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Singh MT, Thaggikuppe Krishnamurthy P, Magham SV. Harnessing the synergistic potential of NK1R antagonists and selective COX-2 inhibitors for simultaneous targeting of TNBC cells and cancer stem cells. J Drug Target 2024; 32:258-269. [PMID: 38252517 DOI: 10.1080/1061186x.2024.2309568] [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: 09/26/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
Triple-negative breast cancer (TNBC) lacks the expression of oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), rendering it unresponsive to endocrine therapy and HER2 targeted treatments. Though certain chemotherapeutics targeting the cell cycle have shown efficacy to a certain extent, the presence of chemotherapy-resistant cancer stem cells (CSCs) presents a significant challenge in tackling TNBC. Multiple lines of evidence suggest the upregulation of neuropeptide Substance P (SP), its NK-1 receptor (NK1R) and the Cyclooxygenase-2 (COX-2) enzyme in TNBC patients. Upregulation of the SP/NK1R system and COX-2 influences major signalling pathways involved in cell proliferation, growth, survival, angiogenesis, inflammation, metastasis and stem cell activity. The simultaneous activation and crosstalk between the pathways activated by SP/NK1R and COX-2 consequently increase the levels of key regulators of self-renewal pathways in CSCs, promoting stemness. The combination therapy with NK1R antagonists and COX-2 inhibitors can simultaneously target TNBC cells and CSCs, thereby enhancing treatment efficacy and reducing the risk of recurrence and relapse. This review discusses the rationale for combining NK1R antagonists and COX-2 inhibitors for the better management of TNBC and a novel strategy to deliver drug cargo precisely to the tumour site to address the challenges associated with off-target binding.
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Affiliation(s)
- Madhu Tanya Singh
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India
| | - Praveen Thaggikuppe Krishnamurthy
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India
| | - Sai Varshini Magham
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India
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Pachuau L, Lalremmawia H, Ralte L, Vanlalpeka J, Pautu JL, Chenkual S, Zomuana T, Lalruatfela ST, Zohmingthanga J, Chhakchhuak L, Varma AK, Kumar NS. Uncovering novel pathogenic variants and pathway mutations in triple-negative breast cancer among the endogamous mizo tribe. Breast Cancer Res Treat 2024:10.1007/s10549-024-07501-9. [PMID: 39384723 DOI: 10.1007/s10549-024-07501-9] [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: 07/21/2024] [Accepted: 09/23/2024] [Indexed: 10/11/2024]
Abstract
PURPOSE The incidence of triple-negative breast cancer (TNBC) in India is higher compared to Western populations. The objective of this study is to identify novel and less reported variants in TNBC in Mizoram, a state with a high cancer incidence in India. METHODS We analysed whole exome sequencing data from triple-negative breast cancer (TNBC) patients in the Mizo population to identify key and novel variants. Moreover, we analysed reported breast cancer-related genes and pathway alterations. RESULTS Somatic mutation analysis revealed that TP53 was the most frequently mutated gene and TP53, CACNA1E, IGSF3, RYR1, and FAM155A as significantly mutated driver genes. Based on the ACMG guidelines, we identified a rare pathogenic germline variant of BRCA1 (p.C1697R) in 13% and a likely pathogenic frameshift insertion in RBMX (p.P106Ffs) in 73% of the patients. We also found that the ATM, STK11, and CDKN2A genes were significantly mutated in germline TNBC samples compared to healthy samples. Moreover, we identified novel somatic variants in CHEK2 (p.K182M) and NF1 (p.C245X), and novel germline variants RB1 (p.D111G), CDH1 (p.A10Gfs), CDKN2A (p.V96G), CDKN2A (p.S12Afs*22), MAP3K1 (CAAdelins0), MSH6 (p.L1226_L1230del), and PMS2 (TTCdelins0). Pathway analysis revealed that most somatic mutations were highly associated with PI3K-Akt signalling pathway and MAPK signalling pathways in TNBC. CONCLUSIONS These findings identified novel variants and key genes contributing to disease development and progression. Further analysis of less studied genes, including RBMX, MRC1, ATM, CTNNB1, and CDKN2A, in TNBC may reveal new potential genes for targeted therapeutic strategies and contribute to clinical advancements in the treatment of TNBC.
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Affiliation(s)
- Lalawmpuii Pachuau
- Department of Biotechnology, Mizoram University, Tanhril, Aizawl, Mizoram, 796004, India
- Department of Pathology, Department of Health & Family Welfare, Civil Hospital Aizawl, Government of Mizoram, Dawrpui, Aizawl, Mizoram, 796001, India
| | - H Lalremmawia
- Department of Biotechnology, Mizoram University, Tanhril, Aizawl, Mizoram, 796004, India
| | - Lalengkimi Ralte
- Department of Biotechnology, Mizoram University, Tanhril, Aizawl, Mizoram, 796004, India
| | - Johan Vanlalpeka
- Department of Medicine, Zoram Medical College, Falkawn, Aizawl, Mizoram, 796 005, India
| | - Jeremy Lalrinsanga Pautu
- Department of Medical Oncology, Mizoram State Cancer Institute, Zemabawk, Aizawl, Mizoram, 796017, India
| | - Saia Chenkual
- Department of Surgery, Department of Health & Family Welfare, Civil Hospital Aizawl, Government of Mizoram, Dawrpui, Aizawl, 796001, Mizoram, India
- Zoram Medical College, Falkawn, Aizawl, Mizoram, 796 005, India
| | - Thomas Zomuana
- Department of Surgery, Department of Health & Family Welfare, Civil Hospital Aizawl, Government of Mizoram, Dawrpui, Aizawl, 796001, Mizoram, India
| | - Sailo Tlau Lalruatfela
- Department of Surgery, Department of Health & Family Welfare, Civil Hospital Aizawl, Government of Mizoram, Dawrpui, Aizawl, 796001, Mizoram, India
| | | | - Lalchhandama Chhakchhuak
- Department of Pathology, Department of Health & Family Welfare, Civil Hospital Aizawl, Government of Mizoram, Dawrpui, Aizawl, Mizoram, 796001, India
| | - Ashok K Varma
- Tata Memorial Centre, Advanced Centre for Treatment, Research and Education in Cancer, Kharghar, Navi Mumbai, Maharashtra, 410210, India
- Homi Bhabha National Institute, Anushaktinagar, Maharastra, 400094, Mumbai, India
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Qayoom H, Mir MA. Mutant P53 modulation by cryptolepine through cell cycle arrest and apoptosis in triple negative breast cancer. Biomed Pharmacother 2024; 179:117351. [PMID: 39216450 DOI: 10.1016/j.biopha.2024.117351] [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: 07/21/2024] [Revised: 08/13/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Triple Negative Breast cancer is an aggressive breast cancer subtype. It has a more aggressive clinical course, an earlier age of onset, a larger propensity for metastasis, and worse clinical outcomes as evidenced by a higher risk of recurrence and a shorter survival rate. Currently, the primary options for TNBC treatment are surgery, radiation, and chemotherapy. These treatments however remain ineffective due to recurrence. However, given that p53 mutations have been identified in more than 60-88 % of TNBC, translating p53 into the clinical situation is particularly important in TNBC. In this study, we screened and evaluated the therapeutic potential of cryptolepine (CRP) in TNBC in-vitro models being an anti-malarial drug it could be repurposed as an anti-cancer therapeutic targeting TNBC. Moreover, the cytotoxicity activity of cryptolepine to TNBC cells and a detailed anti-tumor mechanism in mutant P53 has not been reported before. METHODS MTT assays were used to examine the cytotoxicity and cell viability activity of Cryptolepine in TNBC, non-TNBC T47D and MCF-7 and non-malignant MCF10A cells. Scratch wound and clonogenic assay was used to evaluate the cryptolepine's effect on migration and colony forming ability of TNBC cells. Flow cytometry, MMP and DAPI was used to assess cell cycle arrest and cell apoptosis mechanism. The expression of proteins was detected by western blots. The differential expression of RNAs was evaluated by RT-PCR and the interaction between P53 and drug was evaluated computationally using in-silico approach and in-vitro using ChIP assay. RESULTS In this study, we found that cryptolepine has more preferential cytotoxicity in TNBC than non-TNBC cells. Notably, our studies revealed the mechanism by which cryptolepine induces intrinsic apoptosis and inhibit migration, colony formation ability, induce cell cycle arrest by inducing conformational change in the mutant P53 thereby increasing its DNA binding ability, hence activating its tumor suppressing potential significantly. CONCLUSION Our study revealed that CRP significantly reduced the proliferation, migration and colony forming ability of TNBC cells lines. Moreover, it was revealed that CRP induces cell cycle arrest and apoptosis by activating mutant P53 and enhancing its DNA binding ability to induce its tumor suppressing ability.
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Affiliation(s)
- Hina Qayoom
- Cancer Biology Lab, Department of Bioresources, School of Biological Sciences, University of Kashmir, Srinagar 190006, India
| | - Manzoor A Mir
- Cancer Biology Lab, Department of Bioresources, School of Biological Sciences, University of Kashmir, Srinagar 190006, India.
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Inampudi P, Yadlapalli DC, Gullipalli M. Clinicopathological Profiles of and Patterns of Recurrence in Triple-Negative Breast Cancer Patients at a Cancer Care Center in Southern India. Cureus 2024; 16:e63886. [PMID: 39099998 PMCID: PMC11298067 DOI: 10.7759/cureus.63886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is characterized by the absence of expression of the estrogen receptor and the progesterone receptor by immunohistochemistry and human epidermal growth factor receptor overexpression absence either by immunohistochemistry or absence of amplification by fluorescence in-situ hybridization. TNBCs tend to have rapid growth when compared to other subtypes of breast cancer. TNBC is associated with higher histologic grade and more advanced disease at presentation. TNBC shows aggressive behavior and a high chance of recurrence. AIM The aim was to analyze the clinicopathological profiles of and recurrence patterns in TNBC patients at our institute where most patients are from rural areas. METHODS This retrospective study was done at a tertiary cancer care center in Southern India where most patients come from rural backgrounds. Institutional Ethics Committee approval was obtained before the study. Case files of all breast cancer patients registered and treated at our center from 2014 to 2019 were retrieved from the medical record department and reviewed. Data from patients diagnosed with triple-negative breast cancer were identified and analyzed. RESULTS Among the 841 breast cancer patients registered in our study, 150 (17.8%) were diagnosed with TNBC. The median age of diagnosis was 47 years. The majority of the patients, 89 (59.3%) presented with T2 tumors, and lymph node involvement was observed in 88 (58.6%) cases. Patient distribution based on cancer stage revealed that 77 (51.3%) had early-stage breast cancer (EBC), 70 (46.6%) had locally advanced breast cancer (LABC), and only three patients were categorized as having metastatic breast cancer (MBC). Modified radical mastectomy (MRM) was the preferred surgical approach in 144 (96%) cases, while only four patients underwent breast-conserving surgery (BCS). Adjuvant chemotherapy was administered to 119 (79.3%) patients, with 30 (20%) receiving both neoadjuvant and adjuvant chemotherapy (NACT/ACT). Among those who underwent NACT/ACT, a pathological complete response was observed in five (16.6%) patients out of 30 patients. The median duration of follow-up was 32.8 months. Among all patients, 36 (24%) experienced recurrence, with seven (19.4%) having local recurrence, 24 (66.6%) developing distant metastases, two patients experiencing both local and distant recurrence, and three patients developing contralateral breast cancer. Additionally, three patients experienced a second primary cancer. The most common sites of metastases were the lungs (14), followed by the bone (seven), the liver (four), and the brain (four). Recurrence rates were notably high within the first one to three years post-diagnosis. The median disease-free survival (DFS) of TNBC patients was estimated to be 65.6 months with no statistically significant difference (p=0.174) between EBC and LABC patients. CONCLUSION TNBC is known for its heterogeneity. While it is often regarded as being more responsive to chemotherapy compared to other subtypes of breast cancer, TNBCs tend to behave aggressively, basically due to the underlying aggressive tumor biology. Though there are many treatment options for different subtypes of breast cancer, therapeutic modalities are limited for TNBCs. Aggressive tumor biology with limited treatment options denotes a gap in the development of novel strategies to improve outcomes in this subset of breast cancer patients.
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Affiliation(s)
- Prudhvi Inampudi
- Medical Oncology, Ganni Subbulakshmi Garu Medical College, Rajahmundry, IND
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Shen HY, Xu JL, Zhang W, Chen QN, Zhu Z, Mao Y. Exosomal circRHCG promotes breast cancer metastasis via facilitating M2 polarization through TFEB ubiquitination and degradation. NPJ Precis Oncol 2024; 8:22. [PMID: 38287113 PMCID: PMC10825185 DOI: 10.1038/s41698-024-00507-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 12/06/2023] [Indexed: 01/31/2024] Open
Abstract
Triple-negative breast cancer (TNBC) is a highly aggressive cancer with distant metastasis. Accumulated evidence has demonstrated that exosomes are involved in TNBC metastasis. Elucidating the mechanism underlying TNBC metastasis has important clinical significance. In the present study, exosomes were isolated from clinical specimens and TNBC cell lines. Colony formation, EdU incorporation, wound healing, and transwell assays were performed to examine TNBC cell proliferation, migration, and metastasis. Macrophage polarization was evaluated by flow cytometry and RT-qPCR analysis of polarization markers. A mouse model of subcutaneous tumor was established for assessment of tumor growth and metastasis. RNA pull-down, RIP and Co-IP assays were used for analyzing molecular interactions. Here, we proved that high abundance of circRHCG was observed in exosomes derived from TNBC patients, and increased exosomal circRHCG indicated poor prognosis. Silencing of circRHCG suppressed TNBC cell proliferation, migration, and metastasis. TNBC cell-derived exosomes promoted M2 polarization via delivering circRHCG. Exosomal circRHCG stabilized BTRC mRNA via binding FUS and naturally enhanced BTRC expression, thus promoting the ubiquitination and degradation of TFEB in THP-1 cells. In addition, knockdown of BTRC or overexpression of TFEB counteracted exosomal circRHCG-mediated facilitation of M2 polarization. Furthermore, exosomal circRHCG promoted TNBC cell proliferation and metastasis by facilitating M2 polarization. Knockdown of circRHCG reduced tumor growth, metastasis, and M2 polarization through the BTRC/TFEB axis in vivo. In summary, exosomal circRHCG promotes M2 polarization by stabilizing BTRC and promoting TFEB degradation, thereby accelerating TNBC metastasis and growth. Our study provides promising therapeutic strategies against TNBC.
