• HR+/HER2- advanced/metastatic breast cancer
• abemaciclib
• real-world
• treatment outcomes
• treatment patterns

• Humans
• Female
• Breast Neoplasms/drug therapy
• Breast Neoplasms/pathology
• Breast Neoplasms/mortality
• Middle Aged
• Spain/epidemiology
• Benzimidazoles/therapeutic use
• Aminopyridines/therapeutic use
• Receptor, ErbB-2/metabolism
• Aged
• France/epidemiology
• Adult
• Italy/epidemiology
• Receptors, Progesterone/metabolism
• Receptors, Estrogen/metabolism
• Aged, 80 and over
• Progression-Free Survival
• Retrospective Studies
• Neoplasm Metastasis

• Eli Lilly and Company

• ABC
• Advanced
• Breast cancer
• Consensus
• Guidelines
• Metastatic

• Humans
• Breast Neoplasms/therapy
• Breast Neoplasms/pathology
• Female
• Palliative Care/standards
• Consensus
• Practice Guidelines as Topic

• Breast neoplasms
• Diagnosis
• Guideline
• Treatment

• cancer cell plasticity
• immunotherapy
• organ metastases
• small molecule inhibitor
• triple negative breast cancer

• Breast cancer
• Cancer treatment
• Endocrine resistance
• Prognosis

• U54 CA267776 NCI NIH HHS

• advanced breast cancer
• eribulin mesylate
• observation study
• safety
• toxicity

• Humans
• Ketones/therapeutic use
• Ketones/adverse effects
• Ketones/administration & dosage
• Furans/therapeutic use
• Furans/adverse effects
• Furans/administration & dosage
• Female
• Middle Aged
• Breast Neoplasms/drug therapy
• Breast Neoplasms/pathology
• Breast Neoplasms/mortality
• Anthracyclines/therapeutic use
• Anthracyclines/administration & dosage
• Adult
• Aged
• Prospective Studies
• Taxoids/therapeutic use
• Taxoids/adverse effects
• Taxoids/administration & dosage
• Progression-Free Survival
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Antineoplastic Combined Chemotherapy Protocols/adverse effects
• Treatment Outcome
• Neoplasm Metastasis
• Antineoplastic Agents/therapeutic use
• Antineoplastic Agents/adverse effects
• China
• Polyether Polyketides

• Brain metastases
• HER2+ breast cancer
• HER2-Targeted therapy
• Radiosurgery
• Whole brain radiotherapy

• Adult
• Humans
• Female
• Radiosurgery/methods
• Breast Neoplasms/surgery
• Brain Neoplasms/secondary
• Brain/surgery
• Salvage Therapy/methods

• Cancer-related fatigue
• Network analysis
• Oncology
• Quality of life
• Symptom cluster

• Female
• Humans
• Breast
• Breast Neoplasms/complications
• Gastrointestinal Neoplasms
• Quality of Life
• Syndrome
• Observational Studies as Topic

• Télévie Fonds De La Recherche Scientifique - FNRS
• Télévie Fonds De La Recherche Scientifique - FNRS
• Télévie Fonds De La Recherche Scientifique - FNRS
• 2017064, C/2020/1357 and Social Grant 2023 Stichting Tegen Kanker
• 2017064, C/2020/1357 and Social Grant 2023 Stichting Tegen Kanker
• University Hospital of Liège
• Sector Council for research and valorization in Health Sciences

• Listeria
• cancer vaccine
• immunotherapy
• therapy
• tumor

• Humans
• Listeria monocytogenes
• Neoplasms/therapy
• Immunotherapy
• T-Lymphocytes
• Vaccines
• Tumor Microenvironment

• CDK 4/6 inhibitors
• cell-cycle-specific and non-specific resistance
• metastatic breast cancer

• Humans
• Female
• Cyclin-Dependent Kinase 4
• Cyclin-Dependent Kinase 6
• Breast Neoplasms/drug therapy
• Breast Neoplasms/pathology
• Cell Cycle
• Protein Kinase Inhibitors/pharmacology
• Protein Kinase Inhibitors/therapeutic use

• CDK4/6 inhibitors
• chemotherapy
• endocrine therapy
• metastatic breast cancer
• ribociclib

This study aimed to analyze the expression levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 proliferation index in the brain metastatic lesions and primary lesions in Chinese patients with breast cancer brain metastasis (BCBM) and determine the correlation between their changes and patients' survival.

