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Latest & greatest articles for breast cancer
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on breast cancer or other clinical topics then use Trip today.
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A phase II randomized clinical trial of the effect of metformin versus placebo on progression-free survival in women with metastatic breastcancer receiving standard chemotherapy. Pre-clinical data suggest metformin might enhance the effect of chemotherapy in breastcancer (BC). We conducted a Phase II randomized trial of chemotherapy plus metformin versus placebo in metastatic breastcancer (MBC).In this double blind phase II trial we randomly assigned non-diabetic MBC patients on 1st to 4th (...) placebo, respectively. Mean BMI was 27kg/m2 in both arms. The majority of patients were on 1st line chemotherapy. Grade 3-4 toxicity occurred in 31.8% (metformin) vs 58.8% (placebo). Best response: Partial response 18.2% metformin vs 25% placebo, stable disease 36.4% metformin vs 18.8% placebo, progressive disease 45.4% metformin vs 56.2% placebo. Mean PFS was 5.4 vs 6.3 months (metformin vs placebo), HR 1.2 (95% CI 0.63-2.31). Mean OS was 20.2 (metformin) vs 24.2 months (placebo), HR 1.68 (95% CI
Updated results from MONALEESA-2, a phase III trial of first-line ribociclib plus letrozole versus placebo plus letrozole in hormone receptor-positive, HER2-negative advanced breastcancer. 31407010 2019 08 13 1569-8041 2019 Aug 13 Annals of oncology : official journal of the European Society for Medical Oncology Ann. Oncol. Updated results from MONALEESA-2, a phase III trial of first-line ribociclib plus letrozole versus placebo plus letrozole in hormone receptor-positive, HER2-negative (...) advanced breastcancer. mdz215 10.1093/annonc/mdz215 Hortobagyi G N GN Stemmer S M SM Burris H A HA Yap Y S YS Sonke G S GS Paluch-Shimon S S Campone M M Petrakova K K Blackwell K L KL Winer E P EP Janni W W Verma S S Conte P P Arteaga C L CL Cameron D A DA Mondal S S Su F F Miller M M Elmeliegy M M Germa C C O'Shaughnessy J J eng Journal Article 2019 08 13 England Ann Oncol 9007735 0923-7534 IM 2019 8 14 6 0 2019 8 14 6 0 2019 8 14 6 0 aheadofprint 31407010 5548997 10.1093/annonc/mdz215
Eribulin for Treating Locally Advanced or Metastatic BreastCancer After One Chemotherapy Regimen: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. Eribulin is a recommended treatment option for locally advanced or metastatic breastcancer (LABC/MBC) in adults whose disease has progressed after at least two chemotherapy regimens. The National Institute for Health and Care Excellence (NICE) invited the manufacturer of eribulin (Halaven®; Eisai Ltd) to submit evidence (...) for the clinical and cost effectiveness of eribulin for treating LABC/MBC after one chemotherapy regimen in accordance with the institute's Single Technology Appraisal (STA) process. This article presents a summary of the company's evidence, Evidence Review Group (ERG) review and resulting NICE guidance (TA515), issued 28 March 2018. Clinical evidence for eribulin versus capecitabine in LABC/MBC was derived from a subgroup of 392 patients with human epidermal growth factor receptor (HER2)-negative disease
Effects of omega-3 fatty acids supplementation on neoadjuvant chemotherapy-induced toxicity in patients with locally advanced breastcancer: a randomized, controlled, double-blinded clinical trial. Background: antineoplastic treatment for locally advanced breastcancer (LABC) includes neodjuvant chemotherapy (NeoCT). However, side effects occur frequently, affecting the functional capacity and quality of life of patients as a result of the proinflammatory state of this therapy. In this work
MONARCH 3 final PFS: a randomized study of abemaciclib as initial therapy for advanced breastcancer. At the MONARCH 3 interim analysis, abemaciclib plus a nonsteroidal aromatase inhibitor (AI) significantly improved progression-free survival (PFS) and objective response rate (ORR) with a tolerable safety profile as initial treatment for hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breastcancer (ABC). MONARCH 3 is a randomized, phase III (...) a significantly longer median PFS than the placebo arm (28.18 versus 14.76 months; hazard ratio [95% confidence interval], 0.540 [0.418-0.698]; p = .000002). The ORR was 61.0% in the abemaciclib arm versus 45.5% in the placebo arm (measurable disease, p = .003). The median duration of response was longer in the abemaciclib arm (27.39 months) compared to the placebo arm (17.46 months). The safety profile was consistent with previous reports. The most frequent grade ≥ 3 adverse events in the abemaciclib versus
