Breaking Research News from sources other than Breastcancer.org
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Dear Lumpie, thanks... it is so strange that the very "historic" product like milk does this. Hundreds of generations grew up on milk, if not milk we probably would not be here, but on another hand when we are grown up, we rarely drink milk, only when we are little. Saulius
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Saulius: You are right... there are lots of trade-offs and lots of questions remain unanswered. I believe that the studied population was adult only, so we don't know about childhood vs adult consumption and weather that makes a difference. As an adult, I really don't drink milk, but I put half-n-half in my coffee and I do enjoy cheese occasionally. I also like yogurt... but it can be digested differently because of the live and active cultures. Does this matter? More research to be done....
Edit: Big one: it does not indicate whether milk consumption impacts recurrence or prognosis for those with MBC.
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I remember hearing of a dairy/breast cancer connection back in the 90s, but then science seemed to have reversed itself.
This does make me sad because I love cheese and I eat yogurt every morning. I did switch to oat milk or coconut creamer for coffee. Could switch to coconut milk yogurt a few times a week.
I currently buy sheep milk yogurt and cheese when I can, it is just easier to digest for me and very tasty 😋 Maybe it is a little better than cow milk? I joked that sheep are smaller than cows so maybe the fat makes us less fat than cow products 😆 ,
I will still avoid soy milk, I don’t like the taste anyway.Thank you Lumpie for continuing to gather all this great info for us x
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Re liquid biopsies - as someone who just had one:
I recently had my blood pulled for the F1 liquid biopsy and my MO just sent me the report. This is about 14 months after my tissue biopsy. I haven't met with my MO about it yet (that's on Sept. 8) but I will say that just reading it over and trying to piece it all together, I am ambivalent on whether or not it is that helpful in comparison to a tissue biopsy. For me, the tissue biopsy had a bit more info. The blood biopsy did, however, identify another mutation that hadn't shown up in the tissue biopsy -- TP53. At first I freaked out when I saw that, but then did a little bit of research, and for NON-TNBC folks, it can indicate a sensitivity to immunotherapy (Yay!) which is good for me bc I also have a high tumor mutational burden.
Of interest to me was the fact that on my tissue biopsy, I had 2-3 ERBB2 mutations. On the blood one, it said "not detected." Very interesting. Waiting to find out if my doc thinks that's because of current I/F treatment.
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Regarding milk - the integrative oncologist I worked with told me to cut out dairy or drastically reduce it. I still have milk here or there but way way less. If you have milk, the healthiest milk is organic grass-fed full fat but it still should be limited. He basically advocates a close to vegan diet with deep sea fish. Animal products mostly increase inflammation. Plus they displace vegetables and fruits, which have anti cancer phytonutrients.
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BevJen: Thanks for sharing your experience with the liquid biopsy. It is my understanding that TP53 is a very common mutation. Please keep us posted on how it informs your treatment.
And thanks to others on dairy insights.
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Lumpie, thank you for all your posts. I hope the liquid biopsy becomes more mainstream soon.
As for milk consumption and breast cancer risk, I hope this topic gets more investigation. As BSandra pointed out, milk has been a staple food source for many cultures for hundreds of years. However, modern milk production is not done in the same way it was done historically, and that could be a factor too.
I am not a huge consumer of dairy, but I do have a little bit almost every day. I use a small amount of milk in my coffee, and I find that plain yogurt is sometimes helpful for my stomach during chemo and Ibrance.
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buttonsmachine: I had wondered about hormones, antibiotics... anything that might be added to the situation. Another forum I read raised the issue of BLV (Bovine leukemia virus) DNA. This was something I knew nothing about. If you want to read more on the topic, I will paste a citation below.
