Breaking Research News from sources other than Breastcancer.org
Comments
-
Novel Anti-HER2 Agents Look to Change Practice at SABCS
2019 program to also feature new data on immunotherapy
"It's one of the best meetings," "And it's the most important breast cancer meeting in the world."
Re DESTINY: "I think this is one of the most exciting anti-HER2 drugs out there."
Article includes discussion of several other trials... one on Kadcyla for early stage HER2+ disease.
-
FDA Approves Generic Everolimus Tablets
The FDA has approved 2 abbreviated new drug applications for everolimus (Afinitor) tablets for the treatment of patients with advanced hormone receptor–positive, HER2-negative breast cancer in postmenopausal women; advanced renal cell carcinoma; progressive neuroendocrine tumors (NETs) of pancreatic origin; progressive, well-differentiated, non-functional unresectable NETs of gastrointestinal or lung origin; and renal angiomyolipoma and tuberous sclerosis complex.
-
Giving common antibiotic before radiation may help body fight cancer
The antibiotic vancomycin alters the gut microbiome in a way that can help prime the immune system to more effectively attack tumor cells after radiation therapy. A new study in mice from researchers at the Abramson Cancer Center of the University of Pennsylvania found giving a dose of the common antibiotic not only helped immune cells kill tumors that were directly treated with radiation, but also kill cancer cells that were further away in the body, paving the way for researchers to test the approach in a human clinical trial. The Journal of Clinical Investigation published the findings today.
https://www.eurekalert.org/pub_releases/2019-12/uops-gca120719.php
-
Baicalein induces apoptosis and autophagy of breast cancer cells via inhibiting PI3K/AKT pathway in vivo and vitro
Baicalein, a widely used Chinese herbal medicine, has shown anticancer effects on many types of human cancer cell lines. However, little is known about the underlying mechanism in human breast cancer cells. In this study, we examined the apoptotic and autophagic pathways activated following baicalein treatment in human breast cancer cells in vitro and in vivo.
-
Effects of hormone receptor status on the durable response of trastuzumab-based therapy in metastatic breast cancer
This study investigated the clinical factors that influence patient response to trastuzumab (Herceptin) therapy in human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer (MBC). Hormone receptor (HR) status was found to be a possible predictor of a strong response to trastuzumab-based therapy.
Only 10% of HER2+ MBC patients experience a lasting response of more than 3 years. The role of HR status in HER2+ treatment response is not well known.
This study included 153 women with HER2+ MBC who were treated with trastuzumab and either paclitaxel (Taxol) or docetaxel (Taxotere) as their primary treatment. The patient's HR status and metastases were reviewed. Average follow-up time was 28 months with an average age of 52 years. Progression-free survival (PFS; time from treatment until disease progression) and overall survival (OS; time from treatment until death from any cause) were measured.
HR- patients showed a longer average PFS (19 months), compared to HR+ patients (9 months). The OS of HR- patients was 37 months. HR+ patients had an OS of 47 months.
Bone metastases were also associated with a longer PFS (15 months) and OS (75 months) than metastases to internal organs which showed a PFS of 11 months and OS of 34 months.
The study concluded that HR status is a possible predictor of outcome in patients with HER2+ MBC who receive trastuzumab-based therapy. Sites of metastases were found to independently influence treatment response.https://medivizor.com/view_article/37085117?id=21147
https://link.springer.com/article/10.1007%2Fs10549-017-4175-y
https://doi.org/10.1007/s10549-017-4175-y
-
How Close Are We to a Blood Test for Breast Cancer?
- Researchers are looking at whether we can detect breast cancer via blood test.
- We're still years away from the test being available to the public.
- Early stage cancers shed very small amounts of most biomarkers into blood.
Cancer cells make antigens that cause the body to make antibodies known as autoantibodies. The test looks for the presence of autoantibodies against tumor-associated antigens (TAAs).
The team was able to make a panel that looked for autoantibodies against 40 antigens that are known to be associated with breast cancer.
Another blood test for breast cancer in testing claims to be able to detect 15 different biomarkers (microRNA and methylation markers) in the blood, spotting metastatic and recurring cancers at an early stage, as well as small tumors.
