open access

Vol 6, No 1 (2010)
Review paper
Published online: 2010-05-06
Get Citation

Combining radiotherapy with hormonotherapy and targeted therapies in breast cancer

Krzysztof Adamowicz, Jacek Jassem
Onkol. Prak. Klin 2010;6(1):1-6.

open access

Vol 6, No 1 (2010)
REVIEW ARTICLES
Published online: 2010-05-06

Abstract

Breast cancer is one of the most important global health problems. Over the last years introduction of screening mammography and increased efficacy of adjuvant therapies resulted in the reduction of mortality in this malignancy. Many patients with breast cancer have indications for adjuvant radiotherapy and hormonotherapy, however optimal schedules of combining these two modalities remain controversial. In clinical practice typically radiotherapy and hormonotherapy are used both sequentially and concomitantly. Similarly, the most effective and safe strategies for combining radiotherapy and targeted therapies remain to be developed. It is expected that further preclinical and clinical studies, as well as rapid development of molecular oncology will contribute to better selection of patients for particular therapeutic strategies and their optimization.

Abstract

Breast cancer is one of the most important global health problems. Over the last years introduction of screening mammography and increased efficacy of adjuvant therapies resulted in the reduction of mortality in this malignancy. Many patients with breast cancer have indications for adjuvant radiotherapy and hormonotherapy, however optimal schedules of combining these two modalities remain controversial. In clinical practice typically radiotherapy and hormonotherapy are used both sequentially and concomitantly. Similarly, the most effective and safe strategies for combining radiotherapy and targeted therapies remain to be developed. It is expected that further preclinical and clinical studies, as well as rapid development of molecular oncology will contribute to better selection of patients for particular therapeutic strategies and their optimization.
Get Citation

Keywords

breast cancer; adjuvant therapy; targeted therapies; hormonotherapy; radiotherapy

About this article
Title

Combining radiotherapy with hormonotherapy and targeted therapies in breast cancer

Journal

Oncology in Clinical Practice

Issue

Vol 6, No 1 (2010)

Article type

Review paper

Pages

1-6

Published online

2010-05-06

Bibliographic record

Onkol. Prak. Klin 2010;6(1):1-6.

