2023
Systemic Staging of Locally Advanced Breast Cancer: How Hard to Look?
Pusztai L. Systemic Staging of Locally Advanced Breast Cancer: How Hard to Look? Journal Of Clinical Oncology 2023, 41: 3891-3894. PMID: 37348030, DOI: 10.1200/jco.23.00977.Peer-Reviewed Original Research
2021
Patterns of treatment with everolimus exemestane in hormone receptor-positive HER2-negative metastatic breast cancer in the era of targeted therapy
Rozenblit M, Mun S, Soulos P, Adelson K, Pusztai L, Mougalian S. Patterns of treatment with everolimus exemestane in hormone receptor-positive HER2-negative metastatic breast cancer in the era of targeted therapy. Breast Cancer Research 2021, 23: 14. PMID: 33514405, PMCID: PMC7844919, DOI: 10.1186/s13058-021-01394-y.Peer-Reviewed Original ResearchConceptsPrior endocrine therapyEndocrine therapyMetastatic breast cancerEffective treatment optionTreatment optionsBreast cancerMedian treatmentMedian OSEE therapyHormone receptor-positive HER2-negative metastatic breast cancerMultivariable Cox proportional hazards regression analysisHER2-negative metastatic breast cancerPrior treatmentCox proportional hazards regression analysisFirst-line therapy initiationProportional hazards regression analysisPrior treatment optionsLines of therapyProportion of patientsKaplan-Meier methodHazards regression analysisPatterns of treatmentElectronic health record-derived dataClinical trial dataOS benefit
2020
Effect of Pembrolizumab Plus Neoadjuvant Chemotherapy on Pathologic Complete Response in Women With Early-Stage Breast Cancer
Nanda R, Liu MC, Yau C, Shatsky R, Pusztai L, Wallace A, Chien AJ, Forero-Torres A, Ellis E, Han H, Clark A, Albain K, Boughey JC, Jaskowiak NT, Elias A, Isaacs C, Kemmer K, Helsten T, Majure M, Stringer-Reasor E, Parker C, Lee MC, Haddad T, Cohen RN, Asare S, Wilson A, Hirst GL, Singhrao R, Steeg K, Asare A, Matthews JB, Berry S, Sanil A, Schwab R, Symmans WF, van ‘t Veer L, Yee D, DeMichele A, Hylton NM, Melisko M, Perlmutter J, Rugo HS, Berry DA, Esserman LJ. Effect of Pembrolizumab Plus Neoadjuvant Chemotherapy on Pathologic Complete Response in Women With Early-Stage Breast Cancer. JAMA Oncology 2020, 6: 676-684. PMID: 32053137, PMCID: PMC7058271, DOI: 10.1001/jamaoncol.2019.6650.Peer-Reviewed Original ResearchMeSH KeywordsAntibodies, Monoclonal, HumanizedBreast NeoplasmsFemaleHumansNeoadjuvant TherapyNeoplasm StagingProgrammed Cell Death 1 ReceptorConceptsEarly-stage breast cancerPathologic complete responseNeoadjuvant chemotherapyPhase 3 trialResidual cancer burdenStandard neoadjuvant chemotherapyBreast cancerComplete responseInvestigational armStage II/III breast cancerHigher event-free survival rateERBB2-negative breast cancerEvent-free survival rateAnthracycline-based neoadjuvant chemotherapyDistant recurrence-free survivalEnd pointTriple-negative breast cancerCycles of pembrolizumabEffect of pembrolizumabImmune-related endocrinopathiesNeoadjuvant clinical trialsTriple-negative cohortPrimary end pointSecondary end pointsRecurrence-free survivalPembrolizumab for Early Triple-Negative Breast Cancer
Schmid P, Cortes J, Pusztai L, McArthur H, Kümmel S, Bergh J, Denkert C, Park YH, Hui R, Harbeck N, Takahashi M, Foukakis T, Fasching PA, Cardoso F, Untch M, Jia L, Karantza V, Zhao J, Aktan G, Dent R, O'Shaughnessy J. Pembrolizumab for Early Triple-Negative Breast Cancer. New England Journal Of Medicine 2020, 382: 810-821. PMID: 32101663, DOI: 10.1056/nejmoa1910549.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsCarboplatinCyclophosphamideDoxorubicinEpirubicinFemaleHumansIntention to Treat AnalysisKaplan-Meier EstimateMiddle AgedNeoadjuvant TherapyNeoplasm StagingPaclitaxelTriple Negative Breast NeoplasmsConceptsEarly triple-negative breast cancerTriple-negative breast cancerPathological complete responseCycles of pembrolizumabPercentage of patientsDefinitive surgeryComplete responseBreast cancerNeoadjuvant chemotherapyTreatment-related adverse eventsUntreated stage IIPrimary end pointAcceptable safety profileEvent-free survivalPhase 3 trialSecond primary tumorsFirst interim analysisAdjuvant pembrolizumabTreat populationDistant recurrenceNeoadjuvant therapyPromising antitumor activityAdverse eventsSafety profilePrimary tumor
