Breaking Research News from sources other than Breastcancer.org
Comments
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Study of Nigerian breast cancer patients reveals prevalence of aggressive molecular features
https://www.news-medical.net/news/20181016/Study-o...
Original Source: Oct. 16, 2018 issue of Nature Communications
A study comparing DNA and RNA data from Nigerian breast cancer patients to patients in a United States database found that certain aggressive molecular features were far more prevalent in tumors from Nigerian women than in black or white American women. The researchers found multiple, often unexpected, genetic differences between the racial and ethnic groups.... Although the Nigerian patients in the study were much younger, on average, they had more advanced disease at diagnosis and higher mortality rates than women from the TCGA group, most of whom were of European heritage. Breast cancer rates are increasing in Nigeria and across Sub-Saharan Africa at an alarming pace without the necessary infrastructure to stem the epidemic.... {Researchers} identified 25 different genes from Nigerian patients that were significantly mutated but potentially treatable with novel therapies in clinical trials. Aggressive features found in these women include the inability to repair damaged DNA -- a mutational process known as homologous recombination deficiency, for which there are emerging therapies....
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Per the above, I would be curious to know if anyone has run into limitations on lines of treatment. In case it is of help, here is a link to a very brief page summarizing information - and prohibitions - on lifetime limits for most (not all) insurance policies, including ACA policies.
https://www.hhs.gov/healthcare/about-the-aca/benef...
(Thanks for your reply about Canada, Amica. Once again, that is troubling. I know a number of extraordinary responders who are on their eighth-or-so line of treatment and doing quite well. I am deeply troubled to think that they might be told "though we have therapies that are effective, it's just too expensive to keep you alive. Bye-bye.")
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Breast Cancer as a Dynamic Disease
https://www.news-medical.net/news/20181019/Breast-...
Fascinating article on some bleeding edge research at Hopkins. Includes this very cool, 6 second video of one way our bodies defend us against invasive cancer:
"We knew that the presence and integrity of the myoepithelial layer was the difference between a benign disease and an invasive one, but we wanted to understand how it worked....We started ... to grow whole tissues in the laboratory. What was immediately striking was that the myoepithelium was actively responding to the invasive behavior of the cancer cells. We would see the invasive cancer cells marching forward, and the myoepithelium reach out, recover them, and push them back inside. Most of the time, the myoepithelium would win."
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High rate of non-adherence to hormonal therapy found among premenopausal early breast cancer patients
Nearly one in six premenopausal women being treated for early stage breast cancer do not adhere adequately to tamoxifen therapy after one year of treatment, potentially putting themselves at increased risk of recurrence and reduced survival, a French prospective study reports at ESMO 2018.
https://www.news-medical.net/news/20181019/High-ra...
http://esmo.org/Press-Office/Press-Releases/nonadherence-endocrine-breast-cancer-CANTO-Pistilli
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Wireless 'bio-patch' could aid recovery after breast reconstruction surgery
the wireless 'bio-patch' ...successfully performed continuous monitoring of the level of oxygen saturation in transferred tissue - a key indicator of whether there is a risk of reconstruction failure. "Poor blood supply or failure of breast reconstruction surgery can have a major impact on a breast cancer patient's recovery, prognosis and mental well-being. Clinical signs of failure often occur late and patients may be returned to the operating room on clinical suspicion. Our new bio-patch tackles this problem by providing objective data as an early warning system for medical staff, enabling earlier and simpler interventions, as well as giving patients increased peace of mind.... early detection of possible problems could help further reduce post-surgical complications and cut surgery failure rates."
https://www.news-medical.net/news/20181108/Wireles...
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New City of Hope CAR T cell trial focuses on HER2-positive breast cancer patients with brain metastases
The phase 1 trial will be conducted in an outpatient setting and will also be the first to use intraventricular delivery of CAR T cells directly to the brains of these patients. It will test the safety and effectiveness of the CAR T cell therapy for patients who have tried other types of treatment that are no longer effective. "Our hope is that the HER2-specific CAR T cell therapy will target and kill HER2-positive cancer cells, and safely and effectively treat brain metastases in these patients," CAR T cell therapy is a type of cell-based immunotherapy in which a patient's own T cells are reprogrammed to actively seek out and destroy cancerous cells. For this trial, the patient's T cells will be isolated from the blood and genetically engineered to express a CAR that allows these immune cells to target and eradicate HER2-positive cancer cells.
https://www.news-medical.net/news/20181030/New-Cit...
