Neoadjuvant treatment in a patient with HER2-positive breast cancer — a case study and review of recent recommendations

Leczenie przedoperacyjne (neoadiuwantowe czy indukcyjne) w przebiegu raka piersi jest zarezerwowane dla miejscowo zaawansowanych guzów pierwotnie operacyjnych (leczenie neoadiuwantowe) lub pierwotnie nieoperacyjnych — w celu osiągnięcia operacyjności (leczenie indukcyjne). Leczenie to ma zastosowanie we wszystkich fenotypach raka piersi. Największą korzyść z leczenia przedoperacyjnego odnoszą chore z potrójnie ujemnym rakiem piersi (TNBC) lub z HER2 dodatnim (nadekspresja bądź amplifikacja genu receptora ludzkiego naskórkowego czynnika wzrostu typu 2). W tej grupie pacjentek najczęściej uzyskuje się całkowitą odpowiedź potwierdzoną patologicznie (pCR), co przekłada się na poprawę rokowania. W niniejszej pracy przedstawiono przypadek chorej z całkowitą regresją guza pierwotnego po indukcyjnej chemioterapii w skojarzeniu z trastuzumabem (obecnie wskazanie nierefundowane w Polsce) oraz przegląd piśmiennictwa poświęconego temu zagadnieniu.Pre-operative breast cancer therapy (neoadjuvant or induction) is reserved for patients with locally advanced tumours primarily amenable to surgery (neoadjuvant treatment) or subjects with initially unresectable disease in whom respectability may be achieved following upfront systemic treatment (induction therapy). Initial systemic treatment may be used in all phenotypes of breast cancer. Patients with “triple-negative” breast cancer (TNBC) or human epidermal growth factor receptor 2 (HER-2)-positive tumours benefit most from preoperative therapy. Patients in this group most often achieve pathological complete response (pCR), which results in an improved prognosis. In this report, we present a case of complete tumour regression following neoadjuvant chemotherapy combined with trastuzumab (currently a non-reimbursed indication in Poland) and we review the literature on this issue

Prognostic significance, diagnosis and treatment in patients with gastric cancer and positive peritoneal washings. A review of the literature

Peritoneal dissemination is a common consequence of a relapse following a radical surgical treatment of gastric cancer. The development of the disease in the peritoneum depends not only on its stage, but also on free cancer cells exfoliated from the tumor mass or from involved lymph nodes, and which are capable of being implanted in the peritoneum. According to the latest TNM (7 edition; 2010) classification, patients with free cancer cells in the peritoneal washings qualify for stage IV of the disease. Patients in whom free cancer cells were found during the operation – have a recurrence of gastric cancer – mainly in the peritoneum, and the majority of them die within two years of the diagnosis. To properly assess the prognosis, it is vital to determine the stage of cancer by additionally assessing the washings for the presence of free cancer cells before taking a therapeutic decision. This also allows identifying those patients who require different medical procedures to obtain the best treatment results possible. Medical literature describes various methods of examining peritoneal washings aimed at detecting free cancer cells. The methods apply different cancer cell detection rates, sensitivity and specificity in prediction of a peritoneal relapse. Oncological Departments performing the evaluation of the washings employ non-standard methods of treatment in this group of patients and the results presented are promising

Neoadjuvant treatment in a patient with HER2-positive breast cancer — a case study and review of recent recommendations

Pre-operative breast cancer therapy (neoadjuvant or induction) is reserved for patients with locally advanced tumours primarily amenable to surgery (neoadjuvant treatment) or subjects with initially unresectable disease in whom respectability may be achieved following upfront systemic treatment (induction therapy). Initial systemic treatment may be used in all phenotypes of breast cancer. Patients with "triple-negative" breast cancer (TNBC) or human epidermal growth factor receptor 2 (HER-2)-positive tumours benefit most from preoperative therapy. Patients in this group most often achieve pathological complete response (pCR), which results in an improved prognosis. In this report, we present a case of complete tumour regression following neoadjuvant chemotherapy combined with trastuzumab (currently a non-reimbursed indication in Poland) and we review the literature on this issue