Breast Cancer最新文献

{"title":"Clinical utility of tumor-infiltrating lymphocyte evaluation by two different methods in breast cancer patients treated with neoadjuvant chemotherapy.","authors":"Masayuki Nagahashi, Eri Ishikawa, Takahiro Nagai, Haruka Kanaoka, Aoi Oshiro, Yusa Togashi, Akira Hattori, Junko Tsuchida, Tomoko Higuchi, Arisa Nishimukai, Keiko Murase, Yuichi Takatsuka, Takako Kihara, Yiwei Ling, Shujiro Okuda, Seiichi Hirota, Yasuo Miyoshi","doi":"10.1007/s12282-025-01665-y","DOIUrl":"10.1007/s12282-025-01665-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to examine the clinical utility of tumor-infiltrating lymphocytes (TILs) evaluated by \"average\" and \"hot-spot\" methods in breast cancer patients.</p><p><strong>Methods: </strong>We examined 367 breast cancer patients without neoadjuvant chemotherapy (NAC) by average and hot-spot methods to determine the consistency of TIL scores between biopsy and surgical specimens. TIL scores before NAC were also compared with the pathological complete response (pCR) rate and clinical outcomes in 144 breast cancer patients that received NAC. TIL scores evaluated by the two methods were predicted from clinicopathological data using random forest regression.</p><p><strong>Results: </strong>Surgical specimens showed higher TIL scores than biopsy specimens using the hot-spot method (p < 0.001), while biopsy and surgical specimens showed similar TIL scores using the average method. There was a linear relationship between the pCR rate and TIL scores determined using hot-spot (p < 0.001) and average methods (p = 0.001). Patients without pCR and low TILs by the average method had significantly worse overall survival compared to other patients (p = 0.02). The root mean squared errors of the predicted TIL score for the test set were 19.662 (hot-spot) and 10.955 (average).</p><p><strong>Conclusion: </strong>The average method may have an advantage for breast cancer patients receiving NAC, since the TIL score using this method is more consistent between biopsy and surgical specimens, and it associates better with clinical outcomes. Our exploratory study showed that machine learning from clinicopathological data may better predict TIL scores assessed by the average, rather than hot-spot, method.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"404-415"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 5-year review of genomic medicine in breast cancer: insights from C-CAT data on 3776 Japanese patients.","authors":"Midori Morita, Ryo Tsunashima, Tetsuhiro Yoshinami, Masaki Ishida, Masahiro Iwasaku, Sae Kitano, Chikage Kato, Koichi Sakaguchi, Koichi Takayama, Yasuto Naoi","doi":"10.1007/s12282-024-01656-5","DOIUrl":"10.1007/s12282-024-01656-5","url":null,"abstract":"<p><strong>Background: </strong>In Japan, despite 5 years since CGP tests were covered by insurance in 2019, low drug accessibility rates remain a critical issue. We evaluated drug accessibility in 3776 breast cancer from the C-CAT database using two criteria: the proportion first linked to PMDA-approved drugs with phase III trial evidence for breast cancer through CGP tests but not existing Companion diagnostics [CDx] (*), and the proportion first linked to PMDA-approved drugs including based on phase I and II trial evidence (**). Additionally, cases linked to investigational drugs for non-PMDA-approved drugs were counted.</p><p><strong>Methods: </strong>We identified the top 100 genetic alterations in Japanese breast cancer via CGP tests, listing corresponding drugs from C-CAT reports. Drug accessibility was re-evaluated through simulations with updated evidence levels by a member of the expert panel at Osaka University (EP-EL in OUH).</p><p><strong>Results: </strong>Results showed the proportion improved to 28.4% under the newest EP-EL in OUH, including 3.4% for HER2-negative cases eligible for HER2-targeted therapy due to ERBB2 amplification and 25.0% for ER-positive, HER2-negative cases eligible for capivasertib-fulvestrant therapy due to PIK3CA, AKT1, and PTEN alterations (*). However, in part, initial false negatives for HER2 status and practical difficulties in using CGP tests as a CDx for capivasertib exist. Including mutations like TMB-H, MSI-H, BRAF V600E mutation, and NTRK fusions raised the proportion to 37.9% (**), but lacking drugs with phase III trials evidence.</p><p><strong>Conclusion: </strong>These findings highlight the ongoing difficulties in demonstrating clear clinical utility of CGP tests in Japan, emphasizing the need for broad discussions on its future direction.