scholarly journals A Substantial Response from Adding Palbociclib to Endocrine Therapy in Brain Metastasis from Hormone Receptor-Positive, HER2-Negative Breast Cancer: Case Reports

2021 ◽  
pp. 446-452
Author(s):  
Atlal Abusanad ◽  
Hashem Al Hashem
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Endocrine Therapy ◽  
Hormone Receptor ◽  
Case Reports ◽  
Growth Factor Receptor ◽  
Breast Cancer Case ◽  
Current Data ◽  
Cancer Case ◽  
Breast Cancer Patients

Brain metastasis (BM) from breast cancer has poor prognosis despite new advances and multi-modality treatments. No current data is guiding the use of palbociclib in the management of hormone receptor (HR)-positive breast cancer patients with BM as these patients were excluded systematically from all phase 3 trials. Here, we report an evident clinical response from combining palbociclib with endocrine therapy in HR-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer with BM.

scholarly journals Intrathecal Methotrexate and Craniospinal Radiotherapy Can Be an Effective Treatment of Carcinomatous Meningitis in Patients with Breast Cancer: Case Reports

2016 ◽  
Vol 9 (3) ◽  
pp. 586-592 ◽  
Author(s):  
Magdalena Meissner ◽  
Alfredo Addeo
Keyword(s):  
Breast Cancer ◽  
Case Reports ◽  
Breast Cancer Case ◽  
Intrathecal Methotrexate ◽  
Cancer Case ◽  
Carcinomatous Meningitis ◽  
Breast Cancer Patients ◽  
Similar Treatment ◽  
Craniospinal Radiotherapy ◽  
Sequential Combination

Introduction: Carcinomatous meningitis in breast cancer occurs as a complication in up to 5% of all cases. It is a very devastating diagnosis, with a median patient survival of about 3 months. Treatment is very controversial, and different modalities of treatment have been used but none of them show significant benefit for overall survival. Case Reports: We report 2 cases of carcinomatous meningitis in breast cancer patients. They received a similar treatment of a combination of intrathecal (IT) methotrexate followed by craniospinal radiotherapy. Both patients survived for many years after treatment and are in complete clinical and radiological remission. Conclusion: Meningeal metastasis from breast cancer can be very effectively treated with IT and/or systemic chemotherapy followed by craniospinal radiotherapy. Further studies are needed to determine the effectiveness of this sequential combination of chemotherapy with radiotherapy.

scholarly journals Outcomes of Breast Cancer Receptor Testing at the Georgetown Public Hospital Corporation from December 2016 to December 2018

2019 ◽  
pp. 15-16
Author(s):  
Sandy Solomon ◽  
Ravi Motilall
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Public Hospital ◽  
Triple Negative ◽  
Growth Factor Receptor ◽  
Breast Cancer Patients ◽  
Hormone Receptor Positive ◽  
Her2 Breast Cancer ◽  
The Caribbean ◽  
Design And Methods

Objectives: To review the outcomes of oestrogen receptor (ER), progesterone receptor (PR) and Human epidermal growth factor receptor 2 (HER2) in breast cancer patients at GPHC over a 2 year period from December 2016-December 2018. Hypothesis: There is a higher incidence triple negative(ER (-), PR (-), HER2 (-)) breast cancer among patients in Guyana when compared to the Caribbean. Secondary Objectives: To identify the patients who had hormone receptor testing done at the Georgetown Public Hospital Corporation (GPHC). To specify the current trends of ER, PR and HER2 in patients at GPHC from December 2016- December 2018. To enumerate the percentage of BC diagnosed in the patients under 40 years. Design and Methods: Retrospective cohort study of 90 BC patients with known receptor status from December 2016-Dcember 2018. Results: In this study of 90 patients 46% of the patients are triple negative BC, while 38% are hormone receptor positive. Of least frequency are the triple positive BC representing 3%. The persons 40years and under represent 16% of the population. Conclusion: There in a high percentage of breast cancer in patients under 40 years representing 16% of the study population. There is a higher percentage of triple negative or non-hormonal receptive breast cancer at GPHC of approximately 46% which supersedes 20% when compared to the Caribbean population. Recommendations: Further study is needed, with screening and development of protocols. Breast receptor testing in all patients need to routinely done and a formal cancer registry and Digital database established.

A validated model to predict low recurrence risk distinguished by 21-gene recurrence score in hormone receptor-positive invasive breast cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 532-532
Author(s):  
Yasue Tsuchida ◽  
Sachiko Ohde ◽  
Ryota Nakamura ◽  
Yoko Kanada ◽  
Sakiko Miura ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Prediction Model ◽  
Cancer Patients ◽  
Endocrine Therapy ◽  
Hormone Receptor ◽  
Recurrence Score ◽  
Premenopausal Women ◽  
Breast Cancer Patients ◽  
Derivation Cohort

532 Background: In the prospective TAILORx and RxPONDER trials, the 21-gene Recurrence Score (RS) showed endocrine therapy alone was non-inferior to chemo-endocrine therapy in the analysis of invasive disease-free survival in postmenopausal hormone-receptor (HR)-positive breast cancer patients with RS < = 25. They also indicated chemotherapy was associated with benefit for women 50 years or younger with RS 11 to 25. However, in Japan, the test is not conventionally available because of non-coverage by national insurance. We aimed to develop and validate a model to predict RS using clinicopathological factors that identify patients who would have low risk shown by testing the 21-gene RS and can avoid chemotherapy. Methods: Four hundred patients, including 187 N0/1 postmenopausal, and 213 N0 premenopausal women who underwent surgery and had the RS from St. Luke’s International Hospital, Tokyo, Japan, were included in derivation cohort. Derivation cohort was divided into 2 groups by RS 25; patients with RS of 0 to 25 (n = 321) and with RS over 26 (n = 79). Multivariate logistic regression analysis was performed using candidate factors for all patients and pre- or postmenopausal patients. The prediction model was validated using an external cohort of 70 patients from Showa University School of Medicine, Tokyo, Japan. Results: Nuclear grade (NG) (adjusted OR, 5.28, 95% CI, 2.47–11.30), high Progesterone receptor (PgR) expression (Allred score 7-8) (adjusted OR, 10.62, 95% CI, 5.34–21.13) and low Ki67 level ( < = 20%) (adjusted OR, 5.29, 95% CI, 2.33-12.01) were significant independent predictors of RS of 0 to 25. With these factors could predict RS of 0 to 25 (AUC of 0.848, 95% CI, 0.803-0.893) with the highest probability of low-RS for 100%. The prediction model of the validation cohort had same discriminatory ability having an AUC of 0.812 (95% CI, 0.701-0.923). In postmenopausal patients, NG (adjusted OR, 4.81, 95% CI, 1.72–13.42), high PgR expression (adjusted OR, 10.62, 95% CI, 4.52–37.72), and low Ki67 level (adjusted OR, 4.94, 95%CI, 1.87-13.04) were significantly associated with RS of 0 to 25 in multivariate analysis. A regression model with these 4 factors could predict RS of 0 to 25 (AUC of 0.842, 95%CI, 0.782-0.902). In premenopausal patients, NG (adjusted OR, 8.76, 95% CI, 1.14–67.40), high PgR expression (adjusted OR, 3.22, 95% CI, 1.61–6.43), and low Ki67 level (adjusted OR, 2.87, 95% CI, 1.20–6.87) were significantly associated with RS of 0 to 10 in multivariate analysis. These factors could predict RS of 0 to 10 (AUC of 0.811, 95% CI, 0.731-0.891). However, the highest probability of low-RS provided this model for premenopausal women was 46.8%. Conclusions: Our validated model could provide useful information to distinguish low-RS especially for postmenopausal patients with high reproducibility. However, for premenopausal women, the 21-gene RS is warranted.

Differential outcomes in patients treated with endocrine therapy for early or locally advanced breast cancer based on BRCA mutation status

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22065-e22065 ◽  
Author(s):  
R. Wesolowski ◽  
A. G. Shealy ◽  
J. Tao ◽  
H. C. Moore
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Endocrine Therapy ◽  
Hormone Receptor ◽  
Brca Mutation ◽  
Breast Cancer Patients ◽  
Brca1 And Brca2 ◽  
Mutation Status ◽  
Hormone Receptor Positive ◽  
History Of

e22065 Background: Mutations in BRCA1 and BRCA2 genes lead to defects in DNA repair. Estrogen receptor modulates transcription of genes responsible for cell division, which depends on cell's ability to repair DNA for genomic integrity. Differential efficacy of endocrine therapy for breast cancer, therefore, may be possible depending on the tumor's BRCA mutation status. Methods: Through an IRB approved registry, breast cancer patients tested for BRCA1 and BRCA2 mutations and treated with endocrine therapy for hormone-receptor positive non-metastatic disease were identified. Primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS) respectively. Fisher's exact test or Wilcoxon rank sum test were used to assess differences among subgroups with respect to their characteristics. Cox proportional hazard analysis was used to identify univariate and multivariate risk factors for OS and PFS. Results: Of 115 breast cancer patients tested for BRCA mutations, 63 met the inclusion criteria of whom 16 patients were BRCA 1 or 2 mutation positive and 47 were negative. In the BRCA(+) group, 14 patients (87.5%) had stage I-III disease at diagnosis. In the BRCA(-) group, 5 patients (10.6%) had stage 0 disease while 41 patients (87.2%) had stage I-III disease at diagnosis. Stage at diagnosis was unavailable for 2 BRCA(+) and 1 BRCA(-) patients. Both groups were similar with respect to Her-2 expression status, history of ovarian suppression, age of diagnosis, and age of menopause. Median age was 48 yo in BRCA(+) group, 42 yo in BRCA(-), (p=0.12). Median follow up was 76.1 mos in BRCA(+) and 62.9 mos in BRCA(-) group. OS was worse in BRCA(+) group (HR 7.38, 95% [CI] 1.49–36.4 p=0.014). After adjustment for stage and history of ovarian suppression, the difference remained significant (HR 16.6, 95% [CI] 1.95–142, p=0.010). There was no difference in PFS (HR 2.02, 95% [CI] 0.82–4.96, p=0.13). Conclusions: Patients with BRCA mutation, hormone-receptor positive hereditary breast cancer treated with endocrine therapy had inferior survival compared with similar patients who are BRCA mutation negative. Prospective studies to evaluate the differential effects of endocrine therapy in these populations are warranted. No significant financial relationships to disclose.

Efficacy of six month neoadjuvant endocrine therapy in postmenopausal, hormone receptor-positive breast cancer patients – A phase II trial

2014 ◽  
Vol 50 (13) ◽  
pp. 2190-2200 ◽  
Author(s):  
Duveken B.Y. Fontein ◽  
Ayoub Charehbili ◽  
Johan W.R. Nortier ◽  
Elma Meershoek-Klein Kranenbarg ◽  
Judith R. Kroep ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Endocrine Therapy ◽  
Phase Ii ◽  
Hormone Receptor ◽  
Phase Ii Trial ◽  
Breast Cancer Patients ◽  
Neoadjuvant Endocrine Therapy ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

Preoperative endocrine therapy with goserelin acetate and tamoxifen in hormone receptor-positive premenopausal breast cancer patients

Breast Cancer ◽  
2012 ◽  
Vol 21 (5) ◽  
pp. 557-562 ◽  
Author(s):  
Daisuke Shimizu ◽  
Takashi Ishikawa ◽  
Mikiko Tanabe ◽  
Takeshi Sasaki ◽  
Yasushi Ichikawa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Endocrine Therapy ◽  
Hormone Receptor ◽  
Breast Cancer Patients ◽  
Premenopausal Breast Cancer ◽  
Hormone Receptor Positive ◽  
Goserelin Acetate

scholarly journals Clinical Review on the Management of Hormone Receptor–Positive Metastatic Breast Cancer

2021 ◽  
Author(s):  
Nicholas P. McAndrew ◽  
Richard S. Finn
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Hormone Receptor ◽  
Treatment Plan ◽  
Menopausal Status ◽  
Mammalian Target Of Rapamycin ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Current Data ◽  
Hormone Receptor Positive

The natural history of hormone receptor–positive breast cancer tends to be more favorable than other subtypes such as human epidermal growth factor receptor 2–amplified and triple-negative. In addition, the natural dependence on steroid hormone signaling has allowed for therapeutic targeting of this pathway and significant improvements in survival while maintaining quality of life: the two main goals in management of the disease. The sequential use of endocrine agents including the selective estrogen receptor modulators (tamoxifen), aromatase inhibitors (letrozole, anastrozole, and exemestane) and the selective estrogen receptor degrader fulvestrant has been the backbone of management for years. In the past decade, the introduction of molecularly targeted agents against intracellular targets such as mammalian target of rapamycin (everolimus), cyclin-dependent kinases 4 and 6 (palbociclib, ribociclib, and abemaciclib), and phosphatidylinositol 3-kinase (alpelisib) has offered patients effective nonchemotherapy-based options, which are improving outcomes. Although knowledge gaps still exist in regard to the optimal sequencing of these new regimens, they have expanded our repertoire of options for patients and have shifted the need for cytotoxic chemotherapy and its associated complications to later lines. Still, formatting a plan for these patients includes taking into account traditional prognostic factors such as menopausal status, previous treatments, disease-free interval for those patients with early breast cancer that has recurred, and tumor burden. To assist in developing this treatment plan, we will review the current data with systemic agents in the management of these patients.

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