Clinical breast cancer最新文献

{"title":"Effects of Lasofoxifene Versus Fulvestrant on Vaginal and Vulvar Symptoms in Patients With ESR1-Mutated, ER+/HER2-, Metastatic Breast Cancer From the ELAINE 1 Study.","authors":"Shari B Goldfarb, Sarah L Sammons, Jane L Meisel, Timothy J Pluard, Simon N Jenkins, Barry S Komm, Dominic Carroll, David J Portman","doi":"10.1016/j.clbc.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.002","url":null,"abstract":"<p><strong>Background: </strong>Lasofoxifene, a novel endocrine therapy (ET), showed antitumor activity versus fulvestrant in women with ESR1-mutated, metastatic breast cancer (mBC) that progressed on prior ET (phase 2, ELAINE 1 study). We investigated changes in genitourinary syndrome of menopause (GSM) vulvar-vaginal symptoms with lasofoxifene and how patient/disease characteristics affect baseline vulvar-vaginal symptoms in ELAINE 1.</p><p><strong>Methods: </strong>Women were randomized to oral lasofoxifene 5 mg/day or IM fulvestrant 500 mg (days 1, 15, and 29, then every 28 days) until disease progression/severe toxicity. Changes in mean vaginal (VAS) and vulvar (VuAS) assessment scales, and their composite (average of all symptom scores/patient), from baseline to week 16, and mean baseline VAS/VuAS scores by patient/disease characteristics, were descriptively summarized.</p><p><strong>Results: </strong>Of 103 enrolled patients, 72 (70%) completed the VAS/VuAS (mean age 61.5 years). Vaginal (40%)/vulvar (25%) dryness and vaginal pain (22%) were the most frequently reported symptoms; 26% reported ≥1 moderate/severe symptom. Lasofoxifene decreased the mean composite VAS/VuAS, VAS, and VuAS from baseline to week 16 by 74%, 74%, and 79%, respectively; fulvestrant increased them by 36%, 15%, and 63%, respectively. Baseline vaginal/vulvar symptoms were more severe if patients were under age 40, had no visceral disease, used adjuvant tamoxifen previously, or had longer AI duration in the adjuvant/metastatic settings.</p><p><strong>Conclusions: </strong>Oral lasofoxifene (5 mg/day), but not fulvestrant, appears to improve GSM vaginal symptoms in women with mBC. These preliminary findings suggest further study is needed; such will be explored in the phase 3, registrational, ELAINE 3 trial in patients with ESR1-mutated, ER+/HER2- mBC.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutations in Necroptosis-Related Genes Reported in Breast Cancer: A Cosmic and Uniport Database-Based Study.","authors":"Banita Thakur, Rohit Verma, Alka Bhatia","doi":"10.1016/j.clbc.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.008","url":null,"abstract":"<p><p>Breast cancer (BC) now holds the top position as the primary reason of cancer-related fatalities worldwide, overtaking lung cancer. BC is classified into diverse categories depending on histopathological type, hormone receptor status, and gene expression profile, with ongoing evolution in their classifications. Cancer initiates and advances when there is a disruption in cell death pathways. In BC, the primary cell death pathway, apoptosis, experiences dysregulation across multiple stages. Ongoing studies aim to discover therapeutic targets that enhance cancer cell susceptibility to apoptosis. However, resistance to this therapy remains a significant challenge in treating BC. If apoptosis is hindered, investigating alternative pathways for cell death that can effectively eradicate BC cells during treatment becomes a valuable endeavor. In this context, necroptosis is gaining considerable focus as an alternative cell death pathway. Necroptosis represents a programmed version of necrosis which shares its key regulators with apoptosis. When apoptosis is hampered, necroptosis serves as an alternative cell death pathway even in physiological conditions like formation of limbs during embryonic development. Additionally, it comes into play during bacterial and viral infections when the apoptosis machinery is hijacked and inhibited by proteins from these pathogens. Studies reveal that in BC, mutations significantly impact molecules in the apoptosis pathway, contributing to the onset, advancement, and multiplication of cancer cells. Although some studies do indicate that the functionality of necroptosis pathway may be compromised in malignancy the status of its key molecules remains largely unknown. In this article, we aim to gather the known mutations present in key molecules of necroptosis among various subtypes of BC, utilizing data from the Cosmic and UniProt databases. The same may help to enhance the development of therapeutic strategies to effectively induce necroptosis in apoptosis-resistant BCs.