the atezo trial results have been all over the place. Atezo+abraxane seemed to have some good prelim results, atezo+ taxol was a dud in the trials (though there was some subgroup analysis that again showed some benefit for a subpopulation....but it was underpowered & not part of study design). Atazo + taxol is what I started on & have had good response - I think I've beat the median pfs. I think the more mature atezo+abraxane data might be coming this year.

some onco twitter chatter was that they were wondering if PD-L1 had to be a certain threshold (not just positive/negative) for it to work but I think also some think there's another mutation that it's targetting. There are a few good responders with durable response so ... fingers crossed that I'm one of the unicorns. I've technically had two oligoprogressions on it but my liver mets continue to slowly shrivel up - which apparently is classic immunotherapy response: slow to start, longer duration rather than wham/bam/tumor dead (& then resistance) that you get from effective chemo.

eribulin PLUS pembrolizumab for mTNBC phase 1b/2 reporting https://pubmed.ncbi.nlm.nih.gov/33727258/

higher ORR (34.5% ) and OS (21 mo) in PDL1+ 1L pts

there were a number of complete responses in the trial (Stratum 1 was 1st line); there were complete responses in stratum 2 as well (2nd or 3rd line tx)

Yes SP a lady I follow on Twitter posted it. Really interesting seems like in these cases if I was the patient I’d push for the aggressive curative intent

Oral taxane tesetaxel is being withdrawn from development

https://finance.yahoo.com/news/odonate-therapeutic...

"clinical data package for tesetaxel is unlikely to support FDA approval." ... so it turns out it didn't actually work all that well

Antibody drug conjugates article on Springer

Clinical Development of New Antibody–Drug Conjugates in Breast Cancer: To Infinity and Beyond
https://link.springer.com/content/pdf/10.1007/s40259-021-00472-z.pdf

I have skimmed the paper. Lots of hope for ADCs including ER/PR + Her2-

Dee

PKNC - is breast adipocyte the same as "dense breast". I wonder if that is why I have had so much trouble

Lumpie - thank you for the laugh. One person posted that her DR told her that changes she was seeing in her fingers were because she was losing fat there, rather than in her "handles". It just is not fair. I was considering DIEP at one time, turning love handles into boobs sounded good. But I was not a good candidate, not the right kind of fat in the right places.

since starting letrozole in early January I have gone down some brassiere sizes.

Cyclophosphamide-Free Adjuvant Chemotherapy for Ovarian Protection in Young Women with Breast Cancer

https://www.practiceupdate.com/C/116102/56?elsca1=emc_enews_topic-alert

TAKE-HOME MESSAGE

• This randomized, phase III trial conducted across eight hospitals in China was designed to evaluate the menstrual resumption rate and disease-free survival in women with ER-positive, HER2-negative, early-stage breast cancer receiving epirubicin and cyclophosphamide followed by weekly paclitaxel (EC-P) or epirubicin and paclitaxel followed by weekly paclitaxel (EP-P). The menstrual resumption rate at 12 months after chemotherapy was 48.3% in the EC-P group compared with 63.1% in the EP-P group, with an absolute difference of 14.8% (P < .001) and an estimated odds ratio of 1.83. For the second primary endpoint of disease-free survival (DFS), the 5-year DFS rate was 78.3% in the EC-P group compared with 84.7% in the EP-P group. There was no statistically significant difference in distant disease–free survival or overall survival. Post hoc exploratory analysis found that the successful pregnancy rate was higher in the EP-P group (9.6% vs 2.7%; P = .03).
• Cyclophosphamide-free chemotherapy may be associated with a higher probability of menses resumption with potential fertility implications and minimal impact on disease-free and overall survival.

Thanks AlabameDee. Interesting (selfishly) to me that they included tamoxifen and raloxifen under SERMs but not toremifene.

Also ugh.

Even if a drug does not extend life, if it improves quality of life, it deserves approval. (Anyone who is in treatment for stage iv cancer knows this!) Also, sometimes a drug may not show great results for a whole study group, but may work well for some people, and it should be available to them

One of the rapid approvals they were reconsidering was the drug I'm currently on - atezolizumab/Tecentriq. Two very conflicting trial results (Impassion 130 and Impassion 131)

It was a 7-2 vote to keep it for mTNBC https://www.onclive.com/view/fda-panel-supports-at...

"The FDA's Oncologic Drugs Advisory Committee voted 7 to 2 in support of maintaining the indication of atezolizumab in combination with nab-paclitaxel as a treatment for adult patients with unresectable locally advanced or metastatic triple-negative breast cancer whose tumors are PD-L1 positive."

Tectonic shift - yes, I saw his name and I am a long time non-fan of that guy. Imagine him as your personal oncologist, I shudder at the thought.

He doesn't belong anywhere near public health care planning but unfortunately, he is well connected.

Love this take on old people /not really

"These people who live a vigorous life to 70, 80, 90 years of age—when I look at what those people 'do,' almost all of it is what I classify as play. It's not meaningful work," he said. "They're riding motorcycles; they're hiking. Which can all have value—don't get me wrong. But if it's the main thing in your life? Ummm, that's not probably a meaningful life."

And here’s commentary on the other guy, from a Statnews article :

“His critics, however, say Prasad is putting too much weight on statistical tables, instead of listening to the real-world experience of real-life patients and physicians. They also dismiss him as a generalist who doesn't really understand the specialty fields he so angrily attacks — and doesn't try to.

"He never wanted to hear the other side," said Dr. Ben Davies, a urologist at University of Pittsburgh who has clashed online with Prasad. "In general, there's an absolutism to his voice, which grates a lot of researchers the wrong way."

Dr. Tomasz Beer, a prostate cancer researcher at OHSU — and the man responsible for bringing Prasad up to Portland — has been called upon to defend some of his more controversial remarks: "I've gotten calls from people at respected institutions saying, 'Why the hell did you hire this guy?'" Beer said. "My answer: We support academic freedom and he's doing good work."