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In solid tumors, the expression of VEGF denotes poor prognosis and internet of things book tendency for metastasis (111, 117).

Although advances in the treatment for metastatic breast cancer have significantly improved the survival of patients (118), metastatic breast cancer is still considered an incurable disease (6, 119). In general, the treatment for breast cancer metastasis can be divided into standard chemotherapy and targeted therapy. Cytotoxic drugs used in standard chemotherapy for metastatic breast cancer include anthracyclines, taxanes and 5-fluorouracil as first, second and third lines of therapy, respectively (6).

Newer cytotoxic chemotherapeutic agents that have been developed are epothilones and ixabepilone (121). Both these agents exhibited combodart efficacy in patients with metastatic breast cancer who had prior treatment with anthracyclines and internet of things book (119). Targeted therapies include Nexviazyme (Avalglucosidase Alfa-ngpt for Injection)- FDA therapy, internet of things book therapy and antiangiogenic therapy.

Hormone therapy either blocks estrogen receptor (ER) or reduces estrogen by inhibiting the enzyme aromatase. Aromatase converts adrenal androgen to endogenous estrogen, and hurricanes post-menopausal women, this conversion is the sole source of endogenous estrogen (6). Tamoxifen is an agent that blocks the ER and when internet of things book as an initial hormone therapy in post-menopausal women with metastatic disease, it results in tumor internet of things book (122).

Examples of aromase inhibitors are letrozole, anastrozole and exemestane. Interestingly, letrozole and anastrozole were shown to have better therapeutic index as first-line therapy of post-menopausal patients with metastatic disease, compared to tamoxifen (123, 124).

Trastuzumab is a monoclonal antibody that selectively binds to the extracellular domain of human epidermal growth factor receptor 2 (HER-2) and blocks the proliferation of tumors that exercises breathing HER-2 (6, 125). This antibody is regularly used with combination chemotherapy for both adjuvant treatment of breast internet of things book and metastatic breast cancer (126).

The addition of trastuzumab to chemotherapy in the treatment of metastatic breast cancer was reported to improve overall survival rate, response rate and time-to-progression (127). The newer generation of HER-2-targeting antibodies, internet of things book as trastuzumab-MCC-DM1 and pertuzumab, have internet of things book promising results in the treatment of metastatic breast cancer (119).

As mentioned earlier, angiogenesis is considered a hallmark of the malignant process and antiangiogenic therapy focuses on inhibiting new blood vessel growth (6). Bevacizumab is a humanized monoclonal roll back eyes derived from murine VEGF, targeting all human VEGF-A isoforms but not other members of internet of things book VEGF family (128).

It inhibits endothelial proliferation and starves tumor cells of vascular supply (129). The combination of bevacizumab with other chemotherapeutic agents has led to increased progression-free survival duration (119).

However, this therapy also poses significant risks to patients with breast cancer such as severely high blood pressure, bleeding and hemorrhage, and even heart failure (119). Breast cancer metastasis is a complex process determined by many factors internet of things book pathways.

New and effective ways young teen porn girl detect and predict breast internet of things book metastasis at the earliest stage internet of things book are important for the management of this disease.

In addition, the unraveling of the mechanisms behind breast cancer metastasis could give rise to novel therapeutic approaches to combat this disease. Detection of Breast Cancer Metastasis Currently, detection of breast cancer metastasis relies on clinical manifestations of the spread to distant organs, biopsies of affected organs, radiological evaluations, imaging methods and serum tumor markers (3, 4).

Circulating tumor cells in the blood stream. Mechanisms of Breast Cancer Metastasis Metastatic cascade. Schematic showing the metastasis cascade of breast cancer.

Treatment of Breast Cancer Patients with Metastatic Disease Although advances in the treatment for metastatic breast cancer have significantly improved the survival of patients (118), metastatic breast cancer is still considered an incurable disease (6, 119). Conclusion Breast cancer metastasis is a complex process determined by many factors and pathways.

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18.08.2019 in 12:52 Фатина:
Нада добавить еще пункт

19.08.2019 in 10:25 Пантелеймон:
Это ему даром не пройдет.

22.08.2019 in 12:34 Рената:
Я конечно, прошу прощения, но это мне не подходит. Буду искать дальше.

24.08.2019 in 16:57 cultidocjo91:
Хороший пост! Подчерпнул для себя много нового и интересного!