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Overcoming endocrine resistance in metastatic breast cancer: Current evidence and future directions

World Journal of Clinical Oncology 2014年第5期5卷 990-1001页

作者： Andrea Milani Elena Geuna gloria mittica Giorgio Valabrega Institute for Cancer Research and Treatment at Candiolo University of Torino Medical School FPO(Fondazione del Piemonte per l'Oncologia) Department of Oncology University of Torino Medical School

About 75% of all breast cancers are estrogen receptor(ER)-positive. They generally have a more favorable clinical behavior, prognosis, and pattern of recurrence, and endocrine therapy forms the backbone of treatment. Anti-estrogens(such as tamoxifen and fulvestrant) and aromatase inhibitors(such as anastrozole, letrozole, and exemestane) can effectively control the disease and induce tumor responses in a large proportion of patients. However, the majority of patients progress during endocrine therapy(acquired resistance) and a proportion of patients may fail to respond to initial therapy(de novo resistance). Endocrine resistance is therefore of clinical concern and there is great interest in strategies that delay or circumvent it. A deeper knowledge of the molecular mechanisms that drive endocrine resistance has recently led to development of new strategies that have the promise to effectivelyovercome it. Many resistance mechanisms have been described, and the crosstalk between ER and growth factor receptor signaling pathways seems to represent one of the most relevant. Compounds that are able to inhibit key elements of these pathways and restore endocrine sensitivity have been studied and more are currently under development. The aim of this review is to summarize the molecular pathophysiology of endocrine resistance in breast cancer and its impact on current clinical management.

关键词： Everolimus Mammalian target of rapamycin PI3K inhibitors Estrogen receptor Endocrine resistance

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Role of Mediterranean diet in preventing platinum based gastrointestinal toxicity in gynecolocological malignancies: A single Institution experience

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World Journal of Clinical Oncology 2019年第12期10卷 391-401页

作者： Eleonora Ghisoni Valentina Casalone Gaia Giannone gloria mittica Valentina Tuninetti Giorgio Valabrega Candiolo Cancer Institute FPO-IRCCSTorino 10060 Italy University of Torino Torino 10060Italy

BACKGROUND Gynecological malignancies represent a major cause of death in women and are often treated with platinum-based *** undergoing chemotherapy suffer from alterations in nutritional status which may worsen gastrointestinal(GI)toxicities,quality of life and affect the overall ***,assuring a good nutritional status and limiting toxicities during treatment are still major goals for *** To assess the role of Mediterranean Diet(MD)in reducing GI toxicities in patients with gynecological cancers treated with platinum-based *** We conducted an observational study on 22 patients with gynecological tumors treated with a platinum-based chemotherapy at Candiolo Cancer Institute FPO/IRCCS between January 2018 and June *** food and frequency(FFQ)and the Patient-Reported Outcomes Common Terminology Criteria For Adverse Events(PRO-CTCAE)questionnaires were administered at baseline and at every Day 1 of each *** evaluate the differences in GI toxicities the study population was divided in two groups according to the currently validated Mediterranean Diet Serving Score(MDSS)at *** Patients with high MDSS reported a trend toward lower GI toxicities according to PRO-CTCAE at each timepoint(first evaluation:P=0.7;second:P=0.52;third:P=0.01).In particular,difference in nausea frequency and gravity(P<0.001),stomach pain frequency and gravity(P=0.01 and P=0.02),abdomen bloating frequency and gravity(P=0.02 and P=0.03),and interference with daily activities(P=0.02)were highly statistically significant at the end of *** than 60%of patients changed their food habits during chemotherapy mainly because of GI toxicities.A higher reduction of food intake,both in terms of caloric(P=0.29)and of single nutrients emerged in the group experiencing higher *** Our results show that adherence to MD possibly reduces GI toxicity and prevents nutritional status impairment during chemotherapy treatmen

关键词： Mediterranean diet Gynecological malignancies Gastrointestinal toxicities Platinum-based chemotherapy Nutritional status

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