Search

Triple negative breast cancer (TNBC) is characterized by high rates of recurrence, especially in patients with residual disease after neoadjuvant chemotherapy (NAC). Capecitabine is being used as standard adjuvant treatment in residual TNBC. We aimed to investigate the real-life data regarding the efficacy of capecitabine in residual TNBC. In this retrospective multicenter study, TNBC patients with residual disease were evaluated. Patients, who received standard anthracycline and taxane-based NAC and adjuvant capecitabine were eligible. Overall survival (OS), disease free survival (DFS) and toxicity were analyzed. 170 TNBC patients with residual disease were included. Of these, 62.9% were premenopausal. At the time of analysis, the recurrence rate was 30% and death rate was 18%. The 3-year DFS and OS were 66% and 74%, respectively. In patients treated with adjuvant capecitabine, residual node positive disease stood out as an independent predictor of DFS (p = 0.024) and OS (p = 0.032). Undergoing mastectomy and the presence of T2 residual tumor was independent predictors of DFS (p = 0.016) and OS (p = 0.006), respectively. The efficacy of capecitabine was found lower compared to previous studies. Selected patients may have further benefit from addition of capecitabine. The toxicity associated with capecitabine was found lower than anticipated. [ABSTRACT FROM AUTHOR]

Objective: Alteration of the matrix metalloproteinase (MMP) and their tissue inhibitor (TIMP) plasma level in various cancers can result in tumor invasion, metastasis and poor prognosis. However, there is limited evidence regarding the effect of chemotherapy and surgical interventions on MMPs and TIMPs plasma level in cancer patients. For this purpose, the aim of this study was to investigate circulating pre- and postoperative MMP and TIMP levels in patients with breast cancer. Materials and Methods: Blood plasma samples were obtained from 96 breast cancer patients who were surgically treated at General Surgery Clinics between 2015-2017 and 35 healthy controls. Circulating pre- and postoperative MMP-2, MMP-9, TIMP-1 and TIMP-2 levels were assessed by enzyme linked immunoassay (ELISA). In this retrospective study, we also statistically analyzed the association the MMPs and TIMPs level with clinical data of patients (age, stage, postoperative pathology, lymphovascular invasion, axillary metastasis, molecular subtypes, response to chemotherapy and surgery). Results: MMP2 (p=0.01) MMP9 (p=0.001) and TIMP2 (p=0.002) were had statistically significant differences serum levels when the mean values in the patient and control groups were compared. A significant correlation was found between increased MMP2 with ER (p=0.02) PR negativity (p= 0.046), metastatic lymph node positivity (p=0.041) and complete response to chemotherapy (p=0.037). MMP-9 levels were increased in with the progression of clinical stage (p=0.047). Although these markers showed some differences with chemotherapy and surgery treatment, but these differences were not significant. Conclusion: Serum MMP2 levels were higher in patients with complete response to chemotherapy. It was thought to be higher in patients with aggressive tumor biology. On the other hand MMP2 may be an important marker for predicting patients to respond to neoadjuvant chemotherapy. MMP9 values may be significant in showing advanced clinical stage. However, further studies with larger samples are needed to explore the association between surgical interventions and the plasma level of MMP-2, MMP-9, TIMP-1 and TIMP-2. [ABSTRACT FROM AUTHOR]