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Phase II Trial of Onapristone and Fulvestrant for Patients With ER+ and HER2- Metastatic Breast Cancer.","authors":"Sailaja Kamaraju, Amy M Fowler, Sergey Tarima, Lubna N Chaudhary, Mark E Burkard, Thomas Giever, Yee C Cheng, Amanda Parkes, Carol A Lange, Michele Pipp-Dahm, Robert Hegeman, Nauman Siddiqui, Amy Stella, Saurabh Rajguru, Kyleigh Twaroski, Luke Zurbriggen, Julie M Jorns, Hallgeir Rui, Quinton J Keigley, Scott B Perlman, Kelley Salem, Tyler J Bradshaw, Tarek Sahmoud, Kari Wisinski","doi":"10.1016/j.clbc.2024.11.019","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.019","url":null,"abstract":"<p><strong>Background: </strong>The SMILE study is a multi-institutional phase II clinical trial to determine the efficacy and safety of an antiprogestin, onapristone, in combination with fulvestrant as second-line therapy for patients with ER+, PgR+/-, HER2- metastatic breast cancer. This study was terminated early and herein, we report patient characteristics, and outcomes.</p><p><strong>Methods: </strong>Eligibility criteria included disease progression on ≥2 lines of prior therapy, ECOG performance status ≤ 2, measurable disease per RECIST 1.1 criteria, and optional ¹⁸F-fluorofuranylnorprogesterone (¹⁸F-FFNP) PET/CT imaging.</p><p><strong>Results: </strong>Consented subjects received standard-dose fulvestrant plus onapristone 50 mg orally, twice daily, until disease progression, or unacceptable toxicity. The study enrolled 11 women from 2 sites within the Wisconsin Oncology Network from November 2021 through March 2023. Mean age of the subjects was 58.5 years. Other than grade 1 toxicities, the treatment was well tolerated. None of the 11 subjects met RECIST 1.1 definition of response. The median time to progression was 63 days. A total of 4 of 11 patients had stable disease as best response and 2 of them were on treatment for 5.5 and 7.7 months. Two of the 11 subjects underwent functional imaging with ¹⁸F-FFNP PET/CT before and 10 or 14 days after starting treatment. For both subjects, tumor uptake of ¹⁸F-FFNP was stable or increased in all target lesions while ¹⁸F-FFNP uptake in the uterus, a normal PgR-rich internal control organ, was decreased.</p><p><strong>Conclusion: </strong>The study regimen was well-tolerated with no significant toxicities. Future studies may evaluate antiprogestins with various combinations such as targeted therapies.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Difference of RCB 0 and RCB I in Prognosis of Breast Cancer After Neoadjuvant Therapy: A Meta-Analysis.","authors":"Xinlong Tao, Jingqi Han, Yongxin Li, Yaming Tian, Zhou Juan Li, Jinming Li, Xinjian Guo, Jiuda Zhao","doi":"10.1016/j.clbc.2024.11.023","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.023","url":null,"abstract":"<p><strong>Background: </strong>The use of the residual cancer burden (RCB) for assessing breast cancer after neoadjuvant therapy (NAT) is increasingly common, but the prognostic difference between RCB 0 and RCB I is unclear.</p><p><strong>Methods: </strong>We systematically reviewed literature from PubMed, Embase, Web of Science, and oncology conferences until September 24, 2023. We used fixed- and random-effects models to calculate hazard ratio (HR) with 95% confidence interval (CI) for event-free survival (EFS), overall survival (OS), and distant disease-free survival (DDFS).</p><p><strong>Results: </strong>Our meta-analysis, encompassing 19 studies with 5894 patients, revealed that in the general population, RCB I had worse EFS (HR = 2.13; 95% CI: 1.75-2.58), OS (HR = 2.08; 95% CI: 1.48-2.93), and DDFS (HR = 2.10; 95% CI: 1.65-2.67) than RCB 0. Consistent with results from the general population, RCB I exhibited poorer EFS, OS, and DDFS in human epidermal growth factor 2-positive (HER2+) subtype and triple-negative breast cancer (TNBC) compared to RCB 0. Conversely, luminal subtype with RCB 0 and RCB I showed similar EFS (HR = 1.04; 95% CI: 0.62-1.72).</p><p><strong>Conclusions: </strong>RCB I experienced a poorer prognosis compared to RCB 0 in the general population, a pattern also observed in the HER2+ subtype and TNBC. However, no significant prognostic disparity was noted between RCB 0 and RCB I in the luminal subtype.