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Ebrahimnejad P, Mohammadi Z, Babaei A, Ahmadi M, Amirkhanloo S, Asare-Addo K, Nokhodchid A. Novel Strategies Using Sagacious Targeting for Site-Specific Drug Delivery in Breast Cancer Treatment: Clinical Potential and Applications. Crit Rev Ther Drug Carrier Syst 2024; 41:35-84. [PMID: 37824418 DOI: 10.1615/critrevtherdrugcarriersyst.v41.i1.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
For more than a decade, researchers have been working to achieve new strategies and smart targeting drug delivery techniques and technologies to treat breast cancer (BC). Nanotechnology presents a hopeful strategy for targeted drug delivery into the building of new therapeutics using the properties of nanomaterials. Nanoparticles are of high regard in the field of diagnosis and the treatment of cancer. The use of these nanoparticles as an encouraging approach in the treatment of various cancers has drawn the interest of researchers in recent years. In order to achieve the maximum therapeutic effectiveness in the treatment of BC, combination therapy has also been adopted, leading to minimal side effects and thus an enhancement in the quality of life for patients. This review article compares, discusses and criticizes the approaches to treat BC using novel design strategies and smart targeting of site-specific drug delivery systems.
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Affiliation(s)
- Pedram Ebrahimnejad
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran; Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Mohammadi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amirhossein Babaei
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Melika Ahmadi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shervin Amirkhanloo
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kofi Asare-Addo
- Department of Pharmacy, University of Huddersfield, Huddersfield, UK
| | - Ali Nokhodchid
- Lupin Pharmaceutical Research Center, Coral Springs, Florida, USA; Pharmaceutics Research Lab, Arundel Building, School of Life Sciences, University of Sussex, Brighton, UK
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Yan S, Wang Y, Guo Y, Zhang Y, Peng H, Tang H, Luo Y, Zhang A, Gao H. Prognostic factor analysis and clinical significance of HER‑2‑positive breast cancers with negative lymph nodes and a tumor diameter ≤1 cm. Oncol Lett 2023; 26:491. [PMID: 37854866 PMCID: PMC10579976 DOI: 10.3892/ol.2023.14078] [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: 03/31/2023] [Accepted: 08/16/2023] [Indexed: 10/20/2023] Open
Abstract
The 2021 National Comprehensive Cancer Network guidelines recommend that adjuvant chemotherapy combined with trastuzumab be considered for human epidermal growth factor receptor 2 (HER-2)-positive breast cancer patients with small tumors (tumor diameter ≤1 cm) and negative lymph nodes. Additionally, the prognostic factors and clinical significance of HER-2-positive breast cancer with negative lymph nodes and a tumor diameter ≤1 cm remain unclear. In the present study, the clinical data and prognostic factors of 87 patients with HER-2-positive breast cancer with negative lymph nodes and a tumor diameter ≤1 cm admitted to Guangdong Women and Children Hospital from January 2013 to December 2019 were retrospectively analyzed. The median follow-up time was 70 months, the disease-free survival (DFS) of all patients was 94.3% and the overall survival (OS) was 100%. Univariate analysis of prognosis demonstrated that patients aged ≤40 years had significantly lower DFS than those aged >40 (80.8 vs. 100.0%, P<0.001). DFS was significantly improved in patients who were hormone-receptor-positive and patients who received endocrine therapy compared with patients who were estrogen receptor negative and patients who did not receive endocrine therapy (100.0 vs. 89.6%, P=0.039; 100.0 vs. 90.0%, P=0.049). Prognostic univariate analysis demonstrated that patient age, hormone receptor status and use of endocrine therapy were significantly related to the DFS (P<0.05), while none of these were independent factors related to the DFS in the prognostic multivariate analysis (P=0.240, P=0.976 and P=0.925). The proportion of patients with a tumor diameter 0.5-1 cm receiving adjuvant anti-HER-2 treatment was significantly greater compared with patients with tumors with a diameter ≤0.5 cm (46.4 vs. 18.6%, P<0.05). There was no significance difference in the DFS of patients treated with adjuvant chemotherapy with or without anti-HER-2 therapy with tumor diameters ≤0.5 cm (P>0.05), but there was a significant difference in the DFS of patients with a tumor diameter 0.5-1 cm (P<0.05). These results suggested that adjuvant chemotherapy, with or without anti-HER-2 therapy, may affect the prognosis of HER-2-positive breast cancer patients with negative lymph nodes and a tumor diameter of 0.5-1 cm. Therefore, it could be recommended that such patients receive adjuvant chemotherapy and anti-HER-2 therapy in the future.
