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  • Garnersuz77
    Garnersuz77 Member Posts: 44
    edited December 2020

    Hi!

    Can anyone weigh in on the results of today's RxPonder results? I was diagnosed in 2018 premenopausal 1/4 positive nodes and a low Oncotype of 9. I sought out 3 MO opinions and they all said chemo would have little to no benefit to me so I skipped it. The results from this study seem pretty clear that was a terrible decision as the premenopausal group that received chemo plus ET had a 46%!! reduction in metastatic reoccurrence compared to the arm that did ET only. Ugh.

  • Lumpie
    Lumpie Member Posts: 1,650
    edited December 2020

    Garnersuz77: I read a summary really quickly, but the way I read it, it looked like it changed the risk by maybe 4%. Not nothing, but not huge either. And, of course, (as far as I know,) we didn't have studies before now showing this difference in prognosis. Of course, that is why we need more research. It is great to have all this "smart"/personalized medicine, but if we can't figure out the persons for whom it is smart, we don't really come out ahead. We will get there but... arg... it is to be on the long end of the wait.

  • 2019whatayear
    2019whatayear Member Posts: 767
    edited December 2020

    The doctors discussing it were really leaning toward chemo not being of benefit pre or post if 1-3 nodes . They think the difference is mostly due to younger women being thrown into menopause due to chemo so the perceived benefit is more due to the sudden menopause vrs the chemo itself

    With a score of 9 the endocrine therapy is what you need -Take heart!

  • Garnersuz77
    Garnersuz77 Member Posts: 44
    edited December 2020

    Thank you all very much! I feel better now that I understand it better. The ovarian suppression benefit as a result of chemo vs. a large benefit from the chemo itself make a lot of sense.

  • moth
    moth Member Posts: 4,800
    edited December 2020

    hold your enthusiasm....


    from Annals of Oncology Oct 2020

    "Less than 20% (19.3%) of cancer science discoveries touted as breakthrough, landmark, groundbreaking, or highly promising translated into clinical therapy or practice with a median follow up of 15 years. Among clinically adopted treatments in our analysis, most were approved based on surrogate end points and only 9.1% found a survival benefit. Among 8 therapies with an OS benefit, the median benefit provided was 2.8 months. Our results suggest that claims of major discovery are associated only with modest rates of ultimate clinical success."

    DOI:https://doi.org/10.1016/j.annonc.2020.10.484



  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2020

    MOTH

    Sad report. I don’t even have to read the report to believe that. Those figures pan out in clinical trial reports and even the latest news drugs. Why do they spend so much money on a drug that only gets us OSR of about 3 months (median)

    Because of the hope you are one of the few on the outlying edge of the numbers like my sister. She started on opdivo for NSCLC when it first came out and has survived with stable disease for 5 years and going strong.

    If they don’t keep trying, they won’t find the right one! I’m thankful for the effort and hope the next breakthrough is the one!

    Dee


  • moth
    moth Member Posts: 4,800
    edited December 2020

    oligometastatic peeps -

    improved OS for those who had surgical resection of primary and oligomets

    https://drive.google.com/file/d/18yi0zQK0L4oP5WY4T...


  • BevJen
    BevJen Member Posts: 2,523
    edited December 2020

    Moth,

    Do you have another link for that article? I can't get it to load -- I just get the spinning wheel. Or do you have an exact title so we can find it ourselves?

    Thanks

  • moth
    moth Member Posts: 4,800
    edited December 2020

    weird I just checked and it's working for me. It's a poster presentation ahead of publication from sabcs.

    Someone tweeted a lower quality version here but it doesn't blow up nicely https://twitter.com/stage4kelly/status/13367092193...


  • BevJen
    BevJen Member Posts: 2,523
    edited December 2020

    Thanks. That one worked for me and I was able to blow it up a bit from twitter.

  • MountainMia
    MountainMia Member Posts: 1,307
    edited December 2020

    BevJen, there's been a google problem that includes documents. If you try again later, it might work fine.

  • Lumpie
    Lumpie Member Posts: 1,650
    edited December 2020

    Physicians Commonly Miss Adverse Events in Patients With Breast Cancer

    Physicians commonly underrecognized adverse events of pain, pruritus, edema, and fatigue that patients with breast cancer experienced after radiotherapy, found a study presented at the 2020 Virtual San Antonio Breast Cancer Symposium (SABCS).

    The study included 9868 patients from 29 practices in Michigan who had breast cancer and received radiotherapy after lumpectomy.

    Study researchers reviewed 37,593 reports of pain, pruritus, edema, and fatigue from patient reports and compared them with the grade physicians gave the adverse events. Physicians graded adverse events using the Common Toxicity Criteria for Adverse Events (CTCAE).

