Publications by authors named "Guilherme Nader-Marta"

Purpose: The antibody-drug conjugate trastuzumab deruxtecan has proven to be not only efficient in patients with HER2+ breast cancers (BC), but also in those patients with so-called HER2-low BC. HER2-low tumors are well described in the general BC population, but not in patients with invasive lobular carcinoma (ILC). Here, we aimed at analyzing the association of HER2-low with clinicopathological features and survival outcomes in patients with early-stage pure ILC.

View Article and Find Full Text PDF
Article Synopsis
  • The study explores how low levels of HER2 expression affect breast cancer treatment outcomes and the success of hormone therapy in patients.
  • It analyzes data from a large international study called PALLAS, which included over 5,000 patients to see how HER2 status impacts survival rates and response to the drug palbociclib.
  • The research found that HER2-low levels are common and vary between countries, but HER2 status didn’t significantly change the success rate of hormone therapy in the patients.
View Article and Find Full Text PDF
Article Synopsis
  • The SOLAR-1 and CAPItello-29 studies show that the PI3Ki alpelisib and AKTi capivasertib are beneficial for patients with hormone receptor-positive, HER2-negative metastatic breast cancer who have specific genetic alterations.
  • Despite their effectiveness, these drugs can cause significant toxicities that may limit their use, especially in frail patients, highlighting the need for careful patient selection.
  • The review emphasizes the importance of identifying predictive biomarkers, particularly PIK3CA mutations and AKT pathway alterations, while noting that current diagnostic methods are not yet optimal, and suggests that ongoing monitoring of mutations in metastatic tissue and blood is crucial for effective treatment.
View Article and Find Full Text PDF

Introduction: The CLEOPATRA trial (NCT00567190) established a dual anti-HER2 blockade in combination with docetaxel as the first-line standard of care for patients with metastatic HER2-positive breast cancer. While this treatment is overall associated with significant improvement in progression-free survival (PFS) and overall survival (OS), not all patients respond equally. We hypothesized that a radiological complete response (CR) at week 9 (i.

View Article and Find Full Text PDF

Around 90% of breast tumours are diagnosed in the early stage, with approximately 70% being hormone receptor-positive. The cornerstone of adjuvant therapy for early-stage hormone receptor-positive breast cancer is endocrine therapy, tailored according to disease stage, biological characteristics of the tumour, patient's comorbidities, preferences and age. In premenopausal patients with hormone receptor-positive breast cancer, ovarian function suppression is a key component of the adjuvant endocrine treatment in combination with an aromatase inhibitor or tamoxifen.

View Article and Find Full Text PDF

The results of several studies aiming to tailor early breast cancer treatment to individual risk were released in 2023. Axillary lymph node dissections and radiotherapy may be safely omitted in carefully selected patients. Sustained benefit from adjuvant CDK4/6 inhibitors was observed in high-risk hormone receptor-positive disease and the addition of immunotherapy to neoadjuvant chemotherapy improved pathological response.

View Article and Find Full Text PDF

Introduction: Currently three antibody-drug-conjugates (ADC) are approved by the European Medicines Agency (EMA) for treatment of breast cancer (BC) patient: trastuzumab-emtansine, trastuzumab-deruxtecan and sacituzumab-govitecan. ADC are composed of a monoclonal antibody (mAb) targeting a specific antigen, a cytotoxic payload and a linker. Pharmacokinetics (PK) and pharmacodynamics (PD) distinguish ADC from conventional chemotherapy and must be understood by clinicians.

View Article and Find Full Text PDF

Introduction: In randomized clinical trials (RCTs), blinded independent central review (BICR) is used to minimize heterogeneity and bias associated with radiological response evaluation by local investigators. However, BICR adds costs and complexity to the trial management. We assessed the discrepancy index between progression-free survival (PFS) assessment by local investigators and by BICR in RCTs conducted in patients with metastatic breast cancer (MBC).

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background: Neoadjuvant treatment discriminates responders, but pathologic complete response is uncommon in oestrogen receptor (ER)-positive/HER2-negative early breast cancer. We aimed to assess the prognostic value of Ki-67 index after neoadjuvant endocrine therapy (NET).

Methods: We conducted a systematic literature search of PubMed, Embase, CENTRAL, and conference proceedings up to 22nd August 2023 to identify studies reporting the association of Ki-67 index after NET with recurrence-free survival (RFS) and/or overall survival (OS) in women with ER-positive/HER2-negative early breast cancer.

View Article and Find Full Text PDF
Article Synopsis
  • Invasive lobular carcinoma (ILC) accounts for about 15% of breast cancers, and the relationship between body mass index (BMI) at diagnosis and patient outcomes is under-researched.
  • A study analyzed data from 2856 patients with non-metastatic ILC and found that a higher BMI correlated with older age, larger tumor size, and worse prognosis indicators.
  • Although higher BMI initially showed worse survival outcomes, further analysis suggested that other factors, like tumor grade and size, were more significant indicators of patient prognosis.
View Article and Find Full Text PDF

Up to 20% of breast cancer overexpress HER2 protein, making it a reliable target for antibody-based treatments. In early HER2-positive breast cancer avoiding anthracycline-based chemotherapy is a challenge. Based on the single-arm phase II APT trial results, adjuvant paclitaxel/trastuzumab is an accepted regimen for patients with stage I HER2-positive disease.

