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1. Yalamanchili K, Lalmuanpuii J, Waheed F, Farjami S, Kancherla R, Qureshi Z, Hoang A, Khaled Y, Lake D, Puccio C, Chun HG, Seiter K, Ahmed T: High-dose chemotherapy with autologous stem cell rescue in stage IIIB inflammatory breast cancer. Anticancer Res; 2008 Sep-Oct;28(5B):3139-42
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  • [Title] High-dose chemotherapy with autologous stem cell rescue in stage IIIB inflammatory breast cancer.
  • BACKGROUND: Despite the advances in breast cancer care, inflammatory breast cancer (IBC) has a poor prognosis.
  • The purpose of this study was to determine the efficacy of high-dose chemotherapy (HDCT) with thiotepa, mitoxantrone and carboplatin (TMJ regimen) in women with TNM stage IIIB IBC.
  • PATIENTS AND METHODS: Between 1991 and 1998, twenty-eight patients with stage IIIB IBC underwent an autologous stem cell transplant after undergoing chemotherapy, surgery and/or radiation.
  • Radiation therapy and tamoxifen was offered to patients post HDCT if appropriate.
  • RESULTS: At the time of last follow-up in May, 2007, sixteen patients had relapsed.
  • These results show that HDCT with the TMJ regimen is safe and effective in patients with stage IIIB IBC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Breast Neoplasms / therapy. Stem Cell Transplantation / methods
  • [MeSH-minor] Adult. Carboplatin / administration & dosage. Carboplatin / adverse effects. Dose-Response Relationship, Drug. Female. Follow-Up Studies. Humans. Inflammation / pathology. Middle Aged. Mitoxantrone / administration & dosage. Mitoxantrone / adverse effects. Neoadjuvant Therapy. Neoplasm Staging. Thiotepa / administration & dosage. Thiotepa / adverse effects

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  • (PMID = 19031971.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 905Z5W3GKH / Thiotepa; BG3F62OND5 / Carboplatin; BZ114NVM5P / Mitoxantrone; TMJ protocol
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2. Sportès C, Steinberg SM, Liewehr DJ, Gea-Banacloche J, Danforth DN, Avila DN, Bryant KE, Krumlauf MC, Fowler DH, Pavletic S, Hardy NM, Bishop MR, Gress RE: Strategies to improve long-term outcome in stage IIIB inflammatory breast cancer: multimodality treatment including dose-intensive induction and high-dose chemotherapy. Biol Blood Marrow Transplant; 2009 Aug;15(8):963-70
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  • [Title] Strategies to improve long-term outcome in stage IIIB inflammatory breast cancer: multimodality treatment including dose-intensive induction and high-dose chemotherapy.
  • Inflammatory breast cancer (IBC) is a rare clinicopathologic entity with a poor prognosis, lagging far behind any other form of nonmetastatic breast cancer.
  • Since the advent of systemic chemotherapy over 35 years ago, only minimal progress has been made in long-term outcome.
  • Although multiple randomized trials of high-dose chemotherapy and autologous progenitor cell transplantation (ASCT) for the treatment of breast cancer have yielded disappointing results, these data are not necessarily relevant to IBC, a distinct clinical and pathologic entity.
  • Therefore, the optimal multimodality therapy for IBC is not well established, and remains unsatisfactory.
  • The treatment was overall tolerated with acceptable morbidity, and no post-ASCT 100-day mortality.
  • They strongly suggest, along with results of several already published phase II trials, that ASCT could play a significant role in the first line treatment of IBC.
  • [MeSH-major] Breast Neoplasms / therapy. Inflammation
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Etoposide / therapeutic use. Female. Hematopoietic Stem Cell Transplantation / methods. Humans. Melphalan / therapeutic use. Middle Aged. Remission Induction / methods. Survival Analysis. Treatment Outcome

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  • (PMID = 19589486.001).
  • [ISSN] 1523-6536
  • [Journal-full-title] Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
  • [ISO-abbreviation] Biol. Blood Marrow Transplant.
  • [Language] eng
  • [Grant] United States / Intramural NIH HHS / / Z99 CA999999
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 6PLQ3CP4P3 / Etoposide; Q41OR9510P / Melphalan
  • [Other-IDs] NLM/ NIHMS116531; NLM/ PMC2709825
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3. Mills PJ, Ancoli-Israel S, Parker B, Natarajan L, Hong S, Jain S, Sadler GR, von Känel R: Predictors of inflammation in response to anthracycline-based chemotherapy for breast cancer. Brain Behav Immun; 2008 Jan;22(1):98-104
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  • [Title] Predictors of inflammation in response to anthracycline-based chemotherapy for breast cancer.
  • Although chemotherapy for breast cancer can increase inflammation, few studies have examined predictors of this phenomenon.
  • This study examined potential contributions of demographics, disease characteristics, and treatment regimens to markers of inflammation in response to chemotherapy for breast cancer.
  • Thirty-five women with stage I-III-A breast cancer (mean age 50 years) were studied prior to cycle 1 and prior to cycle 4 of anthracycline-based chemotherapy.
  • Circulating levels of inflammatory markers with high relevance to breast cancer were examined, including C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), Interleukin-1 receptor antagonist (IL1-RA), vascular endothelial growth factor (VEGF), soluble intercellular adhesion molecule-1 (sICAM-1), Interleukin- (IL-6), soluble P-selectin (sP-selectin), and von Willebrand factor (vWf).
  • Chemotherapy was associated with elevations in VEGF (p < or = 0.01), sICAM-1 (p < or = 0.01), sP-selectin (p < or = 0.02) and vWf (p < or = 0.05).
  • Multiple regression analysis controlling for age and body mass index (BMI) showed that higher post-chemotherapy levels of inflammation were consistently related to higher pre-chemotherapy levels of inflammation (ps < or =0.05) as well as to certain disease characteristics.
  • Post-chemotherapy IL-6 levels were higher in patients who had larger tumors (p < or = 0.05) while post-chemotherapy VEGF levels were higher in patients who had smaller tumors (p < or = 0.05).
  • Post-chemotherapy sP-selectin levels were highest in women who had received epirubicin, cytoxan, 5-fluorouracil chemotherapy (p < or = 0.01).
  • These findings indicate that chemotherapy treatment can be associated with elevations in certain markers of inflammation, particularly markers of endothelial and platelet activation.
  • Inflammation in response to chemotherapy is most significantly related to inflammation that existed prior to chemotherapy but also potentially to treatment regimen and to certain disease characteristics.

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  • (PMID = 17706918.001).
  • [ISSN] 1090-2139
  • [Journal-full-title] Brain, behavior, and immunity
  • [ISO-abbreviation] Brain Behav. Immun.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA085264; United States / NCRR NIH HHS / RR / M01 RR00827; United States / NHLBI NIH HHS / HL / HL-57265; United States / NCRR NIH HHS / RR / RR000827-230807; United States / NCI NIH HHS / CA / CA112035; United States / NCI NIH HHS / CA / R01 CA112035; United States / NCRR NIH HHS / RR / M01 RR000827-230807; United States / NHLBI NIH HHS / HL / R01 HL057265; United States / NCI NIH HHS / CA / CA85264; United States / NCRR NIH HHS / RR / M01 RR000827
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Anthracyclines; 0 / Biomarkers; 0 / Interleukin-6; 0 / P-Selectin; 0 / Vascular Endothelial Growth Factor A; 0 / von Willebrand Factor; 126547-89-5 / Intercellular Adhesion Molecule-1
  • [Other-IDs] NLM/ NIHMS36644; NLM/ PMC2199880
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4. Dressman HK, Hans C, Bild A, Olson JA, Rosen E, Marcom PK, Liotcheva VB, Jones EL, Vujaskovic Z, Marks J, Dewhirst MW, West M, Nevins JR, Blackwell K: Gene expression profiles of multiple breast cancer phenotypes and response to neoadjuvant chemotherapy. Clin Cancer Res; 2006 Feb 1;12(3 Pt 1):819-26
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  • [Title] Gene expression profiles of multiple breast cancer phenotypes and response to neoadjuvant chemotherapy.
  • PURPOSE: Breast cancer is a heterogeneous disease, and markers for disease subtypes and therapy response remain poorly defined.
  • For that reason, we employed a prospective neoadjuvant study in locally advanced breast cancer to identify molecular signatures of gene expression correlating with known prognostic clinical phenotypes, such as inflammatory breast cancer or the presence of hypoxia.
  • In addition, we defined molecular signatures that correlate with response to neoadjuvant chemotherapy.
  • EXPERIMENTAL DESIGN: Tissue was collected under ultrasound guidance from patients with stage IIB/III breast cancer before four cycles of neoadjuvant liposomal doxorubicin paclitaxel chemotherapy combined with local whole breast hyperthermia.
  • RESULTS: Gene expression patterns were identified that defined the phenotypes of inflammatory breast cancer as well as tumor hypoxia.
  • In addition, molecular signatures were identified that predicted the persistence of malignancy in the axillary lymph nodes after neoadjuvant chemotherapy.
  • This persistent lymph node signature significantly correlated with disease-free survival in two separate large populations of breast cancer patients.
  • CONCLUSIONS: Gene expression signatures have the capacity to identify clinically significant features of breast cancer and can predict which individual patients are likely to be resistant to neoadjuvant therapy, thus providing the opportunity to guide treatment decisions.

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  • (PMID = 16467094.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / K23 CA106595; United States / NCI NIH HHS / CA / R21 CA108707; United States / NCI NIH HHS / CA / CA112952; United States / NCI NIH HHS / CA / CA42745
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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5. McGuire SE, Gonzalez-Angulo AM, Huang EH, Tucker SL, Kau SW, Yu TK, Strom EA, Oh JL, Woodward WA, Tereffe W, Hunt KK, Kuerer HM, Sahin AA, Hortobagyi GN, Buchholz TA: Postmastectomy radiation improves the outcome of patients with locally advanced breast cancer who achieve a pathologic complete response to neoadjuvant chemotherapy. Int J Radiat Oncol Biol Phys; 2007 Jul 15;68(4):1004-9
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  • [Title] Postmastectomy radiation improves the outcome of patients with locally advanced breast cancer who achieve a pathologic complete response to neoadjuvant chemotherapy.
  • PURPOSE: The aim of this study was to investigate the role of postmastectomy radiation therapy in women with breast cancer who achieved a pathologic complete response (pCR) to neoadjuvant chemotherapy.
  • METHODS AND MATERIALS: We retrospectively identified 226 patients treated at our institution who achieved a pCR at surgery after receiving neoadjuvant chemotherapy.
  • Of these, the 106 patients without inflammatory breast cancer who were treated with mastectomy were analyzed.
  • The patients' clinical stages at diagnosis were I in 2%, II in 31%, IIIA in 30%, IIIB in 25%, and IIIC in 11% (American Joint Committee on Cancer 2003 system).
  • Of the patients, 92% received anthracycline-based chemotherapy, and 38% also received a taxane.
  • A total of 72 patients received postmastectomy radiation therapy, and 34 did not.
  • Use of radiation therapy did not affect the 10-year rates of LRR for patients with Stage I or II disease (the 10-year LRR rates were 0% for both groups).
  • However, the 10-year LRR rate for patients with Stage III disease was significantly improved with radiation therapy (7.3% +/- 3.5% with vs. 33.3% +/- 15.7% without; p = 0.040).
  • Within this cohort, use of radiation therapy was also associated with improved disease-specific and overall survival.
  • CONCLUSION: Postmastectomy radiation therapy provides a significant clinical benefit for breast cancer patients who present with clinical Stage III disease and achieve a pCR after neoadjuvant chemotherapy.

