Multiple nodular foci in the liver associated with chronic hepatic porphyria after previous treatment of breast cancer

1989 ◽  
Vol 67 (11) ◽  
pp. 592-597 ◽  
Author(s):  
W. K. Lelbach ◽  
T. R. Müller ◽  
W. Kersjes ◽  
J. H. Hartlapp ◽  
M. Doss
Keyword(s):  
Breast Cancer ◽  
Previous Treatment ◽  
Chronic Hepatic Porphyria

scholarly journals CATCH: A Prospective Precision Oncology Trial in Metastatic Breast Cancer

2021 ◽  
pp. 676-686
Author(s):  
Mario Hlevnjak ◽  
Markus Schulze ◽  
Shaymaa Elgaafary ◽  
Carlo Fremd ◽  
Laura Michel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Clinical Management ◽  
Metastatic Breast ◽  
Previous Treatment ◽  
Progression Free Survival ◽  
Tumor Board ◽  
Precision Oncology ◽  
Whole Genome ◽  
Free Survival

PURPOSE CATCH (Comprehensive Assessment of clinical feaTures and biomarkers to identify patients with advanced or metastatic breast Cancer for marker driven trials in Humans) is a prospective precision oncology program that uses genomics and transcriptomics to guide therapeutic decisions in the clinical management of metastatic breast cancer. Herein, we report our single-center experience and results on the basis of the first 200 enrolled patients of an ongoing trial. METHODS From June 2017 to March 2019, 200 patients who had either primary metastatic or progressive disease, with any number of previous treatment lines and at least one metastatic site accessible to biopsy, were enrolled. DNA and RNA from tumor tissue and corresponding blood-derived nontumor DNA were profiled using whole-genome and transcriptome sequencing. Identified actionable alterations were brought into clinical context in a multidisciplinary molecular tumor board (MTB) with the aim of prioritizing personalized treatment recommendations. RESULTS Among the first 200 enrolled patients, 128 (64%) were discussed in the MTB, of which 64 (50%) were subsequently treated according to MTB recommendation. Of 53 evaluable patients, 21 (40%) achieved either stable disease (n = 13, 25%) or partial response (n = 8, 15%). Furthermore, 16 (30%) of those patients showed improvement in progression-free survival of at least 30% while on MTB-recommended treatment compared with the progression-free survival of the previous treatment line. CONCLUSION The initial phase of this study demonstrates that precision oncology on the basis of whole-genome and RNA sequencing is feasible when applied in the clinical management of patients with metastatic breast cancer and provides clinical benefit to a substantial proportion of patients.

Prolonged benefit from palbociclib plus letrozole in heavily pretreated advanced male breast cancer: case report and literature overview

2020 ◽  
pp. 030089162097698
Author(s):  
Emma Zattarin ◽  
Francesca Ligorio ◽  
Federico Nichetti ◽  
Giulia Bianchi ◽  
Giuseppe Capri ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Case Report ◽  
Male Breast Cancer ◽  
Clinical Case ◽  
Previous Treatment ◽  
Male Breast ◽  
Cancer Case ◽  
Heavily Pretreated ◽  
Breast Cancer In Men

Introduction: Breast cancer in men is less common than in women and treatment recommendations are often derived from clinical trials exclusively involving women. Data on efficacy of CDK 4/6 inhibitors, which are the mainstay of treatment for hormone receptor–positive/HER2-negative advanced breast cancer, are lacking in male patients. Case report: We present a clinical case of prolonged benefit from palbociclib in combination with letrozole and LHRH analogue in a man who had previously been treated with six lines of endocrine therapies and chemotherapy regimens but was still in excellent clinical condition. Conclusions: This clinical case demonstrates that male breast cancer stands out as an endocrine-sensitive disease, which could potentially benefit from CDK 4/6 inhibitors in combination with endocrine agents even in very heavily pretreated settings of disease, underscoring both the importance of an accurate selection of patients for later treatment lines, taking into account disease history and previous treatment responses, and the peculiarity of breast cancer in men, which deserves dedicated clinical trials to tailor future recommendations.

