PD-L1 And What It Means In Cancer Treatement

https://www.whatnext.com/blog/posts/pd-l1-and-what-it-means-in-cancer-treatement

{Not research, per se, but an brief and accessible article about PD-L1, a bit of history of immunotherapy research, and a very brief explanation of how immunotherapy attempts to work.}

morrigan_2575:

I am not aware of any standard protocols for giving H&P without a cytotoxin (chemo). (There may be instances in which physicans moderate or minimize the chemo for particularly frail or intolerant patients. There may have been clinical trials on this.)

Regarding "replace TCHP and AC+THP with Kadcyla," I personally think this would have many advantages; however, a recent clinical trial found that Kadcyla did not provide better outcomes than TCHP, nor was it deemed meaningfully less expensive, so they plan to make patients keep on getting TCHP. This assessment makes a huge error in appreciating patient experience, in my opinion. While "everyone is different" my experience of TCHP was on a different planet vs Kadcyla. Kadcyla was much easier for me to tolerate. Plus there is the issue of hair loss vs. not - which has implications beyond mere vanity. The trial was reported on this board. It would probably show up by searching for Kadcyla for early stage BC or something similar.

I thought AC was only given for TNBC now, but maybe that is not the case.

Thanks.

sunandsea: Glad that is helpful. If widely adopted, that treatment option would be huge news for lots of people. Less travel, less time off work, and away from family and other obligations. Less reconstruction - or less going without reconstruction. Many forgo the less invasive option of lumpectomy because of challenges with accessing radiation therapy. We can hope that this may make the entire array of options more accessible to the people who need them. Good luck with your treatment!

Thanks BevJen, I thought so too. I was just this week looking at radiation as a Tx option so it really caught my attention. Sure would be great if they could pin down a way to get that immune response to it work reliably!

Santabarbarian, Simone80 and others: It can seem discouraging that there is so much promise from bench research but things don't move to the clinical trial phase. As many of you know, Metavivor funds research on metastatic breast cancer. Someone from the organization said within the last week, there are promising proposals, just not enough funding for all of them. Other organizations fund promising research, too. Unfortunately, I am not able to fund much beyond lunch! But I try to do my part with small donations here and there and fundraising and advocacy work where I can. I don't have to tell readers here how important research is. I think if we all do a little, we can accomplish a lot.

Surgical Intervention for Isolated Breast Cancer Liver Metastasis

• The authors of this study evaluated 148 women with isolated breast cancer liver metastases, comparing outcomes between the 95 patients who underwent intervention (hepatectomy or radiofrequency ablation) and the 53 who did not. After a median follow-up of 36 months, there was no significant difference in progression-free survival between the treatment groups in the overall population. Subgroup analyses suggested a benefit with surgical intervention among patients who received systemic therapy and did not have preoperative progression.

• Hepatic surgery should be considered as a treatment option for select patients with isolated breast cancer liver metastases.

New Clue to Anti-PD-L1 Activity in Breast Cancer?

— Survival benefit with durvalumab in patients with PDL1 copy number alteration

A novel biomarker identified a large subgroup of metastatic breast cancer patients who benefited from an immune checkpoint inhibitor....

Almost a fourth of patients with no identified actionable mutations had copy number alteration (CNA) in the PD-L1 gene. Patients without PD-L1 CNA had a median progression-free survival (PFS) of 9 months when treated with the PD-L1 inhibitor durvalumab (Imfinzi), whereas median PFS had yet to be reached in patients whose tumors had copy number gain (three or four copies) or amplification (more than four).

Data for the CNA analysis came from the SAFIR02 Breast Immuno trial...

https://www.medpagetoday.com/meetingcoverage/additionalmeetings/86683?xid=nl_mpt_SROBGYN_2020-05-30&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=ObGynUpdate_053020&utm_term=NL_Spec_OBGYN_Update_Active

https://cslide.ctimeetingtech.com/breast2020/attendee/confcal/session/calendar/2020-05-24

https://clinicaltrials.gov/ct2/show/NCT02299999

HCQ Linked to Harm in Cancer Patients

— Combination with azithromycin associated with three-fold risk of mortality, registry study shows

Use of hydroxychloroquine in cancer patients who are also diagnosed with COVID-19 provided no benefits, and may have worsened outcomes, researchers suggested.

Treatment with the combination of hydroxychloroquine and azithromycin to treat COVID-19 in cancer patients was associated with a 2.89-fold greater risk of 30-day mortality than use of neither drug, reported Jeremy Warner, MD, of Vanderbilt University in Nashville, in a late-breaker abstract at the virtual American Society of Clinical Oncology (ASCO) annual meeting.

https://www.medpagetoday.com/meetingcoverage/asco/86738?xid=nl_popmed_2020-05-29&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=CoronaBreak_052920&utm_term=NL_Daily_Breaking_News_Active

https://ccc19.org/

ASCO conference coverage here:

https://www.medpagetoday.com/meetingcoverage/asco