Breaking Research News from sources other than Breastcancer.org
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A different article on this subject that went into greater detail on the study said that a handful of people responded--it was something like 15% of the study population--which admittedly is not huge, but encouraging nonetheless. I very much believe that there are some amazing breakthroughs on the horizon. So I think it is definitely worth cheering about
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ASCO 2018: Elevated Serum PD-L1 May Identify Patients With HER2–Positive Metastatic Breast Cancer Who Would Benefit From the Addition of a Checkpoint Inhibitor
https://www.practiceupdate.com/c/69050/67/13/?elsc...
....levated pretreatment serum PD-L1 was associated with a shorter overall but not progression-free survival with trastuzumab treatment. Immune evasion by the tumor may reduce the effectiveness of trastuzumab therapy.
"There appears to be a subgroup of patients with HER2–positive metastatic breast cancer with high serum PD-L1 levels who do less well on trastuzumab treatment," Dr. Lipton said
"Going forward, "he added, "it would be interesting to see how these patients respond to therapy with trastuzumab + a PD-1 or PD-L1 inhibitor."
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ASCO 2018: Shorter Trastuzumab Treatment for HER2–Positive Breast Cancer Can Be as Effective, With Fewer Cardiac Side Effects
https://www.practiceupdate.com/c/69048/67/13/?elsc...
...half of the women took trastuzumab for 6 months, and the other half took it for 12 months. Women also received chemotherapy (anthracycline-based, taxane-based, or a combination of both). "This new trial shows that a shorter length of treatment can benefit patients just as much as a longer treatment, with less risk of cardiac side effects. This is a win–win for patients with breast cancer who are receiving this common treatment."
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The Impact of Surgical Excision of the Primary Tumor in Stage IV Breast Cancer on Survival
https://www.practiceupdate.com/c/68992/67/13/?elsc...
- This meta-analysis was designed to evaluate the survival benefit associated with removal of the primary tumor among patients with stage IV breast cancer. Based on 19 retrospective studies, the pooled hazard ratio for overall survival following excision of the primary tumor was 0.65. However, pooled analysis of three prospective randomized trials showed a pooled hazard ratio of 0.85 associated with primary tumor excision.
- Based on these results, the study authors do not recommend routine resection of the primary tumor in stage IV breast cancer.
- For those with a long life expectancy, physicians could discuss ... it with these patients, put forward surgery as a therapy choice and perform the operation under deliberation.
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Cancer May Contribute to Diabetes Risk
https://www.healio.com/hematology-oncology/gastroi...
A study in JAMA Oncology showed that patients with cancer were at an increased risk for subsequent type 2 diabetes, with the highest diabetes risk detected in the first two years after cancer diagnosis. Researchers followed 524,089 individuals in South Korea with no history of diabetes or cancer for up to 10 years, and they found the strongest association between pancreatic cancer and diabetes, followed by kidney, liver, gall bladder, lung, blood, breast, stomach and thyroid cancers.
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Cardiac Structure Injury After Radiotherapy for Breast Cancer
https://www.practiceupdate.com/C/68593/56?elsca1=e...
- The aim of this study was to evaluate the effect of radiation on specific cardiac segments in 456 women who underwent radiotherapy (RT) for breast cancer and then later experienced a major coronary event. Of women with left ventricular (LV) injury, 243 had left-sided breast cancer and 171 had right-sided breast cancer (ratio of left vs right, 1.42), reflecting the higher typical LV radiation doses in left-sided cancer (average dose left-sided, 8.3 Gy; average dose right-sided, 0.6 Gy). For women with coronary artery disease, the ratios of left-sided versus right-sided RT for six individual coronary artery segments were estimated.
- Higher radiation doses were strongly associated with more frequent injury to individual LV and coronary artery segments, suggesting the radiosensitivity of all cardiac segments and indicating the need to minimize radiation doses to all segments.
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Researchers identify racial differences in breast cancer immune microenvironment
https://www.news-medical.net/news/20180604/Researc...
Roswell Park Comprehensive Cancer Center researchers have identified significant differences in the immune microenvironment of breast cancer tumors between African-American and white women, shedding light on the ways in which race can influence cancer development and outcomes.
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Study: Breast cancer survivors do not receive recommended level of screening after surgery
https://www.news-medical.net/news/20180524/Study-B...
Breast cancer survivors are not getting the recommended level of screening, post-surgery, according to a newly-published study in JNCCN – Journal of the National Comprehensive Cancer Network. {the study} looked at the post-surgery mammography rates for women with health insurance. While NCCN Guidelines® recommend annual mammograms for early-detection of disease recurrence; this study found that even women who remained insured were less likely to meet that standard, as they became long-term survivors.
