Breaking Research News from sources other than Breastcancer.org
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I am guessing a formulation by injection. Unfortunately it will take more research and testing.
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If Only That Phase III Oncology Trial Had Been Designed Differently
The cancer treatment community's ultimate perception of a successfully completed phase III randomized trial depends in large part on how well the trial was conceived and structured....the question it poses must be relevant to ensure interest by clinical investigators, referring clinicians, and potential research subjects. Further, the initiative must have adequate funding for data collection and analysis, translational laboratory investigations, and other trial components. {There is a} risk that study results may lead investigators and others to question the study's design in retrospect.
...the goal {in writing this} has been to emphasize both the critical relevance of very careful consideration of the impact of trial design on the interpretation of possible study results and the legitimate risk that individual trials, no matter how meaningful or even "positive" their outcomes may be, may raise as many clinically relevant questions as they answer.
https://www.onclive.com/publications/Oncology-live...
{An interesting perspective, especially for those in or considering clinical trials.}
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Homing in on Targeted Treatment Strategies in Breast Cancer
The fields of early-stage hormone receptor (HR)–positive and metastatic HER2-positive breast cancer have made great strides in recent years, said Neelima Denduluri, MD, and such progress could be attributed to the emergence of tailored treatment strategies and the use of HER2-directed agents, respectively.
OncLive: How are you approaching treatment in patients with early-stage HR-positive, HER2-negative breast cancer?
Could you discuss the use of genomic assays in practice?
Could you discuss some of the key studies that were presented at the 2019 San Antonio Breast Cancer Symposium?
...anything else ...?
https://www.onclive.com/web-exclusives/homing-in-o...
{Dr. Denduluri shares insight on treatment, advances, etc. An accessible commentary on treatments advances and options.}
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Agnes Dumas, PhD, on the Impact of Breast Cancer Treatment on Employment
Two years post-diagnosis, 21% of patients had not returned to work, study shows
The adverse effects of breast cancer treatment are known to often prevent patients from going back to work -- leading to negative economic as well as psychological consequences. French researchers recently analyzed a prospective cohort of more than 1,800 patients with stages I-III breast cancer who were employed prior to their diagnosis, showing that 2 years after diagnosis, 21% had not returned to work. The odds of not returning were significantly increased among those treated with combinations of chemotherapy and trastuzumab, and other significant factors included arm morbidity and depression.
This is an important study not just for physicians but also for society as a whole, which identifies the vulnerable members in hopes of changing policies to better support them through different strategies.
{Two Medpage articles:}
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“City of Hope scientists have identified an unlikely way to potentially prevent or slow the progression of aggressive breast cancer: target one's internal clock.
Often taken for granted, the circadian rhythm is gaining traction as a potential catalyst or brake for the onset of disease. For example, studies have shown that women who take frequent night shifts have disrupted internal clocks and increased risk of developing breast cancer. Now, City of Hope's David K. Ann, Ph.D., and his colleagues think they may have found a new role for the "clock gene": It is linked to triple-negative breast cancer, an aggressive form of the disease that often results in a poorer prognosis.“
https://www.cityofhope.org/breakthroughs/internal-clock-key-to-slowing-cancer -
The Impact of Dietary Supplement Use on Survival Outcomes in Breast Cancer
- Journal of Clinical Oncology In this observational correlative study, the authors evaluated the impact of dietary supplements during cancer treatment in 1134 patients with metastatic breast cancer queried at registration and during treatment in a randomized phase III trial of chemotherapy treatment schedules.
- The authors found a signal of potential negative impact in terms of recurrence and overall survival with the use of antioxidants, iron, and vitamin B12 during chemotherapy. Multivitamin use was not associated with survival outcomes.
- CONCLUSION
Associations between survival outcomes and use of antioxidant and
other dietary supplements both before and during chemotherapy are
consistent with recommendations for caution among patients when
considering the use of supplements, other than a multivitamin, during
chemotherapy.
doi/10.1200/JCO.19.01203 -
Chemotherapy for Cancer Treatment Could Be Unviable Because of Antibiotic-Resistant Superbugs, Doctors Fear
British oncologists fear antibiotic-resistant superbugs may someday make chemotherapy an unviable treatment option for their cancer patients. (Newsweek)
An estimated one in five cancer patients need antibiotics during their treatment, according to existing research cited by the authors of the report, and cancers including multiple myeloma and acute leukaemia can't be treated without them.The survey revealed that 46 percent of doctors believe drug-resistant bugs will make chemotherapy unviable.
...since we know chemotherapy suppresses the immune system, leaving patients vulnerable to infections...
