Publications by authors named "Jose-Angel Garcia-Saenz"

Standard treatments in hormone receptor-positive (HR+)/HER2-metastatic breast cancer (mBC) typically involve endocrine therapy (ET) combined with CDK4/6 inhibitors, yet resistance to ET remains a persistent challenge in advanced cases. A deeper knowledge of the use of liquid biopsy is crucial for the implementation of precision medicine in mBC with real-time treatment guidance. Our study assesses the prognostic value of and mutations in DNA derived from extracellular vesicles (EV-DNA) in longitudinal plasma from 59 HR+/HER2-mBC patients previously exposed to aromatase inhibitors, with a comparative analysis against circulating tumor DNA (ctDNA).

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  • Imlunestrant is a next-generation oral selective estrogen receptor degrader being tested in the EMBER trial for patients with ER+ advanced breast cancer and endometrioid endometrial cancer (EEC).
  • The trial involves a dose-escalation design to determine optimal doses and measure safety, pharmacokinetics, and anticancer effects, focusing specifically on patients who have already undergone certain previous treatments.
  • Results showed manageable side effects and some evidence of antitumor activity, with better outcomes observed when imlunestrant was combined with abemaciclib compared to imlunestrant alone.
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  • This study looked at how a medicine called nintedanib might help with breast cancer by making the environment around the tumor less stiff.
  • Researchers tested this by comparing two groups of patients: one got regular treatment while the other received nintedanib with their treatment.
  • They found that although overall survival rates were similar, patients with high stiffness scores (MeCo) had a higher risk of cancer returning, but taking nintedanib lowered that risk.
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  • Leptomeningeal disease (LMD) significantly impacts survival and quality of life, and trastuzumab deruxtecan (T-DXd) has demonstrated effectiveness in treating advanced HER2-positive and HER2-low breast cancer in patients with a history of brain metastases or LMD.
  • In a phase 2 trial involving seven patients with confirmed LMD, T-DXd was administered, revealing a median overall survival (OS) of 13.3 months and a progression-free survival (PFS) of 8.9 months, with many patients achieving disease stabilization.
  • The results suggest T-DXd has promising activity in this challenging patient population, indicating a need for further research on its efficacy in treating LMD.
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Purpose: To evaluate the efficacy and safety of the combination of olaparib plus trastuzumab in patients with HER2-positive advanced breast cancer (ABC) and germinal BRCA mutations (gBRCAm).

Methods: OPHELIA (NCT03931551) was a single-arm, open-label, phase 2 clinical trial. Patients aged ≥18 years diagnosed with HER2-positive ABC with germinal deleterious mutations in BRCA1 or BRCA2 who had received at least one prior systemic regimen for advanced disease were enrolled.

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  • - The study investigates how following cancer prevention guidelines from the WCRF/AICR affects the health-related quality of life (HRQL) in breast cancer survivors over a long period, specifically comparing their status at diagnosis and 7-12 years later.
  • - Researchers analyzed data from 406 breast cancer survivors, collecting information on lifestyle, diet, physical activity, and HRQL using a scoring system based on WCRF/AICR recommendations.
  • - Results indicate that higher adherence to these cancer prevention guidelines is linked to slight improvements in the physical aspect of HRQL over time, while no significant change was found in the mental HRQL domain.
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  • Trastuzumab deruxtecan (T-DXd) is now approved for treating HER2-low metastatic breast cancer, but its effectiveness has mostly been studied in clinical trials.
  • The DESTINY-Breast Respond HER2-low Europe study will enroll 1,350 patients across 216 sites in 12 European countries to compare T-DXd with conventional chemotherapy in a real-world setting.
  • This observational study aims to gather data on treatment effectiveness, safety, patient experiences, and overall health, which will help enhance future treatment strategies for patients with advanced breast cancer.
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Purpose: Stromal tumor-infiltrating lymphocytes (sTIL) are associated with pathologic complete response (pCR) and long-term outcomes for triple-negative breast cancer (TNBC) in the setting of anthracycline-based chemotherapy. The impact of sTILs on refining outcomes beyond prognostic information provided by pCR in anthracycline-free neoadjuvant chemotherapy (NAC) is not known.

Experimental Design: This is a pooled analysis of two studies where patients with stage I (T>1 cm)-III TNBC received carboplatin (AUC 6) plus docetaxel (75 mg/m2; CbD) NAC.

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Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate that targets human epidermal growth factor receptor 2 (HER2) and has shown promising results in the treatment of advanced/metastatic breast cancer. The objective of this report is to provide guidance on the prophylaxis, monitoring, and management of adverse events (AEs) in patients with breast cancer treated with T-DXd, and to emphasize that proper management of AEs is needed to optimize the effectiveness of T-DXd treatment and reduce the number of discontinuations. The article covers various aspects of T-DXd treatment, including its clinical efficacy, safety profile, and dosing considerations, and provides practical recommendations for managing AEs, such as nausea/vomiting, interstitial lung disease, and hematologic toxicity.

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Background: The PENELOPE trial investigating efficacy and safety of additional 1-year post-neoadjuvant palbociclib to standard endocrine therapy (ET) high-risk hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) early breast cancer patients failed to improve invasive disease-free survival (iDFS). This analysis compared patient-reported outcomes (PROs) between treatment groups.

Patients And Methods: Patients received 13 cycles of palbociclib 125 mg/day (n = 631) or placebo (n = 619) orally for 3 out of 4 weeks + ET.

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Purpose: Molecular subtyping based on gene expression profiling (i.e., PAM50 assay) aids in determining the prognosis and treatment of breast cancer (BC), particularly in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative tumors, where luminal A and B subtypes have different prognoses and treatments.

