scholarly journals Effect of CMF-chemotherapy on blood coagulation in patients with breast cancer

2002 ◽  
Vol 10 (2) ◽  
pp. 61-66
Author(s):  
Dragana Petrovic

BACKGROUND: Influences of CMF (cyclophosphamide, methotrexate,5-fluorouracil) chemotherapy on blood coagulation were investigated in 30 patients receiving adjuvant chemotherapy and in 30 patients receiving chemotherapy for metastatic breast cancer. METHODS: In plasma samples of 60 patients (median age 49.5), we evaluated the following parameters 1)Markers of in vivo clotting activation thrombin-antithrombin complex (ELISA) and D-dimer (ELISA), 2) Natural anticoagulants (protein C [PC] and antithrombin III [AT III] by chromogenic methods). The coagulation studies were performed at the beginning and at the end of the first cycle of CMF protocol. RESULTS: Before CMF therapy, significant difference was observed between patients with early stage and patients with metastatic breast cancer in the PC (p<0.01), AT III (p<0.01) and TAT (p<0.01) levels. After CMF therapy, patients with stage II (adjuvant) disease manifested a significant decrease in the level of PC and AT III activity (p<0.01) and an increase in TAT level (p<0.01). In patients with disseminated breast cancer CMF therapy provoked an increased level of TAT and D-dimer with a decreased activity of protein C and antithrombin III. There was significant difference in value of TAT, D- dimer, protein C and antithrombin III between the patients with adjuvant and metastatic breast cancer patients after CMF chemotherapy CONCLUSION: Our results suggest that the application of cytotoxic therapy provokes hypercoagulable condition in breast cancer patients. This effect should be considered when chemotherapy is employed in advanced cancer patients at high risk for thrombosis, or in patients with other risk factors.

2020 ◽  
Vol 43 (12) ◽  
pp. 694-702
Author(s):  
Louai Alsaloumi ◽  
Shaima Shawagfeh ◽  
Abdikarim Abdi ◽  
Bilgen Basgut

<b><i>Background:</i></b> Capecitabine is frequently used alone or combined with other chemotherapy agents for the treatment of metastatic breast cancer in relapsed patients. <b><i>Objective:</i></b> The objective of this meta-analysis is to evaluate the effectiveness and safety of capecitabine monotherapy versus combination in the treatment of metastatic breast cancer patients pretreated with anthracycline and taxane. <b><i>Methods:</i></b> Eligible randomized controlled trials examining the efficacy and safety of capecitabine alone compared to capecitabine combination were systematically searched. Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and grades 3–4 drug-related adverse events were the outcomes assessed. <b><i>Results:</i></b> A total of 6,714 patients of 9 trials were involved in the pooled analysis. Our findings demonstrated that capecitabine combination is significantly superior to capecitabine monotherapy in improving PFS (hazard ratio [HR] 1.32, 95% CI 1.13–1.54, <i>p</i> &#x3c; 0.0001) and ORR (risk ratio [RR] 0.67, 95% CI 0.54–0.83, <i>p</i> &#x3c; 0.001), but it was insignificant in OS (HR 1.09, 95% CI 0.98–1.22, <i>p</i> = 0.12). On the other hand, the incidence of non-hematological adverse events such as hand-foot syndrome and diarrhea was lower in capecitabine combination compared to capecitabine monotherapy. <b><i>Conclusion:</i></b> Capecitabine-based combination chemotherapy showed superiority over capecitabine monotherapy in terms of PFS and ORR, with no significant difference in OS. Non-hematological adverse effects such as hand-foot syndrome were fewer with a combination regimen. However, hematological adverse events were fewer with capecitabine monotherapy regimen.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Marwa H. Elnagdy ◽  
Omar Farouk ◽  
Amal K. Seleem ◽  
Hoda A. Nada

