Molecular subtypes as a predictor of response to neoadjuvant chemotherapy in breast cancer patients

Shanmugam, Subbiah; Govindasamy, Gopu; Senthilkumar, P.; Muniasamy, P.

doi:10.4103/ijc.ijc_238_17

Cited by 16 publications

(9 citation statements)

References 14 publications

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“…Neoadjuvant chemotherapy can convert clinically positive nodes to pathological node negative status in about 40-75% cases [12]- [15]. pCR in our study is similar to the study by Vila et al…”

Section: Discussionsupporting

confidence: 90%

Study of response of axillary lymph nodal metastases toneoadjuvant chemotherapy in carcinoma breast

Sahithi

Muralidhar

Srinivasulu

2022

ijhs

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Background and aim of the study: Our study aims to evaluate pathological response in axillary lymph nodes with neoadjuvant chemotherapy. Absence of invasive disease in breast and axilla after completion of neoadjuvant chemotherapy on histological examination was taken as pathological complete response (pCR). Absence of invasive disease in axilla after completion of chemotherapy on histological examination was taken as pathological complete response in axilla. Materials and Methods: A prospective observational study was conducted on breast cancer patients who were treated at MNJ Institute of Oncology and Regional Cancer Centre for a period of 22 months. A total of 55 with operable breast cancer and cytologically proven axillary lymph node metastases and subsequently received neoadjuvant chemotherapy were considered for this study. All these patients were registered in our hospital and were followed prospectively. Of them, 2 patients defaulted chemotherapy, 3 patients did not visit hospital after completion of chemotherapy and 1patient died due to reason other than carcinoma breast and all these patients were excluded from the study. Results:In this study, we had pathological complete response in breast and axilla in 24.5% of the study population.

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Section: Discussionsupporting

confidence: 90%

Study of response of axillary lymph nodal metastases toneoadjuvant chemotherapy in carcinoma breast

Sahithi

Muralidhar

Srinivasulu

2022

ijhs

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“…Gentile et al in their study observed pCR in 48% cases of HER2 overexpression and 23% cases of triple-negative breast cancer [ 19 ]. Luangdilok et al and Subbiah et al also showed that HER2 overexpression and triple-negative breast cancer subtypes had more pCR as compared to luminal subtypes [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Molecular Subtypes As Emerging Predictors of Clinicopathological Response to Neoadjuvant Chemotherapy (NACT) in Locally Advanced Breast Cancer (LABC): A Single-Centre Experience in Western India

Sharma¹,

Rathore²,

Verma³

et al. 2022

Cureus

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Introduction: Locally advanced breast cancer (LABC) is a subset of breast cancer characterized by the most advanced breast tumours in the absence of distant metastasis. Treatment of LABC has evolved from a single modality treatment to multimodality management. Neoadjuvant chemotherapy (NACT) is increasingly being used to treat patients with LABC. This study assessed tumour response after NACT using clinical changes, Response Evaluation Criteria in Solid Tumors (RECIST) criteria and pathological report. Methodology: This study was a prospective as well as retrospective observational study carried out in the department of general surgery, Dr. Sampurnanand Medical College, Jodhpur. All the patients admitted with stage III (IIIA, IIIB, IIIC) were included in the study after obtaining approval from the institutional ethical committee. Clinical response was assessed by RECIST criteria (clinical complete response (cCR), clinical partial response (cPR), clinical progressive disease (cPD), and clinical stable disease (cSD)) and pathological response by histopathological report (pCR). Response of various molecular subtypes was noted. Results: Among 31 patients included in the study, cCR observed in 22.58% cases, cPR observed in 61.29% cases while cPD and cSD seen in 3.22% and 12.90% cases, respectively. Pathological complete response (pCR) observed in 19.35% cases. Favourable response seen with human epidermal growth factor receptor 2 (HER2) overexpression (cCR = 50%, pCR = 37.50%) followed by triple negative (cCR = 25%, pCR = 25%) molecular subtypes. Conclusions: It can be concluded that molecular subtype determination helps in deciding treatment protocol in patients with LABC with HER2 overexpression and triple-negative breast cancers having a better clinicopathological response to NACT than luminal subtypes. NACT results in downstaging of tumours, thus, help in achieving surgically clear margins and elimination of micrometastases which decreases the recurrence rates and morbidity/mortality of patients.