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Study: Few men undergo genetic testing despite high risk of breast cancer
https://www.news-medical.net/news/20180601/Study-F...
It's well-known that women with BRCA are at a very high risk for breast and ovarian cancer. Less known is the fact that men with these mutations also are at risk of breast cancer and other cancers. A study published in April in JAMA Oncology finds that few men are screened for these genetic mutations and the researchers strongly suggest that they be screened.
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New guideline for HER2 testing in breast cancer benefits patients and clinicians
https://www.news-medical.net/news/20180531/New-gui...
"... Notably, the 2018 Focused Update addresses uncommon clinical scenarios and improves clarity, particularly for infrequent HER2 test results that are of uncertain biologic or clinical significance.... a growing body of clinical outcomes literature and survey data enables us to recommend how to best evaluate some of the less common patterns in HER2 results emerging from ISH,"
{Rather technical but will be relevant for/of interest to some...}
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Mismatch Between Cardiac Risk and Imaging Practices in Patients Receiving Chemotherapy for Breast Cancer
https://www.practiceupdate.com/C/68595/56?elsca1=e...
- The purpose of this population-based retrospective cohort study was to assess pre-chemotherapy cardiac imaging practices in relation to patients' heart failure (HF) risk in 18,444 women (median age, 55) receiving chemotherapy for early-stage breast cancer. Women who received anthracyclines without trastuzumab underwent imaging more frequently if they had additional HF risk factors (73.3% vs 62.6%; P < .001). The 5-year incidence of a major adverse cardiac event (MACE) was two to six times higher in patients with HF risk factors across all treatment regimens. Patients with HF risk factors who received anthracyclines without trastuzumab had a higher 5-year incidence of MACE (4.5%) than patients without HF risk factors who received trastuzumab without anthracyclines (2.6%). However, cardiac imaging was performed less frequently in the former group (73.3% vs 93.6%; P < .001). Logistic regression indicated that most variation in baseline imaging was related to chemotherapy regimen followed by physician-level factors. The odds of imaging were doubled with female physicians. Patient-specific factors, including HF risk factors, made minimal contribution to variation in imaging.
- The authors concluded that baseline cardiac imaging was driven by chemotherapy regimen rather than HF risk. This risk–imaging mismatch should be an impetus to reconsider current cardiac imaging practices in patients who receive chemotherapy for breast cancer.
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Long-Term Survival in Trastuzumab-Treated Patients With HER2+ Metastatic Breast Cancer
https://www.practiceupdate.com/c/68104/67/13/?elsc...
- This retrospective study included 4177 women with HER2+ metastatic breast cancer who initiated trastuzumab and was designed to assess real-world treatment patterns in women surviving 5 years or longer. Of these women, 1082 survived at least 5 years. After a median follow-up of 9.4 years, 36% of long-term survivors died. Of long-term survivors, 85% had a break from HER2 therapy that lasted a median of 30.4 months.
- Additional research is warranted to determine the effects of long-term treatment and to identify patients who may safely discontinue HER2 therapy.
{Getting any kind of statistics is pretty huge...}0 -
An antibody that has shrunk tumors (including breast) in mouse models while causing no damage to surrounding tissue.
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ASCO Endorses Some Complementary Therapies in Breast Cancer
Roxanne Nelson, BSN, RN
June 20, 2018
Many cancer patients use alternative medicine, including supplements, massage therapy, yoga, and accupuncture, while undergoing conventional cancer care. Such therapies are usually acceptable, but patients must be discuss such therapies with their oncologist, because interactions may occur.
That appears to be the take-home message from the recent move by the American Society of Clinical Oncology (ASCO) to endorse new guidelines issued by the Society for Integrative Oncology (SIO).
The ASCO endorsement was published online June 11 in the Journal of Clinical Oncology.
The SIO had produced an evidence-based guideline on the use of integrative therapies during and after breast cancer treatment for the management of a variety of symptoms and adverse effects. An ASCO expert panel, cochaired by Gary H. Lyman, MD, MPH, codirector of the Hutchinson Institute for Cancer Outcomes Research at the Fred Hutchinson Cancer Research Center in Seattle, Washington, and Lorenzo Cohen, PhD, director of the Integrative Medicine Program at the University of Texas MD Anderson Cancer Center, Houston, reviewed the guidelines.
The panel determined that the recommendations in the 2017 SIO guideline "are clear, thorough, and based on the most relevant scientific evidence." ASCO endorsed them with a few added discussion points.
"We know that vast the majority of cancer patients, particularly breast cancer patients, are using some type of alternative medicines," Lyman said in an interview. "They may be taking supplements, doing yoga, getting massage therapy or acupuncture, but most doctors don't talk about it. They don't ask about it, and the patient doesn't offer the information."
