Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
A pitfall in the survival benefit of adjuvant chemotherapy for node- and hormone receptor-positive patients with breast cancer: The paradoxical role of Bcl-2 oncoprotein (Review)
Autore:
Kim, R; Osaki, A; Toge, T;
Indirizzi:
Hiroshima Univ, Res Inst Radiat Biol & Med, Dept Surg Oncol, Minami Ku, Hiroshima 7348553, Japan Hiroshima Univ Hiroshima Japan 7348553 nami Ku, Hiroshima 7348553, Japan
Titolo Testata:
INTERNATIONAL JOURNAL OF ONCOLOGY
fascicolo: 5, volume: 19, anno: 2001,
pagine: 1075 - 1080
SICI:
1019-6439(200111)19:5<1075:APITSB>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
LONG-TERM TAMOXIFEN; PREMENOPAUSAL WOMEN; INDUCED APOPTOSIS; CELL-LINE; RANDOMIZED TRIAL; FOLLOW-UP; EXPRESSION; RESISTANCE; ESTROGEN; THERAPY;
Keywords:
adjuvant chemotherapy; breast cancer; tamoxifen; Bcl-2;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
46
Recensione:
Indirizzi per estratti:
Indirizzo: Kim, R Hiroshima Univ, Res Inst Radiat Biol & Med, Dept Surg Oncol, MinamiKu, 1-2-3 Kasumi, Hiroshima 7348553, Japan Hiroshima Univ 1-2-3 Kasumi Hiroshima Japan 7348553 7348553, Japan
Citazione:
R. Kim et al., "A pitfall in the survival benefit of adjuvant chemotherapy for node- and hormone receptor-positive patients with breast cancer: The paradoxical role of Bcl-2 oncoprotein (Review)", INT J ONCOL, 19(5), 2001, pp. 1075-1080

Abstract

The survival benefit of adjuvant chemotherapy in node-positive patients with breast cancer compared with surgery alone has been established. The survival benefit differs considerably between hormone receptor-positive and -negative patients, and it is believed that the effectiveness of adjuvant chemotherapy can be increased by hormonal therapy with tamoxifen. In the present review, we discuss the rationale behind the effectiveness of combination treatment with anticancer drugs. and tamoxifen in terms of the paradoxical role of Bcl-2 in apoptosis in breast cancer. The survival benefit between receptor-positive and -negative patients was assessed using previous reportsof randomized controlled studies for postoperative adjuvant chemotherapy in node-positive breast cancer. Tamoxifen induces the anti-apoptotic gene, Bcl-2, by its effect on estradiol (E2), via an E2-response element in the promotor region of Bcl-2. The effcicay of chemoendocrine therapy was assessedin terms of the influence of tamoxifen on the effect of anticancer drugs. Adjuvant chemotherapy, including anthracycline and non-anthracycline based regimens, has an overall survival benefit in node-positive breast cancer, with a 23.5% reduction in the annual odds of recurrence and a 15% reduction in mortality (P <0.00001). A comparison of the reduction of the relative risk indicates that the survival benefit in receptor-negative patients is superior to that in receptor-positive patients by approximately 3-fold. Further, in contrast to receptor-negative patients, there is no additional benefit from paclitaxel over doxorubicin and cyclophosphamide (AC) in receptor-positive patients. The possible reasons that the chemotherapy benefit in receptor-positive patients is small and marginal are the following: i) concurrent treatment or pretreatment with tamoxifen can increase plasma E2 levels in premenopausal patients, thereby inducing Bcl-2 in residual cancer cells, which might decrease drug-sensitivity in combination with chemotherapy; ii)induction of Bcl-2 might be involved predominantly in the resistance to taxanes, the cytotoxic action of which targets Bcl-2. Co-treatment or pretreatment with tamoxifen for adjuvant therapy might decrease the efficacy of anticancer drugs, an effect that is mediated by induction of Bcl-2, especially in premenopausal patients with node-positive breast cancer. Treatment with anticancer drugs should be followed by treatment with tamoxifen to produce a survival benefit from combination therapy in receptor-positive patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/07/20 alle ore 08:03:29