Hormone Receptor–Positive/Human Epidermal Growth Receptor 2–Negative Metastatic Breast Cancer in Young Women: Emerging Data in the Era of Molecularly Targeted Agents

Abstract

Breast cancer is the most common malignancy in young women worldwide, accounting for an estimated 30% of new cancer diagnoses and 25% of cancer deaths. Approximately two thirds of young women with breast cancer have hormone receptor–positive (HR+)/human epidermal growth receptor 2–negative (HER2−) tumors. Numerous studies, primarily in early‐stage breast cancer, have demonstrated that young age is an independent risk factor for more aggressive disease and worse outcomes. Although more limited data are available regarding outcomes in young patients with advanced disease, these age‐related disparities suggest that breast cancer in premenopausal women has distinct clinicopathologic and molecular features that can impact treatment outcomes. Until recently, limited data were available on the intrinsic molecular subtypes and genetics of young patients with HR+/HER2− metastatic breast cancer (mBC). In this review, we explore insights into the clinical and pathologic features of HR+/HER2− mBC in younger women derived from recent clinical trials of the cyclin‐dependent kinase 4/6 inhibitors palbociclib (PALOMA‐3), ribociclib (MONALEESA‐7), and abemaciclib (MONARCH 2) and the implications of these findings for clinical practice, guideline development, and future research. Implications for Practice This review provides clinicians with an overview of emerging data on the unique clinicopathologic and molecular features of hormone receptor–positive/human epidermal growth receptor 2–negative metastatic breast cancer (mBC) in premenopausal women, summarizes findings from the most recent clinical trials of endocrine‐based treatment in this patient population, and explores the implications of these findings for clinical practice, guideline development, and future research. Improved understanding of the key factors influencing disease course and treatment response in premenopausal patients with mBC may lead to more timely incorporation of evidence‐based treatment approaches, thereby improving patient care and outcomes.

Breast Cancer Chemotherapeutic Options: A General Overview on the Preclinical Validation of a Multi-Target Ruthenium(III) Complex Lodged in Nucleolipid Nanosystems

“…Among luminal BCs, approximately 80% are ER-positive (estrogen-receptor positive), and about 65% of these are also PR-positive (progesterone-receptor positive) [10]. Luminal A cancers ER/PR-positive and HER-2 negative grow slowly in response to hormone stimulation and so can likely respond to hormone therapy, generally having the best prognosis [11]. Luminal B cancers occur with a quicker growth than luminal A, and their prognosis is slightly worse.…”

Clinical and Pathological Characteristics of Young Female Breast Cancer

“…We also reviewed study which reported that HER2 did not have an prognostic in uence on HR-positive young BC [27]. Age has been de ned as an independent risk factor for survival in BC patients [9,28,29]. Xu et al reported a 95.2% 5-year OS in patients under age 60 (mainly composed of post-menopausal women ) [30].…”

“…Additionally, a higher proportion of endocrine therapy resistance has been reported in young BC patients [9]. The incidence of de novo metastatic breast cancer (dnMBC) is approximately 2.6%, and the metastasis rate of primary early-stage or locally advanced BC is 27.1% in young patients [10].…”

Synthesis, docking study, and in vitro anticancer evaluation of new flufenamic acid derivatives

“…According to the American Cancer Society, there is a substantial increase in cancer rates, particularly in African regions (Jemal et al 2012;Shah et al 2013). Breast cancer is the most common cancer in women worldwide, accounting for 25% of cancer cases (Shah et al 2020).…”