CA: A Cancer Journal for Clinicians最新文献

{"title":"A pan-tumor review of the role of poly(adenosine diphosphate ribose) polymerase inhibitors","authors":"Chadi Hage Chehade MD,&nbsp;Georges Gebrael MD,&nbsp;Nicolas Sayegh MD,&nbsp;Zeynep Irem Ozay MD,&nbsp;Arshit Narang MBBS,&nbsp;Tony Crispino,&nbsp;Talia Golan MD,&nbsp;Jennifer K. Litton MD,&nbsp;Umang Swami MD, MS,&nbsp;Kathleen N. Moore MD,&nbsp;Neeraj Agarwal MD","doi":"10.3322/caac.21870","DOIUrl":"10.3322/caac.21870","url":null,"abstract":"<p>Poly(adenosine diphosphate ribose) polymerase (PARP) inhibitors, such as olaparib, talazoparib, rucaparib, and niraparib, comprise a therapeutic class that targets PARP proteins involved in DNA repair. Cancer cells with homologous recombination repair defects, particularly <i>BRCA</i> alterations, display enhanced sensitivity to these agents because of <i>synthetic lethality</i> induced by PARP inhibitors. These agents have significantly improved survival outcomes across various malignancies, initially gaining regulatory approval in ovarian cancer and subsequently in breast, pancreatic, and prostate cancers in different indications. This review offers a comprehensive clinical overview of PARP inhibitor approvals, emphasizing their efficacy across different cancers based on landmark phase 3 clinical trials.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 2","pages":"141-167"},"PeriodicalIF":503.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21870","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underrepresentation of Hispanic women in science, technology, engineering, mathematics, and medicine","authors":"Jovanka Gencel-Augusto PhD,&nbsp;Natasha J. Minaya MD,&nbsp;Daniel E. Johnson PhD,&nbsp;Jennifer R. Grandis MD","doi":"10.3322/caac.21875","DOIUrl":"10.3322/caac.21875","url":null,"abstract":"<p>Despite ongoing efforts to increase the number of women in science, technology, engineering, and mathematics (STEM) and in medicine, Hispanic women remain severely underrepresented in these fields. This disparity not only hinders scientific innovation and the delivery of culturally competent medical care but also perpetuates a systemic exclusion. Research specifically addressing the challenges faced by Hispanic women, the extent of underrepresentation in these disciplines, and strategies to mitigate these issues is sparce. The authors conducted a systematic analysis of peer-reviewed articles to address this gap. The findings reveal a stark underrepresentation of Hispanic women across all examined fields, particularly compared with White women. In addition, the underrepresentation persists when compared with Hispanic men, although the disparity is less pronounced. The authors identify ongoing disparities in promotion, compensation, and retention rates for Hispanic women; present data for barriers to entry and retention; and highlight existing programs and strategies aimed at addressing this underrepresentation. Finally, a framework is presented for future studies and actionable initiatives, and the broader implications of these findings for the field of oncology are highlighted.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 2","pages":"91-110"},"PeriodicalIF":503.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21875","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142937702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlighting American Cancer Society-funded research in CA: A Cancer Journal for Clinicians","authors":"Don S. Dizon MD,&nbsp;Christina M. Annunziata MD, PhD","doi":"10.3322/caac.21876","DOIUrl":"10.3322/caac.21876","url":null,"abstract":"<p>Since 1946, the American Cancer Society (ACS) has invested more to find the causes and cures of cancer than any other single nongovernmental, not-for-profit organization. Each year, the ACS extends this support to investigators at institutions across the United States as part of its grants program, funding research for high school interns through world-renowned professors, including the ACS Professorship.</p><p>We applaud the grantees supported by the ACS; and, as part of this commitment to acknowledge and highlight these investigators, <i>CA: A Cancer Journal for Clinicians</i> (<i>CA</i>), is proud to launch a new series, “American Cancer Society Research Award Spotlight.” As the flagship journal of the ACS, <i>CA'</i>s goal is to educate and widely disseminate their work, and their passions, to our diverse audience of cancer professionals. Topics will be of relevance to the broad audience of <i>CA</i>, and much of the work will be developed in consultation between the authors and the editorial board. Notably, we have not restricted the scope of articles to research directly supported by the ACS. Rather, we will work with the authors on a topic that drives their career, whether in the laboratory or in the clinic, reflecting timely issues within the scope of oncology or society at large.