Lyman estimates that 60% to 80% of breast cancer patients use some type of alternative therapy, but such therapies are not entered into the medical record. That generally is not too much a cause of concern, because most of these approaches are relatively safe, he noted. "But occasionally, there may be some interaction with a supplement and standard medicine," he said.
He told Medscape Medical News, "The biggest fear is that a patient is going to stop using a known effective conventional medicine and use one of the alternative approaches instead.
The biggest fear is that a patient is going to stop using a known effective conventional medicine and use one of the alternative approaches instead. Dr Gary Lyman
"That's why we want to make sure that the doctor and patient are discussing them, the doctor knows what the patient is doing and discusses the subject in a nonjudgmental way, and then encourages the patient to report any problems or side effects they might have," he explained.
It is also important that oncologists reassure patients that they can continue to receive their regular cancer treatment along with these alternative approaches.
Review of Recent Literature
The ASCO guidelines are an endorsement of a guideline from a much smaller organization, explained Lyman. "The SIO had approached ASCO about this, and they had done a really deep review of the available literature on these therapies," he said. "ASCO formed a panel, and we did our own search and added several studies that had come out since the other work had been completed."
ASCO used a modified version of the US Preventive Services Task Force grading system to assign a grade to each therapy, as applied to a specific clinical outcome. Grades A and B indicate that a therapy is recommended for a particular indication; grade C indicates that more evidence is needed or that the net benefit is small; grades D and H indicate that a therapy is not recommended for a particular indication; and grade I indicates that the evidence is inconclusive.
Lyman noted that the ASCO panel supported almost all of the recommendations in the SIO guidelines. "Some had sufficient evidence to recommend them, and for some, there wasn't much evidence, but they didn't incur any harm, and some approaches had no evidence," he said.
Key Recommendations
Some of their key recommendations are as follows:
- Acute radiation skin reaction — aloe vera and hyaluronic acid cream should not be recommended for improving acute radiation skin reaction (grade D).
- Anxiety and stress reduction — meditation (grade A), yoga (grade
, and music therapy (grade are recommended for reducing anxiety. Stress management is recommended for reducing anxiety during treatment; longer group programs are likely better than self-administered home programs or shorter programs (grade . Acupuncture, massage, and relaxation can be considered for reducing anxiety (grade C). - Chemotherapy-induced nausea and vomiting — acupressure (grade , electroacupuncture (grade , ginger (grade C), and relaxation (grade C) can be considered as an addition to antiemetic drugs to control nausea and vomiting during chemotherapy. Glutamine should not be recommended for improving nausea and vomiting during chemotherapy (grade D).
- Depression and mood disturbance — meditation, particularly mindfulness-based stress reduction (grade A), relaxation (grade A), and yoga (grade are recommended for treating mood disturbance and depressive symptoms. Massage (grade and music therapy (grade are recommended for improving mood disturbance.
- Fatigue — hypnosis and ginseng can be considered for improving fatigue during treatment (grade C). Acupuncture and yoga can be considered for improving posttreatment fatigue (grade C). Acetyl-L-carnitine and guarana should not be recommended for improving fatigue during treatment (grade D).
- Lymphedema — low-level laser therapy, manual lymphatic drainage, and compression bandaging can be considered for improving lymphedema (grade C).
- Neuropathy — acetyl-L-carnitine is not recommended for the prevention of chemotherapy-induced peripheral neuropathy in patients with breast cancer because of the potential for harm (grade H).
- Pain — acupuncture, healing touch, hypnosis, and music therapy can be considered for the management of pain (grade C).
- Quality of Life — meditation (grade A) and yoga (grade are recommended for improving quality of life. Acupuncture, mistletoe, qigong, reflexology, and stress management can be considered for improving quality of life (grade C).
- Sleep Disturbance — gentle yoga can be considered for improving sleep (grade C).
- Vasomotor/hot flashes — acupuncture can be considered for improving hot flashes (grade C). Soy is not recommended for hot flashes because of lack of effect (grade D).
"Our hope is that this will help disseminate this good information, break down barriers, and open up dialogs between patient and doctor," Lyman said. "Hopefully, patients will have improvements in their outcomes."
All funding was provided by ASCO. Dr Lyman has relationships with Generex Biotechnology, Halozyme, G1 Therapeutics, Coherus Biosciences, and Amgen (Inst); several coauthors have also disclosed relationships with industry, as noted in the original article.
J Clin Oncol. Published online June 11, 2018. Full text
Medscape Medical News © 2018
Cite this article: ASCO Endorses Some Complementary Therapies in Breast Cancer - Medscape - Jun 20, 2018.
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Tumor Site and Breast Cancer Prognosis
https://www.practiceupdate.com/C/68994/56?elsca1=e...
