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Breast Neoplasms: HELP
Articles from Slotervaart Hospital
Based on 9 articles published since 2010
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These are the 9 published articles about Breast Neoplasms that originated from Slotervaart Hospital during 2010-2020.
 
+ Citations + Abstracts
1 Review Tailored Tamoxifen Treatment for Breast Cancer Patients: A Perspective. 2015

Jager, Nynke G L / Linn, Sabine C / Schellens, Jan H M / Beijnen, Jos H. ·Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute/Slotervaart Hospital, Amsterdam, The Netherlands. Electronic address: ngljager@gmail.com. · Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands. · Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Faculty of Science, Utrecht Institute of Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands. · Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute/Slotervaart Hospital, Amsterdam, The Netherlands; Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Faculty of Science, Utrecht Institute of Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands. ·Clin Breast Cancer · Pubmed #25997856.

ABSTRACT: Tamoxifen, an endocrine agent, is widely used in the treatment of estrogen receptor-positive breast cancer. It has greatly reduced disease recurrence and mortality rates of breast cancer patients, however, not all patients benefit from tamoxifen treatment because in approximately 25% to 30% of the patients the disease recurs. Many researchers have sought to find factors associated with endocrine treatment outcome in the past years, however, this quest has not been finished. In this article, we focus on a factor that might influence outcome of tamoxifen treatment: interpatient variability in tamoxifen pharmacokinetics. In recent years it has become clear that tamoxifen undergoes extensive metabolism and that some of the formed metabolites are much more pharmacologically active than tamoxifen itself. Despite the wide interpatient variability in tamoxifen pharmacokinetics and pharmacodynamics, all patients receive a standard dose of 20 mg tamoxifen per day. Different approaches can be pursued to individualize tamoxifen dosing: genotyping, phenotyping, and therapeutic drug monitoring. Therapeutic drug monitoring seems to be the most direct and promising approach, however, further clinical research is warranted to establish the added value of individual dosing in tamoxifen treatment optimization.

2 Article Feasibility of radioguided occult lesion localization of clip-marked lymph nodes for tailored axillary treatment in breast cancer patients treated with neoadjuvant systemic therapy. 2019

Hellingman, Daan / Donswijk, Maarten L / Winter-Warnars, Gonneke A O / de Koekkoek-Doll, Petra / Pinas, Marilyn / Budde-van Namen, Yvonne / Westerga, Johan / Vrancken Peeters, Marie-Jeanne T F D / Kimmings, Nikola / Stokkel, Marcel P M. ·Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Postbus 90203, 1006, BE, Amsterdam, The Netherlands. · Department of Radiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Postbus 90203, 1006, BE, Amsterdam, The Netherlands. · Department of Radiology, Slotervaart hospital, Postbus 90440, 1006, BK, Amsterdam, The Netherlands. · Department of Radiology, Haaglanden Medical Center, Postbus 432, 2501, CK, The Hague, The Netherlands. · Department of Pathology, Slotervaart hospital, Postbus 90440, 1006, BK, Amsterdam, The Netherlands. · Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Postbus 90203, 1006, BE, Amsterdam, The Netherlands. · Department of Surgical Oncology, Slotervaart hospital, Postbus 90440, 1006, BK, Amsterdam, The Netherlands. · Department of Surgical Oncology, Alexander Monro hospital, Postbus 181, 3720, AD, Bilthoven, The Netherlands. · Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Postbus 90203, 1006, BE, Amsterdam, The Netherlands. m.stokkel@nki.nl. ·EJNMMI Res · Pubmed #31650284.

