- PDQ Cancer Information Summaries: Breast Cancer Treatment (PDQ®): Patient Version [BOOK]
- BOOKNational Cancer Institute (US): Bethesda (MD)
- This PDQ cancer information summary has current information about the treatment of breast cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines…
This PDQ cancer information summary has current information about the treatment of breast cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care. Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.
- NCCN Guidelines Updates: Breast Cancer. [Journal Article]
- JNJ Natl Compr Canc Netw 2019 May 01; 17(5.5):552-555
- Advances in molecular testing have ushered in the new era of precision medicine. The 2018 publication of the TAILORx trial helped refine the use of genetic expression assays, specifically the 21-gene…
Advances in molecular testing have ushered in the new era of precision medicine. The 2018 publication of the TAILORx trial helped refine the use of genetic expression assays, specifically the 21-gene recurrence score, in assigning patients to endocrine therapy alone or with chemotherapy. The NCCN Guidelines for Breast Cancer explore the clinical applications of this study. The algorithm for managing the axilla in early breast cancer has been further refined, based on the presence or absence of clinical evidence of lymph node involvement. Ovarian suppression has been validated as the optimal approach in higher risk premenopausal women, based on updated analysis of the SOFT and TEXT pivotal trials. In the metastatic setting, the NCCN Guidelines further reinforce the benefit of the CDK4/6 inhibitors, extending the "preferred" recommendation to all the available agents in metastatic disease. Options in triple-negative breast cancer now include, for the first time, an immunotherapeutic agent.
- Challenges With the 8th Edition of the AJCC Cancer Staging Manual for Breast, Testicular, and Head and Neck Cancers. [Journal Article]
- JNJ Natl Compr Canc Netw 2019 May 01; 17(5.5):560-564
- Three experts discussed changes in the 8th edition of the AJCC Cancer Staging Manual and challenges regarding these changes for staging of breast cancer, testicular cancer, and head and neck cancer, …
Three experts discussed changes in the 8th edition of the AJCC Cancer Staging Manual and challenges regarding these changes for staging of breast cancer, testicular cancer, and head and neck cancer, respectively. In general, the staging changes for breast cancer and for human papillomavirus-positive oropharyngeal cancer were hailed as improvements, but the changes for testicular cancer were questioned as to their clinical relevance. Better studies are needed to improve staging for human papillomavirus-negative oropharyngeal cancer.
- Mitohormesis Primes Tumor Invasion and Metastasis. [Journal Article]
- CRCell Rep 2019 May 21; 27(8):2292-2303.e6
- Moderate mitochondrial stress can lead to persistent activation of cytoprotective mechanisms - a phenomenon termed mitohormesis. Here, we show that mitohormesis primes a subpopulation of cancer cells…
Moderate mitochondrial stress can lead to persistent activation of cytoprotective mechanisms - a phenomenon termed mitohormesis. Here, we show that mitohormesis primes a subpopulation of cancer cells to basally upregulate mitochondrial stress responses, such as the mitochondrial unfolded protein response (UPRmt) providing an adaptive metastatic advantage. In this subpopulation, UPRmt activation persists in the absence of stress, resulting in reduced oxidative stress indicative of mitohormesis. Mechanistically, we showed that the SIRT3 axis of UPRmt is necessary for invasion and metastasis. In breast cancer patients, a 7-gene UPRmt signature demonstrated that UPRmt-HIGH patients have significantly worse clinical outcomes, including metastasis. Transcriptomic analyses revealed that UPRmt-HIGH patients have expression profiles characterized by metastatic programs and the cytoprotective outcomes of mitohormesis. While mitohormesis is associated with health and longevity in non-pathological settings, these results indicate that it is perniciously used by cancer cells to promote tumor progression.
- Reclassification of breast cancer: Towards improved diagnosis and outcome. [Journal Article]
- PlosPLoS One 2019; 14(5):e0217036
- CONCLUSIONS: We have identified four distinct subgroups of breast cancer using LCA, including one unexpected group with good outcomes despite having the highest average histologic grade and rate of HR- tumours. Deeper understanding of subgroup characteristics can allow us to 1) identify actionable group properties relating to disease biology and patient features and 2) develop group-specific diagnostics and treatments.
- Intravenous versus subcutaneous trastuzumab: an economic and patient perspective. [Journal Article]
- BJBr J Nurs 2019 May 23; 28(10):S15-S20
- Since 2005, when the first patients outside of a clinical trial were treated with trastuzumab at The Christie NHS Foundation Trust, a nurse-led service has been developed to facilitate and support a …
Since 2005, when the first patients outside of a clinical trial were treated with trastuzumab at The Christie NHS Foundation Trust, a nurse-led service has been developed to facilitate and support a safe treatment pathway for patients. There have been significant developments in the number of patients treated, the mode of administration of the drug and patient choice regarding the location of treatment delivery. This article focuses on the change from intravenous to subcutaneous administration, considering patient experience and choice, particularly in light of the advent of biosimilar drugs, which will necessitate a return to the intravenous route. The relative costs of intravenous and subcutaneous administration are illustrated and the results of a patient survey presented, indicating a strong preference for subcutaneous trastuzumab.
