&lt;p&gt;Nab-paclitaxel in pretreated metastatic breast cancer: evaluation of activity, safety, and quality of life&lt;/p&gt;

Luca, Rossella De; Profita, Giuseppe; Cicero, Giuseppe

doi:10.2147/ott.s191519

Cited by 17 publications

(12 citation statements)

References 27 publications

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“…The improved drug delivery system increases intratumoral concentrations while shielding normal, healthy cells from drug toxicities. Clinical trials have shown success with nab-PTX in metastatic breast and pancreatic cancer [ 11 , 12 ], though more research should be done on potential benefits in other cancer types.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of Taxane Resistance

Maloney

Hoover

Morejon-Lasso

et al. 2020

Cancers

126

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The taxane family of chemotherapy drugs has been used to treat a variety of mostly epithelial-derived tumors and remain the first-line treatment for some cancers. Despite the improved survival time and reduction of tumor size observed in some patients, many have no response to the drugs or develop resistance over time. Taxane resistance is multi-faceted and involves multiple pathways in proliferation, apoptosis, metabolism, and the transport of foreign substances. In this review, we dive deeper into hypothesized resistance mechanisms from research during the last decade, with a focus on the cancer types that use taxanes as first-line treatment but frequently develop resistance to them. Furthermore, we will discuss current clinical inhibitors and those yet to be approved that target key pathways or proteins and aim to reverse resistance in combination with taxanes or individually. Lastly, we will highlight taxane response biomarkers, specific genes with monitored expression and correlated with response to taxanes, mentioning those currently being used and those that should be adopted. The future directions of taxanes involve more personalized approaches to treatment by tailoring drug–inhibitor combinations or alternatives depending on levels of resistance biomarkers. We hope that this review will identify gaps in knowledge surrounding taxane resistance that future research or clinical trials can overcome.

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Section: Introductionmentioning

confidence: 99%

Mechanisms of Taxane Resistance

Maloney

Hoover

Morejon-Lasso

et al. 2020

Cancers

126

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“…And metastatic breast cancer by definition is incurable. 7 Our study showed 30% of patients presenting with metastatic disease at the time of the diagnosis whilst 34% had locally advanced disease. Soomro et al 5 retrospectively looked into 10,018 breast cancer patients in a tertiary care center in Karachi Pakistan and reported 28% of patients to have metastatic disease at presentation which is comparable to our study.…”

Section: Discussionmentioning

confidence: 54%

Frequency locally advanced and metastatic breast cancer at the time of presentation in a private hospital in Peshawar.

Ali¹

2019

TPMJ

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Breast cancer is the most common cancer among women and Pakistan has the highest rate of breast cancers in Asia. Breast cancer patients present very late with their symptoms in Pakistan as compared to the developed world. As a result, our survival outcomes are very poor. To estimate the frequency of breast cancer patients presenting with locally advanced and metastatic disease at presentation at our dedicated one-stop breast care unit (BCU) at Rehman Medical Institute Peshawar. Study Design: Observational study. Setting: Rehman Medical Institute Peshawar. Period: 1st January 2018 to 31st December 2018. Material and Methods: Data was prospectively collected of all breast cancer patients presenting to BCU and recorded both electronically and in hard copy, and analysed. Results: A total of 83 patients were identified. 30% of the patients had metastatic disease at presentation while 34% had locally advanced disease. Only 36% had early breast cancer. Conclusion: This study supported the previously reported trend of very late presentation of patients with breast cancer in Pakistan.

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“…Other ionic and block copolymer-based drug modifications are still under study. An albumin-bound paclitaxel, abraxane, has already received FDA approval for treatment of metastatic breast cancers (88). Opaxio/Xyotax, a poly-L-glutamic acid-paclitaxel, is currently under Phase III clinical trials for the treatment of ovarian and esophageal cancers (89).…”

Section: P-gp Substrate and Drug Interactionsmentioning

confidence: 99%

Perplexing Role of P-Glycoprotein in Tumor Microenvironment

2020

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Development of multidrug resistance (MDR) still remains a major obstacle to the long-term success of cancer therapy. P-glycoprotein (P-gp) is a well-identified membrane transporter with capability to efflux drug molecules out of the cancer cell leading to reduced efficiency of chemotherapy. Cancer cells upregulate P-gp expression as an adaptive response to evade chemotherapy mediated cell death. While several P-gp inhibitors have been discovered by in silico and pre-clinical studies, very few have successfully passed all phases of the clinical trials. Studies show that application of P-gp inhibitors in cancer therapy regimen following development of MDR achieved limited beneficial outcomes. While, the non-specific substrate binding to P-gp has made the drug-design a challenge, a bigger perplexing challenge comes from its role in tumor immunology. Expression of P-gp was noted immune cell phenotypes with apparently antagonistic functionality. Both pro-tumor M 2-macrophages and, anti-tumor NK-cell and Th17/CD4 + T cell subsets have shown enhanced expression of P-gp. While drug based inhibition of P-gp in pro-tumor immune cell phenotypes could promote tumor elimination, however, it would not be a rational choice to exert inhibition of P-gp on anti-tumor immune cell phenotypes. This mutually exclusive paradigm of P-gp functionality requires a more comprehensive and detailed understanding of its role in tumor microenvironment with active interplay of cancer and immune cells in the tumor mileu. In this review, we focus on the current understanding of the role of P-gp in cancer cells and immune cells and finally attempt to highlight some caveats in the current understanding of its role in comprehensive tumor microenvironment along with challenges in the development of P-gp inhibitors toward anti-cancer therapy.

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<p>Nab-paclitaxel in pretreated metastatic breast cancer: evaluation of activity, safety, and quality of life</p>

Cited by 17 publications

References 27 publications

Mechanisms of Taxane Resistance

Mechanisms of Taxane Resistance

Frequency locally advanced and metastatic breast cancer at the time of presentation in a private hospital in Peshawar.

Perplexing Role of P-Glycoprotein in Tumor Microenvironment

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