Breaking Research News from sources other than Breastcancer.org
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Paclitaxel With Inhibitor of Apoptosis Antagonist LCL161 for Localized Triple-Negative Breast Cancer
- Journal of Clinical Oncology Women with localized triple-negative breast cancer (T2/N0–2/M0) were prospectively stratified by a tumor necrosis factor-α (TNFα)–based gene expression signature (GS) and randomly assigned to receive oral LCL161 (inhibitor of apoptosis antagonist) and intravenous paclitaxel or paclitaxel alone for 12 weeks, followed by surgery. Those in the GS-positive group experienced improved pathologic complete response with combination therapy relative to paclitaxel alone (38.2% vs 17.2%). For patients in the GS-negative group, pathologic complete response was inferior with combination therapy relative to paclitaxel alone (5.6% vs 16.4%). Patients receiving combination therapy experienced higher rates of adverse events such as neutropenia (24.5%) and diarrhea (5.7%) and were more likely to discontinue treatment due to adverse events than were patients receiving paclitaxel alone (18.1% vs 4.9%).The study authors conclude that the biomarker-driven targeted therapy approach shows promise in terms of efficacy; however, elevate rates of adverse events must be taken into consideration.This neoadjuvant trial provides evidence supporting a biomarker-driven targeted therapy approach for selected patients with GS-positive TNBC and demonstrates the utility of a neoadjuvant trial for biomarker validation and drug development, but also highlights toxicity risk. Future neoadjuvant clinical trials should carefully weigh these considerations for targeted therapy development in biomarker-defined TNBC.
DOI: 10.1200/JCO.2017.74.8392 Journal of Clinical Oncology
PMID: 30235087
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Metastatic Breast Cancer: Later Lines of Therapy
- Expert Opinion / Interview · April 11, 2018
- Video Interviews with practitioners
- https://www.practiceupdate.com/content/metastatic-...
- {This is a few months old but interesting.}
- Expert Opinion / Interview · April 11, 2018
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Prognostic Value of CD3, CD8, and FOXP3 mRNA Expression in Early-Stage Breast Cancer Patients Treated With Anthracycline-Based Adjuvant Chemotherapy
- Published in: Cancer Medicine @ October 08, 2018
- https://www.practiceupdate.com/C/73757/56?elsca1=e...
- First published: 21 September 2018 https://doi.org/10.1002/cam4.1730 This study evaluated 826 tumor tissue samples for mRNA expression of CD3, CD8, and FOXP3 for potential prognostic significance in terms of disease‐free and overall survival among patients with early‐stage breast cancer treated with anthracycline‐based chemotherapy.High CD3 and CD8 mRNA expression was found to be prognostic of decreased risk of relapse and, in the future, could potentially be of importance in deciding the most appropriate therapeutic strategy in light of recent immune‐related treatment developments.
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Screening does not reduce breast cancer mortality
https://www.news-medical.net/news/20180912/Screeni...
published in the scientific journal International Journal of Cancer
"....Here he points towards one of the paradoxes of screening - the popular but erroneous belief that if breast cancer patients who have been screened 'live longer' than other breast cancer patients, then screening works. The problem is that with screening, medical doctors detect cancerous tumors earlier than they would otherwise have done, and thus move the point of diagnosis forward in time. But even if someone who has been screened lives longer as a patient, it is not certain that their life as a whole will be longer. It is important to account for this fact, and the new study shows that screening does not lead to women living longer overall - and this is the study's most important finding."
Original source: http://www.au.dk/
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Aggressive breast cancer cells hijack protective protein to aid growth
reported in the journal Oncogene
DOI https://doi.org/10.1038/s41388-018-0472-0
A study conducted at Augusta University has revealed that a protein known to protect healthy cells also protects cancer cells in aggressive breast cancer.
https://www.news-medical.net/news/20181002/Protein...
Further reporting at: https://www.eurekalert.org/pub_releases/2018-10/mc...
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Stevens researchers develop new class of molecules for breast cancer treatment
https://www.news-medical.net/news/20181004/Stevens...
Researchers at Stevens Institute of Technology and colleagues have designed and developed a new class of molecules that use a never-before-known mechanism that may halt or destroy breast cancer tumors, particularly for patients with drug-resistant or dangerously metastatic stages of the disease.