- Quality of life and personal resilience in the first two years after breast cancer diagnosis: systematic integrative review. [Journal Article]
- BJBr J Nurs 2019 May 23; 28(10):S4-S14
- The aim of this systematic integrative review was to examine the early impacts of a breast cancer diagnosis (up to 2 years after diagnosis) in relation to quality of life and personal resilience. The…
The aim of this systematic integrative review was to examine the early impacts of a breast cancer diagnosis (up to 2 years after diagnosis) in relation to quality of life and personal resilience. The bibliographic databases of Medline, CINAHL, Cochrane, and Psychology and Behavioral Science Collection were searched using predetermined search criteria. Research studies published up to February 2019 were considered and following appraisal 36 articles were included in the review. Younger age, disease progression at first presentation, personality factors such as optimism, and moderators such as social support, clinical interventions and development of self-management abilities predicted better quality of life and personal resilience. Not recovering from the physical and psychological impacts of a new diagnosis has implications for future mental and physical health. This systematic, integrative review highlighted that building resilience and working with women's strengths should be the focus for contemporary clinical interventions for women in the early period after diagnosis of breast cancer.
- Everolimusinduces G1 cell cycle arrest through autophagy-mediated protein degradation of cyclin D1 in breast cancer cells. [Journal Article]
- AJAm J Physiol Cell Physiol 2019 May 22
- PurposeEverolimusinhibit mammalian target of rapamycin (mTORC1) and are known to cause induction of autophagy and G1 cell cycle arrest. However, it remains unknown whether everolimus-induced autophag…
PurposeEverolimusinhibit mammalian target of rapamycin (mTORC1) and are known to cause induction of autophagy and G1 cell cycle arrest. However, it remains unknown whether everolimus-induced autophagy plays a critical role in its regulation of cell cycle. We, for the first time, suggested that everolimus could stimulate autophagy-mediated Cyclin D1 degradation in breast cancer cells. MethodsEverolimus-induced Cyclin D1 degradation through autophagy pathway was investigated in MCF-10DCIS.COM and MCF-7 cell lines upon autophagy inhibitor treatment using western blot assay. Everolimus stimulated autophagy and decreased Cyclin D1 were also tested in explant human breast tissue.Results Inhibiting mTORC1 with everolimus rapidly increased Cyclin D1 degradation, while 3-Methyladenine, chloroquine and bafilomycin A1, the classic autophagy inhibitors could attenuate everolimus-induced Cyclin D1 degradation. Similarly, knockdown of autophagy related gene 7 (Atg-7) also repressed everolimus-triggered Cyclin D1 degradation. In addition, everolimus-induced autophagy occurred earlier than its induction of G1 arrest and blockade of autophagy attenuated everolimus-induced G1 arrest. We also found that everolimus stimulated autophagy and decreased Cyclin D1 levels in explant human breast tissue. ConclusionsThese data support the conclusion that the autophagy induced by everolimusin human mammary epithelial cells appears to cause Cyclin D1 degradation resulting in G1 cell cycle arrest. Our findings contribute to our knowledge of the interplay between autophagy and cell cycle regulation mediated by mTORC1 signaling and Cyclin D1 regulation.
- Stage II Differentiated Thyroid Cancer Is a High-risk Disease in Patients <45/55 Years Old. [Journal Article]
- JCJ Clin Endocrinol Metab 2019 May 22
- CONCLUSIONS: The mortality risk of stage II DTC is sharply differentiated at patient age 45/55 years, being robustly high in younger patients and comparable with stage III/IVA; this emphasizes the importance of taking age in consideration when managing stage II DTC and not treating it as a uniformly low-risk disease.
New Search Next
- DNA double-strand break repair pathway choice - from basic biology to clinical exploitation. [Journal Article]
- CCCell Cycle 2019 May 22; :1-12
- Mutations in genes encoding components of the DNA damage response (DDR) are among the most frequent aberrations in human tumors. Moreover, a large array of human syndromes is caused by mutations in g…
Mutations in genes encoding components of the DNA damage response (DDR) are among the most frequent aberrations in human tumors. Moreover, a large array of human syndromes is caused by mutations in genes involved in DDR pathways. Among others, homologous recombination repair (HR) of DNA double-strand breaks (DSB) is frequently affected by disabling mutations. While impaired HR is clearly promoting tumorigenesis, it is also associated with an actionable sensitivity against PARP inhibitors. PARP inhibitors have recently received FDA approval for the treatment of breast- and ovarian cancer. However, as with all molecularly targeted agents, acquired resistance limits its use. Both pharmaco-genomic approaches and the study of human genome instability syndromes have led to a profound understanding of PARP inhibitor resistance. These experiments have revealed new insights into the molecular mechanisms that drive mammalian DSB repair. Here, we review recent discoveries in the field and provide a clinical perspective.