Supplementary Data from Famitinib with Camrelizumab and Nab-Paclitaxel for Advanced Immunomodulatory Triple-Negative Breast Cancer (FUTURE-C-Plus): An Open-Label, Single-Arm, Phase II Trial
Supplementary Figure from Famitinib with Camrelizumab and Nab-Paclitaxel for Advanced Immunomodulatory Triple-Negative Breast Cancer (FUTURE-C-Plus): An Open-Label, Single-Arm, Phase II Trial
Loco-regional recurrences (LRR) following breast-conserving surgery (BCS) remain a heterogeneous class of disease that has significant variation in its biological behavior and prognosis.To delineate the spatiotemporal patterns of LRR after BCS, we analyzed the data of 4325 patients treated with BCS from 2006 to 2016. Clinico-pathological and treatment specific factors were analyzed using the Cox proportional hazards model to identify factors predictive for LRR events. Recurrence patterns were scrutinized based on recurrence type and recurrence-free interval (RFI). Annual recurrence rates (ARR) were compared according to recurrence type and molecular subtype.With a median follow-up of 66 months, 120 (2.8%) LRRs were recorded as the first site of failure. Age, pathologic stage, and molecular subtype were identified as predictors of LRR. The major recurrence type was ipsilateral breast tumor recurrence, which mainly (83.6%) occurred ≤5y post surgery. In the overall population, ARR curves showed that relapse peaked in the first 2.5 years. Patients with regional nodal recurrence, shorter RFI, and synchronous distant metastasis were associated with a poorer prognosis. HER2-positive disease had a higher rate of LRR events, more likely to have in-breast recurrence, and had an earlier relapse peak in the first 2 years after surgery.LRR risk following BCS is generally low in Chinese ethnicity. Different recurrence patterns after BCS were related to distinct clinical outcomes. Management of LRR should be largely individualized and tailored to the extent of disease, the molecular profile of the recurrence, and to baseline clinical variables.
Abstract Purpose Previous studies provide inconsistent interpretations of the effect of inherited genetic factors on the survival and prognosis of patients with breast cancer. The aim of this study was to examine the effect of germline BRCA1 and BRCA2 mutation on survival and subsequent breast events in Chinese women who underwent breast‐conserving surgery. Methods A retrospective review of the clinical and pathological records was performed in patients diagnosed with primary invasive breast cancer between 2005 and 2018 in the cancer registry database. Clinicopathological data and data regarding treatment and outcomes, including date and site of disease progression, were collected. The survival outcomes and independent risk factors were conducted using SPSS. Results Overall, a total of 501 patients who underwent breast‐conserving surgery were identified and subjected to analyses, of which 63 cases with BRCA1 or BRCA2 mutation. The median age at diagnosis was 41 (range, 24‐74) for carriers and 37 (range, 17‐84) for noncarriers. After a median follow‐up time of 61 months (range, 8‐161) and 70 months (range, 0‐153), respectively, in carriers and noncarriers, the overall survival ( P = .173) and disease‐free survival ( P = .424) were not significantly different. Analogously, there was no significant difference between the two groups about the outcomes of ipsilateral breast tumor recurrence ( P = .348), yet the contralateral breast cancer (CBC) was overt worse than noncarriers ( P < .001). When adjusted to confounding factors, BRCA mutation was the only independent risk factors to CBC (HR = 7.89, P = .01). Conclusion In this study, BRCA mutation carriers have higher risk of CBC. And, BRCA mutation is the only independent risk factor to CBC. Therefore, intensive surveillance and follow‐up as well as more effective individual prevention are urgent. Decisions on alternatively effective prevention, especially the prevention of CBC, are urgent and should take into account patient prognosis and preferences.
