Browsing by Author "Mehrotra, R"

Now showing 1 - 2 of 2

Breast cancer early detection: A phased approach to implementation
(John Wiley and Sons Inc., 2020) Ginsburg, O; Yip, CH; Brooks, A; Cabanes ACaleffi, M; Dunstan Yataco, JA; Gyawali, B; McCormack, V; McLaughlin de Anderson, M; Mehrotra, R; Mohar, A; Murillo, R; Pace, LE; Paskett, ED; Romanoff, A; Rositch, AF; Scheel, JR; Schneidman, M; Unger-Saldaña, K; Vanderpuye, V; Wu, TY; Yuma, S; Dvaladze, A; Duggan, C; Anderson, BO
When breast cancer is detected and treated early, the chances of survival are very high. However, women in many settings face complex barriers to early detection, including social, economic, geographic, and other interrelated factors, which can limit their access to timely, affordable, and effective breast health care services. Previously, the Breast Health Global Initiative (BHGI) developed resource-stratified guidelines for the early detection and diagnosis of breast cancer. In this consensus article from the sixth BHGI Global Summit held in October 2018, the authors describe phases of early detection program development, beginning with management strategies required for the diagnosis of clinically detectable disease based on awareness education and technical training, history and physical examination, and accurate tissue diagnosis. The core issues address include finance and governance, which pertain to successful planning, implementation, and the iterative process of program improvement and are needed for a breast cancer early detection program to succeed in any resource setting. Examples are presented of implementation, process, and clinical outcome metrics that assist in program implementation monitoring. Country case examples are presented to highlight the challenges and opportunities of implementing successful breast cancer early detection programs, and the complex interplay of barriers and facilitators to achieving early detection for breast cancer in real-world settings are considered.
The tale of TILs in breast cancer: A report from The International Immuno-Oncology Biomarker Working Group
(Nature Publishing Group, 2021) El Bairi, K; Haynes, HR; Blackley, E; Fineberg, S; Shear, J; Turner, S; de Freitas, JR; Sur, D; Amendola, LC; Gharib, M; Kallala, A; Arun, I; Azmoudeh-Ardalan F; Fujimoto, L; Sua, LF; Liu, SW; Lien, HC; Kirtani, P; Balancin, M; El Attar, H; Guleria, P; Yang WShash, E; Chen, IC; Bautista, V; Do Prado Moura, JF; Rapoport, BL; Castaneda, C; Spengler, E; Acosta-Haab, G; Frahm, I; Sanchez, J; Castillo, M; Bouchmaa, N; Md Zin, RR; Shui, R; Onyuma, T; Yang, W; Husain, Z; Willard-Gallo, K; Coosemans, A; Perez, EA; Provenzano, E; Ericsson, PG; Richardet, E; Mehrotra, R; Sarancone, S; Ehinger, A; Rimm, DL; Bartlett, JMS; Viale, G; Denkert, C; Hida, AI; Sotiriou, C; Loibl, S; Hewitt, SM; Badve, S; Symmans, WF; Kim, RS; Pruneri, G; Goel, S; Francis, PA; Inurrigarro, G; Yamaguchi, R; Garcia-Rivello, H; Horlings, H; Afqir, S; Salgado, R; Adams, S; Kok, M; Dieci, MV; Michiels, S; Demaria S; Loi, S; International Immuno-Oncology Biomarker Working Group
The advent of immune-checkpoint inhibitors (ICI) in modern oncology has significantly improved survival in several cancer settings. A subgroup of women with breast cancer (BC) has immunogenic infiltration of lymphocytes with expression of programmed death-ligand 1 (PD-L1). These patients may potentially benefit from ICI targeting the programmed death 1 (PD-1)/PD-L1 signaling axis. The use of tumor-infiltrating lymphocytes (TILs) as predictive and prognostic biomarkers has been under intense examination. Emerging data suggest that TILs are associated with response to both cytotoxic treatments and immunotherapy, particularly for patients with triple-negative BC. In this review from The International Immuno-Oncology Biomarker Working Group, we discuss (a) the biological understanding of TILs, (b) their analytical and clinical validity and efforts toward the clinical utility in BC, and (c) the current status of PD-L1 and TIL testing across different continents, including experiences from low-to-middle-income countries, incorporating also the view of a patient advocate. This information will help set the stage for future approaches to optimize the understanding and clinical utilization of TIL analysis in patients with BC.