Judith Bjöhle's research while affiliated with Karolinska University Hospital and other places

Publications (34)

Article
Purpose: PREDIX HER2 is a randomized phase 2 trial that compared neoadjuvant docetaxel, trastuzumab, pertuzumab (THP) with trastuzumab emtansine (T-DM1) for HER2-positive breast cancer. Rates of pathologic complete response (pCR) did not differ between the two groups. Here, we present the survival outcomes from PREDIX HER2 and investigate metaboli...
Article
593 Background: Abundance of tumor infiltrating lymphocytes (TIL) is prognostic in early HER2-positive breast cancer (BC). Response to neoadjuvant therapy (NAT) according to positron emission tomography combined with computed tomography (PET-CT) has been shown to predict pathologic complete response (pCR). There is paucity of data regarding long-te...
Article
Importance Trastuzumab emtansine (T-DM1) is presently approved for treatment of advanced breast cancer and after incomplete response to neoadjuvant therapy, but the potential of T-DM1 as monotherapy is so far unknown. Objective To assess pathologic complete response (pCR) to standard neoadjuvant therapy of combination docetaxel, trastuzumab, and p...
Article
Full-text available
Background Emerging data support the use of thymidine kinase 1 (TK1) activity as a prognostic marker and for monitoring of response in breast cancer (BC). The long-term prognostic value of TK1 kinetics during neoadjuvant chemotherapy is unclear, which this study aimed to elucidate. Methods Material from patients enrolled to the single-arm prospect...
Article
Background and purpose: Patients with breast cancer receiving mastectomy in our institution are offered immediate breast reconstruction (IBR). IBR may have an impact on the optimisation of radiation therapy (RT). Therefore, we aimed to evaluate the clinical target volume (CTV) dose coverage when disregarding the dose received by the breast implant...
Article
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Purpose: The aim of this study was to verify if radiotherapy (RT) safely can be omitted in older women treated for estrogen-receptor positive early breast cancer with breast-conserving surgery (BCS) and endocrine therapy (ET). Patients and methods: Eligibility criteria were: consecutive patients with age ≥65 years, BCS + sentinel node biopsy, cl...
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Pathologic complete response (pCR) is a predictor for favorable outcome after neoadjuvant treatment in early breast cancer. Modulation of gene expression may also provide early readouts of biological activity and prognosis, offering the possibility for timely response-guided treatment adjustment. The role of early transcriptional changes in predict...
Article
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Background: The benefit of radiotherapy in older women with endocrine responsive early breast cancer treated with breast-conserving surgery and endocrine therapy is unclear. The aim of this study was to verify if omission of radiotherapy in a predefined cohort of patients with good prognosis early breast cancer after breast conservation is safe. Me...
Article
Background: Several randomized trials have proven that preoperative chemotherapy is equivalent to adjuvant treatment, and allows for clinical and radiological assessment of efficacy in vivo. Recent results show that response-guided neoadjuvant therapy is a favorable policy for hormone receptor positive tumors, while pCR predicts prognosis for tripl...
Article
Background: Preoperative chemotherapy in breast cancer (bc) provides unique possibilities to evaluate effects of therapy by studying response and changes in the tumor during the course of treatment. A pathologic complete response (pCR) correlates positively with long term prognosis in high-proliferating bc. In triple negative bc (TNBC) the prognosi...
Article
Proliferation-related gene signatures have been proposed to aid breast cancer management by providing reproducible prognostic and predictive information on a patient-by-patient basis. It is unclear however, whether a less demanding assessment of cell division rate (as determined in clinical setting by expression of Ki67) can function in place of ge...
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The aim of this study was to quantify the variation in doses to organs at risk (ipsilateral lung and heart) and the clinical target volume (CTV) in the presence of breast implants. In this retrospective cohort study, patients were identified through the National Breast Cancer Register. Consecutive breast cancer patients undergoing mastectomy betwee...
Article
The primary objective was to estimate serum thymidine kinase 1 (TK1) activity, reflecting total body cell proliferation rate including cancer cell proliferation, in women with loco regional inoperable or metastatic breast cancer participating in a prospective and randomized study. Secondary objectives were to analyze TK1 in relation to progression-...
Article
We have investigated the relationship between gene expression and chromosomal positions in 402 breast cancer patients. Using an overrepresentation approach based on Fisher's exact test, we identified disproportionate contributions of specific chromosomal positions to genes associated with survival. Our major finding is that the gene expression in t...
Article
Full-text available
Molecular markers and the rich biological information they contain have great potential for cancer diagnosis, prognostication and therapy prediction. So far, however, they have not superseded routine histopathology and staging criteria, partly because the few studies performed on molecular subtyping have had little validation and limited clinical c...
Data
Annotated list of 84 genes used for cell line comparisons. HRTrelated_FoldChanges.xls is an Excel spreadsheet containing the genes that matched between the study cohort and the cell line experiments, annotated and linked to EntrezGene. See SupplementaryReport.pdf for description.
Data
Annotated list of 276 HRT- related genes. HRTrelated_GeneList.xls is an Excel spreadsheet containing the age-adjusted list of HRT-related genes, with links to EntrezGene and GenBank at NCBI. See SupplementaryReport.pdf for description.
Data
Supplementary report. SupplementaryReport.pdf is a PDFfile containing additional information on the statistical analysis of the expression data and the comparison with the cell- line data, as well as detailed descriptions of additional data files 2 and 3.
Article
Full-text available
Postmenopausal hormone-replacement therapy (HRT) increases breast-cancer risk. The influence of HRT on the biology of the primary tumor, however, is not well understood. We obtained breast-cancer gene expression profiles using Affymetrix human genome U133A arrays. We examined the relationship between HRT-regulated gene profiles, tumor characteristi...
Data
Supplementary Report presenting (i) details of gene filtering, (ii) details of cross-validation procedure to choose 64-gene signature, (iii) list of 64 genes, and (iv) other statistical analyses based on secondary endpoints.
Article
Full-text available
Adjuvant breast cancer therapy significantly improves survival, but overtreatment and undertreatment are major problems. Breast cancer expression profiling has so far mainly been used to identify women with a poor prognosis as candidates for adjuvant therapy but without demonstrated value for therapy prediction. We obtained the gene expression prof...
Article
Given the promise of rich biological information in microarray data we will expect an increasing demand for a robust, practical and well-tested methodology to provide patient prognosis based on gene expression data. In standard settings, with few clinical predictors, such a methodology has been provided by the Cox proportional hazard model, but no...
Article
Axillary dissection is presently a routine staging procedure in the management of breast cancer. The use of adjuvant systemic treatment is largely based on the diagnosis of axillary metastases. Routine axillary dissection leads to acute and chronic side-effects in a large proportion of patients. The sentinel node technique is presently explored wit...
Article
Toxicity of the respiratory system is quite common after radiotherapy of thoracic tumors; breast cancer patients represent one of the groups for which there is also a long expected survival. The quantification of lung tissue response to irradiation is important in designing treatments associated with a minimum of complications and maximum tumor con...

