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Gao X, Bu T, Wang W, Xu Y. Comparative Analysis and Future Prospects of Human Epidermal Growth Factor Receptor 2 (HER2) and Trophoblast Cell-Surface Antigen 2 (Trop-2) Targeted Antibody-Drug Conjugates in Breast Cancer Treatment. BREAST CANCER (DOVE MEDICAL PRESS) 2024; 16:621-630. [PMID: 39310781 PMCID: PMC11416103 DOI: 10.2147/bctt.s480796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 09/05/2024] [Indexed: 09/25/2024]
Abstract
Breast cancer remains the most prevalent malignancy among women globally, presenting significant challenges in therapeutic strategies due to tumor heterogeneity, drug resistance, and adverse side effects. Recent advances in targeted therapies, particularly antibody-drug conjugates (ADCs), have shown promise in addressing these challenges by selectively targeting tumor cells while sparing normal tissues. This study provides a comprehensive analysis of two innovative ADCs targeting HER2 and Trop-2, which are critical markers in various breast cancer subtypes. These conjugates combine potent cytotoxic drugs with specific antibodies, leveraging the antigens' differential expression to enhance therapeutic efficacy and reduce systemic toxicity. Our comparative analysis highlights the clinical applications, efficacy, and safety profiles of these ADCs, drawing on data from recent clinical trials. In addition, the paper discusses the potential of these ADCs in treating other types of cancers where HER2 and Trop-2 are expressed, as well as the toxicity risks associated with targeting these antigens in normal cells. Additionally, the paper discusses novel synthetic drugs that show potential in preclinical models, focusing on their mechanisms of action and therapeutic advantages over traditional chemotherapy. The findings underscore the transformative impact of targeted ADCs in breast cancer treatment, noting significant advancements in patient outcomes and management of side effects. However, ongoing issues such as resistance mechanisms and long-term safety remain challenges. The conclusion offers a forward-looking perspective on potential improvements and the future trajectory of ADC research. This study not only elucidates the current landscape of ADCs in breast cancer but also sets the stage for the next generation of oncological therapeutics. This study not only elucidates the current landscape of ADCs in breast cancer but also sets the stage for the next generation of oncological therapeutics, with particular attention to their broader applications and associated risks.
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Affiliation(s)
- Xiaojuan Gao
- Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, Gansu Province, People’s Republic of China
| | - Tiansheng Bu
- Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, Gansu Province, People’s Republic of China
| | - Wenying Wang
- Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, Gansu Province, People’s Republic of China
| | - Ying Xu
- Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, Gansu Province, People’s Republic of China
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Ali-Thompson S, Daly GR, Dowling GP, Kilkenny C, Cox L, McGrath J, AlRawashdeh MM, Naidoo S, Power C, Hill ADK. A bibliometric analysis of HER2-positive breast cancer: 1987-2024. Front Oncol 2024; 14:1355353. [PMID: 38769947 PMCID: PMC11103724 DOI: 10.3389/fonc.2024.1355353] [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] [Received: 12/18/2023] [Accepted: 04/10/2024] [Indexed: 05/22/2024] Open
Abstract
Aim The overamplification of human epidermal growth factor (HER2) in breast cancer (BC) has been the subject of numerous research publications since its discovery in 1987. This is the first bibliometric analysis (BA) conducted on HER2-positive (HER2+) BC. The purpose of this BA is to analyze the published research on HER2+ BC from 1987 to 2024, highlighting the most significant scientific literature, as well as the main contributing authors and journals, and evaluating the impact of clinical and lab-based publications on HER2+ BC research. Methods The Web of Science Core Collection (WoSCC) was searched using the terms "Breast cancer" OR "Breast carcinoma" OR "Breast tumor" AND "HER2 positive" OR "HER2+". The search was limited by publication year (1987-2024) and only full English articles were included. WoS returned 7,469 relevant results, and from this dataset, a bibliometric analysis was conducted using the "analyze results" and "journal citation report" functions in WoS and the VOSviewer 1.6.16 software to generate bibliographic coupling and co-citation analysis of authors. Results The analysis encompassed a total of 7,469 publications, revealing a notable increase in the annual number of publications, particularly in recent years. The United States, China, Italy, Germany, and Spain were the top five most prolific countries. The top five significant institutions that published HER2+ research were the University of Texas System, Unicancer, UTMD Anderson Cancer Center, Harvard University, and University of California System. Breast Cancer Research and Treatment, Clinical Cancer Research, and Clinical Breast Cancer were the top three notable journals with the highest number of HER2+ BC publications. Dennis Slamon (Nc = 45,411, H-index = 51) and Jose Baselga (Nc = 32,592, H-index = 55) were the most prolific authors. Evolving research topics include anti-HER2 therapy in the neoadjuvant setting, treatment of metastatic HER2+ BC, and overcoming therapy resistance. Conclusion This study provides an overview of HER2+ BC research published over the past three decades. It provides insight into the most cited papers and authors, and the core journals, and identifies new trends. These manuscripts have had the highest impact in the field and reflect the continued evolution of HER2 as a therapeutic target in BC.