Introduction. Breast cancer metastasis occurs when tumor cells dissociate from the primary tumor and migrate to distant organs through the peripheral bloodstream or lymphatic drainage. Circulating tumor cells (CTCs) originate from primary sites or metastases and circulate in the patients’ bloodstream. Molecular assays for the detection and molecular characterization of CTCs can serve as a liquid biopsy and can represent an alternative to invasive biopsies as a source of tumor tissue in the metastatic patients.Patients and Methods. We analyzed the presence of CTCs in the peripheral blood of 50 breast cancer patients by quantitative real-time reverse transcriptase polymerase chain reaction (RT-qPCR) to detecttrefoil factor family(TFF)1and3genes.Results. We found significant difference in the level of bothTFF1andTFF3mRNA in the blood of nonmetastatic versus metastatic breast cancer patients (p=0.001 and p= 0.038, respectively).TFF1mRNA was detected at higher levels in 34.6% of metastatic breast cancer patients as compared to 0% of nonmetastatic (p= 0.002). As regardsTFF3mRNA, it was detected at higher levels in 46.2% of metastatic breast cancer patients as compared to 4% of nonmetastatic (p= 0.026). Moreover, we found that the high level of bothTFF1andTFF3mRNA was related to estrogen status of the patients. The detection of high level ofTFF1mRNA in CTCs was associated with bone metastases (77.8%), while that ofTFF3was related to lymph node involvement (75%) and lung metastases (68.8%).Conclusion. The combined measurement of bothTFF1andTFF3mRNA level for differentiation of metastatic from nonmetastatic breast cancer gave 57.69% sensitivity and 83.3% specificity.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10593-10593
Author(s):  
V. Mari ◽  
E. Chamorey ◽  
A. Italiano ◽  
F. Van Den Bos ◽  
R. Ferri-Dessens ◽  
...  

10593 Background: Recent data report that HER2 overexpressing metastatic breast cancer patients (HER+ MBC pts) treated with trastuzumab (T) have a high rate of Brain metastasis (BM). This study aimed to evaluate the prognostic significance of BM occurrence and the related clinical outcome in a specific patient population. Methods: All the HER+MBC patients treated with trastuzumab (with or without chemotherapy) between 09/1999 and 12/2004 were included in this study. Results: A total of forty three patients were enrolled into the study cohort. The median follow-up was 48 months (range, 11–166). Fifteen patients (35%) developped BM. The median interval from the the first MBC event to BM was 18 months (range, 1–65). In multivariate analysis; younger age was the only factor associated with BM occurrence (46 versus 57 years; p = 0.01). Patients with BM tend to have a longer median duration of response to T than patients without BM (16 months versus 13 months; p = 0.1). At the time of BM appearance, 6 of the 15 patients (40%) were still responding or had achieved extracranial stable disease while receiving trastuzumab. Twelve out of 15 (80%) pts received a whole-brain radiation therapy, and 8 pts continued to receive trastuzumab until extracranial disease progression. The median overall survival for patients diagnosed with BM was 10 months (range, 2–42). At three-year, there was no significant difference in overall survival rates between the two groups. The 3-YS was 63.5% and 66.7% for pts with or without BM, respectively; (p = 0.7). Conclusions: The BM occurrence in HER2+ MBC pts treated with Trastuzumab is not linked to tumour resistance, but likely related to the T inability to cross the blood-brain barrier. There is no impaired survival for these pts treated with effective and appropriate therapy. [Table: see text]


2021 ◽  
Vol 8 (3) ◽  
pp. 171-174
Author(s):  
Veysel Haksoyler ◽  
Tolga Koseci ◽  
Timucin Cil ◽  
Berna Bozkurt Duman ◽  
Polat Olgun ◽  
...  

