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Inhibitors of the cycline‑dependent kinases 4/6 in the treatment of patients with breast cancer
04/2021 MUDr. Marta Krásenská
Hormone receptor positive breast cancers are characterized by the presence of receptors for estrogen and/or progesterone and represent up to 75 %. Endocrine therapy is effective in neoadjuvant and adjuvant setting and remains the basic treatment modality for advanced disease. Up to half of patients with metastatic disease develop resistance to endocrine therapy. In order to modify the development of resistance to endocrine therapy, inhibitors of the cyclin-dependent kinases 4/6 have been developed. Palbociclib, ribociclib and abemaciclib have shown statistically and clinically significant efficacy in many III phase clinical trials. Consistently, they almost double progression free survival, increase the overall response rates, and prolong patient survival. In combination with an aromatase inhibitor and fulvestrant, they have become the new standard for first and second line treatment of hormone receptor positive metastatic breast cancer.
ENTIRE ARTICLE
Hormone receptor positive breast cancers are characterized by the presence of receptors for estrogen and/or progesterone and represent up to 75 %. Endocrine therapy is effective in neoadjuvant and adjuvant setting and remains the basic treatment modality for advanced disease. Up to half of patients with metastatic disease develop resistance to endocrine therapy. In order to modify the development of resistance to endocrine therapy, inhibitors of the cyclin-dependent kinases 4/6 have been developed. Palbociclib, ribociclib and abemaciclib have shown statistically and clinically significant efficacy in many III phase clinical trials. Consistently, they almost double progression free survival, increase the overall response rates, and prolong patient survival. In combination with an aromatase inhibitor and fulvestrant, they have become the new standard for first and second line treatment of hormone receptor positive metastatic breast cancer.
Platinum‑based chemotherapy in neoadjuvant treatment of breast cancer
04/2019 MUDr. Marta Krásenská
Triple-negative breast cancer is associated with poor outcomes compared to other breast cancer subtypes. It is known to have an aggressive behaviour but on the other hand it is exceptionally chemosensitive. Currently, the only standard treatment modality that is used in both early and advanced triple-negative breast cancer is conventional chemotherapy. When anthracyclines, alkylating agents, and taxanes are administered, 30-40 % of patients treated with neoadjuvant chemotherapy achieve pathological complete remission associated with excellent prognosis. The prognosis of patients with a residual disease after neoadjuvant chemotherapy is poor. In clinical trials, the addition of platinum to standard chemotherapy was attempted to achieve more complete pathological responses. Importance of platinum remains unclear, controversial are the data on their effectiveness especially in patients with germline mutation in the BRCA (breast cancer) genes.
ENTIRE ARTICLE
Triple-negative breast cancer is associated with poor outcomes compared to other breast cancer subtypes. It is known to have an aggressive behaviour but on the other hand it is exceptionally chemosensitive. Currently, the only standard treatment modality that is used in both early and advanced triple-negative breast cancer is conventional chemotherapy. When anthracyclines, alkylating agents, and taxanes are administered, 30-40 % of patients treated with neoadjuvant chemotherapy achieve pathological complete remission associated with excellent prognosis. The prognosis of patients with a residual disease after neoadjuvant chemotherapy is poor. In clinical trials, the addition of platinum to standard chemotherapy was attempted to achieve more complete pathological responses. Importance of platinum remains unclear, controversial are the data on their effectiveness especially in patients with germline mutation in the BRCA (breast cancer) genes.