The molecule, developed by Abhishek Sharma, a chemistry professor at Stevens, could potentially add to the arsenal of drugs actively being developed to degrade or inhibit estrogen receptors, proteins inside cells that have been proven to be the single most important target in breast cancer therapy over the last 30 years.
https://www.stevens.edu/news/novel-molecule-could-...
published in the journal ACS Medicinal Chemistry Letters (Publication Date (Web): July 5, 2018)
DOI: 10.1021/acsmedchemlett.8b00106
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Mitochondrial pathway found to be involved in breast cancer
https://www.news-medical.net/news/20180912/Mitocho...
A team of researchers from Hokkaido University in Japan have discovered a molecular pathway that controls the movement of mitochondria within breast cancer cells and influences how invasive the cells are. The study suggests that blocking the pathway could reduce cancer invasiveness and the cells' ability to resist treatments.
further reporting at:
https://www.global.hokudai.ac.jp/blog/mitochondria...
Published: 11 July 2018 Nature Communications volume 9, Article number: 2682 (2018)
Full article available here:
https://www.nature.com/articles/s41467-018-05087-7
DOI https://doi.org/10.1038/s41467-018-05087-7
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Researchers simulate how different breast tissues respond to heat from MRIs
Without a way to prove that a new MRI technique is safe for all women, clinical MRIs haven't been able to keep pace with the latest advances in MRI research. More informative cancer detection is possible with stronger magnetic fields that also, unfortunately, increase the risk of tissue heating during a screening.
Purdue University researchers have simulated how over 20 different breast tissue ratios respond to heat given off by MRIs at higher field strengths than available in hospitals today.
The simulations would allow cutting-edge MRI techniques to finally show that they meet safety limits, as defined by entities like the U.S. Food and Drug Administration, and start clinical trials for real-life use.
https://www.news-medical.net/news/20180920/Researc...
Further reporting here: https://www.purdue.edu/newsroom/releases/2018/Q3/s...
Published findings are featured in the journal Magnetic Resonance in Medicine
doi:10.1002/mrm.27395
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Nanoparticles show promise in treatment for triple-negative breast cancer, finds study
A new study from the George Washington University (GW) Cancer Center found that nanoparticle-encapsulated doxorubicin is promising in the treatment of triple-negative breast cancer. Doxorubicin is a well-known anthracycline drug class used primarily in combination chemotherapy.
In order to determine the most effective delivery of doxorubicin when encapsulated in a nanoparticle platform, Friedman and his collaborators at the Albert Einstein College of Medicine, synthesized several formulations of doxorubicin containing nanoparticles to identify nanoparticle characteristics which best impact biologic activity against several resistant cancer cell lines.
"This study provides clues for new potential strategies utilizing and manipulating nanotechnology to overcome cancer cell drug resistance," said Friedman. "We have our work cut out for us, but this study shows that we are moving in the right direction."
https://www.news-medical.net/news/20181001/Nanopar...
https://smhs.gwu.edu/news/new-study-finds-nanopart...
To read the full study, visit https://precisionnanomedicine.com/article/22
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Independent Validation of the PREDICT Breast Cancer Prognosis Prediction Tool
- Published in: British Journal of Cancer Published: 17 September 2018
- https://www.practiceupdate.com/C/73704/56?elsca1=e...
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Thanks Lumpie, I love reading the research you share and really appreciate that you take the time to do it
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Lumpie: Thank you for posting. I clicked on the link and took the test. I see it doesn't take into account Perjeta treatments and/or Radiation Therapy. I wonder why? So,for me, the test is really just a very general ball park with percentages since I had Perjeta treatments and Radiation Therapy as part of the standard of care.
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Thanks, beeline!
LillyDuff,
Good questions!
1) In the FAQ it says: What about radiotherapy? For some women, radiotherapy is a potential treatment option. We plan to include it in the next version of the model. (Find FAQ's by going to the "About Predict" tab toward the top left of the screen. FAQ's is an option in that drop-down menu.)
{Unless contraindicated, radiation is pretty much an iron-clad recommendation with lumpectomy so I assumed that the model assumed the two went together. Sounds like it's not. Good catch!}
2) Predict is operated by the NHS (National Health Service) in the United Kingdom. When last I checked, NHS did not pay for Perjeta so may not be incorporating it into the scenarios. If you indicate the use of Herceptin in Predict, you should get a pretty good estimate. The improved outcome bump from Perjeta is only maybe 1-2%, I think.