ABSTRACT: BACKGROUND: Selective removal of initially tumor-positive axillary lymph nodes in breast cancer patients who underwent neoadjuvant systemic treatment (NST) improves the accuracy of nodal staging and provides the opportunity for more tailored axillary treatment. This study evaluated whether radioguided occult lesion localization (ROLL) of clip-marked lymph nodes is feasible in clinical practice. METHODS: Prior to NST, a clip marker was placed inside a proven tumor-positive lymph node in all breast cancer patients (cTis-4N1-3 M0). After NST, technetium-99m-labeled macroaggregated albumin was injected in the clip-marked lymph nodes. The next day, these ROLL-marked nodes were selectively removed at surgery to evaluate the pathological response of the axilla. RESULTS: Thirty-seven patients (38 axillae) underwent clip insertion. After NST, the clip was visible by ultrasound in 36 procedures (95%). In the other two patients, the ROLL-node injection was performed in a sonographically suspicious unclipped node (1), and near the clip under computed tomography guidance (1). Initial surgery successfully identified the ROLL-marked node with clip in 33 procedures (87%). Removed specimens in the other five procedures contained only the sonographically suspicious tumor-positive unclipped node (1), a node with signs of complete response but no clip (2), a clip without node (1), and tissue without node nor clip, and a second successful ROLL-node procedure was performed (1). Overall, 10 ROLL-marked nodes had no residual disease. CONCLUSIONS: This study demonstrates that the ROLL procedure to identify clip-marked lymph nodes is feasible. This facilitates selective removal at surgery and may tailor axillary treatment in patients treated with NST.

3 Article Migrant breast cancer patients and their participation in genetic counseling: results from a registry-based study. 2016

Baars, J E / van Dulmen, A M / Velthuizen, M E / Theunissen, E B M / Vrouenraets, B C / Kimmings, A N / van Dalen, T / van Ooijen, B / Witkamp, A J / van der Aa, M A / Ausems, M G E M. ·Division of Biomedical Genetics, Department of Medical Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands. · NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands. · Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands. · Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway. · Division of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands. · Division of Surgery, St. Lucas Andreas Hospital, Amsterdam, The Netherlands. · Division of Surgery, Slotervaart Hospital, Amsterdam, The Netherlands. · Division of Surgery, Diakonessen Hospital, Utrecht, The Netherlands. · Division of Surgery, Meander Medical Center, Amersfoort, The Netherlands. · Division of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. · Comprehensive Cancer Centre the Netherlands (IKNL), Utrecht, The Netherlands. · Division of Biomedical Genetics, Department of Medical Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands. M.G.E.M.Ausems@umcutrecht.nl. ·Fam Cancer · Pubmed #26833044.

ABSTRACT: Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of non-Turkish/Moroccan newly diagnosed breast cancer patients were studied. All women were diagnosed between 2007 and 2012. Eligibility for genetic counseling was assessed with a checklist. A total of 156 Turkish/Moroccan patients were identified, and 321 patients were assigned to the comparative group. About one third (35%) of the Turkish/Moroccan patients fulfilled criteria for breast cancer genetic counseling, compared to 21% of the comparative group (P = 0.001); this was largely due to a relatively young age at diagnosis in the migrant group (26% <40 years vs 5% in the comparative group, P = 0.0001). Uptake of genetic counseling among eligible patients was 47% in the migrant group and 56% in the comparative group; differences in uptake were seen among the patients diagnosed before 40 years of age (48% in the migrant group vs 81% in the comparative group; P = 0.021). When adjusted for age at diagnosis, ethnicity was associated with discussing referral to genetic counseling and its actual uptake. The Turkish/Moroccan ethnicity appears to be associated with a lower uptake of genetic counseling, mainly caused by the lower uptake in the young age-group. The major barrier to participation in genetic counseling seems to lie within the referral process.

