Breaking Research News from sources other than Breastcancer.org
Comments
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Circulating ESR1 Mutations at the End of Aromatase Inhibitor Adjuvant Treatment and After Relapse in Breast Cancer
https://www.practiceupdate.com/c/69780/67/13/?elsc...
- In this retrospective study, plasma samples from 42 patients with metastatic breast cancer who completed at least 2 years of aromatase inhibitor treatment and relapsed were assessed for circulating ESR1 mutations. No ESR1 mutations were detectable at the end of adjuvant therapy; however, 5.4% of patients had a detectable mutation at first relapse, and 33% of patients on first-line metastatic treatment receiving aromatase inhibitor therapy had a detectable circulating mutation at time of progression compared with no patients receiving chemotherapy.
- The authors came to the conclusion that detection of circulating ESR1 mutations at the end of aromatase inhibitor–based adjuvant therapy is not clinically useful.
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Alpelisib and T-DM1 in HER2+ Metastatic Breast Cancer After Trastuzumab and Taxane Therapy
https://www.practiceupdate.com/c/69777/67/13/?elsc...
- In this study, 17 patients with trastuzumab- and taxane-resistant HER2-positive metastatic breast cancer were treated with alpelisib and T-DM1. Maculopapular rash was the dose-limiting toxicity, and the maximum tolerated dose was alpelisib 250 mg daily. Of 14 evaluable patients, the overall response rate was 43%, whereas the overall response rate was 30% in 10 patients with prior treatment and progression on T-DM1. In evaluable patients and patients with prior T-DM1 therapy, the clinical benefit rate was 71% and 60%, respectively.
- These findings demonstrate the tolerability and activity of alpelisib and T-DM1 in patients with trastuzumab- and taxane-resistant HER2-positive metastatic breast cancer.
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Generation of HER2-Specific Antibody Immunity During Adjuvant Trastuzumab and Reduced Relapse in Resected HER2 Breast Cancer
https://www.practiceupdate.com/C/69665/56?elsca1=e...
- This study analyzed serum anti-HER2 antibodies from a subset of patients enrolled in the NCCTG trial N9831, which includes arm A, in which trastuzumab was not used. Arms B and C received trastuzumab sequentially or concurrently to chemotherapy, respectively. The mean levels of antibodies increased in the trastuzumab arms but not in the chemotherapy-only arm. The proportion of patients who demonstrated antibodies increased by 4% in arm A and by 43% in arms B and C combined (P = .003). Cox modeling demonstrated that larger increases in antibodies were associated with longer disease-free survival in all patients (HR, 0.23; P = .04).
- The authors suggest that the increased endogenous antibody immunity observed in patients treated with adjuvant combination trastuzumab and chemotherapy is clinically significant in view of its association with improved disease-free survival. The findings may have important implications for predicting treatment outcomes in patients treated with trastuzumab in the adjuvant setting.
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Association of Transforming Growth Factor β Polymorphism C-509T With Radiation-Induced Fibrosis Among Patients With Early-Stage Breast Cancer
https://www.practiceupdate.com/C/71045/56?elsca1=e...
- This prospective cohort study evaluating 174 participants in a randomized clinical trial found grade 2 or higher breast fibrosis 3 years after radiotherapy in 13.8% of patients with the C−509T variant allele vs 3.8% of patients without the variant allele, a significant difference.
- The C−509T variant allele may be used prospectively as a genetic marker to identify patients at elevated risk for fibrosis following radiotherapy.
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Cardiotoxicity - heart issues & BC treatment
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ASCO Endorses SIO Guideline for Integrative Tx in Breast Cancer
https://www.practiceupdate.com/C/71666/56?elsca1=e...
Guideline recommends therapies for reducing anxiety/stress, depression/mood disorders, nausea
After determining that the SIO guideline recommendations were clear, thorough, and based on the most relevant scientific evidence, the ASCO Expert Panel endorsed the guideline with a few added points of discussion. Key recommendations include music therapy, meditation, stress management, and yoga for reduction of anxiety/stress. For depression/mood disorders, meditation, relaxation, yoga, massage, and music therapy are recommended. To improve quality of life, meditation and yoga are recommended. For reducing chemotherapy-induced nausea and vomiting, acupressure and acupuncture are recommended. Because of a possibility of harm, acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy.
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Wow! So after the cut, poison and burn of conventional western medicine, we are supposed to get over it on our own by listening to music or meditating? Or drag our beat up bodies out to yoga class or acupuncture appointments? Nevermind if some are working through all this and have husbands and children and a house to tend to. Are they kidding! That may work for some over achievers I suppose....
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John Smith (who started an immunotherapy thread here) shared this on facebook:
An interesting commentary called "Curing Metastatic Breast Cancer".
http://ascopubs.org/doi/full/10.1200/jop.2015.008953
Here's some of the highlights.Lines of Evidence suggesting MBC is curable.