Keywords

breast cancer
adjuvant therapy
targeted therapies
hormonotherapy
radiotherapy

Authors

Krzysztof Adamowicz
Jacek Jassem

References (42)
  1. Ferlay J, Bray F, Piani P, Parkin DM. Globocan 2002: Cancer incidence, mortality and prevalence. IARC CancerBase No 5, version 2.0. IACR Press, Lyon 2004.
  2. Adamowicz K, Marczewska M, Jassem J. Kojarzenie radioterapii i chemioterapii u chorych na raka piersi. Onkol Prakt Klin. 2008; 4: 127–134.
  3. Clarke MJ, Clarke MJ. WITHDRAWN: Tamoxifen for early breast cancer. Cochrane Database Syst Rev. 2008(4): CD000486.
  4. Narod SA, Brunet JS, Ghadirian P, et al. Hereditary Breast Cancer Clinical Study Group. Tamoxifen and risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers: a case-control study. Hereditary Breast Cancer Clinical Study Group. Lancet. 2000; 356(9245): 1876–1881.
  5. Albain KS, Green SJ, Ravdin PM, et al. Adjuvant chemohormonal therapy for primary breast cancer should be given sequential instead of concurrent: Initial results from Intergroup trial 0100 (SWOG-88-14). . J. Clin. Oncol. 2002; 21: 37a (abstr.).
  6. Osborne CK, Boldt DH, Clark GM, et al. Effects of tamoxifen on human breast cancer cell cycle kinetics: accumulation of cells in early G1 phase. Cancer Res. 1983; 43(8): 3583–3585.
  7. Wazer DE, Tercilla OF, Lin PS, et al. Modulation in the radiosensitivity of MCF-7 human breast carcinoma cells by 17B-estradiol and tamoxifen. Br J Radiol. 1989; 62(744): 1079–1083.
  8. Osborne CK, Boldt DH, Estrada P. Human breast cancer cell cycle synchronization by estrogens and antiestrogens in culture. Cancer Res. 1984; 44(4): 1433–1439.
  9. Paulsen GH, Strickert T, Marthinsen AB, et al. Changes in radiation sensitivity and steroid receptor content induced by hormonal agents and ionizing radiation in breast cancer cells in vitro. Acta Oncol. 1996; 35(8): 1011–1019.
  10. Villalobos M, Aranda M, Nuñez MI, et al. Interaction between ionizing radiation, estrogens and antiestrogens in the modification of tumor microenvironment in estrogen dependent multicellular spheroids. Acta Oncol. 1995; 34(3): 413–417.
  11. Sarkaria JN, Miller EM, Parker CJ, et al. 4-Hydroxytamoxifen, an active metabolite of tamoxifen, does not alter the radiation sensitivity of MCF-7 breast carcinoma cells irradiated in vitro. Breast Cancer Res Treat. 1994; 30(2): 159–165.
  12. Singla R, Albuquerque K, Creech S, et al. The presence and timing of tamoxifen and its effect on the radiosensitivity of MCF-7 breast cancer cells. . Breast Cancer Res. Treat. 2003; 82: S161 (abstr.).
  13. Ahn PH, Vu HaT, Lannin D, et al. Sequence of radiotherapy with tamoxifen in conservatively managed breast cancer does not affect local relapse rates. J Clin Oncol. 2005; 23(1): 17–23.
  14. Harris EER, Christensen VJ, Hwang WT, et al. Impact of concurrent versus sequential tamoxifen with radiation therapy in early-stage breast cancer patients undergoing breast conservation treatment. J Clin Oncol. 2005; 23(1): 1–6.
  15. Pierce LJ, Hutchins LF, Green SR, et al. Sequencing of tamoxifen and radiotherapy after breast-conserving surgery in early-stage breast cancer. J Clin Oncol. 2005; 23(1): 24–29.
  16. Bentzen SM, Skoczylas JZ, Overgaard M, et al. Radiotherapy-related lung fibrosis enhanced by tamoxifen. J Natl Cancer Inst. 1996; 88(13): 918–922.
  17. Koc M, Polat P, Suma S. Effects of tamoxifen on pulmonary fibrosis after cobalt-60 radiotherapy in breast cancer patients. Radiother Oncol. 2002; 64(2): 171–175.
  18. Wennberg B, Gagliardi G, Sundbom L, et al. Early response of lung in breast cancer irradiation: radiologic density changes measured by CT and symptomatic radiation pneumonitis. Int J Radiat Oncol Biol Phys. 2002; 52(5): 1196–1206.
  19. Wazer DE, DiPetrillo T, Schmidt-Ullrich R, et al. Factors influencing cosmetic outcome and complication risk after conservative surgery and radiotherapy for early-stage breast carcinoma. J Clin Oncol. 1992; 10(3): 356–363.
  20. Fowble B, Fein D, Hanlon A, et al. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor-positive early-stage breast cancer. International Journal of Radiation Oncology*Biology*Physics. 1996; 35(4): 669–677.
  21. Forbes JF, Cuzick J, Buzdar A, et al. Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trialists' Group. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol. 2008; 9(1): 45–53.