2019
Changing frameworks in treatment sequencing of triple-negative and HER2-positive, early-stage breast cancers
Pusztai L, Foldi J, Dhawan A, DiGiovanna MP, Mamounas EP. Changing frameworks in treatment sequencing of triple-negative and HER2-positive, early-stage breast cancers. The Lancet Oncology 2019, 20: e390-e396. PMID: 31267973, DOI: 10.1016/s1470-2045(19)30158-5.Commentaries, Editorials and LettersConceptsEarly-stage breast cancerHER2-positive breast cancerBreast cancerClinical trialsNeoadjuvant chemotherapyEstrogen receptor-negative breast cancerImproved disease-free survivalReceptor-negative breast cancerParticular chemotherapy regimenResidual invasive cancerNeoadjuvant systemic therapyDisease-free survivalImportant clinical trialsAdo-trastuzumab emtansineNegative breast cancerAdjuvant settingKATHERINE trialOperable diseasePostoperative capecitabineChemotherapy regimenMetastatic diseaseSystemic therapyResidual diseaseInvasive cancerTreatment sequencingExamining the cost-effectiveness of baseline left ventricular function assessment among breast cancer patients undergoing anthracycline-based therapy
Abu-Khalaf MM, Safonov A, Stratton J, Wang S, Hatzis C, Park E, Pusztai L, Gross CP, Russell R. Examining the cost-effectiveness of baseline left ventricular function assessment among breast cancer patients undergoing anthracycline-based therapy. Breast Cancer Research And Treatment 2019, 176: 261-270. PMID: 31020471, DOI: 10.1007/s10549-019-05178-z.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioEquilibrium radionuclide angiographyCardiac risk factorsBreast cancer patientsVentricular function assessmentRisk factorsAbnormal LVEFBaseline LVEFCancer patientsBreast cancerFunction assessmentPotential cardiac risk factorsSelf-reported risk factorsAnthracycline-based therapyLeft ventricular function assessmentCoronary artery diseaseCost-effectiveness ratioArtery diseaseTrastuzumab therapyCardiac screeningPatient populationRadionuclide angiographyCardiotoxicity riskPayer perspectiveRetrospective analysisDefining Risk of Late Recurrence in Early-Stage Estrogen Receptor–Positive Breast Cancer: Clinical Versus Molecular Tools
Foldi J, O'Meara T, Marczyk M, Sanft T, Silber A, Pusztai L. Defining Risk of Late Recurrence in Early-Stage Estrogen Receptor–Positive Breast Cancer: Clinical Versus Molecular Tools. Journal Of Clinical Oncology 2019, 37: jco.18.01933. PMID: 30943126, DOI: 10.1200/jco.18.01933.Peer-Reviewed Original ResearchImmune microenvironment of triple-negative breast cancer in African-American and Caucasian women
O’Meara T, Safonov A, Casadevall D, Qing T, Silber A, Killelea B, Hatzis C, Pusztai L. Immune microenvironment of triple-negative breast cancer in African-American and Caucasian women. Breast Cancer Research And Treatment 2019, 175: 247-259. PMID: 30725384, PMCID: PMC6666415, DOI: 10.1007/s10549-019-05156-5.Peer-Reviewed Original ResearchConceptsTriple-negative breast cancerCaucasian breast cancersER-positive cancersBreast cancerTIL countImmune microenvironmentCaucasian patientsMolecular subtypesAA TNBCHuman epidermal growth factor receptor 2Epidermal growth factor receptor 2Pathologic complete responseGrowth factor receptor 2Immune cell distributionImmune cell populationsCancer Genome Atlas (TCGA) databaseConsistent racial differencesFactor receptor 2Immune gene expressionImmune attenuationNeoadjuvant chemotherapyLymphocyte countLymphocyte infiltrationComplete responseTNBC cases