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“…Identifying molecular subtypes is a major step towards the selection of the treatment strategy and prediction of the treatment outcome. Based on the presence or absence of the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 status, BCs are classified as HER2+ (ER−,PR−, HER2 overexpressed), luminal A (ER+,PR+, HER2−, Ki 67 low), luminal B (ER+, PR low, HER2−, Ki 67 high), and basal/triple-negative (ER−,PR−, HER2−) subtypes [ 16 ]. Invasive BC, which is positive for either one or more of the three important biomarkers ER, PR, and HER2, can be targeted by hormone-based therapy, whereas tumors that are negative for all three receptors, classified as triple-negative breast cancers (TNBC), do not benefit from hormone-based therapy.…”

Section: Altered Glucose Metabolism In Different Subtypes Of Bcmentioning

confidence: 99%

Targeting Glucose Metabolism to Overcome Resistance to Anticancer Chemotherapy in Breast Cancer

Varghese

Samuel

Líšková

et al. 2020

Cancers

143

101

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Breast cancer (BC) is the most prevalent cancer in women. BC is heterogeneous, with distinct phenotypical and morphological characteristics. These are based on their gene expression profiles, which divide BC into different subtypes, among which the triple-negative breast cancer (TNBC) subtype is the most aggressive one. The growing interest in tumor metabolism emphasizes the role of altered glucose metabolism in driving cancer progression, response to cancer treatment, and its distinct role in therapy resistance. Alterations in glucose metabolism are characterized by increased uptake of glucose, hyperactivated glycolysis, decreased oxidative phosphorylation (OXPHOS) component, and the accumulation of lactate. These deviations are attributed to the upregulation of key glycolytic enzymes and transporters of the glucose metabolic pathway. Key glycolytic enzymes such as hexokinase, lactate dehydrogenase, and enolase are upregulated, thereby conferring resistance towards drugs such as cisplatin, paclitaxel, tamoxifen, and doxorubicin. Besides, drug efflux and detoxification are two energy-dependent mechanisms contributing to resistance. The emergence of resistance to chemotherapy can occur at an early or later stage of the treatment, thus limiting the success and outcome of the therapy. Therefore, understanding the aberrant glucose metabolism in tumors and its link in conferring therapy resistance is essential. Using combinatory treatment with metabolic inhibitors, for example, 2-deoxy-D-glucose (2-DG) and metformin, showed promising results in countering therapy resistance. Newer drug designs such as drugs conjugated to sugars or peptides that utilize the enhanced expression of tumor cell glucose transporters offer selective and efficient drug delivery to cancer cells with less toxicity to healthy cells. Last but not least, naturally occurring compounds of plants defined as phytochemicals manifest a promising approach for the eradication of cancer cells via suppression of essential enzymes or other compartments associated with glycolysis. Their benefits for human health open new opportunities in therapeutic intervention, either alone or in combination with chemotherapeutic drugs. Importantly, phytochemicals as efficacious instruments of anticancer therapy can suppress events leading to chemoresistance of cancer cells. Here, we review the current knowledge of altered glucose metabolism in contributing to resistance to classical anticancer drugs in BC treatment and various ways to target the aberrant metabolism that will serve as a promising strategy for chemosensitizing tumors and overcoming resistance in BC.

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Molecular subtypes as a predictor of response to neoadjuvant chemotherapy in breast cancer patients

Cited by 16 publications

References 14 publications

Study of response of axillary lymph nodal metastases toneoadjuvant chemotherapy in carcinoma breast

Study of response of axillary lymph nodal metastases toneoadjuvant chemotherapy in carcinoma breast

Molecular Subtypes As Emerging Predictors of Clinicopathological Response to Neoadjuvant Chemotherapy (NACT) in Locally Advanced Breast Cancer (LABC): A Single-Centre Experience in Western India

Targeting Glucose Metabolism to Overcome Resistance to Anticancer Chemotherapy in Breast Cancer

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