During the past few decades, the incidence of breast cancer (BC) has been increasing rapidly in East Asia, and BC is currently the most common cancer in several countries. The rising incidence is likely related to changing lifestyle and environmental factors in addition to the increase in early diagnosis with BC awareness and screening. The understanding and management of BC are generally based on research and data from the West. However, emerging differences in BC epidemiology and tumor and host biology in Asian populations may be clinically relevant.A higher proportion of premenopausal BCs occur in Asia, although this factor is possibly an age-cohort effect. Although the relative frequencies of different immunohistochemical subtypes of BC may be similar between the East and West, the higher prevalence of luminal B subtypes with more frequent mutations in TP53 may be confounded by disparities in early detection. In addition, Asian BCs appear to harbor a more immune-active microenvironment than BCs in the West. The spectra of germline mutations in BC predisposition genes and single-nucleotide polymorphisms contributing to BC risk vary with ethnicity as well. Differences in tolerability of certain cytotoxic and targeted agents used in BC treatment may be associated with pharmacogenomic factors, whereas the lower body mass of the average woman in East Asia may contribute to higher toxicities from drugs administered at fixed doses. Phenotypic characteristics, such as lower breast volume, may influence the type of surgery performed in East Asian women. On the other hand, increased breast density may affect the sensitivity of mammography in detecting BCs, limiting the benefits of screening mammography.Breast cancer has become a major health problem in Asia. The inclusion of more women from Asia in clinical trials and epidemiologic and translational studies may help unravel the interethnic heterogeneity of BCs and elucidate the complex interplay between environmental and intrinsic factors in its pathogenesis. These insights may help to refine prevention, diagnosis, and management strategies for BC in the setting of ethnic diversity.
Supplementary Data from Famitinib with Camrelizumab and Nab-Paclitaxel for Advanced Immunomodulatory Triple-Negative Breast Cancer (FUTURE-C-Plus): An Open-Label, Single-Arm, Phase II Trial
Due to the lack of high-level data, there is still controversy over the oncological safety of breast conservation in patients with centrally located breast cancer. This study aimed to assess the safety of breast-conserving surgery in patients with centrally located breast cancer based on the data from the Surveillance, Epidemiology, and End Results (SEER) database.We collected data for all cases diagnosed with breast cancer who underwent breast-conserving surgery from 2012-2014 in the SEER database. The primary outcome of our study was disease-specific survival (DSS) and overall survival (OS). The PSM was used to eliminate the effects of non-random statistics. Chi-square test, Kaplan-Meier method and Cox proportional hazards regression model on univariate and multivariate analysis were used to analyze the data.Data from 79,214 patients who had undergone breast-conserving surgery were analyzed in this study, including those with breast cancer in the central region (n=3,128) and outside the central region (n=76,086). The DSS of central breast cancer patients and outside the central breast cancer patients was 58.1 months versus 58.0 months (P>0.05), respectively, while the OS of the 2 groups was 58.0 months versus 58.0 months (P>0.05), respectively.Breast cancer in the central region should not be contraindicated for breast conserving surgery and breast-conserving surgery can benefit a wider range of patients.
Abstract Background Few studies have addressed the biological features of medullary breast carcinoma (MBC) in the context of clinical outcomes. We sought to compare the baseline demographics, standard pathologic factors and long-term clinical outcomes between MBC and infiltrating ductal carcinoma-not otherwise specified (IDC-NOS) using a large database. Methods A total of 2,202 cases with pure IDC-NOS and 188 cases with typical MBC meeting the inclusion criteria were identified. The clinical and biological features, the overall survival (OS) and recurrence/metastasis-free survival (RFS) were compared for both groups. Results There were a higher proportion of patients diagnosed prior to 40 years of age in the MBC group compared to the IDC-NOS group. MBC cases demonstrated less aggressive tumor features such as lower tumor stage, smaller tumor size and a lower proportion of nodal involvement than IDC-NOS; however, immunohistochemical staining revealed that MBC displayed the triple-negative phenotype more often than IDC-NOS cases (40.4% versus 26.2%; P <0.001). Although the clinical behavior of MBC was not commensurate with its pathologic features, women diagnosed with MBC had a lower frequency of recurrence/metastasis ( P = 0.032) and death ( P = 0.042) than those with IDC-NOS, and the 10-year OS and RFS were significantly higher for MBC (91% and 74%) compared to IDC-NOS (81% and 64%). Moreover, multivariate analysis revealed that TNM stage was a statistically significant factor for survival. Conclusions MBC in Chinese women demonstrated less aggressive behavior and better prognosis than IDC-NOS. This favorable outcome was maintained after 10 years.
