Advances in the care of breast cancer survivors

Cathcart-Rake, Elizabeth J; Tevaarwerk, Amye J; Haddad, Tufia C; D’Andre, Stacy D; Ruddy, Kathryn J

doi:10.1136/bmj-2022-071565

Cited by 4 publications

(1 citation statement)

References 267 publications

(410 reference statements)

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“…Breast cancer is the most prevalent malignant tumor in women [ 1 ], with its classification rooted in the expression levels of key molecular biomarkers: estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2) [ 2 ]. Among these, hormone receptor-positive breast cancer emerges as the dominant type, constituting 70% of all cases.…”

Section: Introductionmentioning

confidence: 99%

Application of fluorocarbon nanoparticles of 131I-fulvestrant as a targeted radiation drug for endocrine therapy on human breast cancer

Zhi,

Cheng,

Jing

et al. 2024

J Nanobiotechnol

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Background Breast cancer is the most prevalent malignant tumor among women, with hormone receptor-positive cases constituting 70%. Fulvestrant, an antagonist for these receptors, is utilized for advanced metastatic hormone receptor-positive breast cancer. Yet, its inhibitory effect on tumor cells is not strong, and it lacks direct cytotoxicity. Consequently, there's a significant challenge in preventing recurrence and metastasis once cancer cells develop resistance to fulvestrant. Method To address these challenges, we engineered tumor-targeting nanoparticles termed 131I-fulvestrant-ALA-PFP-FA-NPs. This involved labeling fulvestrant with 131I to create 131I-fulvestrant. Subsequently, we incorporated the 131I-fulvestrant and 5-aminolevulinic acid (ALA) into fluorocarbon nanoparticles with folate as the targeting agent. This design facilitates a tri-modal therapeutic approach—endocrine therapy, radiotherapy, and PDT for estrogen receptor-positive breast cancer. Results Our in vivo and in vitro tests showed that the drug-laden nanoparticles effectively zeroed in on tumors. This targeting efficiency was corroborated using SPECT-CT imaging, confocal microscopy, and small animal fluorescence imaging. The 131I-fulvestrant-ALA-PFP-FA-NPs maintained stability and showcased potent antitumor capabilities due to the synergism of endocrine therapy, radiotherapy, and CR-PDT. Throughout the treatment duration, we detected no notable irregularities in hematological, biochemical, or histological evaluations. Conclusion We've pioneered a nanoparticle system loaded with radioactive isotope 131I, endocrine therapeutic agents, and a photosensitizer precursor. This system offers a combined modality of radiotherapy, endocrine treatment, and PDT for breast cancer. Graphical Abstract

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Section: Introductionmentioning

confidence: 99%

Application of fluorocarbon nanoparticles of 131I-fulvestrant as a targeted radiation drug for endocrine therapy on human breast cancer

Zhi,

Cheng,

Jing

et al. 2024

J Nanobiotechnol

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Optimal yoga dose for improving cancer-related fatigue, quality of life, and sleep quality in breast cancer survivors: a Bayesian dose–response meta-analysis

Liu,

Li,

et al. 2024

J Cancer Surviv

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Mitochondria-based holistic 3PM approach as the ‘game-changer’ for individualised rehabilitation—the proof-of-principle model by treated breast cancer survivors

Pesta,

Mrazova,

Kapalla

et al. 2024

EPMA Journal

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Breast cancer belongs to the most commonly diagnosed malignancies worldwide, with its increasing incidence paralleled by advances in early diagnostics and effective treatments resulting in significantly improved survival rates. However, breast cancer survivors often experience significantly reduced quality of life linked to the long-term health burden as a consequence of aggressive oncological treatments applied. Their most frequently recorded complains include chronic fatigue, reduced physical activity, disordered sleep, chronification of pain, and severe mental health impairments—all per evidence are associated with compromised mitochondrial health and impaired homeostasis. Self-report of a breast cancer survivor is included in this article to illustrate currently uncovered patient needs. This article highlights mechanisms behind the suboptimal health of breast cancer survivors associated with mitochondrial damage, and introduces a novel, mitochondria-based holistic approach addressing rehabilitation concepts for breast cancer survivors following advanced principles of predictive, preventive and personalised medicine (3PM). By operating via mitochondrial function, the proposed holistic approach triggers systemic effects at molecular, sub/cellular and organismal levels positively affecting energy metabolism, repair mechanisms as well as physical and mental health creating, therefore, highly effective rehabilitation algorithms tailored to an individualised patient profile. The proposed methodology integrates mitochondrial health assessments utilising mitochondrial homeostasis biomarkers in tear fluid as a non-invasive diagnostic tool, tailored nutraceuticals and lifestyle adjustments. The introduced approach aligns with advanced principles of 3PM, offering a holistic and proactive framework for managing persistent post-treatment symptoms of suboptimal health in the cohort of cancer survivors. Furthermore, presented approach is also applicable to pre-habilitation programmes considering needs of other patient cohorts affected by chronic diseases such as CVD and orthopaedic disorders with planned major surgical incisions, who require individually adapted pre- and rehabilitation programmes. Implementing such innovative pre- and rehabilitation strategies may lead to a full recovery, sustainable health conditions and, therefore, facilitating patients’ comeback to normal daily activities, family and professional life. Contextually, presented approach is considered a ‘proof-of-principle’ model for the 3PM-related paradigm shift from reactive medicine to a cost-effective holistic health management in both primary and secondary care benefiting a large spectrum of affected patient cohorts, individuals in suboptimal health conditions as well as society at large.

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Advances in the care of breast cancer survivors

Cited by 4 publications

References 267 publications

Application of fluorocarbon nanoparticles of 131I-fulvestrant as a targeted radiation drug for endocrine therapy on human breast cancer

Application of fluorocarbon nanoparticles of 131I-fulvestrant as a targeted radiation drug for endocrine therapy on human breast cancer

Optimal yoga dose for improving cancer-related fatigue, quality of life, and sleep quality in breast cancer survivors: a Bayesian dose–response meta-analysis

Mitochondria-based holistic 3PM approach as the ‘game-changer’ for individualised rehabilitation—the proof-of-principle model by treated breast cancer survivors

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