Publications by authors named "Andrea Gombos"

Article Synopsis
  • The study focused on breastfeeding patterns and their relationship with breast cancer outcomes in women who had early hormone receptor-positive breast cancer and gave birth during the POSITIVE trial.
  • At a follow-up of 41 months, 62.6% of women breastfed, with higher rates among those over 35 and first-time mothers, while the median breastfeeding duration was over 4 months.
  • The incidence of breast cancer events was similar in breastfeeding and non-breastfeeding groups, suggesting that breastfeeding may not adversely affect breast cancer outcomes for women wanting to have children post-diagnosis.
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Background: Body mass index (BMI) may affect prognosis in patients with breast cancer (BC). We assessed the association of BMI and weight changes with outcomes of patients with HER2-positive early BC included in the APHINITY trial.

Methods: This is an exploratory analysis of APHINITY (NCT01358877), randomized trial testing adjuvant dual vs.

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Background: Obesity is associated with a greater risk of developing distant recurrences in patients with estrogen receptor-positive (ER+) breast cancer. This association is however poorly investigated in patients treated with extended endocrine treatment (ET). We therefore evaluated the prognostic role of BMI in the SOLE trial, where postmenopausal patients, after having completed 4-6 years of adjuvant ET, were treated with 5 additional years of continuous or intermittent letrozole.

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Article Synopsis
  • The study aimed to evaluate the time to pregnancy and the effectiveness of fertility preservation methods in women with early hormone receptor-positive breast cancer wanting to conceive.
  • The trial included 518 women who paused their cancer treatment to try for pregnancy, finding that a significant portion resumed menstruation and successfully became pregnant, with younger age being a key factor in shorter time to pregnancy.
  • Cryopreservation of embryos or eggs before treatment showed a notable increase in pregnancy success, with no short-term negative effects on cancer prognosis from ovarian stimulation.
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Background: Immune checkpoint inhibitors have shown minimal clinical activity in hormone receptor-positive metastatic breast cancer (HRmBC). Doxorubicin and low-dose cyclophosphamide are reported to induce immune responses and counter regulatory T cells (Tregs). Here, we report the efficacy and safety of combined programmed cell death protein-1/cytotoxic T-lymphocyte-associated protein 4 blockade concomitant with or after immunomodulatory chemotherapy for HRmBC.

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Article Synopsis
  • Luminal B breast cancer has a poorer prognosis and lower sensitivity to chemotherapy compared to Luminal A, leading to a clinical trial (Neo-CheckRay) that explores combining stereotactic body radiation therapy (SBRT) with the drug oleclumab to enhance treatment effectiveness.
  • The safety run-in of the trial involved six patients receiving a neo-adjuvant treatment regimen, including chemotherapy and immunotherapy, followed by SBRT directed at the primary tumor before surgery.
  • Results showed that the treatment was generally well-tolerated with only one minor adverse event reported, and all patients successfully completed their treatments with surgery occurring 2-4 weeks afterward.
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Background: Prospective data on the risk of recurrence among women with hormone receptor-positive early breast cancer who temporarily discontinue endocrine therapy to attempt pregnancy are lacking.

Methods: We conducted a single-group trial in which we evaluated the temporary interruption of adjuvant endocrine therapy to attempt pregnancy in young women with previous breast cancer. Eligible women were 42 years of age or younger; had had stage I, II, or III disease; had received adjuvant endocrine therapy for 18 to 30 months; and desired pregnancy.

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Article Synopsis
  • A study investigated the long-term survival benefits of adding lapatinib to chemotherapy and trastuzumab in HER2-positive early breast cancer, comparing rates of pathological complete response (pCR).* -
  • Over a ten-year follow-up, patients receiving the combination treatment showed event-free survival (EFS) rates of 67% and overall survival (OS) rates of 80%, with pCR linked to significantly better EFS and OS.* -
  • The findings indicate that neoadjuvant anti-HER2 therapy provides lasting survival advantages for patients, particularly for those achieving pCR, without any new safety issues reported.*
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Purpose: Detection of circulating tumor DNA (ctDNA) after neoadjuvant chemotherapy in patients with early-stage breast cancer may allow for early detection of relapse. In this study, we analyzed ctDNA using a personalized, tumor-informed multiplex polymerase chain reaction-based next-generation sequencing assay.

Methods: Plasma samples (n = 157) from 44 patients were collected before neoadjuvant therapy (baseline), after neoadjuvant therapy and before surgery (presurgery), and serially postsurgery including a last follow-up sample.

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Article Synopsis
  • A study was conducted on patients with "HER2-low" metastatic breast cancer, which means they have low levels of HER2 that could potentially be treated, but existing therapies were not effective.
  • In the trial, patients were randomly assigned to receive either trastuzumab deruxtecan or standard chemotherapy after having one or two previous treatments; the main goal was to measure how long patients remained free from disease progression.
  • Results showed that those treated with trastuzumab deruxtecan had significantly longer progression-free survival (10.1 months vs. 5.4 months) and overall survival (23.9 months vs. 17.5 months) compared to the standard chemotherapy group, despite a high rate of serious adverse
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Background: Neoadjuvant therapy with dual HER2 blockade improved pathological complete response (pCR) rate in HER2-positive breast cancer patients. Nevertheless, it would be desirable to identify patients exquisitely responsive to single agent trastuzumab to minimize or avoid overtreatment. Herein, we evaluated the predictive and prognostic value of basal primary tumor miRNA expression profile within the trastuzumab arm of NeoALTTO study (ClinicalTrials.