1. Adjuvant therapy cures micrometastasis.
2. Adjuvant therapy after isolated local-regional recurrence improves survival.
3. Chemotherapy for overt metastatic disease produces long-term survivors.
4. Exceptional responders with novel agents.
5. Treatment of low-volume metastatic disease with surgery and radiation produces long-term survivors.Suggested ways to improve outcomes:
1. Earlier detection of metastatic breast cancer through better imaging.
2. Early detection of treatable genomic lesions with ctDNA (Liquid biopsies).
3. Generate numerous exceptional responders.
4. Target genetically smart cancers with Immunotherapy approaches.0 -
marijen,
Lol! I love how you put that, the description is very amusing but as one of the over achievers, I couldn’t agree more about the benefits of exercise. In fact, I did my 1st 5k during chemo and my 2nd a week after brain radiation, while working and taking care of the house/husband/dog.
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marijen, I laughed out loud when I saw your post! I so sympathize... exactly when am I supposed to have time for meditation...? (I sure hope they don't send the meditation police for me!) Of course, this may allow some people to get insurance coverage for acupuncture which could be helpful.
KPW3: Thanks for sharing the commentary called "Curing Metastatic Breast Cancer". I always cringe a little when I read that... I fear that any of us who are not "cured" will be deemed underachievers or that they'll decide to discontinue all our treatment since we are supposed to be cured. But real cures would certainly be reason to celebrate.
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Combined Digital Screening Best for Detecting Breast Cancers
https://www.practiceupdate.com/C/71789/56?elsca1=e...
The combination of digital mammography (DM) and digital breast tomosynthesis (DBT) detects 90 percent more breast cancers than digital mammography alone, according to a study published in the August issue of Radiology.
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A week at a full service spa in acoastal location would surely help my stress and anxiety!
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Unmet Need for Clinician Engagement Regarding Financial Toxicity After Diagnosis of Breast Cancer
https://www.practiceupdate.com/C/71677/56?elsca1=e...
- This survey-based study of surgeons, medical oncologists, radiation oncologists, and patients was designed to assess whether growing awareness of financial toxicity related to a cancer diagnosis and treatment has led to increased clinician engagement in the face of their patients' heavy monetary burdens and pressures. Overall, 50.9% of medical oncologists, 15.6% of surgeons, and 43.2% of radiation oncologists reported that someone often or always discusses financial burden with patients. Of women worried about finances, 72.8% reported that physicians and their staff were not helpful. Furthermore, 55.4% of women who desired to talk to providers about the impact of their disease on finances or employment did not report relevant discussion.
- Patients report inadequate engagement with clinicians regarding management of financial toxicity, whereas many providers believe these services are made available to their patients. The authors suggest that curing the disease while bankrupting the patient is untenable.
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{In case you need a justification for chocolate...
} Moderate consumption of chocolate may reduce CVD risk
https://www.healio.com/cardiology/chd-prevention/n...
Consuming less than 100 grams of chocolate per week may help reduce cardiovascular disease risks, according to a study in the journal Heart that found 45 grams per week was the ideal amount. Researchers said the protective effect was lost when consumption was greater than 100 grams per week, or about two chocolate snack bars.
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New strategy may lead to more accurate breast cancer diagnoses
https://www.news-medical.net/news/20180718/New-str...
A study in Molecular Oncology indicates that examining the protein and RNA in leftover materials from routine diagnostic tests for breast cancer may lead to more accurate diagnoses.
Using samples from fine needle aspiration from 25 patients with breast cancer and 33 patients with benign lesions, investigators found that such a strategy could distinguish all cancer patient samples from all benign lesions.
In addition to providing a conclusive diagnosis, the analysis may prove valuable for subtyping of breast cancer, for determining appropriate therapies for individual patients, and for monitoring the course of disease and responses to therapy, all through minimally invasive techniques.
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Research uncovers new target for therapeutic intervention in breast cancer
https://www.news-medical.net/news/20180718/Researc...
Researches at LSU Health New Orleans School of Medicine, have shown for the first time that a tiny piece of RNA deregulates energy metabolism, an emerging hallmark of cancer. The finding identifies a new target for therapeutic intervention in breast cancer.
...miR-27b, a novel microRNA, acts as a breast cancer oncogene. It is found in abundance in breast tumors. In this study working with a line of human breast cancer cells, they demonstrated that it suppresses the production of a protein called PDHX. PDHX is involved in cell metabolism, which among other things affects cell proliferation. Its absence allows the rapid creation of new cells, promoting tumor growth and cancer progression. The team found a significant decrease in PDHX levels in breast cancer cells.
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Lumpie, thank you for all the good research links. I read a lot of them and appreciate you doing this.