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Affiliation(s)
- Shanshan Yan
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
| | - Yongnan Wang
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
| | - Yujuan Guo
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
| | - Yan Zhang
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
| | - Haiyan Peng
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
| | - Huang Tang
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
| | - Yizhong Luo
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
| | - Anqin Zhang
- Breast Disease Center, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
| | - Hongyi Gao
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511400, P.R. China
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O'Shaughnessy J, Gradishar W, O'Regan R, Gadi V. Risk of Recurrence in Patients with HER2+ Early-Stage Breast Cancer: Literature Analysis of Patient and Disease Characteristics. Clin Breast Cancer 2023; 23:350-362. [PMID: 37149421 DOI: 10.1016/j.clbc.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/10/2023] [Accepted: 03/18/2023] [Indexed: 03/31/2023]
Abstract
Human epidermal growth factor receptor 2 (HER2) overexpression occurs in 15% to 20% of patients with early-stage breast cancers (EBCs). Without HER2-targeted therapy, 30% to 50% of patients relapse within 10 years, many developing incurable metastatic disease. This literature review was designed to identify and validate patient- and disease-related factors associated with recurrence in patients with HER2+ EBC. Peer-reviewed primary research articles and congress abstracts were identified by searching MEDLINE. Articles published in English from 2019 to 2022 were included to identify contemporary treatment options. Results were analyzed for the relationship between risk factors and surrogates of HER2+ EBC recurrence to determine how identified risk factors affected HER2+ EBC recurrence. Sixty-one articles and 65 abstracts that assessed age at diagnosis, body mass index (BMI), tumor size at diagnosis, hormone receptor (HR) status, pathologic complete response (pCR) status, and biomarkers were analyzed. We confirmed the results of previously published reviews reporting residual cancer burden >0, non-pCR, and fewer tumor-infiltrating lymphocytes (TILs) as risk factors of recurrence. HR status remained an important risk factor for recurrence, with HER2+/HR+ disease more likely to recur. Two or more positive lymph nodes, higher BMI, larger primary tumor size, and low Ki67 were more commonly associated with HER2+ EBC recurrence. The identification of patient and disease factors frequently associated with HER2+ EBC recurrence in the literature provides insight into potential recurrence risk factors. Further investigation into the risk factors identified in this review could lead to improved treatments for patients at high risk for HER2+ EBC recurrence.
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Affiliation(s)
- Joyce O'Shaughnessy
- Baylor University Medical Center, Dallas, TX; Texas Oncology-Baylor Charles A. Sammons Cancer Center, Dallas, TX.