Bovine leukemia virus DNA associated with breast cancer in women from South Brazil
Nature - Published: 27 February 2019
Schwingel, D., Andreolla, A.P., Erpen, L.M.S. et al. Bovine leukemia virus DNA associated with breast cancer in women from South Brazil. Sci Rep 9, 2949 (2019). https://doi.org/10.1038/s41598-019-39834-7
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Lumpie, thank you for your posts on dairy. Very disturbing. I consume dairy daily, milk, unflavored yogurt, cheese, and a wee bit of ice-cream. Maybe organic is not enough. Nutrition is so hard to pin down, advice changes all the time, lots of disagreement. Was it something else in their lifestyle ? At one time eggs were considered evil incarnate because of cholesteral, but now it seems like they have been redeemed as far as cholesterol is concerned.
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Wow, the bovine leukemia connection just goes to show how far-reaching cause and effect can be - like the butterfly effect I suppose. That is definitely concerning.
I had another thought: is it possible that populations who traditionally consume more milk products are also at statistically higher risk for breast cancer anyway?
In statistics, we must always remember that "correlation is not causation" as they say.
I don't know the answers, but this is an interesting topic.
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This specific study was talking about north American women.
& Actually, I believe we have not been consuming tons of cow milk for generations. Before refrigeration, milk spoiled quickly and thus our predecessors consumed dairy as fermented buttermilk, kefir or cheese. Even being able to consume milk & other dairy after weaning from human milk is geographically limited & linked to European genetic populations - most people become lactose intolerant around age 6 yr.
Also, all mammals produce milk to feed their babies so excess production didn't become common until humans started preferentially breeding animals for it.
The study mentioned here was done on north American women. I didn't see a race breakdown at first glance - will go have another look later.
Bias disclosure - ethical vegan; human lactation consultant
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Re the milk study, I take some comfort in this: "No important associations were noted with cheese and yogurt."
Consistent with moth's point about how we have evolved to consume dairy, and great news for Olma61.
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Bovine leukemia virus DNA associated with breast cancer in women from South Brazil
Nature, Scientific Reports, Published: 27 February 2019
Abstract
Breast cancer is a neoplastic condition with a high morbidity and mortality amongst women worldwide. Recent data linking bovine leukemia virus (BLV) with breast cancer has been contested already. Our study investigated the presence of BLV genome in healthy (n = 72) and cancerous (n = 72) paraffin-embedded samples of breast tissues from women in south Brazil. BLV DNA was found most frequently (30.5%) in breast cancer tissue than in healthy breast (13.9%) (Odds ratio = 2.73; confidence interval = 1.18–6.29; p = 0.027). In contrast, antibodies to BLV were found in a very small percentage of healthy blood donors. There was no association between BLV DNA and other tumor prognostic biological markers such as hormonal receptors, HER2 oncoprotein, proliferation index, metastasis in sentinels lymph nodes, and tumor grade and size. Our findings suggest that BLV should be considered a potential predisposing factor to breast cancer in women.
Schwingel, D., Andreolla, A.P., Erpen, L.M.S. et al. Bovine leukemia virus DNA associated with breast cancer in women from South Brazil. Sci Rep 9, 2949 (2019). https://doi.org/10.1038/s41598-019-39834-7
{Posting this abstract for those disinclined or unable to click through. Full article is open access. I didn't find the reference to yogurt or cheese, but if those are not implicated, I am relieved!}
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A Roadmap for Developing Study Endpoints in Real-World Settings
August 28, 2020
EXECUTIVE SUMMARY
With growing interest in using real-world data (RWD) and real-world evidence (RWE) to support regulatory decision-making, stakeholders are considering how to develop robust real-world study endpoints to evaluate medical product effectiveness when fit-for-use data and valid methods are available. Despite extensive literature and guidance for developing clinical trial endpoints, few resources support real-world endpoint development. Some principles can be carried over from the clinical trial setting, but differences in patient populations, care settings, and data collection in the real-world setting result in unique considerations for endpoint development. Additionally, studies conducted in the realworld setting have the potential to capture outcomes that are more relevant to patients than outcomes captured in clinical trials. This paper explores how key differences in study settings influence a researcher's considerations for developing study endpoints in the real world. First, because stakeholders involved in the realworld endpoint development process have multidisciplinary backgrounds, this paper details the current landscape of endpoint development, provides standardized definitions of key concepts, and introduces existing frameworks. Second, this paper presents a roadmap for endpoint development, beginning with selection of a concept of interest and study outcome that reflect the research question. Within this roadmap, the paper details how real-world settings impact selection of a concept of interest, outcome, and endpoint components, raising challenges for researchers to consider when developing real-world endpoints. Third, this paper addresses key considerations for the validation of real-world endpoints. Finally, this paper examines opportunities to enhance the use of real-world endpoints through stakeholder collaboration.