</p><p>In addition to recipients of our standard grant mechanisms, <i>CA</i> will feature content from recipients of the ACS Professor Award, which recognizes key thought leaders who have made substantial contributions in cancer research.</p><p>For more information around ACS-funded cancer research, please visit https://www.cancer.org/research/currently-funded-cancer-research.html for a full list of up-to-date funded research grants and current and past ACS professors.</p><p>Don S. Dizon reports personal/consulting fees from Doximity, ImmunoGen Inc, Puma Biotechnology Inc, Data and Safety Monitoring board for AstraZeneca, Clovis Oncology Inc., and GlaxoSmithKline LLC; and stock options in Midi outside the submitted work. Christina M. Annuniziata disclosed no conflicts of interest.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 2","pages":"90"},"PeriodicalIF":503.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21876","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142937734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute myeloid leukemia management and research in 2025","authors":"Hagop M. Kantarjian MD,&nbsp;Courtney D. DiNardo MD,&nbsp;Tapan M. Kadia MD,&nbsp;Naval G. Daver MD,&nbsp;Jessica K. Altman MD,&nbsp;Eytan M. Stein MD,&nbsp;Elias Jabbour MD,&nbsp;Charles A. Schiffer MD,&nbsp;Amy Lang MD,&nbsp;Farhad Ravandi MD","doi":"10.3322/caac.21873","DOIUrl":"10.3322/caac.21873","url":null,"abstract":"<p>The first 5 decades of research in acute myeloid leukemia (AML) were dominated by the cytarabine plus anthracyclines backbone, with advances in strategies including allogeneic hematopoietic stem cell transplantation, high-dose cytarabine, supportive care measures, and targeted therapies for the subset of patients with acute promyelocytic leukemia. Since 2017, a turning point in AML research, 12 agents have received regulatory approval for AML in the United States: venetoclax (BCL2 inhibitor); gemtuzumab ozogamicin (CD33 antibody–drug conjugate); midostaurin, gilteritinib, and quizartinib (fms-like tyrosine kinase 3 inhibitors); ivosidenib, olutasidenib, and enasidenib (isocitrate dehydrogenase 1 and 2 inhibitors); oral azacitidine (a partially absorbable formulation); CPX351 (liposomal encapsulation of cytarabine:daunorubicin at a molar ratio of 5:1); glasdegib (hedgehog inhibitor); and recently revumenib (menin inhibitor; approved November 2024). Oral decitabine-cedazuridine, which is approved as a bioequivalent alternative to parenteral hypomethylating agents in myelodysplastic syndrome, can be used for the same purpose in AML. Menin inhibitors, CD123 antibody–drug conjugates, and other antibodies targeting CD123, CD33, and other surface markers are showing promising results. Herein, the authors review the frontline and later line therapies in AML and discuss important research directions.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 1","pages":"46-67"},"PeriodicalIF":503.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21873","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer care for transgender and gender-diverse people: Practical, literature-driven recommendations from the Multinational Association of Supportive Care in Cancer","authors":"Elizabeth J. Cathcart-Rake MD,&nbsp;Alexandre Chan PharmD, MPH,&nbsp;Alvaro Menendez MD,&nbsp;Denise Markstrom PharmD,&nbsp;Carla Schnitzlein DO,&nbsp;Yee Won Chong,&nbsp;Don S. Dizon MD","doi":"10.3322/caac.21872","DOIUrl":"10.3322/caac.21872","url":null,"abstract":"<p>In the United States, over 2 million individuals openly identify with a gender that differs from their sex assigned at birth. A cancer diagnosis is physically and psychologically taxing—and, in some, traumatic. However, for transgender and gender-diverse (TGD) people, many of whom have experienced discrimination in myriad health care settings, the challenges may be even greater. These recommendations focus on how best to deliver quality cancer care to transgender men (individuals who identify as men but were assigned female sex at birth), transgender women (individuals who identify as women but were assigned male sex at birth), and people who identify somewhere beyond this gender spectrum as nonbinary or using other terms, based on the available, albeit sparse, literature. This review broaches: (1) the epidemiology of cancer in TGD individuals, including the incidence of cancer and cancer-related mortality; (2) cancer center practices that are welcoming and affirming to TGD patients; (3) the need for awareness and intentionality in the spaces of diagnosis and treatment for cancer; (4) the inevitable conclusion that gender differences exist but much more needs to be learned about the impact of gender-affirming therapy, consisting of gender-affirming surgeries and gender-affirming hormone therapy, on cancer therapy; and (5) the efficacy and perceived safety of antineoplastic therapy and gender-affirming hormone therapy.