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Breast Imaging with Radiolabeled Antibodies
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Lamk M. Lamki, Bruce J. Barron
Other potential uses of the radiolabeled antibodies in breast cancer management include radioimmuno-guided surgery with a gamma probe. While there have been some studies demonstrating the utility of RIGS in colorectal surgery, the utility of intraoperative detection of involved lymph nodes, in patients with breast cancer, has yet to be evaluated. Intraoperative probe for detection of concentration of radiolabeled antibody in lymph nodes is now available and already being used by many breast surgeons. This can make the surgery more complete, with removal of all diseased nodes.
Breast Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Amy Case, Gwenllian Edwards, Catherine Pembroke
The two main surgical options in breast cancer management are BCS in conjunction with adjuvant radiotherapy and mastectomy. Randomized trials have supported equivalent survival between the two methods when BCS is combined with radiotherapy in early-stage disease.48 The main advantage of BCS over mastectomy is a more cosmetically acceptable breast post-surgically. It is best clinical practice to offer the patient choice between the two methods if appropriate. Absolute contraindications to BCS and radiotherapy include multicentric disease, large tumor to breast size (although neoadjuvant chemotherapy may be considered), diffuse microcalcifications on imaging, or previous radiotherapy affecting the breast. Special clinical consideration should be given to patients who are pregnant (as radiotherapy is contraindicated), although BCS could potentially be performed in the third trimester and radiotherapy postnatally. Patients with connective tissue disorders may not be suitable for radiotherapy as long-term radiation complications may be exacerbated in this group.49
Predictive Markers for Targeted Breast Cancer Treatment
Published in Brian Leyland-Jones, Pharmacogenetics of Breast Cancer, 2020
Hans Christian B. Pedersen, John M. S. Bartlett
ERα and progesterone receptor (PR) status were the first predictive markers used in the clinic to select patients for breast cancer treatment. Today, IHC ERα or PR staining is done routinely on patient tumor samples to predict response to endocrine therapy. More correctly, the assay is used to exclude ERα- or PR- negative patients from ERα- or PR-targeted therapy, as they will have a low probability of responding to treatment (3). Historically however, ERα was first discovered in the late 1960s on its ability to bind radiolabeled ligand (4,5). Within 10 years of its initial discovery, assays had been developed that allowed ER to be used a marker for hormonal responsiveness and clinical aggressiveness of the tumor (6). Many years passed before it was realized that only ERα-positive patients could benefit from treatment and for these finding to be applied as clinical practice (3). It is now almost universally accepted that ERα testing has a central role in breast cancer management, but it is worth noting that no prospective trial has yet tested the predictive value of ERα or PR as predictive biomarkers. Later evidence has emerged supporting testing for PR as well as ERα (7). PR is a transcriptional target of ligand-bound ERα, and it is has been proved that including the PR score in the ERα score provides stronger evidence for true ERα positivity and therefore makes patients more likely to respond to therapy (8–10). However, controversy remains over the value of supplementary markers to ERα, and in several countries, PR testing in not routinely performed.
Increasing importance of breast cancer in Nepal
Published in Hospital Practice, 2022
Ruqaiyyah Siddiqui, Ajnish Ghimire, Jibran Sualeh Muhammad, Naveed Ahmed Khan
In a recent study, breast cancer management quality indicators were investigated in Bhaktapur Cancer Hospital, Bhaktapur, Nepal, which is a public hospital that provides cancer treatment at highly subsidized costs [83]. Several factors were investigated and it was revealed that financial and educational status of patients as well as logistic issues such as arrangement of temporary accommodation near the hospital and lack of family support may reduce quality. This was further exacerbated by the relatively high cost for chemotherapy and management of side effects, leading to lower compliance of completion of treatment in patients [83]. In addition, investigations like immunohistochemistry for hormonal status markers and bone scans were not available at this hospital, leading to an increase in cost due to outsourcing these investigations or not completing them [83]. Prospective quality improvement studies should be conducted at other hospitals in Nepal and are planned in Bhaktapur hospital. This will be useful in developing guidelines for breast cancer management as well as incorporating quality controls [83].
Role of miRNAs in regulating responses to radiotherapy in human breast cancer
Published in International Journal of Radiation Biology, 2021
Zhi Xiong Chong, Swee Keong Yeap, Wan Yong Ho
As compared to other therapeutic options such as chemotherapy, hormonal and targeted therapies, the number of studies aimed to investigate the relationship between miRNAs and treatment response toward radiotherapy appeared to be surprisingly low compared to other forms of treatment. In this review, we aimed to summarize the findings from various in vitro, in vivo and clinical studies on how miRNAs regulate radiosensitivity and radioresistance in human breast cancer cells. In this article, we presented an overview of the miRNAs that were reported to play essential roles in regulating radiosensitivity and radioresistance, along with the affected cellular pathways. We also provided a brief explanation of the current treatment options available in breast cancer management, followed by the mechanism of radiotherapy and the development of radioresistance. Moreover, a summary of the recent clinical studies aimed to study the roles of miRNAs in human breast cancer management was also discussed.
CD19-targeting fusion protein combined with PD1 antibody enhances anti-tumor immunity in mouse models
Published in OncoImmunology, 2020
Zhuangwei Lv, Ping Zhang, Dandan Li, Mengting Qin, Longzhu Nie, Xiaoqian Wang, Li Ai, Zhaozu Feng, Woodvine Otieno Odhiambo, Yunfeng Ma, Yanhong Ji
Breast cancer is the second most common cancer globally, which threatens women’s health.1 Common therapies for breast cancer management include surgery, radiotherapy, chemotherapy, and immunotherapy.2,3 Immunotherapy is a new treatment for breast cancer, inducing the body’s immune system to fight cancer.4,5 The Her2/neu (human epidermal growth factor receptor 2) gene encodes an epidermal growth factor receptor-(EGFR)-related tyrosine kinase that is overexpressed in 20–25% of invasive breast cancers. As such, Her2 has become an important therapeutic target in breast cancer.6 Herceptin, a recombinant humanized monoclonal antibody directed against the extracellular domain (ECD) of the Her2 protein is widely used in oncology for Her2+ patient care.7 However, the objective response rates to Herceptin monotherapy are low, with a median duration of 9 months. Therefore, overcoming antibody tolerance is critical to improve the survival of patients with Her2-overexpressing tumors.3,8 CD8+ T cell responses were found to be effective against these tumors. Thus, generating sustained and active immune responses to the Her2 protein is essential for this existing approach.9,10