86 percent of the doctors said the bugs Staphylococcus, E. coli and pseudomona put cancer patients at the most risk of serious harm.
"Oncologists are right to be concerned about growing levels of antibiotic resistance being experienced by their patients post-surgery or those undergoing chemotherapy.
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'Breakthrough' in Fertility Preservation for Breast Cancer Patient
First successful case using eggs frozen after in vitro maturation
French physicians on Wednesday described the first case of an infertile cancer patient giving birth after her immature eggs were further matured via in vitro maturation (IVM) and subsequently frozen.
"IVM enables us to freeze eggs or embryos in urgent situations or when it would be hazardous for the patient to undergo ovarian stimulation. In addition, using them is not associated with a risk of cancer recurrence."
"...for the average patient, experimental advances in precision medicine should be taken with caution, given that we don't have enough data at this time,"
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Thanks Lumpie for the supplement article-my MO was smart enough to tell me to stop antioxidants and other supplements during chemo, and I'm glad she did.
Claire in AZ
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Mayo researchers recommend all women with breast cancer diagnosis under age 66 be offered genetic testing
A study by researchers at Mayo Clinic published this week in the Journal of Clinical Oncology suggests that all women with a breast cancer diagnosis under the age of 66 be offered germline genetic testing to determine if they have a gene mutation known to increase the risk of developing other cancers and cancers among blood relatives. Current guidelines from the National Comprehensive Cancer Network (NCCN) recommend germline testing for all women diagnosed with breast cancer under the age of 46 regardless of their family history and breast cancer subtype.
https://medicalxpress.com/news/2020-02-mayo-women-breast-cancer-diagnosis.html
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Mammograms not helpful in women 75 and older, study finds
Although studies clearly show mammograms starting at age 50 prevent breast cancer deaths, until now, doctors have had little evidence about when to end screening, Dr. Otis Brawley of Johns Hopkins University and former chief medical officer of the American Cancer Society, wrote in editorial in the Annals of Internal Medicine.
"The study is important because a third of all American women die of breast cancer are diagnosed after the age of 70," Brawley said in a telephone interview.
The U.S. Preventive Services Task Force, which sets screening guidelines, currently states that the evidence is insufficient to assess the harms and benefits in women 75 and older. Recommendations by other groups vary.
https://news.yahoo.com/mammograms-not-helpful-women-75-220427892.html
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As a women diagnosed at age 77 due to a mammogram, with a nonpalpable tumor near the chest wall and grade three, I cannot help but wonder where that cancer would be now (lung, through the skin, bones) without that post age 75 mammogram! As my PCP says, that is herd mentality and he prefers to treat on an individual basis.
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Pertuzumab (P) + trastuzumab (T) with or without chemotherapy both followed by T-DM1 in case of progression in patients with HER2-positive metastatic breast cancer (MBC) - The PERNETTA trial (SAKK 22/10), a randomized open label phase II study (SAKK, UNICANCER, BOOG)
Background: We assumed that a strategy with dual blockade of T+P without chemotherapy followed by T-DM1 at progression might be similarly effective in terms of overall survival (OS), but less toxic resulting in better Quality of Life (QoL) in pts with HER2+ MBC. Updated efficacy results by hormone receptor (HR) status and QoL data are given.
Conclusions: Despite shorter 1st line PFS, OS at 2 years was not affected for P+T alone followed by T-DM1. Side-effects were less frequently seen in the chemotherapy-free arm, although QoL was similar during 1st line in both arms.
Methods: Pts with centrally confirmed HER2+ MBC were randomized 1:1 to receive either P+T alone (arm A) or P+T combined with weekly paclitaxel or vinorelbine (arm
, followed by maintenance treatment with T+P until progression. After progression, T-DM1 was given as 2nd line therapy in both arms. The primary endpoint was OS at 24 months (mo), among secondary endpoints progression free survival (PFS) was included. QoL was assessed every 3 mo up to 24 mo during 1st line by the NFBSI-16 (summary score and subscale scores for disease-related symptoms, treatment side-effects, function/well-being). Two single items assessed treatment burden and coping.Results: Between 05/13 and 01/16, 210 pts were enrolled. Median age was 58 years, 63% of pts had lung or liver metastases, 36% of tumors were HR-, paclitaxel/vinorelbine was given in 46/59 pts. Efficacy results are shown in table. No difference in OS was observed. HR status did not affect PFS for 1st line. During 1st line, changes from baseline showed small improvements in QoL (NFBSI-16 summary scores) in arm A, while QoL scores remained stable in arm B. Patients in arm B reported more treatment burden during the first 6 months, but not thereafter, while coping improved clinically relevant in both arms.