Current Evaluation of Lymphoedema and Assessment by Lymphoscintigraphy of the Effect of a Micronized Flavonoid Fraction (Daflon 500 mg) in the Treatment of Upper Limb Lymphoedema

1994 ◽  
Vol 9 (1_suppl) ◽  
pp. 26-29 ◽  
Author(s):  
A. P. Pecking ◽  
P. Rambert
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Previous Treatment ◽  
University Hospital ◽  
Limb Volume ◽  
Flavonoid Fraction ◽  
Radionuclide Lymphoscintigraphy ◽  
Hospital Outpatients ◽  
Open Pilot ◽  
Volume Decrease

Objective: To assess the effect of Daflon 500 mg on upper lymphoedema occurring after conventional treatment of breast cancer. Design: Open, pilot, single centre trial. Setting: Hospital outpatients attending a University Hospital. Patients: Ten female patients (aged 44–64 years) whose previous treatment for breast cancer was followed by upper limb lymphoedema (mean (SD) time delay = 17±7 months). Interventions: Oral administration of a daily dose of two tablets of Daflon 500 mg for 6 months. Main outcome measures: Symptoms, affected upper limb volume and parameters of radionuclide lymphoscintigraphy using technetium-99m. Results: All patients experienced improvement of symptoms and limb volume (mean volume decrease of the swollen limb: 6.80%). Functional parameters assessed with scintigraphy were significantly improved (half-life: 147.4 (14.9) to 144.1 (14.9) min, p < 0.01; clearance of the colloid: 25.9 (2.5) to 28.3 (2.8) <l/min, p < 0.05; lymphatic speed of the colloid: 7.7 (0.3) to 8.0 (0.2) cm/min, p < 0.05). Conclusion: These preliminary results suggest that this therapy is effective for the treatment of lymphoedema.

scholarly journals Average duration of prior treatment lines predicts clinical benefit to eribulin chemotherapy in patients with metastatic breast cancer

2021 ◽  
Author(s):  
Faye Coe ◽  
Vivek Misra ◽  
Yamini McCabe ◽  
Helen Adderley ◽  
Laura Woodhouse ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Average Duration ◽  
Metastatic Breast ◽  
Previous Treatment ◽  
Cox Proportional Hazards ◽  
Electronic Prescribing ◽  
Prognostic Impact ◽  
Full Cohort ◽  
Metastatic Setting

Abstract Purpose The aim of this study was to identify factors associated with progression-free survival (PFS) and overall survival (OS) in patients with metastatic breast cancer (MBC) treated with eribulin in a real-world setting, to improve information provision in those considering treatment. Methods Patients treated with eribulin for MBC at The Christie NHS Foundation Trust, Manchester, UK, between August 2011 and December 2018 were included (n = 439). Data were collected by retrospective review of medical records and electronic prescribing systems. Factors such as biological subtype, distant recurrence-free interval, previous lines of chemotherapy and the ‘average duration of previous treatment lines’ (ADPT) (calculated as: (date of initiation of eribulin–date of MBC) / the number of previous treatment lines in the metastatic setting) were evaluated for prognostic impact using Cox proportional hazards regression. Results In the full cohort, the median PFS and OS were 4.1 months (95% CI 3.7–4.4) and 8.6 months (95% CI 7.4–9.8), respectively. Outcomes were significantly inferior for those with triple-negative breast cancer (TNBC) (n = 92); PFSTNBC: 2.4 months (95% CI 2.1–3.0), p =  < 0.001 and OSTNBC: 5.4 months (95% CI 4.6–6.6), p =  < 0.001. ADPT was the only factor other than subtype significantly associated with PFS and OS. Longer ADPT was also significantly associated with PFS and OS in those with TNBC. For example, women in the lowest ADPT tertile (< 5.0 months) achieved a median OS of only 4.3 months, whereas those in the upper ADPT tertile (> 8.7 months) had a median OS of 12.1 months (p = 0.004). Conclusion Our results indicate that the ADPT lines is an important factor when predicting the outcome with eribulin chemotherapy in a palliative setting and that quantitative guidance on the likely PFS and OS with treatment can be provided using ADPT. Validation in additional cohorts is warranted.

Clinical outcomes and predictive factors in patients with liver metastasis from breast cancer treated with gemcitabine and cisplatin (GC) salvage regimen

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17568-e17568
Author(s):  
L. Araujo ◽  
O. Metzger Filho ◽  
C. A. Gomes ◽  
M. V. Moitinho ◽  
A. M. Silva ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Liver Metastasis ◽  
Clinical Outcomes ◽  
Predictive Factors ◽  
Metastatic Breast ◽  
Previous Treatment ◽  
Clinical Response Rate ◽  
Clinical Activity ◽  
Salvage Regimen ◽  
Dismal Prognosis

