Molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization. Is there a place of CDK4/6-inhibitors in late-line therapy after chemotherapeutic regimens?
The problem of metastatic breast cancer treatment is linked with clonal selection both in the process of tumor evolution and under the influence of previous treatment. The analysis of metastatic niche microenvironment and the molecular genetic features become essential for treatment individuali...
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| Format: | Article |
| Language: | Russian |
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Remedium Group LLC
2021-12-01
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| Series: | Медицинский совет |
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| Online Access: | https://www.med-sovet.pro/jour/article/view/6580 |
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| author | A. I. Stukan A. Y. Goryainova E. V. Lymar S. V. Sharov V. V. Antipova |
| author_facet | A. I. Stukan A. Y. Goryainova E. V. Lymar S. V. Sharov V. V. Antipova |
| author_sort | A. I. Stukan |
| collection | DOAJ |
| description | The problem of metastatic breast cancer treatment is linked with clonal selection both in the process of tumor evolution and under the influence of previous treatment. The analysis of metastatic niche microenvironment and the molecular genetic features become essential for treatment individualization. Studies demonstrate hormonal expression and epidermal growth factor receptor (HER2neu) discordance between the primary tumor and the metastatic focus. The advantages of combined hormone therapy (CНT) with CDK4/6 inhibitors were revealed in comparison with hormone therapy (НT) with survival rates benefits in the 1st and 2nd lines of НT, as well as after the 1st line of chemotherapy in clinical trials. However, there are lack of data on patients with multiple lines of chemotherapy. In the present retrospective study, more than half of the patients were treated palliative chemotherapy before administration of CDK4/6 inhibitors. Main metastatic foci represented luminal types after biopsy, however, loss of progesterone receptor expression was noted with the initial luminal A-subtype. At the time of the data cut-off, most patients have a longterm clinical effect, improvement conditions and reduction of pain, including the cases of late line CHT setting after chemotherapeutic regimens. Taking into account the heterogeneity of metastatic breast cancer, clonal selection and phenotype discordance there is the crucial need for molecular and genetic characteristics of the metastatic process. At the same time it is possible to consider the appointment of combined hormone therapy with CDK4/6 inhibitors as additional option for late-line treatment of the disseminated process. Prospective studies on combined hormonal therapy with CDK4/6 inhibitors in metastatic breast cancer in late lines of therapy with proven HR+HER2neu-negative receptor status of the metastatic focus are strongly recommended. |
| first_indexed | 2024-04-09T16:40:54Z |
| format | Article |
| id | doaj.art-946ad29af7c647c3af1ecdd024e2de87 |
| institution | Directory Open Access Journal |
| issn | 2079-701X 2658-5790 |
| language | Russian |
| last_indexed | 2024-04-09T16:40:54Z |
| publishDate | 2021-12-01 |
| publisher | Remedium Group LLC |
| record_format | Article |
| series | Медицинский совет |
| spelling | doaj.art-946ad29af7c647c3af1ecdd024e2de872023-04-23T06:56:41ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902021-12-01020546110.21518/2079-701X-2021-20-54-615941Molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization. Is there a place of CDK4/6-inhibitors in late-line therapy after chemotherapeutic regimens?A. I. Stukan0A. Y. Goryainova1E. V. Lymar2S. V. Sharov3V. V. Antipova4Clinical Oncologic Dispensary No. 1; Kuban State Medical UniversityClinical Oncologic Dispensary No. 1; Kuban State Medical UniversityClinical Oncologic Dispensary No. 1Clinical Oncologic Dispensary No. 1; Kuban State Medical UniversityClinical Oncologic Dispensary No. 1; Kuban State Medical UniversityThe problem of metastatic breast cancer treatment is linked with clonal selection both in the process of tumor evolution and under the influence of previous treatment. The analysis of metastatic niche microenvironment and the molecular genetic features become essential for treatment individualization. Studies demonstrate hormonal expression and epidermal growth factor receptor (HER2neu) discordance between the primary tumor and the metastatic focus. The advantages of combined hormone therapy (CНT) with CDK4/6 inhibitors were revealed in comparison with hormone therapy (НT) with survival rates benefits in the 1st and 2nd lines of НT, as well as after the 1st line of chemotherapy in clinical trials. However, there are lack of data on patients with multiple lines of chemotherapy. In the present retrospective study, more than half of the patients were treated palliative chemotherapy before administration of CDK4/6 inhibitors. Main metastatic foci represented luminal types after biopsy, however, loss of progesterone receptor expression was noted with the initial luminal A-subtype. At the time of the data cut-off, most patients have a longterm clinical effect, improvement conditions and reduction of pain, including the cases of late line CHT setting after chemotherapeutic regimens. Taking into account the heterogeneity of metastatic breast cancer, clonal selection and phenotype discordance there is the crucial need for molecular and genetic characteristics of the metastatic process. At the same time it is possible to consider the appointment of combined hormone therapy with CDK4/6 inhibitors as additional option for late-line treatment of the disseminated process. Prospective studies on combined hormonal therapy with CDK4/6 inhibitors in metastatic breast cancer in late lines of therapy with proven HR+HER2neu-negative receptor status of the metastatic focus are strongly recommended.https://www.med-sovet.pro/jour/article/view/6580receptor statusmetastatic focusdiscordancepremetastatic nichebreast cancercombined hormonal therapycdk4/6 inhibitors |
| spellingShingle | A. I. Stukan A. Y. Goryainova E. V. Lymar S. V. Sharov V. V. Antipova Molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization. Is there a place of CDK4/6-inhibitors in late-line therapy after chemotherapeutic regimens? Медицинский совет receptor status metastatic focus discordance premetastatic niche breast cancer combined hormonal therapy cdk4/6 inhibitors |
| title | Molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization. Is there a place of CDK4/6-inhibitors in late-line therapy after chemotherapeutic regimens? |
| title_full | Molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization. Is there a place of CDK4/6-inhibitors in late-line therapy after chemotherapeutic regimens? |
| title_fullStr | Molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization. Is there a place of CDK4/6-inhibitors in late-line therapy after chemotherapeutic regimens? |
| title_full_unstemmed | Molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization. Is there a place of CDK4/6-inhibitors in late-line therapy after chemotherapeutic regimens? |
| title_short | Molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization. Is there a place of CDK4/6-inhibitors in late-line therapy after chemotherapeutic regimens? |
| title_sort | molecular features evaluation of metastatic foci as the basis for metastatic breast cancer treatment personalization is there a place of cdk4 6 inhibitors in late line therapy after chemotherapeutic regimens |
| topic | receptor status metastatic focus discordance premetastatic niche breast cancer combined hormonal therapy cdk4/6 inhibitors |
| url | https://www.med-sovet.pro/jour/article/view/6580 |
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