    Physicians were considered to underrecognize pain if they graded the severity as 0 — that is, absent — and the patient reported the severity as moderate, or if they graded the severity as 1 or lower and the patient reported the severity as severe. Pruritis and edema were considered underrecognized if physicians graded the severity as 0 and patients reported bother often or all of the time. Fatigue was considered underrecognized if physicians graded the severity as 0 and patients reported having significant fatigue most of the time or always.

    Compared with White patients, Black patients had a 92% increased odds of having adverse events underrecognized (odds ratio [OR], 1.92; 95% CI, 1.65-2.23; P <.001).

    Compared with patients aged 60 to 69 years, patients who were younger than 50 years had a 35% increased odds of having adverse events underrecognized (OR, 1.4).

    "We need to do a better job — that's really what it is," commented SABCS Codirector Virginia Kaklamani, MD, UT Health San Antonio MD Anderson Cancer Center, Texas. "We need to conduct studies where patient-reported outcomes are being reported, and we as physicians need to listen more to our patients."

    https://www.cancertherapyadvisor.com/home/news/con...

    Reference: Jagsi R, Griffith KA, Vicini F, et al. Identifying patients whose symptoms are under-recognized during breast radiotherapy: comparison of patient and physician reports of toxicity in a multicenter cohort. Presented at: 2020 Virtual San Antonio Breast Cancer Symposium; December 8-11, 2020. Abstract GS3-07.

    {Stunningly insightful. Many of us have complained about similar issues for years. Access to reporting is at no charge but may require log-in. Not sure about access parameters for prezo. Log in for SABCS may be required.}

  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited December 2020

    Posted this on an exercise thread but I think it's worth posting here too.

    Physical activity of any intensity, whether folding laundry or jogging, can lower the risk of an early death for middle-aged and older people, a new study suggests. Furthermore, the time of day you move your body could affect risk further.
    Researchers analyzed data from 2,795 participants. They identified a group of 781 women with breast
    cancer and 865 female controls, and a group of 504 men with prostate cancer and 645 male controls. Both groups responded to a questionnaire relating to their physical activities and gave data on the timing and frequency of their exercises.
    The study found that exercising in the morning, between 8-10 a.m., showed the highest benefit in reducing the risk of both breast and prostate cancers. Researchers also found that men who exercised between the hours of 7 and 10 p.m. had a 25 percent lower risk of developing prostate cancer. No benefits from evening activity were seen in the group of women.
    "Overall our findings indicate that time of the day of physical activity is an important aspect of physical activity that may potentiate the protective effect of physical activity on cancer risk," the researchers wrote. "The effect of timing of physical activity on cancer risk should be examined in future research with a more detailed assessment of activity patterns, also including occupational activity."

    https://onlinelibrary.wiley.com/doi/10.1002/ijc.33310

  • BlueGirlRedState
    BlueGirlRedState Member Posts: 1,031
    edited December 2020
  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited December 2020

    Interesting BlueGIrl.

  • morrigan_2575
    morrigan_2575 Member Posts: 824
    edited December 2020

    this is interesting, it's from a Phase 2b Trial.

    https://www.onclive.com/view/gp2-gm-csf-combo-elic...

    The GP2 immunotherapy plus granulocyte-macrophage colony-stimulating factor demonstrated potent responses and a 100% disease-free survival in patients with HER2/neu 3–positive disease who received adjuvant trastuzumab.

    Says there's a Phase 3 Trial Coming

  • debbew
    debbew Member Posts: 226
    edited December 2020

    Alpha-TEA [in phase 1 trial] strikes down advanced breast cancer?

    ..."The patients with HER2 driven or positive breast cancer, they actually start losing these T-cells and so they lose that immunologic response," explained William Gwin, MD, an assistant professor at University of Washington School of Medicine and breast cancer specialist at Seattle Cancer Care Alliance.

    But now a phase one clinical trial is underway with advanced HER2 positive breast cancer patients for the oral therapy alpha-TEA in combination with the antibody-drug Herceptin. Alpha-TEA works by activating T-cells.

    "We can boost those and drive those T-cells that target HER2 and sort of restore that immune response against HER2," elaborated Dr. Gwin.

    Attacking cancer cells but leaving the normal cells alone.

    "It does seem to have similar effects to chemotherapy, but really without the side effects," Dr. Gwin shared.


    https://www.wmcactionnews5.com/2020/12/15/best-life-alpha-tea-strikes-down-advanced-breast-cancer/

  • BSandra
    BSandra Member Posts: 836
    edited December 2020

    Dear Debbew, this is crazily good news... :) It is interesting what dosages they use (they do not say this in clinical trial)? I already found they use up to 1500 mg/kg/day in dogs:) Saulius

  • debbew
    debbew Member Posts: 226
    edited December 2020

    Thanks for adding that info, Saulius!

