Comprehensive Clinical Characterization of Decade-Long Survivors of Metastatic Breast Cancer

Shin, Junghoon; Kim, Ji-Yeon; Oh, Jung Min; Lee, Jeong Eon; Kim, Seok Won; Nam, Seok Jin; Park, Won; Park, Yeon Hee; Ahn, Jin Seok; Im, Young-Hyuck

doi:10.3390/cancers15194720

Cited by 3 publications

(1 citation statement)

References 39 publications

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“…The lung was the most common site of recurrence, affecting 46.4% of all patients and 61.1% of patients in the hormone receptor-positive/HER2 subgroups. This was followed by recurrence only in distant lymph nodes (37.3%), which was more common in the HER2+ subgroups, and bone metastasis in 30% of all study patients [28]. Unfortunately, a significant number of cancer cases was diagnosed at an advanced stage in developing countries.…”

Section: Discussionmentioning

confidence: 92%

Breast Cancer: Clinical–Epidemiological Profile and Toxicities of Women Receiving Treatment with Taxanes in the Amazon Region

Costa,

Fernandes,

Pereira

et al. 2023

JPM

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Breast cancer is the most common malignant disease and the leading cause of mortality among women worldwide. Antineoplastic chemotherapy is one of its primary treatments, typically based on the class of drugs known as taxanes. Despite their proven therapeutic efficacy, these drugs can induce severe toxicities, leading to dose limitations or even treatment discontinuation. The objective of this study was to describe the clinical–epidemiological profile, risk factors, and toxicities of taxane-based chemotherapy treatment in women with breast cancer in the Amazon region. This is a cross-sectional, quantitative, and descriptive study conducted with 300 women diagnosed with breast cancer undergoing taxane treatment. Most patients were in the 40–49 age range, of brown ethnicity, and had completed elementary school. The majority of patients had risk factors such as alcoholism and a sedentary lifestyles. Most women had their first pregnancy between the ages of 18 and 21, breastfed their children, had menarche between the ages of 12 and 13, and were pre-menopausal and with a family history of cancer. The most frequent histological type was non-special invasive carcinoma and the Luminal B subtype. Most participants in this study showed taxane toxicity, with neurotoxicity being the most frequent. These findings reveal the importance of early detection, comprehensive risk factors, and effective management of treatment toxicities to improve patient outcomes in breast cancer care in the Amazon region.

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Section: Discussionmentioning

confidence: 92%

Breast Cancer: Clinical–Epidemiological Profile and Toxicities of Women Receiving Treatment with Taxanes in the Amazon Region

Costa,

Fernandes,

Pereira

et al. 2023

JPM

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Surviving Twenty Years to Bone and Liver Metastatic Breast Cancer: A Case Reported by Treating Oncologists and the Patient Herself

Valerio,

Gebbia,

Piazza

et al. 2024

Case Rep Oncol

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Introduction: Metastatic breast cancer (MBC) presents an enduring and significant challenge for affected women, requiring sustained commitment over the years. Case Presentation: This paper presents a case of a woman affected by bone and visceral MBC with a very long 20-year survival, excellent quality of life, and high resilience. She is now 51 years old and underwent quadrantectomy for breast cancer in 2005, and in 2013, she developed a recurrence with bone and liver metastases. Despite the widespread stage of the disease with visceral compromise, the patient was treated with a multidisciplinary approach that included surgery, chemotherapy, radiotherapy, hormone therapy, bone target agents, metabolic radiotherapy, and ozone therapy for medication-related osteonecrosis of the jaw. Multidisciplinary management results in a complete clinical and metabolic response to treatment in a visceral metastatic setting. Conclusion: This report supports the possibility of achieving unusual survival outcomes in patients with MBC. This study also highlights the importance of resilience in breast cancer patients who continue to manage their disease and pursue treatment for over 2 decades. Understanding these resilience factors can improve clinical practice and support patients’ long-term care.

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Predictive Modeling of Long-Term Survivors with Stage IV Breast Cancer Using the SEER-Medicare Dataset

Adam,

Wieder

2024

Cancers

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Importance: Treatment of women with stage IV breast cancer (BC) extends population-averaged survival by only a few months. Here, we develop a model for identifying individual circumstances where appropriate therapy will extend survival while minimizing adverse events. Objective: Our goal is to develop high-confidence deep learning (DL) models to predict survival in individual stage IV breast cancer patients based on their unique circumstances generated by patient, cancer, treatment, and adverse event variables. We previously showed that predictive DL survival modeling of potentially curable stage I–III patients can be improved by combining time-fixed and time-varying covariates. Here, we demonstrate that DL-based predictive survival modeling in stage IV patients, where treatment does not offer a cure, can generate accurate individual survival predictions by considering subsequent lines of potential treatment to guide therapy. This guidance is rarely obtainable in the nearly limitless scenarios of metastatic disease. Design, Setting, and Participants: We applied the SEER-Medicare linked dataset from 1991 to 2016 to investigate 14,312 unique stage IV patients with 1,880,153 entries. We used DeepSurv- and DeepHit-, Nnet-survival- and Cox-Time DL-based predictive models to consider the combination of time-fixed and time-varying covariates at each visit for each patient. We adopted random sampling to divide the input dataset into training, validation, and testing sets. We verified the models’ implementation using the pycox package and fine-tuned the models using the open-source library Amazon SageMaker Python SDK 2.232.2 (software development kit). Our results demonstrated the proof of principle of the models by generating individual patients’ survival curves. Conclusions and Relevance: By extending the survival prediction models to consider stage IV BC patients’ time-fixed and time-varying covariates, we achieved a prediction error below 10%. Based on their circumstance-specific situations, these models can predict survival in individual stage IV patients with high confidence. The models will serve as an important adjunct to treatment decisions in patients with stage IV BC and test what-if scenarios of treatment or no treatment options to optimize therapy for extending patient lives and minimizing adverse events.

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Comprehensive Clinical Characterization of Decade-Long Survivors of Metastatic Breast Cancer

Cited by 3 publications

References 39 publications

Breast Cancer: Clinical–Epidemiological Profile and Toxicities of Women Receiving Treatment with Taxanes in the Amazon Region

Breast Cancer: Clinical–Epidemiological Profile and Toxicities of Women Receiving Treatment with Taxanes in the Amazon Region

Surviving Twenty Years to Bone and Liver Metastatic Breast Cancer: A Case Reported by Treating Oncologists and the Patient Herself

Predictive Modeling of Long-Term Survivors with Stage IV Breast Cancer Using the SEER-Medicare Dataset

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