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Researchers develop diagnostic test to determine risk of developing malignant breast cancer
Currently, with a pre-malignant breast cancer diagnosis from a biopsy, there are three options: observation, chemoprevention or surgery, all of which require a patient to make decisions while operating from a place of fear and unknown outcomes. ...researchers at the University of Cincinnati (UC) are investigating a molecular diagnostic test to determine whether, after biopsy, someone is at high or low risk for actually developing malignant breast cancer. "The test aids in the decision whether to treat aggressively or wait,"
https://www.news-medical.net/news/20181031/Researc...
The study, "Osteopontin and Premalignant Breast Lesions," appears in the Oct. 24, 2018 issue of the British Journal of Cancer.
see alos: http://healthnews.uc.edu/news/?/30292/
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HUTCH NEWS
Metastatic breast cancer research takes the stage
Advocates, oncologists and researchers share findings, resources and reasons for hope at third annual NW Mets Conference
Oct. 31, 2018 | By Diane Mapes / Fred Hutch News Servicehttps://www.fredhutch.org/en/news/center-news/2018...
This page contains links to the video as live streamed of the conference. You can watch the presentations!0 -
thanks once again Lumpie! The Fred Hutch conference looked very interesting. And it is great that the individual sessions can be viewed now--there are several sessions that look very pertinent.
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AMA Delegates Back Physician Freedom in Opioid Prescribing
CDC guidelines are well-intentioned but shouldn't restrict prescribing, they say
Delegates approved a resolution that both applauded the CDC for "its efforts to prevent incidence of new cases of opioid misuse, addiction, and overdose deaths" but also urged the AMA to talk to pharmacy chains, pharmacy benefit managers, state insurance commissioners, and state medical boards and argue against putting blanket limits on the amount and dosage of opioids that physicians can prescribe.
https://www.medpagetoday.com/meetingcoverage/ama/7...
{MedPage may require a free sign up to read this article.}
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Neoadjuvant Chemotherapy With or Without Anthracyclines in the Presence of Dual HER2 Blockade for HER2-Positive Breast Cancer
- The Lancet Oncology This open-label phase III trial evaluated the effect on pathologic complete response of neoadjuvant trastuzumab/ pertuzumab alongside 5-FU/ epirubicin/ cyclophosphamide followed by paclitaxel/ carboplatin compared with neoadjuvant trastuzumab/ pertuzumab followed by paclitaxel/ carboplatin with no addition of anthracyclines in patients with stage II/III HER2+ breast cancer.Pathologic complete response rates were similar between the anthracycline and non-anthracycline groups, and febrile neutropenia was more common in the anthracycline group.
"The most striking finding was the extremely high pCR rate...TRAIN-2 raises the question of routinely doing more neoadjuvant chemotherapy (NACT) cycles with dual anti-HER2 therapy if higher percentage of pCR is the goal. All patients in this trial had nine cycles of therapy, with symmetry between the duration of treatment and total dose of trastuzumab and pertuzumab. Alternatively, the results are supportive of continuing trastuzumab and pertuzumab routinely in the adjuvant setting after shorter (typically, 4–6 cycles) of anti-HER2 therapy with NACT as is commonly given in the US."https://www.thelancet.com/journals/lanonc/article/...(18)30570-9/fulltext0 -
Fine-Needle Aspiration for Assessing Responses to Chemotherapy in Metastatic Nodes in Breast Cancer
- Cancer The goal of this study was to determine whether preoperative fine-needle aspiration (FNA) of nodes after neoadjuvant chemotherapy (NAC) could predict the presence of residual disease. Among the 50 patients with metastatic breast cancer, FNA of nodes that had been marked with clips produced a high rate of false negatives.These findings highlight the importance of surgical staging of the axilla after neoadjuvant chemotherapy for the proper assessment of response.
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Dsuvia Approval History
Reviewed on Nov 13, 2018 by J.Stewart B.Pharm
FDA Approved: Yes (First approved November 2, 2018)
Brand name: Dsuvia
Generic name: sufentanil
Dosage form: Sublingual Tablets
Company: AcelRx Pharmaceuticals, Inc.
Treatment for: PainDsuvia (sufentanil) is a synthetic opioid analgesic formulation for the management of acute pain that is severe enough to require an opioid analgesic, and for which alternative treatments are inadequate.
Because of the potential for life-threatening respiratory depression due to accidental exposure, Dsuvia is available only through a restricted program called the Dsuvia REMS Program. Dsuvia must only be administered by a healthcare provider in a certified medically supervised healthcare setting.
Limitations of Use:
- Not for home use or for use in children. Discontinue treatment with Dsuvia before patients leave the certified medically supervised healthcare setting.
- Not for use for more than 72 hours. The use of Dsuvia beyond 72 hours has not been studied.
- Only to be administered by a healthcare provider.
- Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, reserve Dsuvia for use in patients for whom alternative treatment options [e.g., non-opioid analgesics or opioid combination products]:
- Have not been tolerated, or are not expected to be tolerated,
- Have not provided adequate analgesia, or are not expected to provide adequate analgesia.
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Metastatic Breast Cancer Collateral Damage Project (MBCCD): Scale development and preliminary results of the Survey of Health, Impact, Needs, and Experiences (SHINE)
This study's aims were to characterize MBC-related collateral damage, identify groups most likely to experience collateral damage, and examine its associations with psychological health, illness management, and health behaviors.
Results
Eight domains of MBC-related collateral damage, as well as MBC-related benefit finding, were reliably characterized. Concerns about mortality/uncertainty were most prominent. Participants also endorsed high levels of benefit finding. Participants younger than 50 years, with limited financial resources, or with children under 18 at home reported the most collateral damage. Collateral damage was associated significantly with compromised psychological health, lower illness management efficacy, and poorer health behaviors, beyond sociodemographic and medical characteristics.
Conclusions
Subgroups of MBC patients report long-term, life-altering consequences of MBC and its treatments, which relate to important health outcomes. Clinical implications and recommendations are discussed.
https://link.springer.com/article/10.1007%2Fs10549...
online version of this article ( https://doi.org/10.1007/s10549-018-4823-x)
Commentary at: https://www.practiceupdate.com/c/74285/67/13/?elsc...
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Saving Costs While Maintaining Quality of Care—The Value of Biosimilars in Oncology
Can biosimilar products actually produce the cost savings to the healthcare system that they have promised? According to a review published in Cancer Management and Research, they can.... With 13 biosimilar products now approved in the United States, this class of products can improve access and also reduce overall pharmaceutical expenditures, the authors write.
https://www.ajmc.com/newsroom/saving-costs-while-m...
source article: Patel KB, Arantes LH, Tang WY, Fung S. The role of biosimilars in value-based oncology care. Cancer Manag Res. 2018;10:4591-4602. doi: 10.2147/CMAR.S164201.
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AMA Urges Coverage for Added Breast Cancer Screening
Resolution aimed at women with dense breasts
MedPage Today, November 13, 2018
The decision of whether to conduct additional breast cancer screening on women with dense breasts should be made between the patient and her physician, and insurers should pay for any extra imaging if recommended, American Medical Association (AMA) delegates agreed Monday.
Delegates approved parts of a resolution at their interim meeting here reaffirming existing AMA policy that supports screening mammography and opposes state laws requiring mandatory notification to patients if they are found to have dense breast tissue.
More detail at: https://www.medpagetoday.com/meetingcoverage/ama/7...
{Access to MedPage materials may require free registration.}
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Do NSAIDs Prevent Breast Cancer Recurrence?
An Unanswered Question
A large body of evidence spanning preclinical, observational, and clinical data supports the potential use of nonsteroidal anti-inflammatory agents (NSAIDs) for cancer prevention, and possibly as adjuncts to cancer treatment. NSAIDs hold great appeal in this regard because they are relatively safe and inexpensive, and aspirin offers the potential to prevent, treat, or palliate several common, chronic, age-related diseases (eg, prevention of cardiovascular events, cancer risk reduction, treatment of inflammatory conditions, pain management). ... The results of the UK REACT trial (NCT02429427), the ABC trial (NCT02927249), and the Add-Aspirin trial (NCT02804815) will be critical to determining the true effect of celecoxib and aspirin on breast cancer survival and mortality. Importantly, these studies are randomized clinical trials (as opposed to observational studies) that include overall survival and safety outcomes. The potential for NSAIDs to reduce cancer incidence and mortality is tremendous and has been suggested for decades. ...Additional data from ongoing randomized controlled trials of aspirin in other cancers and other common diseases and in various populations[9–11] will be needed to determine when, where, and how to apply NSAIDs to achieve their maximum benefit in the prevention of cancer and other common chronic diseases.
https://www.medscape.com/viewarticle/903059?src=mk...
J Natl Cancer Inst. 2018;110(9):927-928.
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Good morning,
I am curious of any relevant research re eating whole food soy (tofu, tempeh, soy milk) on ER+ breast cancer recurrence. Does anyone have any links?
Thanks!
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Nomaddd, I don't have any links but when I asked my MO recently about foods she said I must avoid Soy and other plant based Estrogen. She said that Soy products are high in Estrogen and therefore not good for ER+.
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Here are several links to credible sources regarding soy and breast cancer. It was my understanding that the anti-soy position had long-ago been debunked. That seems to be the case, with moderation being the key take-away.
Soy: Is it safe for cancer survivors?
https://www.fredhutch.org/en/treatment/survivorshi...