If funded and evaluated completely, the test could be available in about 4 to 5 years, the researchers said.
Early stage cancers shed very small amounts of most biomarkers into blood, making the pursuit for early detection tests fraught with challenges
"There are multiple subtypes of breast cancer, and to detect these cancers through a blood test may not be a one-size-fits-all approach," Berger said.
Different antigens may be needed to detect hormone receptor-positive breast cancer compared to HER2-positive breast cancer or triple-negative breast cancer...
Tests have to be accurate. They also need to show that they improve outcomes as well...
"We will get there,"
Article states research was presented at
https://conference.ncri.org.uk/
but no specific citation was provided.
{Article is aimed at a non-academic, non-medical audience.}
-
New Standard for Metastatic HER2 Breast Cancer
Consistent PFS, OS benefit with combination including oral HER2 inhibitor tucatinib
Patients with heavily treated metastatic HER2-positive breast cancer lived significantly longer with the addition of an investigational anti-HER2 drug to trastuzumab (Herceptin) and chemotherapy, a large randomized trial showed.
Almost three times as many patients were alive without disease progression after 1 year when treated with tucatinib, trastuzumab, and capecitabine, as compared with the two drugs (33.1% vs 12.3%). The 2-year overall survival (OS) was 44.9% with tucatinib and 26.6% without it. Among patients with brain metastases, a fourth remained alive without disease progression at 1 year versus none of the patients randomized to placebo in addition to trastuzumab and capecitabine.
"Tucatinib in combination with trastuzumab and capecitabine has the potential to become a new standard of care in this population with and without brain metastases."
"Overall, tucatinib reduced risk of progression or death by 50%," Tierstein added. "I think this regimen may be considered a new standard of care for pretreated HER2-positive metastatic breast cancer. Very exciting."
San Antonio Breast Cancer Symposium
Source Reference: Murthy RK, et al "Tucatinib vs placebo, both combined with capecitabine and trastuzumab, for patients with pretreated HER2-positive metastatic breast cancer with and without brain metastases (HER2CLIMB)" SABCS 2019; Abstract GS1-01.New England Journal of Medicine
Source Reference: Murthy RK, et al "Tucatinib, trastuzumab, and capecitabine for HER2-positive metastatic breast cancer" N Engl J Med 2019; DOI: 10.1056/NEJMoa1914609.
-
Lumpie, said it before and do so again....you are a STAR! You’ve hopefully an idea now how much it helps the rest of us knowing there are people like you out there dedicated to sharing their knowledge.
-
Thank you Karenfizedbo15!! You made my day!
-
Chemo-Free Regimen Feasible in High-Risk Luminal Breast Cancer
Downstaging just as frequent with endocrine therapy plus CDK4/6 inhibitor
-
Chemo-Free Regimen Feasible in High-Risk Luminal Breast Cancer
Downstaging just as frequent with endocrine therapy plus CDK4/6 inhibitor
A neoadjuvant chemo-free combination achieved similar responses to a standard chemotherapeutic regimen for postmenopausal women with high-risk luminal B breast cancer, a small randomized trial out of Spain indicated.
In the CORALLEEN trial, 46.9% of patients treated with the aromatase inhibitor letrozole (Femara) plus CDK4/6 inhibitor ribociclib (Kisqali) achieved a low risk of relapse (ROR) following surgery, as compared with 46.1% in the chemotherapy group...
"Neoadjuvant ribociclib and letrozole in high-risk luminal B breast cancer achieves high rates of ROR-low disease at surgery," said Gavilá during an oral abstract session here.
While Gavilá explained that chemotherapy does this just as well, and is the current standard treatment, it comes at the price of higher rates of toxicity.
a chemo-free treatment strategy based on CDK4/6 inhibition is worth exploring in future neoadjuvant trials,"
The Lancet Oncology
Source Reference: Prat A, et al "Ribociclib plus letrozole versus chemotherapy for postmenopausal women with hormone receptor-positive, HER2-negative, luminal B breast cancer (CORALLEEN): An open-label, multicentre, randomised, phase 2 trial" Lancet Oncol 2019; DOI: 10.1016/S1470-2045(19)30786-7.Secondary SourceThe Lancet Oncology
Source Reference: Cristofanilli M, et al "Time for a shift in molecular down staging in luminal breast cancer" Lancet Oncol 2019; DOI: 10.1016/S1470-2045(19)30806-X.
