Breaking Research News from sources other than Breastcancer.org
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Good news about genomic testing -- just a proof of concept now, but hopefully it comes to market.
https://www.cancer.gov/news-events/cancer-currents...
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interesting read, thanks for the link
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ChristianaCare research shows radiation therapy for cancer can be both good and bad
Jennifer Sims-Mourtada, Ph.D., is director of Translational Breast Cancer Research at ChristianaCare's Helen F. Graham Cancer Center. Her research shows the inflammation caused by radiation meant to reduce the size of a tumor can in some cases create a pathway necessary for [triple negative] cancer stem cells to survive...
She notes there are inflammation inhibitors currently in clinical trials that could be paired with radiation therapy to reduce the inflammation and ensure cancer stem cells die from the treatment. Her team also identified an anti-inflammatory drug used to treat rheumatoid arthritis that could also be used to inhibit the growth of cancer stem cells and triple-negative breast cancer tumors.
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FDA Accepts BLA for Subcutaneous Fixed-Dose Pertuzumab/Trastuzumab in HER2+ Breast Cancer
The FDA has accepted a Biologics License Application (BLA) for a fixed-dose combination (FDC) of pertuzumab (Perjeta) and trastuzumab (Herceptin) with hyaluronidase, administered by subcutaneous (SC) injection in combination with intravenous (IV) chemotherapy, for the treatment of eligible patients with HER2-positive breast cancer.
https://www.onclive.com/web-exclusives/fda-accepts...
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Stick to breast imaging evidence, radiologists implore: 'Lives are at stake and compromise is unethical'
The Feb. 26 Journal of the American College of Radiology commentary implored docs to begin mammography testing of women at age 40, and at annual intervals. Recommendations from healthcare administrators or other nonradiologists that say otherwise should not dictate women's care, wrote lead author Harvard Medical School's Daniel Kopans, MD...
The team pointed to models from the National Cancer Institute, which have found that if women in their 30s wait until age 50 to receive screenings, as many as 100,000 could die from breast cancer that could have been caught earlier.
"The bottom line is that members of the ACR should support evidence-based guidelines in which most lives are saved by annual screening starting at the age of 40," the writers concluded.
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Rapid MRI Tops 3D Mammo for Dense Breast Screening
— Accelerated breast MRI finds an additional 7 cancers per 1,000 women
A 10-minute MRI for breast cancer screening in women with dense breasts was associated with improved cancer detection compared with digital breast tomosynthesis (DBT), a cross-sectional study found.
Meaning Among women with dense breasts undergoing screening, abbreviated breast MRI was associated with a significantly higher rate of invasive cancer detection than DBT.
https://www.medpagetoday.com/hematologyoncology/br...
https://jamanetwork.com/journals/jama/article-abst...
doi:10.1001/jama.2020.0572
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Lumpie - thanks for the article about abbreviated MRI. I read carefully to answer my question about contrast, and unfortunately it seems that will still be required. I can't imagine how 10 minutes will work for tech/nurses to put in an IV, position the patient, take the films w/o contract, start the gadolinium running & take the pictures with contrast, etc. Still, it's an interesting advancement. I suppose the chances that it will be cheaper are negligible.
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MinusTwo:
Glad you found it helpful.
I get regular CT scans and they have me in and out of the room - complete with IV contrast - in WAY less than 10 minutes. {They're not just half-fast
} If they start using these fast MRI's for large segments of the population, I bet they will become more efficient and less expensive. Of course, there are many complex issues driving the cost of care. Sorry it sounds like you have a contrast issue. I know that will be a barrier for some. -
Lumpie - Love the "half-fast".... Not a specific contract issue, but lymphadema so I have a "stick" issue. They're hesitant to put the IV in my foot whether for a CT, MRI or PET.
Edited to say - we are so appreciative of the benefits of your research. Thanks so much.
