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  • American Association for Cancer Research (AACR)  (3)
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  • American Association for Cancer Research (AACR)  (3)
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  • 1
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2011
    In:  Cancer Research Vol. 71, No. 24_Supplement ( 2011-12-15), p. P4-18-05-P4-18-05
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 71, No. 24_Supplement ( 2011-12-15), p. P4-18-05-P4-18-05
    Abstract: Background: Ductal carcinoma in situ with microinvasion (DCISM) is a rising rare entity. Because of that and its controversial pathological definition, there is a lack of clear recommendations for treatment. The purpose of this study was to describe the clinical and pathological characteristics, treatments and outcomes of our single institutional experience. Patients and methods: Individual clinical and pathological data were collected from 63 women, diagnosed and treated for DCISM at the Claudius Regaud Cancer Hospital between January 2000 and April 2010. All available histological material (45 patients) was reviewed by an expert pathologist. Results: The median age was 56 years (range 34–83). Seven patients (11.5%) had a personal history of DCIS, 27 patients (42%) a familial history of breast cancer. Fourteen patients (22%) had a clinical sign at the diagnosis. Fifty one patients were mammographically detected (81%). All the patients underwent surgery, mastectomy for 17 patients (27.4%) and conservative surgery for 45 (72.6%). Secondary surgery of the breast was required for 21 patients (46.6%) after conservative surgery, enlarging surgery (N=13) or mastectomy (N=8). Surgical axillary lymph node evaluation was performed on 52 patients (82,5%), axillary dissection alone for 10 patients, sentinel node biopsy alone for 37 patients and the 2 methods for 5 patients. The median size of the DCIS was 16mm (6-80mm) with 37/60 (61.7%) grade III Van Nuys classification. The most histological subtype was comedo carcinoma (68%). Concerning the 45 reviewed biopsies, the size of the microinvasive component was ≤ 1mm for 38 lesions and between 1 and 2 mm for 7 lesions. Hormonal receptor status was positive for 29 (64.4%), 27 (64.3%) for estrogen receptors and 20 (44.4%) for progesterone receptors. HER 2 status was performed for 34 patients, among 12 (35%) of them were found overexpressed on the microinvasive component. Lymph node invasion was found among 2 of the 52 patients (3.8 %) who underwent axillary lymph node evaluation. Radiation therapy was delivered to all the patients after conservative surgery (n=37)(50 Gy with a 10 Gy boost for 22 of them) and 2 after mastectomy (chest wall irradiation (50 Gy)). Adjuvant hormonotherapy was delivered on 11 patients (18%). With a median follow-up of 36,4 months (95%CI=[27.7- 44.16]), 62 patients are alive at the last follow-up and 58/63 free of disease (2 relapses and 3 second cancers).The 3 year disease free survival rate was 91.1 (95%CI=[78.1;96.6] ). During follow-up, two local relapses occurred on patients treated by mastectomy. One of them had local invasive relapse at 43 months and she is still NED after 90 months. The second patient who had local invasive carcinoma with axillary node invasion at 32 months treated by conservative surgery, axillary dissection, radiotherapy and chemotherapy, had metastasis at 51 months and passed away after 70 months. Conclusion: Mammographic screening programmes increase the rate of small diagnosed tumours, specially DCISM. Despite a priori good prognostic outcome, 2 axillary node involvements and 2 delayed relapses were observed. So, this kind of presentation deserves better evaluation of relapse risk factors to determine adapted adjuvant therapies. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-18-05.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
    Location Call Number Limitation Availability
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  • 2
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 72, No. 24_Supplement ( 2012-12-15), p. P3-14-03-P3-14-03
    Abstract: Background: Specific pathological and biological factors differentiating pure DCIS, DCIS with microinvasion (DCIS-MI) and DCIS with concomitant invasive ductal carcinoma (DCIS-IDC) are currently unknown. Identification of such factors would enable us to better understand the transition from an in situ to an invasive carcinoma and improve patient management for patients diagnosed with extensive DCIS. Methods: We previously performed a prospective surgical study demonstrating the benefit of performing upfront sentinel lymph node (SLN) biopsy in patients with extensive DCIS or DCIS-MI undergoing mastectomy. In that study, 196 DCIS and 31 DCIS-MI diagnosed on vacuum-assisted macrobiopsies underwent mastectomy and SLN biopsy. Final pathological status after mastectomy examination revealed 117 DCIS, 38 DCIS-MI, 69 DCIS-IDC, and in 3 cases no residual disease was found. The mastectomy specimens of 216 cases (111 DCIS, 37 DCIS-MI, 68 DCIS-IDC) were available for central