  • BSandra
    BSandra Member Posts: 836
    edited December 2020

    HER2 people, FDA approves Margetuximab!

    https://www.onclive.com/view/fda-approves-margetux...

    Debbew, I tried to look if one can buy alpha-TEA:) No luck - probably a serious agent, although well known for at least a decade. Actually my motivation is based on assumption that this is something "promising", as they never had clinical trials with alpha-TEA in BC patients, and now start directly with ABC (well, there's evidence in dishes with cell lines). And it is strange this substance is not widely out there, as it is a derivative of vitE. I surely can find folks who could synthesize it here in labs:)) but it would be idiotic to use it without quality control. Trastuzumab resistance is real and it would be so cool to overcome it with this "simple" compound...

    Saulius

  • LillyIsHere
    LillyIsHere Member Posts: 830
    edited December 2020

    Systemic Therapy for Estrogen Receptor–Positive, HER2-Negative Breast Cancer.

    Harold J. Burstein, M.D., Ph.D.

    December 24, 2020

    Some of the txt:

    In recent years, the options for adjuvant endocrine treatment have broadened beyond tamoxifen. Aromatase inhibitors block the conversion of androgens into estrogens (Figure 1), suppressing residual estrogen levels by more than 90% in postmenopausal women. These agents are contraindicated in premenopausal women who are not undergoing ovarian suppression, because compensatory physiological responses induce ovarian estrogen production. Aromatase inhibitor therapy results in a greater reduction in the risk of recurrence than 5 years of tamoxifen, such that most postmenopausal women should consider aromatase inhibitor treatment either as initial therapy or after 2 to 3 years of tamoxifen. For women presenting with stage I or IIA cancers — the most common stage at diagnosis in countries where screening mammography is routine — the numerical advantage of aromatase inhibitor–based treatment over tamoxifen alone is modest: a 3% reduction in recurrence and a 2% reduction in mortality at 10 years. Aromatase inhibitors are of more value in the treatment of higher-risk cancers (according to stage or biologic features) because of the underlying prognosis39 and in the treatment of lobular cancers. Extending the duration of treatment from 5 to 10 years with either tamoxifen41 or aromatase inhibitors reduces the risk of recurrence, as compared with just 5 years of treatment. Patients at increased risk for a late recurrence because of nodal status or adverse biologic features of the tumor probably derive the greatest benefit from extended therapy; however, extended aromatase inhibitor treatment in years 8 through 10 is likely to confer a modest benefit, at most. The decision to extend therapy should incorporate the patient's preferences, informed by the estimated risk of recurrence beyond year 5, and the toxic effects of therapy to date (Figures 3 and Figure 4).



  • debbew
    debbew Member Posts: 226
    edited December 2020

    Cleveland Clinic [triple negative] Breast Cancer Vaccine Goes To Clinical Trials

    The shot protects against alpha-lactalbumin, a protein in women's mammary glands that no longer appears after childbearing years but shows up in many cases of triple negative breast cancer, [Dr. Vincent Tuohy, a cancer researcher at the clinic who invented the vaccine] said.

    The idea behind taking this vaccine is the body's immune response would destroy cancer cells before they develop and mature, Tuohy said...

    In animal trials, the vaccine was shown to be very effective, Tuohy added...

    If the trials are successful, Tuohy said he hopes people could eventually get the vaccine as part of their normal preventative care.

    \https://www.ideastream.org/news/cleveland-clinic-b...

  • BevJen
    BevJen Member Posts: 2,523
    edited December 2020

    Interesting article from the National Cancer Institute about exceptional responders --what they've found out so far.

    https://www.cancer.gov/news-events/press-releases/...


  • Springdaisy
    Springdaisy Member Posts: 58
    edited January 2021

    I have stage one and had a lumpectomy and just finished radiation. Does anyone know The name of the blood test that shows how many circulating tumor cells are in a persons blood? And is it possible to get that number down to 0? And if it gets down to 0 can aperson stop taking whatever inhibitor they are taking? Just wondering if anybody has had experience with this. Thank you.

  • moth
    moth Member Posts: 4,800
    edited January 2021

    Springdaisy - Signatera is one brand of the CTC test. AFAIK we don't have enough studies to show if 0 means you can go off hormone therapy.

    Breast Cancer Index measures risk of recurrence but it's for AFTER 5 yrs of hormone therapy to see if hormone therapy should be extended. It's not FDA approved. https://www.breastcancer.org/symptoms/testing/type...


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