View Article and Find Full Text PDF
Article Synopsis
  • This review focuses on the use of circulating tumor DNA (ctDNA) as a biomarker to select breast cancer patients for treatment, examining current evidence and active trials in both early and metastatic stages.* -
  • In metastatic breast cancer, ctDNA analysis can reveal specific genetic changes that allow for targeted therapies; approved tests already exist for mutations like PIK3CA and ESR1 which guide treatment decisions.* -
  • In the early stages, ctDNA may help detect relapses up to 10 months earlier than traditional imaging, potentially leading to better treatment planning, although further validation through trials is necessary.*
View Article and Find Full Text PDF

Antibody-drug conjugates (ADCs) are a class of antineoplastic agents whose structure is composed of three main components: a monoclonal antibody (mAB) targeting a specific target antigen, a cytotoxic payload, and a linker binding the antibody to the payload. By combining the specificity of mABs with the high potency of the payloads, ADCs constitute a smart drug delivery system with improved therapeutic index. After recognition and binding of the mAB to its target surface antigen, ADCs are internalized by endocytosis by the tumor cell, releasing the payloads into the cytoplasm, where they exert their cytotoxic activity, eventually leading to cell death.

View Article and Find Full Text PDF

Background: Cutaneous squamous-cell carcinoma (CSCC) is among the most frequent malignancies worldwide. For those not amenable to treatment with curative intent, immune checkpoint inhibition (ICI) with anti-programmed death receptor 1 (PD-1) antibodies has emerged as a novel therapeutic option. In this study, the authors sought to investigate the activity of the anti-PD-1 agent nivolumab in patients with advanced CSCC (aCSCC).

View Article and Find Full Text PDF

Background: Special histological types (SHT) of triple-negative breast cancer (TNBC) are a heterogeneous group of rare poorly understood diseases. We aimed to evaluate the clinical features, treatment, and outcomes of patients with SHT of TNBC.

Methods: We evaluated patients with a SHT of TNBC treated in a cancer center between 2009 and 2020.

View Article and Find Full Text PDF

Background: Patients with small node-negative HER2-positive breast cancer are commonly treated with paclitaxel and 1 year of adjuvant trastuzumab. We performed a sub-analysis of the ALTTO trial to explore the long-term outcomes of patients with small node-negative tumours.

Methods: The ALTTO trial randomised 8381 patients with early HER2-positive BC treated with adjuvant chemotherapy (anthracycline/taxane- or taxane/carboplatin-based), to trastuzumab (T), lapatinib (L), their sequence (T → L) or their combination (L + T).

View Article and Find Full Text PDF

Purpose: This systematic review and meta-analysis aimed to evaluate the immune response to anti-SARS-CoV-2 prime-vaccination in patients with cancer.

Methods: We performed a systematic literature search using PubMed, Embase, and Cochrane Library until 28/09/2021, and conference proceedings from ASCO and ESMO 2021 annual meetings. We screened for observational or interventional studies including subjects ≥ 16 years old with cancer diagnosis who were vaccinated against SARS-CoV-2.

View Article and Find Full Text PDF

Invasive lobular carcinoma (ILC) is the most common histologic subtype of breast cancer after invasive ductal carcinoma (i.e., no special type [NST]).

View Article and Find Full Text PDF

Introduction: Triple negative breast cancer (TNBC) is an area of high unmet medical need in terms of new effective treatment strategies. Although breast cancer is traditionally considered a 'cold' tumor type, TNBC is the most appropriate subtype for immunotherapeutic strategies; this is due to the high level of tumor infiltrating lymphocytes, PD-L1 expression, and tumor mutational burden compared to other breast cancer subtypes.

Areas Covered: This review examines the available evidence on the use of immunotherapeutic strategies in early and advanced TNBC, discusses the pitfalls and limitations often encountered in clinical research, and summarizes data on novel promising immunomodulatory approaches that have been explored in early-phase trials.

View Article and Find Full Text PDF

Background: This study aimed to validate the Brazilian version of EORTC CAT Core and compare the Brazilian results with those from the original European EORTC CAT Core validation study.

Methods: After validated translation, 168 cancer patients from Brazil receiving radiation therapy with or without chemotherapy was assessed. Translated EORTC CAT Core and all QLQ-C30 items were administered to patients using CHES (Computer-Based Health Evaluation System) before (T0) and after (T1) treatment initiation.

View Article and Find Full Text PDF

Purpose: Patients with cancer are at increased risk for unfavorable outcomes from COVID-19. Knowledge about the outcome determinants of severe acute respiratory syndrome coronavirus 2 infection in this population is essential for risk stratification and definition of appropriate management. Our objective was to evaluate prognostic factors for all-cause mortality in patients diagnosed with both cancer and COVID-19.

View Article and Find Full Text PDF