral, Merseyside CH63 4JY, UK
| | - Geoff Hall
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Marcia Hall
- ACP Executive Member
- Mount Vernon Cancer Centre, Northwood, UK
| | - Danielle Harari
- Supporting Chapter Author
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Michael Hawkins
- Supporting Chapter Author
- University of Birmingham, Edgbaston, Birmingham, West Midlands B15 2TT, UK
| | - Mark Hill
- ACP Executive Member
- Kent Oncology Centre, Maidstone, Kent, UK
| | - Peter Johnson
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | - Alison Jones
- ACP Executive Member
- Royal Free and University College Hospital, London, UK
| | - Tania Kalsi
- Supporting Chapter Author
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | | | - Zoe Kemp
- Supporting Chapter Author
- Royal Marsden Hospital, London, UK
| | - Janine Mansi
- ACP Executive Member
- Supporting Chapter Author
- Guy’s and St Thomas’ Hospitals, London, UK
| | - Ernie Marshall
- Supporting Chapter Author
- Clatterbridge Cancer Centre, Clatterbridge Health Park, Clatterbridge Rd, Wirral, Merseyside CH63 4JY, UK
| | - Alex Mitchell
- Supporting Chapter Author
- University of Leicester, University Rd, Leicester LE1 7RH, UK
| | - Maung Moe
- ACP Executive Member
- North Middlesex University Hospital, UK
| | | | - Richard Neal
- Supporting Chapter Author
- University of Bangor, Bangor, Gwynedd LL57 2DG , Wales, UK
| | - Tom Newsom-Davis
- Supporting Chapter Author
- Chelsea and Westminster Hospital, London, UK
| | | | - Richard Osborne
- Supporting Chapter Author
- Poole Hospital, Longfleet Rd, Poole, Dorset BH15 2JB, UK
| | - Gargi Patel
- ACP Executive Member
- Brighton and Sussex University Hospitals, UK
| | - John Radford
- Supporting Chapter Author
- University of Manchester, Oxford Rd, Manchester M13 9PL, UK
| | - Alistair Ring
- Supporting Chapter Author
- Royal Marsden Hospital, London, UK
| | - Emily Shaw
- Supporting Chapter Author
- Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK
| | - Rod Skinner
- Supporting Chapter Author
- Royal Victoria Infirmary, Newcastle, UK
| | - Dan Stark
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Sam Turnbull
- ACP Executive Member
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Galina Velikova
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - Jeff White
- Supporting Chapter Author
- Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
| | - Alison Young
- ACP Executive Member
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Johnathan Joffe
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Senior Author
- Huddersfield Royal Infirmary, Acre St, Huddersfield, West Yorkshire HD3 3EA, UK
| | - Peter Selby
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Senior Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
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Bešević J, Gunter MJ, Fortner RT, Tsilidis KK, Weiderpass E, Charlotte Onland-Moret N, Dossus L, Tjønneland A, Hansen L, Overvad K, Mesrine S, Baglietto L, Clavel-Chapelon F, Kaaks R, Aleksandrova K, Boeing H, Trichopoulou A, Lagiou P, Bamia C, Masala G, Agnoli C, Tumino R, Ricceri F, Panico S, Bueno-de-Mesquita HB, Peeters PH, Jareid M, Ramón Quirós J, Duell EJ, Sánchez MJ, Larrañaga N, Chirlaque MD, Barricarte A, Dias JA, Sonestedt E, Idahl A, Lundin E, Wareham NJ, Khaw KT, Travis RC, Rinaldi S, Romieu I, Riboli E, Merritt MA. Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study. Br J Cancer 2015; 113:1622-31. [PMID: 26554655 PMCID: PMC4705888 DOI: 10.1038/bjc.2015.377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/06/2015] [Accepted: 10/08/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521,330 total participants (approximately 370,000 women) aged 25-70 years at recruitment from 1992 to 2000. METHODS Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre. RESULTS After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever vs never use, HR=0.80, 95% CI=0.62-1.03) and a significant survival benefit in long-term MHT users (⩾5 years use vs never use, HR=0.70, 95% CI=0.50-0.99, P(trend)=0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk. CONCLUSIONS Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.