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Biomarkers to identify patients without benefit from adding everolimus to endocrine treatment in metastatic breast cancer (MBC) are needed. We report the results of the Pearl trial conducted in five Belgian centers assessing F-FDG-PET/CT non-response (n = 45) and ctDNA detection (n = 46) after 14 days of exemestane-everolimus (EXE-EVE) to identify MBC patients who will not benefit. The metabolic non-response rate was 66.

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Background: Premenopausal women with early hormone-receptor positive (HR+) breast cancer receive 5-10 years of adjuvant endocrine therapy (ET) during which pregnancy is contraindicated and fertility may wane. The POSITIVE study investigates the impact of temporary ET interruption to allow pregnancy.

Methods: POSITIVE enrolled women with stage I-III HR + early breast cancer, ≤42 years, who had received 18-30 months of adjuvant ET and wished to interrupt ET for pregnancy.

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AURORA aims to study the processes of relapse in metastatic breast cancer (MBC) by performing multi-omics profiling on paired primary tumors and early-course metastases. Among 381 patients (primary tumor and metastasis pairs: 252 targeted gene sequencing, 152 RNA sequencing, 67 single nucleotide polymorphism arrays), we found a driver role for and somatic mutations. Metastases were enriched in , and mutations; and amplifications; and deletions.

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Background: The association between obesity and prognosis in HER2-positive early breast cancer remains unclear, with limited data available. This study aimed to determine the impact of body mass index (BMI) at baseline and weight change after 2 years on outcomes of patients with HER2-positive early breast cancer.

Methods: ALTTO was a randomized phase III trial in patients with HER2-positive early breast cancer.

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Purpose: Women with hormone receptor-positive early breast cancers have a persistent risk of relapse and biomarkers for late recurrence are needed. We sought to identify tumor genomic aberrations associated with increased late-recurrence risk.

Experimental Design: In a secondary analysis of Study of Letrozole Extension trial, a case-cohort-like sampling selected 598 primary breast cancers for targeted next-generation sequencing analysis of gene mutations and copy-number gains (CNGs).

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Introduction: The field of metastatic luminal breast cancer (hormone receptor positive, HER-2 negative) is dynamic and evolving, harboring some of the most significant therapeutic advances in medical oncology. Over the last decade, many pivotal trials showed excellent results with drastic improvements in survival as well as the quality of life of metastatic luminal breast cancer patients.

Areas Covered: The successful inhibition of the cyclinD/cyclin-dependent kinases 4 and 6 (CDK4/6)-retinoblastoma protein (RB) pathway with potent CDK4/6 inhibitors improved the outcome of advanced luminal breast cancers.

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Background: Although data from preclinical and clinical studies provide a strong rationale for combining capecitabine with anti-angiogenic agents, clinical development of this fluoropyrimidine in combination with aflibercept has lagged behind other treatments. We conducted a nonrandomized, noncomparative, 2-arm, phase I trial to address this unmet need.

Patients And Methods: Patients with chemorefractory gastrointestinal and breast cancer were sequentially recruited into a continuous (Arm A, starting dose 1100 mg/m/day) or intermittent (Arm B, 2 weeks on/1 week off, starting dose 1700 mg/m/day) capecitabine dosing arm.

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Purpose Of Review: Estrogen receptor-positive breast cancer accounts for 70% of all breast cancers. Sequential endocrine treatment in monotherapy or in combination with CDK 4/6 or m-TOR inhibitors is the mainstay of recommended treatment options in the management of metastatic breast cancer even in the presence of visceral metastasis. There is an emerging need to address endocrine resistance, which despite highly efficacious treatment combinations still can develop.

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Introduction: Despite improvements in the management of HER2+ breast cancer, metastatic disease is still fatal. Usually, these patients receive several lines of chemotherapy associated with HER2 targeted treatments. Most of the trials using innovative approaches are positioning themselves in disease that is resistant to pertuzumab and trastuzumab emtansine (TDM1).

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Background: Heterogeneity and lack of targeted therapies represent the two main impediments to precision treatment of triple-negative breast cancer (TNBC), and therefore, molecular subtyping and identification of therapeutic pathways are required to optimize medical care. The aim of the present study was to define robust TNBC subtypes with clinical relevance.

Methods: Gene expression profiling by means of DNA chips was conducted in an internal TNBC cohort composed of 238 patients.

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Breast cancer is a global health issue. For decades, breast cancer was classified into many histological subtypes on the basis of microscopic and immunohistochemical evaluation. The discovery of many key genomic driver events involved in breast cancer carcinogenesis resulted in a better understanding of the tumor biology, the disease heterogeneity and the prognosis leading to the discovery of new modalities of targeted therapies and opening horizons toward a more personalized medicine.

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