The paper contains disclosures about drug company funding of and participation in the preparation of the paper.
The full paper is available here without charge (but you may have to register): https://healthpolicy.duke.edu/sites/default/files/2020-08/Real-World%20Endpoints.pdf
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Came across this article - it summarises MBC and some of the current clinical trials and may have already been posted here.
https://www.oncozine.com/new-therapies-may-offer-hope-for-patients-with-metastatic-breast-cancer/
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Very early study with a long ways to go but, it's very interesting/cool none the less.
https://www.abc.net.au/news/2020-09-01/new-aus-research-finds-honey-bee-venom-kills-breast-cancer-cells/12618064
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Morrison,
Thanks for the article. Very interesting indeed. Hopefully, they get it to the human clinical trials stage soon
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Here's a wild one -- talking about the venom of the honey bee wiping out breast cancer cells. The ingredient that does is can be synthetically created, so perhaps some drug company will jump on this.
http://dx.doi.org/10.1038/s41698-020-00129-0
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Dear Bev, just read the article - honeybees saving humans - I like this idea:)> Just like Pacific yew tree (taxanes), another organic chemotherapy! Saulius
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Saulius,
Yes, to me, this honey bee stuff sounds very promising -- and also makes me wonder why the heck we haven't found a "cure" for cancer. My pessimistic self says it is because lots of things could "cure" cancer, or at least some types of cancer. But they are not commercially viable, meaning that some company can't make a lot of money in developing it. The good thing about the honey bee story is that the thing that they take from the honey bee can be synthetically created -- so -- maybe commercially viable?
I did have to laugh when I read the article, though. I am seriously allergic to certain bee venoms, and in fact, years ago, had to go through treatments to desensitize me to bee stings because it could be life threatening for me. However, honeybees were not among my list of bees and wasps to which I would react, so bring on the honeybees!
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Aug 30, 2020
Clinical implications of HER2 mRNA expression and intrinsic subtype in refractory HER2-positive metastatic breast cancer treated with pan-HER inhibitor, poziotinib
Breast Cancer Research And Treatment
Abstract
We explored clinical implication of intrinsic molecular subtype in human epidermal growth factor receptor 2 (HER2) + metastatic breast cancer (BC) with pan-HER inhibitor from a phase II clinical trial of poziotinib in refractory HER2+BC patients. For this translational research correlated with phase II clinical trial, we performed an nCounter expression assay, using gene panel including 50 genes for PAM50 prediction and targeted deep sequencing. From 106 participants, we obtained 97 tumor tissues and analyzed gene expression in 91 of these samples. Of 91 HER2+BCs, 40 (44.0%) were HER2-enriched (E) intrinsic molecular subtype, 17 (18.7%) of Luminal A, 16 (17.6%) of Basal-like, 14 (15.4%) of Luminal B and 4 (4.4%) of Normal-like. HER2-E subtype was associated with hormone receptor negativity (odds ratio [OR] 2.93; p = 0.019), 3 + of HER2 immunohistochemistry(IHC) (OR 5.64; p = 0.001), high mRNA expression of HER2 (OR 14.43; p = 0.001) and copy number(CN) amplification of HER2 (OR 12.80; p = 0.005). In genetic alterations, alteration was more frequently observed in HER2-E subtype (OR 3.84; p = 0.022) but there was no association between PIK3CA alteration and HER2-E subtype (p = 0.655). In terms of drug efficacy, high mRNA expression of HER2 was the most powerful predictor of poziotinib response (median progression-free survival [PFS): 4.63 months [high] vs. 2.56 [low]; p < .001). In a combination prediction model, median PFS of intrinsic subtypes except Her2-E with high HER2 mRNA expression without PIK3CA genetic alteration was 6.83 months and that of the remaining group was 1.74 months (p < .001). HER2-E subtype was associated with hormone receptor status, HER2 IHC, CN and mRNA expression and TP53 mutation. In survival analysis, the information of level of HER2 mRNA expression, intrinsic molecular subtype and PI3K pathway alteration would be independent predictors to poziotinib treatment. ClinicalTrials.gov identifier: NCT02418689.
