A population‐based comparison of treatment patterns, resource utilization, and costs by cancer stage for Ontario patients with triple‐negative breast cancer

Fathers, Kelly E.; Coombes, Megan; Pourmirza, Behin; Xue, Cloris; Jerzak, Katarzyna J.

doi:10.1002/cam4.3038

Cited by 17 publications

(37 citation statements)

References 37 publications

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“…Therefore, we are unable to distinguish non-TNBC from TNBC patients who never received hormone therapy or HER2 therapy, and the number and proportion of TNBC subjects might be overestimated. However, the proportions of TNBC among BC patients, distributions of cancer stage and lymph node state, and their survival were similar to those found in previous studies 14 – 16 , 21 . Second, the sixth edition and seventh edition of the AJCC Staging Manual was adopted by the Cancer Registry system before and after 2010, respectively.…”

Section: Discussionsupporting

confidence: 88%

“…In our study, it was found that the total cost from first year to fifth year gradually decreased and most of the costs were incurred by cancer-related health services in mTNBC patients. In addition, hospitalization accounted for a major proportion of medical costs as observed in previous studies 20 , 21 . These findings may reflect the treatment patterns of mTNBC patients.…”

Section: Discussionsupporting

confidence: 61%

“…Healthcare costs of mTNBC patients have been examined in western countries 9 , 20 , 21 . Of the elderly mTNBC patients in the US, the mean cumulative cost was US$73,586, and mean cost in first-line and second-line treatments was US$26,950 and US$33,347, respectively.…”

Section: Introductionmentioning

confidence: 99%

“…Hospitalization costs accounted for almost half of the total cost, followed by the costs of systemic anti-cancer therapy. In Canada, the mean annual per-patient cost of adult stage IV TNBC patients was $140,160, with inpatient services accounted for 45.4% of the total cost 21 . As far as we know, there is no study examining medical costs of mTNBC patients in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

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Survival, treatment regimens and medical costs of women newly diagnosed with metastatic triple-negative breast cancer

Hsu

Chang

Cheng

2022

Sci Rep

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Individuals diagnosed with metastatic triple-negative breast cancer (mTNBC) suffer worse survival rates than their metastatic non-TNBC counterparts. There is little information on survival, treatment patterns, and medical costs of mTNBC patients in Asia. Therefore, this study aimed to examine 5-year survival, regimens of first-line systemic therapy, and healthcare costs of mTNBC patients in Taiwan. Adult females newly diagnosed with TNBC and non-TNBC as well as their survival data, treatment regimens and costs of health services were identified and retrieved from the Cancer Registry database, Death Registry database, and National Health Insurance (NHI) claims database. A total of 9691 (19.27%) women were identified as TNBC among overall BC. The 5-year overall survival rate of TNBC and non-TNBC was 81.28% and 86.50%, respectively, and that of mTNBC and metastatic non-TNBC was 10.81% and 33.46%, respectively. The majority of mTNBC patients received combination therapy as their first-line treatment (78.14%). The 5-year total cost in patients with metastatic non-TNBC and with mTNBC was NTD1,808,693 and NTD803,445, respectively. Higher CCI scores were associated with an increased risk of death and lower probability of receiving combination chemotherapy. Older age was associated with lower 5-year medical costs. In sum, mTNBC patients suffered from poorer survival and incurred lower medical costs than their metastatic non-TNBC counterparts. Future research will be needed when there are more treatment options available for mTNBC patients.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Survival, treatment regimens and medical costs of women newly diagnosed with metastatic triple-negative breast cancer