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  • (PMID = 17418973.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / T32 CA077050; United States / NCI NIH HHS / CA / P30 CA016672; United States / NCI NIH HHS / CA / L30 CA123630-01; United States / NCI NIH HHS / CA / L30 CA123630-02; United States / NCI NIH HHS / CA / CA 16672; United States / NCI NIH HHS / CA / T32 CA 77050; United States / NCI NIH HHS / CA / L30 CA123630
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Other-IDs] NLM/ NIHMS283616; NLM/ PMC4329732
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6. Rizzo M, Lund MJ, Mosunjac M, Bumpers H, Holmes L, O'Regan R, Brawley OW, Gabram S: Characteristics and treatment modalities for African American women diagnosed with stage III breast cancer. Cancer; 2009 Jul 1;115(13):3009-15
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Characteristics and treatment modalities for African American women diagnosed with stage III breast cancer.
  • BACKGROUND: Stage III breast cancers account for about 6% to 7% of all invasive breast cancers diagnosed annually in the United States.
  • In African American (AA) women, the incidence of stage III breast cancers is almost double that in Caucasian women.
  • The aim of this study was to correlate age, receptor status, nuclear grade, and differences in treatment modalities for stage III breast cancer in an inner-city hospital serving a large AA population.
  • METHODS: A retrospective review was performed for all stage III primary breast cancers diagnosed and or treated from 2000 to 2006.
  • RESULTS: : Of 840 primary invasive breast cancers, the authors identified 107 as stage III, 40.2% IIIA, 32.7% IIIB, 16.8% T4D, and 10.3% IIIC.
  • Stage IIIC patients were younger (P < .05).
  • TNT were more likely among the inflammatory breast cancers (50.0%) compared with the other 3 groups (P < .05).
  • Twenty-two patients (20.5%) refused chemotherapy, and 24 of the 91 patients (26.3%) who should have received chest wall radiation refused.
  • There was no difference in race, marital status, religion, or age in the patients that refused chemotherapy or radiation therapy versus the majority of patients in this series who received standard care.
  • CONCLUSIONS: Stage III breast cancers in AA women have distinct clinical characteristics.
  • A high number of these patients refused chemotherapy and radiation therapy.
  • Reasons for refusal need to be better defined so strategies can be implemented to improve compliance for these advanced stage patients.
  • [MeSH-major] African Americans. Breast Neoplasms / ethnology
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Female. Humans. Middle Aged. Neoplasm Staging. Receptors, Estrogen / metabolism. Retrospective Studies. Treatment Refusal / ethnology. Treatment Refusal / statistics & numerical data

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  • (PMID = 19466698.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Receptors, Estrogen
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7. Shenkier T, Weir L, Levine M, Olivotto I, Whelan T, Reyno L, Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer: Clinical practice guidelines for the care and treatment of breast cancer: 15. Treatment for women with stage III or locally advanced breast cancer. CMAJ; 2004 Mar 16;170(6):983-94
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical practice guidelines for the care and treatment of breast cancer: 15. Treatment for women with stage III or locally advanced breast cancer.
  • OBJECTIVE: To define the optimal treatment for women with stage III or locally advanced breast cancer (LABC).
  • RECOMMENDATIONS: The management of LABC requires a combined modality treatment approach involving surgery, radiotherapy and systemic therapy.
  • Systemic therapy: chemotherapy.
  • Patients with operable stage IIIA disease should be offered chemotherapy.
  • They should receive adjuvant chemotherapy following surgery, or primary chemotherapy followed by locoregional management.
  • Chemotherapy should contain an anthracycline.
  • Patients with stage IIIB or IIIC disease, including those with inflammatory breast cancer and those with isolated ipsilateral internal mammary or supraclavicular lymph-node involvement, should be treated with primary anthracycline-based chemotherapy.
  • Acceptable chemotherapy regimens are FAC, CAF, CEF or FEC.
  • Patients with stage IIIB or IIIC disease who respond to primary chemotherapy should be treated until the response plateaus or to a maximum of 6 cycles (minimum 4 cycles).
  • Patients with stage IIIB disease should then undergo definitive surgery and irradiation.
  • The locoregional management of patients with stage IIIC disease who respond to chemotherapy should be individualized.
  • In patients with stage IIIB or IIIC disease who achieve maximum response with fewer than 6 cycles, further adjuvant chemotherapy can be given following surgery and irradiation.
  • Patients whose tumours do not respond to primary chemotherapy can be treated with taxane chemotherapy or can proceed directly to irradiation followed by modified radical mastectomy, if feasible.
  • Systemic therapy: hormonal therapy.
  • Patients with stage IIIA disease should receive both modified radical mastectomy (MRM) and locoregional radiotherapy if feasible.
  • They may be managed with MRM followed by chemotherapy and locoregional radiotherapy, or chemotherapy first followed by MRM and locoregional radiotherapy.
  • Breast-conserving surgery is currently not a standard approach.
  • Patients with stage IIIB disease who respond to chemotherapy should receive surgery plus locoregional radiotherapy.
  • The locoregional management of patients with stage IIIC disease who respond to chemotherapy is unclear and should be individualized.
  • Patients whose disease remains inoperable following chemotherapy should receive locoregional radiotherapy with subsequent surgery, if feasible.
  • VALIDATION: The authors' original text was revised by members of the Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer.
  • SPONSOR: The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer was convened by Health Canada.
  • [MeSH-major] Breast Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Female. Humans. Mastectomy. Neoplasm Staging

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  • (PMID = 15023926.001).
  • [ISSN] 0820-3946
  • [Journal-full-title] CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
  • [ISO-abbreviation] CMAJ
  • [Language] eng
  • [Publication-type] Guideline; Journal Article; Practice Guideline; Review
  • [Publication-country] Canada
  • [Number-of-references] 73
  • [Other-IDs] NLM/ PMC359433
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8. Somlo G, Frankel P, Chow W, Leong L, Margolin K, Morgan R Jr, Shibata S, Chu P, Forman S, Lim D, Twardowski P, Weitzel J, Alvarnas J, Kogut N, Schriber J, Fermin E, Yen Y, Damon L, Doroshow JH: Prognostic indicators and survival in patients with stage IIIB inflammatory breast carcinoma after dose-intense chemotherapy. J Clin Oncol; 2004 May 15;22(10):1839-48
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  • [Title] Prognostic indicators and survival in patients with stage IIIB inflammatory breast carcinoma after dose-intense chemotherapy.
  • PURPOSE: To improve treatment outcome for patients presenting with inflammatory breast cancer (IBC), we have sequentially developed and tested single and tandem dose-intense chemotherapy regimens (DICT).
  • Tumor- and treatment-related factors were analyzed to generate a prognostic model.
  • PATIENTS AND METHODS: Between May 1989 and April 2002, 120 patients received conventional-dose chemotherapy, surgery, and sequentially developed single- or tandem-cycle DICT.
  • Disease- and treatment-specific features were subjected to univariate and multivariate analysis to correlate with outcome.
  • In an age-adjusted multivariate analysis, RFS was better in patients with estrogen receptor (ER)/progesterone receptor (PR)-positive tumors (P =.002), for patients with fewer than four involved axillary nodes before DICT (P =.01), and in patients treated with radiation therapy (P =.001) and tandem DICT (P =.049).
  • OS was improved in patients with ER/PR-positive tumors (P =.002), in those with fewer than four involved axillary nodes before DICT (P =.03), and in patients treated with radiation therapy (P =.002).
  • CONCLUSION: This retrospective analysis suggests that either single or tandem DICT can be administered safely and may benefit selected patients with stage IIIB IBC.
  • Those with receptor-negative IBC and with four or more involved axillary nodes before DICT need improved neoadjuvant and postadjuvant intensification therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / mortality. Breast Neoplasms / therapy
  • [MeSH-minor] Adult. California. Combined Modality Therapy. Disease-Free Survival. Female. Hematopoietic Stem Cell Transplantation. Humans. Medical Records. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • [CommentIn] J Clin Oncol. 2005 Jun 1;23(16):3859-60; author reply 3860-2 [15923586.001]
  • (PMID = 15143076.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 33572; United States / NCI NIH HHS / CA / CA 62505; United States / NCRR NIH HHS / RR / M01 RR00043
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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9. Yuan Z, Qu X, Zhang ZT, Wang Y: Neoadjuvant chemotherapy in patients with stages II and III breast cancer. Chin Med J (Engl); 2009 Dec 20;122(24):2993-7
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  • [Title] Neoadjuvant chemotherapy in patients with stages II and III breast cancer.
  • BACKGROUND: Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer.
  • However, only a few studies have published data concerning the outcomes of patients with stages II and III breast cancer after neoadjuvant chemotherapy.
  • METHODS: This study retrospectively investigated the clinical value of neoadjuvant chemotherapy for patients with stages II and III breast cancer.
  • The patients in Group 1 (n = 54) were treated with neoadjuvant chemotherapy, followed by definitive surgery and adjuvant therapy.
  • The patients in Group 2 (n = 43) initially received definitive surgery, followed by adjuvant chemotherapy and other therapies.
  • The operability rates for breast conservation and dermatoplasty were observed in Group 1 after neoadjuvant chemotherapy.
  • RESULTS: Neoadjuvant chemotherapy increased the operability rates for breast conservation from 17.1% to 40.0% in stage II (P = 0.034) and 0% to 12.6% in stage III (P = 0.016), and decreased the dermatoplasty rates from 17.1% to 2.8% in stage II (P = 0.046) and 28.1% to 8.1% in stage III (P = 0.026).
  • The overall and disease-free survival rates of stage III disease were significantly higher in Group 1 than in Group 2 (68.4% vs 31.2%, P = 0.028, and 63.2% vs 25.0%, P = 0.024, respectively).
  • There were no significant differences in the overall and disease-free survival rates of stage II disease for Group 1 compared with Group 2 (85.7% vs 85.2%, P = 0.953, and 80.6% vs 74.1%, P = 0.400, respectively).
  • CONCLUSIONS: Neoadjuvant chemotherapy resulted in increased operability for breast conservation and decreased dermatoplasty.
  • Neoadjuvant chemotherapy exhibited better recurrence control, and overall and disease-free survival rates in stage III disease.
  • However, neoadjuvant chemotherapy did not confer greater survival on stage II disease.
  • [MeSH-major] Breast Neoplasms / drug therapy. Neoadjuvant Therapy / methods
  • [MeSH-minor] Disease-Free Survival. Female. Humans. Male. Retrospective Studies. Treatment Outcome