4 Article Pharmacokinetics of Selected Anticancer Drugs in Elderly Cancer Patients: Focus on Breast Cancer. 2016

Crombag, Marie-Rose B S / Joerger, Markus / Thürlimann, Beat / Schellens, Jan H M / Beijnen, Jos H / Huitema, Alwin D R. ·Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute/Slotervaart Hospital, Amsterdam 1066 CX, The Netherlands. marie-rose.crombag@slz.nl. · Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands. marie-rose.crombag@slz.nl. · Department of Medical Oncology, Cantonal Hospital, St. Gallen 9007, Switzerland. markus.joerger@kssg.ch. · Breast Center, Cantonal Hospital, St. Gallen 9007, Switzerland. beat.thuerlimann@kssg.ch. · Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands. j.schellens@nki.nl. · Department of Pharmaceutical Sciences, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht 3508 TC, The Netherlands. j.schellens@nki.nl. · Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands. j.schellens@nki.nl. · Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute/Slotervaart Hospital, Amsterdam 1066 CX, The Netherlands. jos.beijnen@slz.nl. · Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands. jos.beijnen@slz.nl. · Department of Pharmaceutical Sciences, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht 3508 TC, The Netherlands. jos.beijnen@slz.nl. · Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute/Slotervaart Hospital, Amsterdam 1066 CX, The Netherlands. alwin.huitema@slz.nl. · Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands. alwin.huitema@slz.nl. ·Cancers (Basel) · Pubmed #26729170.

ABSTRACT: BACKGROUND: Elderly patients receiving anticancer drugs may have an increased risk to develop treatment-related toxicities compared to their younger peers. However, a potential pharmacokinetic (PK) basis for this increased risk has not consistently been established yet. Therefore, the objective of this study was to systematically review the influence of age on the PK of anticancer agents frequently administered to elderly breast cancer patients. METHODS: A literature search was performed using the PubMed electronic database, Summary of Product Characteristics (SmPC) and available drug approval reviews, as published by EMA and FDA. Publications that describe age-related PK profiles of selected anticancer drugs against breast cancer, excluding endocrine compounds, were selected and included. RESULTS: This review presents an overview of the available data that describe the influence of increasing age on the PK of selected anticancer drugs used for the treatment of breast cancer. CONCLUSIONS: Selected published data revealed differences in the effect and magnitude of increasing age on the PK of several anticancer drugs. There may be clinically-relevant, age-related PK differences for anthracyclines and platina agents. In the majority of cases, age is not a good surrogate marker for anticancer drug PK, and the physiological state of the individual patient may better be approached by looking at organ function, Charlson Comorbidity Score or geriatric functional assessment.

5 Article Development of a Tumour Growth Inhibition Model to Elucidate the Effects of Ritonavir on Intratumoural Metabolism and Anti-tumour Effect of Docetaxel in a Mouse Model for Hereditary Breast Cancer. 2016

Yu, Huixin / Hendrikx, Jeroen J M A / Rottenberg, Sven / Schellens, Jan H M / Beijnen, Jos H / Huitema, Alwin D R. ·Department of Pharmacy & Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek/Slotervaart Hospital, Louwesweg 6, PO Box 90440, 1006 BK, Amsterdam, The Netherlands. h.yu@nki.nl. · Department of Pharmacy & Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek/Slotervaart Hospital, Louwesweg 6, PO Box 90440, 1006 BK, Amsterdam, The Netherlands. · Division of Molecular Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands. · Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland. · Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands. · Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. ·AAPS J · Pubmed #26603889.

ABSTRACT: In a mouse tumour model for hereditary breast cancer, we previously explored the anti-cancer effects of docetaxel, ritonavir and the combination of both and studied the effect of ritonavir on the intratumoural concentration of docetaxel. The objective of the current study was to apply pharmacokinetic (PK)-pharmacodynamic (PD) modelling on this previous study to further elucidate and quantify the effects of docetaxel when co-administered with ritonavir. PK models of docetaxel and ritonavir in plasma and in tumour were developed. The effect of ritonavir on docetaxel concentration in the systemic circulation of Cyp3a knock-out mice and in the implanted tumour (with inherent Cyp3a expression) was studied, respectively. Subsequently, we designed a tumour growth inhibition model that included the inhibitory effects of both docetaxel and ritonavir. Ritonavir decreased docetaxel systemic clearance with 8% (relative standard error 0.4%) in the co-treated group compared to that in the docetaxel only-treated group. The docetaxel concentration in tumour tissues was significantly increased by ritonavir with mean area under the concentration-time curve 2.5-fold higher when combined with ritonavir. Observed tumour volume profiles in mice could be properly described by the PK/PD model. In the co-treated group, the enhanced anti-tumour effect was mainly due to increased docetaxel tumour concentration; however, we demonstrated a small but significant anti-tumour effect of ritonavir addition (p value <0.001). In conclusion, we showed that the increased anti-tumour effect observed when docetaxel is combined with ritonavir is mainly caused by enhanced docetaxel tumour concentration and to a minor extent by a direct anti-tumour effect of ritonavir.