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Affiliation(s)
- Sherlissa Ali-Thompson
- Department of Surgery, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences (RCSI), Dublin, Ireland
| | - Gordon R. Daly
- Department of Surgery, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences (RCSI), Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Gavin P. Dowling
- Department of Surgery, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences (RCSI), Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Conor Kilkenny
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Luke Cox
- Department of Surgery, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences (RCSI), Dublin, Ireland
| | - Jason McGrath
- Department of Surgery, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences (RCSI), Dublin, Ireland
| | - Ma’en M. AlRawashdeh
- Department of Surgery, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences (RCSI), Dublin, Ireland
| | - Sindhuja Naidoo
- Department of Surgery, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences (RCSI), Dublin, Ireland
| | - Colm Power
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Arnold D. K. Hill
- Department of Surgery, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences (RCSI), Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
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Dowling GP, Toomey S, Bredin P, Parker I, Mulroe E, Marron J, McLoughlin O, Teiserskiene A, Power C, O'Shea AM, Greally M, Morris PG, Duke D, Hill ADK, Hennessy BT. Neoadjuvant trastuzumab deruxtecan (T-DXd) with response-directed definitive therapy in early stage HER2-positive breast cancer: a phase II study protocol (SHAMROCK study). BMC Cancer 2024; 24:91. [PMID: 38233810 PMCID: PMC10792949 DOI: 10.1186/s12885-024-11851-4] [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: 12/20/2023] [Accepted: 01/06/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND The current standard of care in the neoadjuvant setting for high-risk HER2-positive (HER2 +) breast cancer is to combine systemic chemotherapy with dual HER2 blockade, trastuzumab and pertuzumab. Targeted therapies have significantly improved outcomes for patients with HER2-positive breast cancer. To improve treatment-associated toxicity, chemotherapy-sparing approaches are currently being investigated. Trastuzumab deruxtecan (T-DXd) is an HER2-directed antibody-drug-conjugate (ADC) with promising results in the metastatic setting for HER2-positive breast cancer. The SHAMROCK study investigates neoadjuvant T-DXd in early stage HER2-positive breast cancer, using pathological complete response (pCR) rate as the primary endpoint. METHODS This is a phase II open-label, single arm, adaptive multi-centre trial of T-DXd in the neoadjuvant setting in stage 2-3 HER2-positive breast cancer. Eligible patients will receive 5.4 mg/kg of T-DXd intravenously every 3 weeks for up to 6 cycles. A repeat biopsy will performed after 2 cycles for the RNA disruption index (RDI) score assessment. According to their likelihood of pCR, as determined by the RDI score, patients will either undergo 4 or 6 cycles of T-DXd prior to imaging. Patients with imaging complete response (iCR) after either 4 or 6 cycles will proceed to surgery. Patients who do not achieve iCR will either undergo further systemic therapy or proceed to surgery. DISCUSSION The SHAMROCK study is a chemotherapy-sparing approach to curative intent treatment, investigating neoadjuvant T-DXd. We hypothesise that neoadjuvant T-DXd will have a high pCR rate and be associated low toxicity in early stage HER2-positive breast cancer. TRIAL REGISTRATION EudraCT Number: 2022-002485-32; ClinicalTrials.gov identifier: NCT05710666; Cancer Trials Ireland study number: CTRIAL-IE 22-01.
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Affiliation(s)
- Gavin P Dowling
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland.