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  • (PMID = 20137489.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
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10. Aguiar Bujanda D, Bohn Sarmiento U, Cabrera Suárez MA, Pavcovich Ruiz M, Limeres González MA, Aguiar Morales J: Epirubicin, cyclophosphamide and weekly paclitaxel as neoadjuvant chemotherapy for stage II and III breast cancer. J Cancer Res Clin Oncol; 2006 May;132(5):332-8
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  • [Title] Epirubicin, cyclophosphamide and weekly paclitaxel as neoadjuvant chemotherapy for stage II and III breast cancer.
  • PURPOSE: To assess the efficacy and the toxicity of a new combination of epirubicin, cyclophosphamide and paclitaxel as neoadjuvant chemotherapy for breast cancer.
  • METHODS: Patients with stage II and III breast cancer received 3-4 cycles of epirubicin 75 mg/m(2) plus cyclophosphamide 600 mg/m(2) on day 1, and paclitaxel at a dose of 100 mg on days 1, 8, 15 and 22 on a 28-day cycle.
  • Stage II was present in 16 patients (32.7%) and stage III in 33 patients (67.3%).
  • Relevant toxicities were nausea/vomiting grades III-IV in 6 patients (12.2%) and neutropenia grade III-IV in 33 patients (67.3%).
  • Thirty-three non-inflammatory breast cancer patients underwent surgery, 29 with breast-conserving surgery (87.9%).
  • CONCLUSIONS: The combination of epirubicin, cyclophosphamide and weekly paclitaxel as given in this study is safe and shows good activity in the neoadjuvant setting of stage II and III breast cancer patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Carcinoma / drug therapy. Neoadjuvant Therapy
  • [MeSH-minor] Adult. Aged. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Drug Administration Schedule. Epirubicin / administration & dosage. Epirubicin / adverse effects. Female. Humans. Infusions, Intravenous. Mastectomy, Segmental. Middle Aged. Paclitaxel / administration & dosage. Paclitaxel / adverse effects. Treatment Outcome

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  • (PMID = 16435143.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 8N3DW7272P / Cyclophosphamide; P88XT4IS4D / Paclitaxel
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11. Conti F, Carpano S, Sergi D, Di Lauro L, Amodio A, Vici P, Abbate MI, Ferranti FR, Viola G, Botti C, Foggi P, Sperduti I, Lopez M: [High-dose CEF (cyclophosphamide, epirubicin, fluorouracil) as primary chemotherapy in locally advanced breast cancer: long-term results]. Clin Ter; 2007 Jul-Aug;158(4):331-41
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  • [Title] [High-dose CEF (cyclophosphamide, epirubicin, fluorouracil) as primary chemotherapy in locally advanced breast cancer: long-term results].
  • [Transliterated title] CEF (ciclofosfamide, epirubicina, fluorouracile) ad alte dosi come chemioterapia primaria nel trattamento del carcinoma mammario localmente avanzato: risultati a lungo termine.
  • PURPOSE: To determine wether primary CEF is effective in locally advanced breast cancer, as measured by response, local recurrences, disease free survival (DFS) and overall survival (OS).
  • MATERIAL AND METHODS: From 1990 to 1998, 62 patients with stage III disease were enrolled into a prospective study at Regina Elena Institute for Cancer Research, Rome.
  • Inflammatory breast cancer (IBC) was included.
  • Patients received three 21 days cycles of chemotherapy that consisted in epirubicin 50 mg/m2, cyclophosphamide 400 mg/m2, and fluorouracil 500 mg/m2 i.v. on days 1 and 8.
  • After primary chemotherapy, whenever possible, mastectomy or conservative surgery was performed.
  • Subsequently responding patients received the same regimen, while non responders were given a non cross resistant chemotherapy.
  • In case of conservative surgery or initial T4 tumor radiation therapy was performed at the end of adjuvant chemotherapy.
  • Forty IIIB non inflammatory breast cancer patients had a median DFS of 87 months (C.I.
  • Ten-year OS was 28.6% for stage IIIA, 50.6% for stage IIIB and 36% for IBC.
  • CONCLUSION: Primary CEF appear to be an effective treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Breast Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Analysis of Variance. Antineoplastic Agents, Hormonal / administration & dosage. Chemotherapy, Adjuvant. Cyclophosphamide / administration & dosage. Disease Progression. Disease-Free Survival. Drug Administration Schedule. Epirubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 17953285.001).
  • [ISSN] 0009-9074
  • [Journal-full-title] La Clinica terapeutica
  • [ISO-abbreviation] Clin Ter
  • [Language] ita
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 3Z8479ZZ5X / Epirubicin; 8N3DW7272P / Cyclophosphamide; U3P01618RT / Fluorouracil
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12. Buchholz TA, Tucker SL, Moore RA, McNeese MD, Strom EA, Jhingrin A, Hortobagyi GN, Singletary SE, Champlin RE: Importance of radiation therapy for breast cancer patients treated with high-dose chemotherapy and stem cell transplant. Int J Radiat Oncol Biol Phys; 2000 Jan 15;46(2):337-43
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  • [Title] Importance of radiation therapy for breast cancer patients treated with high-dose chemotherapy and stem cell transplant.
  • PURPOSE: To determine local-regional failure rates in breast cancer patients treated with surgery and high-dose chemotherapy with stem cell transplant and to relate local-regional failure to the use and timing of radiation treatment.
  • METHODS AND MATERIALS: We retrospectively reviewed the records of 165 breast cancer patients treated on institutional protocols with surgery and high-dose chemotherapy with stem cell transplant.
  • All patients had either Stage III disease, 10 or more positive axillary lymph nodes, or 4 or more positive axillary lymph nodes following neoadjuvant chemotherapy.
  • Twelve patients had inflammatory breast cancer.
  • Thirteen patients treated with breast preservation and 5 patients who died from toxicity within 30 days of transplant were excluded from the analyses of local-regional recurrences.
  • The disease stage distribution for these two groups was comparable.
  • The 5-year rates of any local-regional recurrence as a first event (isolated recurrences plus those with simultaneous local-regional and distant recurrences) were 92% versus 82%, respectively for patients whose treatment did and did not include radiation (p = 0.038).
  • CONCLUSIONS: These data indicate that high-dose chemotherapy does not negate the importance of radiation in optimizing local-regional control in patients with high-risk breast cancer.
  • Given the results of recent randomized trials studying postmastectomy radiation, which show that improving local-regional control improves overall survival (OS), we believe that all breast cancer patients with high-risk primary breast cancer who are treated with high-dose chemotherapy with stem cell transplant should receive radiation as a component of their treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Breast Neoplasms / radiotherapy. Hematopoietic Stem Cell Transplantation. Neoplasm Recurrence, Local / prevention & control
  • [MeSH-minor] Adult. Combined Modality Therapy. Female. Humans. Mastectomy. Multivariate Analysis. Neoplasm Staging. Retrospective Studies. Survival Analysis

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  • (PMID = 10661340.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30CA16672; United States / NCI NIH HHS / CA / T32CA77050
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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13. Tanigawa T, Miyamoto Y, Abe M, Hasuo T, Doiguchi M, Sakamoto F: [A case of inflammatory carcinoma, well-controlled by chemotherapy, especially, vinorelbine, S-1 and trastuzumab]. Gan To Kagaku Ryoho; 2009 Sep;36(9):1515-8
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  • [Title] [A case of inflammatory carcinoma, well-controlled by chemotherapy, especially, vinorelbine, S-1 and trastuzumab].
  • We experienced a case of inflammatory carcinoma, which has been well controlled by chemotherapy, especially, vinorelbine, S-1 and trastuzumab.
  • A 54-year-old woman was diagnosed as inflammatory carcinoma with T4d, N3c, M0 in Stage III c.
  • The lesion was diagnosed as invasive ductal carcinoma, scirrhous, ER(-), PgR(-), HER2(3+) by core needle biopsy, The skin lesion was diagnosed as dermal lymphatic carcinomatosis by skin biopsy.
  • The following chemotherapy was performed: FEC(5-FU 500 mg/m2, epirubicin 70 mg/m2, cyclophosphamide 500 mg/m2) followed by docetaxel(DOC 70 mg/m/2), every 3 weeks, each 6 times; after that, sequentially, vinorelbine (25 mg/m2)+trastuzumab (2 mg/kg every week), UFT(300 mg, daily)+cyclophosphamide (100 mg 2 weeks on, 1 week off)+trastuzumab (continued) and S-1 (120 mg/body 4 weeks on, 2 weeks off)+trastuzumab (continued).
  • The patient has been well controlled by the chemotherapy with good QOL.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Carcinoma, Ductal, Breast / drug therapy
  • [MeSH-minor] Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Carcinoma / drug therapy. Cyclophosphamide / administration & dosage. Drug Administration Schedule. Drug Combinations. Female. Humans. Inflammation. Middle Aged. Oxonic Acid / administration & dosage. Skin Neoplasms / drug therapy. Taxoids / administration & dosage. Tegafur / administration & dosage. Trastuzumab. Vinblastine / administration & dosage. Vinblastine / analogs & derivatives

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  • (PMID = 19755823.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; 0 / Drug Combinations; 0 / Taxoids; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 15H5577CQD / docetaxel; 5V9KLZ54CY / Vinblastine; 5VT6420TIG / Oxonic Acid; 8N3DW7272P / Cyclophosphamide; P188ANX8CK / Trastuzumab; Q6C979R91Y / vinorelbine
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14. Wedam SB, Low JA, Yang X, Chow C, Berman A, Eulate R, Danforth D, Hewitt SM, Steinberg SM, Swain SM: A pilot study to evaluate response and angiogenesis after treatment with bevacizumab in patients with inflammatory breast cancer. J Clin Oncol; 2004 Jul 15;22(14_suppl):578

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A pilot study to evaluate response and angiogenesis after treatment with bevacizumab in patients with inflammatory breast cancer.
  • : 578 Background: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer associated with vascular and lymphatic invasion.
  • METHODS: Treatment consisted of BV alone for cycle (C) 1 (15mg/m<sup>2</sup> on day 1) followed by six cycles of BV (15mg/m<sup>2</sup>) with doxorubicin (50mg/m<sup>2</sup>) and docetaxel (75mg/m<sup>2</sup>) q3wk and G-CSF in C2-7.
  • Following mastectomy and radiation, BV was given for eight more cycles with hormonal therapy for ER+ pts.
  • RESULTS: Sixteen pts enrolled received 125 cycles of treatment.
  • Pts: Stage III 87.5% and IV 12.5%, ER+ 38%, Her2 positive 12.5%.
  • A decrease in CD31/Ki67 was seen after BV treatment alone (-1% median change, p=0.031).
  • There were no decreases in Ki67 or MVD after BV alone (p=0.97 and 0.70) or BV and chemotherapy (p=0.23 and 0.85).
  • There were significant decreases in k<sub>21</sub> after treatment (n=12), with a median change of -53% (p=0.019) after C1, -70% (p=0.001) after C4, and -56% (p=0.008) after C7.
  • There were no correlations between k<sub>21</sub>and CD31/Ki67 index, Ki67, or VEGF after BV alone (n=11); but a trend towards a correlation between VEGF and k<sub>21</sub> after BV and chemotherapy (r=0.62, p=0.10).
  • CONCLUSIONS: Preliminary results revealed a decrease in vascular permeability on dMRI and endothelial cell proliferation with BV treatment alone.
  • In responding pts, there were trends toward a decrease in VEGF after BV and tumor cell proliferation after BV and chemotherapy.

