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Xinguang Wang, Yingjian He, Tianfeng Wang, Yuntao Xie, Jinfeng Li, Tao Ouyang, Zhaoqing Fan
PURPOSE: The role of long-acting hematopoietic growth factor in supporting dose-dense chemotherapy and minimizing hematologic toxicity has not been established. We investigated the efficacy and safety of once-per-cycle pegfilgrastim in breast cancer patients receiving neoadjuvant dose-dense epirubicin and cyclophosphamide (ddEC). METHODS: Newly diagnosed stage I to III breast cancer patients received four cycles of ddEC (E, 100 mg/m2 and C, 600 mg/m2 every 2 weeks) and 6 mg of subcutaneous pegfilgrastim on day 2 of each cycle...
January 4, 2019: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Andreas Schneeweiss, Volker Möbus, Hans Tesch, Claus Hanusch, Carsten Denkert, Kristina Lübbe, Jens Huober, Peter Klare, Sherko Kümmel, Michael Untch, Karin Kast, Christian Jackisch, Jörg Thomalla, Barbara Ingold-Heppner, Jens-Uwe Blohmer, Mahdi Rezai, Matthias Frank, Knut Engels, Kerstin Rhiem, Peter Andreas Fasching, Valentina Nekljudova, Gunter von Minckwitz, Sibylle Loibl
BACKGROUND: GeparOcto compared efficacy and safety of two chemotherapy regimens in high-risk early breast cancer (BC): sequential treatment with intense dose-dense epirubicin, paclitaxel, and cyclophosphamide (iddEPC) and weekly treatment with paclitaxel plus non-pegylated liposomal doxorubicin (M, Myocet®) with additional carboplatin (PM(Cb)) in triple-negative BC (TNBC). PATIENTS AND METHODS: Patients with cT1c-cT4a-d and centrally assessed human epidermal growth factor receptor (HER)2-positive BC or TNBC were eligible, irrespective of nodal status, luminal B-like tumours only if pN+...
January 2019: European Journal of Cancer
A Matikas, T Foukakis, V Moebus, R Greil, N O Bengtsson, G G Steger, M Untch, H Johansson, M Hellström, P Malmström, M Gnant, S Loibl, J Bergh
Background: Adjuvant chemotherapy (ACT) for breast cancer improves relapse free (BCRFS) and overall survival. Differences in terms of efficacy and toxicity could partly be explained by the significant interpatient variability in pharmacokinetics which cannot be captured by dosing according to body surface area. Consequently, tailored dosing was prospectively evaluated in the PANTHER trial. Patients and methods: PANTHER is a multicenter, open-label, randomized phase III trial which compared tailored, dose dense epirubicin/cyclophosphamide (EC) and docetaxel (D) (tDD) with standard interval 5-fluorouracil/E/C and D...
October 24, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Gun Min Kim, Joo Hoon Kim, Ji Heung Jeong, Young Up Cho, Seung Il Kim, Seho Park, Hyung Seok Park, Ji Ye Kim, Joohyuk Sohn
Purpose: Dose-dense chemotherapy (DD-CT) is a preferred (neo) adjuvant regimen in early breast cancer (BC). Although the results of reported randomized trials are conflicting, a recent meta-analysis showed improved overall and disease-free survival with DD-CT compared to conventional schedules. However, no DD-CT safety data for Korean BC patients are available. This phase II study was conducted to evaluate the safety and efficacy of pegteograstim in Korean BC patients receiving DD-CT...
September 19, 2018: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Rupert Bartsch, Elisabeth Bergen
In the areas of chemotherapy, targeted therapy and immunotherapy, several interesting and clinically relevant data were presented at the 2017 San Antonio Breast Cancer Symposium (SABCS). This short review focuses on dose-dense and/or sequential administration of adjuvant chemotherapy, provides an update on targeted therapies for HER2-positive and triple-negative breast cancer and summarizes new results in the field of immunotherapy.