| | | | - Ruth O'Regan
- Department of Medicine, University of Rochester, Rochester, NY
| | - Vijayakrishna Gadi
- Department of Medicine, University of Illinois Chicago, Chicago, IL; Translational Oncology Program, University of Illinois Cancer Center, Chicago, IL
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Zhang L, Li H, Wang T, Wang R, Cheng L, Wang G. Real-World Study: A Powerful Tool for Malignant Tumor Research in General Surgery. Cancers (Basel) 2022; 14:5408. [PMID: 36358825 PMCID: PMC9656785 DOI: 10.3390/cancers14215408] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/21/2022] [Accepted: 10/31/2022] [Indexed: 03/01/2024] Open
Abstract
Real-world study (RWS) is a method to draw conclusions by collecting and analyzing real-world data under a real clinical background. Compared with traditional randomized controlled trials (RCTs), RWSs are favored by clinicians because of their low cost and good extrapolation. In recent years, RWS has made remarkable achievements in the field of general surgery, especially in the drug treatment of advanced malignant tumors. Therefore, to further understand the main contents of the existing RWS and the application prospect of RWS in the future, this paper systematically reviews the clinical application of RWS in malignant tumors in general surgery in the past three years.
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Affiliation(s)
- Liang Zhang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - He Li
- Department of Centric Operating Room, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - TianFu Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - RuiXin Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - Long Cheng
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
| | - Gang Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
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Bai CC, Chen MY, Zhou TC, Jiang RL, Dong LY, Wei HW, Kong XJ, Wang XH. Hydrophilic rhodamine B-loaded / boronic acid-modified graphene oxide nanocomposite as a substitute of enzyme-labeled second antibody for ultrasensitive detection of antibodies. J Pharm Biomed Anal 2022; 216:114804. [DOI: 10.1016/j.jpba.2022.114804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/13/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
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Kenny K, Broom A, Page A, Prainsack B, Wakefield CE, Itchins M, Lwin Z, Khasraw M. A sociology of precision-in-practice: The affective and temporal complexities of everyday clinical care. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:2178-2195. [PMID: 34843108 PMCID: PMC9299761 DOI: 10.1111/1467-9566.13389] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/27/2021] [Indexed: 05/20/2023]
Abstract
The idea of 'precision medicine', which has gained increasing traction since the early 2000s, is now ubiquitous in health and medicine. Though varied in its implementation across fields, precision medicine has raised hopes of revolutionary treatments and has spurred the proliferation of novel therapeutics, the alteration of professional trajectories and various reconfigurations of health/care. Nowhere is the promise of precision medicine more apparent, nor further institutionalised, than in the field of oncology. While the transformative potential of precision medicine is widely taken for granted, there remains scant attention to how it is being experienced at the coalface of care. Here, drawing on the perspectives of 54 cancer care professionals gleaned through eight focus group discussions in two hospitals in Australia, we explore clinicians' experiences of the day-to-day dynamics of precision-in-practice. We illustrate some of the affective and temporal complexities, analysed here under the rubrics of enchantment, acceleration and distraction that are emerging alongside the uptake of precision medicine in the field of oncology. We argue that these complexities, and their dis/continuities with earlier iterations of cancer care, demonstrate the need for sociological analyses of precision medicine as it is being implemented in practice and its varied effects on 'routine' care.
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Affiliation(s)
- Katherine Kenny
- Sydney Centre for Healthy SocietiesSchool of Social and Political SciencesThe University of SydneySydneyNew South WalesAustralia
- Department of Sociology and Social PolicyFaculty of Arts and Social SciencesThe University of SydneySydneyNew South WalesAustralia
| | - Alex Broom
- Sydney Centre for Healthy SocietiesSchool of Social and Political SciencesThe University of SydneySydneyNew South WalesAustralia
- Department of Sociology and Social PolicyFaculty of Arts and Social SciencesThe University of SydneySydneyNew South WalesAustralia
| | - Alexander Page