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  • (PMID = 28016528.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Salazar LG, Wallace D, Mukherjee P, Higgins D, Childs J, Bates N, Coveler AL, Disis ML: HER2/neu (HER2) specific T-cell immunity in patients with HER2+ inflammatory breast cancer (IBC) and prognosis. J Clin Oncol; 2009 May 20;27(15_suppl):3057

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] HER2/neu (HER2) specific T-cell immunity in patients with HER2+ inflammatory breast cancer (IBC) and prognosis.
  • Moreover, multimodality treatment has had little impact on overall prognosis.
  • We have developed vaccines that elicit both HER2-specific CD4+ and CD8+ T-cell immunity in HER2+ cancer patients.
  • Generation of HER2-specific T-cell immunity could (1) target immunogenic and biologically relevant proteins such as HER2 in IBC, (2) result in immunogenic eradication of HER2+ tumor cells, and (3) potentially prevent disease relapse when used in the adjuvant setting after standard therapy.
  • The 24 subjects received either a HER2 DNA or HER2 peptide-based vaccine that were admixed with GM-CSF and given intradermally monthly for a total of 3 DNA or 6 peptide vaccines.
  • RESULTS: All 24 subjects had stage III IBC and median age was 48 (range 34-77).
  • 10/24 (42%) patients had ER/PR+ tumors, 9/24 (37%) had received trastuzumab, and 15/24 (62%) had received multimodality treatment (chemotherapy, mastectomy, radiotherapy).
  • 12/18 subjects (66%) evaluable for immunologic response developed HER2-specific T-cell immunity post-vaccination.
  • Median OS for patients (n=6) not generating HER2-specific immunity was 31 months and median OS for the 12 patients who developed HER2-specific immunity has not been reached at median follow-up of 46 months, (p=0.026).

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  • (PMID = 27961997.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Olfa G, Amel T, Rim C, Aymen Z, Faten E, Makrem H, Leila BF, Amel L, Hedi K, Moncef M, Slim BA: Clinical and Pathological Response to Neoadjuvant Anthracycline Based Chemotherapy in women with breast cancer. World J Oncol; 2010 Aug;1(4):167-172

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical and Pathological Response to Neoadjuvant Anthracycline Based Chemotherapy in women with breast cancer.
  • Background: Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer.
  • The aim of this study was to evaluate the predictive value of different histologic factors in breast cancer treated with neoadjuvant anthracycline chemotherapy in Tunisian women.
  • Methods: A total of 109 stage II and III breast cancer patients who received neoadjuvant anthracycline chemotherapy were enrolled in this study.
  • Conclusions: Biological markers that reliably predict clinical and pathological response to primary systemic therapy may have considerable clinical potential.
  • The future of neoadjuvant therapy lies in tailoring treatment to individual patients by identifying response predictors.

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  • (PMID = 29147200.001).
  • [ISSN] 1920-454X
  • [Journal-full-title] World journal of oncology
  • [ISO-abbreviation] World J Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Canada
  • [Keywords] NOTNLM ; Breast cancer / Chemotherapy / Histology / Predictive factors
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17. Perez MA, Ruiz J, Astudillo H, Silva M, Silva J, Pluma MA: Predicitve factors for neoadjuvant chemotherapy in locally advanced breast cancer. J Clin Oncol; 2004 Jul 15;22(14_suppl):863

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Predicitve factors for neoadjuvant chemotherapy in locally advanced breast cancer.
  • : 863 Background: Neoadjuvant chemotherapy is the standard treatment for locally advanced breast cancer.
  • Non randomized studies with various chemotherapy agents administered preoperatively demonstrated significant clinical response rates, but low rates of pathological tumor response.
  • Our purpose is to identify the prognostic factors that determine response to preoperative chemotherapy.
  • METHODS: We made a retrospective analysis of 19 patients with Locally Advanced Breast Cancer (LABC), stages IIIA, IIIB (including inflammatory breast cancer) and IVA.
  • The analysed variables were age, clincal stage (CS), histology, grade, Her2.neu, hormone receptors status, clinical response, pathologic response and Disease free survival.
  • 3 CS IIIA, 10 IIIb, 4 Inflammatory and 2 IVa.
  • 12 (63.15%) Grade II and 7 (36.84%) Grade III.
  • Median follow up of 16 months (3-38m).We made comparisons by the chi square test finding no statistical significance between our varibles to predict rsponse to chemotherapy.
  • CONCLUSIONS: None of our variables (clincal and molecular) predicted response or resistance to treatment.

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  • (PMID = 28014266.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Coplin M, Naughton M: Clinical and pathologic predictors of complete pathologic response to neoadjuvant docetaxel/anthracycline chemotherapy in breast cancer patients. J Clin Oncol; 2004 Jul 15;22(14_suppl):836

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical and pathologic predictors of complete pathologic response to neoadjuvant docetaxel/anthracycline chemotherapy in breast cancer patients.
  • : 836 Background: Neoadjuvant chemotherapy is frequently used in women with primarily operable breast cancer, and is the standard of care in women with locally advanced disease.
  • Response to neoadjuvant therapy is a good predictor of long-term outcome, and women with a pCR have a very good prognosis in comparison with all other subgroups.
  • At the present time, it is not possible to predict whether an individual woman has a higher probability of achieving a pCR to one regimen rather than another.
  • Identifying pre-treatment factors that predict chemotherapy sensitivity would potentially allow for individually tailored chemotherapy regimens.
  • METHODS: Breast cancer patients who received neoadjuvant chemotherapy between 1998 and 2003 were extracted from our institutional transcription service and clinical data was retrieved from medical charts and computer databases.
  • 32% were clinically stage II, 32% stage III, 22% were identified as locally advanced, and 12% inflammatory.
  • CONCLUSIONS: HER2 amplification and ER expression did not predict pCR in breast cancer patients receiving neoadjuvant docetaxel and doxorubicin at our institution.
  • KEY WORDS: docetaxel, breast cancer, neoadjuvant, predictors of response No significant financial relationships to disclose.

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  • (PMID = 28014239.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Smith JW, Buyse M, Rastogi P, Geyer C Jr, Jacobs S, Patocskai E, Wolmark N: Epirubicin plus cyclophosphamide followed by docetaxel plus trastuzumab and bevacizumab as neoadjuvant therapy for HER2-positive locally advanced breast cancer (LABC) or as adjuvant therapy for HER2-positive pathologic stage III breast cancer (PS3BC): A phase II trial of the NSABP Foundation Research Group. J Clin Oncol; 2009 May 20;27(15_suppl):580

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Epirubicin plus cyclophosphamide followed by docetaxel plus trastuzumab and bevacizumab as neoadjuvant therapy for HER2-positive locally advanced breast cancer (LABC) or as adjuvant therapy for HER2-positive pathologic stage III breast cancer (PS3BC): A phase II trial of the NSABP Foundation Research Group.
  • : 580 Background: A previous phase II study evaluating the combination of trastuzumab (tras) and bevacizumab (bev) as first-line therapy in HER2 + MBC showed a response rate of 54%.
  • Targeted therapy: Cohort A (neoadjuvant), bev 15 mg/kg IV with Cycle 4 of EC, continued with the first 3 cycles of T.
  • Standard weekly tras with 4 cycles of T.
  • Postop, bev 15 mg/kg IV and tras 6 mg/kg IV q3wks to complete 1 yr of targeted therapy.
  • Cohort B (adjuvant), bev 15 mg/kg q3wks for 4 cycles and weekly tras with T.
  • After chemotherapy, bev and tras q3wks to complete 1 yr of therapy.
  • Primary endpoints were the rate of cardiac events in both cohorts and pCR rate in breast/axillary lymph nodes in Cohort A.
  • In Cohort A, 28 (53%) patients (pts) were stage IIIA, 20 (38%) stage IIIB, and 5 (9%) stage IIIC.
  • 13 (25%) had inflammatory BC.
  • Toxicity information on the first 73 pts in both cohorts showed that grade 2 LVEF dysfunction has developed in 5 pts and grade 3 LVEF dysfunction in 2, 1 with NYHA Class II and 1 with Class III symptoms.

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  • (PMID = 27960693.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Yildirim E, Semerci E, Berberoğlu U: The analysis of prognostic factors in stage III-B non-inflammatory breast cancer. Eur J Surg Oncol; 2000 Feb;26(1):34-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The analysis of prognostic factors in stage III-B non-inflammatory breast cancer.
  • AIMS: To evaluate factors predicting disease recurrence in patients treated for stage III-B breast cancer by neoadjuvant chemotherapy followed by surgery.
  • METHODS: A retrospective study of 52 patients who responded to neoadjuvant chemotherapy followed by modified radical mastectomy was carried out.
  • The parameters studied included pre-treatment tumour size, clinical axillary status, grade, lymphatic-vascular invasion, pathological axillary status, number of metastatic lymph nodes, menopausal status and oestrogen receptor status.
  • CONCLUSIONS: These results indicate that the number of involved lymph nodes after neoadjuvant chemotherapy, independent of the clinical response of primary tumour, had a most significant impact on disease free survival.
  • Additionally primary tumour size had a marked prognostic significance in spite of clinical changes in tumours following chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / pathology. Lymph Nodes / pathology. Mastectomy, Modified Radical
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Lymphatic Metastasis. Menopause. Middle Aged. Multivariate Analysis. Neoadjuvant Therapy. Neoplasm Invasiveness. Neoplasm Recurrence, Local. Neoplasm Staging. Predictive Value of Tests. Prognosis. Receptors, Estrogen / analysis. Retrospective Studies. Vascular Neoplasms / secondary

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  • (PMID = 10718177.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Receptors, Estrogen
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21. Berberoglu U, Yildirim E, Celen O: Serum levels of tumor necrosis factor alpha correlate with response to neoadjuvant chemotherapy in locally advanced breast cancer. Int J Biol Markers; 2004 Apr-Jun;19(2):130-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Serum levels of tumor necrosis factor alpha correlate with response to neoadjuvant chemotherapy in locally advanced breast cancer.
  • It has been shown that serum levels of tumor necrosis factor alpha (TNF-alpha) are increased in breast cancer patients.
  • There are few data available on the reduction of serum levels of this cytokine following chemotherapy.
  • The aim of this study was to determine the effect of neoadjuvant chemotherapy on serum concentrations of TNF-alpha and the relation to response rates in locally advanced breast cancer.
  • Twenty consecutive patients with non-inflammatory stage III-B breast cancer achieving a partial or complete clinical response to three courses of neoadjuvant chemotherapy followed by modified radical mastectomy were prospectively included in the study and evaluated.
  • Sera were collected before the start and after the termination of chemotherapy.
  • The mean pre-treatment TNF-alpha value of breast cancer patients was 15.9 +/- 0.9 pg/mL while it was 5.8 +/- 1.7 pg/mL in the control group; the difference was statistically significant (p < 0.0001).
  • The serum levels of TNF-alpha were markedly decreased in patients with partial and complete responses compared to pre-treatment values (p < 0.0001).
  • The relative change between pre- and post-treatment values correlated significantly with the type of response (p = 0.004).
  • These results suggest that the serum concentration of TNF-alpha can be an indicator of response and could be used in clinical decision-making for patients with locally advanced breast cancer.
  • [MeSH-major] Biomarkers, Tumor / blood. Breast Neoplasms / blood. Breast Neoplasms / drug therapy. Chemotherapy, Adjuvant. Tumor Necrosis Factor-alpha / biosynthesis
  • [MeSH-minor] Adult. Aged. Case-Control Studies. Cyclophosphamide / therapeutic use. Doxorubicin / therapeutic use. Enzyme-Linked Immunosorbent Assay. Female. Fluorouracil / therapeutic use. Humans. Lymphatic Metastasis. Middle Aged. Time Factors. Treatment Outcome