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Affiliation(s)
- Hong-Yu Shen
- Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, China
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jia-Lin Xu
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Zhang
- Division of Gastrointestinal Surgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, China
| | - Qin-Nan Chen
- Department of Clinical Medicine, Jiangsu Health Vocational College, Nanjing, China.
| | - Zhen Zhu
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Yuan Mao
- Department of Oncology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Kurian NM, Boby JM, Suneesh S, Datta S, Mathew A. A novel strategy to downstage breast cancer: impact of a phone helpline. Ecancermedicalscience 2023; 17:1637. [PMID: 38414941 PMCID: PMC10898877 DOI: 10.3332/ecancer.2023.1637] [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: 06/29/2023] [Indexed: 02/29/2024] Open
Abstract
Breast cancer incidence rates in India are rising. The majority of breast cancers are still diagnosed in later stages. There is also a burden of neglected cancers in India, where patients neglect their symptoms due to fear, ignorance, financial insecurity and lack of access to medical care. This results in greater morbidity and mortality from breast cancer. Systematic screening programs have been tested in an Indian setting, with limited success. An effective strategy to downstage breast cancer is an area of unmet need. We aimed to explore the effectiveness of an anonymous nurse-led telephone helpline in identifying patients with possible breast malignancies and to encourage them to seek healthcare. We created a telephone helpline system by training junior public health nurses (JPHNs) to provide counselling to women who may call with breast-related symptoms. We then created a short video message on the initiative and disseminated it using social media platforms. During the 1-year study period, 434 calls were received from individuals who reported having some breast symptoms. Among them, 28% (122 callers) had never consulted a doctor for their symptoms. 78 callers consulted a nearby doctor upon the advice of the JPHN. Among them, 14 callers (18%) were advised by the doctor to undergo investigations to rule out malignancy, while 64 (82%) of them were found to have some benign/normal breast conditions. 3 (21%) out of the 14 patients who underwent further evaluation were eventually diagnosed with breast cancer. Our study provides evidence that an anonymous nurse-led telephone helpline can be an effective strategy to reduce the incidence of neglected breast cancers and downstage the diagnoses.
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Affiliation(s)
| | | | | | - Sumit Datta
- MOSC Medical College, Kolenchery 682311, Kerala, India
| | - Aju Mathew
- MOSC Medical College, Kolenchery 682311, Kerala, India
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Jotshi A, Sukla KK, Haque MM, Bose C, Varma B, Koppiker CB, Joshi S, Mishra R. Exploring the human microbiome - A step forward for precision medicine in breast cancer. Cancer Rep (Hoboken) 2023; 6:e1877. [PMID: 37539732 PMCID: PMC10644338 DOI: 10.1002/cnr2.1877] [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: 03/08/2023] [Revised: 06/24/2023] [Accepted: 07/22/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The second most frequent cancer in the world and the most common malignancy in women is breast cancer. Breast cancer is a significant health concern in India with a high mortality-to-incidence ratio and presentation at a younger age. RECENT FINDINGS Recent studies have identified gut microbiota as a significant factor that can have an influence on the development, treatment, and prognosis of breast cancer. This review article aims to describe the influence of microbial dysbiosis on breast cancer occurrence and the possible interactions between oncobiome and specific breast cancer molecular subtypes. The review further also discusses the role of epigenetics and diet/nutrition in the regulation of the gut and breast microbiome and its association with breast cancer prevention, therapy, and recurrence. Additionally, the recent technological advances in microbiome research, including next-generation sequencing (NGS) technologies, genome sequencing, single-cell sequencing, and microbial metabolomics along with recent advances in artificial intelligence (AI) have also been reviewed. This is an attempt to present a comprehensive status of the microbiome as a key cancer biomarker. CONCLUSION We believe that correlating microbiome and carcinogenesis is important as it can provide insights into the mechanisms by which microbial dysbiosis can influence cancer development and progression, leading to the potential use of the microbiome as a tool for prognostication and personalized therapy.
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Affiliation(s)
- Asmita Jotshi
- Centre for Translational Cancer Research: A Joint Initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM)PuneIndia
| | | | | | - Chandrani Bose
- Life Sciences R&D, TCS Research, Tata Consultancy Services LimitedPuneIndia
| | - Binuja Varma
- TCS Genomics Lab, Tata Consultancy Services LimitedNew DelhiIndia
| | - C. B. Koppiker
- Centre for Translational Cancer Research: A Joint Initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM)PuneIndia
- Prashanti Cancer Care Mission, Pune, India and Orchids Breast Health Centre, a PCCM initiativePuneIndia
| | - Sneha Joshi
- Centre for Translational Cancer Research: A Joint Initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM)PuneIndia
| | - Rupa Mishra
- Centre for Translational Cancer Research: A Joint Initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM)PuneIndia
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Srivastava NK, Singh S, Mohanty D, Hussain N. Clinicopathological profile of breast cancer from Chhattisgarh India: A single-center hospital-based study. J Family Med Prim Care 2023; 12:1923-1930. [PMID: 38024932 PMCID: PMC10657078 DOI: 10.4103/jfmpc.jfmpc_2315_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: 11/26/2022] [Revised: 04/02/2023] [Accepted: 04/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Global breast cancer incidence is increasing at an annual rate of 3·1%. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%). However, the data from different parts of India are still lacking and the study was conducted to assess the burden of disease at tertiary referral centers in central India. Material and Methods Retrospective record analysis (June 2013-June 2017) of data from outdoor clinics and pathology reports. The patients aged <15 yrs, nonresidence of Chhattisgarh, and diagnosed outside the study period were excluded. The triple assessment was used to diagnose all breast lumps (sensitivity 99%). Results Eighty patients were diagnosed having breast carcinoma. The mean age for breast cancer was 39 ± 3.028 years (ranged 31-50 years). Twenty patients had locally advanced breast carcinoma. The predominant religion was Hindu 55.00%. The referral pathway to seek medical care for breast cancer was via a gynecologist in 40% (32/80). Familial breast cancers were in 0.03% (3/80) of patients. None breast cancer patients have previous histology-proven benign breast disease. The mean size of the breast cancer lump was 3.56 cm (ranged 1.0-11.0 cm). Overlying skin ulceration (n = 2), skin infiltration/peau-d'- orange (n = 2), skin tethering (n = 4), and bloody nipple discharge were found in one patient. Breast cancer was diagnosed during lactation (postnatal period) in one patient. The maximum number of patients have tumor size >5 cm (72.6%). Immunohistochemistry and pathological analysis was done on core biopsy (n = 20) and surgical procedure (n = 60). Modified radical mastectomy was done in 52, breast conservative surgery with Sentinal Lymph node biopsy and axillary lymph node dissection in 6, and toilet mastectomy in two patients. The predominant tumors were solid (n = 79/80), with both solid and cystic types (1/80). The solid and cystic lesion on FNAC was of C3b type, and an excision biopsy revealed medullary carcinoma of the breast. Invasive ductal carcinoma-no special type (IDC-NST) was observed to be the most common histopathologic type (n = 70/80), followed by medullary carcinoma (n = 2), metaplastic carcinoma (n = 1), papillary carcinoma (n = 4), Paget disease with DCIS (n = 1), mucinous carcinoma (n = 1), invasive lobular carcinoma (n = 1). One male patient with breast cancer and two female patient having bilateral breast cancer also have IDC-NST.Scarff Bloom Richardson Grade was predominantly graded 2 in 46.25% (37/80) of breast cancer patients (Grade 1 = 9, Grade 2 = 37, Grade 3 = 34). Lymphovascular (LVI) and perineural invasion (PNI) were predominantly without LVI and PVI. (Lymphovascular present and perineural invasion present = 4, Lymphovascular present and perineural invasion absent = 32, Lymphovascular absent and perineural invasion absent = 42, Lymphovascular absent and perineural invasion present = 2). Histological examination of axillary lymph nodes showed the presence of malignant cells in all. Triple-negative breast carcinoma was 26.58% (21/79). Most breast cancer presented at stage II A = 37.5% (30/80) and II B = 28.7% (23/80) of the AJCC staging system. Conclusion The clinico-epidemio and histological profile of breast cancer in Chhattisgarh is similar to other parts of India. Scarff Bloom Richardson Grade was predominantly grade 2 in 46.25% (37/80) contrary to Grade III (70%) in other series from India.
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Affiliation(s)
- Niraj Kumar Srivastava
- Department of Surgery, All India Institute of Medical Sciences Raebareli, Uttar Pradesh 229405 (Ex- Senior Resident, Department of Surgery, All India Institute of Medical Sciences Raipur, Chhattisgarh), India
| | - Sunita Singh
- Department of Paediatric Surgery All India Institute of Medical Sciences Raebareli (Ex-Assistant Prof., All India Institute of Medical Sciences Raipur, Chhattisgarh), India
| | - Debajyoti Mohanty
- Department of Surgery, All India Institute of Medical Sciences Raipur, Chhattisgarh, India
| | - Nughat Hussain
- Department of Pathology, All India Institute of Medical Sciences Raipur, Chhattisgarh, India
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Kashyap A, Umar SM, Dev J R A, Mathur SR, Gogia A, Batra A, Deo SVS, Prasad CP. Combination of 3PO analog PFK15 and siPFKL efficiently suppresses the migration, colony formation ability, and PFK-1 activity of triple-negative breast cancers by reducing the glycolysis. J Cell Biochem 2023; 124:1259-1272. [PMID: 37450687 DOI: 10.1002/jcb.30443] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 04/14/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Among all the subtypes of breast cancer, triple-negative breast cancer (TNBC) has been associated with the worst prognosis. Recently, for many solid tumors (including breast cancer) metabolic reprogramming has appeared as a cancer cell hallmark, and the elevated glycolytic pathway has been linked to their aggressive phenotype. In the present study, we evaluated the prognostic and therapeutic relevance of PFKFB3 (6-phosphofructo-2- kinase/fructose-2,6-bisphosphatase) in TNBCs. Prognostic significance of PFKFB3 expression was evaluated in overall breast cancers as well as in TNBCs. PFKFB3 inhibitor (3PO potent analogue i.e., PFK15) cytotoxicity in TNBC cell lines (MDA-MB-231 and MDA-MB-468) was analyzed using an MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Cancer cell physiological characteristics like clonogenicity and migration were also investigated after PFK15 treatment. As fructose-2,6-bisphosphate (F-2,6-BP), has been associated with increased PFK-1 activity, the effect of PFKFB3 inhibition by PFK15 was investigated on two major isoforms of phosphofructokinase-1 (PFK-1) in breast cancer, that is, phosphofructokinase-platelet type (PFKP) and phosphofructokinase-liver type (PFKL) (relevant to breast cancer). For PFKL inhibition, the siRNA approach was used. PFKFB3 expression was significantly correlated with inferior overall survival in breast cancer patients including TNBCs. PFK15 treatment in TNBC cells (i.e., MDA-MB-231 and MDA-MB-468) resulted in a decreased PFKP expression, thereby leading to reduced colony formation ability, migration rate, and extracellular lactate levels. However, to our surprise PFK15 treatment in both TNBC cells also resulted in elevated PFKL levels. Our results demonstrated that the combinatorial inhibition of PFK15 with siPFKL was more effective in TNBC cells, as it led to a decrease in colony formation ability, migration rate, extracellular lactate levels, and PFK-1 activity when compared with individual treatments. Using bona fide PFKFB3 inhibitor, that is, AZ67, we further show that AZ67 treatment to TNBC cells has no effect either on the expression of PFKP and PFKL, or on the lactate production. In summary, our present in vitro study demonstrated that 3PO derived PFK15 mechanism of action is totally different from AZ67 in TNBC cells. However, we advocate that the PFK15-mediated inhibition (along with PFKL) on the TNBCs migration, colony formation, and PFK-1 activity can be further explored for the therapeutic advantage of TNBC patients.