Effects of Neratinib on Health-Related Quality-of-Life in Women with HER2-Positive Early-Stage BreastCancer: Longitudinal Analyses from the Randomized Phase III ExteNET Trial. We report longitudinal health-related quality-of-life (HRQoL) data from the international, randomized, double-blind, placebo-controlled phase III ExteNET study, which demonstrated an invasive disease-free survival benefit of extended adjuvant therapy with neratinib over placebo in HER2-positive early-stage breast (...) cancer.Women (N=2840) with early-stage HER2-positive breastcancer who had completed trastuzumab-based adjuvant therapy were randomly assigned to neratinib 240 mg/day or placebo for 12 months. HRQoL was an exploratory endpoint. Patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) and EuroQol 5-Dimensions (EQ-5D) questionnaires at baseline and months 1, 3, 6, 9, and 12. Changes from baseline were compared using analysis of covariance with no imputation for missing values
-positive breastcancer at high risk of recurrence (defined here as patients with node-positive or hormone receptor-negative disease). The comparator is trastuzumab (in combination with chemotherapy). Final data, required by the NCPE, was received on 18th January 2019. 1. Comparative effectiveness of pertuzumab (in combination with trastuzumab and chemotherapy) Evidence was derived from the on-going phase III, randomised, double-blind, placebo- controlled APHINTY study. APHINITY evaluates pertuzumab (...) (in combination with trastuzumab and chemotherapy) versus trastuzumab (in combination with chemotherapy) in patients with HER2-positive early breastcancer with either node-positive or node- negative disease. The trial protocol was amended after about 75% of the population had been randomised; patients with node-negative disease were no longer eligible. This amendment resulted in the intention-to treat population being enriched with patients with node-positive disease. Thus the intention-to-treat population
: following a third resubmission assessed under the orphan equivalent process pertuzumab (Perjeta ® ) is accepted for use within NHSScotland. Indication under review: In combination with trastuzumab and docetaxel, in adult patients with HER2-positive metastatic or locally recurrent unresectable breastcancer, who have not received previous anti-HER2 therapy or chemotherapy for their metastatic disease. Addition of pertuzumab to current first-line treatment, trastuzumab plus docetaxel, significantly (...) (PACE) meeting. Chairman Scottish Medicines Consortium www.scottishmedicines.org.uk 2 Indication In combination with trastuzumab and docetaxel in adult patients with HER2-positive metastatic or locally recurrent unresectable breastcancer, who have not received previous anti-HER2 therapy or chemotherapy for their metastatic disease. 1 Dosing Information 840mg intravenous (IV) infusion over 60 minutes, then 420mg IV infusion over 30 to 60 minutes every three weeks until disease progression
in combination with capecitabine or 5-fluorouracil and cisplatin is indicated for the treatment of adult patients with HER2 positive metastatic adenocarcinoma of the stomach or gastroesophageal junction who have not received prior anti-cancer treatment for their metastatic disease. Ogivri should only be used in patients with metastatic gastric cancer (MGC) whose tumours have HER2 overexpression as defined by IHC2+ and a confirmatory SISH or FISH result, or by an IHC 3+ result. Accurate and validated assay (...) for solution for infusion (powder for concentrate). White to pale yellow lyophilised powder. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Breastcancer Metastatic breastcancer Ogivri is indicated for the treatment of adult patients with HER2 positive metastatic breastcancer (MBC): - as monotherapy for the treatment of those patients who have received at least two chemotherapy regimens for their metastatic disease. Prior chemotherapy must have included at least an anthracycline and a taxane unless
Adjuvant Endocrine Therapy for Women With Hormone Receptor?Positive BreastCancer Adjuvant Endocrine Therapy for Women With Hormone Receptor–Positive BreastCancer: ASCO Clinical Practice Guideline Focused Update | Journal of Clinical Oncology Search in: Menu Article Tools ASCO SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.18.01160 Journal of Clinical Oncology - published online before print November 19, 2018 PMID (...) : Adjuvant Endocrine Therapy for Women With Hormone Receptor–Positive BreastCancer: ASCO Clinical Practice Guideline Focused Update , MD, PhD 1 x Harold J. Burstein ; , MHSc 2 x Christina Lacchetti ; , RN 3 x Holly Anderson ; , MD 4 x Thomas A. Buchholz ; , MD 5 x Nancy E. Davidson ; , MD 6 x Karen A. Gelmon ; , MD 4 x Sharon H. Giordano ; , MD 7 x Clifford A. Hudis ; , MD 8 x Alexander J. Solky ; , MD 9 x Vered Stearns ; , MD 1 x Eric P. Winer ; and , MD 10 x Jennifer J. Griggs 1Dana-Farber Cancer