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopausal Symptom Burden in Premenopausal Breast Cancer Patients: Interaction of Chemotherapy and Ovarian Function Suppression on Tamoxifen Treatment.","authors":"Young-Won Lee, Seunghee Baek, Jong Won Lee, Young-Jin Lee, Tae-Kyung Robyn Yoo, Jisun Kim, Il Yong Chung, Beom Seok Ko, Byung Ho Son, Kyung Hae Jung, Sung-Bae Kim, Sae Byul Lee, Yul Ha Min","doi":"10.1016/j.clbc.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.007","url":null,"abstract":"<p><strong>Aim: </strong>To compare menopausal symptoms between tamoxifen alone and tamoxifen with ovarian function suppression (OFS) over 12 months, identifying related factors.</p><p><strong>Methods: </strong>This prospective, observational study included 209 premenopausal patients with breast cancer on tamoxifen, recruited from Asan Medical Center, Republic of Korea. We collected demographic and clinical information from the participants' medical records and assessed menopausal symptoms using the Korean Menopause Rating Scale (MRS) at 3-, 6-, and 12-months postdiagnosis.</p><p><strong>Results: </strong>Of the 209 participants, 27.8% were administered tamoxifen in conjunction with OFS. Compared with the tamoxifen alone group, the tamoxifen plus OFS group had lower baseline MRS scores but higher scores at 6 and 12 months, and the scores showed a plateau within a year for both groups. Factors contributing to higher MRS scores at 6 months included the baseline MRS score (estimate, -0.326; standard error, 0.077) and addition of OFS (estimate, 6.084; standard error, 1.306; P < .001 for both). A significant interaction between OFS and prior chemotherapy was identified, with the OFS impact being significantly notable only in patients without prior chemotherapy (estimate, -6.643; standard error, 2.946; P = .025).</p><p><strong>Conclusions: </strong>Addition of OFS to tamoxifen in premenopausal patients with breast cancer can exacerbate menopausal symptoms relative to those when tamoxifen is used alone, especially in patients without prior chemotherapy. Thus, personalized treatment decisions about ovarian function suppression should consider potential symptom burdens, particularly for chemotherapy-naive patients, to balance treatment efficacy and quality of life.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer.","authors":"Anita M Huws, Gareth R Davies, Paul D Lewis, Claire Morgan","doi":"10.1016/j.clbc.2024.11.022","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.022","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant therapy decisions in hormone receptor positive, HER2 negative breast cancer are evolving. Gene panel testing has reduced the number of patients recommended for chemotherapy by up to two thirds. Identifying low risk genomic cases before testing could represent a significant economic impact. Systemic inflammatory indices have shown promise as prognostic markers in early breast cancer. We investigated the utility of four systemic inflammatory indices with the Nottingham Prognostic Index to predict the Oncotype DX® recurrence scores threshold level (low or high score), in women aged 50 and over with node negative invasive ductal carcinoma of the breast.</p><p><strong>Methods: </strong>A retrospective review of 245 patients with Oncotype DX® Recurrence Score testing from 2007 to 2021 were identified. The Nottingham Prognostic Index and systemic inflammatory indices ratios were estimated from histology results and preoperative peripheral blood samples respectively.</p><p><strong>Results: </strong>22.4% of the cohort had a Recurrence Score in the higher risk group. This group had a greater percentage of grade 3 tumours, progesterone receptor negativity, higher Nottingham Prognostic Scores, and inflammatory indices ratios than the lower risk group. A decision tree incorporating the Neutrophil Lymphocyte Ratio with clinicopathological features showed potential as an indicator of a high Oncotype DX® RS score, such that further investigation is warranted to assess whether Recurrence Score testing could be triaged in certain cohorts of patients. In this study, 38% of patients might be able to avoid genomic testing based on the decision tree analysis.</p><p><strong>Conclusion: </strong>Utility of inflammatory indices with clinicopathological features may help triage gene panel testing.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of a Remote Monitoring Regional Adjuvant Abemaciclib Service for Patients With High-Risk Early Breast Cancer.","authors":"Nicole L Brown, Ann Tivey, Suzanne Frank, Siow Chin Phua, Jack E Johnson, Anne Armstrong, Caroline Wilson, Sophie Raby, Sophie Low, Yvonne Hulmes, Fiona Britton, Sacha J Howell","doi":"10.1016/j.clbc.