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Affiliation(s)
- Akanksha Kashyap
- Department of Medical Oncology (Laboratory), Dr. BRA IRCH, AIIMS, New Delhi, India
| | - Sheikh Mohammad Umar
- Department of Medical Oncology (Laboratory), Dr. BRA IRCH, AIIMS, New Delhi, India
| | - Arundhathi Dev J R
- Department of Medical Oncology (Laboratory), Dr. BRA IRCH, AIIMS, New Delhi, India
| | | | - Ajay Gogia
- Department of Medical Oncology, Dr. BRA IRCH, AIIMS, New Delhi, India
| | - Atul Batra
- Department of Medical Oncology, Dr. BRA IRCH, AIIMS, New Delhi, India
| | - S V S Deo
- Department of Surgical Oncology, Dr. BRA IRCH, AIIMS, New Delhi, India
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Nag S, Dikshit R, Desai S, Mane A, Mhatre S, Neve R, Gurav M, Bhosale N, Perumal P, Kembhavi Y, Jethwa D, Badwe R, Gupta S. Risk factors for the development of triple-negative breast cancer versus non-triple-negative breast cancer: a case-control study. Sci Rep 2023; 13:13551. [PMID: 37599285 PMCID: PMC10440340 DOI: 10.1038/s41598-023-40443-8] [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: 03/26/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023] Open
Abstract
The risk factors for breast cancer have been defined in several studies but there is deficient data for specific subtypes. We report here the pathological characteristics of a breast cancer cohort and risk factors for patients with triple-negative disease. In this case-control study, a prospective breast cancer cohort was evaluated for demographic, reproductive, obesity-related and other risk factors using a validated questionnaire. Tumors were characterized for routine pathological characteristics and immunohistochemical markers of basal-like breast cancer. Patients with triple-negative breast cancer (TNBC) constituted cases and those with non-TNBC were controls. Odds ratios (OR) were calculated for each risk factor and independent associations were tested in an unconditional logistic regression analysis. Between 2011 and 2014, 1146 patients were recruited, of whom 912 [TNBC 266 (29.1%), non-TNBC 646 (70.9%)] with sufficient pathology material were analysed. Reproductive factors of parity, breastfeeding, age-at-menarche, age at first full-term pregnancy and oral contraceptive use were not significantly associated with TNBC. Higher body mass index (BMI > 24.9 vs ≤ 24.9, OR 0.89, 95%CI 0.63-1.24, p = 0.49) was not significantly associated while lesser waist circumference (> 80 cm vs ≤ 80 cm, OR 0.64, 95%CI 0.45-0.9, p = 0.012) and lower waist-to-hip ratio were significantly associated (> 0.85 vs ≤ 0.85, OR 0.72, 95%CI 0.51-1.0, p = 0.056), with TNBC. History of tobacco use was not significantly associated while lower socio-economic status was borderline associated with TNBC (socio-economic category > 5 versus ≤ 5, OR 0.73, 95%CI 0.50-1.06, p = 0.106). No factor was significant after adjustment for covariates. Central obesity seems to be preferentially associated with non-TNBC, and lower socio-economic status with TNBC in India, while most other conventional risk factors of breast cancer show no significant association with TNBC versus non-TNBC.
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Affiliation(s)
- Shona Nag
- Medical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Rajesh Dikshit
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sangeeta Desai
- Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anupama Mane
- Surgical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Sharayu Mhatre
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rakesh Neve
- Surgical Oncology, Jehangir Clinical Development Center, Pune, India
| | - Mamta Gurav
- Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | | | - Prema Perumal
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Yogesh Kembhavi
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Dinesh Jethwa
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rajendra Badwe
- Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sudeep Gupta
- Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
- Tata Memorial Hospital/Centre, Room 1109, Homi Bhabha Block, Parel, Mumbai, 400012, India.
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Shadmani N, Gohari S, Kadkhodamanesh A, Ghaderinia P, Hassani M, Sharifyrad M. The synthesis and development of poly(ε-caprolactone) conjugated polyoxyethylene sorbitan oleate-based micelles for curcumin drug release: an in vitro study on breast cancer cells. RSC Adv 2023; 13:23449-23460. [PMID: 37546220 PMCID: PMC10401665 DOI: 10.1039/d3ra03660j] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND it is now known that curcumin (Cur) has a broad range of biological properties; however, photosensitivity, as well as low bioavailability and short half-life, have limited its clinical application. To overcome these problems the synthesis of poly(ε-caprolactone)-Tween 80 (PCL-T) copolymers was performed. METHODS the copolymers of PCL-T were created using the solvent evaporation/extraction technique. Then Cur was loaded in PCL-T micelles (PCL-T-M) by a self-assembly method. The characterization of copolymer and micelles was assessed by gel permeation chromatography (GPC), Fourier transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance spectroscopy (1HNMR), differential scanning calorimetry (DSC), transmission electron microscopy (TEM), and dynamic light scattering (DLS) methods. The MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay was used to indicate the cytotoxicity of the free Cur, PCL-T-M, and Cur-loaded PCL-T-M. RESULTS TEM analysis showed monodispersed and spherical shapes with a size of about 90 nm. Cur was released from PCL-T-M at pH 7.4 (45%) and 5.5 (90%) during 6 days. After 24 and 48 h, the IC50 of the free Cur, PCL-T-M, and Cur-loaded PCL-T-M on MCF-7 cells were 80.86 and 54.45 μg mL-1, 278.30 and 236.19 μg mL-1, 45.47 and 19.05 μg mL-1, respectively. CONCLUSION this study showed that, in the same concentration, the effectiveness of the Cur-loaded PCL-T-M is more than the free Cur, and the nano-system has been able to overcome delivery obstacles of Cur drug. Thus, PCL-T-M can be a candidate as a drug carrier for the delivery of Cur and future therapeutic investigations on breast cancer.
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Affiliation(s)
- Nasim Shadmani
- Trita Nanomedicine Research & Technology Development Center (TNRTC) Zanjan Health Technology Park Zanjan Iran
| | - Sepehr Gohari
- Student Research Center, School of Medicine, Zanjan University of Medical Sciences Zanjan Iran
| | - Azin Kadkhodamanesh
- School of Pharmacy, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Parivash Ghaderinia
- Research and Technology Development Center of the Motahar Zist Gostar, Islamic Azad University Zanjan Branch Zanjan Iran 45156-58145 +98 9191815229
- Department of Microbiology, Islamic Azad University Zanjan Branch Zanjan Iran
| | - Maryam Hassani
- Department of Pharmaceutical Biomaterials, Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences Tehran Iran
| | - Motahare Sharifyrad
- Research and Technology Development Center of the Motahar Zist Gostar, Islamic Azad University Zanjan Branch Zanjan Iran 45156-58145 +98 9191815229
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Parikh P, Babu G, Singh R, Krishna V, Bhatt A, Bansal I, Rajappa S, Sahoo TP, Aggarwal S, Bapna A, Biswas G, Somashekhar SP, Bajpai J, Maniar V, Desai S, Raja T, Rath GK. Consensus guidelines for the management of HR-positive HER2/neu negative early breast cancer in India, SAARC region and other LMIC by DELPHI survey method. BMC Cancer 2023; 23:714. [PMID: 37525142 PMCID: PMC10391857 DOI: 10.1186/s12885-023-11121-9] [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: 05/18/2022] [Accepted: 06/28/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Precise prognostication is the key to optimum and effective treatment planning for early-stage hormone receptor (HR) positive, HER2/neu negative breast cancer patients. Differences in the breast cancer incidence and tumor anatomical features at diagnosis, pharmacogenomics data between Western and Indian women along with the vast diversity in the economic status and differences in insurance policies of these regions; suggest recommendations put forward for Western women might not be applicable to Indian/Asian women. Opinions from oncologists through a voting survey on various prognostic factors/tools to be considered for planning adjuvant therapy are consolidated in this report for the benefit of oncologists of the sub-continent, SAARC and Asia's LMIC (low and middle-income countries). METHODS A three-phase DELPHI survey was conducted to collect opinions on prognostic factors considered for planning adjuvant therapy in early-stage HR+/HER2/neu negative breast cancer patients. A panel of 25 oncologists with expertise in breast cancer participated in the survey conducted in 2021. The experts provided opinions as 'agree' or disagree' or 'not sure' in phases-1 and 2 which were conducted virtually; in the final phase-3, all the panel experts met in person and concluded the survey. RESULTS Opinions on 41 statements related to prognostic factors/tools and their implications in planning adjuvant endocrine/chemotherapy were collected. All the statements were supported by the latest data from the clinical trials (prospective/retrospective). The statements with opinions of consensus less than 66% were disseminated in phase-2, and later in phase-3 with supporting literature. In phase-3, all the opinions from panelists were consolidated and guidelines were framed. CONCLUSIONS This consensus guideline will assist oncologists of India, SAARC and LMIC countries in informed clinical decision-making on adjuvant treatment in early HR+/HER2/neu negative breast cancer patients.
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Affiliation(s)
- Purvish Parikh
- Dept of Clinical Hematology, Mahatma Gandhi Medical College Hospital, Jaipur, 302023, India.
| | - Govind Babu
- HCG Cancer Hospital, Bengaluru, 560027, India
| | - Randeep Singh
- Narayana Super speciality Hospital, Gurugram, 122002, India
| | - Vamshi Krishna
- Asian Institute of Gastroenterology, Hyderabad, 500082, India
| | - Amit Bhatt
- Avinash Cancer Clinic, Pune, 411004, India
| | - Indu Bansal
- Narayana Super speciality Hospital, Gurugram, 122002, India
| | - Senthil Rajappa
- Basavaratakam Indo American Cancer Hospital & Research Institute, Hyderabad, 500034, India
| | | | | | - Ajay Bapna
- Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, 302017, India
| | | | - S P Somashekhar
- Manipal Comprehensive Cancer Center, Manipal Hospital, Bengaluru, 560017, India
| | | | | | - Sharad Desai
- Mahatma Gandhi Cancer Hospital, Miraj, 416410, India
| | - T Raja
- Apollo Speciality Cancer Hospital, Chennai, 600035, India
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13
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Mohapatra M. Clinicopathological and prognostic characteristic features of triple negative and nontriple negative breast cancer at a tertiary care hospital. J Cancer Res Ther 2023; 19:1186-1193. [PMID: 37787282 DOI: 10.4103/jcrt.jcrt_1222_21] [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] [Indexed: 10/04/2023]
Abstract
Context Carcinoma breast is a complex disease having diverse clinical, histopathological, and immunohistochemical features. Basing on estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 receptor (HER2) status, these tumors are divided into triple-negative breast cancers (TNBC) where tumor cells are negative for all three receptors and nontriple negative breast cancer (non-TNBC) where tumor cells are positive for one or two or all. The clinicopathological and characteristic prognostic features are highlighted here. Aim The aim of this study is to evaluate the clinicopathological and prognostic features of TNBC and non-TNBC cases diagnosed in our hospital setting. Settings and Design Single institution, retrospective study conducted over 7 and half years. Subjects and Methods Histopathologically confirmed breast cancer cases with ER, PR, and HER2 receptor assessment were categorized into TNBC and non-TNBC. Detailed study on clinicopathological and prognostic features including pathological prognostic stage as per 8th AJCC was done in cases who underwent modified radical mastectomy. Statistical Analysis Used Data were analyzed in percentage and presented in tables and charts. Results The present study included 794 cases consisting of 253, 31.9% TNBC and 541, 68.1% non-TNBC cases. The mean age of TNBC and non-TNBC cases was 50.4 years and 51.7 years, respectively. Coagulative necrosis, lymphovascular invasion, lymph nodal metastasis, higher histopathological tumor grade, and NPI were observed in higher percentage of TNBC cases, i.e., 19 (10.9%), 21 (11.6%), 105 (57.7%), 127 (69.8%), and 149 (81.9%) cases, respectively, than non-TNBC seen in 18 (6.6%), 24 (8.8%), 135 (49.6%), 165 (60.7%), and 194 (71.3%) cases, respectively. Further, 25 (13.7%) TNBC and 1 (0.4%) non-TNBC case were upstaged, whereas 130 (47.8%) non-TNBC and 2 (1.1%) TNBC cases were downstaged by the pathological prognostic stage. Conclusions TNBC is more aggressive having a poor prognosis than non-TNBC.
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Affiliation(s)
- Manisha Mohapatra
- Department of Pathology, GSL Medical College and General Hospital, Rajahmundry, Andhra Pradesh, India
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14
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Somal PK, Sancheti S, Sharma A, Sali AP, Chaudhary D, Goel A, Dora TK, Brar R, Gulia A, Divatia J. A Clinicopathological Analysis of Molecular Subtypes of Breast Cancer using Immunohistochemical Surrogates: A 6-Year Institutional Experience from a Tertiary Cancer Center in North India. South Asian J Cancer 2023; 12:104-111. [PMID: 37969672 PMCID: PMC10635761 DOI: 10.1055/s-0043-1761942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Puneet Kaur SomalObjective Classification of breast cancer into different molecular subtypes has important prognostic and therapeutic implications. The immunohistochemistry surrogate classification has been advocated for this purpose. The primary objective of the present study was to assess the prevalence of the different molecular subtypes of invasive breast carcinoma and study the clinicopathological parameters in a tertiary care cancer center in rural North India. Materials and Methods All female patients diagnosed with invasive breast cancer and registered between January 1, 2015, and December 31, 2020, were included. Patients with bilateral cancer, missing information on HER2/ER/PR receptor status, absence of reflex FISH testing after an equivocal score on Her 2 IHC were excluded. The tumors were classified into different molecular subtypes based on IHC expression as follows-luminal A-like (ER- and PR-positive, Her2-negative, Ki67 < 20%), luminal B-like Her2-negative (ER-positive, Her2-negative and any one of the following Ki67% ≥ 20% or PR-negative/low, luminal B-like Her2-positive (ER- and HER2-positive, any Ki67, any PR), Her2-positive (ER- and PR-negative, Her2-positive) and TNBC (ER, PR, Her2-negative). Chi square test was used to compare the clinicopathological parameters between these subtypes. Results A total of 1,625 cases were included. Luminal B-like subtype was the most common (41.72%). The proportion of each subtype was luminal A (15.69%), luminal B Her2-negative (23.93%), luminal B Her2-positive (17.78%), Her2-positive (15.26%), TNBC (27.32%). Majority of the tumors were Grade 3 (75.81%). Nodal metastases were present in 59%. On subanalysis of the luminal type tumors without Her2 expression (luminal A-like and luminal B-like (Her2-negative), luminal A-like tumors presented significantly with a lower grade ( p < 0.001) and more frequent node-negative disease in comparison to luminal B-like (Her2-negative) tumors. In comparison to other subtypes, TNBC tumors were more frequently seen in the premenopausal age group ( p < 0.001) and presented with node-negative disease ( p < 0.001). Conclusion This is one of the largest studies that enumerates the prevalence of various molecular subtypes of breast cancer in North India. Luminal B-like tumors were the most common followed by TNBC. TNBC tumors presented more commonly in premenopausal age group and with node negative disease in comparison to other subtypes.
