855 research outputs found
A clinical perspective on escalating or de-escalating adjuvant therapy in HER2+ breast cancer
Introduction: Patients with early HER2-positive breast cancer (BC) benefit from HER2-targeted systemic therapy. The endorsed standard adjuvant treatment for patients with early HER2-positive breast cancer is chemotherapy plus trastuzumab administered for 1 year. Areas covered: Several trials have investigated modifications of the standard treatment in terms of de-escalation by either shortening the duration or giving less resource-demanding regimens and in terms of escalation by either adding a second anti-HER2 agent or extending the duration of HER2-targeted treatment for more than 12\ua0months. In this perspective, we would offer a comprehensive view of these trials and discuss their findings. Expert commentary: At the current state of knowledge, there are still open questions regarding the management of HER2+ BC patients, such as the most adequate duration of trastuzumab therapy, the optimal chemotherapy regimen that should be combined with trastuzumab, and the addition of a second anti-HER2 agent. Growing evidences suggest that some HER2+ BC patients may not need chemotherapy. If these patients could be recognized upfront, optimal response could potentially be reached with HER2-targeted therapy alone
A review of the CTRC-AACR San Antonio Breast Cancer Symposium 2012
The annual San Antonio Breast Cancer Symposium (SABC) is a multidisciplinary conference that covers basic molecular and cellular biology, epidemiology, diagnosis and treatment of all types of breast cancer and premalignant breast disease. In 2012, this meeting was held at the Henry B. Gonzalez Convention Center in San Antonio, Texas, United States, from 4 to 8 December. The symposium consisted of lectures within six general sections covering a range of topics in breast cancer research. These included discussions on research of breast cancer posters, a large number of specialist sessions, and several minisymposia. The report below describes much of the research presented in those general lecture sessions
How to achieve optimal care in early breast cancer with 'less' or 'more' treatment
From precision medicine to cancer care through the immunome: Highlights from the European Society of Medical Oncology Congress, Madrid, 26-30th September 2014
The recognition that cancer is a 'spectrum' of diseases, and that medical oncologists should achieve 'convergence' from 'divergence' to treat cancer patients was the main theme of the 2014 European Society of Medical Oncology (ESMO) Congress. The meeting assembled 19,859 participants from nearly 134 countries worldwide. The educational content was centered on precision medicine in cancer care, from mutational burden to the immunome, through the epigenome and the proteome. Precision medicine has been defined as the tailoring of medical treatment to the characteristics of an individual patient. Knowing an individual's genomics has created a remarkable and unprecedented opportunity to improve medical treatment and develop preventative strategies to preserve health. Clinical oncologists across the range of diseases recognise that for precision medicine to take hold, it will require intensive, rigorous validation that these new approaches do indeed improve patient outcomes. Not all molecular alterations are predictive of response to a specific targeted treatment nor are they all druggable, raising issues of cost - benefit, validation of specific biomarkers, and of managing patient expectations. Addressing all these issues will be essential for the medical community to embrace any given opportunities. Along with it, it will also require educational programmes that squarely address the knowledge chasm that currently exists for practicing physicians. The promise of genomic and precision medicine has created greater demands for both those providing the scientific expertise - bioinformatics, statisticians, molecular biologists - and those delivering clinical care - physicians, nurses, psychologists - to the patients. This ESMO 2014 report will highlight the major findings of this outstanding meeting
Targeting HER3 for cancer treatment: a new horizon for an old target
Human epidermal growth factor receptor 3 (HER3) is a member of the human epidermal growth factor receptors family, having as its main ligands neuregulins 1 and 2. Although its poor tyrosine kinase activity entails a weak oncogenic power on its own, HER3 can heterodimerize with HER2 and/or epidermal growth factor receptor (EGFR), leading to a drastic enhancement of transphosphorylation and activation of downstream signaling pathways, ultimately promoting oncogenesis, metastatic dissemination, and drug resistance. Given its ubiquitous expression across solid tumors, multiple efforts have been done to therapeutically target HER3 by blocking either the ligand binding domain or its dimerization with other receptors. Treatment with anti-HER3 monoclonal antibodies or bispecific antibodies, both as single agents and in combination with other compounds, unfortunately led to unsatisfactory results across several tumor types. The HER3-directed delivery of cytotoxic payloads through antibody-drug conjugates has recently demonstrated encouraging activity in several tumor types, however, suggesting a potential role for the therapeutic targeting of HER3 in cancer treatment
The PROMISe to increase precision in adjuvant therapy for early breast cancer: To “Type” or to “Print”?
Defining the immunogram of breast cancer: a focus on clinical trials
In phase III ImPassion130 trial, the addition of immunotherapy to chemotherapy improved overall survival in metastatic triple-negative breast cancer patients. This benefit was significant only in patients harboring PD-L1-positive tumors, suggesting that stratification according to response biomarkers is needed to achieve consistent responses. Besides PD-L1 expression, a variety of potential biomarkers are under investigation for predicting immunotherapy efficacy in breast cancer, such as tumor-infiltrating lymphocytes, gene signatures, tumor mutational burden, microsatellite instability, and gut microbiome. Enriching future trials through these biomarkers could help identifying the population of responders, realizing what has been called precision immunotherapy
- …