2018
Long‐Term Survival of De Novo Stage IV Human Epidermal Growth Receptor 2 (HER2) Positive Breast Cancers Treated with HER2‐Targeted Therapy
Wong Y, Raghavendra AS, Hatzis C, Irizarry JP, Vega T, Horowitz N, Barcenas CH, Chavez‐MacGregor M, Valero V, Tripathy D, Pusztai L, Murthy RK. Long‐Term Survival of De Novo Stage IV Human Epidermal Growth Receptor 2 (HER2) Positive Breast Cancers Treated with HER2‐Targeted Therapy. The Oncologist 2018, 24: 313-318. PMID: 30139836, PMCID: PMC6519755, DOI: 10.1634/theoncologist.2018-0213.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBreast NeoplasmsFemaleHumansMiddle AgedNeoplasm StagingProgression-Free SurvivalReceptor, ErbB-2SurvivorsTreatment OutcomeConceptsDe novo stage IVProgression-free survivalMetastatic breast cancerHigher progression-free survivalPositive metastatic breast cancerExcellent long-term outcomesOverall survivalLong-term outcomesNED statusBreast cancerStage IVOS ratesLocoregional therapyRandomized studyDe novo stage IV diseaseDisease statusHER2-Targeted TherapyMedian overall survivalStage IV diseaseFirst-line therapyTrastuzumab-based therapyEstrogen receptor-positive statusPositive breast cancerImportant therapeutic goalNED patientsRandomized controlled trial of weight loss versus usual care on telomere length in women with breast cancer: the lifestyle, exercise, and nutrition (LEAN) study
Sanft T, Usiskin I, Harrigan M, Cartmel B, Lu L, Li FY, Zhou Y, Chagpar A, Ferrucci LM, Pusztai L, Irwin ML. Randomized controlled trial of weight loss versus usual care on telomere length in women with breast cancer: the lifestyle, exercise, and nutrition (LEAN) study. Breast Cancer Research And Treatment 2018, 172: 105-112. PMID: 30062572, DOI: 10.1007/s10549-018-4895-7.Peer-Reviewed Original ResearchConceptsBreast cancer survivorsWeight loss interventionUsual care groupBody mass indexBreast cancer riskCancer survivorsUsual careLoss interventionBreast cancerStage 0Quantitative polymerase chain reactionCare groupTelomere lengthCancer riskStage II/III breast cancerObese breast cancer survivorsWeight lossI breast cancerNon-Hispanic whitesPurposeSome studiesMass indexIntervention groupPhysical activityBlood samplesConclusionOur findingsIncorporating Genomics Into the Care of Patients With Advanced Breast Cancer
Kratz J, Burkard M, O'Meara T, Pusztai L, Veitch Z, Bedard PL. Incorporating Genomics Into the Care of Patients With Advanced Breast Cancer. American Society Of Clinical Oncology Educational Book 2018, 38: 56-64. PMID: 30231387, DOI: 10.1200/edbk_200731.Peer-Reviewed Original ResearchConceptsBreast cancerGenomic alterationsTumor genomic heterogeneityAdvanced breast cancerMetastatic breast cancerRecurrent genomic alterationsCare of patientsGenetic diversityMetastatic tumor sitesImproved clinical careGenomic sequencingLaboratory-developed testsClinical trialsGenomic heterogeneityDrug treatmentPatient tumorsClinical careSame patientBlood samplesHeterogeneous diseaseClinical relevanceTumor sitePatientsClonal evolutionCell populations
2017
Cardiac biomarkers for early detection and prediction of trastuzumab and/or lapatinib-induced cardiotoxicity in patients with HER2-positive early-stage breast cancer: a NeoALTTO sub-study (BIG 1-06)
