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Related Concept Videos

Cancer Therapies02:49

Cancer Therapies

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Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Updated: Sep 18, 2025

Intraductal Delivery and X-ray Visualization of Ethanol-Based Ablative Solution for Prevention and Local Treatment of Breast Cancer in Mouse Models
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Multimodal De-Escalation Strategies in Early Breast Cancer.

Icro Meattini1,2, Ana Tecic Vuger3, Carlotta Becherini2

  • 1Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

American Society of Clinical Oncology Educational Book. American Society of Clinical Oncology. Annual Meeting
|June 24, 2025
PubMed
Summary

Therapy de-escalation for early-stage breast cancer (EBC) aims to reduce treatment burden while maintaining high cure rates. Key strategies include omitting sentinel lymph node biopsy and chemotherapy (CTx) in select patients, guided by biomarkers.

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Area of Science:

  • Oncology
  • Breast Cancer Research
  • Clinical Trial Design

Background:

  • Current early-stage breast cancer (EBC) treatments achieve excellent cure rates, setting a high standard for de-escalation.
  • Therapy de-escalation must be integrated into a multimodal treatment strategy to avoid compensatory escalation of other modalities.

Purpose of the Study:

  • To review current evidence and strategies for de-escalating therapy in early-stage breast cancer (EBC).
  • To highlight the role of biomarkers and multimodal treatment concepts in safe de-escalation.
  • To emphasize the need for evidence-based de-escalation validated by prospective trials.

Main Methods:

  • Review of clinical trial data and current treatment guidelines for EBC.
  • Analysis of surgical, radiation therapy (RT), and chemotherapy (CTx) de-escalation strategies.
  • Evaluation of biomarker utility, including gene expression assays and Ki67 determination.

Main Results:

  • Omission of sentinel lymph node biopsy is safe for low-risk hormone receptor-positive/human epidermal growth factor receptor 2-negative (HER2-) disease.
  • Adapting surgical and RT to systemic treatment response is feasible with quality assurance.
  • Gene expression assays and Ki67 assessment aid in omitting chemotherapy (CTx) for specific EBC patient groups.

Conclusions:

  • Therapy de-escalation in EBC can reduce treatment burden without compromising outcomes.
  • Biomarker-driven de-escalation, such as omitting sentinel lymph node biopsy and chemotherapy (CTx), is supported by evidence.
  • Continued validation through prospective clinical trials is essential for de-escalation concepts and biomarkers.