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Affiliation(s)
- Puneet Kaur Somal
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Sankalp Sancheti
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Aishwarya Sharma
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Akash Pramod Sali
- Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Debashish Chaudhary
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Alok Goel
- Department of Medical Oncology, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Tapas Kumar Dora
- Department of Radiotherapy, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Rahat Brar
- Department of Radio-diagnosis, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Ashish Gulia
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
| | - Jigeeshu Divatia
- Department of Anesthesiology, Homi Bhabha Cancer Hospital and Research Centre, Punjab (A Unit of Tata Memorial Centre), India
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Jeethy Ram T, Lekshmi A, Darvin P, Rajappan P, Jagathnath Krishna KM, Anoop TM, Augustine P, Mathew AP, Cherian K, Bhargavan RV, Somanathan T, Radhakrishna Pillai M, Santhosh Kumar TR, Sujathan K. Co-expression of galectin-3 and vimentin in triple negative breast cancer cells promotes tumor progression, metastasis and survival. Tumour Biol 2023; 45:31-54. [PMID: 37574746 DOI: 10.3233/tub-230002] [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] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Lack of druggable targets and complex expression heterogeneity of known targets is common among TNBC subtypes. An enhanced expression of galectin-3 in TNBCs has already been documented. We have observed a tumor progression-dependent galectin-3 expression in TNBCs compared to adjacent epithelium and non TNBCs. OBJECTIVE To unravel the association of galectin- 3 in tumor progression, aggressiveness and drug resistance in TNBC patients. METHODS Galectin-3 expression in 489 breast cancer tissues was correlated with clinicopathological features and the results were validated in cell lines and mouse model by silencing galectin-3 using shRNA and the proteins were profiled by western blot and qRT-PCR. Protein interaction was analyzed by GFP Trap and Mass spectrometry. RESULTS Galectin-3 expression correlated with tumor stage in TNBC and a lower galectin-3 expression was associated with poor patient survival. The positive correlation between galectin-3, vimentin and CD44 expression, pinpoints galectin-3 contribution to epithelial to mesenchymal transition, drug resistance and stemness. Vimentin was found as an interacting partner of galectin-3. Duplexing of galecin-3 and vimentin in patient samples revealed the presence of tumor cells co-expressing both galectin-3 and vimentin. In vitro studies also showed its role in tumor cell survival and metastatic potential, elementary for tumor progression. In vivo studies further confirmed its metastatic potential. CONCLUSIONS Tumor progression dependent expression pattern of galectin 3 was found to indicate prognosis. Co-expression of galectin-3 and vimentin in tumor cells promotes tumor dissemination, survival and its metastatic capability in TNBCs.
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Affiliation(s)
- T Jeethy Ram
- Division of Cancer Research, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Asha Lekshmi
- Division of Cancer Research, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Pramod Darvin
- Cancer Research, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
| | - Prakash Rajappan
- Cancer Research, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
| | | | - T M Anoop
- Medical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Paul Augustine
- Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Arun Peter Mathew
- Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Kurian Cherian
- Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Rexeena V Bhargavan
- Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Thara Somanathan
- Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - M Radhakrishna Pillai
- Cancer Research, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
| | - T R Santhosh Kumar
- Cancer Research, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
| | - K Sujathan
- Division of Cancer Research, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Panda C, Islam S, Basu M, Roy A, Alam N. Association of Augmented Immune-Staining of G-Quadruplex Tertiary DNA Structure in Chemo-Tolerant TNBC with Downregulation of WNT/Epidermal Growth Factor Receptor Pathway receptor Genes: A Pilot Clinicopathological Study. JOURNAL OF RADIATION AND CANCER RESEARCH 2023. [DOI: 10.4103/jrcr.jrcr_23_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Reddy VA, Sarin R, Panda D, Hanitha R, Jain J, Chatterjee S, Annapurneswari S, Saipillai MZ, Gupta S, Khan E, Bhattacharya J, Bhandari TPS, Prasad SVSS, Swain M. A Multi-centric retrospective study into the epidemiological distribution of breast cancer patients in India. J Cancer Res Ther 2023; 19:S869-S876. [PMID: 38384068 DOI: 10.4103/jcrt.jcrt_1876_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/01/2022] [Indexed: 02/23/2024]
Abstract
BACKGROUND A multicentric private hospital-based retrospective study was conducted to understand the epidemiology of breast cancer in terms of demographics and clinical characteristics (staging and hormone receptor status) at the time of diagnosis. METHODS The data for 5,688 female breast cancer patients were collected from the hospital and clinical records of four study centres. All statistical analysis was performed using Microsoft Excel 2016 and R software. Survival was estimated by the Kaplan-Meier method and compared by the log-rank test. A P value of <.05 was considered statistically significant. RESULTS The mean and median age of the study population was 52.6 (± 12.4) years and 53.0 (range 51-54 across the four centers) years, respectively. About 68% of patients were in the age category of 41 65 years, 17.6% were <40 years old among whom 23.4% of patients reported a positive family history. Most of the patients (66.3%) were diagnosed at an early stage (Stage I and II). The 3-year OS probability was 100%, 97.5%, 94.1%, and 74.7% for TNM Stages I, II, III, and IV, respectively. The 3-year RFS was 95.7%, 95.5%, 84.5%, and 49% for TNM Stages I, II, III, and IV, respectively. CONCLUSION The present study highlights the epidemiological distribution of breast cancer patients. It emphasizes the importance of disease awareness among the urban and educated female population as most patients were diagnosed at earlier stages and demonstrated higher OS and RFS than reported in government registries.
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Affiliation(s)
- Vijay Anand Reddy
- Apollo Health City Jubilee Hills, Jubilee Hills, Hyderabad, Telangana, India
| | - Ramesh Sarin
- Indraprastha Apollo Hospitals, Sarita Vihar, Delhi, India
| | - Dipanjan Panda
- Indraprastha Apollo Hospitals, Sarita Vihar, Delhi, India
| | - Rnm Hanitha
- Sapien Biosciences Private Limited, AIMSR Building, Apollo Health City, Jubilee Hills, Hyderabad, Telangana, India
| | - Jugnu Jain
- Sapien Biosciences Private Limited, AIMSR Building, Apollo Health City, Jubilee Hills, Hyderabad, Telangana, India
| | - Soma Chatterjee
- Sapien Biosciences Private Limited, AIMSR Building, Apollo Health City, Jubilee Hills, Hyderabad, Telangana, India
| | - S Annapurneswari
- Apollo Cancer Center No. 320, Anna Salai, Thiru Vi Ka Kudiyiruppu, Teynampet, Chennai, Tamil Nadu, India
| | - Mohamed Zehran Saipillai
- Apollo Cancer Center No. 320, Anna Salai, Thiru Vi Ka Kudiyiruppu, Teynampet, Chennai, Tamil Nadu, India
| | - Shaikat Gupta
- Apollo Multispecialty Hospitals, Kolkata, West Bengal, India
| | - Enamuddin Khan
- Apollo Multispecialty Hospitals, Kolkata, West Bengal, India
| | | | | | - S V S S Prasad
- Apollo Health City Jubilee Hills, Jubilee Hills, Hyderabad, Telangana, India
| | - Meenakshi Swain
- Apollo Health City Jubilee Hills, Jubilee Hills, Hyderabad, Telangana, India
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Vaid PM, Puntambekar AK, Jumle NS, Banale RA, Ansari D, Reddy RR, Unde RR, Namewar NP, Kelkar DA, Shashidhara LS, Koppiker CB, Kulkarni MD. Evaluation of tumor-infiltrating lymphocytes (TILs) in molecular subtypes of an Indian cohort of breast cancer patients. Diagn Pathol 2022; 17:91. [PMID: 36411483 PMCID: PMC9677664 DOI: 10.1186/s13000-022-01271-y] [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: 07/05/2022] [Accepted: 10/21/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Evaluation of tumor-infiltrating lymphocytes (TILs) distribution in an Indian cohort of breast cancer patients for its prognostic significance. METHODS A retrospective cohort of breast cancer patients from a single onco-surgeon's breast cancer clinic with a uniform treatment strategy was evaluated for TILs. Tumor sections were H&E stained and scored for the spatial distribution and percent stromal TILs infiltration by a certified pathologist. The scores were analysed for association with treatment response and survival outcomes across molecular subtypes. RESULTS Total 229 breast cancer tumors were evaluated. Within spatial distribution categories, intra-tumoral TILs were observed to be associated with complete pathological response and lower recurrence frequency for the entire cohort. Subtype-wise analysis of stromal TILs (sTILs) re-enforced significantly higher infiltration in TNBC compared to HER2-positive and ER-positive tumors. A favourable association of higher stromal infiltration was observed with treatment response and disease outcomes, specifically in TNBC. CONCLUSION Intra-tumoral TILs showed a higher proportion with favourable association with better patient outcomes in an Indian cohort, unlike western cohorts where both stromal and intra-tumoral TILs show similar association with prognosis. With further validation, TILs can be developed as a cost-effective surrogate marker for treatment response, especially in a low-resource setting such as India.
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Affiliation(s)
- Pooja M. Vaid
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.449178.70000 0004 5894 7096Department of Biological Sciences, Ashoka University, Sonipat, India
| | | | - Nutan S. Jumle
- grid.414967.90000 0004 1804 743XDepartment of Pathology, Jehangir Hospital, Pune, India
| | - Rituja A. Banale
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.506045.20000 0004 4911 4105Prashanti Cancer Care Mission, Pune, Maharashtra India
| | - Danish Ansari
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.506045.20000 0004 4911 4105Prashanti Cancer Care Mission, Pune, Maharashtra India
| | - Ruhi R. Reddy
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.506045.20000 0004 4911 4105Prashanti Cancer Care Mission, Pune, Maharashtra India
| | - Rohini R. Unde
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.506045.20000 0004 4911 4105Prashanti Cancer Care Mission, Pune, Maharashtra India
| | - Namrata P. Namewar
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.506045.20000 0004 4911 4105Prashanti Cancer Care Mission, Pune, Maharashtra India
| | - Devaki A. Kelkar
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.506045.20000 0004 4911 4105Prashanti Cancer Care Mission, Pune, Maharashtra India
| | - L. S. Shashidhara
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.449178.70000 0004 5894 7096Department of Biological Sciences, Ashoka University, Sonipat, India ,grid.417959.70000 0004 1764 2413Indian Institute of Science Education and Research, Pune, India
| | - Chaitanyanand B. Koppiker
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.506045.20000 0004 4911 4105Prashanti Cancer Care Mission, Pune, Maharashtra India
| | - Madhura D. Kulkarni
- grid.417959.70000 0004 1764 2413Centre for Translational Cancer Research: a joint initiative of Indian Institute of Science Education and Research (IISER) Pune and Prashanti Cancer Care Mission (PCCM), Pune, India ,grid.506045.20000 0004 4911 4105Prashanti Cancer Care Mission, Pune, Maharashtra India
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Mukherjee Das A, Shrivastav KD, Taneja N, Awasthi AA, Rashid S, Gogia A, Janardhanan R. Knowledge and awareness of breast cancer and breast self-examination among college-going female students in Delhi-NCR: a cross sectional study. HEALTH EDUCATION 2022. [DOI: 10.1108/he-10-2021-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeBreast cancer (BC) presents a major public health challenge world-over including India. While several risk-factors, early signs and symptoms of BC are known, the knowledge and awareness of this disease remains poor among the population. The present study aimed to determine the extent of knowledge and awareness of BC, its risk factors, early signs and symptoms and breast self-examination (BSE) practice as an early detection method among Indian college-going female students.Design/methodology/approachThe authors conducted a cross-sectional survey at a University in Delhi-NCR. Data on socio-demographic, knowledge and awareness of BC including BSE was collected using a pretested questionnaire. Chi-square test and logistic regression analysis was performed. All tests were two-sided and significance was set at p < 0.05.FindingsA total of 866 female students participated in the study with mean age of 22.32 (±0.146) years having mean body mass index (BMI) of 21.22 (±3.52). As high as 82.1% of the participants had heard of BC but while 74.8% thought early detection is possible, 70.7% believed BC cannot be prevented. Gene mutations (60.2%) were identified as a significant risk factor, while breast pain (61.4%) was commonly recognized as a sign of BC. Only 29.8% of students ever performed BSE. Increased odds of performing BSE (OR = 3.4) was found among students who recognized gene mutations as an important BC risk factor.Research limitations/implicationsKnowledge and awareness of BC including BSE among female college students were found to be below average. It is suggested that there is an urgent need for increasing BC awareness among young girls through workshops and mobile-health interventions.Practical implicationsThis study provides new information on the level of knowledge and awareness of BC risk factors, sign and symptoms and self-examination practice among young college girls. Moreover, this study advocates the need for design and implementation of a sustainable digital health model for active population BC screening, which is not being done currently.Social implicationsBC is a highly aggressive disease, which is now one of the leading causes of morbidity and mortality in India and world over. Although the knowledge of BC risk factors and its signs and symptoms have increased, the awareness of these elements among the general population at large is low and/or missing, especially in India. Furthermore, as a consequence of unorganized screening programs in the country, majority of women are presenting young with locally advanced disease. Understanding the existing level of knowledge and educating school, college and University students of the pertinent factors and screening practices such as BSE could drastically help in improving the self-screening and/or clinical examination rates. This could potentially lead to early detection and improved prognosis, thus ameliorating disease burden.Originality/valueThis study is one of the few studies conducted in India among young female college students belonging to non-medical backgrounds, delineating the level of knowledge and awareness of BC risk factors and signs and symptoms along with practice of early detection method such as BSE. The study has a considerable sample size and provides valuable evidence for a need to implement programs incorporating digital health models for accelerating awareness and screening of young girls in both rural and urban settings.