Objective: When metastasis develops in some breast cancer patients, hormone receptors (HR) and Human Epidermal Growth Factor-2 (Her-2) status can change and the tumor alters its character. We tried to determine the rate of these changes in tumor biology in 110 patients that we followed in our clinic and performed the change of the biopsy from the metastatic site (re-bx). We aimed to determine the biological changes of tumors and, contribute to the literature by examining the relationship of these changes with the adjuvant endocrine treatments (ET) or chemotherapy type (CT). Material and Methods: We included 110 metastatic breast cancer patients in our study. These patients had previously completed their local treatments followed by CT, and those with positive HR completed ET. After the first metastasis developed in the patients, we performed metastasectomy or biopsy from the metastatic site. Results: The median ki-67 value was 25% at the time of primary diagnosis and 30% in re-bx. 20.9% of patients estrogen receptor (ER), 31.8%  of patients progesterone receptor (PR) and 26.3% of patients Her-2 changed when metastasis developed. Conclusions: We found that the metastatic tumor has more aggressive properties than the primary tumor. Adjuvant chemotherapy and endocrine treatments or the location of metastasis did not make a significant difference in tumor biology.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11592-e11592
Author(s):  
Senem Karabulut ◽  
Leyla Kilic ◽  
Rumeysa Ciftci ◽  
Ibrahim Yildiz ◽  
Fatma Sen ◽  
...  

e11592 Background: Activated coagulation and fibrinolytic system in cancer patients is associated with tumor stroma formation and metastasis in different cancer types. The aim of this study is to explore the correlation of blood coagulation tests for various clinicopathologic factors in breast cancer patients. Methods: The study involves treatment-naive female breast cancer patients. Pretreatment blood coagulation tests including prothrombin time (PT), activated partial thromboplastin time (APTT), prothrombin activity (PTA), INR, D-dimer, fibrinogen levels and platelet counts were evaluated. Results: Between February 2010 and June 2011, 123 consecutive female patients with breast cancer were enrolled into the study. Median age of diagnosis was 51 years old (range: 26-82). 22 % of the group consisted of metastatic breast cancer patients. The plasma level of all coagulation factors revealed statistically significant difference between patient and control group except for PT (p<0.001 for all variables except for PT; p=0.08). Elderly age (>50 years) was associated with higher D-dimer levels (median 174 vs 345 U/ml, p=0.003). Metastatic patients exhibited significantly higher D-dimer values when compared with early breast cancer patients (median 205 U/ml vs 407.2 U/ml, p=0.049). Advanced tumor stage (T3&T4 vs T1&T2) was associated with higher INR (median 1.15 vs 1.09, p=0.05) and lower prothrombin activity (median: 82 % vs 70 %, p=0.025). Conclusions: Plasma D-dimer levels are elevated among metastatic breast cancer patients. Involvement of axillary lymph nodes and hormone receptor status does not seem to have an effect on coagulation parameters. For daily practice, D-dimer may be a suitable test for evaluation of disease extent before designing treatment strategy.


Author(s):  
Besse Rosmiati ◽  
Uleng Bahrun ◽  
Ruland DN Pakasi

Matrix Metalloproteinase-2 is a family of extra cellular matrix degrading proteinases. Study results on the role of MMP-2 in breastcancer progression and metastasis are still controversial. The aim of this study was to know the MMP-2 level by analyzing in metastaticand non metastatic breast cancer patients by using a cross sectional design, it was carried out in the Wahidin Sudirohusodo, Ibnu Sina,Labuang Baji Hospitals and at the Research Unit of UNHAS Makassar from April 2012 until June 2012. The 56 breast cancer patientswere divided into two groups: metastatic and non metastatic based on their thorax photo, ultrasonography and/or bone scan results. Theywere also divided into early and advanced stage, based on their TNM staging. The matrix metalloproteinase-2 level was determined byELISA method. The result of this study showed that the mean levels of MMP-2 in metastatic and non metastatic breast cancer were 20.18ng/mL and 17.14 ng/mL, respectively. The independent sample T test showed there was a significant difference (p=0.018) in MMP-2levels between metastatic and non metastatic breast cancer. The mean level of MMP-2 in early and advanced stages was 17.10 ng/mLand 18.31 ng/mL, respectively, the independent sample T test showed no significant difference of MMP-2 level between both stages. Oneway ANOVA test showed no significant difference of MMP-2 level based on tumour size and regional lymph node infiltration. The MMP-2contributed to the metastasis in breast cancer patients. The matrix metalloproteinase-2 level in metastatic was higher than in the nonmetastatic breast cancer, so this condition could be used as a biomarker to predict the metastasis of breast cancer.