- Beaumont RCSI Cancer Centre, Beaumont Hospital, Dublin, Ireland.
| | - Sinead Toomey
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland
| | - Philip Bredin
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland
- Beaumont RCSI Cancer Centre, Beaumont Hospital, Dublin, Ireland
| | | | | | | | | | | | - Colm Power
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland
- Beaumont RCSI Cancer Centre, Beaumont Hospital, Dublin, Ireland
| | | | - Megan Greally
- Beaumont RCSI Cancer Centre, Beaumont Hospital, Dublin, Ireland
| | - Patrick G Morris
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland
- Beaumont RCSI Cancer Centre, Beaumont Hospital, Dublin, Ireland
| | - Deirdre Duke
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland
- Beaumont RCSI Cancer Centre, Beaumont Hospital, Dublin, Ireland
| | - Arnold D K Hill
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland
- Beaumont RCSI Cancer Centre, Beaumont Hospital, Dublin, Ireland
| | - Bryan T Hennessy
- Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, 123 St Stephen's Green, Dublin 2, Ireland
- Beaumont RCSI Cancer Centre, Beaumont Hospital, Dublin, Ireland
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Cazzaniga ME, Ademuyiwa F, Petit T, Tio J, Generali D, Ciruelos EM, Califaretti N, Poirier B, Ardizzoia A, Hoenig A, Lex B, Mouret-Reynier MA, Giesecke D, Isambert N, Masetti R, Pitre L, Wrobel D, Augereau P, Milani M, Rask S, Solbach C, Pritzker L, Noubir S, Parissenti A, Trudeau ME. Low RNA disruption during neoadjuvant chemotherapy predicts pathologic complete response absence in patients with breast cancer. JNCI Cancer Spectr 2024; 8:pkad107. [PMID: 38113421 PMCID: PMC10765091 DOI: 10.1093/jncics/pkad107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/20/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
In previously reported retrospective studies, high tumor RNA disruption during neoadjuvant chemotherapy predicted for post-treatment pathologic complete response (pCR) and improved disease-free survival at definitive surgery for primary early breast cancer. The BREVITY (Breast Cancer Response Evaluation for Individualized Therapy) prospective clinical trial (NCT03524430) seeks to validate these prior findings. Here we report training set (Phase I) findings, including determination of RNA disruption index (RDI) cut points for outcome prediction in the subsequent validation set (Phase II; 454 patients). In 80 patients of the training set, maximum tumor RDI values for biopsies obtained during neoadjuvant chemotherapy were significantly higher in pCR responders than in patients without pCR post-treatment (P = .008). Moreover, maximum tumor RDI values ≤3.7 during treatment predicted for a lack of pCR at surgery (negative predictive value = 93.3%). These findings support the prospect that on-treatment tumor RNA disruption assessments may effectively predict post-surgery outcome, possibly permitting treatment optimization.
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Affiliation(s)
- Marina Elena Cazzaniga
- Phase 1 Research Unit, IRCCS San Gerardo dei Tintori, Monza, MB, Italy
- School of Medicine and Surgery, Milano Bicocca University, Monza, MB, Italy
| | - Foluso Ademuyiwa
- Division of Medical Oncology, Washington University, Saint Louis, MO, USA
| | - Thierry Petit
- Institut Cancérologie Strasbourg Europe, Strasbourg, France
| | - Joke Tio
- Department of Gynecology and Obstetrics, Universitätsklinikum Münster, Münster, Germany
| | - Daniele Generali
- Breast Cancer Unit, ASST of Cremona and Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Eva M Ciruelos
- Medical Oncology Department, Breast Cancer Unit, University Hospital, 12 de Octubre, Madrid, Spain
| | | | | | | | - Arnd Hoenig
- Breast Center, Women's Hospital, Marienhaus Hospital, Mainz, Germany
| | - Benno Lex
- Klinikum Kulmbach—Frauenheilkunde und Geburtshilfe, Kulmbach, Germany
| | | | - Dagmar Giesecke
- Hochtaunus-Kliniken Bad Homburg, Women’s Hospital, Bad Homburg, Germany
| | - Nicolas Isambert
- Pôle Régional de Cancérologie, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | | | | | - Denise Wrobel
- Sozialstiftung Bamberg Klinikum Frauenklinik, Bamberg, Germany
| | | | - Manuela Milani
- Department of Gynecology and Obstetrics, Universitätsklinikum Münster, Münster, Germany
| | - Sara Rask
- Royal Victoria Regional Health Centre, Barrie, ON, Canada
| | - Christine Solbach
- Department of Gynecology and Obstetrics, University Hospital Frankfurt, Germany
| | | | | | - Amadeo Parissenti
- Policlinico Gemelli, Rome, Italy
- Rna Diagnostics, Inc, Toronto, ON, Canada