A retrospective analysis was performed on patients with BCBM. The clinical characteristic of these patients was collected. The differences in the expression levels of the ER, PR, HER-2, and Ki-67 index between the primary lesions and brain lesions were evaluated, and the association between the differences and survival was analyzed.

The conversion rate of anyone receptor (ER, PR, or HER2) between the primary lesions and brain metastatic lesions was 45.0% (18/40), of which the ER inconsistency rate was 25.0%, the PR inconsistency rate was 22.5%, and the HER-2 inconsistency rate was 15.0%, and the receptor conversion resulted in a subtype conversion of 27.5% (11/40). The patients with HER-2 expression discordance between the primary lesions and the brain metastatic lesions had significantly longer survival times (58.9 vs. 26.4 months, P = 0.04) after diagnosis of brain metastases.

In this study, 45.0% of breast cancer patients developed biomarker-conversion between the primary lesions and brain metastatic lesions, and the differences in the expression levels of the ER, PR, and HER-2, the change in Ki-67 index between the primary lesions and brain lesions may predict patients' survival.

• Chronicity
• Metastatic breast cancer
• Multidisciplinary
• Needs
• Oncology
• Policies

• Adult
• Aged
• Breast Neoplasms/pathology
• Breast Neoplasms/therapy
• Female
• Humans
• Italy
• Middle Aged
• Qualitative Research

• Breast Neoplasms/drug therapy
• Female
• Histamine/analogs & derivatives
• Humans
• Liver Neoplasms/secondary
• Lung Neoplasms/secondary
• Prognosis
• Prospective Studies
• Receptor, ErbB-2/metabolism
• Registries
• Retrospective Studies

Approximately 40% of hormone receptor positive/human epidermal receptor 2 negative (HR + /HER2-) metastatic breast cancer (mBC) patients harbor phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutations. However, associations between PIK3CA mutation status and clinical outcomes among patients with HR + /HER2- mBC have been heterogeneous across clinical trials. This meta-analysis was conducted to survey recently available trial data to assess the prognostic effects of PIK3CA among patients with HR + /HER2- mBC. 

Randomized clinical trials reporting progression-free survival (PFS) or overall survival (OS) stratified by PIK3CA status in HR + /HER2- mBC were identified via systematic literature review. Trial arms receiving phosphatidylinositol 3-kinase (PI3K)-targeted therapies were excluded. Meta-regression analysis was used to estimate the association between PIK3CA status and PFS and OS among included studies.

The analyzed data included 3,219 patients from 33 study arms across 11 trials (PIK3CA mutated: 1,386, wild type: 1,833). PIK3CA mutation was associated with shorter median PFS (difference [95% CI] (months): -1.8 [-3.4, -0.1], I² = 35%) and shorter median OS (-8.4 [-13.4, -3.5], I² = 58%, N = 1,545). Findings were similar for PFS rates at 6 months (odds ratio [95% CI]: 0.74 [0.59, 0.94], I² = 42%, N = 3,160) and 12 months (0.76 [0.59, 0.99], I² = 42%, N = 2,468) and directionally consistent but not statistically significant at 18 months (N = 1,726).

Pooling evidence across multiple studies, PIK3CA mutation was associated with shorter PFS and OS. These findings suggest a negative prognostic value of PIK3CA mutations in patients with HR + /HER2- mBC.

The online version contains supplementary material available at 10.1186/s12885-022-10078-5.