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 1","pages":"68-81"},"PeriodicalIF":503.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Density Modifications Toward High Mechanical Performance Nanocellulose Aerogels","authors":"Gaigai Duan, Qin Qin, Rubei Hu, Zhao Liang, Xiaoshuai Han, Haoqi Yang, Yong Huang, Chunmei Zhang, Shuijian He, Shaohua Jiang","doi":"10.1002/pol.20240736","DOIUrl":"https://doi.org/10.1002/pol.20240736","url":null,"abstract":"Mechanical properties are crucial for the application of nanocellulose aerogels. In this work, a series of nanocellulose aerogels with solid content concentration gradient (0.5, 1.0, 1.5, 2.0 wt%) of precursor dispersion are prepared by freeze-drying method, and the effect of nanocellulose solid content on the mechanical properties of nanocellulose aerogels was investigated. As the solid content concentration increased, the internal microstructure of the aerogel underwent a transition from a sparse reticular structure to a tightly arranged lamellar structure. This transition led to a substantial improvement in the mechanical properties of the aerogel. At 50% strain, the compressive strength of the aerogel increased from 8.4 to 37.56 kPa with the increase of nanofibrillar cellulose solid content. Furthermore, the specific strength, specific modulus, and compressive modulus also increased, while maintaining a low density (20.02 mg/cm³) and high porosity (98.63%). This work confirms the feasibility of structural strengthening and mechanical property enhancement of nanocellulose aerogels by density modification, which provides a guidance for the design of durability enhancement of nanocellulose aerogels for broadening their application fields.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"11 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142637038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral mastectomy may not reduce mortality risk","authors":"Mike Fillon","doi":"10.3322/caac.21869","DOIUrl":"10.3322/caac.21869","url":null,"abstract":"&lt;p&gt;Although rates of contralateral prophylactic mastectomy and bilateral mastectomy are increasing among women with unilateral sporadic breast cancer, a new study reports that despite the procedure diminishing the risk of contralateral breast cancer, the patients experienced mortality rates similar to those of patients treated with lumpectomy or unilateral mastectomy.&lt;/p&gt;&lt;p&gt;The primary goal of the study, appearing in &lt;i&gt;JAMA Oncology&lt;/i&gt; (doi:10.1001/jamaoncol.2024.2212), was to determine the 20-year cumulative risk of breast cancer mortality among women with stage 0–III unilateral breast cancer divided by each patient’s initial surgical procedures.&lt;/p&gt;&lt;p&gt;In an editorial accompanying the study, Seema A. Khan, MD, Bluhm Family Professor of Cancer Research at the Feinberg School of Medicine at Northwestern University in Chicago, Illinois, and Masha Kocherginsky, PhD, professor of biostatistics and director of the Quantitative Data Sciences Core at the Robert H. Lurie Comprehensive Cancer Center at Northwestern Medicine, wrote that although contralateral breast cancer is the most frequent second malignant tumor among women who have experienced a diagnosis of primary breast cancer, it is less frequent and less ominous than recurrence of the initial cancer. “Nevertheless,” they wrote, “for many patients with newly diagnosed unilateral breast cancer, it can be a prominent source of worry as they navigate their treatment decisions. This worry is accentuated among young patients and those with early-stage disease.”&lt;/p&gt;&lt;p&gt;The cohort study included patients from the Surveillance, Epidemiology, and End Results Program registry database. The researchers identified 661,270 eligible women with unilateral breast cancer diagnosed from 2000 to 2019. The average age of the patients was 58.7 years. In each treatment group, approximately 83% were White, just over 8% were Black, approximately 2% were East Asian, and 2% were Southeast Asian. The remainder of the patients were American Indian/Alaska Native, Pacific Islander, South Asian, or “unknown” (approximately 1% in each category).&lt;/p&gt;&lt;p&gt;The research team identified 564,062 cases of invasive breast cancer (85.3%) and 97,208 cases of ductal carcinoma in situ (14.7%). According to study author Steven A. Narod, MD, a professor in the Dalla Lana School of Public Health and the Department of Medicine at the University of Toronto, the researchers matched 90.7% of the patients with bilateral mastectomy into three surgical groups of equal size (36,028 women in each treatment group): lumpectomy, unilateral mastectomy, and bilateral mastectomy. All three groups were similar across demographic, clinical, and treatment variables and propensity scores. More than 70% of the cohort had undergone breast-conserving surgery, whereas 23.4% had undergone unilateral mastectomy, and 6.0% had undergone bilateral mastectomy.