Hsu

Chang

Cheng

2022

Sci Rep

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“…Triple-negative breast cancer (TNBC) is an aggressive cancer, most common in African American women, being associated with fewer treatment options, advanced stage diagnosis, high recurrence, and low overall survival rates [ 1 , 2 ]. While a wide variety of solid tumors display elevated aerobic glycolysis, concomitant to over-expressed lactic acid dehydrogenase (LDH) and production of lactic acid, these factors are accentuated in TNBC compared with hormone receptor-positive breast cancers [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Triple Isozyme Lactic Acid Dehydrogenase Inhibition in Fully Viable MDA-MB-231 Cells Induces Cytostatic Effects That Are Not Reversed by Exogenous Lactic Acid

et al. 2021

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A number of aggressive human malignant tumors are characterized by an intensified glycolytic rate, over-expression of lactic acid dehydrogenase A (LDHA), and subsequent lactate accumulation, all of which contribute toward an acidic peri-cellular immunosuppressive tumor microenvironment (TME). While recent focus has been directed at how to inhibit LDHA, it is now becoming clear that multiple isozymes of LDH must be simultaneously inhibited in order to fully suppress lactic acid and halt glycolysis. In this work we explore the biochemical and genomic consequences of an applied triple LDH isozyme inhibitor (A, B, and C) (GNE-140) in MDA-MB-231 triple-negative breast cancer cells (TNBC) cells. The findings confirm that GNE-140 does in fact, fully block the production of lactic acid, which also results in a block of glucose utilization and severe impedance of the glycolytic pathway. Without a fully functional glycolytic pathway, breast cancer cells continue to thrive, sustain viability, produce ample energy, and maintain mitochondrial potential (ΔΨM). The only observable negative consequence of GNE-140 in this work, was the attenuation of cell division, evident in both 2D and 3D cultures and occurring in fully viable cells. Of important note, the cytostatic effects were not reversed by the addition of exogenous (+) lactic acid. While the effects of GNE-140 on the whole transcriptome were mild (12 up-regulated differential expressed genes (DEGs); 77 down-regulated DEGs) out of the 48,226 evaluated, the down-regulated DEGS collectively centered around a loss of genes related to mitosis, cell cycle, GO/G1–G1/S transition, and DNA replication. These data were also observed with digital florescence cytometry and flow cytometry, both corroborating a G0/G1 phase blockage. In conclusion, the findings in this work suggest there is an unknown element linking LDH enzyme activity to cell cycle progression, and this factor is completely independent of lactic acid. The data also establish that complete inhibition of LDH in cancer cells is not a detriment to cell viability or basic production of energy.

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Regulatory T cells: Their role in triple‐negative breast cancer progression and metastasis

Malla¹,

Padmaraju²,

Vempati³

et al. 2022

Cancer

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Triple‐negative breast cancer (TNBC) is an aggressive and immunogenic subtype of breast cancer. This tumorigenicity is independent of hormonal or HER2 pathways because of a lack of respective receptor expression. TNBC is extremely prone to drug resistance and early recurrence because of T‐regulatory cell (Treg) infiltration into the tumor microenvironment (TME) in addition to other mechanisms like genomic instability. Tumor‐infiltrating Tregs interact with both tumor and stromal cells as well as extracellular matrix components in the TME and induce an immune‐suppressive phenotype. Hence, treatment of TNBC with conventional therapies remains challenging. Understanding the protective mechanism of Tregs in shielding TNBC from antitumor immune responses in the TME will pave the way for developing novel, immune‐based therapeutics. The current review focuses on the role of tumor‐infiltrating Tregs in tumor progression and metabolic reprogramming of the TME. The authors have extended their focus to oncotargeting Treg‐mediated immune suppression in breast cancer. Because of its potential role in the TME, modulating Treg activity may provide a novel strategic intervention to combat TNBC. Both under laboratory conditions and in clinical trials, currently available anticancer drugs and natural therapeutics as potential agents for targeting Tregs are explored.

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A population‐based comparison of treatment patterns, resource utilization, and costs by cancer stage for Ontario patients with triple‐negative breast cancer

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 17 publications

References 37 publications

Survival, treatment regimens and medical costs of women newly diagnosed with metastatic triple-negative breast cancer

Survival, treatment regimens and medical costs of women newly diagnosed with metastatic triple-negative breast cancer

Triple Isozyme Lactic Acid Dehydrogenase Inhibition in Fully Viable MDA-MB-231 Cells Induces Cytostatic Effects That Are Not Reversed by Exogenous Lactic Acid

Regulatory T cells: Their role in triple‐negative breast cancer progression and metastasis

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