RE: the NHS & Perjeta, here is an article dated 20 AUGUST 2018:
https://www.pharmaceutical-technology.com/news/nic...
It states that: "Roche provided evidence from its Aphinity trial to support its drug. However, overall survival data from the study was immature and primary analysis showed no apparent difference between pertuzumab plus trastuzumab and chemotherapy plus trastuzumab. At year three the difference in invasive disease-free survival event rates between the two treatment arms was 0.9%; this increased slightly to 1.7% at year four. ... Roche's revised base case incremental cost-effectiveness ratios (ICERs) for pertuzumab combination compared to chemotherapy is £30,561. NICE's evidence review group's (ERG) ICER was £47,856."
From what I am reading, the NHS may have differing policies re Perjeta for early stage vs advanced stage, recurrent or stage 4 BC. I gather it may be available for those more advanced stage cancers.
https://www.independent.co.uk/news/health/breast-c...
Anyone from the UK wish to enlighten us?
Purely editorial: Personally, I like the bar chart provided by the older versions. You can also see the bar chart by clicking on the "Chart" tab right under "Results" in version 2.1. To compare, find version 2.0 here: http://www.predict.nhs.uk/predict_v2.0.html
or by going to the "Home" tab at the top left of version 2.1 and click on "Home" to see a drop down which will send you to "all versions" to access the older versions 2.0 and 1.2.
{I was shocked to see ...percentage-wise...how much surgery & how little chemo and Herceptin improved outcomes for me.... but every little bit helps.}
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Lumpie:
Thank you! I'll check out those links. Knowledge is power! Keep it comin'!!!
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Lumpie
You're doing an incredible job presenting all this info! thank you so much!
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Expanded FDA Clearances Speed Scalp Cooling Acceptance in Oncology Community
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Expert Highlights Management of Locoregional Recurrence in Breast Cancer
Danielle TernyilaPublished: Friday, Oct 12, 2018
Monica Morrow, MD
The frequency of locoregional recurrence in breast cancer is decreasing over time, according to Monica Morrow, MD, due in part to improved patient selection for breast-conserving surgery. Moreover, key approaches to managing such recurrences have also been defined.
In the past, locoregional therapy was considered similar to metastatic disease, and while it still can have a poor prognosis in a small subset of patients, certain cases of locoregional recurrence can be considered curable, she explained.
"The face of locoregional recurrence has changed, because the surgery we do today is more conservative than the surgery that was done in the past," said Morrow, who is chief of Breast Service at Memorial Sloan Kettering Cancer Center. "Some people have had a fairly nihilistic attitude towards locoregional recurrence—considering it to be the equivalent of metastatic disease. And while that is true of some early locoregional recurrences, where after adequate primary therapy they are associated with a poor prognosis, it's not true in specific clinical scenarios—isolated axillary recurrence being one of them."
In an interview with OncLive during the 20th Annual Lynn Sage Breast Cancer Symposium, Morrow addressed how she approaches patients with locoregional recurrence and how treatment has evolved over recent years.OncLive: Can you discuss how often locoregional recurrence is seen in breast cancer?
Morrow: Locoregional recurrence is something that has become progressively less frequent over time and the reasons for that are 2-fold. One is that, over time, we have gotten better at selecting patients for breast conserving surgery, understanding how much tissue we need to remove, and that we need to give radiation treatment. The other more important reason is that systemic therapy, which has now become widespread for patients with early-stage breast cancer, not only reduces the risk of dying of breast cancer, but it also reduces the risk of locoregional recurrence.
What has happened with locoregional recurrence over time is that it's gone from 30% of all recurrences, to 15% of all recurrences. That is true, independent of patient menopausal status and whether they are treated with breast conserving surgery or mastectomy. That's good news for our patients, but it makes it more difficult for us to study locoregional recurrence.What are your recommended approaches for managing locoregional recurrence?
