Breast Cancer in the Elderly

Breast cancer is a serious health problem in the elderly female population. The approach to treating healthy women aged 65–70 years should be similar to treating younger patients with a similar stage and biological subtype of breast cancer. Greater individualization of treatment is necessary in the case of patients with worse parameters of functional efficiency and features of the frail syndrome. It should also be emphasized the need for closer cooperation with geriatricians, especially when defining the management plan and conducting systemic treatment in this group of patients. There is also a great need for research into the proper selection of treatment in elderly breast cancer patients. This is especially important in groups of patients with early and locally advanced breast cancer

Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy

Brain metastases are detected in 5% of patients with breast cancer at diagnosis. The rate of brain metastases is higher in HER2-positive and triple-negative breast cancer patients (TNBC). In patients with metastatic breast cancer, the risk of brain metastases is much higher, with up to 50% of the patients having two aggressive biological breast cancer subtypes. The prognosis for such patients is poor. Until recently, little was known about the response to systemic therapy in brain metastases. The number of trials dedicated to breast cancer with brain metastases was scarce. Our review summarizes the current knowledge on this topic including very significant results of clinical trials which have been presented very recently. We focus on the intracranial response rate of modern drugs, including new antibody–drug conjugates, HER2- targeted tyrosine kinase inhibitors and other targeted therapies. We highlight the most effective and promising drugs. On the other hand, we also suggest that further efforts are needed to improve the prognosis, especially patients with TNBC and brain metastases. The information contained in this article can help oncologists make treatment-related decisions

Expression of Soluble Form of Aurora A as a Predictive Factor for Neoadjuvant Therapy in Breast Cancer Patients: A Single-Center Pilot Study

Purpose: To search for new predictive breast cancer biomarkers. We analyzed the serum concentrations of biomarkers involved in carcinogenesis, which can also be targeted by therapy. Methods: In a single-center prospective study, the serum levels of Aurora A, thymidine kinase 1, and human epidermal growth factor receptor type 3 (HER3) were determined in 119 women with BC before neoadjuvant treatment using ELISA kits. Results: The following clinical data were analyzed: age; TNM; the expression of ER, PGR, HER2, and Ki67; histological grade (G); and the response to neoadjuvant treatment (NAT) in the residual tumor burden classification (RCB). A complete pathological response (pCR) was achieved after NAT in 41 patients (34%). The highest proportion of the patients with a confirmed pCR was found for triple negative breast cancer (TNBC) (62.5%); non-luminal HER2-positive (52.6%) cancer subtypes (p = 0.0003); and in the G3 group (50%; p = 0.0078). The patients with higher levels of Aurora A were more likely to achieve pCR (p = 0.039). In the multivariate analysis, the serum Aurora A levels ≥ 4.75 ng/mL correlated with a higher rate of pCR (OR: 3.5; 95% CI: 1.2–10.1; p = 0.023). Conclusions: We showed that in a biologically heterogeneous group of BC patients, the pretreatment serum Aurora A levels were of significant value in predicting the response to NAT

Ocena skuteczności chemioterapii z zastosowaniem kapecytabiny i oksaliplatyny u chorych na uogólnionego raka jelita grubego. Wpływ lokalizacji ogniska pierwotnego raka na skuteczność leczenia.

Introduction. Colorectal cancer is an increasingly common cancer, and due to the possibility of using many drugs nd combination therapy, it bears the hallmarks of a chronic disease. Improving the quality of life is important.  Material and methods. The following analysis applies to the oxaliplatin and capecitabine (CAPOX) regimen in a group of 305 patients. This chemotherapy was used as part of palliative treatment lines I, II or III.  Results. The work proved the effectiveness of the scheme despite the reduction of drug doses in about 50% of patients, and toxicity grade 3 was only present in 5% (grade 4 complications were not observed). The group of patients in which CAPOX was used as the first treatment line was considered representative, and the effectiveness of the treatment depending on the location of the primary tumour was evaluated.  Conclusion. Differences in overall survival of patients after stratification were observed relative to the location of the primary tumour. Survival was longer in patients with left-sided primary tumour compared to right-sided localisation and was, respectively, 20.4 (95% CI, 17.5–23.4) and 12.1 months (95% CI, 10.5–13.8) (P = 0.014).Rak jelita grubego jest coraz częstszym nowotworem, a dzięki możliwości stosowania wielu leków oraz terapii skojarzonej nosi znamiona choroby przewlekłej. Poprawa jakości życia ma istotne znaczenie. Poniższa analiza dotyczy schematu opartego o oksaliplatynę i kapecytabinę (CAPOX) w grupie 305 chorych. Chemioterapię tę zastosowano w ramach I, II lub III linii leczenia paliatywnego. W pracy udowodniono skuteczność schematu mimo redukcji dawek leków u około 50% chorych, a 3. stopień toksyczności dotyczył zaledwie 5% (powikłań 4. stopnia nie obserwowano). Grupę chorych, w której zastosowano CAPOX jako I linię leczenia, uznano za reprezentatywną i poddano ocenie skuteczność leczenia w zależności od umiejscowienia guza pierwotnego. Zaobserwowano różnice w przeżyciu całkowitym chorych po stratyfikacji względem lokalizacji guza pierwotnego. Przeżycie było dłuższe u chorych z guzem pierwotnym po stronie prawej w porównaniu z umiejscowieniem lewostronnym i wynosiło – odpowiednio – 20,4 (95% CI, 17,5-23,4) wobec 12,1 (95% CI, 10,5-13,8) miesiąca (p=0,014)

Retracing Circulating Tumour Cells for Biomarker Characterization after Enumeration

Background Retracing and biomarker characterization of individual circulating tumour cells (CTCs) may potentially contribute to personalized metastatic cancer therapy. This is relevant when a biopsy of the metastasis is complicated or impos‐ sible to acquire. Methods A novel disc format was used to map and retrace individual CTCs from breast-cancer patients and nucleated cells from healthy blood donors using the CytoTrack platform. For proof of the retracing concept, CTC HER2 characterization by immunofluorescence was tested. Results CTCs were detected and enumerated in three of four blood samples from breast-cancer patients and the locations of each individual CTCs were mapped on the discs. Nucleat‐ ed cells were retraced on seven discs with 96.6%±8.5% recovery on five fields of view on each disc. Shifting of field of view for retracing was measured to 4-29 μm. In a blood sample from a HER2-positive breast-cancer patient, CTC enumeration and mapping was followed by HER2 charac‐ terization and retracing to demonstrate downstream immunofluorescence analysis of the CTC. Conclusion Mapping and retracing of CTCs enables downstream analysis of individual CTCs for existing and future cancer genotypic and phenotypic biomarkers. Future studies will uncover this potential of the novel retracing technology