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I see...yes, most places have special rules for non-conventional (depending on how the institution defines it, that can be non-arm or below the belt) placement of IV's because they are deemed an elevated risk for infection. It can be a huge issue for those who have contraindication in both arms.
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FDA Approves Neratinib Combo for HER2+ Breast Cancer
The FDA has approved a supplemental new drug application (sNDA) for neratinib (Nerlynx) in combination with capecitabine (Xeloda) for the treatment of adult patients with advanced or metastatic HER2-positive breast cancer who have received ≥2 prior anti–HER2-based regimens in the metastatic setting.
The approval is based on findings from the phase III NALA trial, which showed that the combination of neratinib and capecitabine reduced the risk of disease progression or death by 24% compared with lapatinib (Tykerb) plus capecitabine.
...neratinib in combination with capecitabine offers a significant improvement over currently available therapies in this heavily pretreated patient population and can be added to Nerlynx's established role in the treatment of early breast cancer."
https://www.onclive.com/web-exclusives/fda-approve...
Additional References
- Puma Biotechnology Receives U.S. FDA Approval of Supplemental New Drug Application for Neratinib to Treat HER2-Positive Metastatic Breast Cancer [news release]: Los Angeles, CA. Puma Biotechnology. Published February 27, 2019. https://bwnews.pr/2I02Xx8. Accessed February 27, 2019.
- Saura C, Oliveira M, Feng Y-H, et al. Neratinib + capecitabine versus lapatinib + capecitabine in patients with HER2+ metastatic breast cancer previously treated with ≥ 2 HER2-directed regimens: Findings from the multinational, randomized, phase III NALA trial. J Clin Oncol. 2019;37 (suppl; abstr 1002).
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The Cancer Industry: Hype vs. Reality
Cancer medicine generates enormous revenues but marginal benefits for patients
"Today I'm giving a talk at my school, Stevens Institute of Technology, titled "The Cancer Industry: Hype Versus Reality." The talk focuses on the enormous gap between the grim reality of cancer medicine in the U.S. and the upbeat claims made by the cancer industry and its media enablers. Below are points I plan to make in my talk, which expand upon ones I've made in previous posts.—John Horgan"
https://blogs.scientificamerican.com/cross-check/t...
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Casting for Recovery - Time to Apply
The 2020 retreat season kicks off in March and runs through November. Do you know someone who would benefit from a CfR retreat?
Please encourage them to apply!
Retreats are provided to women with breast cancer of any age and any stage of treatment or recovery, at no cost to the participants.https://castingforrecovery.org/breast-cancer-retre...
{Not research but I wanted to share the word! I have had the good fortune to attend a retreat. It was great!}
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The Questionable Practice That Permeates Oncology Clinical Trials
{The problem is} a practice known as the 3-plus-3 approach, which is a type of rule-based design.
Rule-based designs identify the maximum-tolerated dose (MTD) on the basis of toxicity seen in a very small group of patients, and of the rule-based designs, the 3-plus-3 approach has been the most popular choice for decades. "It's ludicrous,"
The 3-plus-3 approach works like this: 3 patients are given a dose, which is often based on preclinical data, and if no dose-limiting toxicity (DLT) occurs, the next-higher dose is given to 3 different patients. This continues until one or more DLTs is seen.
"For the hundreds, if not thousands, of patients that are then being treated in later-stage trials, you're sort of stuck with that dose that's really based on 6 patients,"
...the decision to use the 3-plus-3 approach when other designs are available is a matter of ethics. "To my mind, that is ethically dubious to be using an outmoded design that is exposing more patients than needed to an unsafe and ineffective drug,"
other designs can be complex and pose a challenge for ... researchers
When cytotoxic agents were being developed, the belief was that efficacy and toxicity were correlated with dose.5 "For a long time, the approach to curing cancer has been to give the largest dose possible,"
{With newer drugs} the right dose could be one that exposes a patient to a therapeutically relevant amount, which can be determined by measuring the drug concentrations in the plasma — a practice also known as therapeutic drug monitoring.