- Sydney Centre for Healthy SocietiesSchool of Social and Political SciencesThe University of SydneySydneyNew South WalesAustralia
- Department of Sociology and Social PolicyFaculty of Arts and Social SciencesThe University of SydneySydneyNew South WalesAustralia
| | - Barbara Prainsack
- Department of Political ScienceUniversity of ViennaViennaAustria
- Department of Global Health & Social MedicineKing’s College LondonLondonUK
| | - Claire E. Wakefield
- School of Women’s and Children’s HealthUNSW Medicine and HealthUNSWSydneyNew South WalesAustralia
- Behavioural Sciences UnitKids Cancer CentreSydney Children’s HospitalRandwickNew South WalesAustralia
| | - Malinda Itchins
- Northern Clinical SchoolUniversity of SydneySt LeonardsNew South WalesAustralia
- Northern Cancer InstituteSt LeonardsNew South WalesAustralia
- Department of Medical OncologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Zarnie Lwin
- Department of Medical OncologyRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandSt LuciaQueenslandAustralia
| | - Mustafa Khasraw
- The Preston Robert Tisch Brain Tumor CenterDuke Center for Cancer ImmunotherapyDuke UniversityDurhamUSA
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Zhao W, Bian L, Wang T, Zhang S, Li J, Xu F, Jiang Z. Effectiveness of second-line anti-HER2 treatment in HER2-positive metastatic breast cancer patients previously treated with trastuzumab: A real-world study. Chin J Cancer Res 2020; 32:361-369. [PMID: 32694900 PMCID: PMC7369172 DOI: 10.21147/j.issn.1000-9604.2020.03.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective Several studies have demonstrated different benefits for patients whose disease progressed despite previous trastuzumab treatment. Due to limited real-world data, we evaluate the effectiveness of anti-human epidermal growth factor receptor 2 (HER2) therapy (lapatinib or trastuzumab) plus chemotherapy or chemotherapy alone in patients who were previously treated with trastuzumab-containing regimens and investigate factors associated with effectiveness. And we further show the effectiveness of the two anti-HER2 therapy groups. Methods A total of 342 HER2-positive metastatic breast cancer (MBC) patients whose disease progressed during prior anti-HER2 (trastuzumab) and standard chemotherapy therapy from Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General Hospital, from August 2010 to December 2016 were included. Seventy-eight patients received standard chemotherapy only, 148 patients continued to receive trastuzumab and switched to other chemotherapy drugs, and 116 patients received tyrosine-kinase inhibitors (TKIs; lapatinib) and chemotherapy. The main outcome measures were progression-free survival (PFS), overall response rate (ORR), and clinical benefit rate (CBR). Subgroup analyses were conducted to identify patient characteristics associated with the greatest clinical benefit. Results After a median follow-up of 26.2 (range, 2.0−56.0) months, PFS significantly improved with anti-HER2 therapy compared with chemotherapy alone: median 6.0 months with lapatinib [95% confidence interval (95% CI), 4.53−7.47], 4.5 months with trastuzumab (95% CI, 3.99−5.01)vs. 3.0 months with chemotherapy alone (95% CI, 2.42−3.58); stratified hazard ratio (HR)=0.70, 95% CI, 0.60−0.81; P<0.0001. The ORR values were 33.6%, 25.0% and 12.8 %, respectively, the CBR values were 60.3%, 48.6% and 26.9%, respectively. The effectiveness of lapatinib group and trastuzumab group were further analyzed. In multivariate analysis, lapatinib group was associated with a longer PFS, after controlling other potential confounders (HR=0.68, 95% CI, 0.52−0.90; P=0.006).
Conclusions The combination of TKIs and chemotherapy was effective in this cohort previously treated with trastuzumab treatment. Therefore, TKIs combined with chemotherapy is an option for Chinese HER2-positive MBC patients previously treated with trastuzumab treatment.
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Affiliation(s)
- Wei Zhao
- Department of Breast Oncology, Academy of Military Medical Sciences, Beijing 100850, China.,Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China.,PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - Li Bian
- Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China
| | - Tao Wang
- Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China
| | - Shaohua Zhang
- Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China
| | - Jianbin Li
- Department of Breast Oncology, Academy of Military Medical Sciences, Beijing 100850, China.,Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China
| | - Fengrui Xu
- Department of Breast Oncology, Academy of Military Medical Sciences, Beijing 100850, China.,Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China
| | - Zefei Jiang
- Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China
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