Publications by authors named "Azambuja E"

Background: Concomitant intake of proton pump inhibitors (PPIs) may create drug-drug interactions, potentially impacting efficacy of anticancer agents. In the phase III PALLAS trial, the addition of palbociclib capsules to standard adjuvant endocrine therapy in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative early breast cancer did not improve invasive disease-free survival (iDFS). We explored whether concomitant use of PPIs affected survival outcomes in patients treated with palbociclib in PALLAS.

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Background: In HER2+ early breast cancer (EBC), we investigated tumor and immune changes during neoadjuvant treatment and their impact on residual disease (RD) biology and prognostic implications across 4 neoadjuvant studies of trastuzumab with or without lapatinib, and with or without chemotherapy: CALGB 40601, PAMELA, NeoALTTO and NSABP B-41.

Patients And Methods: We compared tumor and immune gene expression changes during neoadjuvant treatment and their association with with event-free survival (EFS) by uni- and multivariable Cox regression models in different cohorts and timepoints: 452 RD samples at baseline including 169 with a paired RD, and biomarker changes during neoadjuvant therapy, evaluating model performance via the c-index.

Results: Analysis of 169 paired tumor samples revealed a shift in intrinsic subtype proportions from HER2-Enriched at baseline (50.

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Article Synopsis
  • - Patients with HER2-positive breast cancer face a high risk of brain metastases, impacting their survival and quality of life, and there is a need for better primary prevention strategies.
  • - Experts developed consensus statements through a modified Delphi process to address current unmet needs and assess available evidence on brain metastases management.
  • - Out of 55 statements reviewed by contributors, 34 achieved consensus regarding areas like prevention, screening, and treatment efficacy, while some statements lacked agreement due to insufficient evidence; these consensus statements can guide clinical practice and future research.
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  • Recent advancements in antibody-drug conjugates (ADCs) have improved outcomes for patients with HER2-low-expressing breast cancer, a group that previously lacked effective targeted therapies.
  • A systematic review and meta-analysis was conducted to evaluate the effectiveness of various ADCs, including trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan (SG), in treating HER2-low advanced or metastatic breast cancer, pulling data from multiple reputable sources.
  • The findings revealed that patients treated with T-DXd had significantly better outcomes in terms of objective response rate, disease control rate, and overall survival compared to those receiving traditional treatment options, highlighting the potential of ADCs as effective therapies.
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Background: Burnout in health care professionals (HCPs) results from exposure to psychosocial risks at work. Left unaddressed, burnout can lead to chronic health problems, increased staff turnover, reduced work hours, absenteeism, and early retirement from clinical practice, thus impacting patient care. The European Society for Medical Oncology (ESMO) Resilience Task Force (RTF) was established in December 2019 to support the well-being of oncology HCPs globally.

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Background: Dual anti-human epidermal growth factor receptor 2 (HER2) blockade has improved the outcomes of patients with early and metastatic HER2-positive breast cancer. Here we present the final 10-year analysis of the ALTTO trial.

Patients And Methods: The ALTTO trial (NCT00490139) is a prospective randomized, phase III, open-label, multicenter study that investigated the role of adjuvant chemotherapy and trastuzumab alone, in combination or sequentially with lapatinib.

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  • The study explores how low levels of HER2 expression affect breast cancer treatment outcomes and the success of hormone therapy in patients.
  • It analyzes data from a large international study called PALLAS, which included over 5,000 patients to see how HER2 status impacts survival rates and response to the drug palbociclib.
  • The research found that HER2-low levels are common and vary between countries, but HER2 status didn’t significantly change the success rate of hormone therapy in the patients.
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  • Young women with breast cancer have a higher likelihood of carrying harmful BRCA gene variants, but data on tumor histology's prognostic value is limited.
  • A study involving 4,628 patients revealed that lobular tumors are generally diagnosed at a later stage and are more often linked to BRCA2 mutations, while ductal tumors are frequently associated with BRCA1 mutations.
  • Despite differences in tumor characteristics and treatment approaches, the study found no significant differences in disease-free or overall survival between those with ductal and lobular tumors, indicating that histology may not influence prognosis.
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JCO The APHINITY trial (ClinicalTrials.gov identifier: NCT01358877) previously demonstrated that pertuzumab added to adjuvant trastuzumab and chemotherapy improved invasive disease-free survival (iDFS) for patients with early human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC). Here, we report the preplanned third interim analysis of overall survival (OS) and a descriptive updated iDFS analysis with 8.

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Objectives: The study was undertaken to assess the association between certification and volume of breast centres on the one hand and survival on the other in patients with invasive breast cancer (IBC).