DOI: 10.1007/S10549-020-05891-0
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Published in Oncology
September 01, 2020
Surgery at Primary and Metastatic Sites for Stage IV Breast Cancer
- The authors of this National Cancer Database study of 54,871 patients with stage IV breast cancer found longer overall survival to be associated with lumpectomy or mastectomy compared with no surgery. There was also a survival benefit associated with liver, lung, and brain metastasectomy.
- These findings add to previous retrospective studies suggesting improved survival with surgical management in the setting of metastatic breast cancer but are in contrast to various prospective studies which have failed to demonstrate a survival benefit with the addition of local management to systemic treatment, including the updated results from E2108 presented at ASCO 2020.
{Access to full article requires a fee or subscription.} -
Anyone hear of this drug that should perform better than fulvestrant?
Arvinas is developing ARV-471, an oral estrogen receptor (ER)-targeting PROTAC® protein degrader for the potential treatment of patients with locally advanced or metastatic ER positive / HER2 negative breast cancer.Trial NCT04072952
I am going to check it out when I go to Sarah Cannon next week
Dee -
Lumpie, in the article about surgery for stage iv, do they mean stage iv in the technical sense of de novo stage iv, or as many use the term to mean metastatic whether de novo or distant recurrence? (I have not subscribed so could not access the articles.)
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Dee, I see that is a phase I study with ARV-471. On the Ibrance thread Cure-ious recently posted about the current status of oral SERD trials. Apparently there are only three that are beyond phase 1 right now.
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ShetlandPony: Good question. The full article may go more explicitly into methodology. Reviewing the info available to us, it says they were only looking at women classified as stage 4 in the "National Cancer Database," by which I assume that they mean the SEER database in the US. (The authors are all associated with the Cleveland Clinic.) We all know that there are problems with classification in SEER. (Link below to the MBCN discussion of these issues.) Since the database only counts those diagnosed de novo's as stage 4, it would seem that they are only looking at the case histories of de novo diagnoses for this study. It would be interesting to parse more complex histories to try to identify patterns. Someday, someone will take on that project.
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Thanks, Lumpie. That’s what I figured.
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Harry Perkins Institute of Medical Research study finds honeybee venom rapidly kills aggressive breast cancer cells:
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Dear Bev, I am not allergic to bees but I love nature, spend lot's of time by lakes and get stung once in a while, so... it hurts:) Cannot imagine being stung by 100 bees but if that'd be a cure for C, I'd take it:) Sure the are looking into commercializing this compound (melittin), and therefore it will take years to get it to the market if all stars align:/ Saulius
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For HER2+/ERBB2- MBC adding Keytruda/pembrolizumab to eribulin doesn't improve PFS
"The results do not support the use of pembrolizumab in combination with eribulin for patients with hormone receptor–positive/ERBB2-negative metastatic breast cancer, independent of programmed cell death ligand 1 status."
https://jamanetwork.com/journals/jamaoncology/article-abstract/2769923?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=090320#.X1E_Ap9GuxA.twitter
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