  22. Goss PE, Ingle JN, Martino S, et al. A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med. 2003; 349(19): 1793–1802.
  23. Coombes RC, Hall E, Gibson LJ, et al. Intergroup Exemestane Study. A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer. N Engl J Med. 2004; 350(11): 1081–1092.
  24. Azria D, Larbouret C, Cunat S, et al. Letrozole sensitizes breast cancer cells to ionizing radiation. Breast Cancer Res. 2005; 7(1): R156–R163.
  25. Ishitobi M, Komoike Y, Motomura K, et al. Retrospective analysis of concurrent vs. sequential administration of radiotherapy and hormone therapy using aromatase inhibitor for hormone receptor-positive postmenopausal breast cancer. Anticancer Res. 2009; 29(11): 4791–4794.
  26. Pietras RJ, Poen JC, Gallardo D, et al. Monoclonal antibody to HER-2/neureceptor modulates repair of radiation-induced DNA damage and enhances radiosensitivity of human breast cancer cells overexpressing this oncogene. Cancer Res. 1999; 59(6): 1347–1355.
  27. Pirollo KF, Tong YA, Villegas Z, et al. Oncogene- transformed NIH 3T3 cells display radiation resistance levels indicative of a signal transduction pathway leading to the radiation-resistant phenotype. Radiat Res. 1993; 135(2): 234–243.
  28. Wollman R, Yahalom J, Maxy R, et al. Effect of epidermal growth factor on the growth and radiation sensitivity of human breast cancer cells in vitro. Int J Radiat Oncol Biol Phys. 1994; 30(1): 91–98.
  29. Pietras RJ, Fendly BM, Chazin VR, et al. Antibody to HER-2/neu receptor blocks DNA repair after cisplatin in human breast and ovarian cancer cells. Oncogene. 1994; 9(7): 1829–1838.
  30. Halyard MY, Pisansky TM, Dueck AC, et al. Radiotherapy and adjuvant trastuzumab in operable breast cancer: tolerability and adverse event data from the NCCTG Phase III Trial N9831. J Clin Oncol. 2009; 27(16): 2638–2644.
  31. Rusnak DW, Lackey K, Affleck K, et al. The effects of the novel, reversible epidermal growth factor receptor/ErbB-2 tyrosine kinase inhibitor, GW2016, on the growth of human normal and tumor-derived cell lines in vitro and in vivo. Mol Cancer Ther. 2001; 1(2): 85–94.
  32. Konecny GE, Pegram MD, Venkatesan N, et al. Activity of the dual kinase inhibitor lapatinib (GW572016) against HER-2-overexpressing and trastuzumab-treated breast cancer cells. Cancer Res. 2006; 66(3): 1630–1639.
  33. Geyer CE, Forster J, Lindquist D, et al. Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med. 2006; 355(26): 2733–2743.
  34. Medina PJ, Goodin S. Lapatinib: a dual inhibitor of human epidermal growth factor receptor tyrosine kinases. Clin Ther. 2008; 30(8): 1426–1447.
  35. Zhou H, Kim YS, Peletier A, et al. Effects of the EGFR/HER2 kinase inhibitor GW572016 on EGFR- and HER2-overexpressing breast cancer cell line proliferation, radiosensitization, and resistance. Int J Radiat Oncol Biol Phys. 2004; 58(2): 344–352.
  36. Hanna NN, Seetharam S, Mauceri HJ, et al. Antitumor interaction of short-course endostatin and ionizing radiation. Cancer J. 2000; 6(5): 287–293.
  37. Dings RPM, Williams BW, Song CW, et al. Anginex synergizes with radiation therapy to inhibit tumor growth by radiosensitizing endothelial cells. Int J Cancer. 2005; 115(2): 312–319.
  38. Citrin D, Ménard C, Camphausen K. Combining radiotherapy and angiogenesis inhibitors: clinical trial design. Int J Radiat Oncol Biol Phys. 2006; 64(1): 15–25.
  39. Fogarty M. Learning from angiogenesis trial failures. The Scientist. 2002; 16: 33–35.
  40. Gorski DH, Beckett MA, Jaskowiak NT, et al. Blockage of the vascular endothelial growth factor stress response increases the antitumor effects of ionizing radiation. Cancer Res. 1999; 59(14): 3374–3378.
  41. Abdollahi A, Griggs DW, Zieher H, et al. Combined therapy with direct and indirect angiogenesis inhibition results in enhanced antiangiogenic and antitumor effects. Cancer Res. 2003; 63(24): 8890–8898.
  42. Winkler F, Kozin SV, Tong RT, et al. Kinetics of vascular normalization by VEGFR2 blockade governs brain tumor response to radiation: role of oxygenation, angiopoietin-1, and matrix metalloproteinases. Cancer Cell. 2004; 6(6): 553–563.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl