Browsing by Author "Neciosup, Silvia"

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Improving equitable access to comprehensive care for people with advanced breast cancer: a global expert review and call-to-action for 2025–2035 (Goal 9)
(Elsevier, 2025) Eniu, Alexandru; Chidebe, Runcie; Vuylsteke, Peter; Chavez-MacGregor, Mariana; Penault-Llorca, Frederique; Lopes, Gilberto; Aapro , Matti; Neciosup, Silvia; Pillay, Nisha; Lewis, Alexandra; Attfield, Georgia; Cardoso, Fatima
Advanced breast cancer (ABC) remains an incurable yet treatable disease, requiring lifelong care. While treatment advancements have extended survival for many patients, access to these innovations is far from universal. There remains a critical need to ensure equitable access to proven and established interventions for all individuals with ABC, while continuing to drive progress in care and survival outcomes. This manuscript assesses the evolving economic landscape for and access to comprehensive ABC care since 2015. It describes the persistent access barriers and inequities, and outlines recommendations for the ABC community over the next decade. It summarizes research conducted for the ABC Global Alliance’s Global Decade Report 2.0. The main findings are: a) Disparities in access to ABC care are widening globally; b) Variable access to diagnostic services delays timely and adequate ABC treatment; c) Infrastructure, supply, and reimbursement barriers hinder ABC treatment access; d) High out-of-pocket costs drive severe financial toxicity across all income settings; e) In low-income contexts, multi-stakeholder efforts are improving access to ABC care. The findings from the ABC Global Alliance’s Global Decade Report 2.0 have informed the development of a new ABC Global Charter. The ABC Global Charter 2.0 defines ten new achievable and measurable goals for the decade 2025–2035, aiming at improving the lives of people living with ABC worldwide.
Metronomic chemotherapy for non-metastatic triple negative breast cancer: Selection is the key
(Baishideng Publishing Group, 2017) Rabanal, Connie; Ruiz, Rossana; Neciosup, Silvia; Gomez, Henry L
Triple negative breast cancer (TNBC) accounts for 15%-20% of all breast cancer, and is still defined as what it is not. Currently, TNBC is the only type of breast cancer for which there are no approved targeted therapies and maximum tolerated dose chemotherapy with taxanes and anthracycline-containing regimens is still the standard of care in both the neoadjuvant and adjuvant settings. In the last years, metronomic chemotherapy (MC) is being explored as an alternative to improve outcomes in TNBC. In the neoadjuvant setting, purely metronomic and hybrid approaches have been developed with the objective of increasing complete pathologic response (pCR) and prolonging disease free survival. These regimens proved to be very effective achieving pCR rates between 47%-60%, but at the cost of great toxicity. In the adjuvant setting, MC is used to intensify adjuvant chemotherapy and, more promisingly, as maintenance therapy for high-risk patients, especially those with no pCR after neoadjuvant chemotherapy. Considering the dismal prognosis of TNBC, any strategy that potentially improves outcomes, specially being the oral agents broadly available and inexpensive, should be considered and certainly warrants further exploration. Finally, the benefit of MC needs to be validated in properly designed clinical trials were the selection of the population is the key.