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Cancer stem cell markers interplay with chemoresistance in triple negative breast cancer: A therapeutic perspective. Bull Cancer 2022; 109:960-971. [DOI: 10.1016/j.bulcan.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/18/2022] [Accepted: 05/03/2022] [Indexed: 11/19/2022]
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Bajpai J, Kashyap L, Vallathol DH, Das A, Singh M, Pathak R, Rath S, Sekar A, Mohanta S, Reddy A, Joshi S, Nandhana R, Ravind R, Wadasadawala T, Nair N, Ghosh J, Parmar V, Gulia S, Desai S, Shet T, Thakur M, Patil A, Sarin R, Gupta S, Badwe R. Outcomes of non-metastatic triple negative breast cancers: Real-world data from a large Indian cohort. Breast 2022; 63:77-84. [PMID: 35334242 PMCID: PMC8942859 DOI: 10.1016/j.breast.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 11/26/2022] Open
Abstract
Background Triple negative Breast tumor (TNBC) is an aggressive tumor with sparse data worldwide. Methods We analyzed non-metastatic TNBC from 2013 to 2019 for demographics, practice patterns, and survival by the Kaplan Meir method. Prognostic factors for OS and DFS were evaluated using Cox Proportional Hazard model estimator for univariate and multivariable analysis after checking for collinearity among the variables. Results There were 1297 patients with median age of 38 years; 41 (33.3%) among 123 tested were BRCA-positives. Among these 593 (45.7%) had stage III disease, 1279 (98.6%) were grade III, 165 (13.0%) had peri-nodal extension (PNE), 212 (16.0%) lympho-vascular invasion (LVI), and 21 (1.6%) were metaplastic; 1256 (96.8%) received chemotherapy including 820 (63.2%) neoadjuvant with 306 (40.0%) pCR. Grade ≥3 toxicities occurred in 155 (12.4%) including two deaths and 3 s-primaries. 1234 (95.2%) underwent surgery [722 (55.7%) breast conservations] and 1034 (79.7%) received radiotherapy. At a median follow-up of 54 months, median disease-free (DFS) was 92.2 months and overall survival (OS) was not reached. 5-year estimated DFS and OS was 65.9% and 80.3%. There were 259 (20.0%) failures; predominantly distant (204, 15.7%) - lung (51%), liver (31.8%). In multivariate analysis presence of LVI (HR-2.00, p-0.003), PNE (HR-2.09 p-0.003), older age (HR-1.03, p-0.002) and stage III disease (HR-4.89, p-0.027), were associated with poor OS. Conclusion Relatively large contemporary data of non-metastatic TNBC confirms aggressive biology and predominant advanced stage presentation which adversely affects outcomes. The data strongly indicate the unmet need for early detection to optimize care. TNBC affects young women and majority are locally advanced at presentation. Multimodal management achieves favorable survival with limited resources. Most relapses are at distant visceral sites, outcomes dismal after relapse. Challenges in implementing resource intensive interventions.
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Chaudhuri A, Kumar DN, Dehari D, Singh S, Kumar P, Bolla PK, Kumar D, Agrawal AK. Emergence of Nanotechnology as a Powerful Cavalry against Triple-Negative Breast Cancer (TNBC). Pharmaceuticals (Basel) 2022; 15:542. [PMID: 35631368 PMCID: PMC9143332 DOI: 10.3390/ph15050542] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/11/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is considered one of the un-manageable types of breast cancer, involving devoid of estrogen, progesterone, and human epidermal growth factor receptor 2 (HER 2) receptors. Due to their ability of recurrence and metastasis, the management of TNBC remains a mainstay challenge, despite the advancements in cancer therapies. Conventional chemotherapy remains the only treatment regimen against TNBC and suffers several limitations such as low bioavailability, systemic toxicity, less targetability, and multi-drug resistance. Although various targeted therapies have been introduced to manage the hardship of TNBC, they still experience certain limitations associated with the survival benefits. The current research thus aimed at developing and improving the strategies for effective therapy against TNBC. Such strategies involved the emergence of nanoparticles. Nanoparticles are designated as nanocavalries, loaded with various agents (drugs, genes, etc.) to battle the progression and metastasis of TNBC along with overcoming the limitations experienced by conventional chemotherapy and targeted therapy. This article documents the treatment regimens of TNBC along with their efficacy towards different subtypes of TNBC, and the various nanotechnologies employed to increase the therapeutic outcome of FDA-approved drug regimens.
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Affiliation(s)
- Aiswarya Chaudhuri
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (BHU), Varanasi 221005, India; (A.C.); (D.N.K.); (D.D.); (S.S.); (D.K.)
| | - Dulla Naveen Kumar
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (BHU), Varanasi 221005, India; (A.C.); (D.N.K.); (D.D.); (S.S.); (D.K.)
| | - Deepa Dehari
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (BHU), Varanasi 221005, India; (A.C.); (D.N.K.); (D.D.); (S.S.); (D.K.)
| | - Sanjay Singh
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (BHU), Varanasi 221005, India; (A.C.); (D.N.K.); (D.D.); (S.S.); (D.K.)
- Babasaheb Bhimrao Ambedkar University, Lucknow 226025, India
| | - Pradeep Kumar
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa;
| | - Pradeep Kumar Bolla
- Department of Biomedical Engineering, College of Engineering, The University of Texas at El Paso, 500 W. University Ave, El Paso, TX 79968, USA;
| | - Dinesh Kumar
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (BHU), Varanasi 221005, India; (A.C.); (D.N.K.); (D.D.); (S.S.); (D.K.)
| | - Ashish Kumar Agrawal
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (BHU), Varanasi 221005, India; (A.C.); (D.N.K.); (D.D.); (S.S.); (D.K.)
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Roy N, Mathew A. Triple Negative Breast Cancer in India: What Is the Real Incidence? Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1742612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Neil Roy
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States
| | - Aju Mathew
- Department of Oncology, MOSC Medical College, Kolenchery, Kerala, India
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Anand A, Mishra A, Damde H, Saxena A, Yadav SK, Sharma D. Molecular Profile and Clinico-pathological Characteristics of Breast Cancer in Central India: First Investigative Report. Indian J Surg Oncol 2022; 13:421-425. [DOI: 10.1007/s13193-022-01502-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 01/11/2022] [Indexed: 12/09/2022] Open
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Sahasrabuddhe NA, Korlimarla A, Kulkarni M, Kusuma V, Prabhu JS, Dixit S, Deshmukh C, Sridhar TS, Phatak A, Koppiker C. NGS-based profiling of key cancer genes in Indian triple-negative breast cancer patients reinforces molecular heterogeneity of the disease. Indian J Cancer 2022; 58:598-602. [PMID: 34975100 DOI: 10.4103/ijc.ijc_432_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Triple-negative breast cancers (TNBC) are one of the most aggressive forms of breast cancers. With poor patient outcomes, it presents a great burden on the healthcare systems. There have been some efforts to explore the genomic changes that occur in TNBCs. However, there is not enough data on Indian TNBCs. We sought to understand the mutational landscape of key cancer-associated genes in Indian TNBC patients using TruSeq Cancer Amplicon Panel. We sequenced 51 TNBC patient samples and found great heterogeneity amongst samples with respect to the genomic variants. Several previously reported including alterations in PI3K-AKT pathway genes were also identified. Likewise, we identified several novel high-frequency variants, for example, GNAQ F341S (17%), the functional role of which remains unclear. Our study lays the foundation of larger efforts needed to understand the genomic landscape of Indian TNBCs which can aid in classification and better therapeutic management of patients.
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Affiliation(s)
| | | | - Madhura Kulkarni
- Prashanti Cancer Care Mission (PCCM); Center for Translational Cancer Research - a joint initiative of PCCM and Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, India
| | - Vinay Kusuma
- PierianDx India Pvt. Ltd. Pune, Maharashtra, India
| | | | - Santosh Dixit
- Prashanti Cancer Care Mission (PCCM); Center for Translational Cancer Research - a joint initiative of PCCM and Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, India
| | - Chetan Deshmukh
- Prashanti Cancer Care Mission (PCCM), Pune, Maharashtra, India
| | - T S Sridhar
- St. John's Research Institute, Bengaluru, Karnataka, India
| | | | - Chaitanyananda Koppiker
- Prashanti Cancer Care Mission (PCCM); Center for Translational Cancer Research - a joint initiative of PCCM and Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, India
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Dubashi B, Matta K, Kayal S, Thumathy D, Nisha Y, Dharanipragada K, Gunaseelan K, ch Toi P, Ganesan P. Modified neoadjuvant clinicopathological risk stratification as a prognostic score in early and locally advanced triple-negative breast cancer. J Cancer Res Ther 2022; 18:168-172. [DOI: 10.4103/jcrt.jcrt_986_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Ba R, Karanam VPK, Mundada AB. Immunohistochemical Markers in Breast Cancer: A Cross-Sectional Study on Triple-Negative Breast Cancer in a Rural Tertiary Care Hospital. Cureus 2021; 13:e19486. [PMID: 34912627 PMCID: PMC8664371 DOI: 10.7759/cureus.19486] [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] [Accepted: 11/11/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction The incidence of breast cancer in India is on the rise, and it is now the most common cancer affecting women in India. The main objective of our study was to estimate the prevalence of triple-negative breast cancer (TNBC) in our study population and compare the various clinicopathological characteristics of TNBC with those of non-TNBC in these patients. Methods A retrospective, cross-sectional study was conducted among 249 cases of female breast cancer who reported to a tertiary care hospital in Southern India from September 2017 to September 2021. Results The mean age at presentation was 52 years (range: 26-82 years). The prevalence of triple-negative breast cancer was 19.7%. Most of the subjects belonged to the age group of 40-60 years. The majority were with grade 2 and 3 diseases. Of the cases, 50.6% were estrogen receptor (ER) positive and 48.2% were progesterone receptor (PR) positive, and 40.1% were HER2/neu positive. Conclusion The prevalence of triple-negative breast cancer in our study population is 19.7%, which is in concordance with the literature. Large tumor size, high-grade tumors, and a higher rate of axillary lymph node metastasis are characteristic features of TNBC. TNBC are tumors with aggressive tumor biology and are associated with poor prognosis.
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Affiliation(s)
- Rakesh Ba
- General Surgery, DM Wayanad Institute of Medical Sciences (DM WIMS), Wayanad, IND
| | - Venkata Pavan Kumar Karanam
- General Surgery, Employees' State Insurance Corporation Medical College and Hospital (ESIC MCH), Hyderabad, IND
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Kumari M, Krishnamurthy PT, Pinduprolu SKSS, Sola P. DR-5 and DLL-4 mAb Functionalized SLNs of Gamma-Secretase Inhibitors- An Approach for TNBC Treatment. Adv Pharm Bull 2021; 11:618-623. [PMID: 34888208 PMCID: PMC8642801 DOI: 10.34172/apb.2021.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/06/2020] [Accepted: 10/17/2020] [Indexed: 12/16/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is the most aggressive and heterogeneous cancer subtypes. High rates of metastasis, poor prognosis, and drug resistance are the major problems associated with TNBC. The current chemotherapeutics eliminate only the bulk tumor cells (non-BCSCs) and do not affect breast cancer stem cells (BCSCs). The BCSCs which are left behind after chemotherapy is reported to promote recurrence and metastasis of TNBC. Death receptor-5 (DR-5) is exclusively expressed in TNBCs and mediates the extrinsic pathway of apoptosis. DR-5, therefore, can be exploited for targeted drug delivery and to induce apoptosis. Gamma-secretase mediated Notch signaling in BCSCs regulates its proliferation, differentiation, and metastasis. The endogenous ligand, Delta-like ligand 4 (DLL4), is reported to activate this Notch signaling in TNBC. Blocking this signaling pathway using both gamma-secretase inhibitors (GSIs) and DLL4 monoclonal antibody (mAb) may produce synergistic benefits. Further, the GSIs (DAPT, LY-411575, RO4929097, MK0752, etc.) suffer from poor bioavailability and off-target side effects such as diarrhea, suppression of lymphopoiesis, headache, hypertension, fatigue, and ventricular dysfunctions. In this hypothesis, we discuss Solid lipid nanoparticles (SLNs) based drug delivery systems containing GSIs and surface modified with DR-5 and DLL4 monoclonal antibodies (mAb) to effectivity target and treat TNBC. The delivery system is designed to deliver the drug cargo precisely to TNBCs through its DR-5 receptors and hence expected to reduce the off-target side effects of GSIs. Further, DLL4 mAb and GSIs are expected to act synergistically to block the Notch signal mediated BCSCs proliferation, differentiation, and metastasis.