{The article discusses alternative approaches.}
https://www.cancertherapyadvisor.com/home/cancer-t...
{The site did not require me to register. No subscription required.}
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Lumpie - thanks again for your posts, questions on effectiveness/hype/max tolerated dose etc. It can be so hard to make the decisions on what to do. In 2016 for chemo a DR wanted to add a 3rd drug to the cocktail. When I asked, she said it would be a much more aggressive treatment, but that she thought I was young enough(58) and strong enough to tolerate it. SEs - over 10% women end up with heart problems. No thanks. As it turns out, the chemo did not do much to the tumor on the left side, and then 3 years later, the R-side has one, even after a bi-lateral. Would the 3rd drug have helped? Not convinced. And now, because of another medical condition, genetic counciling not realted to BC is recommended because it could indicate/recommend/get health insurance to pay for more screening and possible prevention of other non-BC cancers. Not convinced any of it would be more than diagnostic, without any real treatment. Do I want to be a F#*!#! lab rat ? No. Knowing what quesitons to ask. When to question the experts. So hard.
Ibrance and Arimidex. Supplements include Mg, D, biotin, C, Turmeric(Curcumin), Gluchosamine-Chondroitin,BoneUp(multi with Coligen),Thorne (another multi), Melatonine(at night).
2009 ER+ left breast. 52 yrs. Lumpectomy, Sentinel node removal, negative. Radiation 6 weeks, tamoxifen 5 years. Dense lumpy left breast, normal right. Acupuncture offered at facility as part of integrative medicine. It really helped with anxiety/stress during radiation treatment.
2016 ER+ left breast. Probably a new cancer, but unknown. 4 rounds TC Aug-Oct 2016, Bi-lateral (my choice) Nov 2016, no reconstruction. 2 sentinel nodes remove, negative. Cold Capping using Chemo Cold Caps (DIGNICAP not available). Anastrozole 1 mg starting May 2017. Joint issues noticed immediately. Stopped Anastrozole after 3-4 months due to joint stiffness in. After several months of no AIs, fingers were feeling better. Started tamoxifen March 2018
10/2018 noticed stiffness and some trigger finger again. Was eating meat a lot more (daily) than normal. Usually 1-2 /wk. Have cut way back on the meat, seems to help, but one finger still very prone to trigger finger. Trigger finger seemed to be getting better, but now 4/2019 seems worse, is it the break from added turmeric to meals?
6/18/2019 Noticed Swelling in R-arm, opposite side from where lymph nodes removed. . Could have been swelling earlier but wearing long sleeves. Ultra sounds for clots, Trip to urgent care. They did ultrasound, concerned that there might be a clot, there was not. 7/2/2019 lymphatic therapist recognized that there was something very wrong and sent me back to the DR.
8/2019 CT, Breast/chest , neck/thyroid ultra sound
9/2019 DR ordered biopsy, said it could be lymphoma, cancer, benign lymphatic. Biopsy R-axilla. Cancer. Genetic test showed no known markers (20+ looked for)
9/29/2019 PET scan, no indication of spread. Arimidex and Ibrance prescribed to shrink tumor prior to surgery, if needed.
10/2019 – Stopped Tamoxifen. Started Arimidex and Ibrance. Brand name Arimidex so far does not seem to have the SEs that generics did, but stiff/trigger finger on left middle finger returned.
1/2020 CT showed tumor in Axilla shrunk (hooray!!) from 2.3 to 1.1 but picked up something in lower bowel. DR consulted a DR I saw in 2011 who compared it to 2011 image, said they had not grown, but one has changed and was starting to obstruct.
2/14/2020 Happy Valentine's Day. Surgery removed to remove, waiting for pathology. 2/25/2020 – Pathology. Not cancerous. Hooray
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BlueGirl: wow. That's a lot. And you are correct that, so often, it is difficult to discern the best course of action. I am glad that the recent pathology said not cancerous!
