Research

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12 pages, 298 KiB

Open AccessArticle

Breast Cancer: Clinical–Epidemiological Profile and Toxicities of Women Receiving Treatment with Taxanes in the Amazon Region

by Marta Solange Camarinha Ramos Costa, Marianne Rodrigues Fernandes, Esdras Edgar Batista Pereira, Diana Feio da Veiga Borges Leal, Rita de Cássia Calderaro Coelho, Elisa da Silva Menezes, Antônio André Conde Modesto, Paulo Pimentel de Assumpção, Rommel Mario Rodriguez Burbano, Sidney Emanuel Batista dos Santos and Ney Pereira Carneiro dos Santos

J. Pers. Med. 2023, 13(10), 1458; https://doi.org/10.3390/jpm13101458 - 30 Sep 2023

Viewed by 1046

Abstract

Breast cancer is the most common malignant disease and the leading cause of mortality among women worldwide. Antineoplastic chemotherapy is one of its primary treatments, typically based on the class of drugs known as taxanes. Despite their proven therapeutic efficacy, these drugs can [...] Read more.

Breast cancer is the most common malignant disease and the leading cause of mortality among women worldwide. Antineoplastic chemotherapy is one of its primary treatments, typically based on the class of drugs known as taxanes. Despite their proven therapeutic efficacy, these drugs can induce severe toxicities, leading to dose limitations or even treatment discontinuation. The objective of this study was to describe the clinical–epidemiological profile, risk factors, and toxicities of taxane-based chemotherapy treatment in women with breast cancer in the Amazon region. This is a cross-sectional, quantitative, and descriptive study conducted with 300 women diagnosed with breast cancer undergoing taxane treatment. Most patients were in the 40–49 age range, of brown ethnicity, and had completed elementary school. The majority of patients had risk factors such as alcoholism and a sedentary lifestyles. Most women had their first pregnancy between the ages of 18 and 21, breastfed their children, had menarche between the ages of 12 and 13, and were pre-menopausal and with a family history of cancer. The most frequent histological type was non-special invasive carcinoma and the Luminal B subtype. Most participants in this study showed taxane toxicity, with neurotoxicity being the most frequent. These findings reveal the importance of early detection, comprehensive risk factors, and effective management of treatment toxicities to improve patient outcomes in breast cancer care in the Amazon region. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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13 pages, 2905 KiB

Open AccessArticle

Current Situation of Diagnosis and Treatment of HER2-Positive Metastatic Breast Cancer Patients in China: A Nationwide Cross-Sectional Survey of Doctors

by Kuikui Jiang, Danyang Zhou, Ruoxi Hong, Qianyi Lu, Fei Xu, Wen Xia, Qiufan Zheng and Shusen Wang

J. Pers. Med. 2023, 13(2), 365; https://doi.org/10.3390/jpm13020365 - 19 Feb 2023

Viewed by 1796

Abstract

Background: The Advanced Breast Cancer Alliance conducted a nationwide investigation to understand the current situation of the diagnosis and treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) patients. Methods: In 2019, electronic questionnaires including basic information about respondents, [...] Read more.

Background: The Advanced Breast Cancer Alliance conducted a nationwide investigation to understand the current situation of the diagnosis and treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) patients. Methods: In 2019, electronic questionnaires including basic information about respondents, characteristics of patients, and the present status of diagnosis and treatment were sent to 495 doctors from 203 medical centers covering 28 provinces. Results: The factors that influenced treatment plans included the disease process, the performance status, and the economic status of patients. Regimens and response to neoadjuvant/adjuvant chemotherapy were important factors in the decision of the first-line treatment. Overall, 54% of doctors retained trastuzumab and replaced chemotherapy drugs in second-line treatment regimens for patients with progression-free survival (PFS) ≥ 6 months in the first-line setting, while 52% of participants chose pyrotinib plus capecitabine for patients with PFS < 6 months. Economic factors played an important role in doctors’ decision-making and the varying treatment options for respondents in first-tier, second-tier, and other cities. Conclusions: This large-scale survey regarding the diagnosis and treatment of HER2-positive MBC patients revealed that clinical decisions made by Chinese doctors followed the guidelines, but their choices were constrained by economic factors. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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12 pages, 3726 KiB