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Affiliation(s)
- Mamta Kumari
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India
| | - Praveen T Krishnamurthy
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India
| | - Sai Kiran S S Pinduprolu
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India
| | - Piyongsola Sola
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, The Nilgiris, Tamil Nadu, India
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Rana MK, Rana APS, Khera U. Expression of p53 and p16 in Carcinoma Breast Tissue: Depicts Prognostic Significance or Coincidence. Cureus 2021; 13:e19395. [PMID: 34925997 PMCID: PMC8654126 DOI: 10.7759/cureus.19395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/30/2022] Open
Abstract
Breast cancer remains the most common malignancy among the Indian female population. The p16 and p53 genes are frequently mutated in breast cancer. Therefore, we aimed to evaluate the prognostic significance of p16 and p53 overexpression in breast cancer and their correlation with various traditional prognostic parameters. Total of 100 confirmed cases of breast cancers were selected. Patients who underwent chemotherapy treatment were excluded from the study. Estrogen receptor (ER), progesterone receptor (PR), and Her2neu immunohistochemistry were performed. The p16 and p53 immunohistochemistry was performed on all cases and association with various clinicopathologic parameters was determined. The mean age of carcinoma breast was 53.3+11.6 with age ranging from 28 to 82 years. On histopathological examination, 93% of cases were of invasive ductal cell carcinoma (IDC) with majority of grade I (43%). Only 14% of cases showed positive p53 expression and 19% of cases showed positive p16 expression. P16 was seen in a very significant correlation with p53 expression in all breast carcinoma cases (<0.002). p53 expression showed a positively significant (<0.05) correlation with age and grade III. The p16 expression was seen significantly correlated with low mitotic activity index (MAI) only. The p53 over-expression was seen in worse prognostic factors such as high tumor grade, Her2neu and triple-negative expression suggested its potential role in pathogenesis of carcinoma breast. In addition, high expression of p16 seen in low mitotic count and Her2neu expression also emphasized the role of this biomarker and recommends further molecular-based research.
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Mittal A, Pramanik R. ASO Author Reflections: Germline Testing for All Patients With Breast Cancer: Has the Time Finally Come? Ann Surg Oncol 2021; 29:1433-1434. [PMID: 34654988 PMCID: PMC8519625 DOI: 10.1245/s10434-021-10880-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 11/18/2022]
Abstract
For the young breast cancer population in India, the burden of hereditary breast cancer is not well defined. Moreover, genetic testing criteria (National Comprehensive Cancer Network and Mainstreaming Cancer Genetics (MCG) plus) have never been validated for the Indian population. Therefore, this study tested 236 consecutive breast cancer patients for germline pathogenic mutations using next-generation sequencing and reflex Multiplex Ligation Probe Amplification (MLPA). The findings showed a high prevalence of pathogenic/likely pathogenic (P/LP) mutations (18.64%), with 34% mutations in non BRCA genes. The sensitivity of the testing criteria was inadequate (88.6% for NCCN and 86.36% for MCG plus criteria), reiterating the need to expand the criteria. The uptake of cascade testing was low (10% of eligible previvors), highlighting this as an area of unmet need. Multicentric studies to validate these data and provide further insight into the hereditary cancer burden in India are the need of the hour.
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Affiliation(s)
- Abhenil Mittal
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Raja Pramanik
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
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Mittal A, Deo SVS, Gogia A, Batra A, Kumar A, Bhoriwal S, Deb KS, Dhamija E, Thulkar S, Ramprasad VL, Olopade O, Pramanik R. Profile of Pathogenic Mutations and Evaluation of Germline Genetic Testing Criteria in Consecutive Breast Cancer Patients Treated at a North Indian Tertiary Care Center. Ann Surg Oncol 2021; 29:1423-1432. [PMID: 34601666 PMCID: PMC8487333 DOI: 10.1245/s10434-021-10870-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/16/2021] [Indexed: 01/14/2023]
Abstract
Background The burden of hereditary breast cancer in India is not well defined. Moreover, genetic testing criteria (National Comprehensive Cancer Network [NCCN] and Mainstreaming Cancer Genetics [MCG] Plus) have never been validated in the Indian population. Methods All new female breast cancer patients from 1st March 2019 to 28th February 2020 were screened. Those providing informed consent and without previous genetic testing were recruited. Multigene panel testing (107 genes) by next-generation sequencing was performed for all patients. The frequency of pathogenic/likely pathogenic (P/LP) mutations between patients qualifying and not qualifying the testing criteria was compared and their sensitivity was computed. Results Overall, 275 breast cancer patients were screened and 236 patients were included (median age 45 years); 30 patients did not consent and 9 patients previously underwent genetic testing. Thirty-four (14%) women had a positive family history and 35% had triple-negative breast cancer. P/LP mutations were found in 44/236 (18.64%) women; mutations in BRCA1 (22/47, 46.8%) and BRCA2 (9/47, 19.1%) were the most common, with 34% of mutations present in non-BRCA genes. Patients qualifying the testing criteria had a higher risk of having a P/LP mutation (NCCN: 23.6% vs. 7.04%, p = 0.03; MCG plus: 24.8% vs. 7.2%, p = 0.01). The sensitivity of the NCCN criteria was 88.6% (75.4–96.2) and 86.36% (72.65–94.83) for MCG plus. More than 95% sensitivity was achieved if all women up to 60 years of age were tested. Cascade testing was performed in 31 previous (16/44 families), with 23 testing positive. Conclusions The frequency of P/LP mutations in India is high, with significant contribution of non-BRCA genes. Testing criteria need modification to expand access to testing. Supplementary Information The online version contains supplementary material available at 10.1245/s10434-021-10870-w.
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Affiliation(s)
- Abhenil Mittal
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - S V S Deo
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Gogia
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Batra
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Akash Kumar
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Bhoriwal
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Koushik Sinha Deb
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ekta Dhamija
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Thulkar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | | | - Olufunmilayo Olopade
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, IL, USA
| | - Raja Pramanik
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
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Association Between Endemic Vitamin D Deficiency in India and High Prevalence of Poor-Prognosis Triple-Negative Breast Cancer: a Cross-Sectional Study. Indian J Surg 2021. [DOI: 10.1007/s12262-021-03065-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Desai A, Mathew A. The Great Breast Cancer Screening Conundrum. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1731859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Aakash Desai
- Division of Medical Oncology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Aju Mathew
- Department of Oncology, MOSC Medical College, Kolenchery, Kerala, India
- Department of Internal Medicine, Markey Cancer Center, University of Kentucky, Lexington, Kentucky, United States
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Kumari M, Krishnamurthy PT, Sola P. Targeted Drug Therapy to Overcome Chemoresistance in Triple-negative Breast Cancer. Curr Cancer Drug Targets 2021; 20:559-572. [PMID: 32370716 DOI: 10.2174/1568009620666200506110850] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 02/07/2023]
Abstract
Triple-negative Breast Cancer (TNBC) is the most aggressive and prevailing breast cancer subtype. The chemotherapeutics used in the treatment of TNBC suffer from chemoresistance, dose-limiting toxicities and off-target side effects. As a result, conventional chemotherapeutics are unable to prevent tumor growth, metastasis and result in failure of therapy. Various new targets such as BCSCs surface markers (CD44, CD133, ALDH1), signaling pathways (IL-6/JAK/STAT3, notch), pro and anti-apoptotic proteins (Bcl-2, Bcl-xL, DR4, DR5), hypoxic factors (HIF-1α, HIF-2α) and drug efflux transporters (ABCC1, ABCG2 and ABCB1) have been exploited to treat TNBC. Further, to improve the efficacy and safety of conventional chemotherapeutics, researchers have tried to deliver anticancer agents specifically to the TNBCs using nanocarrier based drug delivery. In this review, an effort has been made to highlight the various factors responsible for the chemoresistance in TNBC, novel molecular targets of TNBC and nano-delivery systems employed to achieve sitespecific drug delivery to improve efficacy and reduce off-target side effects.
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Affiliation(s)
- Mamta Kumari
- Department of Pharmacology, JSS College of Pharmacy, (A Constituent College of JSS Academy of Higher Education & Research), Ooty, Tamilnadu, India
| | - Praveen Thaggikuppe Krishnamurthy
- Department of Pharmacology, JSS College of Pharmacy, (A Constituent College of JSS Academy of Higher Education & Research), Ooty, Tamilnadu, India
| | - Piyong Sola
- Department of Pharmacology, JSS College of Pharmacy, (A Constituent College of JSS Academy of Higher Education & Research), Ooty, Tamilnadu, India
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Wijesinghe HD, Fernando J, Senarath U, Wijesinghe GK, S Lokuhetty MD. A clinicopathological study of triple-negative breast carcinoma in a patient cohort from a tertiary care center in Sri Lanka. INDIAN J PATHOL MICR 2021; 63:388-396. [PMID: 32769327 DOI: 10.4103/ijpm.ijpm_657_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Triple negative breast carcinoma (TNBC) and basal-like breast carcinoma (BLBC) are subtypes of breast carcinoma (BCa) that are associated with poor survival. Aims To study the prevalence, clinicopathological profile and survival of TNBC among a Sri Lankan patient cohort and to determine the proportion and predictive histological features of BLBC among TNBCs. Study Setting and Design A cohort of 221 women undergoing primary surgery for BCa at a tertiary-care center in Sri Lanka was studied. Materials and Methods Clinicopathological and follow-up information were collected by patient interviews and review of slides and clinical records. Estrogen, progesterone, HER2 receptors, and basal markers (CK5/6, CK14, EGFR, 34βE12) were evaluated immunohistochemically. Statistical Analysis Data was analyzed with Chi-square test, multinomial logistic regression, and Cox regression using SPSS20.0. Results Fifty-three (24%) tumors were triple-negative (95%CI = 18.37%-29.63%). On multivariate analysis, young age (P = 0.002), high Nottingham grade (P = 0.005), moderate to severe tumor necrosis (P = 0.004), absent ductal carcinoma in situ (DCIS) (P = 0.04), reduced vascular density at tumor edge (P = 0.016) and distinct cell margins (P = 0.047) predicted TNBC over luminal subgroups, whereas reduced vascular density (P = 0.004) and low TNM stage (P = 0.011) distinguished TNBC and HER2. BLBC accounted for 45.28% (95%CI 32.66%-58.55%-24/53) of TNBC. The presence of extensive necrosis in TNBC correlated significantly with BLBC (P = 0.03). The survival among the TNBC subgroup did not differ significantly from other subgroups. Conclusion Twenty four percent were TNBCs by immunohistochemical analysis, comparable to studies in the Indian subcontinent, however higher than the West. TNBC status correlated with younger age, high tumor grade, necrosis, absent DCIS, reduced vascular density at tumor edge, and distinct cell margins. The presence of moderate to extensive necrosis in TNBC was predictive of BLBC.
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Affiliation(s)
| | - Janakie Fernando
- Department of Pathology, National Hospital of Sri Lanka, Sri Lanka
| | - Upul Senarath
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Gayani K Wijesinghe
- Department of Pathology, Faculty of Medicine, University of Colombo, Sri Lanka
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Bondhopadhyay B, Sisodiya S, Kasherwal V, Nazir SU, Khan A, Tanwar P, Dil-Afroze, Singh N, Rasool I, Agrawal U, Rath G, Mehrotra R, Hussain S. The differential expression of Promyelocytic Leukemia (PML) and retinoblastoma (RB1) genes in breast cancer. Meta Gene 2021. [DOI: 10.1016/j.mgene.2021.100852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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37
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McDonald JA, Rao R, Gibbons M, Janardhanan R, Jaswal S, Mehrotra R, Pandey M, Radhakrishnan V, Ramakant P, Verma N, Terry MB. Symposium report: breast cancer in India-trends, environmental exposures and clinical implications. Cancer Causes Control 2021; 32:567-575. [PMID: 33909208 PMCID: PMC8089075 DOI: 10.1007/s10552-021-01428-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/29/2021] [Indexed: 12/02/2022]
Abstract
Purpose Incidence of breast cancer (BC), particularly in young women, are rising in India. Without population-based mammography screening, rising rates cannot be attributed to screening. Investigations are needed to understand the potential drivers of this trend. Methods An international team of experts convened to discuss the trends, environmental exposures, and clinical implications associated with BC in India and outlined recommendations for its management. Results Panels were structured across three major BC themes (n = 10 presentations). The symposium concluded with a semi-structured Think Tank designed to elicit short-term and long-term goals that could address the challenges of BC in India. Conclusion There was consensus that the prevalence of late-stage BC and the high BC mortality rates are associated with the practice of detection, which is primarily through clinical and self-breast exams, as opposed to mammography. Triple-Negative BC (TNBC) was extensively discussed, including TNBC etiology and potential risk factors, the limited treatment options, and if reported TNBC rates are supported by rigorous scientific evidence. The Think Tank session yielded long-term and short-term goals to further BC reduction in India and included more regional etiological studies on environmental exposures using existing India-based cohorts and case–control studies, standardization for molecular subtyping of BC cases, and improving the public’s awareness of breast health.