• Hormone receptor positive/human epidermal receptor 2 negative (HR + /HER2-)
• Metastatic breast cancer (mBC)
• Overall survival
• PIK3CA
• Progression-free survival

• Africa
• Choosing wisely
• Harmful practices
• Overuse
• Value-based care

• Social work
• cancer care
• management
• metastatic breast cancer
• support

• Breast Neoplasms/therapy
• Female
• Health Personnel/psychology
• Humans
• Nigeria
• Palliative Care
• Social Workers/psychology

Describe breast cancer in Italy by age, geographical area, stage and sites of metastases. In addition, incident and prevalent cases by region are provided.

This population-based study included all female patients with histologically confirmed breast cancer diagnosed in Italy between 2013 and 2019 in the eight participating Cancer Registries. Cases were described by geographic area (north, center, south), age group (<50, 50–69 and 70+) and site of metastases. In addition, the study also provided an estimate of the cases of metastatic breast cancer per single region.

Of the total 5731 cases, the number of unknown stage cases (eliminated from our analyses) was 545 (10.5% of cases); therefore, the study was conducted on 5186 cases. Overall, 333 (6.5%) of tumors were metastatic at diagnosis but the distribution by geographical area was different: 5.1% in the north, 7.4% in the center and 7.8% in the south. Related to age, 5.6% were diagnosed before the age of 50 and 5.6% within the screening target group (50–69 years), while in elderly women the percentage rose to 8.1%. As regards the site of the metastases, 27.1% developed metastasis to the bone, 12.4% to the liver, 8.6% to the lung and 2.6% to the brain; in 34.9%, multiple sites were already present at the beginning of the cancer. Overall, 3520 cases of incident mBC are estimated in Italia every year (520 in Lombardy in northern Italy, 350 in Lazio in the center, followed by 330 in Campania in the south), and finally they are out of 52,000 prevalent cases.

A greater possibility of treating and living with the disease for a long time now requires careful monitoring of these tumors.

• Biopsy, Fine-Needle/methods
• Breast Neoplasms/metabolism
• Estrogens
• Female
• Humans
• In Situ Hybridization, Fluorescence
• Prognosis
• Receptor, ErbB-2/metabolism
• Receptors, Estrogen/metabolism
• Receptors, Progesterone/metabolism
• Retrospective Studies
• Ultrasonography, Interventional

• Breast Neoplasms/pathology
• Breast Neoplasms/therapy
• Female
• Humans
• Palliative Care
• Quality of Life
• Terminal Care

• breast cancer
• immune tumour microenvironment
• immunoediting
• immunotherapy

• Breast Neoplasms/immunology
• Breast Neoplasms/pathology
• Breast Neoplasms/therapy
• Female
• Humans
• Immune Checkpoint Inhibitors/therapeutic use
• Immunologic Surveillance
• Immunotherapy/methods
• Immunotherapy, Adoptive/methods
• Oncolytic Virotherapy/methods

• 3-dimensional cell culture
• Baeckea frutescens
• apoptosis
• breast cancer
• hypoxia

• everolimus
• metastatic breast cancer
• overall survival
• prognostic nomogram
• progression-free survival

• Adult
• Aged
• Antineoplastic Agents/administration & dosage
• Breast Neoplasms/drug therapy
• Breast Neoplasms/pathology
• Everolimus/administration & dosage
• Female
• Follow-Up Studies
• Humans
• Middle Aged
• Neoplasm Metastasis
• Nomograms
• Predictive Value of Tests
• Prognosis
• Progression-Free Survival
• Retrospective Studies
• Survival Rate
• Time Factors

• funding

Choosing Wisely Africa (CWA) builds on Choosing Wisely (CW) in the United States, Canada, and India and aims to identify low-value, unnecessary, or harmful cancer practices that are frequently used on the African continent. The aim of this work was to use physicians and patient advocates to identify a short list of low-value practices that are frequently used in African low- and middle-income countries.

