Publications by authors named "Leone Jose Pablo"

Special histologic subtypes of breast cancer (BC) exhibit unique phenotypes and molecular profiles with diagnostic and therapeutic implications, often differing in behavior and clinical trajectory from common BC forms. Novel methodologies, such as artificial intelligence may improve classification. Genetic predisposition plays roles in a subset of cases.

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Purpose: Trimodal therapy (TMT) is the standard treatment for patients with nonmetastatic inflammatory breast cancer (IBC). TMT consists of neoadjuvant systemic therapy, modified radical mastectomy (MRM), and postmastectomy radiation therapy. Although broadly considered the best approach for IBC, in the United States, only a third of patients receive TMT.

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Purpose: The COVID-19 pandemic created significant disruptions in the diagnosis and treatment of breast cancer (BC). Several public health measures were taken with limited evidence on their potential impact. In this observational study, we sought to compare the incidence of BC, treatment patterns, and mortality during 2020 versus 2018 and 2019.

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Purpose: Patients with HER2-positive breast cancer brain metastases have few effective systemic therapy options. In a prior study, pertuzumab with high-dose trastuzumab demonstrated a high clinical benefit rate (CBR) in the central nervous system (CNS) in patients with brain metastases. The current trial evaluated whether the addition of atezolizumab to this regimen would produce further improvements in CNS response.

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Breast cancer is a disease encompassing a spectrum of molecular subtypes and clinical presentations, each with distinct prognostic implications and treatment responses. Breast cancer has traditionally been considered an immunologically "cold" tumor, unresponsive to immunotherapy. However, clinical trials in recent years have found immunotherapy to be an efficacious therapeutic option for select patients.

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Background: Male breast cancer (MaBC) has limited data on genomic alterations. We aimed to comprehensively describe and compare MaBC's genomics with female breast cancer's (FBC) across subtypes.

Methods: Using genomic data from Foundation Medicine, we categorized 253 MaBC into estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative (n = 210), ER-positive/HER2-positive (n = 22) and triple-negative (n = 20).

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Purpose: Male breast cancer accounts for approximately 1% of all breast cancer diagnoses. Unfortunately, a lack of information exists regarding late effects of breast cancer treatment in men.

Methods: An online survey directed towards male breast cancer patients was distributed via social medial and emails from June to July 2022.

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Central nervous system (CNS) metastases are common in breast cancer (BC) patients and are particularly relevant as new treatments for BC are prolonging survival. Here, we review advances in the treatment of CNS metastases from BC, including radiotherapy, systemic therapies, and the evolving role of immunotherapy. The use of radiotherapy and chemotherapy is the cornerstone of treatment for CNS metastases.

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Article Synopsis
  • Neoadjuvant chemotherapy (NAC) is commonly used for treating breast cancer in women, but its effectiveness in men with breast cancer (MaBC) is not well understood, prompting this study to compare pathologic complete response (pCR) rates between MaBC and female breast cancer (FBC).
  • The study analyzed data from the National Cancer Database for patients treated with NAC between 2010 and 2016, finding that FBC has higher pCR rates compared to MaBC across various tumor subtypes, indicating a significant difference in response to treatment.
  • Results showed that FBC patients had twice the odds of achieving pCR compared to MaBC patients, and both groups demonstrated better overall survival (OS) rates for
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Male breast cancer (MaBC) is a rare clinical entity, which makes up approximately 1% of all breast cancers. However, the incidence of MaBC has been steadily increasing over the past few decades. The risk factors for MaBC include age, black race, family history of breast cancer, genetic mutations, liver cirrhosis, and testicular abnormalities.

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Purpose: We sought to understand the attitudes of individuals with abnormal breast imaging findings prompting a diagnostic breast biopsy toward donation of blood, excised tissue, or percutaneous biospecimens for research, and to understand medical oncologists' attitudes toward research biospecimen collection in this population.

Methods: We included individuals who presented to a single academic medical center for a clinically indicated, image-guided, percutaneous breast biopsy. We administered a survey prior to knowledge of biopsy results to assess willingness to consider, entirely for research purposes, donating blood or excess excised breast tissue, or having additional biospecimens (AB) obtained during a clinically indicated percutaneous biopsy.

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It is estimated that approximately one-third of patients with triple-negative breast cancer (TNBC) will develop brain metastases. The prognosis for patients with breast cancer brain metastasis has improved in the recent past, especially for hormone receptor and human epidermal growth factor receptor 2 (HER) positive subtypes. However, the overall survival rate for patients with triple-negative subtype remains poor.