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Immunotherapy Super-Responder: What Is Life, Not Exactly Cured?
— Lisa Geller's cancer has been gone nearly 4 years, but life has been far from normal
{Interesting piece on young-ish non-breast metastatic cancer patient who has responded to treatment but is living in limbo. Many will relate.}
https://www.medpagetoday.com/special-reports/exclu...
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Thanks for this Lumpie. Effectively it appears that Lisa is exhibiting signs of PTSD... frankly I am not in the least surprised. I hope she receives the support she needs and deserves.
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interesting story about Lisa Geller. My sister has been on opdivo for 5 years for metastatic lung cancer. She has stable mets. She is a walking miracle for many reasons. I keep telling her she should contact the mftr and be a paid spokesperson.
Dee
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Do Proton Pump Inhibitors Exacerbate the Cognitive Effects of Breast Cancer Treatment?
The OSU researchers reviewed data from 3 prior unrelated studies. Rather than focus on specifically on PPI use, the studies focused on fatigue, yoga practice, and vaccine response in breast cancer survivors and patients. However, participants in each study self-reported use of prescription and nonprescription medications and provided regular self-reports of any cognitive symptoms they experienced.
When they examined the data, Ms Madison's team found that participants in 2 studies (labeled as study 1 and study 2) who used PPIs reported more severe problems with concentration compared with the nonusers, but did not report problems with their memory. In the third study (labeled as study 3), the women who used PPIs reported more severe memory problems compared with those who did not take PPIs. Participants in this group also reported an overall lower quality of life related to cognitive problems.
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New drug combination could support better cancer treatments
Researchers have identified a promising new drug combination that could significantly help the immune system target cancer cells and kill them.
The study published in Cell, describes a treatment that works by combining an intravenous dosage of a well known anti-nausea drug, prochlorperazine (called Stemetil in Australia), with existing cancer treatments...
"Our long-term vision is to use this approach to not only clear a patient's cancer in the immediate term, but to prevent their cancer coming back in the future by establishing protective 'immune memory'," Dr Wells said.
Dr Simpson's team is now completing a safety trial of the combination of Stemetil and cetuximab in head and neck cancer, triple-negative breast cancer and adenoid cystic carcinoma patients at the Princess Alexandra Hospital.
This study is published in Cell (DOI: 10.1016/j.cell.2020.02.019).
https://www.miragenews.com/new-drug-combination-could-support-better-cancer-treatments/
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New insight into breast cancer resistance to hormone therapy
An international team of researchers led by scientists at Baylor College of Medicine has new insights into the function of neurofibromin, a tumor suppressor produced by the NF1 gene. It is well known that neurofibromin keeps cancer growth in check by repressing the activity of a cancer driver called Ras. The new research reveals a previously unknown function of neurofibromin — directly repressing gene expression controlled by the estrogen receptor-α (ER). Thus, when neurofibromin is lost, Ras and ER functions are both activated, causing treatment resistance and metastasis for ER+ breast cancer.
These findings, appearing in Cancer Cell, suggest that a therapeutic approach must combine two different drugs, a SERD (e.g., fulvestrant) to degrade ER and a MEK inhibitor (e.g., selumetinib or binimetinib) to inhibit Ras downstream signaling, in order to effectively treat neurofibromin-depleted ER+ breast cancer. When this combination therapy was tested in animal models, the result was tumor regression. The next step is to begin clinical trials of the effectiveness of this therapeutic approach in patients.
https://community.breastcancer.org/forum/73/topics/860294?page=64&post_creation=true
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debbew - Thanks for putting the article about the PPIs on here. I had read this before and was trying to find it again but couldn't find it. The article you linked also says that PPIs, if I understood it correctly, says that PPIs could be beneficial to chemotherapy. I wish the article provided more information about the studies. I know a couple of years ago PPIs were listed as one of the drug groups that could cause dementia but my gastroenterologist said that it was later shown that there was no link. I shared an article a week or so ago on I think the Ibrance thread about omeprazole may keep breast cancer from spreading. It's quite a quandary on whether it is beneficial or not.
