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Your search keyword '"Hudis, Clifford A."' showing total 2 results
Start Over Author "Hudis, Clifford A." Topic axilla Publication Year Range Last 10 years
2 results on '"Hudis, Clifford A."'

1. Axillary Management of Stage II/III Breast Cancer in Patients Treated with Neoadjuvant Systemic Therapy: Results of CALGB 40601 (HER2-Positive) and CALGB 40603 (Triple-Negative).

Author

Ollila, David W., Cirrincione, Constance T., Berry, Donald A., Carey, Lisa A., Sikov, William M., Hudis, Clifford A., Winer, Eric P., and Golshan, Mehra

Subjects
*BREAST cancer treatment, *ADJUVANT treatment of cancer, *HER2 protein, *BREAST biopsy, *BREAST cancer diagnosis, *BREAST tumor treatment, *AXILLA, *BIOPSY, *BREAST cancer, *BREAST tumors, *CELL receptors, *COMBINED modality therapy, *SURGICAL excision, *LYMPH nodes, *LYMPH node surgery, *MASTECTOMY, *METASTASIS, *RESEARCH funding, *TUMOR classification, *DUCTAL carcinoma, *SENTINEL lymph node biopsy, *LOBULAR carcinoma, *THERAPEUTICS
Abstract

Background: Management of the axilla in stage II/III breast cancer undergoing neoadjuvant systemic therapy (NST) is controversial. To understand current patterns of care, we collected axillary data from 2 NST trials: HER2-positive (Cancer and Leukemia Group B [CALGB] 40601) and triple-negative (CALGB 40603).Study Design: Axillary evaluation pre- and post-NST was per the treating surgeon and could include sentinel node biopsy. Post-NST, node-positive patients were recommended to undergo axillary lymph node dissection (ALND). We report pre-NST histopathologic nodal evaluation and post-NST axillary surgical procedures with correlation to clinical and pathologic nodal status.Results: Seven hundred and forty-two patients were treated, 704 had complete nodal data pre-NST and post-NST. Pre-NST, 422 (60%) of 704 patients underwent at least 1 procedure for axillary node evaluation (total of 468 procedures): fine needle aspiration (n = 234; 74% positive), core needle biopsy (n = 138; 72% positive), and sentinel node biopsy (n = 96; 33% positive). Pre-NST, 304 patients were considered node-positive. Post-NST, 304 of 704 patients (43%) underwent sentinel node biopsy; 44 were positive and 259 were negative (29 and 36 patients, respectively, had subsequent ALND). Three hundred and ninety-one (56%) patients went directly to post-NST ALND and 9 (1%) pre-NST node-positive patients had no post-NST axillary procedure. Post-NST, 170 (24%) of the 704 patients had residual axillary disease. Agreement between post-NST clinical and radiologic staging and post-NST histologic staging was strongest for node-negative (81%) and weaker for node-positive (N1 31%, N2 29%), with more than half of the clinically node-positive patients found to be pathologic negative (p < 0.001).Conclusions: Our results suggest there is no widely accepted standard for axillary nodal evaluation pre-NST. Post-NST staging was highly concordant in patients with N0 disease, but poorly so in node-positive disease. Accurate methods are needed to identify post-NST patients without residual axillary disease to potentially spare ALND. [ABSTRACT FROM AUTHOR]

Published
2017
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2. International Expert Consensus on Primary Systemic Therapy in the Management of Early Breast Cancer: Highlights of the Fifth Symposium on Primary Systemic Therapy in the Management of Operable Breast Cancer, Cremona, Italy (2013)

Author

Vladimir Semiglazov, Christos Hatzis, Daniele Generali, Sarah C. Darby, Gaia Schiavon, Alberto Bottini, Thorsten Kühn, Serena Di Cosimo, Giuseppe Curigliano, Alfredo Berruti, Michael A. Jacobs, Vito Amoroso, Peter A. Barry, Alessandra Gennari, Kerstin Hermelink, Andrea Ravelli, Rebecca Pedersini, Anna Sapino, Maria Grazia Daidone, Paolo Pedrazzoli, Lucia Vassalli, Massimo Cristofanilli, Fraser Symmans, Edda Simoncini, Adrian L. Harris, Maria Rosa Cappelletti, Clifford A. Hudis, Andreas Makris, Luigi Dogliotti, Gunter von Minckwitz, Thomas A. Buchholz, Stephen B. Fox, Mitchell Dowsett, Amoroso, Vito, Generali, Daniele, Buchholz, Thoma, Cristofanilli, Massimo, Pedersini, Rebecca, Curigliano, Giuseppe, Daidone, Maria Grazia, Di Cosimo, Serena, Dowsett, Mitchell, Fox, Stephen, Harris, Adrian L., Makris, Andrea, Vassalli, Lucia, Ravelli, Andrea, Cappelletti, Maria Rosa, Hatzis, Christo, Hudis, Clifford A., Pedrazzoli, Paolo, Sapino, Anna, Semiglazov, Vladimir, Von Minckwitz, Gunter, Simoncini, Edda L., Jacobs, Michael A., Barry, Peter, Kühn, Thorsten, Darby, Sarah, Hermelink, Kerstin, Symmans, Fraser, Gennari, Alessandra, Schiavon, Gaia, Dogliotti, Luigi, Berruti, Alfredo, and Bottini, Alberto

Subjects
Oncology, Cancer Research, Neoplasm, Residual, Receptor, ErbB-2, medicine.medical_treatment, International Cooperation, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Chemotherapy, Adjuvant, Female, Humans, Molecular Targeted Therapy, Neoadjuvant Therapy, Outcome Assessment (Health Care), Prognosis, Remission Induction, Sentinel Lymph Node Biopsy, Consensus, Expert Testimony, Systemic therapy, ErbB-2, Breast-conserving surgery, Adjuvant, Neoadjuvant therapy, food and beverages, General Medicine, medicine.anatomical_structure, Residual, Breast Neoplasm, Receptor, Human, medicine.medical_specialty, Prognosi, Consensu, Article, Breast cancer, Internal medicine, medicine, Chemotherapy, Antineoplastic Combined Chemotherapy Protocol, Surrogate endpoint, business.industry, fungi, medicine.disease, Surgery, Clinical trial, Radiation therapy, Axilla, Neoplasm, business
Abstract

Expert consensus-based recommendations regarding key issues in the use of primary (or neoadjuvant) systemic treatment (PST) in patients with early breast cancer are a valuable resource for practising oncologists. PST remains a valuable therapeutic approach for the assessment of biological antitumor activity and clinical efficacy of new treatments in clinical trials. Neoadjuvant trials provide endpoints, such as pathological complete response (pCR) to treatment, that potentially translate into meaningful improvements in overall survival and disease-free survival. Neoadjuvant trials need fewer patients and are less expensive than adjuvant trial, and the endpoint of pCR is achieved in months, rather than years. For these reasons, the neoadjuvant setting is ideal for testing emerging targeted therapies in early breast cancer. Although pCR is an early clinical endpoint, its role as a surrogate for long-term outcomes is the key issue. New and better predictors of treatment efficacy are needed to improve treatment and outcomes. After PST, accurate management of post-treatment residual disease is mandatory. The surgery of the sentinel lymph-node could be an acceptable option to spare the axillary dissection in case of clinical negativity (N0) of the axilla at the diagnosis and/or after PST. No data exists yet to support the modulation of the extent of locoregional radiation therapy on the basis of the response attained after PST although trials are underway.

Published
2015

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