2011 San Antonio Breast Cancer Symposium....

voraciousreader

It starts next week! Anyone excited? I can't wait to hear the latest developments in clinical research. Does anyone recall the uproar last year with the results of the AZURE trial? This week there has been an uptick in news reports about what we can expect. I am ready to roll up my sleeves and try to make sense of the data and what it means to me! Sisters... Clear your calendars and join me in understanding!

barbe1958

I'm curous.....

FireKracker

so am I...

coraleliz

I'm ready.......

geewhiz

Hoping to hear something about this dang neratinib trial I am slogging through...

bellydancer

Do you know if there will be any information on the TailorRx Study?

Thats the one I am looking forward to hearing about!

1Athena1

VR - Just thinking about that AZURE trial makes me groan. I was so depressed when I heard it. At this point, I have developed the emotional depth of an amoeba when approaching such conferences. Cancer research is like an unfaithful lover - full of promises but big on disappointments, while somnehow managing to muster the sort of charisma that keeps ones hopes up.

If they come out saying that eating wood cures BC acording to a placebo controlled study I will be neither surprised nor tempted to gnaw at my coffee table. Only half joking there. The other half says, skeptically "wake me up when you can rely on science and not statistics."

But it will certainy be interesting....

Sherryc

I was just looking at the website today to see what they are covering.  Will be interesting to hear what comes out of it.

voraciousreader

Bellydancer...I was hoping there would be something about TailorRX too...but I didn't notice anything... Who knows....

1Athena1...Looks like Gnant will have some more info on his study...Then we'll see what Coleman has to say....to be continued.......  And my stomach STILL churns too!

REKoz

Hey there fellow Lawgulander!

#1) I already know you're doing well as per my lurking. HAPPY HAPPY!! 

#2) I look forward to your "studies" of the conference.  So much of that stuff is wayyyy above my tiny brain.

voraciousreader

Okay... First controversial news is that twice as many women who do brachytherapy will go on to have mastectomies due to recurrence compared to women who have whole breast radiation.



Gnant will update in the morning his Austrian study on premenstual women receiving Zometa. The title of his lecture mentions the word "significant" reduction in recurrance.

voraciousreader

The Johns Hopkins folks who DON'T do brachytherapy have put out their own press release saying pretty much... We told ya!





The formal presentations haven't begun and already the disagreements are flying! Stay tuned!

Sherryc

Voraciousreader thanks for the update

Beesie

Other news from today is that the Oncotype test will be available for the first time to women with DCIS, to help with the decision as to whether or not radiation is required after a lumpectomy. 

http://ca.finance.yahoo.com/news/genomic-health-announces-positive-study-233000822.html 

voraciousreader

 Here's the most interesting news (IMHO) so far --- Keep in mind...this is VERY preliminary...but, nonetheless, exciting!

Researchers discover patterns of genes associated with timing of breast cancer recurrences

Knowing biology of early or late recurring tumors could help extend survival by identifying interventions to delay or prevent recurrences after tamoxifen

SAN ANTONIO -- An international research team led by Georgetown Lombardi Comprehensive Cancer Center has found biological differences in hormone-receptor positive breast cancer that are linked to the timing of recurrence despite endocrine therapy.

They say their findings, presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, may help oncologists find ways to individualize systemic therapy to delay or prevent recurrences, and to avoid excessive treatment of patients who will never recur. 

"We found that, at the time of diagnosis, there are clear biological differences within the supposedly uniform group of hormone receptor positive breast cancers, and these differences distinguish subtypes relative to the time at which they recur," says Minetta Liu, M.D., director of translational breast cancer research at Georgetown Lombardi Comprehensive Cancer Center.

"We need to exploit these differences and use our data to figure out what drives a tumor to never metastasize. Then we will try to manipulate the cancers that are programmed to recur to act like that of the non-recurrences," she says.

Tamoxifen is credited with saving the lives of thousands of women with estrogen receptor-positive (ER+) breast cancer, which accounts for two-thirds of all diagnoses of invasive breast cancer in the United States. As the world's leading breast cancer treatment and prevention drug, tamoxifen can stave off cancer recurrences for more than 10 years in some patients, but for others, the cancer returns much earlier.