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  • (PMID = 15255545.001).
  • [ISSN] 0393-6155
  • [Journal-full-title] The International journal of biological markers
  • [ISO-abbreviation] Int. J. Biol. Markers
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Tumor Necrosis Factor-alpha; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; U3P01618RT / Fluorouracil
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22. Gianni L, Eiermann W, Semiglazov V, Manikhas A, Lluch A, Tjulandin S, Zambetti M, Vazquez F, Byakhow M, Lichinitser M, Climent MA, Ciruelos E, Ojeda B, Mansutti M, Bozhok A, Baronio R, Feyereislova A, Barton C, Valagussa P, Baselga J: Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. Lancet; 2010 Jan 30;375(9712):377-84
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort.
  • BACKGROUND: The monoclonal antibody trastuzumab has survival benefit when given with chemotherapy to patients with early, operable, and metastatic breast cancer that has HER2 (also known as ERBB2) overexpression or amplification.
  • We aimed to assess event-free survival in patients with HER2-positive locally advanced or inflammatory breast cancer receiving neoadjuvant chemotherapy with or without 1 year of trastuzumab.
  • METHODS: We compared 1 year of treatment with trastuzumab (given as neoadjuvant and adjuvant treatment; n=117) with no trastuzumab (118), in women with HER2-positive locally advanced or inflammatory breast cancer treated with a neoadjuvant chemotherapy regimen consisting of doxorubicin, paclitaxel, cyclophosphamide, methotrexate, and fluorouracil.
  • Randomisation was done with a computer program and minimisation technique, taking account of geographical area, disease stage, and hormone receptor status.
  • Investigators were informed of treatment allocation.
  • A parallel cohort of 99 patients with HER2-negative disease was included and treated with the same chemotherapy regimen.
  • FINDINGS: Trastuzumab significantly improved event-free survival in patients with HER2-positive breast cancer (3-year event-free survival, 71% [95% CI 61-78; n=36 events] with trastuzumab, vs 56% [46-65; n=51 events] without; hazard ratio 0.59 [95% CI 0.38-0.90]; p=0.013).
  • Trastuzumab was well tolerated and, despite concurrent administration with doxorubicin, only two patients (2%) developed symptomatic cardiac failure.
  • Both responded to cardiac drugs.
  • INTERPRETATION: The addition of neoadjuvant and adjuvant trastuzumab to neoadjuvant chemotherapy should be considered for women with HER2-positive locally advanced or inflammatory breast cancer to improve event-free survival, survival, and clinical and pathological tumour responses.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antibodies, Monoclonal / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Receptor, ErbB-2 / drug effects
  • [MeSH-minor] Adult. Antibodies, Monoclonal, Humanized. Chemotherapy, Adjuvant. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Disease-Free Survival. Doxorubicin / administration & dosage. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Genes, erbB-2 / genetics. Humans. Infusions, Intravenous. Methotrexate / administration & dosage. Middle Aged. Neoadjuvant Therapy. Paclitaxel / administration & dosage. Proportional Hazards Models. Prospective Studies. Time Factors. Trastuzumab

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  • [Copyright] Copyright 2010 Elsevier Ltd. All rights reserved.
  • [CommentIn] Lancet. 2010 Jan 30;375(9712):349-50 [20113810.001]
  • (PMID = 20113825.001).
  • [ISSN] 1474-547X
  • [Journal-full-title] Lancet (London, England)
  • [ISO-abbreviation] Lancet
  • [Language] eng
  • [Databank-accession-numbers] ISRCTN/ ISRCTN86043495
  • [Publication-type] Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; EC 2.7.10.1 / Receptor, ErbB-2; P188ANX8CK / Trastuzumab; P88XT4IS4D / Paclitaxel; U3P01618RT / Fluorouracil; YL5FZ2Y5U1 / Methotrexate
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23. Huang J, Zhang P, Liu P, Ou GF, Wang ZP, Xu BH: [Inflammatory breast cancer: 38 cases clinical report]. Ai Zheng; 2002 Aug;21(8):888-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Inflammatory breast cancer: 38 cases clinical report].
  • BACKGROUND & OBJECTIVE: Inflammatory breast cancer (IBC) is a special form of rapidly progressive breast cancer with poor prognosis.
  • The purpose of this study was to investigate the clinical characters, treatment, and prognosis of inflammatory breast cancer.
  • METHODS: Thirty-eight patients with inflammatory breast cancer who were diagnosed and treated from March 20, 1970 to December 21, 2001 in our hospital were analyzed retrospectively.
  • RESULTS: All IBC patients presented clinically with an erythematous or swollen and tender breast, no fever.
  • Twenty-four patients were in stage III b and 14 in stage IV.
  • Eighteen patients received local treatment (radiotherapy or surgery) firstly and 20 patients underwent chemotherapy firstly.
  • The administration of chemotherapy first improved the outcome of IBC.
  • Earlier stage showed more favorable prognosis.
  • CONCLUSIONS: Combination therapy with chemotherapy first was an effective treatment for IBC.
  • [MeSH-major] Breast Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Humans. Inflammation. Middle Aged. Neoplasm Staging. Retrospective Studies. Survival Analysis. Survival Rate. Treatment Outcome

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  • (PMID = 12478900.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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24. Mina L, Soule SE, Badve S, Baehner FL, Baker J, Cronin M, Watson D, Liu ML, Sledge GW Jr, Shak S, Miller KD: Predicting response to primary chemotherapy: gene expression profiling of paraffin-embedded core biopsy tissue. Breast Cancer Res Treat; 2007 Jun;103(2):197-208
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  • [Title] Predicting response to primary chemotherapy: gene expression profiling of paraffin-embedded core biopsy tissue.
  • PURPOSE: Primary chemotherapy provides an ideal opportunity to correlate gene expression with response to treatment.
  • We used paraffin-embedded core biopsies from a completed phase II trial to identify genes that correlate with response to primary chemotherapy.
  • PATIENTS AND METHODS: Patients with newly diagnosed stage II or III breast cancer were treated with sequential doxorubicin 75 mg/M2 q2 wks x 3 and docetaxel 40 mg/M2 weekly x 6; treatment order was randomly assigned.
  • RESULTS: Of 70 patients enrolled in the parent trial, core biopsies samples with sufficient RNA for gene analyses were available from 45 patients; 9 (20%) had inflammatory breast cancer (IBC).
  • In an exploratory analysis we compared gene expression in IBC to non-inflammatory breast cancer; twenty-four (9%) of the genes were differentially expressed (p < 0.05), 5 were upregulated and 19 were downregulated in IBC.
  • CONCLUSION: Gene expression analysis on core biopsy samples is feasible and identifies candidate genes that correlate with pCR to primary chemotherapy.
  • Gene expression in IBC differs significantly from noninflammatory breast cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Gene Expression Profiling
  • [MeSH-minor] Adult. Aged. Biopsy. Breast / metabolism. Breast / pathology. Female. Humans. Middle Aged. Paraffin Embedding

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  • (PMID = 17039265.001).
  • [ISSN] 0167-6806
  • [Journal-full-title] Breast cancer research and treatment
  • [ISO-abbreviation] Breast Cancer Res. Treat.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
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25. Coudert BP, Arnould L, Moreau L, Chollet P, Weber B, Vanlemmens L, Moluçon C, Tubiana N, Causeret S, Misset JL, Feutray S, Mery-Mignard D, Garnier J, Fumoleau P: Pre-operative systemic (neo-adjuvant) therapy with trastuzumab and docetaxel for HER2-overexpressing stage II or III breast cancer: results of a multicenter phase II trial. Ann Oncol; 2006 Mar;17(3):409-14
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  • [Title] Pre-operative systemic (neo-adjuvant) therapy with trastuzumab and docetaxel for HER2-overexpressing stage II or III breast cancer: results of a multicenter phase II trial.
  • BACKGROUND: Trastuzumab plus chemotherapy has become the standard of care for women with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer.
  • Trastuzumab-based pre-operative systemic (neo-adjuvant) therapy (PST) also appears promising, warranting further investigation.
  • PATIENTS AND METHODS: Patients with HER2-positive, stage II/III non-inflammatory, operable breast cancer requiring a mastectomy (but who wished to conserve the breast) received weekly trastuzumab and 3-weekly docetaxel for six cycles before surgery.
  • Twenty-nine patients completed six cycles of therapy and one patient withdrew prematurely due to progressive disease.
  • Surgery was performed in 30 patients, breast conserving in 23 (77%).
  • Treatment was generally well tolerated.
  • CONCLUSIONS: PST with trastuzumab plus docetaxel achieved promising efficacy, with a high pCR rate and good tolerability, in women with stage II or III HER2-positive breast cancer.

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  • (PMID = 16332965.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Taxoids; 15H5577CQD / docetaxel; P188ANX8CK / Trastuzumab
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26. Gutierrez-Delgado F, Holmberg LA, Hooper H, Appelbaum FR, Livingston RB, Maziarz RT, Weiden P, Rivkin S, Montgomery P, Kawahara K, Bensinger W: High-dose busulfan, melphalan and thiotepa as consolidation for non-inflammatory high-risk breast cancer. Bone Marrow Transplant; 2000 Jul;26(1):51-9
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  • [Title] High-dose busulfan, melphalan and thiotepa as consolidation for non-inflammatory high-risk breast cancer.
  • The purpose of this study was to evaluate the toxicity and efficacy of high-dose busulfan, melphalan and thiotepa (Bu/Mel/TT) in patients with high-risk non-inflammatory breast cancer defined as stage II disease > or =10 lymph nodes (n = 52) or stage III (n = 69), and prognostic factors for treatment outcome.
  • One hundred patients were initially treated with surgery followed by standard adjuvant chemotherapy prior to HDC/ASCI.
  • Twenty-one patients with stage III disease had inoperable tumors at diagnosis and were treated with neoadjuvant chemotherapy and surgery before HDC/ASCI.
  • The probabilities of event-free survival (EFS) at 3 and 5 years (median follow-up of 36 months) from transplant were, for all patients: 0.62-0.60; stage II: 0.71-0.67: stage III: 0.55-0.55 (for stage III adjuvant and neoadjuvant groups: 0.60-0.60 and 0.42-0.42, respectively).
  • The efficacy of Bu/Mel/TT is similar to other HDC regimens reported for patients with high-risk non-inflammatory breast cancer.
  • Bu/Mel/TT has high activity in stage II disease and a moderate benefit in stage III operable tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / therapy. Hematopoietic Stem Cell Transplantation
  • [MeSH-minor] Adult. Busulfan / administration & dosage. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Follow-Up Studies. Humans. Inflammation. Melphalan / administration & dosage. Middle Aged. Multivariate Analysis. Neoplasm Staging. Survival Rate. Thiotepa / administration & dosage. Time Factors

