The rationale for the effectiveness of systemic treatment of breast cancer depending on the body weight index
| Autor: | M.I.M. Hojouj |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Oncology
medicine.medical_specialty Randomization Proliferation index business.industry Incidence (epidemiology) medicine.medical_treatment Hematology medicine.disease Systemic therapy Levocarnitine Breast cancer Internal medicine medicine medicine.symptom business Abdominal obesity Neoadjuvant therapy |
| Zdroj: | Annals of Oncology. 30:v71 |
| ISSN: | 0923-7534 |
| Popis: | Background Breast cancer in the world in general and in Ukraine is steadily increasing. Epidemiological, experimental and clinical studies have shown that metabolic disturbances associated with BMI> 30 kg / m2 increase the risk of occurrence and worsen the clinical course of breast cancer. Thus, in patients with obesity, a decrease in the sensitivity of the tumor to systemic antitumor therapy, an increase in the frequency of postoperative complications and a decrease in the rates of general and non-recurrent survival. Methods The aim of the study was to improve the results of neoadjuvant systemic antitumor therapy in breast cancer patients with abdominal obesity (BMI greater than 30 kg / m2) by administering levocarnitine in combination with neoadjuvant systemic anticancer therapy (NSAT) for the correction of metabolic disorders as the main pathogenetic part of obesity. Following randomization of all patients (n = 108) with breast cancer with BMI> 30 kg / m2, depending on the appointment of levocarnitine during NSAT, were divided into 2 groups: comparison and observation. In the comparison group, patients (n = 58) with BMI> 30 kg / m2 patients with breast cancer who did not receive levocarnitine during NSPT, and in the, observation group - patients (n = 50) on breast cancer with BMI> 30 kg / m2 who received levocarnitine during NIST Results After neoadjuvant systemic anticancer therapy, regardless of the purpose levocarnitine decreased residual tumor cell proliferation index (Ki-67) and increased incidence of Luminal A molecular type of breast cancer. Against neoadjuvant systemic anticancer therapy for breast cancer patients with a BMI over 30 kg / m2 to be additionally administered drugs that increases the incidence of complete morphological regression. This drug is levocarnitine in therapeutic doses (1500 mg / day), which has proven to be an effective means to increase the number of cases of clinically relevant responses (CR + PR) to the treatment. Conclusions Levocarnitine contributes to an increase in the number of cases of objective clinical (complete regression and partial regression) and morphological (therapeutic pathomorphosis IV and V degree) tumor response to cytotoxic breast cancer therapy in patients with BMI> 30 kg / m2 and frequency of organ-saving surgical interventions. Legal entity responsible for the study The author. Funding Has not received any funding. Disclosure The author has declared no conflicts of interest. |
| Databáze: | OpenAIRE |
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