2021 ◽  
Author(s):  
Kuikui Jiang ◽  
Danyang Zhou ◽  
Fei Xu ◽  
Wen Xia ◽  
Qiufan Zheng ◽  
...  

Abstract Purpose: We aimed to identify the relationship between the genomic characteristics and clinicopathological features of oligo-metastatic breast cancer.Methods: Oligo-metastatic breast cancer diagnosed by pathology from January 2001 and August 2019 were identified and we matched the poly-metastatic patients based on the clinicopathological features of the oligo-metastatic patients included. The database of all genomic alterations was shown according to the FoundationOne CDx reports. Clinicopathological characteristics were collected and the results of next-generation sequencing were analyzed.Results: A total of 26 breast cancer patients were enrolled in our study, including 14 patients with oligo-metastatic disease and 12 patients with poly-metastatic disease. There was no significant difference in number of gene alteration, tumor mutational burden, variants of unknown significance (VUS), and actional mutation in oligo- and poly-metastasis. PIK3CA, TP53 and ERBB2 were the most common shared alterations identified in patients included. Based on the median time of oligo-progression disease (oligo-PD), we divided the patients with oligo-metastasis into longer oligo-PD group (oligo-PD > 31.04 months) and shorter oligo-PD group (oligo-PD ≤ 31.04 months). The analysis of PIK3CA mutation sites showed that H1047R was associated with a good prognosis in patients with metastatic breast cancer. HER2 positive patients with oligo-metastasis was more likely to have a good prognosis. In addition, VUS might also be a potential prognostic biomarker in metastatic breast cancer. Conclusion: Through the genetic analysis of oligo-metastasis, we found PIK3CA H1047R, HER2 and VUS might predict the different clinical outcomes of breast cancer patients with oligo-metastasis for the individualized treatment.


2003 ◽  
Vol 21 (10) ◽  
pp. 1967-1972 ◽  
Author(s):  
A. Lipton ◽  
S.M. Ali ◽  
K. Leitzel ◽  
L. Demers ◽  
H.A. Harvey ◽  
...  

Purpose: To determine the effect of elevated serum HER-2/neu on the response of metastatic breast cancer patients to an aromatase inhibitor versus an antiestrogen. Patients and Methods: Five hundred sixty-two estrogen receptor–positive metastatic breast cancer patients were randomized to first-line hormone therapy with either letrozole or tamoxifen. An automated enzyme-linked immunosorbent assay was used to detect serum HER-2/neu. Results: For patients with normal serum HER-2/neu (70.5%), objective response rate (ORR; 39% in letrozole-treated patients v 26% in tamoxifen-treated patients; P = .008), clinical benefit (CB; 57% v 45%; P = .016), time to progression (TTP; median, 12.2 v 8.5 months; P = .0019), and time to treatment failure (TTF; median, 11.6 v 6.2 months; P = .0066) were significantly better in patients treated with letrozole. In the elevated HER-2/neu group (29.5%), there was no significant difference in ORR (17% in letrozole-treated patients v 13% in tamoxifen-treated patients; P = .45) or CB (33% v 26%; P = .31), but there was a strong trend in favor of a longer TTP with letrozole (median, 6.1 v 3.3 months; P = .0596) and a significantly longer TTF with letrozole (median, 6.0 v 3.2 months; P = .0418). Multivariate analysis revealed that elevated serum HER-2/neu was a negative predictor for ORR and TTP. Conclusion: Patients with normal serum HER-2/neu receiving letrozole demonstrated a significantly greater ORR and CB and longer TTP and TTF than patients receiving tamoxifen. Although in patients with elevated serum HER-2/neu there was no significant difference between letrozole and tamoxifen in ORR or CB, there was a strong trend favoring longer TTP and significantly longer TTF with letrozole.


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