Effects of toremifene and anastrozole on serum lipids and bone metabolism in postmenopausal females with estrogen receptor-positive breast cancer: The results of a 2-year multicenter open randomized study
Anan K.,Kitakyushu Municipal Medical Center |
Mitsuyama S.,Kitakyushu Municipal Medical Center |
Yanagita Y.,Gunma Prefectural Cancer Center |
Kimura M.,Ota General Hospital |
And 4 more authors.
Breast Cancer Research and Treatment | Year: 2011
The potential long-term adverse effects on quality of life have to be considered when selecting agents for adjuvant hormonal treatment for postmenopausal patients with estrogen receptor-positive breast cancer. We performed a 2-year multicenter randomized study to assess the differences in the time course effects between toremifene (TOR) and anastrozole (ANA) on serum lipid profiles and bone metabolism. This study assessed the serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-1 (Apo A1), and apolipoprotein B (Apo B) as lipid profiles and bone-specific alkaline phosphatase (BAP) and the N-telopeptide of type-I collagen (NTX) as bone turnover markers in patients who received daily doses of 40 mg and 1 mg for TOR and ANA, respectively. A decreased serum level of TC, LDL-C, and Apo B was, respectively, observed at 6 months in 6.2, 12.9, and 13.8% of the patients who received TOR compared with the baseline. These decreases were maintained for at least 24 months. These lipid levels were not changed in those who received ANA. In the TOR patients, there was an increase in the serum level of HDL-C and Apo A1 at 6 months in 17.1 and 16.3%, respectively, which was maintained for at least 24 months, whereas these levels were almost stable in the patients who received ANA. Serum BAP decreased by 12.1% at 12 months and further decreased at 24 months and the serum NTX decreased by 22.0% at 6 months, which was maintained for at least 24 months in the patients who received TOR. In contrast, the serum BAP was increased by 26.0% at 6 months and by 29.2% at 12 months and the serum NTX increased by 21.3% at 24 months compared with baseline in those received ANA. However, the serum BAP increase was not significant at 24 months. TOR provides better effects than ANA in terms of lipid profiles and bone metabolism in postmenopausal females with early breast cancer. © 2011 Springer Science+Business Media, LLC.
Yoshimoto M.,University of Tokyo |
Takao S.,Hyogo Cancer Center |
Hirata M.,JR Tokyo General Hospital |
Okamoto Y.,Toho University |
And 6 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2012
Purpose Metronomic combination chemotherapy with the oral fluoropyrimidine doxifluridine/50-deoxy-5-fluorouridine (5 -DFUR) and oral cyclophosphamide (C) showed promising efficacy in a single-arm study. The oral fluoropyrimidine capecitabine was designed to deliver 5-fluorouracil preferentially to tumors, potentially improving efficacy over doxifluridine. We conducted a phase II multicenter study to evaluate an all-oral XC combination in patients with HER2-negative metastatic breast cancer (MBC). Materials and methods Patients received capecitabine 828 mg/m 2 twice daily with cyclophosphamide 33 mg/m 2 twice daily, days 1-14 every 3 weeks. The primary endpoint was overall response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety. Results Between May 2007 and April 2009, 51 patients were enrolled and 45 were included in the efficacy analysis. The median follow-up was 18.1 months. ORR was 44.4% and stable disease (≥ 24 weeks) was achieved in 13.4%, resulting in a 57.8% clinical benefit response rate. Median PFS was 12.3 months (95% confidence interval: 8.9-18.9 months). Median PFS was 10.7 months in triplenegative disease and 13.2 months in estrogen-receptor positive, HER2-negative disease. The 1- and 2-year OS rates were 86 and 71%, respectively. Median OS has not been reached. Grade 3 adverse events comprised leukopenia (26%), neutropenia (16%), and decreased hemoglobin (2%). There was no grade 3 hand-foot syndrome. Conclusions Oral XC is an effective first- or second-line therapy forMBC, demonstrating high activity in both luminal A and triple-negative disease with few severe side effects. This metronomic oral combination chemotherapy could be beneficial for the treatment of HER2-negative MBC. © Springer-Verlag 2012.
Nishimura R.,Kumamoto City Hospital |
Rai Y.,Sagara Hospital |
Matsuo F.,Fukuoka University |
Anan K.,Kitakyushu Municipal Medical Center |
And 13 more authors.
Anticancer Research | Year: 2012
Aim: Neoadjuvant epirubicin/docetaxel (ET) combination chemotherapy was administered to breast cancer patients in order to investigate their clinical and pathological response. Moreover, the breast-conserving surgery (BCS) rate, disease-free (DFS) and overall survival (OS), safety profile and the correlation of biological markers were investigated. Patients and Methods: Out of the 46 enrolled patients, 45 patients were analyzed for clinical response, and 40 patients were examined for pathological response. Estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor type2 (HER2) expression were examined immunohistologically. Results: The median tumor size was 4.5 cm in diameter. Complete (CR) and partial responses were seen in 3 and 30 patients, respectively. A pathological CR was achieved in 4 patients and correlated with ER and PgR negativity. Moreover, BCS was performed on 16 patients. The 5-year cumulative DFS was 60.7% and OS was 91.8%. Conclusion: ET therapy is clinically effective with a pathological CR rate of 10% for patients with a large tumor, and should be considered as a neoadjuvant treatment option.