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Affiliation(s)
- Jelena Bešević
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, Ioannina 45110, Greece
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway, Tromsø N–9037, Norway
- Department of Research, Cancer Registry of Norway, PB 5313 Majorstuen, 0304 Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, Stockholm 17177, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, FI-00290 Helsinki, Finland
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands
| | - Laure Dossus
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Villejuif F-94805, France
- Université Paris Sud, UMRS 1018, Villejuif F-94805, France
- Institut Gustave Roussy, Villejuif F-94805, France
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen DK-2100, Denmark
| | - Louise Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen DK-2100, Denmark
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Alle 2, Aarhus C DK-8000, Denmark
| | - Sylvie Mesrine
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Villejuif F-94805, France
- Université Paris Sud, UMRS 1018, Villejuif F-94805, France
- Institut Gustave Roussy, Villejuif F-94805, France
| | - Laura Baglietto
- Cancer Epidemiology Center, Cancer Council of Victoria, 615 St Kilda Road, Melbourne 3004, Victoria, Australia
- Center for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne 3010, Victoria, Australia
| | - Françoise Clavel-Chapelon
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Villejuif F-94805, France
- Université Paris Sud, UMRS 1018, Villejuif F-94805, France
- Institut Gustave Roussy, Villejuif F-94805, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114–116, Nuthetal 14558, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114–116, Nuthetal 14558, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
| | - Pagona Lagiou
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Mikras Asias 75, Goudi, Athens GR-115 27, Greece
| | - Christina Bamia
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Mikras Asias 75, Goudi, Athens GR-115 27, Greece
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute–ISPO, Ponte Nuovo Palazzina 28A ‘Mario Fiori', Via delle Oblate 4, Florence 50141, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, Milano 20133, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, ‘Civic–M.P. Arezzo' Hospital, ASP, Via Dante No. 109, Ragusa 97100, Italy
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASL TO3, Via Sabaudia 164, Grugliasco (TO) 10095, Italy
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Via Santena 7, Turin 10126, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, via Pansini 5, 80131 Naples, Italy
| | - HB(as) Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, Bilthoven 3720 BA, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Heidelberglann 100, Utrecht 3584 cx, The Netherlands
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Petra H Peeters
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands
| | - Mie Jareid
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway, Tromsø N–9037, Norway
| | - J Ramón Quirós
- Public Health Directorate, Asturias, Ciriaco Miguel Vigil St 9, Oviedo 33006, Spain
| | - Eric J Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Avda Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - María-José Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Hospitales Universitarios de Granada/Universidad de Granada, Cuesta del Observatorio, 4, Campus Universitario de Cartuja, Granada 18080, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
| | - Nerea Larrañaga
- CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
- Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain
| | - María-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB–Arrixaca, Ronda de Levante 11, Murcia 30008, Spain
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
- Navarra Public Health Institute, c/Leyre 15, Pamplona 31003, Spain
- IdiSNA, Navarra Institute for Health Research, Recinto de Complejo Hospitalario de Navarra c/Irunlarrea 3, Pamplona 31008, Spain
| | - Joana A Dias
- Department of Clinical Sciences Malmö, Lund University, Malmö 20502, Sweden
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö 20502, Sweden
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, SE-901 87 Umeå, Sweden
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, SE-901 87 Umeå, Sweden
| | - Eva Lundin
- Department of Medical Biosciences and Pathology, Umeå University, Umeå SE-901 87, Sweden
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Kay-Tee Khaw
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford OX3 7LF, UK
| | - Sabina Rinaldi
- International Agency for Research on Cancer, 150 Cours Albert-Thomas, Lyon Cedex 08 69372, France
| | - Isabelle Romieu
- International Agency for Research on Cancer, 150 Cours Albert-Thomas, Lyon Cedex 08 69372, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Melissa A Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
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Brewer JR, Morrison G, Dolan ME, Fleming GF. Chemotherapy-induced peripheral neuropathy: Current status and progress. Gynecol Oncol 2015; 140:176-83. [PMID: 26556766 DOI: 10.1016/j.ygyno.2015.11.011] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 11/03/2015] [Accepted: 11/06/2015] [Indexed: 12/17/2022]
Abstract
As there are increasing numbers of cancer survivors, more attention is being paid to the long term unwanted effects patients may experience as a result of their treatment and the impact these side effects can have on their quality of life. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common long-term toxicities from chemotherapy. In this review we will briefly review the clinical presentation, evaluation and management of chemotherapy-induced peripheral neuropathy, with a focus on CIPN related to platinum and taxane agents. We will then discuss current clinical models of peripheral neuropathy and ongoing research to better understand CIPN and develop potential treatment options.