Open AccessArticle

Dynamic Biobanking for Advancing Breast Cancer Research

by Maryam Abdollahyan, Emanuela Gadaleta, Millahat Asif, Jorge Oscanoa, Rachel Barrow-McGee, Samantha Jones, Louise J Jones and Claude Chelala

J. Pers. Med. 2023, 13(2), 360; https://doi.org/10.3390/jpm13020360 - 18 Feb 2023

Cited by 1 | Viewed by 2058

Abstract

Longitudinal patient biospecimens and data advance breast cancer research through enabling precision medicine approaches for identifying risk, early diagnosis, improved disease management and targeted therapy. Cancer biobanks must evolve to provide not only access to high-quality annotated biospecimens and rich associated data, but [...] Read more.

Longitudinal patient biospecimens and data advance breast cancer research through enabling precision medicine approaches for identifying risk, early diagnosis, improved disease management and targeted therapy. Cancer biobanks must evolve to provide not only access to high-quality annotated biospecimens and rich associated data, but also the tools required to harness these data. We present the Breast Cancer Now Tissue Bank centre at the Barts Cancer Institute as an exemplar of a dynamic biobanking ecosystem that hosts and links longitudinal biospecimens and multimodal data including electronic health records, genomic and imaging data, offered alongside integrated data sharing and analytics tools. We demonstrate how such an ecosystem can inform precision medicine efforts in breast cancer research. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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21 pages, 5410 KiB

Open AccessArticle

Nomograms for Predicting Disease-Free Survival Based on Core Needle Biopsy and Surgical Specimens in Female Breast Cancer Patients with Non-Pathological Complete Response to Neoadjuvant Chemotherapy

by Ailin Lan, Han Li, Junru Chen, Meiying Shen, Yudi Jin, Yuran Dai, Linshan Jiang, Xin Dai, Yang Peng and Shengchun Liu

J. Pers. Med. 2023, 13(2), 249; https://doi.org/10.3390/jpm13020249 - 29 Jan 2023

Viewed by 1160

Abstract

Purpose: While a pathologic complete response (pCR) is regarded as a surrogate endpoint for pos-itive outcomes in breast cancer (BC) patients receiving neoadjuvant chemotherapy (NAC), fore-casting the prognosis of non-pCR patients is still an open issue. This study aimed to create and evaluate [...] Read more.

Purpose: While a pathologic complete response (pCR) is regarded as a surrogate endpoint for pos-itive outcomes in breast cancer (BC) patients receiving neoadjuvant chemotherapy (NAC), fore-casting the prognosis of non-pCR patients is still an open issue. This study aimed to create and evaluate nomogram models for estimating the likelihood of disease-free survival (DFS) for non-pCR patients. Methods: A retrospective analysis of 607 non-pCR BC patients was conducted (2012–2018). After converting continuous variables to categorical variables, variables entering the model were progressively identified by univariate and multivariate Cox regression analyses, and then pre-NAC and post-NAC nomogram models were developed. Regarding their discrimination, ac-curacy, and clinical value, the performance of the models was evaluated by internal and external validation. Two risk assessments were performed for each patient based on two models; patients were separated into different risk groups based on the calculated cut-off values for each model, including low-risk (assessed by the pre-NAC model) to low-risk (assessed by the post-NAC model), high-risk to low-risk, low-risk to high-risk, and high-risk to high-risk groups. The DFS of different groups was assessed using the Kaplan–Meier method. Results: Both pre-NAC and post-NAC nomogram models were built with clinical nodal (cN) status and estrogen receptor (ER), Ki67, and p53 status (all p < 0.05), showing good discrimination and calibration in both internal and external validation. We also assessed the performance of the two models in four subtypes, with the tri-ple-negative subtype showing the best prediction. Patients in the high-risk to high-risk subgroup have significantly poorer survival rates (p < 0.0001). Conclusion: Two robust and effective nomo-grams were developed to personalize the prediction of DFS in non-pCR BC patients treated with NAC. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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11 pages, 1709 KiB