6 Article Use of dried blood spots for the determination of serum concentrations of tamoxifen and endoxifen. 2014

Jager, N G L / Rosing, H / Schellens, J H M / Beijnen, J H / Linn, S C. ·Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute/Slotervaart Hospital, Louwesweg 6, 1066 EC, Amsterdam, The Netherlands, Nynke.Jager@slz.nl. ·Breast Cancer Res Treat · Pubmed #24859000.

ABSTRACT: The anti-estrogenic effect of tamoxifen is suggested to be mainly attributable to its metabolite (Z)-endoxifen, and a minimum therapeutic threshold for (Z)-endoxifen in serum has been proposed. The objective of this research was to establish the relationship between dried blood spot (DBS) and serum concentrations of tamoxifen and (Z)-endoxifen to allow the use of DBS sampling, a simple and patient-friendly alternative to venous sampling, in clinical practice. Paired DBS and serum samples were obtained from 50 patients using tamoxifen and analyzed using HPLC-MS/MS. Serum concentrations were calculated from DBS concentrations using the formula calculated serum concentration = DBS concentration/([1-haematocrit (Hct)] + blood cell-to-serum ratio × Hct). The blood cell-to-serum ratio was determined ex vivo by incubating a batch of whole blood spiked with both analytes. The average Hct for female adults was imputed as a fixed value. Calculated and analyzed serum concentrations were compared using weighted Deming regression. Weighted Deming regression analysis comparing 44 matching pairs of DBS and serum samples showed a proportional bias for both analytes. Serum concentrations were calculated using [Tamoxifen] serum, calculated  = [Tamoxifen] DBS /0.779 and [(Z)-Endoxifen] serum, calculated = [(Z)-Endoxifen] DBS /0.663. Calculated serum concentrations were within 20 % of analyzed serum concentrations in 84 and 100 % of patient samples for tamoxifen and (Z)-endoxifen, respectively. In conclusion, DBS concentrations of tamoxifen and (Z)-endoxifen were equal to serum concentrations after correction for Hct and blood cell-to-serum ratio. DBS sampling can be used in clinical practice.

7 Article Tamoxifen dose and serum concentrations of tamoxifen and six of its metabolites in routine clinical outpatient care. 2014

Jager, N G L / Rosing, H / Schellens, J H M / Linn, S C / Beijnen, J H. ·Department of Pharmacy and Pharmacology, Slotervaart Hospital/The Netherlands Cancer Institute, Louwesweg 6, 1066 EC, Amsterdam, The Netherlands, Nynke.Jager@slz.nl. ·Breast Cancer Res Treat · Pubmed #24390246.

ABSTRACT: A sensitive and selective HPLC-MS/MS assay was used to analyze steady-state serum concentrations of tamoxifen, N-desmethyltamoxifen (E)-endoxifen, (Z)-endoxifen, N-desmethyl-4'-hydroxytamoxifen, 4-hydroxytamoxifen, and 4'-hydroxytamoxifen to support therapeutic drug monitoring (TDM) in patients treated with tamoxifen according to standard of care. When the (Z)-endoxifen serum concentration was below the predefined therapeutic threshold concentration of 5.9 ng/mL, the clinician was advised to increase the tamoxifen dose and to collect another serum sample. Paired serum samples from patients at one dose level at different time points during the tamoxifen treatment were used to assess the intra-patient variability. A total of 251 serum samples were analyzed, obtained from 205 patients. Of these patients, 197 used 20 mg tamoxifen per day and 8 patients used 10 mg/day. There was wide variability in tamoxifen and metabolite concentrations within the dosing groups. The threshold concentration for (Z)-endoxifen was reached in one patient (12 %) in the 10 mg group, in 153 patients (78 %) in the 20 mg group, and in 26 (96 %) of the patients who received a dose increase to 30 or 40 mg/day. Dose increase from 20 to 30 or 40 mg per day resulted in a significant increase in the mean serum concentrations of all analytes (p < 0.001). The mean intra-patient variability was between 10 and 20 % for all analytes. These results support the suitability of TDM for optimizing the tamoxifen treatment. It is shown that tamoxifen dose is related to (Z)-endoxifen exposure and increasing this dose leads to a higher serum concentration of tamoxifen and its metabolites. The low intra-patient variability suggests that only one serum sample is needed for TDM, making this a relatively noninvasive way to optimize the patient's treatment.