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Dowling GP, Daly GR, Keelan S, Boland F, Toomey S, Hill ADK, Hennessy BT. Efficacy and Safety of Trastuzumab Deruxtecan in Breast Cancer: A Systematic Review and Meta-Analysis. Clin Breast Cancer 2023; 23:847-855.e2. [PMID: 37775347 DOI: 10.1016/j.clbc.2023.09.005] [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: 01/04/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 10/01/2023]
Abstract
Trastuzumab deruxtecan (T-DXd) is a novel antibody-drug-conjugate (ADC), primarily used in the treatment of HER2-positive breast cancer. This study aimed to conduct a systematic review to evaluate the efficacy and safety of T-DXd in treating breast cancer, based on clinical trials. A systematic search of the literature was conducted to identify clinical trials investigating the efficacy and safety of T-DXd in breast cancer. Clinical trials of any phase were included. Outcome measures were any adverse events and survival. Meta-analysis was conducted where possible. Pooled prevalence for each adverse event of any grade and grade 3 or greater were estimated. Progression-free survival (PFS), overall survival (OS) and objective response rates (ORRs) were also reported to evaluate the efficacy of T-DXd in breast cancer. A total of 1593 patients from 6 clinical trials were included. Common adverse events of any grade were nausea, anemia, neutropenia, vomiting, fatigue, constipation and diarrhea, occurring in greater than 30% of cases. In terms of adverse events of grade 3 or more, only anemia and neutropenia occurred at a relatively high rate. Median PFS ranged from 11.1 to 22.1 months. There was evidence of a benefit of T-DXd compared to controls in terms of both PFS (OR: 0.38; 95% CI: 0.32, 0.45) and OS (OR: 0.61; 95% CI: 0.48, 0.78). ORRs ranged from 37% to 79.9%. The present systematic review shows evidence that T-DXd is a safe and effective agent in the treatment of breast cancer based on currently available data. The most common adverse events affected the blood, lymphatic and gastrointestinal systems. Interstitial lung disease (ILD) is a notable and potentially serious adverse event.
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Affiliation(s)
- Gavin P Dowling
- Department of Molecular Medicine, Medical Oncology Lab, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland; Department of Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Department of Surgery, Bons Secours Hospital, Dublin, Ireland.
| | - Gordon R Daly
- Department of Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Stephen Keelan
- Department of Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Sinead Toomey
- Department of Molecular Medicine, Medical Oncology Lab, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Arnold D K Hill
- Department of Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Bryan T Hennessy
- Department of Molecular Medicine, Medical Oncology Lab, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
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Wyszogrodzka-Gaweł G, Shuklinova O, Lisowski B, Wiśniowska B, Polak S. 3D printing combined with biopredictive dissolution and PBPK/PD modeling optimization and personalization of pharmacotherapy: Are we there yet? Drug Discov Today 2023; 28:103731. [PMID: 37541422 DOI: 10.1016/j.drudis.2023.103731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/06/2023]
Abstract
Precision medicine requires selecting the appropriate dosage regimen for a patient using the right drug, at the right time. Model-Informed Precision Dosing (MIPD) is a concept suggesting utilization of model-based prediction methods for optimizing the treatment benefit-harm balance, based on individual characteristics of the patient, disease, treatment method, and other factors. Here, we discuss a theoretical workflow comprising several elements, beginning from the physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) models, through 3D printed tablets with the model proposed dose, information range and flow, and the patient themselves. We also describe each of these elements, and the connection between them, highlighting challenges and potential obstacles.
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Affiliation(s)
- Gabriela Wyszogrodzka-Gaweł
- Department of Social Pharmacy, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland.
| | - Olha Shuklinova
- Chair of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy. Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Bartek Lisowski
- Chair of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy. Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland.
| | - Barbara Wiśniowska
- Chair of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy. Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland.
| | - Sebastian Polak
- Chair of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy. Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland.
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