-
Residual Cancer Burden Predicts Patient Outcomes Across Breast Cancer Subtypes
Residual cancer burden (RCB) after neoadjuvant chemotherapy has been shown to be an accurate long-term predictor of disease recurrence and survival across all breast cancer subtypes, according to data from a large meta-analysis presented at the 2019 San Antonio Breast Cancer Symposium.
-
T-DM1 for Early Stage Breast Cancer
Promising efficacy but higher discontinuation rates and cost likely a deterrent
Adjuvant treatment with ado-trastuzumab emtansine (Kadcyla), or T-DM1, demonstrated acceptable efficacy as a standalone treatment for women with stage I HER2-positive breast cancer, but failed to reduce clinically relevant toxicities, a randomized phase II trial found.
The so-called ATEMPT study met its primary efficacy endpoint, with 97.7% of patients treated with T-DM1 remaining disease free at 3 years (95% CI 96.2%-99.3%), Sara Tolaney, MD, MPH, of the Dana-Farber Cancer Institute in Boston, reported here at the San Antonio Breast Cancer Symposium (SABCS).
...the rate of clinically relevant toxicities -- the study's other primary endpoint -- was no better than standard paclitaxel plus trastuzumab (TH), landing at 46% for both arms.
grade ≥3 non-hematologic events were similar between the T-DM1 and TH arms (10% vs 11%, respectively), as were rates of febrile neutropenia (0% vs 2%) and grade ≥4 hematologic events (1% vs 0%).
"It's also important to note that not all toxicities that are significant for our patients are captured in this clinically relevant toxicity endpoint, such as alopecia,"
"Given the low event rate seen in this trial, T-DM1 may be considered an alternative treatment approach to TH for select patients with stage I HER2-positive disease..." {but} "For stage I disease, paclitaxel and trastuzumab remains the standard of care."
Primary Source
San Antonio Breast Cancer Symposium
{Gratuitous editorial commentary: toxicities were similar (curious given that I think neutropenia is much more common on taxanes); not having (sometimes permanent) alopecia is a BIG deal!; the article discusses at some length the cost of Tx with Kadcyla. The bills I have seen would indicate that Kadcyla is less expensive than T&H, certainly less than TCHP. I would be interested to hear from others about billed costs of these drugs.}
-
HRT Has 20-Year Impact on Breast Cancer Risks
Prospective data confirm long-term benefit with estrogen-only and harm with added progestin
Menopausal hormone replacement therapy (HRT) with estrogen alone yielded lasting reductions in breast cancer incidence and death while estrogen plus progestin showed persistent increases in both, long-term data from two Women's Health Initiative (WHI) trials indicated.
At over 16 years of cumulative follow-up, women with prior hysterectomy randomized to estrogen-only HRT had a 23% reduction in breast cancer diagnosis compared to those assigned placebo (HR 0.77, 95% CI 0.62-0.92), driven in large part by fewer diagnoses of estrogen receptor-positive/progesterone receptor-negative disease,
Primary Source
San Antonio Breast Cancer Symposium
-
Subdivision of M1 Stage for De Novo Metastatic Breast Cancer to Better Predict Prognosis and Response to Primary Tumor Surgery
Patients with de novo metastatic breast cancer (MBC) constitute a heterogeneous group with different clinicopathologic characteristics and survival outcomes. Despite controversy regarding its prognostic value, primary tumor surgery may improve survival for selected patients.
Subdivision of M1 stage facilitates prognosis prediction and treatment planning for patients with de novo MBC. Treatment offered should be decided in a coordinated multidisciplinary setting. Primary tumor surgery may play an important role in the management of selected patients.
DOI: https://doi.org/10.6004/jnccn.2019.7332 -
Checkpoints Show Different Outcomes in Breast Cancer
Atezolizumab misses complete response benefit in triple negative patients
The PD-L1 checkpoint inhibitor atezolizumab (Tecentriq) plus chemotherapy came up short in getting women with early stage triple-negative breast cancer to a pathologic complete response in the neoadjuvant setting when compared with chemotherapy alone, researchers reported...
In the preliminary results of the NeoTRIPaPDL1 Michelangelo trial, 43.5% of patients achieved a pathologic complete response when they were taking atezolizumab and the chemotherapy regimen of carboplatin and nab-paclitaxel compared with 40.8% of those taking only the chemotherapy (P=0.66)
patients who had PD-L1 positive tumors fared better with atezolizumab therapy than women who had PD-L1 negative tumors. Women with a high level of PD-L1 were twice as likely to achieve a pathologic complete response if they were in the atezolizumab group of patients.
In the KEYNOTE-522 trial ...64.8% of the triple-negative breast cancer patients achieved pathologic complete response with pembrolizumab plus two chemotherapy regimens compared with 51.2% of patients treated with chemotherapy alone.
...atezolizumab appeared to show activity in the metastatic setting, and was surprised that it did not show similar activity in the early stage setting.
-
Yikes with the RCB study. I mean, I knew at some level, but this did not start my day off well...
-
I am in the same boat Lexica and I agree...BUMMER
-
Lumpie I can answer your question about the cost of those drugs. My Kadcyla is being billed at $8050 every 3 weeks. My Herceptin was $6300 and Perjeta was $5625 earlier this year (it went up again this year), again every 3 weeks. Taxol is cheap and was only a couple hundred dollars when every 3 weeks ($300-$400). Taxol and Herceptin without Perjeta would be cheaper than Kadcyla, but THP is more expensive. A large percentage drop the Perjeta due to side effects, and a lot of early stage never even go on Perjeta, they just do the one year of Herceptin. So it's valid to compare the cost of Kadcyla to TH like they did in the study, and from my billing rates Kadcyla would definitely be more expensive.
What I don't understand is why they would have someone who is early stage do one full year of chemo instead of one year of a biologic with relatively few side effects like Herceptin.
-
LoriCA,
Wow! Thanks for sharing that info. Where are you getting your drugs!? My were being billed at:
Herceptin $9,424 discounted to $8,010 per dose
Perjeta $12,180 discounted to $10,353 per dose
That was in April. I wonder if it went up after that? Yikes! I do not see the bills for my Kadcyla since I am in a clinical trial.
I know that my Taxotere was being billed at around $3,500 per dose. I also got Cyclophosphomide. Can't find cost records for it right now. (All of these are drug only prices. Does not include administration, etc.)
I was actually told by one woman that she was being bill approximately triple the amount I was. Insane.
The combination of drugs used and these very different price numbers would make a big difference in the total treatment cost for early stage. Based on the charges for my TCH vs your Kadcyla, the Kadcyla would be cheaper. As I noted, one huge advantage of Kadcyla would be avoiding hair loss. I realize that cost analysts may say "not a big deal" but for those of us that 1) live with the loss and 2) *never* get our hair back, it is a HUGE, HUGE deal. Not to mention the fact that I am tolerating Kadcyla so, so much better than TCH. I don't feel nearly as bad as on the taxane. Huge QOL issue for me.
PS: Does it not strike people as utterly crazy that we are all charged incredibly different prices for these drugs? Crazy-making!
-
Promising news for those of us with lymphedema!
-
Lumpie I'm not sure if some of the drugs are dosed based on weight, but I'm a petite 5'4" so maybe that affects my costs. I live in one of the most expensive areas of the country (LA metro) and everything is more expensive here, so I don't understand why someone in another part of the country would pay more. Unless maybe the volume of patients treated in an area like mine means the facilities get volume discounts on drugs hahaha! It is crazy that pricing could be so different for each of us. Someone once posted that their cost for H&P was $21,000 every 3 months and it left me scratching my head, how could that be? (And yes, the costs I posted were for drugs only.)
I agree about no hair loss and better QoL than a taxane. That's the reason I asked to move on to Kadcyla this time instead of trying another Herceptin + chemo combo. I wanted to keep my hair for Christmas this year haha! But still, a full year of chemo vs a few months when you're early stage is something to think about. QoL of Herceptin for one year is much better than QoL of Kadcyla, especially if they're like me and have a tough time getting along with Kadcyla. It says there is a higher discontinuation rate for Kadcyla than TH, and I'm guessing that's due to the SEs. I think Kadcyla would have to show a major improvement over TH to be worthwhile. And a small number of people do lose their hair with Kadcyla for some reason (3.9% according to manufacturer), so it's not a complete guarantee one wouldn't lose their hair.
Would be interesting to hear what early stage people think about it.
-
Thanks Murfy. Very interesting research about LE.
-
Denosumab Does Not Alter the Course of Early Breast Cancer
-D-CARE trial failure spurs reassessment of adjuvant treatment with bone-modifying agent
-
I don’t remember seeing this posted here yet. Sorry if I am reposting.
-
-
Radiotherapy for ductal in situ carcinoma ups mortality risk in invasive second breast cancer
For women with primary ductal carcinoma in situ (DCIS), use of radiotherapy (RT) is associated with increased rates of breast cancer-specific mortality for those women who subsequently develop an invasive second breast cancer (SBC), according to a study published in the November issue of the Journal of the National Comprehensive Cancer Network...
The researchers found that even after controlling for cancer stage, prior RT was associated with higher rates of breast cancer-specific mortality (hazard ratio, 1.70; 95 percent confidence interval, 1.18 to 2.45; P = 0.005). The risk trended higher in patients with ipsilateral versus contralateral SBC (hazard ratio, 2.07 versus 1.26; P = 0.16). Patients with ipsilateral SBC were younger and more often lacked estrogen receptor expression compared with patients who developed contralateral SBC...
https://medicalxpress.com/news/2019-12-radiotherapy-ductal-situ-carcinoma-ups.html
-
I feel like that article is misleading. It should be comparing survival in women who get radiotherapy after DCIS vs women who don't, with both groups randomly assigned. It could be that women who have radiotherapy and go on to develop a second breast cancer had a radiation-resistant strain of breast cancer to begin with, which is more aggressive and less treatable. Whereas the women who didn't have radiotherapy may have developed a second breast cancer more often, and many of theirs were successfully treated with radiotherapy, but just as many died of radiation-resistant breast cancer in the end. Not to mention, some of those women could have been recommended radiation because their DCIS was of a more aggressive variety and thus more likely to recur.
Edit: I tracked down the original article, and it does cover this possibility:
"One factor likely contributing to the finding of increased mortality associated with ipsilateral SBC after prior RT is that prior radiation to the ipsilateral breast limits subsequent salvage options in the same breast. In our cohort, the proportion of patients receiving RT for contralateral SBC was higher than the proportion receiving RT for ipsilateral SBC after DCIS (P<.001). Another hypothesis that may explain this finding is that BCS followed by RT is less effective in preventing recurrence of invasive disease that is more aggressive biologically, and therefore prior treatment with RT may in fact confer a worse prognosis among patients who develop an invasive SBC. Indeed, our findings showed that patients who developed ipsilateral SBC were younger at the time of SBC development and had breast cancers that were more likely to lack ER expression, characteristics that are associated with more aggressive cancer biology. These possible explanations for the increased mortality associated with prior RT are not mutually exclusive, and both may be true."
Full article for anyone who is interested: https://jnccn.org/view/journals/jnccn/17/11/article-p1367.xml
In any event, looking only women at who have gotten a second breast cancer for the study instead of comparing all women and seeing how many of them 1) got second breast cancers and 2) survived completely discounts all the women who were cured by the radiation they received. If you did a study the other way around, discounting all the women who died or had recurrence and looking at the effects of treatment in the remaining population, it would be totally ridiculous.
-
hapa, thats exactly the thought that occurred to me. Thanks for stating it so well.
-
Categories
- All Categories
- 679 Advocacy and Fund-Raising
- 289 Advocacy
- 68 I've Donated to Breastcancer.org in honor of....