8 Article Hot flashes are not predictive for serum concentrations of tamoxifen and its metabolites. 2013

Jager, Nynke G L / Koornstra, Rutger H T / Vincent, Andrew D / van Schaik, Ron H N / Huitema, Alwin D R / Korse, Tiny M / Schellens, Jan H M / Linn, Sabine C / Beijnen, Jos H. ·Department of Pharmacy & Pharmacology, Slotervaart Hospital/The Netherlands Cancer Institute, Louwesweg 6, 1066 EC Amsterdam, The Netherlands. Nynke.Jager@slz.nl. ·BMC Cancer · Pubmed #24373320.

ABSTRACT: BACKGROUND: Tamoxifen has dramatically reduced the recurrence and mortality rate of estrogen receptor positive breast cancer. However, the efficacy of tamoxifen varies between individuals and 40% of patients will have a recurrence despite adjuvant tamoxifen treatment. Factors that predict tamoxifen efficacy would be helpful for optimizing treatment. Serum concentrations of the active metabolite, endoxifen, may be positively related to treatment outcome. In addition, hot flashes are suggested to be positively associated with tamoxifen treatment outcome. METHODS: We investigated in a series of 109 patients whether the frequency and severity of hot flashes were related to concentrations of tamoxifen and its metabolites. A serum sample of all patients was analyzed for the concentration of tamoxifen, N-desmethyltamoxifen, endoxifen and 4-hydroxytamoxifen, as well as for estradiol concentrations and several single nucleotide polymorphisms in CYP2D6. Additionally, these patients completed a questionnaire concerning biometric data and treatment side effects. RESULTS: We found no evidence supporting an association between concentrations of tamoxifen or metabolites and either the frequency or severity of hot flashes in the covariate unadjusted analyses. However, including interactions with menopausal status and pre-treatment hot flash (PTHF) history indicated that post-menopausal women with PTHF experienced an increasing frequency of hot flashes with increasing serum concentrations of tamoxifen and its metabolites. This finding was not altered when adjusting for potential confounding factors (duration of tamoxifen treatment, CYP2D6 phenotype, estradiol serum concentration, age and body mass index). In addition we observed a positive association between body mass index and both hot flash frequency (p = 0.04) and severity (p < 0.0001). We also observed that patients with lower estradiol levels reported more severe hot flashes (p = 0.02). CONCLUSIONS: No univariate associations were observed between concentrations of active tamoxifen metabolites and either the frequency or severity of hot flashes during treatment. However, the frequency of hot flashes may be exacerbated by higher serum concentrations of tamoxifen and its metabolites in post-menopausal women with a history of hot flashes prior to tamoxifen treatment.

9 Minor Dried Blood Spot Self-Sampling at Home for the Individualization of Tamoxifen Treatment: A Feasibility Study. 2015

Jager, Nynke G L / Rosing, Hilde / Linn, Sabine C / Schellens, Jan H M / Beijnen, Jos H. ·*Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute/Slotervaart Hospital, Amsterdam †Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam ‡Department of Pathology, University Medical Center Utrecht, Utrecht §Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam ¶Faculty of Science, Utrecht Institute of Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands. ·Ther Drug Monit · Pubmed #26035041.

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