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The three approved cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, including abemaciclib, have shown differences in their preclinical, pharmacological, and clinical data. Abemaciclib stands out for its broader target range and more rapid and intense activity. It has demonstrated efficacy as a monotherapy or in combination with tamoxifen in endocrine-refractory metastatic breast cancer (MBC) patients with prior chemotherapy.

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  • Cardiotoxicity due to anthracyclines (CDA) is a major concern for cancer patients, but predicting who will develop this complication remains challenging due to its complex genetic basis.
  • Researchers conducted a study using genetically diverse mice treated with doxorubicin and docetaxel to explore the link between intermediate molecular phenotypes (IMPs) in the heart and CDA susceptibility, identifying quantitative trait loci (QTLs) associated with these traits.
  • The study revealed that specific genetic variants related to IMPs could serve as markers for CDA risk in patients, which may help tailor more personalized treatment strategies for those receiving cancer therapies like anthracyclines.
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Endocrine-resistant, hormone receptor-positive, and HER2-negative (HR+/HER2-) metastatic breast cancer (mBC) is largely governed by acquired mutations in the estrogen receptor, which promote ligand-independent activation, and by truncal alterations in the PI3K signaling pathway, with a broader range of gene alterations occurring with less prevalence. Circulating tumor DNA (ctDNA)-based technologies are progressively permeating the clinical setting. However, their utility for serial monitoring has been hindered by their significant costs, inter-technique variability, and real-world patient heterogeneity.

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  • Polygenic risk scores (PRSs), derived from genome-wide association studies (GWASs), can enhance breast cancer risk evaluation but are primarily based on European populations.
  • This study analyzed the effectiveness of European-based PRS models in identifying breast cancer risk among Ashkenazi Jewish women in Israel using data from two cohorts.
  • Results indicated that these PRS models successfully identified Ashkenazi Jewish women at high risk for breast cancer, suggesting they could improve risk assessment in this group.
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Background: Xentuzumab is a humanised monoclonal antibody that binds to IGF-1 and IGF-2, neutralising their proliferative activity and restoring inhibition of AKT by everolimus. This study evaluated the addition of xentuzumab to everolimus and exemestane in patients with advanced breast cancer with non-visceral disease.

Methods: This double-blind, randomised, Phase II study was undertaken in female patients with hormone-receptor (HR)-positive/human epidermal growth factor 2 (HER2)-negative advanced breast cancer with non-visceral disease who had received prior endocrine therapy with or without CDK4/6 inhibitors.

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Advanced breast cancer represents a challenge for patients and for physicians due its dynamic genomic changes yielding to a resistance to treatments. The main goal is to improve quality of live and survival of the patients through the most appropriate subsequent therapies based on the knowledge of the natural history of the disease. In these guidelines, we summarize current evidence and available therapies for the medical management of advanced breast cancer.

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  • Researchers are focusing on the need for biomarkers to enhance the use of pertuzumab in treating early-stage ERBB2-positive breast cancer, moving beyond just ERBB2 status.
  • The study aims to evaluate if the HER2DX genomic assay can predict patient responses to trastuzumab-based chemotherapy, with or without pertuzumab, using tissue samples taken before treatment.
  • In a retrospective analysis involving 155 patients, the study found significant associations between baseline pCR scores from the genomic assay and the likelihood of achieving a pathologic complete response in breast and axillary tissues.
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Cardiotoxicity due to anthracyclines (CDA) affects cancer patients, but we cannot predict who may suffer from this complication. CDA is a complex disease whose polygenic component is mainly unidentified. We propose that levels of intermediate molecular phenotypes in the myocardium associated with histopathological damage could explain CDA susceptibility; so that variants of genes encoding these intermediate molecular phenotypes could identify patients susceptible to this complication.

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Purpose: Predictive biomarkers for capecitabine benefit in triple-negative breast cancer (TNBC) have been recently proposed using samples from phase III clinical trials, including non-basal phenotype and biomarkers related to angiogenesis, stroma, and capecitabine activation genes. We aimed to validate these findings on the larger phase III GEICAM/CIBOMA clinical trial.

Experimental Design: Tumor tissues from patients with TNBC randomized to standard (neo)adjuvant chemotherapy followed by capecitabine versus observation were analyzed using a 164-gene NanoString custom nCounter codeset measuring mRNA expression.

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Breast cancer (BC) survivors are advised to follow the WCRF/AICR cancer prevention recommendations, given their high risk of developing a second tumour. We aimed to explore compliance with these recommendations in BC survivors and to identify potentially associated clinical and sociodemographic factors. A total of 420 BC survivors, aged 31-80, was recruited from 16 Spanish hospitals.

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Importance: Patients selected to receive neoadjuvant chemotherapy (NAC) are usually those at higher risk of relapse, and there is a need to find better therapeutic options for these patients.

Objective: To determine the efficacy and safety outcomes for patients with hormone receptor (HR)-positive, ERBB2 (formerly HER2)-, high-risk early breast cancer enrolled in the randomized clinical trial monarchE who received NAC.

Design, Setting, And Participants: The monarchE randomized clinical trial was a multicenter, phase 3, open-label study that evaluated adjuvant treatment with abemaciclib plus endocrine therapy (ET) compared with ET alone in patients with HR+, ERBB2-, and node-positive early breast cancer who were at high risk of recurrence.

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The Epi-GEICAM study comprises 1017 invasive BC cases matched with controls of similar age (49 ± 9 years) and residence. Diet and OO consumption were collected through a validated food frequency questionnaire. 75% of women referred OO, common (refined) or virgin, as the main fat source.

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