2018: Memo
Farzaneh Ashrafi, Mehrzad Salmasi
Background: Myelosuppression is one of the frequent side effects of chemotherapy in breast cancer patients. Granulocyte-colony stimulating factor (G-CSF) and pegylated G-CSF are used for the prevention of neutropenia after chemotherapy. Pegylated G-CSF has longer half-life of action and can be used as a single dose in comparison to G-CSF. The aim of this study is to compare the grade of cytopenia and side effects between G-CSF and biosimilar pegylated G-CSF in breast cancer patients treated with dose-dense chemotherapy...
2018: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Omar Najim, Yanina Dockx, Ivan Huyghe, Tim van den Wyngaert, Konstantinos Papadimitriou, Wiebren A A Tjalma, Manon T Huizing
OBJECTIVE: A sentinel Node (SN) has replaced axillary lymph node dissection (ALND) in patients with clinically node negative axilla (cN0). SN after Neo-adjuvant chemotherapy (NACT) is feasible but not accurate in clinically node positive (cN1-3) patients. The goal of this study is to determine the negative predictive value (NPV) of SN in cN0 breast cancer after NACT. A secondary endpoint is to determine if ALND can be avoided after NACT regardless of the pre-treatment clinical staging of the axilla, in case of a normalization of the 18 F-fluoro-2-deoxy-glucose positron emission tomography scan (PET-CT scan)...
October 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
A G J van Rossum, M Kok, E van Werkhoven, M Opdam, I A M Mandjes, A E van Leeuwen-Stok, H van Tinteren, A L T Imholz, J E A Portielje, M M E M Bos, A van Bochove, J Wesseling, E J Rutgers, S C Linn, H M Oosterkamp
BACKGROUND: Dose-dense administration of chemotherapy and the addition of taxanes to anthracycline-based adjuvant chemotherapy have improved breast cancer survival substantially. However, clinical trials directly comparing the additive value of taxanes with dose-dense anthracycline-based chemotherapy are lacking. PATIENTS AND METHODS: In the multicentre, randomised, biomarker discovery Microarray Analysis in breast cancer to Tailor Adjuvant Drugs Or Regimens (MATADOR) trial, patients with pT1-3, pN0-3 breast cancer were randomised (1:1) between six adjuvant cycles of doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2 every 2 weeks (ddAC) and six cycles of docetaxel 75 mg/m2 , doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2 every 3 weeks (TAC)...
October 2018: European Journal of Cancer
Florence Van Ryckeghem, Chloë Haverbeke, Wim Wynendaele, Guy Jerusalem, Luc Somers, Anke Van den Broeck, Sofie Vingerhoedt, Simon Van Belle
PURPOSE: To prevent febrile neutropenia (FN), European Organisation for Research and Treatment of Cancer (EORTC) guidelines recommend primary prophylaxis with granulocyte colony-stimulating factors (PPG) for patients at high risk (≥ 20%) of FN. In Belgium, the use of PPG is restricted by specific reimbursement criteria. The impact of these criteria on PPG use and adherence to guidelines is unknown. METHODS: This multicentre, cross-sectional, observational study aimed to describe PPG use by FN risk category in breast cancer patients who were scheduled to receive myelosuppressive chemotherapy in outpatient clinics in Belgium during a 2-week period between 13 October and 12 December 2014...
August 11, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
John Hilton, Carol Stober, Sasha Mazzarello, Lisa Vandermeer, Dean Fergusson, Brian Hutton, Mark Clemons
INTRODUCTION: Despite the importance of chemotherapy in the treatment of early stage triple negative breast cancer (TNBC), no one optimal regimen has been identified. We conducted a pilot trial comparing outcomes for the three most commonly used chemotherapy regimens to assess the feasibility of conducting a larger definitive trial. METHODS: Using integrated consent, newly diagnosed TNBC patients were randomised to one of three standard regimens: dose-dense doxorubicin-cyclophosphamide then paclitaxel, doxorubicin-cyclophosphamide then weekly paclitaxel or 5-FU-epirubicin-cyclophosphamide then docetaxel...