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"314-328"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775142","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":"Importance of circulating tumor DNA analysis at diagnosis in early triple-negative breast cancer patients.","authors":"Min-Seung Park, Eun Hye Cho, Youngjin Youn, In-Gu Do, Hee-Yeon Woo, Hyosoon Park, Eun Young Kim, Min-Jung Kwon","doi":"10.1007/s12282-025-01673-y","DOIUrl":"10.1007/s12282-025-01673-y","url":null,"abstract":"<p><strong>Background: </strong>Circulating tumor DNA (ctDNA) enables non-invasive evaluation and is considered a promising tool for diagnosis, treatment selection, risk stratification, and disease monitoring. However, while the utility of ctDNA has been demonstrated in advanced-stage cancers, its detection in early breast cancer (EBC) remains limited. This study investigated the characteristics of EBC patients associated with higher ctDNA detectability.</p><p><strong>Methods: </strong>A total of 101 patients with EBC were enrolled. Formalin-fixed paraffin-embedded samples (FFPEs) were obtained from biopsy tissue, and plasma samples were collected before and after neoadjuvant chemotherapy (NAC). Forty-seven breast cancer-related genes were analyzed using next-generation sequencing. The diagnostic performance of ctDNA was evaluated, and logistic regression analyses were conducted to assess the impact of clinical and molecular factors on ctDNA status.</p><p><strong>Results: </strong>The most frequently identified gene was TP53 (FFPE, 66.7%; ctDNA, 46.4%), followed by PIK3CA (FFPE, 36.2%; ctDNA, 17.4%). The diagnostic performance of the three most common genes showed a sensitivity range of 11.1-58.7%, specificity of 78.3-100%, and diagnostic accuracy of 65.2-78.3%. The triple-negative breast cancer (TNBC) subtype exhibited the strongest association with ctDNA detection (odds ratio [OR] 209.50, p = 0.005) in multivariate analysis. Also, those who exhibited ctDNA clearance after NAC had a higher pathological complete response rate compared to those without clearance (38.5% vs. 11.1%, p = 0.238).</p><p><strong>Conclusions: </strong>Our study highlights that ctDNA analysis can complement genetic testing from a single tissue biopsy in breast cancer patients. Furthermore, ctDNA analysis may be particularly important in patients with TNBC.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"416-425"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076191","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":"Management of nausea and vomiting induced by antibody-drug conjugates.","authors":"Jawhara Farhat, Hitomi Sakai, Junji Tsurutani","doi":"10.1007/s12282-025-01670-1","DOIUrl":"10.1007/s12282-025-01670-1","url":null,"abstract":"<p><p>Antibody-drug conjugates (ADCs) are an emerging class of anticancer therapy that combines the specificity and long circulation half-life of monoclonal antibodies with the cytotoxic potency of the payload connected through a chemical linker. The optimal management of toxicities is crucial for improving quality of life in patients undergoing ADCs and for avoiding improper dose reductions or discontinuations. This article focuses on the characteristics and management of nausea and vomiting (NV) induced by three ADCs: trastuzumab deruxtecan (T-DXd), sacituzumab govitecan (SG), and datopotamab deruxtecan (Dato-DXd). We summarize the proposed mechanism of NV, clinical study data on NV, and recommendations from clinical guidelines. We also discuss three prospective studies evaluating prophylactic antiemetic therapy in patients receiving T-DXd, along with future perspectives.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"278-285"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The complex role of regulatory cells in breast cancer: implication for immunopathogenesis and immunotherapy.","authors":"RuiJuan Guo, Ping Wang","doi":"10.1007/s12282-024-01654-7","DOIUrl":"10.1007/s12282-024-01654-7","url":null,"abstract":"<p><p>Breast cancers (BCs) are frequently linked to an immunosuppressive microenvironment that facilitates tumor evasion of anti-cancer immunity. The cells that suppress the immune system such as regulatory B cells (Bregs), regulatory T cells (Tregs), tumor-associated macrophages (TAMs), tumor-associated neutrophils (TANs), myeloid-derived suppressor cells (MDSCs), play a crucial role in immune resistance. Also, tumor progression and immune evasion of cancers are facilitated by cytokines and factors released by tumor cells or immunosuppressive cells. Targeting these regulatory cells therapeutically, whether through elimination, inactivation, or reprogramming, has resulted in hopeful anti-tumor reactions. Yet, the substantial diversity and adaptability of these cells, both in terms of appearance and function, as well as their variation over time and depending on where they are in the body, have posed significant challenges for using them as reliable biomarkers and creating focused therapies that could target their creation, growth, and various tumor-promoting roles. The immunotherapy approaches in BC and their effectiveness in treating certain subtypes are still in their initial phases. In this review, we thoroughly outlined the characteristics, roles, and possible treatment options for these immune-suppressing cells in the tumor environment.