Annals of Oncology : Official Journal of the European Society for Medical Oncology 2019
https://www.meta.org/papers/pertuzumab-p--trastuzu...
https://www.annalsofoncology.org/article/S0923-753...(19)30418-1/fulltext
DOI: https://doi.org/10.1093/annonc/mdz100.001
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Trastuzumab Deruxtecan With Nivolumab in Advanced Breast Cancer
— Charles Shapiro, MD, on new study building off drug's recent approval
The FDA recently announced approval of fam-trastuzumab deruxtecan (Enhertu) for the later-line treatment of unresectable or metastatic HER2-positive breast cancer. Investigators at Mount Sinai Hospital, led by Charles L. Shapiro, MD, are now testing the safety and efficacy of this new agent in combination with an anti-PD1 checkpoint inhibitor, nivolumab (Opdivo).
Shapiro discusses both the DESTINY-Breast01 results and his current study.
https://www.medpagetoday.com/meetingcoverage/sabcs...
{Brief video.}
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The art of innovation: clinical development of trastuzumab deruxtecan and redefining how antibody-drug conjugates target HER2-positive cancers
Annals of Oncology : Official Journal of the European Society for Medical Oncology 2020
A systematic evaluation of all identifiable shortcomings of previous Antibody-drug conjugate (ADC) designs led the team... to create the proprietary linker and payload technology with seven key attributes. {Critical features}, combined with the short half-life of DXd in vivo, limits systemic exposure of the payload, with the aim of reducing toxicity. {The authors suggest that} innovative advantages ... may allow for further customization of the ADC development process.
Conclusion
The promising efficacy of T-DXd across HER2-expressing tumors, along with its potential broad scope of indications and rapid development, led DS to invest in clinical development capabilities, scaling development functions to support an ambitious development program. A comprehensive review of the potential of T-DXd and the organizational model of DS revealed that entering into a collaboration would serve the dual objectives of accelerating and expanding clinical development of T-DXd. With the objective of bringing T-DXd to more patients faster, DS entered into an equal co-development and commercialization collaboration with AstraZeneca in March 2019, with the goal of combining DS's scientific and technological excellence with AstraZeneca's global experience and resources in oncology to efficiently advance the development of T-DXd in HER2-expressing cancers.https://www.meta.org/papers/the-art-of-innovation-...
https://www.annalsofoncology.org/article/S0923-753...(19)43225-0/fulltext
DOI: https://doi.org/10.1016/j.annonc.2019.11.019
{A rather technical discussion of trastuzumab deruxtecan, the mechanisms which have made it a successful therapy, prospects for development of variants in the future and movement of the drug to market.}
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Progress in Breast Cancer: 'What Would Bill Think?'
— At SABCS, the McGuire Award recipient asked what the late pioneer might have thought of the newest research advancements
At the recent San Antonio Breast Cancer Symposium (SABCS), Joseph A. Sparano, MD, received the William L. McGuire Memorial Lecture Award for his leadership, collaboration, and practice-changing achievements in breast cancer research. Sparano is the study chair of the landmark TAILORx study, the largest ever breast cancer treatment trial, and in his talk he discussed his study -- and how McGuire might have viewed the work.
https://www.medpagetoday.com/meetingcoverage/sabcs...
@{Video discussion of encouraging advances in treatment. @ 5 minutes long.}
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Genomic Analysis Reveals That Immune Function Genes Are Strongly Linked to Clinical Outcome in the North Central Cancer Treatment Group N9831 Adjuvant Trastuzumab Trial
Purpose
To develop a genomic signature that predicts benefit from trastuzumab in human epidermal growth factor receptor 2–positive breast cancer.
Results {abbreviated}
Immune gene enrichment was linked to increased RFS in arms B and C, whereas arm B and C patients who did not exhibit immune gene enrichment did not benefit from trastuzumab.
Conclusion
Increased expression of a subset of immune function genes may provide a means of predicting benefit from adjuvant trastuzumab.
https://ascopubs.org/doi/full/10.1200/JCO.2014.57....
DOI: 10.1200/JCO.2014.57.6298 Journal of Clinical Oncology 33, no. 7 (March 01, 2015) 701-708.
Published online January 20, 2015.
{This article has some age on it but it an interesting topic which I have not seen discussed elsewhere.}
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Prospective Decision Analysis Study of Clinical Genomic Testing in Metastatic Breast Cancer
Purpose: To evaluate the impact of targeted DNA sequencing on selection of cancer therapy for patients with metastatic breast cancer (MBC).
