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Systemic Treatment for Breast Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (12 May 2026) | Viewed by 823

Special Issue Editor


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Guest Editor
Section of Medical Oncology, Department of Biomedical Sciences and Clinical Oncology (DIMO), University of Bari ‘Aldo Moro’, 70121 Bari, Italy
Interests: clinical research; immunology; melanoma; translational research; breast cancer care

Special Issue Information

Dear Colleagues,

Breast cancer is a heterogeneous disease encompassing distinct biological subtypes with unique molecular drivers and clinical behaviors. The last decade has witnessed remarkable progress in the systemic management of breast cancer, with the introduction of targeted agents, immunotherapy, and antibody–drug conjugates, leading to improved survival outcomes across disease stages. However, several unmet needs remain, including optimization of treatment sequencing, management of primary and acquired resistance, and development of predictive biomarkers to enable individualized therapeutic strategies.

This Special Issue will focus on the latest advances in systemic therapy for breast cancer, spanning the spectrum from early-stage to metastatic disease. We encourage the submission of original research articles, clinical trials, translational studies, and comprehensive reviews. Topics of interest include, but are not limited to, the following:

  • Endocrine therapy and CDK4/6 inhibitor optimization in HR+/HER2− disease;
  • Novel strategies for HER2-positive, HER2-low, and triple-negative breast cancer;
  • Real-world evidence on antibody–drug conjugates, PARP inhibitors, and immune checkpoint inhibitors;
  • Biomarker-driven patient selection, early response assessment, and treatment de-escalation/escalation strategies;
  • Mechanisms of treatment resistance and strategies to overcome them;
  • Toxicity management, survivorship, and quality-of-life outcomes;
  • Multidisciplinary and health-economics approaches to systemic treatment.

By gathering high-quality contributions, this Special Issue aims to provide clinicians and researchers with state-of-the-art knowledge to guide personalized treatment decisions and ultimately improve patient outcomes.

Dr. Luigia Stefania Stucci
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast cancer
  • biomarker
  • treatment
  • management

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Published Papers (1 paper)

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Research

17 pages, 443 KB  
Article
Impact of Time of Administration, Fasting, and a Low-Carbohydrate Diet on Alpelisib-Associated Hyperglycemia and Efficacy: A Pilot Randomized Controlled Phase IIb Trial
by Eduard Vrdoljak, Marija Pancirov, Josipa Flam, Dora Čerina Pavlinović, Matea Jakas Vučić, Marica Barać, Natalija Dedić Plavetić, Paula Podolski, Mladen Krnić and Žarko Bajić
Cancers 2026, 18(7), 1156; https://doi.org/10.3390/cancers18071156 - 3 Apr 2026
Viewed by 533
Abstract
Background: Alpelisib plus fulvestrant improves outcomes in PIK3CA-mutated, hormone receptor-positive, HER2-negative metastatic breast cancer. However, on-target hyperglycemia often leads to dose modification or discontinuation. We aimed primarily to determine whether evening alpelisib after a ≥5 h fast with low-carbohydrate guidance reduces [...] Read more.
Background: Alpelisib plus fulvestrant improves outcomes in PIK3CA-mutated, hormone receptor-positive, HER2-negative metastatic breast cancer. However, on-target hyperglycemia often leads to dose modification or discontinuation. We aimed primarily to determine whether evening alpelisib after a ≥5 h fast with low-carbohydrate guidance reduces severe hyperglycemia versus standard morning dosing, and secondarily, to assess time to first grade 3–4 hyperglycemia, efficacy, and quality of life (QoL). Methods: ITACA was an open-label, randomized, phase IIb trial in three Croatian centers. Patients progressing on endocrine therapy were randomized 1:1 to evening alpelisib 300 mg after a ≥5 h fast with low-carbohydrate guidance or standard morning alpelisib, both with fulvestrant. The primary endpoint was the exposure-adjusted incidence rate (EAIR) of first grade 3–4 hyperglycemia within 90 days or 30 days post-discontinuation. Secondary endpoints were time to first grade 3–4 hyperglycemia, efficacy, and QoL. Results: Forty-two patients were randomized (21 per arm). Median age was 60 vs. 63 years in the evening vs. morning arms. In the safety set, EAIR of first grade 3–4 hyperglycemia was 378 vs. 742 per 100 person-years (11/21 vs. 14/20 patients with ≥1 event, unadjusted IRR 0.51, 95% CI 0.23–1.12). Adjusted Poisson models favored evening dosing. Analyses suggested delayed onset (median 73 vs. 9.5 days), with no detriment in efficacy or QoL. Conclusions: Evening alpelisib preceded by fasting and low-carbohydrate guidance may improve metabolic tolerability without compromising efficacy or QoL. These findings support evaluation in a larger trial incorporating prospective metabolic adherence and pharmacokinetic assessments. Full article
(This article belongs to the Special Issue Systemic Treatment for Breast Cancer)
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