Citations

... Consequently, standard NT does not currently include a TKI. Similarly, the ADC ado-trastuzumab emtansine (T-DM1) has been compared with standard chemotherapy in the neoadjuvant setting and did not improve pCR rate, although it was associated with less toxicity [53][54][55]. Small studies have evaluated T-DM1 in combination with other agents and have shown promising results, but currently T-DM1 does not have a clear role in NT. A flow diagram of standard neoadjuvant therapy and risk-adapted adjuvant therapy for HER2 + disease is shown in Fig. 2. ...
... In one study TK1 measured by ELISA was shown to be a sensitive and specific marker for the detection of early-stage lung cancer (16), but TK1 was not able to differentiate cancer from benign lung disease in another (17). In some solid tumors, serum TK1 levels have been reported to associate with tumor stage and predict response to therapy and outcome (14,18,19). Most studies relating TK1 levels to a malignant diagnosis or its outcome have included cases with both early and advanced tumors (7,17,20,21). ...
... For systemic therapy, this has been addressed in patients with HER2-positive disease. The PREDIX HER2-trial compared docetaxel, trastuzumab and pertuzumab to T-DM1 and found similar rates of pathologic complete response and event-free survival in both arms [20,21]. Results on survival outcomes are pending. ...
... All included studies were published between February 2003 43 and October 2020 68 (Table 2). Among the 55 studies, 48 studies (87.3%) 4,8,9,11,13,[19][20][21][22][23][25][26][27][28][29][30][31][32]34,36,[38][39][40][41][43][44][45][46][47][48][49][50][51][52][53][54][56][57][58][60][61][62][63][64][65][66][67][68] were retrospective and seven (12.7%) 24,33,35,37,42,55,59 were prospective. The quality of included studies ranged from 6 to 12 points for noncomparative studies, and from 10 to 20 points for comparative studies (Table 1). ...
... 37 Furthermore, a Swedish multicenter cohort study of omission of RT in 603 patients age older than 65 years and with ER1, grade 1-2, and T1 tumors treated with endocrine agents found a very low rate of IBTR (1.2% at 5 years). 38 These results demonstrate proof of principle that RT can be safely omitted in select patients. ...
... e Violin plots of the GSEA results in residual vs primary tumors for multiple human cancer types using the MP signature. BC: breast cancer (GSE87455) 21 , AML: acute myeloid leukemia (GSE40442) 24 , REC: rectal cancer (GSE15781) 23 , EADC: esophageal cancer (GSE165252) 22 . NES: normalized enrichment scores. ...
... Another study showed that compliance with QUANTEC recommendation of V25 <10% and a mean heart dose of less than 4 Gy in breast cancer therapy can be achieved with a predicted risk of cardiac mortality of less than 1%. 50 However, since the probability of cardiac toxicity approached 1% even with a smaller value of V25, no single-dose volume cut-off value seems to ensure the lowest risk of cardiac toxicity. On top of that, QUANTEC recommendations deal with fractionated radiotherapy instead of singleshot irradiation as in cardiac SBRT. ...
... [2,[25][26][27][28][29][30] Typical statistical analyses applied to clinical transcriptomics data includes differential gene expression (DE) based on group mean differences; [8,31,32] regression analyses of transcript abundance versus clinical status; [2,6,30,[33][34][35][36] and classification approaches. [9,[37][38][39][40][41][42][43][44] Regression and DE analyses are then used to identify the molecular pathways regulated between groups. ...
... 9,10,12- 15 Thompson et al noted up to 30% dose attenuation under a single beam compared to the plan dose. 16 A few studies, however, have reported no obvious dose changes due to MPs. 11,12,17 These results should be interpreted carefully because the dose effects of artifacts on CT simulation images were not considered in all studies. 9,18 Most studies investigating dose attenuation caused by MPs have mainly focused on the relationship between the electron density of the MP, beam angles, and beam energy. ...
... Our data demonstrate sTK1 activity a promising biomarker of prognosis and disease monitoring in patients receiving CDK4/6 inhibitors. 20,32 for all patients with available samples at baseline, C1D15, C2D1, and C4D1, as well as every 3 cycles up to progression in those who progressed by the time of data cutoff. TK1 activity was determined using a refined ELISA-based method (DiviTum ® ) according to the manufacturer's instruction (www.biovica.com) ...