Ponde N, Bradbury I, Lambertini M, Ewer M, Campbell C, Ameels H, Zardavas D, Di Cosimo S, Baselga J, Huober J, Izquierdo M, Fumagalli D, Bozovic-Spasojevic I, Maetens M, Harbeck N, Pusztai L, Berghorn M, Im YH, Borrego MR, Chen DR, Rodeheffer R, Piccart M, Suter T, de Azambuja E. Cardiac biomarkers for early detection and prediction of trastuzumab and/or lapatinib-induced cardiotoxicity in patients with HER2-positive early-stage breast cancer: a NeoALTTO sub-study (BIG 1-06). Breast Cancer Research And Treatment 2017, 168: 631-638. PMID: 29280043, PMCID: PMC5843537, DOI: 10.1007/s10549-017-4628-3.Peer-Reviewed Original ResearchConceptsAnti-HER2 therapyNT-proBNPBiomarker elevationCardiac toxicityEarly predictorHER2-positive early-stage breast cancerEarly-stage breast cancerAnthracycline-naïve patientsEarly cardiac toxicityLevels of TnTNT-proBNP elevationBrain natriuretic peptideBreast cancer patientsNeoALTTO trialWeekly paclitaxelCardiac dysfunctionTreatment armsCardiac damageNatriuretic peptideCancer patientsCardiac biomarkersBreast cancerPatientsTroponin TAmino-terminal fragmentBidirectional Text Messaging to Monitor Endocrine Therapy Adherence and Patient-Reported Outcomes in Breast Cancer
Mougalian SS, Epstein LN, Jhaveri AP, Han G, Abu-Khalaf M, Hofstatter EW, DiGiovanna MP, Silber ALM, Adelson K, Pusztai L, Gross CP. Bidirectional Text Messaging to Monitor Endocrine Therapy Adherence and Patient-Reported Outcomes in Breast Cancer. JCO Clinical Cancer Informatics 2017, 1: 1-10. PMID: 30657377, DOI: 10.1200/cci.17.00015.Peer-Reviewed Original ResearchConceptsAdverse effectsEndocrine therapyClinical trialsBreast cancerFrequency of AEsMedication-related adverse effectsTherapy-related adverse effectsBidirectional Text MessagingEndocrine therapy adherenceAdjuvant endocrine therapyMajority of patientsMedical record reviewSevere adverse effectsText message systemConsecutive patientsVaginal symptomsRecord reviewHot flashesTherapy adherenceClinic nursesHistorical controlsPatient acceptanceProvider teamGeneral populationPatientsImpacts of Early Guideline-Directed 21-Gene Recurrence Score Testing on Adjuvant Therapy Decision Making
Dzimitrowicz H, Mougalian S, Storms S, Hurd S, Chagpar AB, Killelea BK, Horowitz NR, Lannin DR, Harigopal M, Hofstatter E, DiGiovanna MP, Adelson KB, Silber A, Abu-Khalaf M, Chung G, Zaheer W, Abdelghany O, Hatzis C, Pusztai L, Sanft TB. Impacts of Early Guideline-Directed 21-Gene Recurrence Score Testing on Adjuvant Therapy Decision Making. JCO Oncology Practice 2017, 13: jop.2017.022731. PMID: 29048991, DOI: 10.1200/jop.2017.022731.Peer-Reviewed Original ResearchConceptsAdjuvant therapy decisionsRecurrence scoreChemotherapy useRS testingMedical oncologistsHistorical controlsChemotherapy decisionsTherapy decisionsEligibility criteriaNational Comprehensive Cancer Network guidelinesProspective quality improvement projectEarly-stage breast cancerAdjuvant chemotherapy recommendationsTime of diagnosisTime of surgeryQuality improvement projectTesting groupChemotherapy initiationChemotherapy recommendationsMedian timeTrial enrollmentNetwork guidelinesSurgical oncologistsClinical trialsBreast cancerRevisiting the definition of estrogen receptor positivity in HER2-negative primary breast cancer
Fujii T, Kogawa T, Dong W, Sahin AA, Moulder S, Litton JK, Tripathy D, Iwamoto T, Hunt KK, Pusztai L, Lim B, Shen Y, Ueno NT. Revisiting the definition of estrogen receptor positivity in HER2-negative primary breast cancer. Annals Of Oncology 2017, 28: 2420-2428. PMID: 28961844, PMCID: PMC5834134, DOI: 10.1093/annonc/mdx397.Peer-Reviewed Original ResearchConceptsHER2-negative primary breast cancerAdjuvant hormonal therapyPrimary breast cancerTriple-negative breast cancerEstrogen receptor positivityHormonal therapyBreast cancerER expressionNeoadjuvant chemotherapyOverall survivalReceptor positivityPathological complete response rateHER2-negative breast cancerStage IIHuman epidermal growth factor 2Better long-term outcomesEpidermal growth factor 2Complete response rateProgesterone receptor expressionLong-term outcomesNegative breast cancerTerms of pCRLogistic regression modelsDefinitive surgeryGrowth factor 2Discussion of: “Does lymph node status influence adjuvant therapy decision-making in women 70 years of age or older with clinically node negative hormone receptor positive breast cancer?”