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Affiliation(s)
- Jasmine A McDonald
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th St, New York, NY, 10032, USA. .,Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
| | - Roshni Rao
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.,Division of Breast, Melanoma and Soft Tissue Surgery, Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Marley Gibbons
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th St, New York, NY, 10032, USA
| | - Rajiv Janardhanan
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Uttar Pradesh, India
| | - Surinder Jaswal
- School of Research Methodology, Centre for Health and Mental Health, School of Social Work, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Ravi Mehrotra
- Indian Council of Medical Research (ICMR) - India Cancer Research Consortium, New Delhi, India
| | - Manoj Pandey
- Institute of Medical Sciences, Department of Surgical Oncology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | | | - Pooja Ramakant
- King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - Nandini Verma
- TNBC Precision Medicine Research Laboratory, Advanced Centre for Treatment, Research, and Education in Cancer, Tata Memorial Center, Khargar, Navi Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, Maharashtra, India
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, 722 West 168th St, New York, NY, 10032, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
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Meeta M, Tanvir T. Menopause Hormone Therapy in the Changing Trends of Breast Cancer in India. J Midlife Health 2021; 11:196-198. [PMID: 33767558 PMCID: PMC7978056 DOI: 10.4103/jmh.jmh_291_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/19/2020] [Accepted: 12/28/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Meeta Meeta
- Obstetric and Gynaecology Department, Tanvir Hospital, Hyderabad, Telangana, India E-mail:
| | - Tanvir Tanvir
- Obstetric and Gynaecology Department, Tanvir Hospital, Hyderabad, Telangana, India E-mail:
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Gupta V, Agarwal P, Deshpande P. Impact of RASSF1A gene methylation on clinico-pathological features of tumor and non-tumor tissue of breast cancer. Ann Diagn Pathol 2021; 52:151722. [PMID: 33621744 DOI: 10.1016/j.anndiagpath.2021.151722] [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: 09/26/2020] [Revised: 12/31/2020] [Accepted: 02/08/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Breast cancer is the most common malignancy in women caused by genetic and epigenetic changes. Promoter DNA methylation in tumor suppressor gene plays a major role in breast cancer. The study determined the association of promoter DNA methylation of RASSF1A gene with clinicopathological features in tumor and non-tumor tissue. MATERIALS AND METHODS A cross sectional study was conducted in the Department of Pathology, Government Institute of Medical Sciences, Greater Noida and Molecular Pathology Laboratory, Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences. Two sections, one from tumor and the other from non-tumor tissue, were obtained and processed for DNA extraction and bisulphite conversion. Methylation specific PCR was done and results of RASSF1A promoter methylation were statistically correlated with clinicopathological features. RESULTS Of the 27 breast cancer tissue, 22 showed invasive ductal carcinoma, one showed invasive lobular carcinoma, another showed ductal carcinoma in situ and three cases showed malignant phyllodes tumor of breast. DNA promoter methylation was found in all the cases. 93% of tumor tissue samples and 67% of the non-tumor tissue samples were found to be aberrantly methylated. Tumor size and histological grade were found to be significantly (p-val <0.05) associated with the RASSF1A gene promoter methylation. CONCLUSION A significant association of higher tumor size and tumor histological grade with promoter methylation of RASSF1A gene exists suggestive of its being an important determinant of prognostic staging. This critical event in tumorigenesis may be of clinical utility in assessing breast cancer progression. MICRO ABSTRACT The study focuses on the RASSF1A gene promoter methylation and its impact on the clinicopathological features in Indian breast cancer patients highlighting the differences from other genetically different population. We found that RASFF1A gene methylation has significant impact on tumor size and tumor grade. The work carries high significance because it addresses the DNA methylation of tumor suppressor gene in relevance of breast cancer. It may also be the first such report on Indian patients with breast cancer.
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Affiliation(s)
- Vivek Gupta
- Department of Pathology & In-charge, Molecular Diagnostics and Research Laboratory, Government Institute of Medical Sciences, India.
| | - Prerna Agarwal
- Department of Physiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, India
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Sentinel Lymph Node Biopsy in Early Breast Cancer Using Methylene Blue Dye Alone: a Safe, Simple, and Cost-Effective Procedure in Resource-Constrained Settings. Indian J Surg Oncol 2021; 12:210-217. [PMID: 33814855 DOI: 10.1007/s13193-020-01273-6] [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: 08/10/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022] Open
Abstract
Sentinel lymph node biopsy (SLNB) is done by different techniques in clinically node-negative patients with early breast cancer. In this study, we aim to estimate the identification rates, positivity rates, cost-effectiveness, and outcomes for patients who underwent sentinel node biopsy using methylene blue dye alone. This was a retrospective review of 172 patients with early breast cancer (cT1-3, N0) who underwent SLNB using methylene blue dye alone between January 2014 and December 2018 including their follow-up details until December 2019. The mean age was 51 ± 10.3 (range: 28 to 76) years. There were 63 (36.6%) patients with cT1 tumor, 108 (62.7%) with cT2, and only 1 patient with cT3 tumor. Breast conservation surgery was performed in 62 (36%) while the remaining 110 (64%) underwent simple mastectomy. Sentinel nodes were successfully identified in 165 (95.9%) with a positivity rate of 23.6%. There was no dye-related adverse reactions intra-operatively. The mean duration of follow-up was 26.68 ± 15.9 months (range: 1-60). Chronic arm pain was present in 7 (4%) while none of the patients had lymphedema or restriction of shoulder joint motion. There were no documented axillary nodal recurrences in this cohort. Eight (4.65%) patients were detected to have systemic metastasis. One patient died of brain metastasis from bilateral breast cancer. The mean disease-free survival was 57 months (95% CI: 55-59). Sentinel lymph node biopsy using methylene dye alone is a safe, simple, and cost-effective alternative to isosulfan blue or radio isotope technique in surgical centers with resource constraints.
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Rachmi E, Purnomo BB, Endharti AT, Fitri LE. Identification of afzelin potential targets in inhibiting triple-negative breast cancer cell migration using reverse docking. Porto Biomed J 2020; 5:e095. [PMID: 33283065 PMCID: PMC7710241 DOI: 10.1097/j.pbj.0000000000000095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/02/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) tends to be aggressive and metastatic, characteristics attributable to its cellular migration capabilities. Afzelin is a chemical compound with anti-metastatic potentials. This study aimed to predict proteins involved in TNBC cell migration which could be inhibited by afzelin. METHODS The protein database was constructed from the Kyoto Encyclopedia of Genes and Genomes pathways collection which related to cell motility, then screened for druggability using SuperTarget and Therapeutic Target Database. The involvement of druggable proteins in the TNBC metastasis process was investigated through existing publications in The National Center for Biotechnology Information PubMed database. Inhibitory potential of afzelin toward target proteins was compared to the proteins' known-inhibitor, using the reverse docking method. RESULTS Ten proteins identified as potential targets of afzelin, with the top 3 being ERK2, KRas, and FAK, respectively. Afzelin's 3-O-rhamnoside group played a dominant role in forming hydrogen bonds with the target proteins. Further analysis with STRING suggested that afzelin might be able to inhibit chemotaxis and haptotaxis of TNBC cells. CONCLUSIONS Afzelin was predicted to inhibit TNBC cell motility, by targeting ERK2, KRas, and FAK activation.
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Affiliation(s)
- Eva Rachmi
- Department of Anatomy, Medical Faculty, Universitas Mulawarman, Samarinda
| | - Basuki Bambang Purnomo
- Department of Urology, Medical Faculty, Universitas Brawijaya/dr. Saiful Anwar General Hospital
| | - Agustina Tri Endharti
- Doctoral Program in Medical Science, Medical Faculty, Universitas Brawijaya
- Department of Parasitology, Medical Faculty, Universitas Brawijaya, Malang, Indonesia
| | - Loeki Enggar Fitri
- Doctoral Program in Medical Science, Medical Faculty, Universitas Brawijaya
- Department of Parasitology, Medical Faculty, Universitas Brawijaya, Malang, Indonesia
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Jonnada PK, Sushma C, Karyampudi M, Dharanikota A. Prevalence of Molecular Subtypes of Breast Cancer in India: a Systematic Review and Meta-analysis. Indian J Surg Oncol 2020; 12:152-163. [PMID: 33994741 DOI: 10.1007/s13193-020-01253-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/15/2020] [Indexed: 12/24/2022] Open
Abstract
In the last two decades, India has witnessed a substantial increase in the incidence of breast cancer and associated mortality. Studies on the prevalence of molecular subtypes of breast cancer in India have reported inconsistent results. Therefore, we conducted a systematic review of observational studies to document the prevalence of molecular subtypes of breast cancer. A complete literature search for observational studies was conducted in MEDLINE and EMBASE databases using key MeSH terms ((molecular classification) OR (molecular subtypes)) AND (breast cancer)) OR (breast carcinoma)) AND (prevalence)) AND (India). Two reviewers independently reviewed the retrieved studies. The screened studies satisfying the eligibility were included. The quality of included studies was assessed using the selected STROBE criteria. The overall pooled prevalence of luminal A, luminal B, HER2-enriched, and triple-negative breast cancer (TNBC) subtypes of breast cancer were 0.33 (95% CI 0.23-0.44), 0.17 (95% CI 0.12-0.23), 0.15 (95% CI 0.12-0.19), and 0.30 (95% CI 0.27-0.33), respectively. Subgroup analyses were performed by mean age of patients, time period, region, and sample size of the study. Among molecular subtypes of breast cancer, luminal A was the most prevalent subtype followed by TNBC, luminal B, and HER2-enriched subtypes. The overall prevalence of TNBC in India is high compared to other regions of the world. Additional research is warranted to identify the determinants of high TNBC in India. Differentiating TNBC from other molecular subtypes is important to guide therapeutic management of breast cancer.
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Affiliation(s)
- Pavan Kumar Jonnada
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Dr. M H Marigowda road, Bangalore, Karnataka 560029 India
| | - Cherukuru Sushma
- Department of Pathology, AmPath Laboratory Pvt. Limited, Citizens Hospital, Hyderabad, India
| | - Madhuri Karyampudi
- Department of Radiation Oncology, MNJ Institute of Oncology, Hyderabad, India
| | - Anvesh Dharanikota
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Dr. M H Marigowda road, Bangalore, Karnataka 560029 India
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Banerjee S, Kalyani Yabalooru SR, Karunagaran D. Identification of mRNA and non-coding RNA hubs using network analysis in organ tropism regulated triple negative breast cancer metastasis. Comput Biol Med 2020; 127:104076. [PMID: 33126129 DOI: 10.1016/j.compbiomed.2020.104076] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/17/2020] [Accepted: 10/17/2020] [Indexed: 12/15/2022]
Abstract
Triple negative breast cancer (TNBC) is aggressive in nature, resistant to conventional therapy and often ends in organ specific metastasis. In this study, publicly available datasets were used to identify miRNA, mRNA and lncRNA hubs. Using validated mRNA-miRNA, mRNA-mRNA and lncRNA-miRNA interaction information obtained from various databases, RNA interaction networks for TNBC and its subtype specific as well as organ tropism regulated metastasis were generated. Further, miRNA-mRNA-lncRNA triad classification was performed using social network analysis from subnetworks and visualized using Cytoscape. Survival analysis of the RNA hubs, oncoprint analysis for mRNAs and pathway analysis of the lncRNAs were also performed. Results indicated that two lncRNAs (NEAT1 and CASC7) and four miRNAs (hsa-miR-106b-5p, hsa-miR-148a-3p, hsa-miR-25-3p and hsa-let-7i-5p) were common between hubs identified in TNBC and TNBC associated metastasis. The exclusive hubs for TNBC associated metastasis were hsa-miR-200b-3p, SP1, HSPA4 and RAB1B. HMGA1 was the top ranked hub in mesenchymal subtype associated lung metastasis, while hsa-miR-27a-3p was identified as the top ranked hub mRNA in luminal androgen receptor subtype associated bone metastasis. When lncRNA associated pathway analysis was performed, Hs Cytoplasmic Ribosomal Protein pathway was found to be the most significant and among the selected hubs, CTNND1, SON and hsa-miR-29c emerged as TNBC survival markers. TP53, FOXA1, MTDH and HDGF were found as the top ranked mRNAs in oncoprint analysis. The pipeline proposed for the first time in this study with validated RNA interaction data integration and graph-based learning for miRNA-mRNA-lncRNA triad classification from RNA hubs may aid experimental cost reduction and its successful execution will allow it to be extended to other diseases too.
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Affiliation(s)
- Satarupa Banerjee
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, 600036, Tamilnadu, India; School of Biosciences and Technology, Vellore Institute of Technology, Vellore, 632 014, Tamil Nadu, India
| | - Surya Radhika Kalyani Yabalooru
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, 600036, Tamilnadu, India
| | - Devarajan Karunagaran
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, 600036, Tamilnadu, India.
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Somashekhar SP, Zaveri S, Vijay DG, Dattatreya PS, Kumar R, Islahi F, Bahl C. Individualized Chemotherapy Benefit Prediction by EndoPredict in Patients With Early Breast Cancer in an Indian Cohort. JCO Glob Oncol 2020; 6:1363-1369. [PMID: 32897733 PMCID: PMC7529538 DOI: 10.1200/go.20.00250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE There are new advancements in the modulation of the treatment of patients with early-stage breast cancer, including the use of several molecular profiling tests to identify or select those patients who require additional adjuvant chemotherapy together with hormonal therapy on the basis of a recurrence score. One such tool is EndoPredict (Myriad Genetics; Salt Lake City, UT), which provides support in clinical decision making. The objective of this analysis was to study the landscape of absolute chemotherapy benefit and the likelihood of recurrence within 5 to 15 years in Indian patients with breast cancer who are undergoing EndoPredict testing. PATIENTS AND METHODS This study included 308 patients with hormone-positive, human epidermal growth factor receptor 2–negative early breast cancer. Their postsurgical blocks were analyzed using the EndoPredict test. The MEDCALC statistical tool (Panum Education; Seoul, Republic of Korea) was used to estimate the correlation coefficient and to conduct multiple regression analysis. RESULTS On the basis of the EndoPredict EPclin Risk Score, 52.12% of patients were classified as being in the low-risk category and could safely forgo adjuvant chemotherapy. For every unit increase in the EPclin Risk Score, the percentage increase in absolute chemotherapy benefit was 6.82%. Similarly, the correlation between the likelihood of recurrence within 5 to 15 years and the EPclin Risk Score suggested that there is a 10.34% increase in recurrence for each unit of EPclin Risk Score. CONCLUSION The EPclin Risk Score has good prognostic and predictive power; it also provides the range of chemotherapy benefit for Indian patients.
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Affiliation(s)
- S P Somashekhar
- Manipal Comprehensive Cancer Care Centre, Manipal Hospital, Bengaluru, Karnataka, India
| | - Shabber Zaveri
- Manipal Comprehensive Cancer Care Centre, Manipal Hospital, Bengaluru, Karnataka, India
| | | | | | - Rajeev Kumar
- Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, Delhi, India
| | - Fatma Islahi
- Department of Clinical Genomics and Bioinformatics, Positive Bioscience, Kohinoor Mall, Kurla West, Mumbai, India
| | - Charu Bahl
- Department of Clinical Genomics and Bioinformatics, Positive Bioscience, Kohinoor Mall, Kurla West, Mumbai, India
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Sengupta D, Banerjee S, Mukhopadhyay P, Guha U, Ganguly K, Bhattacharjee S, Sengupta M. A meta-analysis and in silico analysis of polymorphic variants conferring breast cancer risk in the Indian subcontinent. Future Oncol 2020; 16:2121-2142. [PMID: 32744066 DOI: 10.2217/fon-2020-0333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Genetic association studies on breast cancer on the Indian subcontinent have yielded conflicting results, and the precise effect of these variants on breast cancer pathogenesis is not known. Methods: Genomic variants, as obtained from selected studies from the Indian subcontinent, were subjected to random-effects and fixed-effect meta-analysis. Functional annotation of the relevant variants was done through a tried and tested in silico pipeline. Results: We found rs4646903/CYP1A1, rs1799814/CYP1A1, rs61886492/GCPII, del2/GSTM1, rs4680/COMT and rs1801394/MTRR to be associated with breast cancer. The del2/GSTM1 holds the association in premenopausal women. Conclusions: This is the first study of its kind from the Indian subcontinent analysing the extent of association of variants across populations followed by their functional annotation in the disease pathway.
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Affiliation(s)
- Debmalya Sengupta
- Department of Genetics, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, India
| | - Souradeep Banerjee
- Department of Genetics, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, India
| | - Pramiti Mukhopadhyay
- Department of Genetics, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, India
| | - Udayan Guha
- Department of Genetics, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, India
| | - Kausik Ganguly
- Department of Genetics, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, India
| | - Samsiddhi Bhattacharjee
- National Institute of Biomedical Genomics, Near Netaji Subhas Sanatorium Post Office, Kalyani, West Bengal 741251, India
| | - Mainak Sengupta
- Department of Genetics, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, India
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Kulkarni A, Kelkar DA, Parikh N, Shashidhara LS, Koppiker CB, Kulkarni M. Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer. JCO Glob Oncol 2020; 6:1052-1062. [PMID: 32639876 PMCID: PMC7392736 DOI: 10.1200/go.20.00054] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Breast cancer is the most common cancer in women in India, with higher incidence rates of aggressive subtypes, such as triple-negative breast cancer (TNBC). METHODS A systematic review was performed to compute pooled prevalence rates of TNBC among patients with breast cancer, and clinical features at presentation were systematically compared with non-TNBC in an Indian cohort of 20,000 patients. RESULTS Combined prevalence of TNBC among patients with breast cancer was found to be on the higher side (27%; 95% CI, 24% to 31%). We found that the estrogen receptor (ER) expression cutoff used to determine ER positivity had an influence on the pooled prevalence and ranged from 30% (ER/progesterone receptor [PR] cut ff at 1%) to 24% (ER/PR cutoff at 10%). Odds for TNBC to present in the younger age-group were significantly higher (pooled odds ratio [OR], 1.35; 95% CI, 1.08 to 1.69), with a significantly younger mean age of incidence (weighted mean difference, -2.75; 95% CI, -3.59 to -1.92). TNBC showed a significantly higher odds of presenting with high grade (pooled OR, 2.57; 95% CI, 2.12 to 3.12) and lymph node positivity (pooled OR, 1.39; 95% CI, 1.21 to 1.60) than non-TNBC. CONCLUSION Systematic review and meta-analysis of 34 studies revealed a high degree of heterogeneity in prevalence of TNBC within Indian patients with breast cancer, yet pooled prevalence of TNBC is high in India. High proportions of patients with TNBC present with aggressive features, such as high grade and lymph node positivity, compared with patients without TNBC. We emphasize the need for standardized methods for accurate diagnosis in countries like India.
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Affiliation(s)
- Apurv Kulkarni
- Indian Institute of Science Education and Research, Pune, India
| | - Devaki A. Kelkar
- Prashanti Cancer Care Mission, Pune, India
- Center for Translational Cancer Research: A Joint Initiative of Prashanti Cancer Care Mission and Indian Institute of Science Education and Research, Pune, India
| | - Nidhi Parikh
- Indian Institute of Science Education and Research, Pune, India
| | - Lingadahalli S. Shashidhara
- Indian Institute of Science Education and Research, Pune, India
- Center for Translational Cancer Research: A Joint Initiative of Prashanti Cancer Care Mission and Indian Institute of Science Education and Research, Pune, India
| | - Chaitanyanand B. Koppiker
- Prashanti Cancer Care Mission, Pune, India
- Center for Translational Cancer Research: A Joint Initiative of Prashanti Cancer Care Mission and Indian Institute of Science Education and Research, Pune, India
| | - Madhura Kulkarni
- Prashanti Cancer Care Mission, Pune, India
- Center for Translational Cancer Research: A Joint Initiative of Prashanti Cancer Care Mission and Indian Institute of Science Education and Research, Pune, India
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47
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Batra A, Patel A, Gupta VG, Mehta P, Tvsvgk T, Biswas B, Pramanik R, Das CK, Srivastava P. Oncotype DX: Where Does It Stand in India? J Glob Oncol 2020; 5:1-2. [PMID: 31310569 PMCID: PMC6690658 DOI: 10.1200/jgo.19.00151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Atul Batra
- All India Institute of Medical Sciences, New Delhi, India
| | - Amol Patel
- Army Hospital-Research and Referral, New Delhi, India
| | | | | | | | | | - Raja Pramanik
- All India Institute of Medical Sciences, New Delhi, India
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48
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Bhattacharyya GS, Doval DC, Desai CJ, Chaturvedi H, Sharma S, Somashekhar S. Overview of Breast Cancer and Implications of Overtreatment of Early-Stage Breast Cancer: An Indian Perspective. JCO Glob Oncol 2020; 6:789-798. [PMID: 32511068 PMCID: PMC7328098 DOI: 10.1200/go.20.00033] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
Abstract
The prevalence and mortality of breast cancer is increasing in Asian countries, including India. With advances in medical technology leading to better detection and characterization of the disease, it has been possible to classify breast cancer into various subtypes using markers, which helps predict the risk of distant recurrence, response to therapy, and prognosis using a combination of molecular and clinical parameters. Breast cancer and its therapy, mainly surgery, systemic therapy (anticancer chemotherapy, hormonal therapy, targeted therapy, and immunotherapy), and radiation therapy, are associated with significant adverse influences on physical and mental health, quality of life, and the economic status of the patient and her family. The fear of recurrence and its devastating effects often leads to overtreatment, with a toxic cost to the patient financially and physically in cases in which this is not required. This article discusses some aspects of a breast cancer diagnosis and its impact on the various facets of the life of the patient and her family. It further elucidates the role of prognostic factors, the currently available biomarkers and prognostic signatures, and the importance of ethnically validating biomarkers and prognostic signatures.
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Affiliation(s)
| | - Dinesh C. Doval
- Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Chirag J. Desai
- Vedanta Institute of Medical Sciences, Ahmedabad, Gujarat, India
| | | | - Sanjay Sharma
- Asian Cancer Institute, Somaiya Ayurvihar, Mumbai, Maharashtra, India
| | - S.P. Somashekhar
- Department of Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital, Bengaluru, India
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49
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Islam S, Dasgupta H, Basu M, Roy A, Alam N, Roychoudhury S, Panda CK. Downregulation of beta-catenin in chemo-tolerant TNBC through changes in receptor and antagonist profiles of the WNT pathway: Clinical and prognostic implications. Cell Oncol (Dordr) 2020; 43:725-741. [PMID: 32430683 DOI: 10.1007/s13402-020-00525-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 03/30/2020] [Accepted: 04/16/2020] [Indexed: 02/01/2023] Open
Abstract
PURPOSE In approximately 30% of triple-negative breast cancer (TNBC) patients a complete pathological response is achieved. However, after neo-adjuvant chemotherapy treatment (NACT) residual tumour cells can be intrinsically resistant to chemotherapy. In this study, associations of the WNT/beta-catenin pathway with chemo-tolerance of NACT treated TNBC patients were compared to that of pre-treatment TNBC patients. METHODS Expression analyses were performed in both pre-treatment and NACT treated TNBC samples using immunohistochemistry and qRT-PCR, along with DNA copy number variation (CNV) and promoter methylation analyses to elucidate the mechanism(s) underlying chemo-tolerance. In addition, in vitro validation experiments were performed in TNBC cells followed by in vivo clinicopathological correlation analyses. RESULTS A reduced expression (41.1%) of nuclear beta-catenin together with a low proliferation index was observed in NACT samples, whereas a high expression (59.0%) was observed in pre-treatment samples. The reduced nuclear expression of beta-catenin in the NACT samples showed concordance with reduced expression levels (47-52.9%) of its associated receptors (FZD7 and LRP6) and increased expression levels (35.2-41.1%) of its antagonists (SFRP1, SFRP2, DKK1) compared to those in the pre-treatment samples. The expression levels of the receptors showed no concordance with its respective gene copy number/mRNA expression statuses, regardless treatment. Interestingly, however, significant increases in promoter hypomethylation of the antagonists were observed in the NACT samples compared to the pre-treatment samples. Similar expression patterns of the antagonists, receptors and beta-catenin were observed in the TNBC-derived cell line MDA-MB-231 using the anthracyclines doxorubicin and nogalamycin, suggesting the importance of promoter hypomethylation in chemotolerance. NACT patients showing reduced receptor and/or beta-catenin expression levels and high antagonist expression levels exhibited a comparatively better prognosis than the pre-treatment patients. CONCLUSIONS Our data suggest that reduced nuclear expression of beta-catenin in NACT TNBC samples, due to downregulation of its receptors and upregulation of its antagonists through promoter hypomethylation of the WNT pathway, plays an important role in chemo-tolerance.
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Affiliation(s)
- Saimul Islam
- Department of Oncogene Regulation, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, West Bengal, 700026, India
| | - Hemantika Dasgupta
- Department of Oncogene Regulation, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, West Bengal, 700026, India
| | - Mukta Basu
- Department of Oncogene Regulation, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, West Bengal, 700026, India
| | - Anup Roy
- Department of Pathology, Nil Ratan Sircar Medical College and Hospital, 138, Acharya Jagadish Chandra Bose Rd, 700014, Kolkata, India
| | - Neyaz Alam
- Department of Surgical Oncology, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, West Bengal, 700026, India
| | - Susanta Roychoudhury
- Saroj Gupta Cancer Centre and Research Institute, Thakurpukur, Kolkata, 700 063, India
| | - Chinmay Kumar Panda
- Department of Oncogene Regulation, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata, West Bengal, 700026, India.
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50
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Are Basal-Like and Non-Basal-Like Triple-Negative Breast Cancers Really Different? JOURNAL OF ONCOLOGY 2020; 2020:4061063. [PMID: 32256581 PMCID: PMC7102473 DOI: 10.1155/2020/4061063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 02/11/2020] [Indexed: 01/07/2023]
Abstract
Objective Triple-negative breast cancer (TNBC) accounts for 15–25% of breast cancers. It is increasingly recognized that TNBC is a motley disease. TNBC and basal-like (BL) subtype are different molecular classes of breast cancer with a high degree of overlap. However, a smaller fraction lacks the expression of basal markers in spite of being TNBC and is called non-basal-like (NBL). The aim of this study is to assess the clinicopathological features in TNBC and compare its BL and NBL subtypes. Material and Methods. A total of 200 subjects fulfilling the inclusion criteria of study were identified from the electronic medical records of institution. The tumor sections of subjects were immunohistochemically stained for basal markers, namely, 34βE12, c-Kit, and EGFR, in order to differentiate between BL and NBL subtypes. Comprehensive data were assembled from subjects' clinical records. The features of TNBC and their associations with the two subtypes were assessed using statistical analyses. Results TNBC constituted 22% of all breast cancers. The family history of cancer was observed to be significantly associated with stage (p=0.013). The proportions of BL and NBL subtypes were equal. Of all parameters compared between two subtypes, only lymphovascular invasion was found to have statistically significant difference (p=0.019). Though no statistical significant difference between overall survival (OS) and disease-free survival (DFS) of two subgroups was found, BL subtype has slightly shorter DFS and OS compared to NBL. Conclusion Both BL and NBL subtypes occur in equal proportions; hence, basalness and triple negativity are not synonyms. Though BL and NBL are prognostically similar, BL subtype shows a trend towards slightly shorter DFS and OS compared to NBL.
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