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A fascinating article about the abscopal effect and research that's currently being done to see how to induce/replicate this effect, using radiation coupled with other treatments, including immunotherapy
https://www.cancer.gov/news-events/cancer-currents...
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bevjen
That would be such a great discovery if the flu vaccine could shrink tumors. I wish there was a clinical trial.
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^You're welcome, cowgal! The article mentions that they are just starting to study the possibility that PPIs might be helpful to chemo, so for now I have not heard of any evidence of that yet.
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Study reveals breast cancer cells shift their metabolic strategy to metastasize
New discovery in breast cancer could lead to better strategies for preventing the spread of cancer cells to other organs in the body, effectively reducing mortality in breast cancer patients. According to a study, published today in Nature Cell Biology, breast cancer cells shift their metabolic strategy in order to metastasize. Instead of cycling sugar (glucose) for energy, they preferentially use mitochondrial metabolism.
"This has important potential clinical implications because it suggests that drugs targeting mitochondrial metabolism may have efficacy for preventing metastatic spread in patients," said Devon A. Lawson, Ph.D., assistant professor in the UCI Department of Physiology and Biophysics and a member of the Chao Family Comprehensive Cancer Center at the UCI School of Medicine. "Historically, tumors were thought to contain dysfunctional mitochondria and be principally sustained by anaerobic glycolysis, or Warburg metabolism. Our work challenges that dogma and shows that breast cancer cells use mitochondrial metabolism during metastatic spread."
https://phys.org/news/2020-03-reveals-breast-cancer-cells-shift.html
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Could cancer immunotherapy success depend on gut bacteria? [not bc-specific]
Using mouse models of malignancy, the scientists found that the intestinal microbe Bifidobacterium accumulates within tumors, transforming anti-CD47 unresponsive tumors into responsive ones.
The team's study, published today in the Journal of Experimental Medicine, discovered that the response to treatment depends on the type of bacteria living in the animals' guts. They then identified the mechanism, finding that the combination of antibodies against CD47 and gut bacteria works via the body's STING pathway of innate immunity—the body's first line of defense against infection...
The findings suggest that a probiotic might someday be used to improve anti-CD47 therapy, says Fu, a Cancer Prevention and Research Institute (CPRIT) Scholar and holder of the Mary Nell and Ralph B. Rogers Professorship in Immunology at UT Southwestern.
https://medicalxpress.com/news/2020-03-cancer-immunotherapy-success-gut-bacteria.html
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Cancerous tumors, surrounding cells illuminated by new imaging agent
The imaging agent, referred to as LS301, has been approved for investigational use in small clinical trials at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. The first trial will investigate its use in imaging breast cancer.
"This unique imaging agent identifies cancer cells as well as other compromised cells surrounding the tumor," said Samuel Achilefu, PhD, the Michel M. Ter-Pogossian Professor of Radiology...
Achilefu expects that with a tumor and its surrounding fiefdom illuminated by the new imaging agent, doctors would have a better chance of removing the entire tumor as well as any areas that are likely to harbor microscopic cancer cells...
"There seems to be a type of immune cell that carries the imaging agent into the core of the tumor. So we now see the tumor margin and the core light up. This allows us to imagine a situation in which we could deliver a drug to the outside and the inside of the tumor at the same time. This dual targeting is not something we purposefully designed — it's not something we ever anticipated."
With this in mind, Achilefu's team conducted mouse studies to show that the researchers can attach a chemotherapy drug to the compound and use it to image the tumor and treat the disease simultaneously.
https://medicine.wustl.edu/news/cancerous-tumors-surrounding-cells-illuminated-by-new-imaging-agent/
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