e17568 Background: Liver metastasis (mets) from breast cancer is typically associated with poor prognosis. GC is a good option, since patients (pts) have often failed anthracycline and taxane therapy and liver dysfunction may preclude these regimens. Methods: Retrospective study designed to evaluate the clinical outcomes and predictive factors in pts with metastatic breast cancer treated with GC, with special interest for liver mets. Results: From 2004 to 2007, 56 pts were treated with GC. Median age was 52.1 years, 33 pts had PS 0–1, 26 were hormone receptor (HR) negative, 32 had been treated with 3 or more chemotherapy (CT) regimens and 34 had liver mets. The median overall survival (OS) was 7,1 mo (95% CI; 4.3–9.7), the progression free survival was 3.3 mo (95% CI; 2.2–5.5) and the clinical response rate was 25%. OS was 4.0 mo (95% CI; 2.3–8.9) for pts with liver mets and 9.7 mo (95% CI; 6.9–12.9) for pts without liver mets (p = 0.03). No factor showed correlation with OS in pts with liver mets, including age < 45 years (median OS [95% CI]: 2.8 mo [1.8–11.5] versus 4.5 mo [2.5–8.9]; p = 0.74), PS 0–1 (median OS [95% CI]: 7.3 mo [2.5–11.5] versus 2.8 mo [0.8–9.7]; p = 0.55), HR positivity (median OS [95% CI]: 7.3 mo [2.0–11.5] versus 5.9 mo [1.9–9.7]; p = 0.87), bilirubin level ≥ 5 times the superior limit of the normality (median OS [95% CI]: 5.9 mo [0.5–16.7] versus 4.5 mo [2.5–9.7]; p = 0.45), progression free interval after the previous CT ≤ 1 mo (median OS [95% CI]: 4.0 mo [2.0–9.7] versus 7.1 mo [2.5–14.7]; p = 0.93) and previous treatment with ≥ 3 CT regimens (median OS [95% CI]: 7.3 mo [1.0–11.0] versus 4.0 mo [2.0–9.7]; p = 0.93). Conclusions: These data is in accordance with the literature concerning the dismal prognosis in liver mets from breast cancer and the clinical activity of GC. We could not define predictive factors in this cohort, which was probably due to the relatively small number of pts. No significant financial relationships to disclose.

The efficacy of first-line chemotherapy in endocrine-resistant hormone receptor-positive (HR+), human epidermal growth factor receptor 2- negative (HER2-) metastatic breast cancer (MBC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1056-1056
Author(s):  
Sudpreeda Chainitikun ◽  
James Long ◽  
Ruben Rodriguez-Bautista ◽  
Toshiaki Iwase ◽  
Debu Tripathy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Metastatic Breast ◽  
Previous Treatment ◽  
Mtor Inhibitors ◽  
Prior Exposure ◽  
Cancer Center ◽  
First Line ◽  
Chemotherapy Agents ◽  
Line Chemotherapy

1056 Background: Combinations of endocrine therapy (ET) and targeted therapy (CDK4/6 or mTOR inhibitors) are standard of care for HR+/HER2- MBC. When ET is not effective, chemotherapy is commonly used. However, clinical outcomes of chemotherapy in the endocrine-resistant setting are limited. We hypothesized that clinicopathological baseline and prior ET factors determine chemotherapy’s efficacy. We sought to identify predictive factors and the compare efficacies of chemotherapy agents in endocrine-resistant MBC. Methods: We conducted a retrospective study of patients with HR+/HER2- MBC who received chemotherapy after progression on ET with or without targeted therapy at MD Anderson Cancer Center from 1999-2017. We collected baseline clinicopathological and all treatment data. The primary endpoint was time to treatment failure (TTF) of first-line chemotherapy for MBC. We performed univariate and multivariate analyses using the Cox proportional hazard model. Kaplan-Meier methods were used to analyze TTF. Results: In the 1,258 patients analyzed, the mean age was 55.3 years (range 21-91). Forty-five patients (3.6%) had inflammatory breast cancer (IBC). Three hundred ninety patients (31%) received previous targeted therapy: 264 with CDK4/6 inhibitor, 205 with mTOR inhibitor, and 79 with both. The most frequent chemotherapy agents were capecitabine (48.9%) and taxanes (paclitaxel, nab-paclitaxel, or docetaxel; 28.6%). After adjustment for all factors in a multivariate model, IBC and prior exposure to a CDK4/6 inhibitor were significantly associated with shorter TTF. Previous treatment with a CDK4/6 inhibitor had the strongest negative effect on chemotherapy TTF regardless of ET duration (adjusted hazard ratio [HR] 1.84; 95%CI 1.49-2.27; p < 0.001). Capecitabine had significantly longer median TTF than taxanes regardless of whether patients had prior exposure to taxanes in (neo)adjuvant setting (6.1 vs 4.9 months; HR 0.64; 95%CI 0.55-0.75; p < 0.001). Conversely, the median TTF for taxanes was shorter in patients who received prior (neo)adjuvant taxanes than in those who did not (4.5 vs 5.1 months). Conclusions: Previous exposure to CDK4/6 inhibitor had a negative predictive effect for the efficacy of chemotherapy. Capecitabine had the best efficacy against endocrine-resistant breast cancer.