2018: PloS One
Kathy D Miller, Anne O'Neill, William Gradishar, Timothy J Hobday, Lori J Goldstein, Ingrid A Mayer, Stuart Bloom, Adam M Brufsky, Amye J Tevaarwerk, Joseph A Sparano, Nguyet Anh Le-Lindqwister, Carolyn B Hendricks, Donald W Northfelt, Chau T Dang, George W Sledge
Purpose Bevacizumab improves progression-free survival but not overall survival in patients with metastatic breast cancer. E5103 tested the effect of bevacizumab in the adjuvant setting in patients with human epidermal growth factor receptor 2-negative disease. Patients and Methods Patients were assigned 1:2:2 to receive placebo with doxorubicin and cyclophosphamide (AC) followed by weekly paclitaxel (arm A), bevacizumab only during AC and paclitaxel (arm B), or bevacizumab during AC and paclitaxel followed by bevacizumab monotherapy for 10 cycles (arm C)...
September 1, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Wenqi Zhou, Shizhe Chen, Faliang Xu, Xiaohua Zeng
BACKGROUND: Dose-dense chemotherapy is a widely accepted regimen for high-risk breast cancer patients. However, conflicting survival benefits of pure dose-dense chemotherapy have been reported in different randomized controlled trials (RCTs). This meta-analysis aimed to further assess the efficacy and safety of pure dose-dense chemotherapy in breast cancer. METHODS: A literature search of electronic databases and websites was performed to identify phase III RCTs reporting the efficacy and toxicity of pure dose-dense chemotherapy...
July 14, 2018: World Journal of Surgical Oncology
Hitomi Mori, Makoto Kubo, Masaya Kai, Kanako Kurata, Mai Yamada, Masafumi Nakamura
BACKGROUND/AIM: The dose-dense doxorubicin and cyclophosphamide (ddAC) for patients with HER-2-negative breast cancer is recommended by the National Comprehensive Cancer Network guideline in US. However, there are little data on serum G-CSF concentrations in patients undergoing bi-weekly dose-dense therapy with pegfilgrastim. The objective of this study was to compare the serum G-CSF concentrations in patients receiving pegfilgrastim in bi- or tri-weekly regimens. PATIENTS AND METHODS: This study included 26 patients who received ddAC or docetaxel and cyclophosphamide (TC) for primary breast cancer...
July 2018: Anticancer Research
Daisuke Takabatake, Yukiko Kajiwara, Shoichiro Ohtani, Yoko Itano, Mari Yamamoto, Shinichiro Kubo, Masahiko Ikeda, Mina Takahashi, Fumikata Hara, Kenjiro Aogi, Shozo Ohsumi, Yutaka Ogasawara, Yoshitaka Nishiyama, Hajime Hikino, Kinya Matsuoka, Yuko Takahashi, Tadahiko Shien, Naruto Taira, Hiroyoshi Doihara
BACKGROUND: Perioperative dose-dense chemotherapy (DDCT) with granulocyte-colony stimulating factor (G-CSF) prophylaxis is a standard treatment for patients with high-risk breast cancer. The approval of this approach in Japan led to the widespread adoption of DDCT, despite limited efficacy and safety data among Japanese patients. We evaluated the efficacy and safety of neoadjuvant DDCT for Japanese patients with breast cancer. METHODS: This prospective, multicenter, phase II study evaluated 52 women with operable human epidermal growth factor receptor 2-negative breast cancer and axillary lymph node metastasis...
November 2018: Breast Cancer: the Journal of the Japanese Breast Cancer Society
Valentina Cocciolone, Katia Cannita, Alessandra Tessitore, Valentina Mastroiaco, Lucia Rinaldi, Stefania Paradisi, Azzurra Irelli, Paola Lanfiuti Baldi, Tina Sidoni, Enrico Ricevuto, Antonella Dal Mas, Giuseppe Calvisi, Gino Coletti, Antonietta Ciccozzi, Laura Pizzorno, Valter Resta, Alberto Bafile, Edoardo Alesse, Corrado Ficorella
Background: Dose-dense chemotherapy is one of the treatments of choice for neoadjuvant therapy in breast cancer (BC). Activating mutations in PIK3CA gene predict worse response to neoadjuvant chemotherapy for HER2-positive patients, while their role is less clearly defined for HER2-negative tumors. Methods: We conducted a phase I/II study of neoadjuvant, sequential, dose-dense anthracycline/taxane chemotherapy, plus trastuzumab in HER2-positive patients and investigated the correlation of pre-treatment PIK3CA mutation status with pathologic complete response (pCR) and long-term outcome in a real-life setting...