The CWA Task Force was convened by the African Organization for Research and Training in Cancer and included representatives from surgical, medical, and radiation oncology, the private and public sectors, and patient advocacy groups. Consensus was built through a modified Delphi process, shortening a long list of practices to a short list, and then to a final list. A voting threshold of ≥ 60% was used to include an individual practice on the short list. A consensus was reached after a series of teleconferences and voting processes.

Of the 10 practices on the final list, one is a new suggestion and 9 are revisions or adaptations of practices from previous CW campaign lists. One item relates to palliative care, 8 concern treatment, and one relates to surveillance.

The CWA initiative has identified 10 low-value, common interventions in Africa’s cancer practice. The success of this campaign will be measured by how the recommendations are implemented across sub-Saharan Africa and whether this improves the delivery of high-quality cancer care.

Anthracycline (A) or taxane T-based regimens are the standard early-line chemotherapy for metastatic breast cancer (BC). A previous study has shown a survival benefit of eribulin in heavily pretreated advanced/recurrent BC patients. The present study aimed to compare the benefit of eribulin with treatment of physician’s choice (TPC) as first- or second-line chemotherapy for recurrent HER2-negative BC.

Patients with recurrent HER2-negative BC previously receiving anthracycline and taxane AT-based chemotherapy in the adjuvant or first-line setting were eligible for this open-label, randomized, parallel-group study. Patients were randomized 1:1 by the minimization method to receive either eribulin (1.4 mg/m² on day one and eight of each 21-day cycle) or TPC (paclitaxel, docetaxel, nab-paclitaxel or vinorelbine) until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). Secondary endpoints included time to treatment failure (TTF), overall response rate (ORR), duration of response, and safety (UMIN000009886).

Between May 2013 and January 2017, 58 patients were randomized, 57 of whom (26 eribulin and 31 TPC) were analyzed for efficacy. The median PFS was 6.6 months with eribulin versus 4.2 months with TPC (hazard ratio: 0.72 [95% confidence interval (CI), 0.40–1.30], p = 0.276). Median TTF was 6.0 months with eribulin versus 3.6 months with TPC (hazard ratio: 0.66 [95% CI, 0.39–1.14], p = 0.136). Other endpoints were also similar between groups. The most common grade ≥ 3 adverse event was neutropenia (22.2% with eribulin versus 16.1% with TPC).

Eribulin seemed to improve PFS or TTF compared with TPC without statistical significance. Further validation studies are needed.

• Breast cancer
• Clinical trial
• Eribulin

Patient: Female, 58-year-old

Final Diagnosis: Gastric perforation

Symptoms: Abdominal pain • peritonitis

Medication: —

Clinical Procedure: Jejunostomy tube placement • laparoscopic surgery • open surgery

Specialty: Surgery

Breast cancer (BC) brain metastases (BM) can have discordant hormonal or human epidermal growth factor receptor 2 (HER2) expression compared with corresponding primary tumors. This study aimed to describe incidence, predictors, and survival outcomes of discordant receptors and associated subtype switching in BM.

BCBM patients seen at 4 tertiary institutions who had undergone BM resection or biopsy were included. Surgical pathology reports were retrospectively assessed to determine discordance between the primary tumor and the BCBM. In discordant cases, expression in extracranial metastases was also assessed.

In BM from 219 patients, prevalence of any discordance was 36.3%; receptor-specific discordance was 16.7% for estrogen, 25.2% for progesterone, and 10.4% for HER2. Because estrogen and progesterone were considered together for hormonal status, 50 (22.8%) patients switched subtype as a result; 20 of these switches were HER2 based. Baseline subtype predicted switching, which occurred in up to 37.5% of primary HR+ patients. Moreover, 14.8% of initially HER2-negative patients gained HER2 in the BM. Most (63.6%) discordant patients with extracranial metastases also had discordance between BM and extracranial subtype. Loss of receptor expression was generally associated with worse survival, which appeared to be driven by estrogen loss (hazard ratio = 1.80, P = 0.03). Patients gaining HER2 status (n = 8) showed a nonsignificant tendency toward improved survival (hazard ratio = 0.64, P = 0.17).