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Affiliation(s)
- Jamie R Brewer
- Section of Hematology-Oncology, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Ave, Chicago, IL 60637, United States
| | - Gladys Morrison
- Section of Hematology-Oncology, Department of Medicine, The University of Chicago, Knapp Center for Biomedical Discovery, 900 East 57th Street, Chicago, IL 60637, United States
| | - M Eileen Dolan
- Section of Hematology-Oncology, Department of Medicine, The University of Chicago, Knapp Center for Biomedical Discovery, 900 East 57th Street, Chicago, IL 60637, United States
| | - Gini F Fleming
- Section of Hematology-Oncology, Department of Medicine, The University of Chicago, Knapp Center for Biomedical Discovery, 900 East 57th Street, Chicago, IL 60637, United States.
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Abstract
Breast cancer is the mostly commonly diagnosed cancer in women both in the United States and worldwide. Although advanced age at diagnosis is associated with more favorable tumor biology, mortality rates are comparatively higher in older adults, possibly attributed to advanced stage at presentation. There are minimal specific treatment-based guidelines in elderly patients with cancer, mostly attributable to their limited inclusion on clinical trials. In addition to the existing evidence from clinical trials and retrospective studies, practitioners need to take into consideration functional status, social support, patient preference, presence of comorbidities, and life expectancy when selecting optimal treatment.
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48
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Zahedifard M, Lafta Faraj F, Paydar M, Yeng Looi C, Hajrezaei M, Hasanpourghadi M, Kamalidehghan B, Abdul Majid N, Mohd Ali H, Ameen Abdulla M. Synthesis, characterization and apoptotic activity of quinazolinone Schiff base derivatives toward MCF-7 cells via intrinsic and extrinsic apoptosis pathways. Sci Rep 2015; 5:11544. [PMID: 26108872 PMCID: PMC4479988 DOI: 10.1038/srep11544] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 05/21/2015] [Indexed: 01/01/2023] Open
Abstract
The current study investigated the cytotoxic effect of 3-(5-chloro-2-hydroxybenzylideneamino)-2-(5-chloro-2-hydroxyphenyl)-2,3-dihydroquinazolin-41(H)-one (A) and 3-(5-nitro-2-hydroxybenzylideneamino)-2-(5-nitro-2-hydroxyphenyl)-2,3-dihydroquinazolin-4(1H)-one (B) on MCF-7, MDA-MB-231, MCF-10A and WRL-68 cells. The mechanism involved in apoptosis was assessed to evaluate the possible pathways induced by compound A and B. MTT assay results using A and B showed significant inhibition of MCF-7 cell viability, with IC50 values of 3. 27 ± 0.171 and 4.36 ± 0.219 μg/mL, respectively, after a 72 hour treatment period. Compound A and B did not demonstrate significant cytotoxic effects towards MDA-MB-231, WRL-68 and MCF-10A cells. Acute toxicity tests also revealed an absence of toxic effects on mice. Fluorescent microscopic studies confirmed distinct morphological changes (membrane blebbing and chromosome condensation) corresponding to typical apoptotic features in treated MCF-7 cells. Using Cellomics High Content Screening (HCS), we found that compound A and B could trigger the release of cytochrome c from mitochondria to the cytosol. The release of cytochrome c activated the expression of caspases-9 and then stimulated downstream executioner caspase-3/7. In addition, caspase-8 showed remarkable activity, followed by inhibition of NF-κB activation in A-and B-treated MCF-7 cells. The results indicated that A and B could induce apoptosis via a mechanism that involves either extrinsic or intrinsic pathways.