profiling tests EndoPredict, MammaPrint, Oncotype DX Breast Recurrence Score, Prosigna and IHC4+C provide information on the activity of genes in tumour samples from people with early breastcancer. The results provide a risk profile of a person's breastcancer, which can be used with other routinely assessed clinical risk factors, such as nodal status and tumour size. It is claimed that the risk profile can be used to better predict the risk of disease recurrence. Some tests also claim to predict (...) on the stage of the disease at diagnosis, the treatment received and the biology of the tumour. More than 90% of women diagnosed with early breastcancer survive for at least 5 years, and 78% survive for 10 years (Cancer Research UK 2016). In contrast, only 13% of those diagnosed with advanced disease survive for more than 5 years. The diagnostics and care pathways Diagnosis Diagnosis 2.7 Breastcancer may be diagnosed following an abnormal result in the NHS breastcancer screening programme, or after
A Systematic Review and Meta-Analysis of the Safety, Feasibility, and Effect of Exercise in Women With Stage II+ BreastCancer To systematically evaluate the safety, feasibility, and effect of exercise among women with stage II+ breast cancer.CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus were searched for articles published before March 1, 2017.Randomized, controlled, exercise trials (...) involving at least 50% of women diagnosed with stage II+ breastcancer were included.Risk of bias was assessed and adverse event severity was classified using the Common Terminology Criteria. Feasibility was evaluated by computing median (range) recruitment, withdrawal, and adherence rates. Meta-analyses were performed to evaluate exercise safety and effects on health outcomes only. The influence of intervention characteristics (mode, supervision, duration and timing) on exercise outcomes were also
-targeted agents trastuzumab and pertuzumab.The TRAIN-2 study is an open-label, randomised, controlled, phase 3 trial being done in 37 hospitals in the Netherlands. We recruited patients aged 18 years or older with previously untreated, histologically confirmed stage II-III HER2-positive breastcancer. Patients were randomly allocated using central randomisation software (1:1 ratio) with minimisation without a random component, stratified by tumour stage, nodal stage, oestrogen receptor status, and age (...) Neoadjuvant chemotherapy with or without anthracyclines in the presence of dual HER2 blockade for HER2-positive breastcancer (TRAIN-2): a multicentre, open-label, randomised, phase 3 trial The optimal chemotherapy backbone for dual HER2 blockade in the neoadjuvant setting for early breastcancer is unknown. We investigated whether the addition of anthracyclines would improve pathological complete response compared with a carboplatin-taxane regimen, when given in combination with the HER2
,FentimanIS,etal.Radiotherapyinbreast-conserving treatment for ductal carcinoma in situ: First results of the EORTC randomised phase III trial 10853: EORTC BreastCancer Cooperative Group and EORTC Radiotherapy Group. Lancet. 2000;355(9203): 528-533. 7. Wapnir IL, Dignam JJ, Fisher B, et al. Long-term outcomes of invasive ipsilateral breasttumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS. J Natl Cancer Inst. 2011;103(6):478-488. 8. Emdin SO, Granstrand B (...) : 15-year recurrenceratesandoutcomeafterarecurrence,fromtheEORTC10853 randomizedphaseIIItrial.JClinOncol.2013;31(32):4054-4059. 20. Faverly DR, Burgers L, Bult P, et al. Three dimensional imaging of mammary ductal carcinoma in situ: Clinical implications. Semin Diagn Pathol. 1994;11(3):193-198. 21. Guidi AJ, Connolly JL, Harris JR, et al. The relationship between shavedmarginandinkedmarginstatusinbreastexcisionspecimens. Cancer. 1997;79(8):1568-1573. 22. Carter D. Margins of "lumpectomy" for breast
BreastCancer Risk After Recent Childbirth: A Pooled Analysis of 15 Prospective Studies. Parity is widely recognized as protective for breastcancer, but breastcancer risk may be increased shortly after childbirth. Whether this risk varies with breastfeeding, family history of breastcancer, or specific tumor subtype has rarely been evaluated.To characterize breastcancer risk in relation to recent childbirth.Pooled analysis of individual-level data from 15 prospective cohort studies.The (...) international Premenopausal BreastCancer Collaborative Group.Women younger than 55 years.During 9.6 million person-years of follow-up, 18 826 incident cases of breastcancer were diagnosed. Hazard ratios (HRs) and 95% CIs for breastcancer were calculated using Cox proportional hazards regression.Compared with nulliparous women, parous women had an HR for breastcancer that peaked about 5 years after birth (HR, 1.80 [95% CI, 1.63 to 1.99]) before decreasing to 0.77 (CI, 0.67 to 0.88) after 34 years
