344 research outputs found
Erratum: Lack of immunity against rubella among Italian young adults. [BMC Infect Dis., 17, (2017) (199)] Doi: 10.1186/s12879-017-2295-y
No full textAfter publication of this article [1], the authors noted that the given names and family names of all authors had been inverted, and are therefore incorrect in the original article. In the original article, the author names appear as the following: Gallone Maria Serena, Gallone Maria Filomena, Larocca Angela Maria Vittoria, Germinario Cinzia and Tafuri Silvio. However, this is incorrect, and the author names should appear as per the below: Maria Serena Gallone, Maria Filomena Gallone, Angela Maria Vittoria Larocca, Cinzia Germinario, Silvio Tafuri. The author names have been corrected in the author list and the citation for this Erratum
Gaining ground in personalized breast cancer therapy: lesson learned from PHERGain
No full textDe-escalation of treatment for HER2+ breast cancer is a priority, given the increase in cure rates owing in part to improved HER2-targeted therapies. In this regard, the neoadjuvant approach provides the ideal platform to test less-intensive treatment regimens. Here we highlight a study that demonstrated the role of the metabolic response after dual HER2 blockade as a method of selecting patients who are most likely to benefit from chemotherapy-free neoadjuvant therapy
PIK3CA: a Target or a Marker in Breast Cancers
No full textThe phosphoinositide 3 kinase (PI3K)/Akt pathway is frequently aberrantly activated in breast cancer and, basing on preclinical data, leads to cell growth and tumor proliferation. PI3K pathway activation has been suggested as a potential driver of resistance to endocrine and anti-HER2 therapies. Large genomic studies have observed that the PIK3CA gene is mutated in up to 40 % of breast cancers, mainly estrogen receptor- and HER2-positive. Some strategies targeting the PI3K/Akt/mTOR axis, in particular co-targeting the estrogen receptor and mTOR in endocrine resistant estrogen receptor-positive breast cancer, have proven successfully this hypothesis. Pan-class I PI3K inhibitors and more selective p110 alpha inhibitors are currently under investigation in different clinical settings. In this review, clinical data on the prognostic and predictive role of PIK3CA mutations in different breast cancer subtypes are covered, and a picture on the current clinical research on PI3K inhibitors is provided
Enhancing intracellular taxane delivery: current role and perspectives of nanoparticle albumin-bound paclitaxel in the treatment of advanced breast cancer.
No full textINTRODUCTION:
Docetaxel and paclitaxel are among the most active agents for the treatment of breast cancer. These first-generation taxanes are extremely hydrophobic; therefore, solvents are needed for its parenteral administration. Albumin nanoparticle technology allows for the transportation of such hydrophobic drugs without the need of potentially toxic solvents. Nab-paclitaxel can be administered without premedication, in a shorter infusion time and without the need for a special infusion set. Moreover, this technology allows the selective delivery of larger amounts of anticancer drug to tumors, by exploiting endogenous albumin pathways.
AREAS COVERED:
An overview of the albumin nanoparticle technology, from a clinical perspective, is reported in this paper. The preclinical and clinical development of nab-paclitaxel is reviewed, in the context of available therapies for advanced breast cancer, with a focus on safety data. Preclinical and clinical data on the prognostic and predictive role of SPARC (secreted protein, acidic and rich in cysteine) are also reported.
EXPERT OPINION:
Nab-paclitaxel is approved at present for the treatment of metastatic breast cancer, after the failure of first-line standard therapy, when anthracyclines are not indicated. Efficacy and safety data, along with a more convenient administration, confirm the potential for nab-paclitaxel to become a reference taxane in breast cancer treatmen
Escalation and de-escalation in HER2 positive early breast cancer
No full textPURPOSE OF REVIEW:
Current standard for HER2+ early breast cancer patients includes chemotherapy and trastuzumab for 1 year. The purpose of this article is to review available evidence on escalated treatment strategies for high-risk patients and de-escalated treatments for patients at low risk of relapse or high risk of cardiac toxicity.