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"227-241"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717891","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":"Clinicopathological significance of androgen receptor expression and tumor infiltrating lymphocytes in triple-negative breast cancer: a retrospective cohort study.","authors":"Takeshi Ushigusa, Nami Hirakawa, Yuka Kajiura, Atsushi Yoshida, Hideko Yamauchi, Naoki Kanomata","doi":"10.1007/s12282-024-01662-7","DOIUrl":"10.1007/s12282-024-01662-7","url":null,"abstract":"<p><strong>Background: </strong>Triple-negative breast cancer (TNBC) is a serious disease with limited treatment options. We explored the significance of androgen receptor (AR) expression and tumor-infiltrating lymphocytes (TILs) in predicting neoadjuvant chemotherapy (NAC) resistance in TNBC, hypothesizing that AR/TIL classification using pretreatment biopsies can identify NAC-resistant subgroups and improve the understanding of apocrine differentiation.</p><p><strong>Methods: </strong>This retrospective study included 156 consecutive patients with TNBC treated with NAC. AR immunostaining was defined positive if ≥ 1% of the tumor cell nuclei were stained. Stromal TIL levels were assessed, with high levels defined as ≥ 50%. Apocrine differentiation was detected using an anti-15-PGDH antibody. The pathological response to NAC was evaluated.</p><p><strong>Results: </strong>Overall, 36% (n = 56) of the patients achieved a pathological complete response (pCR). AR⁺/TIL^low tumors had a high non-pCR rate (76%, 42/55) and were resistant to NAC. Kaplan-Meier plots showed significant differences in overall survival (OS) and distant metastasis-free survival (DMFS) among the four AR/TIL subgroups (OS: p = 0.013; DMFS: p = 0.0016). All 11 cases with some degree of apocrine differentiation were AR⁺/TIL^low, 15-PGDH-positive, and NAC-resistant. AR⁺/TIL^low status was significantly associated with a high likelihood of non-pCR (OR = 0.26, p = 0.009). Multivariate analysis confirmed pCR as an independent predictor of better prognosis (OS, HR = 0.13, p = 0.006; DMFS, HR = 0.15, p = 0.002), whereas AR⁺/TIL^low status was not significantly associated with OS or DMFS.</p><p><strong>Conclusions: </strong>AR/TIL classification using pretreatment biopsies identified TNBC subgroups with distinct NAC responses and prognoses. AR⁺/TIL^low TNBC, including apocrine differentiation cases, were NAC-resistant, highlighting the need for alternative therapies.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"357-368"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899432","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":"Pembrolizumab added to neoadjuvant chemotherapy may improve pathological complete response in androgen-receptor positive and low tumor-infiltrating lymphocytes triple-negative breast cancer patients.","authors":"Kadri Altundag","doi":"10.1007/s12282-025-01672-z","DOIUrl":"10.1007/s12282-025-01672-z","url":null,"abstract":"","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"456"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069923","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":"Economic impact of screening on postdiagnosis work productivity in Japanese women with breast cancer: a life-table modeling approach.","authors":"Yoshie Takatori-Shirakami, Mitsue Saito, Kazuhito Yokoyama","doi":"10.1007/s12282-024-01637-8","DOIUrl":"10.1007/s12282-024-01637-8","url":null,"abstract":"<p><strong>Background: </strong>In Japan, biennial mammography screening has been recommended for the early detection of breast cancer (BC) in women aged 40 years or above since 2004 by the Ministry of Health, Labor and Welfare. The purpose of this study is to estimate the economic impact of BC screening on work productivity, using a new measure called the productivity-adjusted life-year (PALY).</p><p><strong>Methods: </strong>We used a dynamic life table modeling approach to estimate the work productivity of female patients aged 40-64 years diagnosed with BC in 2019 over the year of diagnosis and the subsequent 5 years. Changes in life-years, PALYs, and gross domestic product (GDP) were assessed by changing the screening detection rate from the current (34.2%) to an ideal (100%) percentage. Each input for modeling was obtained from the most recent public database available.