June 8, 2018: Oncotarget
Karen A Cadoo, Peter A Kaufman, Andrew D Seidman, Cassandra Chang, Dongyuan Xing, Tiffany A Traina
BACKGROUND: Eribulin has significantly improved overall survival for patients with metastatic breast cancer who received ≥ 2 prior chemotherapy regimens for advanced disease. This trial assessed eribulin as adjuvant therapy for patients with early-stage breast cancer. PATIENTS AND METHODS: Patients with human epidermal growth factor receptor 2-negative, stage I to III breast cancer received doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2 provided intravenously on day 1 of each 14-day cycle for 4 cycles, with pegfilgrastim on day 2, followed by 4 cycles of eribulin mesylate 1...
April 7, 2018: Clinical Breast Cancer
Tal Sella, Einav Nili Gal Yam, Keren Levanon, Tal Shapira Rotenberg, Moran Gadot, Iryna Kuchuk, Rinat Bernstein Molho, Amit Itai, Tami Mekel Modiano, Raya Gold, Bella Kaufman, Shani Paluch Shimon
PURPOSE: The addition of carboplatin (Cb) to neoadjuvant chemotherapy in triple-negative breast cancer (TNBC) has been demonstrated to improve pathologic complete response (pCR) at the expense of increased toxicity. We aimed to evaluate the effectiveness and tolerability of dose-dense anthracycline & cyclophosphamide (ddAC) followed by weekly paclitaxel (wT) in combination with weekly Cb. METHODS: Retrospective data was collected on patients with clinical stage I-III TNBC treated with neoadjuvant ddAC-wTCb (four cycles of ddA 60 mg/m2 and ddC 600 mg/m2 every 2 weeks followed by 12 cycles of wT 80 mg/m2 with Cb AUC 1...
August 2018: Breast: Official Journal of the European Society of Mastology
Heather Katz, Hassaan Jafri, Thomas Dougherty, Yehuda Lebowicz
Metaplastic breast cancer (MBC) in men is an extremely rare entity. MBC is typically very aggressive with a poor prognosis. In men, it has only been reported three times in the literature. We report a 47-year-old man who presented with right-sided breast erythema and nipple inversion. Mammogram revealed a 2.4 cm spiculated mass. Initial pathology was inconclusive; however, right-sided simple mastectomy showed invasive metaplastic carcinoma with adenosquamous histology. He received adjuvant chemotherapy with 4 cycles of dose dense Adriamycin and cyclophosphamide followed by 12 weeks of paclitaxel and chest wall radiation...
March 7, 2018: BMJ Case Reports
Dong Hoon Suh, Miseon Kim, Kyung Hun Lee, Keun Yong Eom, Maj Kamille Kjeldsen, Mansoor Raza Mirza, Jae Weon Kim
In 2017, 10 topics were selected as major clinical research advances in gynecologic oncology. For cervical cancer, efficacy and safety analysis results of a 9-valent human papillomavirus (HPV) vaccine and long-term impact of reduced dose of quadrivalent vaccine were updated. Brief introduction of KEYNOTE trials of pembrolizumab, a monoclonal antibody that blocks the interaction between programmed death (PD)-1 and its ligands, PD-L1 and PD-L2, followed. Tailored surveillance programs for gynecologic cancer related with Lynch syndrome and update on sentinel lymph node mapping were reviewed for uterine corpus cancer...
March 2018: Journal of Gynecologic Oncology
Hadar Goldvaser, Habeeb Majeed, Domen Ribnikar, Boštjan Šeruga, Alberto Ocaña, David W Cescon, Eitan Amir
PURPOSE: Results from clinical trials of adjuvant dose-dense chemotherapy in patients with breast cancer are inconsistent. METHODS: A systematic search of MEDLINE identified studies comparing the efficacy of dose-dense adjuvant chemotherapy to a standard treatment. The primary analysis included studies that used identical regimens in the experimental and control groups, but varied only dose density. A secondary analysis included studies that used either different drugs or doses in the experimental and the control groups...
June 2018: Breast Cancer Research and Treatment
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