Neoadjuvant Chemotherapy in Breast Cancer: Review of the Evidence and Conditions That Facilitated Its Use during the Global Pandemic

Tse, Tabitha; Sehdev, Sandeep; Seely, Jean M.; Gravel, Denis; Clemons, Mark; Cordeiro, Erin; Arnaout, Angel

doi:10.3390/curroncol28020127

Cited by 11 publications

(9 citation statements)

References 38 publications

(64 reference statements)

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“…Chemotherapy is one of the main treatments of cancer and is usually performed as neoadjuvant and adjuvant therapy (12,13). Although chemotherapy can improve the overall survival and prognosis of cancer patients, chemoresistance remains a clinical obstacle that needs to be overcome due to the diversity, heterogeneity, and adaptability to environmental alters in clinics (14,15).…”

Section: Introductionmentioning

confidence: 99%

The Mechanism of Warburg Effect-Induced Chemoresistance in Cancer

2021

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Although chemotherapy can improve the overall survival and prognosis of cancer patients, chemoresistance remains an obstacle due to the diversity, heterogeneity, and adaptability to environmental alters in clinic. To determine more possibilities for cancer therapy, recent studies have begun to explore changes in the metabolism, especially glycolysis. The Warburg effect is a hallmark of cancer that refers to the preference of cancer cells to metabolize glucose anaerobically rather than aerobically, even under normoxia, which contributes to chemoresistance. However, the association between glycolysis and chemoresistance and molecular mechanisms of glycolysis-induced chemoresistance remains unclear. This review describes the mechanism of glycolysis-induced chemoresistance from the aspects of glycolysis process, signaling pathways, tumor microenvironment, and their interactions. The understanding of how glycolysis induces chemoresistance may provide new molecular targets and concepts for cancer therapy.

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Section: Introductionmentioning

confidence: 99%

The Mechanism of Warburg Effect-Induced Chemoresistance in Cancer

2021

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“…The use of NAC was 13.5% in the Commercial cohort and 6.7% in the Medicare cohort reflecting an increasing trend in NAC utilization, consistent with prior studies. 44 – 46 We found that NAC was associated with a 29% decreased risk of reoperations in the Commercial cohort and a 35% decreased risk in the Medicare cohort. Lower rates of reoperation are expected in this subset of patients as tumor response to neoadjuvant therapy allows for patients to become better candidates for BCS with a higher chance of achieving negative margins.…”

Section: Discussionmentioning

confidence: 75%

Contemporary Analysis of Reexcision and Conversion to Mastectomy Rates and Associated Healthcare Costs for Women Undergoing Breast-Conserving Surgery

Kim,

Ganduglia-Cazaban,

Tamirisa

et al. 2024

Ann Surg Oncol

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Purpose This study was designed to provide a comprehensive and up-to-date understanding of population-level reoperation rates and incremental healthcare costs associated with reoperation for patients who underwent breast-conserving surgery (BCS). Methods This is a retrospective cohort study using Merative™ MarketScan® commercial insurance data and Medicare 5% fee-for-service claims data. The study included females aged 18–64 years in the commercial cohort and females aged 18 years and older in the Medicare cohort, who underwent initial BCS for breast cancer in 2017–2019. Reoperation rates within a year of the initial BCS and overall 1-year healthcare costs stratified by reoperation status were measured. Results The commercial cohort included 17,129 women with a median age of 55 (interquartile range [IQR] 49–59) years, and the Medicare cohort included 6977 women with a median age of 73 (IQR 69–78) years. Overall reoperation rates were 21.1% (95% confidence interval [CI] 20.5–21.8%) for the commercial cohort and 14.9% (95% CI 14.1–15.7%) for the Medicare cohort. In both cohorts, reoperation rates decreased as age increased, and conversion to mastectomy was more prevalent among younger women in the commercial cohort. The mean healthcare costs during 1 year of follow-up from the initial BCS were $95,165 for the commercial cohort and $36,313 for the Medicare cohort. Reoperations were associated with 24% higher costs in both the commercial and Medicare cohorts, which translated into $21,607 and $8559 incremental costs, respectively. Conclusions The rates of reoperation after BCS have remained high and have contributed to increased healthcare costs. Continuing efforts to reduce reoperation need more attention.

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“…Still, this is somewhat counterintuitive, as cytotoxic chemotherapy and radiation are known to be myelosuppressive and surgery as well may predispose to infectious risk 43 . At the same time, we also speculate that many clinicians, when understanding the risk of SARS-CoV-2 infection, were already more careful in only selecting robust patients for cancer therapy and excluding higher risk patients 44 . Given the role of estrogen in enhancing adaptive and humoral immunity, we had hypothesized that patients receiving endocrine therapy would have worse outcomes from COVID-19 24, 25 .…”

Section: Discussionmentioning

confidence: 91%

Factors Associated With Hospitalization Among Breast Cancer Patients With COVID-19: A Diverse Multi-Center Los Angeles Cohort Study

Kathuria‐Prakash

Antrim

Hornstein

et al. 2022

Clinical Breast Cancer

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Background The SARS-CoV-2 virus has infected and killed millions of people worldwide. Breast cancer is the most prevalent cancer in women and few studies have investigated the outcomes of patients with a history of breast cancer and COVID-19. We report the clinical outcomes of patients with invasive breast cancer who tested positive for SARS-CoV-2, including hospitalization and death, and evaluate demographic and cancer-related factors associated with these outcomes. Patients Patients with a history of invasive breast cancer and positive SARS-CoV-2 test from January 1 to December 31, 2020 at two large, academic Los Angeles health systems were included. Methods Retrospective chart review of the electronic medical record was performed. Data for demographic and cancer-related factors were manually abstracted. Relationships between outcomes and clinical variables were evaluated using Fisher's exact test and linear regression analysis. Results Among a total of 132 patients, 40 (30.3%) were hospitalized, while 11 (8.3%) required intensive care support, and 8 patients (6.1%) died. Older age and presence of one or more additional comorbidities were associated with hospitalization and death (p=0.010, p=0.003, p=0.034, p<0.001). Hispanic/Latinx ethnicity was associated with hospitalization (p=0.047). Cancer treatment was not associated with hospitalization or death. Conclusion In our diverse, multi-center, breast cancer cohort, Hispanic/Latinx ethnicity, older age and presence of other comorbidities were associated with worse outcomes from COVID-19. Breast cancer treatment, including surgery, radiation, systemic therapy, and endocrine therapy, was not associated with hospitalization in our cohort. Further studies are needed to explore the relationship between breast cancer and COVID-19 outcomes.

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Neoadjuvant Chemotherapy in Breast Cancer: Review of the Evidence and Conditions That Facilitated Its Use during the Global Pandemic

Cited by 11 publications

References 38 publications

The Mechanism of Warburg Effect-Induced Chemoresistance in Cancer

The Mechanism of Warburg Effect-Induced Chemoresistance in Cancer

Contemporary Analysis of Reexcision and Conversion to Mastectomy Rates and Associated Healthcare Costs for Women Undergoing Breast-Conserving Surgery

Factors Associated With Hospitalization Among Breast Cancer Patients With COVID-19: A Diverse Multi-Center Los Angeles Cohort Study

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