Effect of preoperative chemotherapy on the outcome of women with operable breast cancer.

Fisher, Bernard; Bryant, John; Wolmark, Norman; Mamounas, E.P.; Brown, A; Fisher, Edwin R.; Wickerham, D. Lawrence; Begovič, Mirsada; DeCillis, Arthur P.; Robidoux, André; Margolese, Richard G.; Cruz, Anatolio B.; Hoehn, James L.; Lees, Alan; Dimitrov, Nikolay V.; Bear, Harry D.

doi:10.1200/jco.1998.16.8.2672

Cited by 1,981 publications

(1,373 citation statements)

References 14 publications

Supporting

Mentioning

1,246

Contrasting

Unclassified

Order By: Relevance

“…Evidence suggests that a pCR correlates with better survival, and it may serve as a surrogate marker of clinical benefit. 24,25 Factors like hormone receptor status play a part in attaining a pCR with neoadjuvant chemotherapy. Patients with ER-negative tumors are more likely to achieve a pCR after neoadjuvant chemotherapy than those with ER-positive tumors.…”

Section: Evaluating the Efficacy Of Neoadjuvant Therapymentioning

confidence: 99%

Trastuzumab‐based neoadjuvant therapy in patients with HER2‐positive breast cancer

Chang

2010

Cancer

View full text Add to dashboard Cite

Overexpression, or gene amplification, of the human epidermal growth factor receptor 2 (HER2) is evident in 20% to 25% of breast cancers. The biologic agent trastuzumab is an HER2-targeted monoclonal antibody that inhibits the proliferation of tumor cells and induces tumor cell death through multiple mechanisms of action. Currently, trastuzumab is approved for use in the adjuvant and metastatic settings. Trials combining trastuzumab with neoadjuvant chemotherapy suggest that patients with HER2-positive breast cancer also may benefit from preoperative trastuzumab. For this article, the author reviewed efficacy and safety data from key studies of patients who received neoadjuvant trastuzumab-based therapy. Studies were identified from literature searches of publication and congress databases. The results of 3 large phase 3 trials (the M. D. Anderson Cancer Center neoadjuvant trastuzumab trial, the Neoadjuvant Herceptin [NOAH] trial, and the German Breast Group/Gynecologic Oncology Study Group ''GeparQuattro'' trial) demonstrated that, compared with chemotherapy alone, neoadjuvant trastuzumab plus chemotherapy significantly increased pathologic complete response rates to as high as 65%. Improvements in disease-free, overall, and event-free survival also were reported in the NOAH trial. In addition to demonstrated efficacy, a low incidence of cardiac dysfunction suggests that neoadjuvant trastuzumab is both effective and well tolerated. Similar results have been reported in a range of phase 2 studies using different trastuzumab-based regimens. These encouraging data led the National Comprehensive Cancer Network to recommend treating patients who have operable, locally advanced, HER2-positive breast cancer with neoadjuvant paclitaxel plus trastuzumab followed by 5-fluorouracil, epirubicin, and cyclophosphamide plus trastuzumab. Cancer 2010;116:2856-67. V C 2010 American Cancer Society.KEYWORDS: neoadjuvant, trastuzumab, HER-2, chemotherapy, biologic, breast cancer, breast conservation surgery, lymph node management.Breast cancer (BC) is the most frequently diagnosed form of cancer among women in the United States. 1 Of the various subtypes of BC, tumors that have gene amplification or protein overexpression of human epidermal growth factor receptor 2 (HER2) are among the most aggressive and are associated with poor clinical outcomes compared with tumors that do not have HER2 overexpression. 2-4 Of the total number of patients diagnosed with BC in the United States, 20% to 25% will have tumors that exhibit HER2 gene amplification or protein overexpression. 2,5,6 Trastuzumab (Herceptin), a humanized, monoclonal antibody that blocks the activity of HER2, is the only anti-HER2 agent that is approved for adjuvant therapy in patients who have HER2-positive disease with either positive or negative lymph node status, estrogen receptor (ER)/progesterone receptor (PR)-negative disease, or a high-risk feature, either in combination with chemotherapy or as a single agent after chemotherapy. Adjuvant trastuzumab significantly imp...

show abstract

Section: Evaluating the Efficacy Of Neoadjuvant Therapymentioning

confidence: 99%

Trastuzumab‐based neoadjuvant therapy in patients with HER2‐positive breast cancer