Efficacy of palbociclib after everolimus in hormone receptor-positive, HER2-negative advanced breast cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13030-e13030
Author(s):  
Anja Kovac ◽  
Cvetka Grasic Kuhar ◽  
Tanja Ovcaricek ◽  
Erika Matos ◽  
Marina Mencinger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Hormone Receptor ◽  
Previous Treatment ◽  
Advanced Breast ◽  
Primary Study ◽  
Naive Group ◽  
Hormone Receptor Positive ◽  
Group A ◽  
Group B

e13030 Background: Palbociclib and other selective cyclin-dependent kinases 4 and 6 inhibitors in combination with endocrine therapy (ET) have become the standard of care in the treatment of patients with hormone receptor-positive (HR+), HER2-negative advanced breast cancer (ABC). Their role in the first and second line of therapy is well established, whereas their use in subsequent lines and after treatment with everolimus remains unclear. Methods: We performed retrospective observational study of all patients who initiated treatment with palbociclib at the Institute of Oncology Ljubljana between March 8, 2018 and March 8, 2019 and received at least two prior lines of treatment for ABC. We collected individual patient data from electronic medical records. Patients were divided in two groups – everolimus-pretreated (group A) and everolimus-naïve (group B). The primary study outcomes were clinical benefit rate (CBR), time to treatment failure (TTF) and overall survival (OS). Results: Overall, 65 patients´ data was evaluated. The majority of patients (n = 50, 76.9%) received palbociclib in combination with fulvestrant, others (n = 15, 23.1%) with aromatase inhibitors. There were 25 (38.5%) patients in group A and 40 (61.5%) in group B. Patients´ and previous treatment characteristics are shown in table. CBR was the same, 40%, in both groups. The median follow-up time was 14.9 months. The median TTF was 5.28 months for the whole group, 5.0 months for everolimus-pretreated and 5.5 months for everolimus-naïve group (p = 0.7). The median OS was 18.1 months for the whole group, 14 months for everolimus-pretreated and 18.1 months for everolimus- naïve group (p = 0.7). Conclusions: Patients with HR+, HER-2-negative ABC benefit from addition of palbociclib to ET after two lines of prior systemic therapy. The benefit remained unchanged if the patients were previously treated with everolimus. [Table: see text]

Management of Locoregional Recurrence of Breast Cancer

2019 ◽  
Author(s):  
Devon Livingston-Rosanoff ◽  
Sarah E. Tevis ◽  
Lee G. Wilke
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Locoregional Recurrence ◽  
Previous Treatment ◽  
Close Monitoring ◽  
Curative Intent ◽  
Regional Lymph Nodes ◽  
Cancer Disease ◽  
Lymph Node Mapping ◽  
Increased Risk

Following treatment for breast cancer, disease can recur locally, regionally, or at distant sites. Locoregional recurrence is defined as recurrence in the ipsilateral breast, skin, chest wall, or regional lymph nodes. Concurrent metastatic disease is common in patients with locoregional recurrence; therefore, patients with recurrence should undergo a complete metastatic work-up. Isolated locoregional recurrence should be approached with curative intent, and patients should undergo resection and adjuvant therapy, as indicated, based on previous treatment and location of recurrence. Following treatment for locoregional recurrence, close monitoring should be performed, as patients are at an increased risk for developing metastatic disease. This review contains 5 figures, 1 table, and 50 references Key Words: breast cancer, CALOR clinical trial, locoregional recurrence, repeat radiation therapy, repeat sentinel lymph node mapping, adjuvant chemotherapy, repeat breast conserving therapy, mastectomy

Management of Locoregional Recurrence of Breast Cancer

2019 ◽  
Author(s):  
Devon Livingston-Rosanoff ◽  
Sarah E. Tevis ◽  
Lee G. Wilke
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Locoregional Recurrence ◽  
Previous Treatment ◽  
Close Monitoring ◽  
Curative Intent ◽  
Regional Lymph Nodes ◽  
Cancer Disease ◽  
Lymph Node Mapping ◽  
Increased Risk