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  • (PMID = 10918405.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 15704; United States / NCI NIH HHS / CA / CA 18221; United States / NCI NIH HHS / CA / CA 47748; etc
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 905Z5W3GKH / Thiotepa; G1LN9045DK / Busulfan; Q41OR9510P / Melphalan
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27. Okawa Y, Sugiyama K, Aiba K, Hirano A, Uno S, Hagino T, Kawase K, Shioya H, Yoshida K, Usui N, Kobayashi M, Kobayashi T: Successful combination therapy with trastuzumab and Paclitaxel for adriamycin- and docetaxel-resistant inflammatory breast cancer. Breast Cancer; 2004;11(3):309-12
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  • [Title] Successful combination therapy with trastuzumab and Paclitaxel for adriamycin- and docetaxel-resistant inflammatory breast cancer.
  • We present a case of adriamycin-and docetaxel-resistant inflammatory breast cancer (IBC) in which partial response was achieved with combination therapy using trastuzumab and paclitaxel.
  • A 48-year old woman noticed a lump in her right breast.
  • She was diagnosed with IBC and the disease was staged as T4d N1 M0, stage III B.
  • The patient was started on neoadjuvant chemotherapy with adriamycin (50 mg/m2) and docetaxel (60 mg/m2) administered every three weeks.
  • After one month, contralateral breast swelling indicated bilateral IBC.
  • To treat the clinically advanced breast cancer, combination therapy with trastuzumab (initially 4 mg/kg followed by two or more cycles of 2 mg/kg) and paclitaxel (80 mg/m2) were given intravenously every week for eight cycles and then every two weeks thereafter.
  • A total of 32 courses of therapy were performed, the pleural effusion completely disappeared and partial response was maintained for a duration of 482 days.
  • This report suggests that weekly combination therapy of trastuzumab and paclitaxel was useful for treatment of adriamycin-and docetaxel-resistant metastatic breast cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy
  • [MeSH-minor] Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Antineoplastic Agents / administration & dosage. Combined Modality Therapy. Doxorubicin / administration & dosage. Female. Humans. Leukopenia / chemically induced. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Pleural Effusion, Malignant / etiology. Pleural Effusion, Malignant / therapy. Taxoids / administration & dosage. Trastuzumab. Treatment Outcome

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  • (PMID = 15550852.001).
  • [ISSN] 1340-6868
  • [Journal-full-title] Breast cancer (Tokyo, Japan)
  • [ISO-abbreviation] Breast Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Antineoplastic Agents; 0 / Taxoids; 15H5577CQD / docetaxel; 80168379AG / Doxorubicin; P188ANX8CK / Trastuzumab; P88XT4IS4D / Paclitaxel
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28. Low JA, Berman AW, Steinberg SM, Danforth DN, Lippman ME, Swain SM: Long-term follow-up for locally advanced and inflammatory breast cancer patients treated with multimodality therapy. J Clin Oncol; 2004 Oct 15;22(20):4067-74
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  • [Title] Long-term follow-up for locally advanced and inflammatory breast cancer patients treated with multimodality therapy.
  • PURPOSE: To determine long-term event-free (EFS) and overall survival (OS) for patients with stage III breast cancer treated with combined-modality therapy.
  • PATIENTS AND METHODS: Between 1980 and 1988, 107 patients with stage III breast cancer were prospectively enrolled for study at the National Cancer Institute and stratified by whether or not they had features of inflammatory breast cancer (IBC).
  • Patients with pathologic complete response received definitive radiotherapy to the breast and axilla, whereas patients with residual disease underwent mastectomy, lymph node dissection, and radiotherapy.
  • All patients underwent six additional cycles of adjuvant chemotherapy.
  • RESULTS: OS and EFS were obtained with a median live patient follow-up time of 16.8 years.
  • The 46 IBC patients had a median OS of 3.8 years and EFS of 2.3 years, compared with 12.2 and 9.0 years, respectively, in stage IIIA breast cancer patients.
  • Fifteen-year OS survival was 20% for IBC versus 50% for stage IIIA patients and 23% for stage IIIB non-IBC.
  • Pathologic response was not associated with improved survival for stage IIIA or IBC patients.
  • CONCLUSION: Fifteen-year follow-up of stage IIIA and inflammatory breast cancer is rarely reported; IBC patients have a poor long-term outlook.
  • [MeSH-major] Breast Neoplasms / therapy. Combined Modality Therapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents, Alkylating. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Disease-Free Survival. Female. Follow-Up Studies. Humans. Inflammation. Mastectomy. Middle Aged. Neoadjuvant Therapy. Survival Rate


29. Maughan KL, Lutterbie MA, Ham PS: Treatment of breast cancer. Am Fam Physician; 2010 Jun 1;81(11):1339-46
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  • [Title] Treatment of breast cancer.
  • Understanding breast cancer treatment options can help family physicians care for their patients during and after cancer treatment.
  • This article reviews typical treatments based on stage, histology, and biomarkers.
  • Lobular carcinoma in situ does not require treatment.
  • Ductal carcinoma in situ can progress to invasive cancer and is treated with breast-conserving surgery and radiation therapy without further lymph node exploration or systemic therapy.
  • Stages I and II breast cancers are usually treated with breast-conserving surgery and radiation therapy.
  • Radiation therapy following breast-conserving surgery decreases mortality and recurrence.
  • Sentinel lymph node biopsy is considered for most breast cancers with clinically negative axillary lymph nodes, and it does not have the adverse effects of arm swelling and pain that are associated with axillary lymph node dissection.
  • Choice of adjuvant systemic therapy depends on lymph node involvement, hormone receptor status, ERBB2 (formerly HER2 or HER2/neu) overexpression, and patient age and menopausal status.
  • In general, node-positive breast cancer is treated systemically with chemotherapy, endocrine therapy (for hormone receptor-positive cancer), and trastuzumab (for cancer overexpressing ERBB2).
  • Anthracycline- and taxane-containing chemotherapeutic regimens are active against breast cancer.
  • Stage III breast cancer typically requires induction chemotherapy to downsize the tumor to facilitate breast-conserving surgery.
  • Inflammatory breast cancer, although considered stage III, is aggressive and requires induction chemotherapy followed by mastectomy, rather than breastconserving surgery, as well as axillary lymph node dissection and chest wall radiation.
  • Prognosis is poor in women with recurrent or metastatic (stage IV) breast cancer, and treatment options must balance benefits in length of life and reduced pain against harms from treatment.
  • [MeSH-major] Breast Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Humans. Mastectomy. Neoplasm Staging. Sentinel Lymph Node Biopsy

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  • [CommentIn] Am Fam Physician. 2010 Jun 1;81(11):1330-2 [20521750.001]
  • [CommentIn] Am Fam Physician. 2011 Mar 1;83(5):507; author reply 507 [21391515.001]
  • [CommentIn] Am Fam Physician. 2011 Mar 1;83(5):502-6; author reply 507 [21391514.001]
  • [CommentIn] Am Fam Physician. 2010 Jun 1;81(11):1347-9 [20527363.001]
  • (PMID = 20521754.001).
  • [ISSN] 1532-0650
  • [Journal-full-title] American family physician
  • [ISO-abbreviation] Am Fam Physician
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 63
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30. Franceschini G, Terribile D, Fabbri C, Magno S, D'Alba P, Chiesa F, Di Leone A, Masetti R: Management of locally advanced breast cancer. Mini-review. Minerva Chir; 2007 Aug;62(4):249-55
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  • [Title] Management of locally advanced breast cancer. Mini-review.
  • The term locally advanced breast cancer (LABC) encompasses a heterogeneous group of breast neoplasms; in the last revision of the American Joint Committee on Cancer (AJCC) staging system, all of stage III disease is considered locally advanced.
  • LABC constitutes up to 20% of breast cancer in medically underserved populations in the United States and up to 75% of breast cancers in developing countries.
  • The prognosis depends on tumor size, extent of lymph node involvement, and the presence or absence of an inflammatory component.
  • However, a multidisciplinary approach is always recommended combining surgery, radiotherapy and systemic therapy (chemotherapy and/or hormone therapy).
  • In this paper, we discuss the possible options in the management of operable (stage IIIA) and inoperable (stage IIIB-IIIC) LABC.
  • [MeSH-major] Breast Neoplasms / pathology. Breast Neoplasms / therapy
  • [MeSH-minor] Algorithms. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Decision Trees. Female. Humans. Mastectomy / methods. Neoadjuvant Therapy / methods. Neoplasm Invasiveness. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 17641585.001).
  • [ISSN] 0026-4733
  • [Journal-full-title] Minerva chirurgica
  • [ISO-abbreviation] Minerva Chir
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 34
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31. Buchholz TA, Strom EA, Perkins GH, McNeese MD: Controversies regarding the use of radiation after mastectomy in breast cancer. Oncologist; 2002;7(6):539-46
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  • [Title] Controversies regarding the use of radiation after mastectomy in breast cancer.
  • It is clear that radiation therapy plays a critical role in the multidisciplinary management of patients with locally advanced or inflammatory breast cancer.
  • It is also accepted that postmastectomy radiation is not required for most women with noninvasive disease or stage I disease.
  • Randomized clinical trials studying radiation treatments for women with stage II or III breast cancer have shown that the addition of radiation after mastectomy can reduce local-regional recurrence rates, which then improves survival.
  • However, other data have indicated that the risk of local-regional recurrence after mastectomy and chemotherapy is low for patients with small tumors and one to three positive lymph nodes, leading some to question whether postmastectomy radiation is useful for this group.
  • A second controversy regards the sequencing of postmastectomy radiation and breast reconstruction.
  • [MeSH-major] Breast Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Humans. Mastectomy. Neoplasm Recurrence, Local. Randomized Controlled Trials as Topic. Reconstructive Surgical Procedures. Survival Analysis. Treatment Outcome

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  • (PMID = 12490741.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 16672; United States / NCI NIH HHS / CA / T32 CA 77050
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] United States
  • [Number-of-references] 24
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32. Cameron DA, Stein S: Drug Insight: intracellular inhibitors of HER2--clinical development of lapatinib in breast cancer. Nat Clin Pract Oncol; 2008 Sep;5(9):512-20
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  • [Title] Drug Insight: intracellular inhibitors of HER2--clinical development of lapatinib in breast cancer.
  • Targeting the human epidermal growth factor receptor type 2 (HER2) in breast cancer patients whose tumors overexpress HER2 has been clearly demonstrated to be effective in clinical trials with the monoclonal antibody trastuzumab.
  • Not all patients, however, respond to trastuzumab therapy.
  • In a pivotal phase III trial, a combination of lapatinib and capecitabine significantly decreased the risk of disease progression relative to capecitabine alone in women with HER2-positive advanced or metastatic breast cancer previously treated with anthracyclines, taxanes, and trastuzumab.
  • Other trials are evaluating lapatinib in inflammatory breast cancer--for which encouraging data have been reported--in combination with hormone therapy, in combination with trastuzumab, and as an adjunct to adjuvant therapy for early-stage disease.
  • These features make lapatinib an ideal agent to evaluate more fully in HER2-positive metastatic and early-stage breast cancer.
  • [MeSH-major] Breast Neoplasms / drug therapy. Genes, erbB-2 / drug effects. Protein Kinase Inhibitors / therapeutic use. Quinazolines / therapeutic use. Receptor, ErbB-2 / antagonists & inhibitors
  • [MeSH-minor] Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Capecitabine. Clinical Trials, Phase I as Topic. Clinical Trials, Phase II as Topic. Clinical Trials, Phase III as Topic. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Disease Progression. Female. Fluorouracil / administration & dosage. Fluorouracil / analogs & derivatives. Humans. Paclitaxel / administration & dosage. Randomized Controlled Trials as Topic. Tamoxifen / administration & dosage. Time Factors. Trastuzumab

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  • (PMID = 18594499.001).
  • [ISSN] 1743-4262
  • [Journal-full-title] Nature clinical practice. Oncology
  • [ISO-abbreviation] Nat Clin Pract Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Protein Kinase Inhibitors; 0 / Quinazolines; 094ZI81Y45 / Tamoxifen; 0VUA21238F / lapatinib; 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; EC 2.7.10.1 / Receptor, ErbB-2; P188ANX8CK / Trastuzumab; P88XT4IS4D / Paclitaxel; U3P01618RT / Fluorouracil
  • [Number-of-references] 55
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33. Dawood S, Broglio K, Kau SW, Islam R, Symmans WF, Buchholz TA, McGuire SE, Meric-Bernstam F, Cristofanilli M, Hortobágyi GN, Gonzalez-Angulo AM: Prognostic value of initial clinical disease stage after achieving pathological complete response. Oncologist; 2008 Jan;13(1):6-15
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  • [Title] Prognostic value of initial clinical disease stage after achieving pathological complete response.
  • The aim of this retrospective study was to determine the prognostic impact of initial clinical stage in patients who achieved a pathological complete response (pCR) after receiving primary systemic chemotherapy (PST).
  • Cox proportional hazards models were fit to determine the association of initial clinical stage with survival outcomes after adjusting for patient and tumor characteristics.
  • Twenty (4.1%) patients had stage I disease, 243 (49.7%) had stage II disease, 189 (38.7%) had stage III disease, and 37 (7.5%) had inflammatory breast cancer (IBC).
  • Lower clinical stage at diagnosis was associated with statistically significant higher RFS and OS rates.
  • In a multivariate model, patients with clinical stage IIIB/C disease and those with IBC had lower RFS rates than patients with clinical stage I/II/IIIA disease.
  • In addition, patients with clinical stage IIIB/C disease and those with IBC had a greater hazard of death than patients with clinical stage I/II/IIIA disease.
  • However, higher clinical stage and IBC were associated with worse outcomes in breast cancer patients who achieved a pCR after PST.
  • [MeSH-major] Anthracyclines / therapeutic use. Breast Neoplasms / drug therapy. Breast Neoplasms / pathology
  • [MeSH-minor] Disease-Free Survival. Female. Humans. Kaplan-Meier Estimate. Middle Aged. Neoplasm Staging. Prognosis. Remission Induction. Retrospective Studies. Treatment Outcome

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  • (PMID = 18245008.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 2P30 CA016672; United States / NCI NIH HHS / CA / K23CA121994-01; United States / NCI NIH HHS / CA / P50 CA116199-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anthracyclines
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34. Tokunaga Y, Hosogi H, Nakagami M, Tokuka A, Ohsumi K: A case of chest wall recurrence of breast cancer treated with paclitaxel weekly, 5'-deoxy-5-fluorouridine, arterial embolization and chest wall resection. Breast Cancer; 2003;10(4):366-70
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  • [Title] A case of chest wall recurrence of breast cancer treated with paclitaxel weekly, 5'-deoxy-5-fluorouridine, arterial embolization and chest wall resection.
  • Chest wall resection and reconstruction has proved to be a safe surgical procedure for local recurrence of breast cancer.
  • Recently, as second- or third-line chemotherapy for the patients with recurrent breast cancer or ovarian cancer, weekly paclitaxel has provided a significant response rate in those patients, and generated much clinical interest.
  • We report here a case of chest wall recurrence of breast cancer successfully treated by a combination of weekly paclitaxel, 5'-deoxy-5-fluorouridine, arterial embolization, and chest wall resection.
  • A recurrent tumor developed and enlarged one-and-half years after undergoing modified radical mastectomy for advanced breast cancer (T4N2M0, stage III B) at another hospital.
  • The mass had enlarged while the patient underwent chemotherapy with cyclophosphamide, doxorubicin, 5-fluorouracil, and anastozole, followed by low-dose cisplatin, 5-fluorouracil, and goserelin.
  • To reduce the mass and inflammatory changes of the skin, weekly paclitaxel and 5'-deoxy-5-fluorouridine was given.
  • Chest wall resection, reconstruction of the bony chest wall with polypropylene mesh folded 8 times, and soft tissue reconstruction with a contralateral myocutaneous flap were carried out successfully.
  • A multimodal approach with chemotherapy and arterial embolization was effective in this case in treating chest wall recurrence of breast cancer.
  • Reconstruction of the chest wall bone with polypropylene mesh folded 8 times and soft tissue reconstruction with a contralateral myocutaneous flap was a useful procedure after chest wall resection, even after chemotherapy and arterial embolization.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / therapy. Carcinoma, Ductal / therapy. Embolization, Therapeutic. Reconstructive Surgical Procedures / methods. Thoracic Wall
  • [MeSH-minor] Angiography. Female. Floxuridine / administration & dosage. Humans. Middle Aged. Paclitaxel / administration & dosage. Tomography, X-Ray Computed

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  • (PMID = 14634517.001).
  • [ISSN] 1340-6868
  • [Journal-full-title] Breast cancer (Tokyo, Japan)
  • [ISO-abbreviation] Breast Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 039LU44I5M / Floxuridine; P88XT4IS4D / Paclitaxel; V1JK16Y2JP / doxifluridine
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35. Vujaskovic Z, Kim DW, Jones E, Lan L, McCall L, Dewhirst MW, Craciunescu O, Stauffer P, Liotcheva V, Betof A, Blackwell K: A phase I/II study of neoadjuvant liposomal doxorubicin, paclitaxel, and hyperthermia in locally advanced breast cancer. Int J Hyperthermia; 2010;26(5):514-21
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  • [Title] A phase I/II study of neoadjuvant liposomal doxorubicin, paclitaxel, and hyperthermia in locally advanced breast cancer.
  • PURPOSE: The prognosis for locally advanced breast cancer (LABC) patients continues to be poor, with an estimated five-year survival of only 50-60%.
  • Preclinical data demonstrates enhanced therapeutic efficacy with liposomal encapsulation of doxorubicin combined with hyperthermia (HT).
  • Therefore this phase I/II study was designed to evaluate the safety and efficacy of a novel neoadjuvant combination treatment of paclitaxel, liposomal doxorubicin, and hyperthermia.
  • They subsequently underwent either a modified radical mastectomy or lumpectomy with axillary node dissection followed by radiation therapy and then eight cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) chemotherapy.
  • RESULTS: Forty-seven patients with stage IIB-III LABC were enrolled and 43 patients were evaluable.
  • Fourteen patients (33%) had inflammatory breast cancer.
  • Sixteen patients were eligible for breast-conserving surgery.
  • CONCLUSIONS: Neoadjuvant therapy using paclitaxel, liposomal doxorubicin and hyperthermia is a feasible and well tolerated treatment strategy in patients with LABC.

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  • (PMID = 20377362.001).
  • [ISSN] 1464-5157
  • [Journal-full-title] International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group
  • [ISO-abbreviation] Int J Hyperthermia
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P01 CA042745; United States / NCI NIH HHS / CA / P01 CA042745-23; United States / NCI NIH HHS / CA / P01CA42745
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] England
  • [Chemical-registry-number] 80168379AG / Doxorubicin; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ NIHMS237516; NLM/ PMC2956498
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36. Figueiredo JC, Ennis M, Knight JA, McLaughlin JR, Hood N, O'Malley F, Andrulis IL, Goodwin PJ: Influence of young age at diagnosis and family history of breast or ovarian cancer on breast cancer outcomes in a population-based cohort study. Breast Cancer Res Treat; 2007 Sep;105(1):69-80
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  • [Title] Influence of young age at diagnosis and family history of breast or ovarian cancer on breast cancer outcomes in a population-based cohort study.
  • PURPOSE: The objective of this study was to examine the association of: (i) diagnosis at age </=35, (ii) first-degree family history of breast or ovarian cancer (BOC) and (iii) a research based definition of genetic risk, with tumor characteristics, treatment and survival in breast cancer (BC).
  • PATIENTS AND METHODS: Consenting female participants in the population-based Ontario Familial Breast Cancer Registry diagnosed with primary invasive BC between 1996 and 1998 were followed prospectively until 2005.
  • Individuals diagnosed at age </=35 were more likely to self-detect tumors, to present with inflammatory BC, to have invasive ductal carcinoma of no special type, high T stage, and tumors with lymphovascular invasion (LVI), high grade and negative estrogen receptors.
  • Younger women were more likely to receive chemotherapy and less likely to receive hormonal therapy.
  • Diagnosis </=35 years old was associated with significantly reduced distant recurrence free survival, an effect that did not persist after adjustment for tumor and treatment related variables.
  • Family history was associated with increased rates of mammographic detection of BC, lower tumor stage and less frequent inflammatory BC, but had no association with BC outcomes.
  • [MeSH-major] Breast Neoplasms / diagnosis. Ovarian Neoplasms / diagnosis. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adult. Age of Onset. Cohort Studies. Female. Humans. Middle Aged. Models, Genetic. Ontario. Prognosis. Registries. Risk. Treatment Outcome


37. Cance WG, Carey LA, Calvo BF, Sartor C, Sawyer L, Moore DT, Rosenman J, Ollila DW, Graham M 2nd: Long-term outcome of neoadjuvant therapy for locally advanced breast carcinoma: effective clinical downstaging allows breast preservation and predicts outstanding local control and survival. Ann Surg; 2002 Sep;236(3):295-302; discussion 302-3
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  • [Title] Long-term outcome of neoadjuvant therapy for locally advanced breast carcinoma: effective clinical downstaging allows breast preservation and predicts outstanding local control and survival.
  • OBJECTIVE: To review the long-term follow-up data from the authors' institutional experience of 62 patients with locally advanced breast cancer (LABC) treated with a uniform multimodality regimen.
  • The authors determined the rate of breast preservation, the disease-free and overall survival, and the factors associated with locoregional and distant recurrent disease.
  • Over the last decade, preoperative or neoadjuvant chemotherapy has emerged as the standard of care for these patients.
  • Successful tumor downstaging has been associated with increased rates of breast-conserving therapy (BCT), but the overall effect on long-term survival remains to be seen.
  • The uniform treatment regimen consisted of neoadjuvant doxorubicin (Adriamycin), followed by operation (BCT if sufficient clinical downstaging), followed by non-cross-resistant cyclophosphamide/methotrexate/5-fluorouracil, followed by radiation therapy.
  • Treatment was both dose-intensive and time-intensive, with a total treatment time of 32 to 35 weeks.
  • Eighty-two percent of patients were clinical stage III at presentation, 13 patients had T4d inflammatory cancers, and 3 patients were stage IV at diagnosis.
  • The local recurrence rate was 14%, including two ipsilateral breast tumor recurrences (10%) in the BCT patients.
  • Seven (12%) patients developed a new primary cancer in the contralateral breast.
  • CONCLUSIONS: Dose-intensive and time-intensive multimodality neoadjuvant therapy was successfully administered to a mixed racial group over shortened times.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / therapy. Carcinoma / therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cohort Studies. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Humans. Methotrexate / administration & dosage. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Retrospective Studies. Survival Rate