RECENT FINDINGS:
Recent results have led to the approval of two adjuvant escalated treatment strategies: pertuzumab and trastuzumab combined with chemotherapy for up to 1 year for high-risk patients; extension of adjuvant anti-HER2 treatment with 1 year of neratinib. However, these treatments are associated with increased costs and toxicity, therefore careful patients' selection is highly required. With regard to de-escalated treatments, the anthracycline-free regimen of adjuvant paclitaxel and 1 year trastuzumab has entered clinical practice for early-stage patients. One year of trastuzumab remains the standard; however, shorter trastuzumab could be an option for low-risk patients and in case of increased risk of cardiotoxocity. Chemotherapy-free regimens are attractive but deserve further evaluation.
SUMMARY:
There have been advances in treatment individualization for HER2+ early breast cancer patients. Integration of promising biomarkers into risk classification will further help progressing in the field
Relapsed Triple-Negative Breast Cancer: Challenges and Treatment Strategies
No full textTriple negative breast cancer (TNBC) is the most lethal form of breast cancer. Treatment options for advanced disease are limited, with a median survival from the time of developing metastases rarely exceeding 1year. TNBC is heterogeneous, and harbours several molecular alterations. Unfortunately, up to now, clinical trials combining targeted agents and chemotherapy have failed to show substantial survival improvement; therefore, chemotherapy remains the backbone of treatment. No major advances have been made in the field of cytotoxic treatments, and hopefully ongoing trials will contribute to a more precise definition of the role of platinum salts in sporadic and BRCA-mutated TNBC. Moreover, recent gene expression data suggest that TNBC can be further segmented into smaller subgroups, characterized by different activated pathways, which may therefore warrant different targeted treatments. The lack of efficacy that has been observed for the majority of targeted agents in TNBC so far may derive from the inclusion of unselected TNBC patient populations, not enriched for patients presenting an alteration in the target. Therefore, one of the major challenges in the future is to integrate biological data into clinical trials to obtain the highest efficacy from promising targeted treatments such as anti-angiogenetic agents, poly (ADP-ribose) polymerase-1 (PARP), epidermal growth factor receptor, fibroblast growth factor receptor, androgen receptor and phosphoinositide 3-kinase/mammalian target of rapamycin (PI3K/mTOR) inhibitors
New strategies to overcome resistance to mammalian target of rapamycin inhibitors in breast cancer
No full textTo review the studies addressing mammalian target of rapamycin (mTOR) inhibitors in breast cancer and resistance to rapalogs. Preclinical and clinical studies have suggested mTOR inhibitors may help overcome the resistance to endocrine therapy and trastuzumab. Despite much interest, knowledge of the mechanism and molecular response to mTOR inhibitors is incomplete.|Resistance to mTOR inhibitors has been explored in preclinical studies and can be defined as primary, associated with amplifications or mutations of different kinases, or secondary, in which rapalog activates the feedback loops involving the insulin-like growth factor I receptor (IGF-IR), platelet-derived growth factor receptor and mitogen-activated protein kinase (MAPK) pathway. Current clinical trials are testing the combinations of rapamycin with other kinase inhibitors including IGF-IR, phosphoinositide 3-kinase and MAPK-extracellular signal-regulated kinase inhibitors.|Recent findings on the resistance to rapalogs have stimulated the assessment of combinations of inhibitors in clinical trials. This review summarizes the current knowledge of primary and secondary rapalog resistance, and the current efforts to overcome this resistance
The Future of Chemotherapy in the Era of Personalized Medicine
No full textChemotherapy still represents the mainstay of therapy for many breast cancer patients. Indeed, it is the only available option for the treatment of triple-negative disease. Moreover, targeted agents, in particular anti-HER2 compounds, show the highest efficacy when combined with chemotherapy. Research efforts should therefore continue to investigate new chemotherapeutic drugs, with the attempt to increase efficacy and reduce toxicity. Similarly to targeted drugs, cytotoxic compounds should be developed in the context of personalized medicine, by adopting tools including high-throughput technologies to select sensitive patient subsets. Indeed, it seems clear by now that great advances in the general, unselected breast cancer population are no longer possible. The attention has to be moved to smaller breast cancer disease groups and this will have obvious implications in clinical trials design and conception in the next future
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