Chagpar AB, Horowitz N, Sanft T, Wilson LD, Silber A, Killelea B, Moran MS, DiGiovanna MP, Hofstatter E, Chung G, Pusztai L, Lannin DR. Discussion of: “Does lymph node status influence adjuvant therapy decision-making in women 70 years of age or older with clinically node negative hormone receptor positive breast cancer?”. The American Journal Of Surgery 2017, 214: 1089-1090. PMID: 28987415, DOI: 10.1016/j.amjsurg.2017.09.025.Commentaries, Editorials and LettersDoes lymph node status influence adjuvant therapy decision-making in women 70 years of age or older with clinically node negative hormone receptor positive breast cancer?
Chagpar AB, Horowitz N, Sanft T, Wilson LD, Silber A, Killelea B, Moran MS, DiGiovanna MP, Hofstatter E, Chung G, Pusztai L, Lannin DR. Does lymph node status influence adjuvant therapy decision-making in women 70 years of age or older with clinically node negative hormone receptor positive breast cancer? The American Journal Of Surgery 2017, 214: 1082-1088. PMID: 28939252, DOI: 10.1016/j.amjsurg.2017.07.036.Peer-Reviewed Original ResearchConceptsHormone receptor-positive breast cancerReceptor-positive breast cancerPositive breast cancerLymph nodesRadiation therapyBreast cancerPost-lumpectomy radiation therapyPost-mastectomy radiation therapyNational Cancer DatabaseSentinel LN biopsyBreast cancer patientsWomen 70 yearsAdjuvant chemotherapyAdjuvant therapyHormonal therapyLN biopsyLN evaluationLN statusCancer patientsCancer DatabasePatientsTherapyCancerChemotherapyHrAssociation of LN Evaluation with Survival in Women Aged 70 Years or Older With Clinically Node-Negative Hormone Receptor Positive Breast Cancer
Chagpar AB, Hatzis C, Pusztai L, DiGiovanna MP, Moran M, Mougalian S, Sanft T, Evans S, Hofstatter E, Wilson LD, Lannin DR. Association of LN Evaluation with Survival in Women Aged 70 Years or Older With Clinically Node-Negative Hormone Receptor Positive Breast Cancer. Annals Of Surgical Oncology 2017, 24: 3073-3081. PMID: 28766195, DOI: 10.1245/s10434-017-5936-x.Peer-Reviewed Original ResearchConceptsBreast cancer-specific survivalLN evaluationPositive breast cancerOverall survivalBreast cancerHormone receptor-positive breast cancerWomen Aged 70 YearsReceptor-positive breast cancerLymph node evaluationCancer-specific survivalLower hazard rateLN surgeryBetter OSPatient ageSEER databasePatient selectionTumor characteristicsSEER dataPatientsNode evaluationHormone receptorsCancerSurvivalTreatment variablesNCDBBone Density Screening in Postmenopausal Women With Early-Stage Breast Cancer Treated With Aromatase Inhibitors
Stratton J, Hu X, Soulos PR, Davidoff AJ, Pusztai L, Gross CP, Mougalian SS. Bone Density Screening in Postmenopausal Women With Early-Stage Breast Cancer Treated With Aromatase Inhibitors. JCO Oncology Practice 2017, 13: jop.2016.018341. PMID: 28267392, DOI: 10.1200/jop.2016.018341.Peer-Reviewed Original ResearchConceptsBaseline DXA scanAromatase inhibitorsBreast cancerDXA scansPostmenopausal womenAI treatmentBaseline bone mineral density testingDual-energy X-ray absorptiometry scanBone mineral density testingBone mineral density evaluationEarly-stage breast cancerX-ray absorptiometry scansBone density screeningOlder Medicare beneficiariesMultivariable logistic regressionSEER-Medicare databaseRepeat DXA scansAI therapyBisphosphonate usePatient characteristicsRetrospective analysisWhite raceMedicare beneficiariesOsteoporosis diagnosisStage IIntratumor Heterogeneity of Homologous Recombination Deficiency in Primary Breast Cancer
von Wahlde MK, Timms KM, Chagpar A, Wali VB, Jiang T, Bossuyt V, Saglam O, Reid J, Gutin A, Neff C, Lanchbury JS, Hatzis C, Hofstatter E, Pusztai L. Intratumor Heterogeneity of Homologous Recombination Deficiency in Primary Breast Cancer. Clinical Cancer Research 2017, 23: 1193-1199. PMID: 27601588, DOI: 10.1158/1078-0432.ccr-16-0889.Peer-Reviewed Original Research