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  • (PMID = 12192316.001).
  • [ISSN] 0003-4932
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; YL5FZ2Y5U1 / Methotrexate
  • [Other-IDs] NLM/ PMC1422583
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38. de Matteis A, Nuzzo F, D'Aiuto G, Labonia V, Landi G, Rossi E, Mastro AA, Botti G, De Maio E, Perrone F: Docetaxel plus epidoxorubicin as neoadjuvant treatment in patients with large operable or locally advanced carcinoma of the breast: a single-center, phase II study. Cancer; 2002 Feb 15;94(4):895-901
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  • [Title] Docetaxel plus epidoxorubicin as neoadjuvant treatment in patients with large operable or locally advanced carcinoma of the breast: a single-center, phase II study.
  • BACKGROUND: The objective of this study was to test the activity and toxicity of epirubicin plus docetaxel as primary chemotherapy for women with large, operable (T2; > 3 cm) or locally advanced (Stage III) breast carcinoma, including patients with inflammatory breast carcinoma.
  • METHODS: In this single-center, open-label, single-stage, Phase II trial, epirubicin (75 mg/m(2); intravenous bolus) followed by docetaxel (80 mg/m(2); 1-hour intravenous infusion) was administered on Day 1 of each cycle for four cycles.
  • RESULTS: Nine of 30 patients (30%) had inflammatory breast carcinoma.
  • CONCLUSIONS: Neoadjuvant chemotherapy with epirubicin plus docetaxel was a feasible treatment and was active in an unfavorable series of patients with locally advanced breast carcinoma, including patients with inflammatory breast carcinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Paclitaxel / analogs & derivatives. Taxoids
  • [MeSH-minor] Adult. Aged. Epirubicin / administration & dosage. Female. Humans. Infusions, Intravenous. Injections, Intravenous. Middle Aged. Neoadjuvant Therapy. Neutropenia / chemically induced. Treatment Outcome

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  • [Copyright] Copyright 2002 American Cancer Society.DOI 10.1002/cncr.20335
  • (PMID = 11920456.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Taxoids; 15H5577CQD / docetaxel; 3Z8479ZZ5X / Epirubicin; P88XT4IS4D / Paclitaxel
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39. Limentani SA, Brufsky AM, Erban JK, Jahanzeb M, Lewis D: Phase II study of neoadjuvant docetaxel, vinorelbine, and trastuzumab followed by surgery and adjuvant doxorubicin plus cyclophosphamide in women with human epidermal growth factor receptor 2-overexpressing locally advanced breast cancer. J Clin Oncol; 2007 Apr 1;25(10):1232-8
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  • [Title] Phase II study of neoadjuvant docetaxel, vinorelbine, and trastuzumab followed by surgery and adjuvant doxorubicin plus cyclophosphamide in women with human epidermal growth factor receptor 2-overexpressing locally advanced breast cancer.
  • PURPOSE: To evaluate the combination of docetaxel, vinorelbine, and trastuzumab as neoadjuvant therapy for human epidermal growth factor receptor 2 (HER2)--overexpressing breast cancer.
  • PATIENTS AND METHODS: Patients with stage IIB or III breast cancer, including inflammatory disease, and HER2 overexpression (determined by fluorescent in situ hybridization) were treated with six cycles of docetaxel 60 mg/m2 and vinorelbine 45 mg/m2 administered every 14 days with granulocyte colony-stimulating factor and quinolone prophylaxis.
  • The primary efficacy end point was pathologic complete response (pCR) in the breast.
  • Twelve patients (39%; 95% CI, 21.6% to 55.9%) achieved pCR in the breast and lymph nodes and 14 patients (45%; 95% CI, 27.6% to 62.7%) achieved pCR in the breast alone, and 19 patients (61%; 95% CI, 44.1% to 78.4%) were node negative after neoadjuvant therapy.
  • CONCLUSION: With clinical response and pCR rates of 94% and 39%, respectively, docetaxel, vinorelbine, and trastuzumab is a highly active neoadjuvant therapy for HER2-overexpressing locally advanced breast cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Receptor, ErbB-2 / analysis
  • [MeSH-minor] Adult. Aged. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Humans. Middle Aged. Neoadjuvant Therapy. Taxoids / administration & dosage. Trastuzumab. Vinblastine / administration & dosage. Vinblastine / analogs & derivatives

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  • (PMID = 17296975.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Taxoids; 15H5577CQD / docetaxel; 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; EC 2.7.10.1 / Receptor, ErbB-2; P188ANX8CK / Trastuzumab; Q6C979R91Y / vinorelbine
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40. Rao KV, Goodin S: Prevention and management of colorectal cancer in women. J Am Pharm Assoc (Wash); 2001 Jul-Aug;41(4):585-95
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  • [Title] Prevention and management of colorectal cancer in women.
  • OBJECTIVE: To review prevention and management strategies for colorectal cancer, with an emphasis on studies pertaining to women.
  • DATA SOURCES: Articles published from January 1990 through February 2001 identified through a MEDLINE search using the term colorectal cancer and the additional terms screening, prevention, and treatment.
  • DATA SYNTHESIS: Colorectal cancer is the third most common non-skin cancer in women, after breast and lung cancers.
  • Many women underestimate their risk of colorectal cancer, which may lead them to underuse screening measures that have been proven to reduce disease morbidity and mortality.
  • For average-risk women and men > or = 50 years of age, pharmacists should recommend regular screening for early detection and prevention of colorectal cancer.
  • In its earliest, most curable stages, colorectal cancer is often asymptomatic.
  • The use of chemopreventive agents for colorectal cancer, such as nonsteroidal anti-inflammatory drugs, hormone replacement therapy, and dietary calcium, holds significant promise, but further studies are needed before these agents can be recommended for cancer prevention in the general population.
  • Surgical resection is the primary treatment modality for colorectal cancer, and adjuvant chemotherapy is recommended in patients with stage III disease and some high-risk patients with stage II disease.
  • Pharmacists should be aware that women are more susceptible to dose-related toxicity effects of fluorouracil and leucovorin combination chemotherapy, the first-line regimen for adjuvant chemotherapy.
  • CONCLUSION: Although often perceived as a disease that primarily affects men, colorectal cancer is an equally important health concern for women.
  • [MeSH-minor] Chemotherapy, Adjuvant. Colon / anatomy & histology. Female. Humans. Incidence. Male. Middle Aged. Patient Education as Topic. Pharmaceutical Services. Risk Factors. United States / epidemiology

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  • (PMID = 11486985.001).
  • [ISSN] 1086-5802
  • [Journal-full-title] Journal of the American Pharmaceutical Association (Washington,D.C. : 1996)
  • [ISO-abbreviation] J Am Pharm Assoc (Wash)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 69
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41. Dawood S, Gonzalez-Angulo AM, Peintinger F, Broglio K, Symmans WF, Kau SW, Islam R, Hortobagyi GN, Buzdar AU: Efficacy and safety of neoadjuvant trastuzumab combined with paclitaxel and epirubicin: a retrospective review of the M. D. Anderson experience. Cancer; 2007 Sep 15;110(6):1195-200
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  • BACKGROUND: A previously published prospective randomized phase 3 trial showed that administration of 24 weeks of primary systemic chemotherapy (PST) with paclitaxel and FEC(75) (fluorouracil, epirubicin, cyclophosphamide) concurrently with trastuzumab in patients with HER2-positive primary breast cancer resulted in a 60% pathologic complete response rate (PCR) with no associated severe cardiac toxicity.
  • METHODS: Patients with HER2-positive breast cancer (defined as either immunohistochemical 3+ or fluorescence in situ hybridization-positive) that had received 24 weeks of neoadjuvant trastuzumab concurrently with taxane and anthracycline-based chemotherapy between 2004 and 2006 were included in the analysis.
  • PST chemotherapy consisted of paclitaxel (80 mg/m(2)) weekly for 12 weeks followed by 4 cycles of FEC(75) (500 mg/m(2), 75 mg/m(2), and 500 mg/m(2), respectively).
  • In all, 60% of patients had stage III disease and 4 had inflammatory breast cancer.
  • CONCLUSIONS: Stage II and III HER2-positive breast cancer patients achieved a high rate of PCR with trastuzumab given concurrently with paclitaxel and FEC(75) chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / drug therapy. Neoadjuvant Therapy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Epirubicin / administration & dosage. Female. Humans. In Situ Hybridization, Fluorescence. Middle Aged. Paclitaxel / administration & dosage. Receptor, ErbB-2 / analysis. Retrospective Studies. Texas. Trastuzumab. Treatment Outcome

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  • [Copyright] (c) 2007 American Cancer Society.
  • (PMID = 17647266.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Biomarkers, Tumor; 3Z8479ZZ5X / Epirubicin; EC 2.7.10.1 / Receptor, ErbB-2; P188ANX8CK / Trastuzumab; P88XT4IS4D / Paclitaxel
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42. Moy B, Goss PE: Lapatinib-associated toxicity and practical management recommendations. Oncologist; 2007 Jul;12(7):756-65
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Lapatinib has been shown to have activity in ErbB-2-overexpressing breast cancer in several phase II and III clinical trials.
  • Specifically, lapatinib is effective in patients with metastatic breast cancer, with inflammatory breast cancer, and possibly, with brain metastases.
  • An ongoing clinical trial and another anticipated clinical trial will investigate lapatinib as adjuvant treatment in early-stage disease.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Breast Neoplasms / drug therapy. Quinazolines / adverse effects
  • [MeSH-minor] Clinical Trials, Phase II as Topic. Clinical Trials, Phase III as Topic. Female. Humans. Neoplasm Recurrence, Local / drug therapy. Protein Kinase Inhibitors / adverse effects. Protein Kinase Inhibitors / therapeutic use. Receptor Protein-Tyrosine Kinases / antagonists & inhibitors. Receptor, ErbB-2

  • MedlinePlus Health Information. consumer health - Breast Cancer.
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  • (PMID = 17673607.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Protein Kinase Inhibitors; 0 / Quinazolines; 0VUA21238F / lapatinib; EC 2.7.10.1 / Receptor Protein-Tyrosine Kinases; EC 2.7.10.1 / Receptor, ErbB-2
  • [Number-of-references] 58
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43. Dizdar O, Ozçakar L, Malas FU, Harputluoglu H, Bulut N, Aksoy S, Ozisik Y, Altundag K: Sonographic and electrodiagnostic evaluations in patients with aromatase inhibitor-related arthralgia. J Clin Oncol; 2009 Oct 20;27(30):4955-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To investigate the prevalence of arthralgia in breast cancer patients taking aromatase inhibitors (AIs) and perform a detailed rheumatologic assessment including autoimmune serology, musculoskeletal sonography, and electromyography (EMG) in these patients.
  • PATIENTS AND METHODS: Postmenopausal patients with stage I to III breast cancer who were taking adjuvant AIs were enrolled (n = 92).
  • Patients who were not receiving hormone treatment were included as a control group (n = 28).
  • CONCLUSION: Patients with AI-related arthralgia often show tenosynovial changes suggesting tenosynovitis, exerting local problems but lacking a systemic inflammatory component.
  • [MeSH-major] Aromatase Inhibitors / adverse effects. Arthralgia / chemically induced. Arthralgia / diagnosis. Breast Neoplasms / drug therapy

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  • [CommentIn] J Clin Oncol. 2009 Oct 20;27(30):4932-4 [19752332.001]
  • (PMID = 19752344.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aromatase Inhibitors
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