To determine why some ER+ cancers treated with tamoxifen recur earlier rather than later, if at all, Liu and her Georgetown team collaborated with researchers at the University of Edinburgh and with engineers at Virginia Tech.

The Scottish collaborators shared  high quality tumor biopsies collected from patients with different stages of breast cancer before they had started tamoxifen therapy. Critical clinical information was available to determine whether or not patients developed metastatic disease, and when the recurrence (if any) was found. The samples were processed and analyzed at Georgetown. Then scientists at Virginia Tech examined the gene expression patterns generated from the tumor biopsies relative to the known clinical outcomes to develop a predictive model of early, late or no disease recurrence.

The final analysis revealed distinct patterns in cancers that recurred early (up to three years from diagnosis) or late (more than ten years from diagnosis). Liu says that some of the genes that were identified were "expected and reassuring," but others were "unexpected and novel." Work is ongoing to validate selected genes as biological drivers of metastasis.

"Endocrine therapy and chemotherapy are not without toxicity," Liu says. "The ability to predict which patients will recur early in their treatment course can lead to more appropriate recommendations for adjuvant chemotherapy. It might also identify those women who would benefit most from studies using investigational agents to enhance the effects of tamoxifen or aromatase inhibitors."

voraciousreader

Beesie -- Thanks for posting the DCIS!  I saw that too and somehow knew YOU would post it!  Didn't want to steal your thunder!

voraciousreader

Houston study questions partial breast radiationTODD ACKERMA, HOUSTON CHRONICLECopyright 2011 HOUSTON CHRONICLE. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. By TODD ACKERMAN, HOUSTON CHRONICLE

                Published 09:20 p.m., Tuesday, December 6, 2011           



Houston and Texas





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Page 1 of 1A more targeted form of radiation increasingly popular with women with early-stage breast cancer increases the risk of recurrence, according to a Houston study.The University of Texas  M.D. Anderson Cancer Center study found the treatment known as partial breast treatment, or brachytherapy, is associated not just with increased complications and side effects, but also almost double the rate of follow-up mastectomy than traditional whole breast radiation."This study reflects that there are some complex trade-offs in deciding between the two therapies," said Dr. Benjamin Smith, a professor of radiation oncology and the study's principal investigator. "To my surprise, there was a small but statistically significant difference in effectiveness."Smith, who will present the study at a national breast cancer conference in San Antonio on Wednesday, said the study shows the downside of rapidly adopting relatively unproven cancer treatment. Early, small studies of brachytherapy showed low recurrence rates, but no trials have compared its outcomes with whole breast radiation.Growing popularityThe use of breast brachytherapy has increased from less than 1 percent of Medicare breast cancer cases in 2000 to 13 percent in 2007, the period covered in the study. Smith guessed that the trend has continued to grow.The therapy's popularity is due to its convenience. In typical cases of early-stage breast cancer, treatment involves surgery to remove the tumor, then radiation to the entire breast five days a week for up to seven weeks - no small matter for women who work or don't live near a hospital or have other medical issues.Brachytherapy, by contrast, only lasts a week. Doctors implant a thin tube that delivers radiation to the tumor site in the cavity left after the cancer's surgical removal. The total radiation dose is the same, but a smaller area is treated.To compare the two therapies, Smith's team looked at Medicare records of 130,535 women over 66 who had breast-conserving surgery and radiation. They were followed for five years after treatment.The team found 4 percent of those receiving brachytherapy had undergone a mastectomy within five years, compared with 2.2 percent of those treated with whole breast radiation. They also found that infections, broken ribs, breast pain and hospitalization were more common after brachytherapy.They did not find survival rates were any lower."More definitive results still await the results of ongoing randomized trials, but this data definitely needs to be incorporated into discussions between patients and doctors," said Dr. Shawna Willey, chief of breast surgery at Georgetown University Hospital. "This is a bit of a surprise, given previous data."But Willey noted that the study did not determine why the women went on to have a mastectomy. She acknowledged that the logical explanation is cancer recurrence, but other reasons could include the discovery of a new tumor in a different part of the breast and preventative surgery because of genetic testing or the higher-definition MRIs picking up sometimes false-positive spots.Those possibilities were emphasized by Jill Anderson, chief executive officer of Cianna Medical, which makes one of three devices currently approved for brachytherapy. She downplayed the findings, arguing that the therapy's "five-day approach has been validated by the American Society for Therapeutic Radiation and Oncology" and that the technology has improved in the years after the study period.Costs up to $25,000Anderson said Cianna's device, which was approved by the Food and Drug Administration in 2006, has been implanted in about 10,000 women. The website for MammoSite says more than 50,000 women have been treated with its device, approved in 2002.About 225,000 cases of breast cancer are diagnosed each year.Results of ongoing randomized trials comparing brachytherapy and whole breast radiation are not expected until 2018. M.D. Anderson and Baylor College of Medicine only offer brachytherapy through such trials.Brachytherapy, widely available in nonacademic hospitals, costs from $20,000 to $25,000, about twice as much as standard radiation.todd.ackerman@chron.com