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.001","url":null,"abstract":"<p><strong>Introduction: </strong>Adjuvant abemaciclib was recently approved in high-risk early breast cancer, leading to an increase in oncology resource utilisation. We thus developed a regional, remote monitoring clinical service. The set-up, delivery processes and outcomes from the first 6 months' consecutive patients are presented.</p><p><strong>Methods: </strong>A regional delivery model with remote monitoring using optional electronic patient outcome measures (ePROMs) and bloods closer to home (BCTH) was implemented. Electronic patient records of patients entering the service (October 31, 2022 to May 31, 2023) were reviewed. Time-in-motion and on-line patient satisfaction surveys were conducted with questions adapted from prior questionnaires used by our cancer center. An independent t-test was used to assess differences in creatinine levels whilst on abemaciclib and a Mann-Whitney test to determine whether the time taken to complete follow-up appointments differed with and without ePROMs.</p><p><strong>Results: </strong>The first 103 patients to commence abemaciclib (median age 58 [range, 27-85], 66.0% White) had completed a median of 6 cycles (range, 0-9). 51.5% had treatment interruption, 52.4% a dose reduction and 15.5% discontinued therapy. Diarrhoea (90.3%), fatigue (84.9%) and anorexia (73.1%) were the most commonly reported toxicities on ePROMs. 10.8% of patients reported grade 3-4 toxicities. Neutropenia was also common and low grade. 89.5% of patients would recommend ePROMs and 98.0% found the BCTH service easy to use. Review appointments with ePROMs were a similar length to those without (P = .138).</p><p><strong>Conclusions: </strong>We have successfully implemented a remote, regional adjuvant clinical service which could serve as a blueprint for other NHS trusts for this and other cancer drugs.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axillary Reverse Mapping Using Indocyanine Green in Breast Cancer: Standardization of the Technique.","authors":"Ortega-Expósito Carlos, Pla Maria, Campos Miriam, Falo Catalina, Perez-Montero Hector, Azcarate Juan, Benítez Ana, Salinas Sira, Bosch Jan, Aranguena-Peñacoba Marina, Pernas Sonia, Ponce Jordi, Garcia-Tejedor Amparo","doi":"10.1016/j.clbc.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.003","url":null,"abstract":"<p><strong>Purpose: </strong>To validate the Axillary Reverse Mapping (ARM) technique with indocyanine green (ICG), focusing on the detection rate and the procedure's feasibility. The predictive factors for metastatic involvement of ARM nodes are also analyzed to define the target population for ARM indication.</p><p><strong>Methods: </strong>This prospective, observational, non-randomized study of patients with breast cancer included patients with an indication for axillary lymph node dissection (ALND) performed between June 2021 and June 2023. Participants were divided into two cohorts based on pattern of ICG migration: standard technique (all ARM nodes) and targeted technique (in contact with axillary vein). The feasibility of identifying and preserving ARM nodes during ALND was assessed. Multivariate logistic regression was used to analyze predictive factors (eg, tumor size, molecular surrogate subtype, multifocality, and neoadjuvant therapy) for metastatic ARM nodes.</p><p><strong>Results: </strong>Of the 41 patients in whom we performed the ARM technique, ARM nodes were identified and preserved after ALND in 36 patients (87.8%). Of these, 17 (89.5%) underwent the standard technique and 19 (86.4%) underwent the targeted technique. ARM metastases were identified in 12 patients: 9 (47.1%) with the standard technique and 3 (15.7%) with the targeted technique (P = .026). The ARM technique was the only risk factor for ARM involvement (odds ratio, 15.9; 95% confidence interval, 1.1-218.6).</p><p><strong>Conclusions: </strong>ICG facilitates the successful completion of ARM in almost 90% of patients undergoing ALND. In addition, by selecting the ARM nodes closest to the axillary vein, the number of cross metastases can be significantly reduced.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling Inequities: Racial Disparities in Risk-Reducing Mastectomy for Breast Cancer Prevention.","authors":"Samuel Knoedler, Fortunay Diatta, Felix J Klimitz, Olivier Noel, Joanna Kempa, Doha Obed, Seung-Yong Song, Horacio Mayer, Bong-Sung Kim, Martin Kauke-Navarro, Bohdan Pomahac, Paris D Butler","doi":"10.1016/j.clbc.