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Scientists develop a way to deliver curcumin as an anti-cancer agent
Researchers from the university of Illinois College of Engineering have developed a way of delivering curcumin so that it can be effective as a therapeutic agent for cancer.
https://www.news-medical.net/news/20180807/Scienti...0 -
Study suggests cancer to be a metabolic disorder rather than genetic disease
Excerpt:
Using mass spectrometry to measure minute quantities of sugars, amino acids and lipids in the blood of cancer patients, these scientists found metabolic signatures that clearly identified breast cancer patients with a greater than 95 percent accuracy. Breast cancer patients have changes in their metabolism that "predispose" them to the development of their disease.
https://www.news-medical.net/news/20180807/Study-s...0 -
'Dangerous Nightmare for Cancer Patients': Step Therapy
Roxanne Nelson, BSN, RN
August 09, 2018
Cancer groups have reacted negatively to an announcement from the Centers for Medicare & Medicaid Services (CMS) about allowing Medicare Advantage plans to use a "step therapy" approach to Part B drugs. The policy is part of an effort to rein in prescription drug costs.
This is a "dangerous nightmare for cancer patients," said the Community Oncology Alliance (COA), which sees it as a step toward the government's dictating what cancer treatments Medicare recipients can or cannot receive.
The American Society of Clinical Oncology (ASCO) also said it "strongly objects" to the plan, which it believes will delay access to appropriate treatments.
More at
https://www.medscape.com/viewarticle/900503
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Muddling Through: Thanks for your kind words of encouragement. Glad to know that these are of some help and interest. Thanks to everyone who shares research here! (Marijen, I am particularly concerned about your last post re "step therapy." Given new FDA approved testing tools which indicate which drugs are likely to be effective.... might they require patients to use drugs they know ahead of time are not going to be effective...? Troubling. Reading and following....)
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Experimental drug may treat 'undruggable' cancers
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Lumpie, I think there is room for appeal but who has cancer and wants to spend time on that. It’s not right. I guess we’ll find out how bad it gets. My question is why just Medicare Advantage? I hope they didn't forget to include Medicare Gap. I hope the whole darn plan is not set in atone. If Trump wants to make America Great, then Americans need to be healthy first. And if he wants the economy to grow he can’t bankrupt all the medical patients. He is working on the drug companies but this seems the wrong way to go about it I would rather they go after all the bad food choices available on market shelves.
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I agree Marijen and thank you all for sharing. On that same note- I’m pretty darn happy about what’s happening to Monsanto!!! Finally they’re being held responsible
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Yes, we used to live very close to Monsanto field. This is pretty interesting -
Media Advisory
Friday, July 20, 2018
NIH Clinical Center releases dataset of 32,000 CT images
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Guidelines Conflict for Long-Term Opioid Tx in Cancer Survivors
https://www.empr.com/news/cdc-oncology-clinicians-...0 -
Breast Cancer Treatment and Its Effects on Aging
https://www.practiceupdate.com/C/71685/56?elsca1=e...
Published in Journal of Geriatric Oncology
- This review looks at breast cancer survival in the context of accelerated aging.
- Evidence suggests an increased rate of physical and cognitive decline in women who have been treated for breast cancer that may be associated with the effect that the treatments have on normal cellular function.
{This probably doesn't surprise most of us!}
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Breast Cancer Screening Using Tomosynthesis or Mammography
https://www.practiceupdate.com/C/72026/56?elsca1=e...
Published in Journal of the National Cancer Institute
- This was systematic review and meta-analysis of 17 studies with 1,009,790 participants comparing tomosynthesis vs 2D mammography for the screening of asymptomatic women with breast cancer. Incremental cancer detection rates were significantly higher in European/Scandinavian studies, wherein the participants had both tests (2.4 per 1000 screenings) compared with US studies in which the participants had one test or the other (1.1 per 1000 screenings). The recall rate with tomosynthesis was significantly lower than with mammography in US studies.
- Results show that cancer detection rates and recall rates are better with tomosynthesis. However, the improvements with tomosynthesis appear to be related to setting, with improved cancer detection rates in European/Scandinavian settings and reduction in recall rates in the US.
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One-Stage Implant-Based Breast Reconstruction With an Acellular Dermal Matrix vs Two-Stage Breast Reconstruction
Published in The Lancet Oncology
https://www.practiceupdate.com/C/72025/56?elsca1=e...
- This randomized, controlled trial evaluated quality-of-life outcomes among women undergoing one-stage implant-based breast reconstruction with an acellular dermal matrix vs two-stage breast reconstruction. Overall, 8 hospitals in the Netherlands were involved in the study; the one-stage group included 60 patients and 61 patients were included in the two-stage group.
- Patient-reported quality-of-life outcomes were not better with a one-stage procedure, and risks for adverse outcomes were significantly higher.
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Talazoparib Beneficial in Patients With Advanced Breast Cancer {and germline BRCA1/2 mutation}
https://www.practiceupdate.com/C/72170/56?elsca1=e...
Original source: published online Aug. 15 in the New England Journal of Medicine.
Single-agent talazoparib provides significant benefit over standard chemotherapy for patients with advanced breast cancer and germline BRCA1/2 mutation, according to a study... Outcomes reported by patients favored talazoparib, with significant overall improvements and significant delays noted in the time to clinically meaningful deterioration according to the global health status-quality-of-life and breast symptoms scales.
"Talazoparib resulted in a significantly longer progression-free survival than standard-of-care chemotherapy,"
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