- This registry study explored the association between tumor site and prognosis among patients with breast cancer. Tumors from the lower-outer quadrant were associated with a lower risk of death (HR, 0.64); tumors with overlapping regions were associated with a higher risk of death (HR, 1.28).
- These results suggest that the site of the primary tumor is relevant to prognosis of patients with breast cancer.
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Tucatinib With Capecitabine and Trastuzumab in Advanced HER2-Positive Metastatic Breast Cancer
https://www.practiceupdate.com/C/68671/56?elsca1=e...
- This open-label phase IB study evaluated the activity and safety of tucatinib in combination with capecitabine and trastuzumab in patients with HER2-positive breast cancer, both in the presence and absence of brain metastases. The objective response rate was 83% with tucatinib and capecitabine; 40% with tucatinib and trastuzumab; and 61% with tucatinib, capecitabine, and trastuzumab.
- The safety profile of tucatinib combined with capecitabine and trastuzumab was considered to be acceptable and demonstrated initial activity.
Published in Oncology May 31, 20180 -
Read a couple of very interesting interviews/articles at OncLive. For Her 2 one mentioned after analysis Perjeta is actually more beneficial with Herceptin for hormone negative bc, while Neratinib is more beneficial for hormone positive. Although, they are still trying to figure out how to sequence the therapies, either concurrently or consecutively.
The other fascinating interview was regarding breast cancer stem cells and how they really should be the target for all breast cancers. Apparently the University of Michigan has 9 early Stage 1 trials focusing on treatment from this angle. It is fairly new science that was only realized in 2003 and took another 10 years for them to figure out how to approach it.
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ONEOME pharmacogenomic testing for medicines
Does anyone know anything about Oneome - Right Med?
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Majijen, I used Kailos Genetics and it was truly helpful. It showed me I was a Met /Met (double allele) and what that means for BC and me. I also showed me I was an ultra rapid processor of Tamoxifen. I highly recommend.
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Lisey, I really like my new name, I think I'll change it. I went to the site and there's a list of tests and prices. Did you need to go through your doctor? The Oneome you can do on your own. It's $349 for everything. Here's the link for the Kailos https://www.kailosgenetics.com/buy-gene-test
Thanks Lisey. Anyone else?
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Mari, sorry about the name... on Kailos, I bought this: www.kailosgenetics.com/pgxcomplete. It was a huge test, about 60 pages of reports. Because Kailos is certified by the Medicaid/ Medicare dept, they have stricter rules for their lab. You can purchase the test directly, they just fax the doctor you list an authorization form to allow them to speak to you and send the report to you. There is minimal doctor involvement, I just notified my family doc our entire family was getting them done. Since I paid for it myself they didn't care.
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New drug technology may improve treatment options for aggressive types of breast cancer
researchers have developed a new technology that may change how TNBC is treated. Isaac-Lam's team developed new drug candidates that are potent at lower concentrations than chemotherapy. The technology employs molecules that are selectively taken up by cancer cells and activated by light. The new drug candidates may also prove effective in treatments for other types of breast cancer. A patent application has been filed by the Purdue Office of Technology Commercialization and the technology is available for licensing.
https://www.purdue.edu/newsroom/releases/2018/Q2/n...
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Marijen & Lisey: Thanks for the info on the labs. I'd love to do this testing. MO has not felt it necessary yet, so it has not been covered by insurance. But I would feel greatly reassured if I has an idea what might be next. An I sure don't want to try something that is not going to work OR wait around for results after we have determined that I need a new drug (even though it looks like these should result quickly).
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Higher Cancer Rates Confirmed in Women With Dense Breasts
Higher rate of recall, lower sensitivity, larger tumor diameter, and more lymph node-positive disease
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Trastuzumab vs Observation for HER2 Non-Amplified Early Breast Cancer With Circulating Tumor Cells
- This randomized phase II trial evaluated whether trastuzumab might decrease the detection rate of circulating tumor cells (CTCs) among women with high-risk, HER2 non-amplified early breast cancer. At week 18, there was no difference between the trastuzumab group and the observation group in the detection of CTCs.
- Trastuzumab did not reduce the CTC detection rate in HER2 non-amplified, nonmetastatic breast cancer.
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Resveratrol prevents p53 aggregation in vitro and in breast cancer cells
PDF | HTML | Supplementary Files | Order a Reprint
Oncotarget. 2018; 9:29112-29122. https://doi.org/10.18632/oncotarget.256310 -
How a red wine compound may prevent cancer
Published TodayBy Ana Sandoiu
Fact checked by Jasmin Collier
https://www.medicalnewstoday.com/articles/322300.p...
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Marijen, the amount of red wine I have drunk over the years, I should be cancer free, lol. Good excuse to fill up our glasses, cheers girls
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