In this multicenter study, we report incidence and predictors of subtype switching, the risk of which varies considerably by baseline subtype. Switches can have clinical implications for prognosis and treatment choice.

• brain metastases
• breast cancer
• receptor discordance
• subtype

To explore the concepts and practices of advanced breast cancer treatment.

Metastatic breast cancer (MBC) has become a chronic disease, with a median overall survival (OS) of around 3 years and a 5-year survival rate of about 25%. OS are strongly associated with the best available care, which consists of not only application of guidelines, but also multidisciplinary specialized care, the most efficacious medicines, and so on. Advanced breast cancer (ABC) Guidelines are the most important and authoritative guidelines for MBC.

In this review, we demonstrate the history and evolution of the global ABC Guidelines. Since 2015, Chinese multidisciplinary experts have drafted guidelines for clinical diagnosis and treatment of MBC. All of these ABC guidelines describe specialized therapeutic principles for different subtypes MBC in detail. Encouragingly, we have found that some special subtypes are hopeful of being cured, such as HER-2 positive patients with low tumor burden or HR-positive (HR+) MBC with non-visceral metastasis. In our opinion, the definition of cure of MBC is that MBC patients achieve CR and remain for more than five years after systemic treatment, including those with local therapy. Consequently, we also have conducted some researches and meaningful explorations in different subtypes of MBC. In HER2 positive MBC, our study revealed that regular HER2 circulating extracellular domain (ECD) assay can provide the real-time monitoring of tumor burden and prediction of poor outcome, and may present an important opportunity to reassess HER2 status. In HR+ MBC, we suggested that hormone therapy (HT) maintenance is the priority choice for HR+/HER2− MBC after first-line combined chemotherapy. Besides, our real-world study revealed that fulvestrant combined with ovarian suppression was an active option for premenopausal HR+/HER2- MBC. And also, we observed that everolimus (low-dose) combined with hormone therapy was still effective for HR+/HER2− MBC. For mTNBC patients, we found that THA and endostatin exhibited potential efficacy and was well tolerated in pretreated patients.

Our concepts and practices will contribute to the design of relevant clinical research and accumulation of evidence, and cure of MBC is promising.

• Metastatic breast cancer (MBC)
• cure
• molecular types
• targeted therapy
• treatment

Breast cancer is the most common tumor in women, and about one-third of cases develop metastatic disease. However, metastatic breast cancer rarely invades the common bile duct (CBD) directly without involving the liver, and involvement of the gastrointestinal tract is rare. Cases of such metastases pose a particular diagnostic challenge.

A 55-year-old female presented to the Department of Gastroenterology with complaint of a 2 mo history of right upper abdominal pain accompanied by pain in the right back, aggravated after eating greasy diet. The patient had received a diagnosis of breast cancer 3 years prior. Physical examination showed obvious superficial protuberant erythema on the left neck and chest skin, with slight tenderness and burning sensation. Endoscopic retrograde cholangiopancre-atography showed an obstruction at the end of the CBD. Histopathology of the CBD and symptomatic skin biopsies showed positivity for cytokeratin 7 and trans-acting T-cell-specific transcription factor breast cancer biomarkers. A cancer embolus was also found in the skin vasculature. Accordingly, the diagnosis of breast cancer metastases to the skin and biliary ducts was made. A plastic biliary sent was placed, which relieved the right upper abdominal pain and protected against unnecessary hepatectomy surgery.

Although rare, biliary metastasis should be considered in patients with bile duct stenosis and a history of breast cancer.

• Breast cancer
• Common bile duct
• Metastases
• Plastic stent
• Prognosis
• Case report

• Biofabrication techniques
• Biomimetic 3D models
• Breast cancer
• Collagen
• Extracellular matrix

• ABC
• ESO-ESMO
• advanced
• breast cancer
• guidelines
• metastatic

• Breast Neoplasms/drug therapy
• Consensus
• Humans
• Societies, Medical