The area of management of locoregional recurrence has really changed in terms of what we do with the axilla. Previously, almost all patients were treated with a modified radical mastectomy—meaning an axillary dissection, so axillary recurrence was very infrequent. Now, when sentinel node biopsy is the way we manage node-negative, and increasingly node-positive axilla, what to do with axillary recurrence has changed a bit. If you have someone who has a negative sentinel node biopsy, the likelihood of having a first isolated axillary recurrence is only about six-tenths of a percent. If you have someone who has 1 or 2 positive sentinel nodes treated without dissection, it's about 1.1%. In those patients, it is important to exclude the presence of distant metastases before you do anything locally, then axillary dissection is the standard treatment because those patients still have potentially curable disease. This is because a significant number of them will not be true recurrences, but disease left behind from sentinel node biopsies.
The other thing we are seeing, because of the use of sentinel node biopsy, is in patients who recur locally in their breast or on the chest wall after mastectomy. The questions that come up are, "Should we restage the axilla? Can you do a repeat sentinel node biopsy, and does it make sense to do that? Does it influence therapy?" It turns out that the success of repeat sentinel node biopsy is highly correlated with the number of lymph nodes that were removed at the first operation. In about 80% of women who started out with a sentinel node biopsy, you can find a sentinel node the second time around. Although we don't have great data on its predictive value, it does appear to accurately stage the axilla.Page: 12 Next Page (2) >> View Other News on Breast Cancer
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marijen - thanks for this one. I had a "local recurrence" up by my collar bone two years after having a BMX for DCIS with SNB showing clear on both sides. Of course I don't fit any of the criteria so I was glad to read that there's really no way to get data and percentages.
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Me too MinusTwo. This is interesting to me because I had an Axilla dissection and now have lumps on the other axilla. All along I’ve been thinking it’s all draining to the other side. Although four USs have found nothing. Interesting that now only 15% of early stage recurrence are locoregional, so why only mammograms for follow-up years?
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I have to call BULLSHIT on the loco-regional reccurrence data... I had node negative first time around - limited to axilla 2nd time. Like my one rad onc admitted...we may have data that says the risk was less than 10% - it was 100% for you. Yup. 6 tenths of a percent...NO I should have been given radiation and had an ooph. Coulda shoulda woulda...it's in the past and thank God I'm still here for my kid but there is way too much emphasis on the sentinal node (my surgeon even sighed and said "here is another recurrence after negative sentinal node negative biopsy") I think all women should have axilla monitored for several years after a mastectomy or even lumpectomy via ultrasound. It's cheap and quick. Any ladies listening, do push for one. Most doctors will ok one if you ask or complain of any tightness, change or worry.
Lumpie - I do follow this page regularly. Its a GREAT resource and gives hope - and in this one case I'll say throws up a caution sign to not take loco risk too lightly. Don't mean to sound ungrateful to you - just the opposite. Thank you, thank you thank you for the effort and studies you post - the good, the bad, the ugly and the promising!
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7of9, you did not have either chemo or radiation back to 2012, because your risk was very low? do you think that is what made the difference in terms of the recurrence?
My wife is having neo-adjuvant chemo (TCHP) now and we are thinking about the upcoming surgery options. If we choose lumpectomy instead of mastectomy, we are wondering how much it impacts the recurrence rate. Nowadays, it sounds like a standard treatment for radiation after lumpectomy, am I correct?
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7of9 et al: Ditto! As I have said many times, I think the data will eventually prove that SNB has very little "specificity" (very little negative predictive value / little reliable power to predict that one will NOT develop metastases). Turns out, I was already metastatic when I had my SNB and it was negative! I have heard similar accounts from others. I am sure that part of the problem is that this leaves practitioners (not to mention the rest of us) scratching their heads wondering "so what tests do we rely on?" I truly hope that liquid biopsies will fill this role - and do so more reliably, cost effectively, and with fewer morbidities.
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Lily - yes it is my understanding that radiation after surgery is the standard of care for lumpectomy. I've seen some of your posts in the past, but can't remember details of your wife's diagnosis. If you are comfortable with it, you might go to My Profile and make her diagnosis 'public' so we can refresh our knowledge as you continue through the process. It is my personal opinion that age is relevant in making any decisions.
I did not have chemo or radiation with my original surgery because in addition to negative SNBs, they got clean margins on both breasts. And after all, it was "only" DCIS in the beginning - so even though I did have an MO at the time, further treatment wasn't really indicated based on all the path reports. Everyone was shocked by the recurrence.