Effect of weekly paclitaxel followed by 5-fluorouracil, epirubicin, and cyclophosphamide as neoadjuvant treatment for patients with triple-negative and luminal-type breast cancer - A multicenter study
Anan K.,Kitakyushu Municipal Medical Center |
Tanaka M.,JCHO Kurume General Hospital |
Yoshinaga Y.,Fukuoka University |
Maeda S.,National Hospital Organization |
And 11 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2015
This study examined the pathological complete response (pCR) rate and safety of induction chemotherapy with 12 cycles of weekly paclitaxel (80mg/m2) followed by 4 cycles of 5-fluorouracil (500 mg/m2), epirubicin (100 mg/m2), and cyclophosphamide (500 mg/m2). The study medication was administered to female patients (n=31) with a mean age of 51 years, diagnosed with stage IIA (n=18), IIB (n=11) and 1A (n=2) disease and with an estrogen receptor positive rate of 65% (20/31). No patient was HER2-IHC [human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC)] (3 +) or HER2-FISH (fluorescence in situ hybridization) positive. Twenty-eight patients completed the treatment regimen. Treatment was halted in 2/31 patients due to progression of disease in one patient and a Grade 3 non-hematological adverse effect of skin eruption and itching in the other patient. A third patient died of causes unrelated to the study medication. Central review ascertained a pCR in 6 patients. In patients with triple-negative disease we observed a pCR rate of 67% (6/9). In patients with the Luminal (A+B) subtype, 0% (0/19) had a pCR. Grade 3/4 toxicity included leucopenia (58%), neutropenia (58%), febrile neutropenia (26%), fatigue (10%), and ALT elevation (7%). In terms of pCR, patients presenting with triple-negative disease and manageable safety profiles appear to respond well to this treatment regimen, while only a modest response was observed in patients with Luminal subtype disease.
Shibuta K.,Ueo Breast Surgical Hospital |
Ueo H.,Ueo Breast Surgical Hospital |
Furusawa H.,Breastopia Namba Hospital |
Komaki K.,Breastopia Namba Hospital |
And 4 more authors.
Breast Cancer | Year: 2011
Background: Estrogen receptor (ER), progesterone receptor (PgR), and HER2 expression status in breast cancer function as prognostic and predictive factors that enable individualized treatment. Intrinsic subtype classification has also been performed based on these and other biological and prognostic characteristics. However, clinical analysis of such subtypes in a large number of Japanese breast cancer patients has not yet been reported. Methods: Between January 2003 and December 2007, 4,266 patients with primary breast cancer were registered. Four subtypes based on immunohistochemically evaluated ER/PgR/HER2 status, clinicopathological features, and prognosis were analyzed retrospectively. Results: The following subtype distribution was observed: luminal A type (ER+ and/or PgR+, HER2-), 3,046 cases (71%); luminal B type (ER+ and/or PgR+, HER2+), 321 cases (8%); HER2 type (ER-, PgR-, HER2+), 398 cases (9%); and triple negative (TN) type (ER-, PgR-, HER2-), 501 cases (12%). The HER2+ subtypes (luminal B and HER2 types) had a significantly higher incidence of lymph node metastasis and lymphatic permeation, while the hormone receptor negative subtypes (HER2 and TN types) showed a significantly higher nuclear grade. Overall, patients with HER2-type and TN-type disease had a significantly poorer prognosis than other subtypes. Conclusion: Intrinsic breast cancer subtypes are associated with clinicopathological features and prognosis in Japanese women. Long-term clinical observation of the relationship between each subtype and therapies used should provide useful information for selecting appropriately tailored treatments. © 2010 The Japanese Breast Cancer Society.
Nakayama R.,Mie University |
Namba K.,Hokuto Hospital and Clinic |
Watanabe R.,Hakuaikai Hospital |
Nakahara H.,Breastopia Namba Hospital |
Smathers R.,Mammography Specialists Medical Group
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2014
We compared the usefulness of the presentation of likelihood of histological classifications with that of malignancy evaluated by a CAD scheme in the differential diagnosis of clustered microcalcifications (MCs) on magnified spot mammograms. The likelihood of histological classifications was evaluated by the CAD scheme using 5 objective features that radiologists commonly use for describing MCs. The likelihood of malignancy was evaluated based on the likelihood of histological classifications. Unknown cases for an observer study consisted of 22 benign MCs (15 micro-cysts and 7 mastopathies) and 26 malignant MCs (10 DCISs of comedo type and 16 DCISs of noncomedo type). Thirteen observers independently provided their confidence level regarding the malignancy of the unknown case before viewing the evaluated result by the CAD scheme, after viewing the likelihood of malignancy and after viewing the likelihood of histological classifications. The results were evaluated with multi-reader, multi-case receiver operating characteristic (ROC) analysis. The average area under the curve (AUC) for all observers without CAD, with CAD for malignancy and with CAD for histological calcifications was 0.670, 0.802 and 0.819 (P < .01), respectively. The presentation of the likelihood of histological classifications improved radiologists' performance than that of malignancy in the differential diagnosis of MCs. © 2014 Springer International Publishing.
Furusawa H.,Breastopia Namba Hospital
Japanese Journal of Clinical Radiology | Year: 2013
Magnetic resonance imaging (MRI) is the best modality to know preoperatively breast cancer spreading in most of all patients. The prognoses of breast cancer patients do not depend on the way of local treatment. Accordingly the aim of local therapy is to completely eradicate viable cancer cells in the breast. This means no need of adherence to the usual surgical procedures. MR guided focused ultrasound surgery (MRgFUS) is one of the non-surgical ablation and thermal coagulation as local therapy of breast cancer. The clinical studies in our facility has proved that this local treatment has the potential to take place of the usual surgery in some cases. The case of MRgFUS must be strictly selected.