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Affiliation(s)
- Maryam Zahedifard
- Institute of Biological Science, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Fadhil Lafta Faraj
- Department of Chemistry, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohammadjavad Paydar
- Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Chung Yeng Looi
- Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Maryam Hajrezaei
- Institute of Biological Science, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | | | - Behnam Kamalidehghan
- Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nazia Abdul Majid
- Institute of Biological Science, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Hapipah Mohd Ali
- Department of Chemistry, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mahmood Ameen Abdulla
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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49
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Rosenberg PS, Barker KA, Anderson WF. Estrogen Receptor Status and the Future Burden of Invasive and In Situ Breast Cancers in the United States. J Natl Cancer Inst 2015; 107:djv159. [PMID: 26063794 DOI: 10.1093/jnci/djv159] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/13/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND No study has predicted the future incidence rate and annual burden (number) of new cases in the United States of invasive and in situ female breast cancers stratified by the estrogen receptor (ER) status. METHODS We constructed forecasts for women age 30 to 84 years in 2011 through 2030 using cancer incidence data from the Surveillance, Epidemiology, and End Results Program, novel age-period-cohort forecasting models, and population projections from the US Census Bureau. RESULTS The total number of new tumors (invasive plus in situ) is expected to rise from 283 000 in 2011 to 441 000 in 2030 (plausible range 353 500 to 466 700 cases). The proportion of all new case patients age 70 to 84 years is expected to increase from 24.3% to 34.8%, while the proportion ages 50 to 69 years is expected to decrease from 54.7% to 43.6%. The proportion of ER-positive invasive cancers is expected to remain nearly the same at 62.6%, whereas the proportion of ER-positive in situ cancers is expected to increase from 19.1% to 28.9%. The proportion of ER-negative cancers (invasive and in situ) is expected to decrease from 16.8% to 8.6%. CONCLUSIONS Breast cancer overall will rise in the United States through 2030, especially for ER-positive in situ tumors among women age 70 to 84 years. In contrast, ER-negative invasive and in situ tumors will fall, for reasons that are not fully understood. These results highlight a need to optimize case management among older women, characterize the natural history of in situ cancers, and identify those factors responsible for declining ER-negative incidence.
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Affiliation(s)
- Philip S Rosenberg
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (PSR, KAB, WFA).
| | - Kimberly A Barker
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (PSR, KAB, WFA)
| | - William F Anderson
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (PSR, KAB, WFA)
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50
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Bourdeanu L, Liu EA. Systemic treatment for breast cancer: chemotherapy and biotherapy agents. Semin Oncol Nurs 2015; 31:156-62. [PMID: 25951744 DOI: 10.1016/j.soncn.2015.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To describe current systemic chemotherapy and biotherapy breast cancer treatments to better inform clinical nursing practice. DATA SOURCES CINAHLl, Medline, Academic Research Periodicals, PubMed Clinical Queries, CANCERLIT, and EBM Reviews-Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews (CDSR). CONCLUSION Systemic therapeutic options for patients with breast cancer can be complex and varied. Furthermore, the guidelines for the treatment of breast cancer are frequently changing as new chemotherapies and biotherapies are being developed. IMPLICATIONS FOR NURSING PRACTICE Nursing clinical practice has to remain current to accommodate new treatments and the side effect profiles. This knowledge is essential to providing evidence-based care for breast cancer patients receiving these treatments.
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