Open AccessArticle

Prognostic Factors for Triple-Negative Breast Cancer with Residual Disease after Neoadjuvant Chemotherapy

by Zhijun Li, Yiqun Han, Jiayu Wang and Binghe Xu

J. Pers. Med. 2023, 13(2), 190; https://doi.org/10.3390/jpm13020190 - 21 Jan 2023

Viewed by 1833

Abstract

Valid factors to evaluate the prognosis of triple-negative breast cancer (TNBC) with residual disease after neoadjuvant chemotherapy (NAC) are still lacking. We performed this study to explore prognostic factors focusing on genetic alterations and clinicopathology features in non- pathologic complete response (pCR) TNBC [...] Read more.

Valid factors to evaluate the prognosis of triple-negative breast cancer (TNBC) with residual disease after neoadjuvant chemotherapy (NAC) are still lacking. We performed this study to explore prognostic factors focusing on genetic alterations and clinicopathology features in non- pathologic complete response (pCR) TNBC patients. Patients initially diagnosed with early-stage TNBC, treated with NAC, and who had residual disease after primary tumor surgery at the China National Cancer Center during 2016 and 2020 were enrolled. Genomic analyses were performed by targeted sequencing for each tumor sample. Univariable and multivariable analyses were conducted to screen prognostic factors for the survival of patients. Fifty-seven patients were included in our study. Genomic analyses showed that TP53 (41/57, 72%), PIK3CA (12/57, 21%), and MET (7/57, 12%), and PTEN (7/57, 12%) alternations commonly occurred. The clinical TNM (cTNM) stage and PIK3CA status were independent prognostic factors of disease-free survival (DFS) (p < 0.001, p = 0.03). A prognostic stratification indicated that patients with clinical stages I &II possessed the best DFS, followed by those with clinical stage III & wild-type PIK3CA. In contrast, patients with clinical stage III & the PIK3CA mutation had the worst DFS. In TNBC patients with residual disease after NAC, prognostic stratification for DFS was observed by combining the cTNM stage and PIK3CA status. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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23 pages, 14985 KiB

Open AccessArticle

PRLR and CACNA2D1 Impact the Prognosis of Breast Cancer by Regulating Tumor Immunity

by Jiamin Liang, Yu Deng, Yubi Zhang, Bin Wu and Jing Zhou

J. Pers. Med. 2022, 12(12), 2086; https://doi.org/10.3390/jpm12122086 - 19 Dec 2022

Cited by 2 | Viewed by 1527

Abstract

Phosphatase and tensin homolog (PTEN) is one of the highly susceptible genes to breast cancer (BC); however, the role of PTEN-related RNAs in BC remains poorly understood. Understanding the effect of PTEN-related RNAs and their mechanisms may be helpful to clinicians. We screened [...] Read more.

Phosphatase and tensin homolog (PTEN) is one of the highly susceptible genes to breast cancer (BC); however, the role of PTEN-related RNAs in BC remains poorly understood. Understanding the effect of PTEN-related RNAs and their mechanisms may be helpful to clinicians. We screened the differentially expressed RNAs (deRNAs) related to PTEN and established the competitive endogenous RNA (ceRNA) network by integrating several databases. After that, the RNA model, prolactin receptor (PRLR)/calcium voltage-gated channel auxiliary subunit alpha2delta 1 (CACNA2D1), was obtained by KM survival analysis and logistic regression analysis. Finally, mutation, methylation, functional enrichment, and immune correlation were analyzed to explore the roles of these RNAs. Our results showed that PRLR might be harmful to BC, while CACNA2D1 might be beneficial to BC. Furthermore, the abnormal expression of PRLR in BC might result from mutation and hypomethylation, while the aberrant expression of CACNA2D1 might be ascribed to methylation. Mechanistically, PRLR might affect the prognosis of BC by inhibiting the expression of immune checkpoints, while CACNA2D1 might improve the prognosis of BC by increasing the immune cells infiltrating into BC and up-regulating the expression of immune checkpoints. The abnormal expression of PRLR and CACNA2D1 in BC is closely related to the prognosis of BC, and they may serve as targets for the treatment of BC. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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14 pages, 3066 KiB