&lt;/p&gt;&lt;p&gt;Nearly two-thirds of the patients underwent radiotherapy, whereas approximately 37% received chemotherapy. T","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 6","pages":"469-470"},"PeriodicalIF":503.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21869","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Most young female cancer survivors are at minimal risk for obstetric problems","authors":"Mike Fillon","doi":"10.3322/caac.21868","DOIUrl":"10.3322/caac.21868","url":null,"abstract":"&lt;p&gt;A study based in the United Kingdom reports that, in general, most women between the ages of 15 and 39 years who have survived a cancer diagnosis are at low risk for pregnancy complications later in their lives. The study appears in &lt;i&gt;The Lancet Oncology&lt;/i&gt; (doi:10.1016/S1470-2045(24)00269-9).&lt;/p&gt;&lt;p&gt;According to the study authors, limited data are available on the risks of obstetric complications among survivors of adolescent and young adult (AYA) cancer, and they noted that most earlier studies report risks only for all types of cancers combined. The purpose of this population-based cohort study—the Teenage and Young Adult Cancer Survivor Study—was to determine whether there was a negative impact on birth rates and risks of obstetric complications after treatment for one of 17 cancers in the AYA population. The authors compared the observed number of births affected to the number expected based on general population rates.&lt;/p&gt;&lt;p&gt;The study included more than 200,000 5-year survivors of cancer from England and Wales who were initially diagnosed between the ages of 15 and 39 years. The cohort was based on cancer registrations obtained through the Office for National Statistics and the Welsh Cancer Registry. The investigators ascertained 27 specific obstetric complications among 96,947 female survivors. They compared the observed number of affected births in the cohort with the expected number in the general population of England.&lt;/p&gt;&lt;p&gt;Specifically, the researchers found that between April 1, 1997 and March 31, 2022, 22,033 births occurred among 14,051 female survivors of AYA cancer from England. They also found that survivors of cervical cancer and leukemia had an increased risk for more than two specific complications from among the 27 complications investigated.&lt;/p&gt;&lt;p&gt;Overall, the number of births was “lower than expected” (observed-to-expected ratio, 0.68; 95% CI, 0.67–0.69). Notably, the researchers reported that survivors of genitourinary, cervical, and breast cancers reported a birth rate that was less than 50% of that in the general population.&lt;/p&gt;&lt;p&gt;When they focused on more common obstetric complications that were above normal, they discovered that survivors of cervical cancer were at risk of many serious pregnancy and labor complications: malpresentation of fetus, obstructed labor, amniotic fluid and membrane disorders, premature rupture of membranes, preterm birth, placental disorders (including placenta previa), and antepartum hemorrhage.&lt;/p&gt;&lt;p&gt;Also of particular concern were patients with leukemia, who were at greater risk of preterm delivery, obstructed labor, postpartum hemorrhage, and retained placenta. By contrast, the other cancers observed had two or fewer obstetric complications that exceeded an “observed-to-expected ratio of 1:25 or greater.” Based on their data, the researchers concluded that survivors of cervical cancer and leukemia are at risk of several serious obstetric complications: “Therefore, any pregnancy in the","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 6","pages":"467-468"},"PeriodicalIF":503.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21868","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer statistics 2024","authors":"Angela N. Giaquinto MSPH,&nbsp;Hyuna Sung PhD,&nbsp;Lisa A. Newman MD, MPH,&nbsp;Rachel A. Freedman MD, MPH,&nbsp;Robert A. Smith PhD,&nbsp;Jessica Star MA, MPH,&nbsp;Ahmedin Jemal DVM, PhD,&nbsp;Rebecca L. Siegel MPH","doi":"10.3322/caac.21863","DOIUrl":"10.3322/caac.21863","url":null,"abstract":"<p>This is the American Cancer Society's biennial update of statistics on breast cancer among women based on high-quality incidence and mortality data from the National Cancer Institute and the Centers for Disease Control and Prevention. Breast cancer incidence continued an upward trend, rising by 1% annually during 2012–2021, largely confined to localized-stage and hormone receptor-positive disease. A steeper increase in women younger than 50 years (1.4% annually) versus 50 years and older (0.7%) overall was only significant among White women. Asian American/Pacific Islander women had the fastest increase in both age groups (2.7% and 2.5% per year, respectively); consequently, young Asian American/Pacific Islander women had the second lowest rate in 2000 (57.4 per 100,000) but the highest rate in 2021 (86.3 per 100,000) alongside White women (86.4 per 100,000), surpassing Black women (81.5 per 100,000). In contrast, the overall breast cancer death rate continuously declined during 1989–2022 by 44% overall, translating to 517,900 fewer breast cancer deaths during this time. However, not all women have experienced this progress; mortality remained unchanged since 1990 in American Indian/Alaska Native women, and Black women have 38% higher mortality than White women despite 5% lower incidence. Although the Black-White disparity partly reflects more triple-negative cancers, Black women have the lowest survival for every breast cancer subtype and stage except localized disease, with which they are 10% less likely to be diagnosed than White women (58% vs. 68%), highlighting disadvantages in social determinants of health. Progress against breast cancer could be accelerated by mitigating racial, ethnic, and social disparities through improved clinical trial representation and access to high-quality screening and treatment.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 6","pages":"477-495"},"PeriodicalIF":503.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer: The good, the bad, and an important call to effective risk reduction strategies","authors":"Virginia G. Kaklamani MD, DSc,&nbsp;Carlos L. Arteaga MD","doi":"10.3322/caac.21867","DOIUrl":"10.3322/caac.21867","url":null,"abstract":"&lt;p&gt;The 2024 Breast Cancer Statistics highlight a few interesting trends: breast cancer incidence is increasing, there is a greater increase in younger women, and most of this increase is driven by early stage diagnosis and hormone receptor (HR)-positive disease.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In addition, compared with other racial groups, women with Asian American/Pacific Islander (AAPI) heritage have a greater increase in breast cancer; and, despite overall declining death rates from breast cancer, Black women continue to have higher mortality compared with White women. Let us consider these findings in more detail.&lt;/p&gt;&lt;p&gt;Breast cancer incidence in the United States briefly decreased in the early 2000s, possibly related to a decline in the use of hormone-replacement therapy, but it has since shown an increase of approximately 1% per year. This increase is associated with HR-positive breast cancers and is mostly seen in younger women. A potential contributing factor for this association may be a decrease in the number of live births.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Another possibility may be the greater incidence of young-onset HR-positive breast cancer in Indian and Chinese women.&lt;span&gt;&lt;sup&gt;3-5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;AAPI women have a greater increase in breast cancer incidence, which is largely noted in Asian women immigrating to the United States rather than Asian women born in the United States.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Compared with Asian American women born in the United States, Asian American women who have immigrated to the United States and have lived more than 50% of their life in the United States, on average, are three times more likely to be diagnosed with breast cancer.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Specifically for Indian women, there has been a rise in breast cancer incidence by almost 50% between 1965 and 1985,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; and Chinese women are projected to have a rise in breast cancer incidence by greater than 11% by 2030.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In the past 35 years, breast cancer mortality rates have decreased by 44%. This decrease is attributed to early diagnosis stemming from nationwide screening recommendations as well as treatment advances in all disease stages.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; Based on simulation models, 25% of the reduction in mortality rates comes from screening mammography, 29% comes from treatment advances in metastatic disease, and 47% comes from treatment advances in early stage disease. The addition of trastuzumab has increased survival in metastatic HER2-positive breast cancer by 16 months&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; and, in early stage disease, by 26%–37%.&lt;span&gt;&lt;sup&gt;10-12&lt;/sup&gt;&lt;/span&gt; Most recently, the addition of CDK4/6 inhibitors has broken the 5-year barrier in median overall survival in metastatic HR-positive breast cancer,&lt;span&gt;&lt;sup&gt;13&lt;/sup&gt;&lt;/span&gt; suggesting that mortality rates will continue to show an improvement in patient survival in subsequent iterations of the breast cancer statistics.&lt;/p&gt;&lt;p&gt;Non","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 6","pages":"471-474"},"PeriodicalIF":503.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}