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Overview of Traditional Methods of Diagnosis and Treatment for Women-Associated Cancers
Published in Shazia Rashid, Ankur Saxena, Sabia Rashid, Latest Advances in Diagnosis and Treatment of Women-Associated Cancers, 2022
Malika Ranjan, Namyaa Kumar, Safiya Arfi, Shazia Rashid
Breast cancer is the type of cancer originating from the cell lining of the milk-forming ducts of the breast (ductal carcinoma) or from lobules in the glandular tissue of the breast (lobular carcinoma). Breast cancer has several subtypes based on the expression level of the receptors such as progesterone, estrogen and HER-2/neu (human epidermal growth factor receptor), and are classified into three groups [14]: Hormone receptor (estrogen and progesterone) sensitive (ER+ or PR+).Human epidermal growth factor–sensitive (HER2+).Triple-negative breast cancer (ER−, PR−, HER2−).The main factors that influence the risk for breast cancer in women include old age, genetic mutations, reproductive history, personal history of breast/ovarian cancer or any non-cancerous breast diseases, previous treatment involving radiation therapy and other lifestyle factors (diet, weight, alcohol consumption). Thus, regular screening mammography at the age of 40 and above might reduce the risk of breast cancer mortality in average-risk women.
Endocrine Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Adjuvant drug therapy may include the use of chemotherapy, molecularly targeted agents, endocrine therapy, bisphosphonate agents, or the use of biological agents (e.g., antibodies). The decision to use adjuvant drug therapy is usually based on factors including disease prognosis, the risks and benefits of treatment, and predictive factors such as the status of key biomarkers such as the estrogen (ER) and progesterone (PR) receptors, and the presence or absence of HER2. Patients who have low or negligible levels of these three biomarkers are described as having “triple negative” breast cancer (i.e., they are ER-ve/PR-ve/HER2-ve), and this is considered one of the most challenging conditions to successfully treat. There are also a growing number of sophisticated assays available (e.g., Oncotype DXTM, MammostatTM, and MammaPrintTM) to assist clinicians with evaluating prognosis and disease progression through the analysis of mutation profiles in multiple genes, and these are described in Chapter 10.
BRCA Mutation and PARP Inhibitors
Published in Sherry X. Yang, Janet E. Dancey, Handbook of Therapeutic Biomarkers in Cancer, 2021
Arjun Mittra, James H. Doroshow, Alice P. Chen
A phase 1/2 trial of niraparib and thePD-1 inhibitor pembrolizumab in patients with metastatic triple negative breast cancer or recurrent platinum-resistant ovarian cancer, Irrespective of BRCA status has shown promising results. Of a total of 62 women with recurrent platinum-resistant ovarian cancer enrolled, there were 3 complete responses, 8 partial responses, and 28 patients with stable disease [63]. Of the 55 women with metastatic triple-negative breast cancer, 5 had a complete response, 5 had a partial responses and 13 had stable disease [130].
Sex difference in response to non-small cell lung cancer immunotherapy: an updated meta-analysis
Published in Annals of Medicine, 2022
Jiali Liang, Jiaze Hong, Xin Tang, Xinyi Qiu, Keying Zhu, Liyuan Zhou, Dina Guo
As for another therapeutic regimen that is included in this article, the association of chemotherapy plus immunotherapy with better prognosis in female patients has ever been found in triple-negative breast cancer (TNBC). The clinical effect showed that the combination regimen of PD-1/L1 inhibitor plus chemotherapy had a higher success rate in metastatic TNBC (mTNBC) than ICIs alone [36]. Biological studies show that ICIs combined with chemotherapy have the potential to enhance the recognition and elimination of tumour cells by the immune system [37]. Squamous, the main type of NSCLC in male patients, responds poorer to chemotherapy, and lung adenocarcinoma, the main type of NSCLC in female patients, is more sensitive to chemotherapy. Therefore, the sex differences in ICIs plus chemotherapy treatment patterns in the two sexes may mainly stem from the difference in benefit in chemotherapy. Indeed, studies have attributed the poor immunotherapy outcomes observed in female patients to weaker antigenicity in females, and chemotherapy is thought could increase the mutational load of tumours and thus increase the antigenicity of tumour cells [26]. However, the results can only show that males and females benefit differently under different treatment regimens. It is not clear the immunotherapy regimen that females or males could benefit most is ICIs alone or combined with chemotherapy. Therefore, RCTs in males and females compared ICIs alone to ICIs combination chemotherapy may be warranted.
Is the benefit of using adjuvant capecitabine in patients with residual triple-negative breast cancer related to pathological response to neoadjuvant chemotherapy?
Published in Expert Review of Anticancer Therapy, 2022
Özgecan Dülgar, Başak Bala Öven, Muhammed Mustafa Atcı, Rukiye Arıkan, Seval Ay, Murat Ayhan, Oğuzhan Selvi, Deniz Tataroglu Ozyukseler, Ertuğrul Bayram, Erkan Özcan, Ayşe İrem Yasin, Mahmut Gümüş
We collected data from eight cancer centers. Patients with pCR were excluded in 218 patients with TNBC. 160 consecutive patients with treated NAC who had residual tumor were included. All patients had histologically confirmed triple negative breast cancer and residual disease, whose data were collected from medical records retrospectively. Patients who received NAC and achieved pCR were excluded and hormone receptor positive tumors were also excluded. The histopathological characteristics of the patients as patients age, histologic type, menopausal status, clinical stage at diagnosis, nodal stage, Ki 67, histologic grade, surgery type, median residual tumor size, tumor lymphocyte infiltration (TIL), and completion of doses of adjuvant capecitabine were collected from the patients’ file. History and physical examination were performed every 3 months for 2 years, and every 6 months after that until 5 years, then annually for follow-up.
Dietary Phytochemicals as a Potential Source for Targeting Cancer Stem Cells
Published in Cancer Investigation, 2021
Prasath Manogaran, Devan Umapathy, Manochitra Karthikeyan, Karthikkumar Venkatachalam, Anbu Singaravelu
Triple-negative breast cancer (15–20% in total breast cancer patients) is one of the most common cancers in women at the global level (30). The incidence of breast cancerwas estimated in 2020, as per that the 279,100 new cases, and 42,690 deaths were expected in the United States (28). It is incredibly varied and clinically classified into different subtypes based on the status of surface receptors with cancer stem cells properties (31). A recent study has documented that YAP/TAZ is over-expressed in drug resistant cells which required sustaining the self-renewal and tumor-initiation capacities of CSCs (32,33). However, there is a lack of therapeutic targets for YAP/TAZ that lead to resistance for chemotherapeutic drugs, cancer stem cells phenotype, imperfect diagnoses/prognosis process, and bring the mortality rate of the triple-negative is very high. A recent study has confirmed that apigenin disrupted the YAP/TAZ-TEADs protein interaction in triple-negative breast cancer cells with stem cells property that leads to an apoptotic mode of cell death in triple-negative breast cancer cells, therefore, apigenin may act against the triple-negative breast cancer stem cells through the YAP/TAZ activity (34).