Methods: The study comprises a cohort of 46,035 patients diagnosed with IBC between 2014 and 2018, selected from the nation-wide Belgian Cancer Registry (BCR) database, which was linked with health insurance, hospital discharge and vital status data. Overall and relative survival probabilities were obtained with Kaplan-Meier method and an actuarial approach based on Ederer II, respectively.

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Background: Surgical de-escalation aims to reduce morbidity without compromising oncological outcomes. Trials to de-escalate breast cancer (BC) surgery among exceptional responders after neoadjuvant systemic therapy (NST) are ongoing. Combined patient and clinician insights on this strategy are unknown.

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Background: Most premenopausal patients with early breast cancer (eBC) are diagnosed with hormone receptor-positive disease and therefore candidate for adjuvant endocrine therapy (ET).

Patients And Methods: The Gruppo Italiano Mammella (GIM) 23-POSTER (GIM23) is a multicenter, prospective, observational study conducted in 26 Italian institutions, aiming to evaluate ET choices for premenopausal patients affected by hormone receptor-positive eBC in a real-world setting. Here we report also the results in terms of type of ET prescribed according to the definition of high-risk patients by monarchE and NATALEE trials.

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Introduction: Anticancer treatments have significantly contributed to increasing cure rates of breast cancer in the last years; however, they can also lead to short- and long-term side effects, including gonadotoxicity, and compromised fertility in young women. Oncofertility is a crucial issue for young patients who have not yet completed their family planning at the time of cancer diagnosis.

Areas Covered: This review aims to cover all the latest available evidence in the field of oncofertility, including the gonadotoxicity of currently adopted anticancer therapies in the curative breast cancer setting, the available strategies for fertility preservation and the feasibility of achieving a pregnancy following anticancer treatment completion.

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Background: Hormone receptor expression is a known positive prognostic and predictive factor in breast cancer; however, limited evidence exists on its prognostic impact on prognosis of young patients harboring a pathogenic variant (PV) in the BRCA1 and/or BRCA2 genes.

Patients And Methods: This international, multicenter, retrospective cohort study included young patients (aged ≤40 years) diagnosed with invasive breast cancer and harboring germline PVs in BRCA genes. We investigated the impact of hormone receptor status on clinical behavior and outcomes of breast cancer.

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Article Synopsis
  • The SOLAR-1 and CAPItello-29 studies show that the PI3Ki alpelisib and AKTi capivasertib are beneficial for patients with hormone receptor-positive, HER2-negative metastatic breast cancer who have specific genetic alterations.
  • Despite their effectiveness, these drugs can cause significant toxicities that may limit their use, especially in frail patients, highlighting the need for careful patient selection.
  • The review emphasizes the importance of identifying predictive biomarkers, particularly PIK3CA mutations and AKT pathway alterations, while noting that current diagnostic methods are not yet optimal, and suggests that ongoing monitoring of mutations in metastatic tissue and blood is crucial for effective treatment.
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Purpose: The relevance of cardiotoxicity in the context of HER2-positive breast cancer is likely to increase with increasing patient treatment exposure, number of treatment lines, and prolonged survival. Circulating biomarkers to early identify patients at risk of cardiotoxicity could allow personalized treatment and follow-up measures. The aim of this study is to examine the relationship between circulating microRNAs and adverse cardiac events in HER2-positive breast cancer patients.

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Introduction: The CLEOPATRA trial (NCT00567190) established a dual anti-HER2 blockade in combination with docetaxel as the first-line standard of care for patients with metastatic HER2-positive breast cancer. While this treatment is overall associated with significant improvement in progression-free survival (PFS) and overall survival (OS), not all patients respond equally. We hypothesized that a radiological complete response (CR) at week 9 (i.

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Around 90% of breast tumours are diagnosed in the early stage, with approximately 70% being hormone receptor-positive. The cornerstone of adjuvant therapy for early-stage hormone receptor-positive breast cancer is endocrine therapy, tailored according to disease stage, biological characteristics of the tumour, patient's comorbidities, preferences and age. In premenopausal patients with hormone receptor-positive breast cancer, ovarian function suppression is a key component of the adjuvant endocrine treatment in combination with an aromatase inhibitor or tamoxifen.

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Background: The incorporation of circulating tumor DNA (ctDNA) into the management of operable breast cancer (BC) has been hampered by the heterogeneous results from different studies. We aimed to assess the prognostic value of ctDNA in patients with operable (non metastatic) BC.

Materials And Methods: A systematic search of databases (PubMed/Medline, Embase, and CENTRAL) and conference proceedings was conducted to identify studies reporting the association of ctDNA detection with disease-free survival (DFS) and overall survival (OS) in patients with stage I-III BC.

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