Cardiac Outcomes of Patients Receiving Adjuvant Weekly Paclitaxel and Trastuzumab for Node-Negative, ERBB2-Positive Breast Cancer

Trastuzumab is life-saving but is associated with symptomatic and asymptomatic left ventricular ejection fraction (LVEF) decline. Here we report the low cardiac toxicity of a non-anthracycline and trastuzumab based treatment for patients with early stage HER2-positive breast cancer (BCA)

Adjuvant Paclitaxel and Trastuzumab for Node-Negative, HER2-Positive Breast Cancer

No single standard treatment exists for patients with small, node-negative, human epidermal growth factor receptor type 2 (HER2)–positive breast cancers, because most of these patients have been ineligible for the pivotal trials of adjuvant trastuzumab

Chemotherapy-related amenorrhea after adjuvant paclitaxel–trastuzumab (APT trial)

Chemotherapy-related amenorrhea (CRA) is associated with infertility and menopausal symptoms. Learning how frequently paclitaxel and trastuzumab cause amenorrhea is important. Most other adjuvant breast cancer therapies induce CRA in approximately 50% of all premenopausal recipients [1]

Evolving Concepts: Immunity in Oncology from Targets to Treatments

Cancer is associated with global immune suppression of the host. Malignancy-induced immune suppressive effect can be circumvented by blocking the immune checkpoint and tip the immune balance in favor of immune stimulation and unleash cytotoxic effects on cancer cells. Human antibodies directed against immune checkpoint proteins: cytotoxic T lymphocytes antigen-4 (CTLA-4) and programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), have shown therapeutic efficacy in advanced melanoma and non-small-cell lung cancer and other malignancies. Immune check point blockade antibodies lead to diminished tolerance to self and enhanced immune ability to recognize and eliminate cancer cells. As a class these agents have immune-related adverse events due to decreased ability of effector immune cells to discriminate between self and non-self. Seventy percent of patients participating in clinical trials have experienced anticancer activities and varying degrees of immune mediated dose-limiting side effects

Evolving lipid-based delivery systems in the management of neoplastic disease

Drug delivery systems for the therapeutic use of cytotoxic chemotherapy are an essential aspect of successful treatment and remain under active evaluation. Such systems offer advantages such as they can change the pharmacologic and pharmacodynamic properties of an active drug in preclinical screens to meet the needs of therapy in humans. For example, unstable or insoluble agents can be formulated in a manner to allow effective exposure in the tumor. Liposomal delivery systems are the most mature with regulatory approval for several liposomal preparations. The liposome is attractive as the charge, size, composition, and the payload (drug) can be manipulated to enhance efficacy. Targeting agents such as antibodies, antibody fragments, or ligands can be incorporated into the liposomal structure to enhance specificity. The liposome can be manipulated to be thermal or pH sensitive. In addition, variations of the liposome can incorporate more than one agent and also allow for sequential exposure of the active agents to the tumor. Additional lipid formulations include micelles and nanocochleates, which are earlier in development, but many offer an alternative to liposomal technology. The size, shape, adducts, and composition of the micelles may offer more flexibility in the delivery platform. Further clinical trials are eagerly awaited