</p><p><strong>Results: </strong>BC patients were estimated to lose 1903 in life-years, 3596 in PALYs, and US$281 million in GDP at the current screening detection rate compared with the ideal detection rate. On the other hand, the following gains are expected when the current screening detection rate was increased to 40-80%; life-years gain; 168-1325, PALYs gain; 317-2503, GDP gain: US$25-196 million.</p><p><strong>Conclusion: </strong>This study has used modeling to show that detecting BC without screening is associated with a lower work productivity and an economic and life-years loss. Encouraging BC screening may be beneficial to maintaining work productivity after diagnosis.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"101-108"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373631","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":"Clinicopathogenomic analysis of PI3K/AKT/PTEN-altered luminal metastatic breast cancer in Japan.","authors":"Hiroshi Tada, Minoru Miyashita, Narumi Harada-Shoji, Akiko Ebata, Miku Sato, Tokiwa Motonari, Mika Yanagaki, Tomomi Kon, Aru Sakamoto, Takanori Ishida","doi":"10.1007/s12282-024-01639-6","DOIUrl":"10.1007/s12282-024-01639-6","url":null,"abstract":"<p><p>This rapid communication highlights the correlation between protein kinase B alpha (AKT1)-phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA)- phosphatase and tensin homolog (PTEN) alterations and clinicopathological factors in Japanese patients with metastatic recurrent breast cancer (mBC). This study analyzed 1967 patients with luminal-type breast cancer who underwent cancer gene panel testing. The results demonstrated that AKT pathway alterations, including PI3K/AKT/PTEN, occurred in 1038 (52.8%) cases. Patients with AKT pathway mutations were older (p = 0.002) and had a higher rate of invasive lobular carcinoma (ILC) histology (p = 0.001), progesterone receptor (PgR) positivity (p = 0.006), and bone metastases (p = 0.001), and a lower rate of germline BRCA2 (p < 0.001). Comprehensive genomic profile results demonstrated a higher tumor mutational burden (TMB) (< 0.001) and lower tumor BRCA1/2 expression (< 0.001) in patients with mutations in the AKT pathway. These results are crucial for characterizing candidates for AKT pathway-targeted molecular therapies and conceptualizing optimal treatment strategies. Clinical trial registration: This study is an observational study and is therefore not registered with the clinical trials registration.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"208-216"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mirror therapy for patients with breast cancer: A systematic review and meta-analysis.","authors":"Jie Hao, Andréas Remis, Dongqi Zhu, Yao Yao, Yupi Pu, Yanfei Li, Biying Huang","doi":"10.1007/s12282-024-01642-x","DOIUrl":"10.1007/s12282-024-01642-x","url":null,"abstract":"<p><strong>Background: </strong>Pain and dysfunction of the shoulder and arm are prevalent among patients with breast cancer. This review aimed to evaluate current evidence regarding the effects of mirror therapy on pain, function, and quality of life in patients with breast cancer.</p><p><strong>Methods: </strong>Five bibliographic databases in English and Chinese, PubMed, Embase, Scopus, CNKI, and Wanfang were searched from inception to May 15, 2024. Randomized controlled trials comparing the effects of mirror therapy to conventional treatment were eligible for inclusion. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were performed to determine the effects of mirror therapy.</p><p><strong>Results: </strong>Four randomized controlled trials were included, with a total of 311 patients with breast cancer. All included studies were scored six to seven on the PEDro scale, indicating good quality. No adverse events related to mirror therapy were reported. Compared to conventional treatment, mirror therapy demonstrated significantly reduced pain (SMD: - 1.17, 95% CI: - 1.64 to - 0.70, p < 0.001), improved upper extremity function (SMD: 1.03, 95% CI: 0.05-2.02, p = 0.04), and enhanced quality of life (SMD: 0.43, 95% CI: 0.07-0.79, p = 0.02).</p><p><strong>Conclusions: </strong>Mirror therapy is feasible and effective for upper extremity pain and dysfunction following breast cancer surgery. Clinicians may consider mirror therapy as an adjunctive intervention for breast cancer postoperative rehabilitation to advance the quality of care.</p>","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"60-68"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378648","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}