- Test
- 322 Walks, Runs and Fundraising Events for Breastcancer.org
- 5.6K Community Connections
- 282 Middle Age 40-60(ish) Years Old With Breast Cancer
- 53 Australians and New Zealanders Affected by Breast Cancer
- 208 Black Women or Men With Breast Cancer
- 684 Canadians Affected by Breast Cancer
- 1.5K Caring for Someone with Breast cancer
- 455 Caring for Someone with Stage IV or Mets
- 260 High Risk of Recurrence or Second Breast Cancer
- 22 International, Non-English Speakers With Breast Cancer
- 16 Latinas/Hispanics With Breast Cancer
- 189 LGBTQA+ With Breast Cancer
- 152 May Their Memory Live On
- 85 Member Matchup & Virtual Support Meetups
- 375 Members by Location
- 291 Older Than 60 Years Old With Breast Cancer
- 177 Singles With Breast Cancer
- 869 Young With Breast Cancer
- 50.4K Connecting With Others Who Have a Similar Diagnosis
- 204 Breast Cancer with Another Diagnosis or Comorbidity
- 4K DCIS (Ductal Carcinoma In Situ)
- 79 DCIS plus HER2-positive Microinvasion
- 529 Genetic Testing
- 2.2K HER2+ (Positive) Breast Cancer
- 1.5K IBC (Inflammatory Breast Cancer)
- 3.4K IDC (Invasive Ductal Carcinoma)
- 1.5K ILC (Invasive Lobular Carcinoma)
- 999 Just Diagnosed With a Recurrence or Metastasis
- 652 LCIS (Lobular Carcinoma In Situ)
- 193 Less Common Types of Breast Cancer
- 252 Male Breast Cancer
- 86 Mixed Type Breast Cancer
- 3.1K Not Diagnosed With a Recurrence or Metastases but Concerned
- 189 Palliative Therapy/Hospice Care
- 488 Second or Third Breast Cancer
- 1.2K Stage I Breast Cancer
- 313 Stage II Breast Cancer
- 3.8K Stage III Breast Cancer
- 2.5K Triple-Negative Breast Cancer
- 13.1K Day-to-Day Matters
- 132 All things COVID-19 or coronavirus
- 87 BCO Free-Cycle: Give or Trade Items Related to Breast Cancer
- 5.9K Clinical Trials, Research News, Podcasts, and Study Results
- 86 Coping with Holidays, Special Days and Anniversaries
- 828 Employment, Insurance, and Other Financial Issues
- 101 Family and Family Planning Matters
- Family Issues for Those Who Have Breast Cancer
- 26 Furry friends
- 1.8K Humor and Games
- 1.6K Mental Health: Because Cancer Doesn't Just Affect Your Breasts
- 706 Recipe Swap for Healthy Living
- 704 Recommend Your Resources
- 171 Sex & Relationship Matters
- 9 The Political Corner
- 874 Working on Your Fitness
- 4.5K Moving On & Finding Inspiration After Breast Cancer
- 394 Bonded by Breast Cancer
- 3.1K Life After Breast Cancer
- 806 Prayers and Spiritual Support
- 285 Who or What Inspires You?
- 28.7K Not Diagnosed But Concerned
- 1K Benign Breast Conditions
- 2.3K High Risk for Breast Cancer
- 18K Not Diagnosed But Worried
- 7.4K Waiting for Test Results
- 603 Site News and Announcements
- 560 Comments, Suggestions, Feature Requests
- 39 Mod Announcements, Breastcancer.org News, Blog Entries, Podcasts
- 4 Survey, Interview and Participant Requests: Need your Help!
- 61.9K Tests, Treatments & Side Effects
- 586 Alternative Medicine
- 255 Bone Health and Bone Loss
- 11.4K Breast Reconstruction
- 7.9K Chemotherapy - Before, During, and After
- 2.7K Complementary and Holistic Medicine and Treatment
- 775 Diagnosed and Waiting for Test Results
- 7.8K Hormonal Therapy - Before, During, and After
- 50 Immunotherapy - Before, During, and After
- 7.4K Just Diagnosed
- 1.4K Living Without Reconstruction After a Mastectomy
- 5.2K Lymphedema
- 3.6K Managing Side Effects of Breast Cancer and Its Treatment
- 591 Pain
- 3.9K Radiation Therapy - Before, During, and After
- 8.4K Surgery - Before, During, and After
- 109 Welcome to Breastcancer.org
- 98 Acknowledging and honoring our Community
- 11 Info & Resources for New Patients & Members From the Team