disease-free survival (defined as freedom from ipsilateral invasive breasttumor recurrence, ipsilateral locoregional invasive breastcancer recurrence, contralateral invasive breastcancer, distant recurrence, or death from any cause).At the interim analysis, among 1486 randomly assigned patients (743 in the T-DM1 group and 743 in the trastuzumab group), invasive disease or death had occurred in 91 patients in the T-DM1 group (12.2%) and 165 patients in the trastuzumab group (22.2%). The estimated (...) with metastatic breastcancer that was previously treated with chemotherapy plus HER2-targeted therapy.We conducted a phase 3, open-label trial involving patients with HER2-positive early breastcancer who were found to have residual invasive disease in the breast or axilla at surgery after receiving neoadjuvant therapy containing a taxane (with or without anthracycline) and trastuzumab. Patients were randomly assigned to receive adjuvant T-DM1 or trastuzumab for 14 cycles. The primary end point was invasive
Cohort Study Key results There is an association between periodontal disease and breastcancer. A 36% increased risk of breastcancer was found among former smokers with self-reported periodontal disease who had quit smoking in the previous 20 years (HR = 1.36, 95% CI: 1.05–1.77). No statistically significant association was found in never-smokers. Evidence Search (("breastneoplasms"[MeSH Terms] OR ("breast"[All Fields] AND "neoplasms"[All Fields]) OR "breastneoplasms"[All Fields] OR ("breast"[All (...) regarding the relationship between periodontal disease and breastcancer. Previous studies hypothesize that periodontal infection induces a chronic systemic inflammation resulting in tumor growth, but direct evidence for a biological mechanism exists. More research should be done in the future with better-defined diagnostic criteria for periodontal disease and greater control for confounding factors before suggesting an increased risk exists. Applicability Middle-aged women make up a significant portion
BreastCancer Risk Factors At a Glance Age 50 years old 30 years old Height 172 cm 162 cm ( average female height in Australia ) Reproductive factors Family history and genetic factors Lifestyle factors Personal factors VS. VS. 152 cm 162 cm ( average female height in Australia ) Mammographic breast density VS. Extremely dense breasts averagely dense breasts VS. Body mass index ( postmenopausal women ) VS. Adult weight gain ( postmenopausal women ) Weight gain (5kg) no weight gain VS. Weight (...) gain (10kg) Weight gain (20kg) Alcohol consumption 2 drinks per day no daily alcohol consumption VS. Physical activity Most active least active ( postmenopausal women ) VS. 4 drinks per day 6 drinks per day BreastCancer Risk Factors At a Glance Decreased risk Increased risk 1 2 3 4 5 6 7 8 910 0.5 0.33 0.25 0.2 0.125 0.1 10 1.17 0.85 2.14 1.12 1.25 1.40 1.06 1.12 1.26 1.15 1.31 1.50 0.87 VS. VS. no weight gain VS. no weight gain VS. no daily alcohol consumption VS. no daily alcohol consumption VS
systematic literature review (CUP Breast SLR) 10 were used for the relevant factors. Breastcancer risk factors: A review of the evidence 6 Bibliographic searches were performed on the Cochrane Library, Medline, Embase, and PsycINFO for articles appearing between 1 January 2008 and 30 October 2017 using MeSH terms and free text words: BreastNeoplasms [MeSH Terms] #2 Breast AND (cancer* OR neoplasm* OR tumour* OR tumor* OR carcinoma* OR adenocarcinoma*) #3 mammary AND (cancer* OR neoplasm* OR tumour (...) * OR tumor* OR carcinoma* OR adenocarcinoma*) and relevant exposure search terms. Each factor of interest was searched again using the simple search string ‘[factor]’ AND ‘breastcancer’ AND ‘risk OR incidence’, on both PubMed and the IARC website (http://monographs.iarc.fr). Snowballing In addition, a citation search of key studies was conducted to identify any more recent primary research studies or any other key studies that may have been missed in the PubMed search. 2.3 Study selection Inclusion
Recommendations on screening for breastcancer in women 40-74 years of age who are not at increased risk Recommendations on screening for breastcancer in women aged 40–74 years who are not at increased risk for breastcancer | CMAJ Main menu User menu Search Search for this keyword Search for this keyword Guideline Recommendations on screening for breastcancer in women aged 40–74 years who are not at increased risk for breastcancer Scott Klarenbach , Nicki Sims-Jones , Gabriela Lewin (...) POINTS Low-certainty evidence indicates that screening for breastcancer with mammography results in a modest reduction in breastcancer mortality for women aged 40 to 74 years; the absolute benefit is lowest for women younger than 50 years. Screening may lead to overdiagnosis, resulting in unnecessary treatment of cancer that would not have caused harm in a woman’s lifetime and false-positive results that can lead to both physical and psychological consequences; overdiagnosis and false-positives