cp418

Conventional Radiation May Be Better Than Brachytherapy For Early Breast Cancer.

The New York Times (12/7, Pollack, Subscription Publication) reports, "A faster form of radiation therapy that is becoming increasingly popular for women with early-stage breast cancer may not be as effective and safe as conventional radiation treatment, according to a study" scheduled to be presented at the San Antonio Breast Cancer Symposium. Investigators, who "looked at Medicare records of more than 130,000 women, found that those who underwent the faster treatment, called brachytherapy, were about twice as likely to have a mastectomy in the following five years -- a probable sign that the cancer had come back -- as those who received conventional whole breast radiation."

        The AP (12/7) reports, "Hospitalization, infections, broken ribs and breast pain also were more common with brachytherapy." Also covering the story are MedPage Today (12/7, Bankhead), the Houston Chronicle (12/7, Ackerman), and Bloomberg News (12/7, Cortez).

Husband11

I hope you don't mind me reposting some of these SABC releases as separate topics.  I think it will make searching it out later easier, and organize the comments for each discrete topic.

voraciousreader

Timothy... The more the merrier!

Racy

Thanks for posting these very positive developments!

Moderators

Read what BCO has to say about the latest news:

SABCS: Gene Test Predicts DCIS Recurrence Risk
December 7, 2011
The OncotypeDx test can help doctors decide if women diagnosed with DCIS need radiation therapy. Read more...

Omaz

Treatment surprise: Bone drug boosts survival in younger breast cancer patients.

Omaz

And this one, just reported -  

NanoString Nails Breast Cancer Study, Challenging Genomic Health

The company reported today that its instrument, called nCounter, was able to predict whether or not women with early-stage breast cancer were likely to have a recurrence in the future, by looking at an array of 50 genes known as the PAM50 signature.

Sherryc

Wow on the nanostring.  I was one of those intermediate ladies and would certainly have like a more definitive answer on chemo.

painterly

Very interesting reading. Does that mean lowering ones risk by diet and exercise is thrown out the window?

For example, does that mean those women who are not likely to recur based on the nanostring, do not need to worry about diet and exercise for prevention? 

Omaz

painterly - Check these out from the conference - (edited - I took out the life choices link since it wasn't from the conference)

Eating white bread and pasta could increase risk of breast cancer returning in patients: Starch-rich diet linked to new tumours developing. 

cp418

The Life choices article failed to mention the pesticides and hormones in our "food".  Easier to put the blame back on the patients.  Why make multi-million (billion?) dollar companies who manufacture chemical fertizers and pesticides take any responsibilty?  I guess they forget why DDT was banned back in the early-60's many thanks to Rachel Carson who wrote Silent Spring.  BTW - she died of Breast Cancer after fighting for this cause.

http://www.enotes.com/silent-spring

Omaz

cp418 - I read a biography of her and remember reading that.  She was very forward thinking.  In my opinion all these reports should be taken cautiously.  I'm going to take that link out since it isn't from the conference.  Sorry. 

3monstmama

hmmmm how interesting. I had a call into my oncologist and it turns out--this is where she is. I'll be interested in hearing what she learns.

cp418

Absolutely no harm in posting it.  I simply was pointing out that we need to keep an open view pont for how we read articles as to how they may be slanted.  That includes many of the research articles I post here too!  Please do not feel you need to remove it based on my comments.  Just my 2 cents...