pathological review and a TMA containing DCIS lesions of 214 cases (110 DCIS, 36 DCIS-MI, 68 DCIS-IDC) was performed. DCIS morphological features (histological size, nuclear grade, comedo necrosis, inflammation) and immunohistochemical factors (ER, PR, Ki-67 and Her2) were assessed in each of the three groups and compared using Chi2 or Wilcoxon tests. Results: Median histological DCIS sizes did not significantly differ between DCIS and DCIS-MI groups (70mm [4–160] and 60mm [4–180] , respectively, p = 0.33), nor between DCIS and DCIS-IDC (70mm [4–160] and 65 mm [10–140] , respectively, p = 0.98). DCIS nuclear grade was significantly higher in DCIS-MI compared to DCIS (p = 0.01), but there was no difference in nuclear grade between DCIS and DCIS-IDC (p = 0.22). Comedo necrosis was more often present in DCIS-MI compared to DCIS (p = 0.04), and no such difference was found between DCIS and DCIS-IDC (p = 0.81). Stromal inflammation surrounding DCIS was more often found in DCIS-MI and DCIS-IDC compared to DCIS (p = 0.03 and p & lt; 0.001, respectively). DCIS-MI was more often ER-negative than DCIS (p = 0.009), and no such difference was found between DCIS and DCIS-IDC (p = 0.6). No other significant differences concerning PR and Her2 status or Ki-67 index were found between the 3 groups. Conclusions: In patients with extensive DCIS there are few morphological or current immunohistochemical factors differentiating in situ cases from those that have associated microinvasion or invasive ductal carcinoma. DCIS-MI cases have more aggressive histological features than DCIS. Stromal inflammation surrounding DCIS was the only feature distinguishing DCIS from DCIS-IDC. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-14-03.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2012
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
    Location Call Number Limitation Availability
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  • 3
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 71, No. 24_Supplement ( 2011-12-15), p. P3-16-08-P3-16-08
    Abstract: Background Iniparib (BSI-201) is an investigational anticancer agent whose precise mechanism of action is under active investigation. In breast cancer cell lines and xenograft models of triple-negative breast cancer (TNBC), iniparib exhibits anti-proliferative activity and potentiates the cell cycle effects of some DNA damaging agents. In a randomized, open-label phase 2 study in pts with metastatic TNBC (mTNBC), iniparib combined with gemcitabine (G) and carboplatin (C) (GC) improved efficacy outcomes compared with GC alone. A confirmatory phase 3 study with GCI failed to meet pre-specified criteria for PFS and OS; however, an exploratory subset analysis demonstrated a potential benefit amongst 2nd/3rd line pts (O'Shaughnessy et al. ASCO 2011). Here we report results of a randomized phase 2 study (NCT01045304) in pts with mTNBC, which assesses efficacy and pharmacokinetics (PK) of iniparib administered either biw or qw in combination with GC. Patients and methods: Eligible pts (N=163; median age 49 yrs) had documented and measurable TNBC, ECOG PS 0–1, normal organ/marrow function, and had received ≤2 prior chemotherapy (CT) regimens for metastatic disease. Pts were randomized (1:1) to receive G (1,000 mg/m2, IV, d 1, 8) plus C (AUC 2, IV, d 1, 8) and iniparib either biw (5.6 mg/kg, IV d 1,4,8,11) or qw (11.2 mg/kg, IV d 1,8) on a 21 d cycle. Pts were stratified according to prior CT for mTNBC (0 vs. 1–2). The primary efficacy endpoint was overall response rate (ORR; CR + PR); secondary endpoints included: clinical benefit rate (CBR; CR + PR + SD for 24 weeks), PFS, OS and PK. Results: At the time of analysis, 23% of patients were still on treatment. The median number of cycles administered per patient was 6 in both arms; exposure to iniparib was identical. Safety data are not fully validated. All pts experienced at least 1 treatment emergent adverse event (TEAE). Grade (Gr) ≥3 TEAEs occurred in 94% and 85% of pts in the biw and qw arms, respectively. TEAEs Gr ≥3 occurring in ≥5% of pts regardless of relationship to study drug (biw vs qw) are as follows: blood and lymphatic 71% vs 67%; hepatobiliary 7.5% vs 9.8%; asthenia/fatigue 7.5% vs 11%; GI 8.8% vs 8.5%; infections 7.5% vs 3.7%; respiratory, thoracic and mediastinal 5% vs 8.5%, metabolism and nutrition 4% vs 6%. For response data see table. No major difference was observed in drug exposure (based on AUC within one cycle) between the two dosing regimens. Conclusion: Dosing of GCI on a qw schedule produced a similar ORR to that obtained with the biw schedule. A comparable safety profile in both arms, and consistency with results of previous studies, suggests that the weekly combination of GCI may be an appropriate schedule for further studies evaluating this combination. OS and PFS data are not yet mature; updated efficacy and safety data will be presented. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-16-08.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
    Location Call Number Limitation Availability
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