Abstract Objective: The aim of this study was to conduct a bibliometric and visual analysis of breast reconstruction related research at China and abroad published in the past five years, to understand the research status and development trend in this field, to discuss the focus of research in different countries and different disciplines, and to provide reference for other researchers. Methods: Relevant literatures about breast reconstruction were retrieved from the Web of Science Core Collection. The VOS viewer 1.6.15 software was used to extract the authors, countries, institutions and keywords to generate network maps of high-yield authors, institutions and high-frequency keywords clustering network. Results: 4,815 documents meeting the requirements were retrieved, which showed an upward trend in the past five years. Regarding the discipline, 838 documents (17.40%) were published by breast surgery and Cancer Surgery, 3308 (68.70%) were published by plastic surgery, and 669 (13.90%) were jointly published by both types of researchers. A total of 161 clinical trials were registered in the US clinical trial registry (ClinicalTrial.gov), of which intervention trials accounted for the highest proportion (107, 66.46%), followed by observational trials (54, 33.54%) and patient registry (4, 2.48%). Regarding country distribution, the United States conducted the largest number of breast reconstruction-related clinical trials (45, 27.95%), followed by China (22, 13.66%), Italy (12, 7.45%), France (11, 6.83%), the Netherlands (9, 5.59%). The top ten institutions contributed 983 articles (20.41%), and the institution with the highest number of publications was MD Anderson Cancer Center (144, 2.99%), followed by Harvard Medical School (139, 2.89%), Sloan-Kettering Cancer Center (125, 2.60%), Stanford University (113, 2.35%) and University of Michigan (102, 2.12%). The author with the largest number of documents was Bernard T. Lee of Beth Israel Deaconess Medical Center (BIDMC), with 56 papers and 540 citations. The most cited author was Andrea L. Pusic of Brigham and Women’s Hospital, with 48 papers and 1,332 citations. Chinese authors published 310 documents, accounting for 6.44%. There were differences in the disciplines of the main authors between China and abroad. In China, authors from breast surgery published a larger proportion of documents (138, 44.52%), while the number of documents published by authors of plastic surgery (129, 44.52%) and the joint publication of both types of authors (43, 13.87%) was relatively small. However, foreign documents mainly came from authors of plastic surgery (74.74%). There were more cooperative groups (155) formed by major foreign authors, and joint publishing between groups was more frequent; while Chinese author formed only 16 cooperative groups with less cooperation. Keyword cluster analysis showed that top five keywords were flap, implant, breast cancer, immediate breast reconstruction, tissue. In breast surgery publications, top five keywords were breast cancer, breast reconstruction, complications, implant, immediate breast reconstruction, while in plastic surgery publications top five keywords were flap, implant, tissue, breast cancer, infection. Authors from breast surgery focus more on oncology-related issues in breast reconstruction, while in plastic surgery, more attentions were paid on autologous tissue reconstruction. Conclusion: Breast reconstruction had gradually attracted the attention of Chinese and foreign researchers. Compared with foreign countries, there were problems such as lack of high-quality research and less cooperative research in China. There were differences in the research focus of breast reconstruction between China and abroad, which is mainly related to the differences in the disciplines of researchers. Citation Format: Hengyu Ren, Shuang Hao, Jiajian Chen, Zhimin Shao, guangyu liu, A-Yong Cao, Jiong Wu. Current Status and Focus of Breast Reconstruction Research in China and Abroad-A Bibliometric Study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-56.
Supplementary Figure from Famitinib with Camrelizumab and Nab-Paclitaxel for Advanced Immunomodulatory Triple-Negative Breast Cancer (FUTURE-C-Plus): An Open-Label, Single-Arm, Phase II Trial
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