RESUMO
A decision regarding adjuvant chemotherapy in early (operable) breast cancer in the past was made entirely on the basis of clinical and pathological features. However with the growing awareness of tumor biology and the possibility of the genomic analysis to determine the molecular subtypes of breast cancer it is getting real to identify patients whose tumors are resistant to chemotherapy or vice versa benefit from its addition. Despite the fact that genomic analysis allows some patients avoiding chemotherapy (especially patients with localized breast cancer), such studies do not indicate the most appropriate chemotherapy regimens. Therefore treatment decisions should be based on a combination of biological features of the tumor, its stage and signs that characterize the patient such as age and tolerance to the side effects of therapy.
Assuntos
Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Quimioterapia Adjuvante , Fatores Etários , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Ductal de Mama/metabolismo , Técnicas de Apoio para a Decisão , Feminino , Humanos , Mastectomia Segmentar , MicroRNAs/metabolismo , Estadiamento de Neoplasias , Receptor ErbB-2/metabolismo , Medição de Risco , Fatores de RiscoRESUMO
Preliminary data are confirmed on the more rare prevalence of family history of diabetes mellitus (DM) in cancer patients, mainly females, with diabetes in comparison with diabetics without cancer pathology. Familial diabetes does not worsen additionally tumor characteristics against the same in patients with non-familial diabetes. More than that, familial diabetes in diabetics with breast cancer goes together with lesser size of tumor and demonstrates an inclination to the rarer distant metastases in breast and endometrial cancer patients. The signs of systemic DNA damage (evaluated, in particular, on the basis of 8-OH-dG serum levels) are pronounced in postmenopausal diabetic cancer patients with familial diabetes in lesser degree than in non-familial variant of DM. In toto, this allows to consider family history of DM in patients with type-2 diabetes as a particular factor of tumor growth containment, which mechanisms and causes, warrant further studies.
Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Dano ao DNA , Diabetes Mellitus Tipo 2/genética , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/patologia , 8-Hidroxi-2'-Desoxiguanosina , Idoso , Biomarcadores Tumorais/sangue , Neoplasias da Mama/sangue , Neoplasias da Mama/genética , Desoxiguanosina/análogos & derivados , Desoxiguanosina/sangue , Neoplasias do Endométrio/sangue , Neoplasias do Endométrio/genética , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pós-MenopausaAssuntos
Antineoplásicos Hormonais/uso terapêutico , Biomarcadores Tumorais/análise , Neoplasias da Mama/tratamento farmacológico , Neoplasias Hormônio-Dependentes/tratamento farmacológico , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama/química , Quimioterapia Adjuvante , Esquema de Medicação , Feminino , Humanos , Neoplasias Hormônio-Dependentes/química , Pré-Menopausa , Tamoxifeno/uso terapêutico , Resultado do TratamentoAssuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Complicações Neoplásicas na Gravidez/diagnóstico , Complicações Neoplásicas na Gravidez/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/epidemiologia , Quimioterapia Adjuvante/efeitos adversos , Feminino , Feto/efeitos dos fármacos , Feto/efeitos da radiação , Humanos , Mastectomia/métodos , Terapia de Alvo Molecular/métodos , Neoplasias Hormônio-Dependentes/diagnóstico , Neoplasias Hormônio-Dependentes/terapia , Gravidez , Complicações Neoplásicas na Gravidez/epidemiologia , Radioterapia Adjuvante/efeitos adversosAssuntos
Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/metabolismo , Terapia de Alvo Molecular/métodos , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Genes BRCA1 , Genes BRCA2 , Humanos , Lapatinib , Mutação , Inibidores de Poli(ADP-Ribose) Polimerases , Inibidores de Proteínas Quinases/uso terapêutico , Quinazolinas/uso terapêutico , Quinolinas/uso terapêutico , Ligante RANK/antagonistas & inibidores , Receptor ErbB-2/antagonistas & inibidores , Receptores de Estrogênio/metabolismo , TrastuzumabRESUMO
Nanobiotechnology, defined as an arm of a nano-system is a rapidly developing area of medicine. Nanomaterials ranging from 1 to 1000 nm in size offer unique advantages of interaction with biological systems on the molecular level. Nanobiotechnologies can be used in definition, diagnosis and treatment of cancer thus leading to the new development of a new discipline--nanooncology. The potential of nanoparticles to be used in in-vivo tumor visualization, biomolecular profiling of tumor growth factors and targeted drug delivery is being studied. These methods stemming from nanotechnology may soon find a broad application in oncology.
Assuntos
Antineoplásicos/administração & dosagem , Desenho de Fármacos , Nanoestruturas/uso terapêutico , Nanotecnologia/tendências , Antraciclinas/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Docetaxel , Doxorrubicina/administração & dosagem , Feminino , Humanos , Lipossomos , Nanopartículas/uso terapêutico , Neoplasias/tratamento farmacológico , Paclitaxel/administração & dosagem , Tamoxifeno/administração & dosagem , Taxoides/administração & dosagemRESUMO
Data are presented on a randomized study (stage II) which was undertaken to assess the efficacy of neoadjuvant chemotherapy (doxorubicin+paclitaxel) vis-a-vis endocrine therapy with aromatase inhibitors (anastrazole or exemestane) in postmenopausal women with ER-positive and/or PgR-positive tumors. Preoperative neoadjuvant chemotherapy was well tolerated and showed similar rates of overall response as compared with the latter regimen.