Conclusion: In this prospective study, genomic profiling of tumors in patients with MBC frequently identified potential treatments and resulted in treatment change in a minority of patients. Patients whose therapy was not changed on the basis of genomic testing seemed to have a decrease in confidence of treatment success.
"...suggests a need to better understand barriers to implementation of mutation-directed therapy as well as a need for improved understanding of patient perception of somatic genomic testing."
https://www.medscape.com/viewarticle/924847?src=wn...
JCO Precis Oncol. 2019;3
https://ascopubs.org/doi/abs/10.1200/PO.19.00090
DOI: 10.1200/PO.19.00090 JCO Precision Oncology - published online November 18, 2019
{Discusses some benefits and challenges of personalized medicine.}
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For those who may be interested in advocating around breast cancer and healthcare related issues, I have set up a new thread. You can find it here:
https://community.breastcancer.org/forum/110/topic...
Thanks.
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Study warns drinking [cow] milk may drastically increase breast cancer risk
The study was recently published in the International Journal of Epidemiology; it evaluated the potential breast cancer risk associated with drinking dairy milk and soy milk. The results call current US Dietary guidelines into question — the public is advised to drink three cups of milk daily, but as little as 1/4 to 1/3-cup of daily cow milk was found to increase breast cancer risk by 30-percent...
The study's first author Gary E. Fraser explained, 'By drinking up to one cup [of cow milk] per day, the associated risk went up to 50%, and for those drinking two to three cups per day, the risk increased further to 70% to 80%.'
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okay so if the average woman has a risk of 12 percent than a glass of milk could increase risk 30 percent would mean 4 percent additional risk -correct?
I have not been running around drinking glasses of milk since I was like 10. :-) If anyone is looking for a good milk sub -Silk Oat Yeah! Is delicious
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For years now, I have only had organic milk. It irritates my husband, because it is more expensive, but I feel that it's a better option. Not crazy about other "milks," and I only use it in my coffee and occasionally in either cooking or in cereal.
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Super skeptical about the "milk and increase in b.c. risk" study. Here's one comment at the bottom: (paid for and conducted by a borderline religious cult that doesn't believe in science nor eating or drinking animal products. I'm sure that didn't impact their findings though
); it was provided by a .com website that I've never heard of before (like Science Daily). I'll wait till Mayo, or Sloan Ketterling, or Science Daily releases the same findings and endorses them.I, however, haven't drank cow's milk in decades. No need to once you're a grown up. We were sold a bill of goods by the dairy lobby in the early 20c century to sell their product--"everybody needs milk", which isn't true, and we've been drinking the "kool-milk" message ever since
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Oy. I've recently been thinking about my dairy intake. I'm starting with trying to drink my tea and coffee black. Still have some cheese (although allegedly that has no negative impact??) but cutting back a bit on that too. I also get a little sad reading about the beef/dairy industry. Those poor cows. I dunno. . . I've been in a mood lately that there's nothing that I enjoy eating/drinking that isn't bad for me, or for the environment (which non-dairy milk is it that's killing bees??). (Also recently read some research on eggs--that > 5/week is bad for us. What ever.)
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Dairy Milk or Plant Milk....... It is so hard to find consistent information on nutrition. Very contentious. Interesting article in Consumers Report on plant milk. They do not have an opinion on cow vs plan, but advise, read the label. They are not all the same. They may or may not add vitamins, minerals, protein, and add at different amounts. Sweeteners - generally something to avoid. For years I've heard that soy (as food, not supplements) is ok for ER+ BC, but now that is being questioned. Many advocate cutting back on dairy and meat. I've eaten/drunk dairy my entire life. Does it contribute to my BC?
https://www.breastcancer.org/research-news/soy-may-turn-on-genes-linked-to-cancer
https://www.breastcancer.org/research-news/soy-may-offer-benefits-for-hr-neg-disease
https://www.consumerreports.org/plant-milk/are-plant-milks-more-healthful-than-cows-milk/
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Had a great appt with my MO this week and I asked him about several topics that have come up in the articles mentioned on this board ...
— if no heart damage was detected after chemo, would/could damage occur later? Answer - yes but it is very very rare.
--does chemo affect the structure of our brain icells i.e. are we stuck with that forever? Answer - both chemo and AIs do affect brain cells but studies show that over time we go back to baseline.