Open AccessArticle

Discovering Breast Cancer Biomarkers Candidates through mRNA Expression Analysis Based on The Cancer Genome Atlas Database

by Dong Hyeok Kim and Kyung Eun Lee

J. Pers. Med. 2022, 12(10), 1753; https://doi.org/10.3390/jpm12101753 - 21 Oct 2022

Cited by 3 | Viewed by 2147

Abstract

Background: Research on the discovery of tumor biomarkers based on big data analysis is actively being conducted. This study aimed to secure foundational data for identifying new biomarkers of breast cancer via breast cancer datasets in The Cancer Genome Atlas (TCGA). Methods: The [...] Read more.

Background: Research on the discovery of tumor biomarkers based on big data analysis is actively being conducted. This study aimed to secure foundational data for identifying new biomarkers of breast cancer via breast cancer datasets in The Cancer Genome Atlas (TCGA). Methods: The mRNA profiles of 526 breast cancer and 60 adjacent non-cancerous breast tissues collected from TCGA datasets were analyzed via MultiExperiment Viewer and GraphPad Prism. Diagnostic performance was analyzed by identifying the pathological grades of the selected differentially expressed (DE) mRNAs and the expression patterns of molecular subtypes. Results: Via DE mRNA profile analysis, we selected 14 mRNAs with downregulated expression (HADH, CPN2, ADAM33, TDRD10, SNF1LK2, HBA2, KCNIP2, EPB42, PYGM, CEP68, ING3, EMCN, SYF2, and DTWD1) and six mRNAs with upregulated expression (ZNF8, TOMM40, EVPL, EPN3, AP1M2, and SPINT2) in breast cancer tissues compared to that in non-cancerous tissues (p < 0.001). Conclusions: In total, 20 DE mRNAs had an area under cover of 0.9 or higher, demonstrating excellent diagnostic performance in breast cancer. Therefore, the results of this study will provide foundational data for planning preliminary studies to identify new tumor biomarkers. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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13 pages, 1607 KiB

Open AccessEditor’s ChoiceArticle

Clinical Significance of the Histone Deacetylase 2 (HDAC-2) Expression in Human Breast Cancer

by Nikolaos Garmpis, Christos Damaskos, Dimitrios Dimitroulis, Gregory Kouraklis, Anna Garmpi, Panagiotis Sarantis, Evangelos Koustas, Alexandros Patsouras, Iason Psilopatis, Efstathios A. Antoniou, Michail V. Karamouzis, Konstantinos Kontzoglou and Afroditi Nonni

J. Pers. Med. 2022, 12(10), 1672; https://doi.org/10.3390/jpm12101672 - 08 Oct 2022

Cited by 10 | Viewed by 1495

Abstract

Background/Aim: There is a strong association between malignancy and histone deacetylases (HDACs). Histone deacetylase inhibitors (HDACIs) are now being tested as antitumor agents in various clinical trials. We aimed to assess the clinical importance of HDAC-2 in breast cancer (BC). Materials and Methods: [...] Read more.

Background/Aim: There is a strong association between malignancy and histone deacetylases (HDACs). Histone deacetylase inhibitors (HDACIs) are now being tested as antitumor agents in various clinical trials. We aimed to assess the clinical importance of HDAC-2 in breast cancer (BC). Materials and Methods: A total of 118 BC specimens were examined immunohistochemically. A statistical analysis was conducted in order to examine the relation between HDAC-2 and the clinicopathological features and survival of the patients. Results: Higher HDAC-2 expression was related to lobular histological type of cancer, grade III, and stage III BC. In addition, the disease-free period and overall survival were curtailed and negatively related to the over-expression of HDAC-2. Other factors correlating with worse survival were histological types other than ductal or lobular, and the stage of the disease. Conclusions: This study showed a relationship between HDAC-2 and BC. Further studies are required in order to eventually potentiate the role of HDACIs as anticancer agents in BC. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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10 pages, 875 KiB