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.004","url":null,"abstract":"<p><strong>Background: </strong>Risk-reducing mastectomy (RRM) significantly lowers breast cancer risk as a preventive surgery. While racial disparities in breast cancer treatment are well-documented, research on racial differences in the utilization and outcomes of RRM is limited.</p><p><strong>Methods: </strong>We retrospectively analyzed the American College of Surgeons National Surgical Quality Improvement Program (2008-2022) to identify women who underwent RRM. Patient demographics, comorbidities, surgical characteristics, and 30-day postoperative outcomes were compared between White and racial minority patients, including Black/African American women.</p><p><strong>Results: </strong>Among 1,285 patients, 88% (n = 1,126) self-identified as White and 12.4% (n = 159) as racial minorities, including 5.8% (n = 74) Black. Minority patients were younger than White patients (50.7±11.4 years vs. 52.6±12.6 years; P = .66). Black patients had a significantly higher mean BMI than White patients (33.6±8.4 kg/m² vs. 30.6±8.0 kg/m²; P = .03), and higher prevalence of obesity (65%, n = 48 vs. 47%, n = 524; P = .03) and hypertension (51%, n = 38 vs. 30%, n = 342; P = .007). Racial minority patients were more likely to undergo outpatient surgery (81%, n = 129 vs. 57%, n = 645; P < .001) and had shorter hospital stays than White patients (0.8±1.3 days vs. 1±2 days; P = .001). Black patients experienced higher rates of superficial incisional infections (9.5%, n = 7 vs. 2.9%, n = 33; P = .18) and overall complications (18%, n = 13 vs. 10%, n = 113; P = .48) CONCLUSION: This multi-institutional study reveals racial disparities in RRM, with minority patients significantly more likely to present with comorbidities and experience higher complication rates. These findings underscore the need for targeted strategies to ensure equitable access to RRM and improve outcomes for minority patients, advancing health equity in breast cancer prevention.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyrotinib Plus Taxanes or Vinorelbine for the Treatment of Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer: Prospective Evaluation of Efficacy and Safety.","authors":"Weili Xiong, Jiukang Sun, Quan Gu, Ting Xu, Lili Zhang, Yuan Yuan","doi":"10.1016/j.clbc.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.006","url":null,"abstract":"<p><strong>Purpose: </strong>The clinical benefits of pyrotinib plus taxanes or vinorelbine have not been studied systemically. Consequently, we conducted a prospective evaluation to assess the efficacy and safety of pyrotinib plus taxanes or vinorelbine in patients with human epidermal growth factor 2 (HER2)-positive metastatic breast cancer (MBC).</p><p><strong>Methods: </strong>Patients with HER2-positive MBC were included to receive pyrotinib combined with taxanes or vinorelbine in Jiangsu Cancer Hospital. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were objective response rate (ORR), disease control rate (DCR), clinical benefit rate (CBR), and adverse effects (AEs).</p><p><strong>Results: </strong>Between December 22, 2020 and January 11, 2023, a total of 101 patients were assigned to pyrotinib plus taxanes (n = 83) and pyrotinib plus vinorelbine (n = 18) groups. As of May 24, 2023, the median PFS for all patients was 11.5 months (95% confidence interval [CI], 8.8-15.7). The median PFS was significantly longer in pyrotinib plus taxanes group than in pyrotinib plus vinorelbine group (median PFS, 12.2 months [95% CI, 9.2-18.6] vs. 8.4 months [95% CI, 5.5-13.7]; P = .005). All the treatment-related side effects were tolerated. The most frequent grade 3 or 4 side effects included diarrhea (22.8%), leukopenia (19.5%), and neutropenia (18.2%).</p><p><strong>Conclusion: </strong>Pyrotinib plus taxanes could be an alternative or even the preferred treatment strategy for patients with HER2-positive MBC after trastuzumab and small-molecule tyrosine kinase inhibitors (TKIs). We also suggest that pyrotinib combined with vinorelbine has a therapeutic potential.</p><p><strong>Registration: </strong>This trial was registered in Chinese Clinical Trial Registry. URL: https://www.chictr.org.cn/showproj.html?proj=65697 (ChiCTR2000041217).</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}