—The newest drugs developed for stage 4 patients are showing great promise in removing or slowing further metastases - will they be made available, either during chemo or post chemo to help prevent metastases in stage 1, 2, and 3 patients? Answer - protocol recommendations, if any, should come out by the end of this year. Could be based on whether there was node involvement or any number of other factors. If recommended, patients that have completed treatment would take the appropriate drug along with their AIs - they are in pill form. There are side effects, for example low blood counts, so all this has to be figured in any new protocol recommendations.
On a personal note, I'm a little over 2 years past chemo, surgery, and rads, and have started to obsess over what may happen in the future. Since itt doesn't seem to be the “standard of care" to get any scans post treatment (unless or until new symptoms arise), i'm finding It pretty hard to move on with things without having at least some confirmation that treatment seems to have worked. I know this is irrational bcs nothing might show today but could in a month or year or 5 years from now - but I'd still like a new baseline (and frankly a new baseline every year or two to know what is or isn't going on in my body). Anywho, my sweet MO said he'd be doing me a disservice if I needed a scan to move forward - so I'm getting one. Whoop! Hope insurance pays ...
Also, heard a story on NPR about development of an “MRI lite" used instead of mammograms. These 15-second MRIs were hugely more successful at finding cancers, especially in women with dense breasts, than 3D mammography. I'm hoping the new MRIs will be developed enough so that we CAN all get affordable post treatment scans at regular intervals.
Lanne
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Ingerp, I'm kind of like you-, every time I put cheese or eggs in my shopping cart at the supermarket I try to find out if it is a local, small family farm that treats their animals humanely. I've even gone so far as to email the company asking them how they treat their animals. I don't eat meat of any kind; opt for wild-caught fish only from time to time (I guess fish is meat). I know that growing almonds uses the most water, and I'm concerned about our over-use of that resource. Mostly I don't use any kind of plant milk much at all. I have been cautioned against eating a lot of calcium rich foods anyway-my MO tells me this because the AC chemo I had, coupled with a lot of calcium intake, increases my risk for heart disease. I take a 1000 mg tums every night. That's my calcium intake, which is enough according to my MO. I'm sure I get more in my plant-based diet as well.
Claire in AZ
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The only info I got from 3 MOs and my BS was to stay active, at least 150 minutes per week Cardio and Strength. Get my BMI under 25, no smoking, limited alcohol and try to follow the Mediterranean Diet. High level the diet includes 2.5 servings of fruits & veggies daily, 3+ servings of fish weekly, 2-3 servings of Chicken/Turkey weekly, limited red meat (once per month) only use Olive Oil, cut down/out butter, whole grain only and increase healthy nuts (almonds, walnuts, cashews and Pistachios))
No mention of dairy, or soy or whatever i find online which seems to swing from good to bad every few years.
I don't drink a lot of milk but, I'm switching to Almond milk anyway since I need to take in more healthy nuts. I'm also looking at some vegan cheese recipes since they're made with cashews but, a lot of that will depend on the taste.
I'm going to do the best I can but, not going to make myself miserable. I want to do everything I can to live a long life but, that includes living happily while being healthy.
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[University of Waterloo] researcher finds new, simple way to screen for breast cancer
A professor of electrical and computer engineering by trade, Ramahi and his team have created a prototype that uses micro-waves and artificial intelligence to detect abnormalities in the breast within minutes...
Ramahi said he hopes the device will be straightforward enough for any health care provider to use.
The prototype is also less harmful than traditional ways of breast cancer screening, Ramahi said, because it eliminates exposure to radiation.
"Our device uses a tiny, tiny fracture of what our cell phones emit," he said.
Ramahi and his team were able to build the device with less than $5,000 and its software can be uploaded to any Microsoft laptop. The versatility and affordability could help bring the technology to developing countries.
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High [injected, not oral] doses of vitamin C found to enhance immunotherapy in combating cancer in mice
The researchers [of this new study in the journal Science Translational Medicine] found that adding high doses of vitamin C without immunotherapy resulted in delayed tumor growth in test mice. When it was given as part of an immunotherapy regimen with the mice, they found it slowed or stopped growth of melanoma, colorectal, pancreatic and breast cancer tumors. Furthermore, they found that it did so by providing support to T cells. They also found that vitamin C boosted the effectiveness of PD-1 and CTLA-4 checkpoint antibodies. And they found that in some cases, adding vitamin C to the immunotherapy regimen resulted in some breast cancer tumors disappearing completely.
https://medicalxpress.com/news/2020-02-high-doses-vitamin-immunotherapy-combating.html
Another article about the study: https://european-biotechnology.com/up-to-date/latest-news/news/vitamin-c-boost-checkpoint-inhibitor-efficacy.html
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