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Background: In early trials, hypersensitivity reactions (HSRs) to paclitaxel were common, thus prompting the administration of antihistamines and corticosteroids before every paclitaxel dose. We tested the safety of omitting corticosteroids after cycle 2 during the paclitaxel portion of the dose-dense (DD) doxorubicin-cyclophosphamide (AC)-paclitaxel regimen.

Patients, Materials, And Methods: In this prospective, single-arm study, patients who completed four cycles of DD-AC for stage I-III breast cancer received paclitaxel 175 mg/m every 2 weeks for four cycles.

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Background: Fewer than 1% of all breast cancers occur in men. As a result, a distinct lack of data exists regarding the management and outcomes in this cohort.

Methods: Any male patient with pathologically confirmed breast cancer diagnosed between August 2000 and October 2017 at either Massachusetts General Hospital or Brigham and Women's Hospital/Dana-Farber Cancer Institute and their affiliate satellite locations were included.

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Article Synopsis
  • Male breast cancer is rare and primarily hormone receptor positive, but its tumor subtype's impact on survival rates remains unclear.
  • A study using SEER data analyzed 2,389 men with invasive breast cancer, finding that different tumor subtypes significantly affected overall survival (OS) and breast cancer-specific survival (BCSS).
  • Results indicated that men with triple-negative (TN) tumors had the worst survival rates among subtypes, highlighting a need for further research to address potential under-treatment and aggressive disease presentation in these cases.
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Article Synopsis
  • The study investigates how the pattern of metastatic spread in male breast cancer affects overall survival, as this has been well-established in women but not understood for men.
  • Data from the SEER database involving 250 male patients with newly diagnosed metastatic breast cancer between 2010 and 2017 revealed different median overall survival rates based on the metastatic pattern, with bone-only metastases associated with the longest survival.
  • The findings indicate that specific factors, such as tumor subtype and the presence of brain metastases, significantly influence survival outcomes, highlighting that brain metastases lead to a significantly poorer prognosis, particularly in younger patients.
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The management of breast cancer, the most common cancer in the female population, has changed dramatically over years with the introduction of newer therapies. An increased incidence of brain metastases in recent years has created a challenge for oncologists because this population continues to have a poorer prognosis compared to metastatic breast cancer without central nervous system involvement. Historically, the exclusion of breast cancer patients with brain metastases from clinical trials has made treatment options even more limited.

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Background: The objective of this study was to describe the perspective of patients with early breast cancer toward research biopsies. The authors hypothesized that more patients at academic sites than at community-based sites would be willing to consider these procedures.

Methods: In total, 198 patients with early stage breast cancer were recruited from 3 academic centers (n = 102) and from 1 community oncology practice (n = 96).

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Background: We aimed to examine the safety and efficacy of bevacizumab and carboplatin in patients with breast cancer brain metastases.

Methods: We enrolled patients with breast cancer and > 1 measurable new or progressive brain metastasis. Patients received bevacizumab 15 mg/kg intravenously (IV) on cycle 1 day 1 and carboplatin IV AUC = 5 on cycle 1 day 8.

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Purpose: The use of growth factors adds considerable expense and some toxicity to adjuvant breast cancer chemotherapy. We tested the feasibility and safety of omitting routine peg-filgrastim use during the paclitaxel portion of the dose-dense doxorubicin-cyclophosphamide-paclitaxel regimen.

Patients And Methods: This was a prospective, single-arm study in which patients 18 to 65 years of age who completed 4 cycles of dose-dense doxorubicin-cyclophosphamide for stage I-III breast cancer received paclitaxel 175 mg/m every 2 weeks.

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Article Synopsis
  • The study examined cabozantinib's effectiveness and tolerability alone or with trastuzumab in breast cancer brain metastases (BCBM) patients.
  • Enrollment included three cohorts based on cancer subtype, and patients received cabozantinib daily on a 21-day cycle, with specific objectives related to tumor response and survival rates.
  • Results showed low CNS objective response rates and common severe side effects, indicating limited efficacy in heavily pretreated BCBM patients despite some antiangiogenic activity.
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Many factors contribute to the poor survival of malignant brain tumor patients, some of which are not easily remedied. However, one contributor to the lack of progress that may be modifiable is poor clinical trial accrual. Surveys of brain tumor patients and neuro-oncology providers suggest that clinicians do a poor job of discussing clinical trials with patients and referring patients for clinical trials.

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The original version of this article, which published in Current Oncology Reports, Volume 21, Issue 6, June 2019, contained an error in addressing the indication for use of neratinib in early stage breast cancer.

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