Following treatment for breast cancer, disease can recur locally, regionally, or at distant sites. Locoregional recurrence is defined as recurrence in the ipsilateral breast, skin, chest wall, or regional lymph nodes. Concurrent metastatic disease is common in patients with locoregional recurrence; therefore, patients with recurrence should undergo a complete metastatic work-up. Isolated locoregional recurrence should be approached with curative intent, and patients should undergo resection and adjuvant therapy, as indicated, based on previous treatment and location of recurrence. Following treatment for locoregional recurrence, close monitoring should be performed, as patients are at an increased risk for developing metastatic disease. This review contains 5 figures, 1 table, and 50 references Key Words: breast cancer, CALOR clinical trial, locoregional recurrence, repeat radiation therapy, repeat sentinel lymph node mapping, adjuvant chemotherapy, repeat breast conserving therapy, mastectomy

scholarly journals Therapy-Related AML (t-AML), a Heterogeneous Disease: Multicenter Analysis on Biological and Clinical Differences between Cases Following Breast Cancer and Lymphoma Treatment

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 31-31
Author(s):  
Giambattista Bertani ◽  
Fabio Guolo ◽  
Valentina Mancini ◽  
Rosa Greco ◽  
Paola Minetto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Normal Karyotype ◽  
Previous Treatment ◽  
Response To Therapy ◽  
Categorical Variables ◽  
Genetic Profile ◽  
Fisher Exact Test ◽  
Genetic Characteristics ◽  
Fisher Test ◽  
Response To Chemotherapy

BACKGROUND Therapy related AML (tAML), a late complication of chemo and/or radiotherapy (RT) for a prior neoplasm, most often develops after breast cancer (BC) and lymphoproliferative disorders (LD). T-AML pathogenesis may involve 1) induction of a fusion oncogene, most often caused by use of topoisomerase II inhibitors, 2) genome instability, often amplified by p53 mutations, developped most frequently after alkylating agents and radiotherapy and 3) selection of pre-existing hematopoietic cell clones (a condition known as CHIP) under chemotherapy pressure. Moreover, genetic susceptibility, i.e. mutations in genes involved in DNA damage-sensing and repair (BRCA 1 and 2, p53, Fanconi genes, BCL2L10), may play a role in the development of a second cancer. Finally some cases of tAML, may be temporally consequent but not etiologically related to previous treatment, an event more likely if the primary cancer is more frequent in the general population (as, for example, breast cancer). The aforementioned etiological factors may be involved with greater or smaller importance in different tAML patients groups and result in clinical heterogeneity even in patients classified in the same WHO AML category, with heterogeneous disease features and response to therapy. AIM OF THE STUDY AND METHODS We analysed data about patients treated at two Italian hospitals, ASST Niguarda Ca' Granda (Milan) and Policlinico San Martino (Genoa) from year 2009 to 2019 for a tAML secondary to breast cancer or to LD (Hodgkin and non Hodgkin lymphoma) and looked for possible differences in the clinical and genetic characteristics and response to therapy (i.e. achievement of CR). Descriptive statistics was used for categorical variables. Furthermore, Fisher exact test was used to compare the frequency of different genetic prophiles and response to therapy in different tAML patient populations. RESULTS Clinical and genetic characteristics of the patients, as well as data on previous treatment and response to therapy of tAML cases are reported in the table. Median age and time to AML onset were similar in the two groups of patients (BC and LD) and both had been largely treated with chemotherapy (including anthracyclines and alkylators) and radiotherapy, even if the use of chemotherapy was more extensive in lymphomas, with a significant proportion of patients also receiving HD chemotherapy and ASCT. We found biological and clinical differences between the two cohorts of tAML patients: Patients with previous BC had a genetic profile that is closer to that of de novo AMLs, with an high frequency of normal karyotype or recurrent translocations, including cases of CBF AML and PML. A MDS-related karyotype was found only in a minority of patients. Conversely, patients treated for a previous lymphoma had a much higher proportion of MDS-related cytogenetics (14/23 in LD vs 5/20 in BC, Fisher test, p=0,03), with only 7/23 patients harbouring a normal karyotype. As regards response to chemotherapy, the proportion of patients achieving a CR was 16/20 in breast cancer group, compared to 11/23 in LD patiens, a difference nearly achieving statistical significance (Fisher test, p=0,06). This difference was observed in spite of a larger use of fludarabine containing regimens in the latter cohort (according to clinicians choice). CONCLUSIONS Our data suggest that tAMLs, even if categorized as a whole in WHO 2016 classification, are a heterogeneous entity as regards pathogenesis and clinical behaviour and may deserve a personalized approach. The use of a wide genetic screening may help to discriminate the biological characteristics and prognosis of each patient with possible implications in therapeutic choices. Figure Disclosures No relevant conflicts of interest to declare.

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