7/9 - I agree about ULS. I had several CT scans and at least one MRI and one PET/CT in the two years after my initial surgery, but I remained clear - until I wasn't.
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MinusTwo, I just did,thx.
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I was too afraid to do a lymph node biopsy before Neo Adjunct chemo (I refused - dumb dumb dumb) 2 tumors at 40 - never a smoker or drugs, healthy weight - I thought it was "too much" to absorb. My butt still hurts from kicking myself. No rads first time around since clear margins and clear (2) sentinal nodes. After I thought about it a few days I begged them to let me do rads but they said no - and the plastics guy was so happy for me to start expansion.
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October 03, 2018
FDA Fast-Tracks Non-Opioid Treatment for Neuropathic Pain
AV-101 is an orally bioavailable, small molecule N-methyl-D-aspartate (NMDA) receptor glycine B antagonistThe Food and Drug Administration (FDA) has granted Fast Track designation to AV-101 (VistaGen Therapeutics), an investigational non-opioid treatment for neuropathic pain.
AV-101 is an orally bioavailable, small molecule N-methyl-D-aspartate (NMDA) receptor glycine B antagonist. According to the Company, AV-101 has the potential to achieve ketamine-like antidepressant effects, but without the side effects and safety concerns. The treatment is currently being evaluated in a Phase 2 study (ELEVATE) in patients with major depressive disorder who have had an inadequate response to standard antidepressant therapy (ie, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors).
"We have evaluated AV-101 in multiple models of serious CNS conditions, including those that cause patients to suffer from neuropathic pain, for which current treatment options are inadequate," said Shawn Singh, Chief Executive Officer of VistaGen. "After considering peer-reviewed data published last year in The Journal of Pain, together with published safety data from our Phase 1 program, we believe AV-101 has the potential to address the high unmet need for a new non-opioid, non-sedating treatment for neuropathic pain."
For more information visit Vistagen.com..
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Hello Ladies - not sure if you all have seen this recent article in TIME magazine about immunotherapy and BC..it says that in about 5 yrs, all BC patients will be likely treated with immunotherapy..some hope for us..
Here is the link...
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Great article on immunotherapy. I have a friend who has been NED for the last 4 years from stage 4 lung cancer - she''s on checkpoint inhibitors. MY TNBC did evoke an immune response... I found the lump because I had a fever and a pink spot on my breast (presented like mastitis).
Another way to get cancer cells to reveal themselves to the immune system is heat - hyperthermia. Cancer cells can't tolerate heat (apx 106-109 degrees for one hour will kill or badly stress them) and healthy cells can shake that off. The heat makes the cells give off heat shock protein and makes them recognizable to the immune system.
As my tumor was right near the surface of my breast and easy to feel, I have done a lot of heat on it. I read that veterinarians use a simple recirculating hot water bottle system to shrink tumors.... so decided I'd do that too. Cleveland Clinic is one place using hyperthermia.
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Study ties organic food consumption to lower cancer risk
Individuals who ate the most organic food had a 25% lower overall cancer risk, with 73% reduced odds of developing non-Hodgkin lymphoma and 21% reduced odds of developing postmenopausal breast cancer, compared with those who ate the least organic foods, researchers reported in JAMA Internal Medicine. The findings, based on data involving 68,946 French adults, showed reduced cancer risk even among those who had low- to medium-quality diets accompanied by organic food consumption.
https://jamanetwork.com/journals/jamainternalmedic...
JAMA Intern Med. Published online October 22, 2018. doi:10.1001/jamainternmed.2018.4357
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Study: Team sports are good for mental health
An analysis of CDC data from 1.2 million US adults found people who exercise reported fewer days of poor mental health than those who did not, and those who participated in team sports reported the fewest days of poor mental health. The findings, published in The Lancet Psychiatry, underscore that "very simple forms of social support can be beneficial," said Jack Raglin, a professor at the School of Public Health at Indiana University, who was not involved with the study.
https://www.npr.org/sections/health-shots/2018/10/...
Published:August 08, 2018 DOI:https://doi.org/10.1016/S2215-0366(18)30227-X
{While not directly related to cancer, I thought that this was an interesting and important reminder about the importance of community for mental health.}
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