Chang

2010

Cancer

View full text Add to dashboard Cite

show abstract

“…The neoadjuvant and adjuvant chemotherapy comprise different drug combinations, according to the individual patient situation. Although the neoadjuvant therapy has not demonstrated convincing evidence regarding survival benefit (1–6), it has certain advantages, such as downstaging of an inoperable cancer to an operable one, increasing the possibility of breast-conserving surgery and potentially reducing the risk of metastatic disease (1,7). Although the type of therapy is important for survival and quality of life after treatment, the prognosis prior to treatment initiation and the monitoring of the outcome following treatment are equally important.…”

Section: Introductionmentioning

confidence: 99%

Serum thymidine kinase 1 levels predict cancer-free survival following neoadjuvant, surgical and adjuvant treatment of patients with locally advanced breast cancer

Chen

Tang

Xia

et al. 2013

Molecular and Clinical Oncology

View full text Add to dashboard Cite

In this study, the use of serum thymidine kinase 1 protein (STK1p) concentration for the prognosis of the overall survival of patients with locally advanced breast cancer (n=51) following routine treatment (neoadjuvant treatment, surgery and chemotherapy) was investigated. The patients were followed up for 44 months and the STK1p values were determined by a high-sensitivity enhanced chemiluminescence (ECL) dot blot assay. The variables investigated in relation to metastasis and survival were STK1p, clinical stage, tumor size and age, by the Kaplan-Meier method, the log-rank test and Cox uni- and multivariate analyses. Patients with high STK1p values (≥2.0 pM) 3–6 months after surgery exhibited a positive correlation to clinical stage, tumor size, occurrence of metastasis and survival. The hazard risk for the development of metastatic disease and mortality among breast cancer patients was 11–12 times higher in patients with high compared to those with low STK1p values (<2.0 pM). Notably, patients with stage III/IV disease and low STK1p values exhibited statistically significantly improved survival compared to patients with high STK1p values. A multivariate Cox analysis demonstrated that the STK1p levels 6 months after surgery was the only independent prognostic factor for metastasis and survival. In conclusion, STK1p is a prognostic marker in patients with locally advanced breast cancer and it may help identify a subgroup of stage III/IV patients with improved cancer-free survival expectancy, enabling personalized treatment.

show abstract

“…Results from the NSABP B-18 study confirmed that neoadjuvant and adjuvant chemotherapy are equally effective on locoregional disease in women with operable breast cancer. Moreover, this study demonstrated that clinical and pathological response to neoadjuvant chemotherapy is predictive of patient outcome (Fisher et al, 1997(Fisher et al, , 1998. However, the failure of a number of tumours to respond to treatment and the appearance of resistant tumour cell populations upon relapse of an originally responsive malignancy are still major impediments to successful chemotherapy.…”

mentioning

confidence: 96%

Expression of Endothelin-A-Receptor predicts unfavourable response to neoadjuvant chemotherapy in locally advanced breast cancer

et al. 2004

View full text Add to dashboard Cite

Endothelin-1 (ET-1) and its receptors (ET A R and ET B R), referred to as the endothelin (ET) axis, are overexpressed in breast carcinomas and appear to influence tumour growth and progression. The objective of this study was to determine the effect of expression of the ET axis in breast carcinomas on response to cytotoxic chemotherapy. The study included 44 patients with locally advanced breast cancer participating in a prospective phase III study evaluating high-dose neoadjuvant chemotherapy of epirubicin and cyclophosphamide. Expression of ET-1, ET A R and ET B R was determined by semiquantitative immunohistochemical analysis of breast cancer tissue from prechemotherapy tru-cut biopsies. Immunohistochemical staining was positive for ET-1 in 61.5%, for ET A R in 35% and for ET B R in 35.9% of breast carcinomas. Pathological response to chemotherapy was significantly decreased in ET A Rpositive patients (P ¼ 0.002). In total, 50% of ET A R-positive patients as compared to 7.7% of ET A R-negative patients attained pathologically 'no change'. Logistic regression confirmed ET A R as an independent predictive marker for pathological response (P ¼ 0.009). These data indicate that increased expression of ET A R in breast carcinomas is associated with resistance to chemotherapy. Determination of ET A R status may serve as a predictive marker for identifying patients less likely to be responsive to conventional chemotherapy.

show abstract

Effect of preoperative chemotherapy on the outcome of women with operable breast cancer.

Cited by 1,981 publications

References 14 publications

Trastuzumab‐based neoadjuvant therapy in patients with HER2‐positive breast cancer

Trastuzumab‐based neoadjuvant therapy in patients with HER2‐positive breast cancer

Serum thymidine kinase 1 levels predict cancer-free survival following neoadjuvant, surgical and adjuvant treatment of patients with locally advanced breast cancer

Expression of Endothelin-A-Receptor predicts unfavourable response to neoadjuvant chemotherapy in locally advanced breast cancer

Contact Info

Product

Resources

About