Open AccessArticle

“No Ink on Tumor” in Breast-Conserving Surgery after Neoadjuvant Chemotherapy

by Giulia Atzori, Marco Gipponi, Chiara Cornacchia, Raquel Diaz, Marco Sparavigna, Maurizio Gallo, Tommaso Ruelle, Federica Murelli, Simonetta Franchelli, Francesca Depaoli, Daniele Friedman and Piero Fregatti

J. Pers. Med. 2022, 12(7), 1031; https://doi.org/10.3390/jpm12071031 - 23 Jun 2022

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Abstract

Background/Aim: Patients with Stage I-II breast cancer undergoing breast-conserving surgery after neoadjuvant chemotherapy (BCS-NAC) were retrospectively assessed in order to evaluate the extent of a safe excision margin. Materials and Methods: Between 2003 and 2020, 151 patients underwent risk-adapted BCS-NAC; margin involvement was [...] Read more.

Background/Aim: Patients with Stage I-II breast cancer undergoing breast-conserving surgery after neoadjuvant chemotherapy (BCS-NAC) were retrospectively assessed in order to evaluate the extent of a safe excision margin. Materials and Methods: Between 2003 and 2020, 151 patients underwent risk-adapted BCS-NAC; margin involvement was always assessed at definitive histology. Patients with complete pathological response (pCR) were classified as the RX group, whereas those with residual disease and negative margins were stratified as R0 < 1 mm (margin < 1 mm) and R0 > 1 mm (margin > 1 mm). Results: Totals of 29 (19.2%), 64 (42.4%), and 58 patients (38.4%) were included in the R0 < 1 mm, R0 > 1 mm, and RX groups, respectively, and 2 patients with margin involvement had a mastectomy. Ten instances of local recurrence (6.6%) occurred, with no statistically significant difference in local recurrence-free survival (LRFS) between the three groups. A statistically significant advantage of disease-free survival (p = 0.002) and overall survival (p = 0.010) was observed in patients with pCR. Conclusions: BCS-NAC was increased, especially in HER-2-positive and triple-negative tumors; risk-adapted BCS should be preferably pursued to highlight the cosmetic benefit of NAC. The similar rate of LRFS in the three groups of patients suggests a shift toward the “no ink on tumor” paradigm for patients undergoing BCS-NAC. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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Review

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18 pages, 869 KiB

Open AccessReview

The Role of Nodes and Nodal Assessment in Diagnosis, Treatment and Prediction in ER+, Node-Positive Breast Cancer

by Charlene Kay, Carlos Martinez-Perez, J. Michael Dixon and Arran K. Turnbull

J. Pers. Med. 2023, 13(10), 1476; https://doi.org/10.3390/jpm13101476 - 08 Oct 2023

Viewed by 1376

Abstract

The majority of breast cancers are oestrogen receptor-positive (ER+). In ER+ cancers, oestrogen acts as a disease driver, so these tumours are likely to be susceptible to endocrine therapy (ET). ET works by blocking the hormone’s synthesis or effect. A significant number of [...] Read more.

The majority of breast cancers are oestrogen receptor-positive (ER+). In ER+ cancers, oestrogen acts as a disease driver, so these tumours are likely to be susceptible to endocrine therapy (ET). ET works by blocking the hormone’s synthesis or effect. A significant number of patients diagnosed with breast cancer will have the spread of tumour cells into regional lymph nodes either at the time of diagnosis, or as a recurrence some years later. Patients with node-positive disease have a poorer prognosis and can respond less well to ET. The nodal metastases may be genomically similar or, as is becoming more evident, may differ from the primary tumour. However, nodal metastatic disease is often not assessed, and treatment decisions are almost always based on biomarkers evaluated in the primary tumour. This review will summarise the evidence in the field on ER+, node-positive breast cancer, including diagnosis, treatment, prognosis and predictive tools. Full article

(This article belongs to the Special Issue New Advances in Clinical and Translational Breast Cancer Research)

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