In human studies, scientists have not found that diets high in soy increase breast cancer risk. In fact, most have found the opposite. All long-term human studies of soy have shown a protective effect against cancer, fewer cancer recurrences, or had neutral findings (neither negative nor positive effects). There have never been any direct correlations between soy and cancer. Soy has also been shown to protect heart and breast health in women who ate it during puberty.
Soy and Breast Cancer: Should breast cancer survivors eat soy foods?
https://www.oncolink.org/support/nutrition-and-can...
Most experts agree that it is probably safe, and possibly beneficial, for breast cancer survivors to eat traditional soy foods.
How Your Diet May Affect Your Risk of Breast Cancer
https://www.cancer.org/latest-news/how-your-diet-m...
Soy contains compounds called isoflavones. Isoflavones can act like estrogen in the body and may help protect against hormone-dependent cancers. There is growing evidence that eating traditional soy foods such as tofu may lower the risk of cancers of the breast, prostate, or endometrium (lining of the uterus), and there is some evidence it may lower the risk of certain other cancers. This might be because the isoflavones can actually block the more potent natural estrogens in the blood.
KOMEN PERSPECTIVES - ANSWERING QUESTIONS ABOUT SOY AND BREAST CANCER (APRIL 2015)
https://ww5.komen.org/KomenPerspectives/Answeringq...
current studies suggest that eating moderate amounts of soy foods is safe for breast cancer survivors.
Will eating soy increase my risk of breast cancer?
https://www.mayoclinic.org/healthy-lifestyle/nutri...
food sources of soy don't contain high enough levels of isoflavones to increase the risk of breast cancer.
For Breast Cancer Survivors, Eating Soy Tied To A Longevity Boost
https://www.npr.org/sections/thesalt/2017/03/07/51...
A new study helps to resolve this question. "Our finding would suggest that soy food consumption does not have a harmful effect," says Fang Fang Zhang, a cancer epidemiologist at Tufts University.
The title of the Breastcancer.org article on this topic is misleading, IMHO. But here is the link:
https://www.breastcancer.org/research-news/soy-may...
{Interestingly, I did not find articles that made a distinction between a history of ER+ and ER- breast cancer when making recommendations. Given the prevalence of ER+ breast cancer and the lack of "prohibition" suggested in these articles, a more adverse impact seems highly unlikely. In other words, those of use who are ER- would seem to have even less to worry about vis-a-vis soy.}
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I second Lumpie's mention of "no soy for bc patients and survivors" debunking. Great links, Lumpie, thank you. I tracked this whole controversy the minute I found out about my dx because I'm vegetarian, and enjoy soy-based entrees from time to time. I avoided it like the plague for 5 years, but eat a bit more now.
Claire in AZ
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Thanks! Now that I moved to a mostly plant based diet, I am eating more soy for protein. And I love the taste of tempeh!:)
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One of my doc's at the Mayo, also a BC researcher, said soy fine if ER+ and premenopausal or ER-. But said to limit, not necessarily eliminate, soy if on AIs. Her rationale was on AIs you have low levels of estrogen and your body is sensitive to dietary estrogens, even very low amounts. I cannot find a reference to support or refute this hypothesis, but don't eat edamame any more!
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Walgreens Launches "Feel More Like You" Program to Assist People Living with Cancer Manage the Physical Changes Associated with Treatment
Business Wire Press Release - Mon Nov 19 07:00:00 CST 2018
Company is the first U.S. pharmacy, health and beauty retailer to integrate personalized oncology clinical care from pharmacists with beauty support services from specially trained beauty consultantsWalgreens today announced that it has launched a new program called Feel More Like You™, developed to help people living with cancer and their caregivers manage the potential physical changes associated with cancer treatment. The exclusive offering will be available at more than 400 Walgreens stores in select markets across the country.
Walgreens is proud to develop this comprehensive offering by collaborating with Look Good, Feel Better, the leading cancer support program focusing attention on the appearance and beauty needs of cancer patients, and Cancer Support Community, the largest professionally led nonprofit network of cancer support worldwide.
https://www2.smartbrief.com/bwad/industryBW-detail...0 -
Circulating MicroRNAs in the Early Prediction of Disease Recurrence in Primary Breast Cancer
Breast Cancer Res. 2018;20(72)
Circulating miRNAs are differentially expressed among relapsed and non-relapsed patients with early breast cancer and predict recurrence many years before its clinical detection. Our results suggest that miRNAs represent potential circulating biomarkers in early breast cancer.
https://www.medscape.com/viewarticle/901775?src=mk...
{No DOI provided. Sorry.}
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Docs Fail to Tell New Moms Breastfeeding Can Reduce Cancer Risk
Few women report being told by their obstetrician that prolonged breastfeeding, from 6 to 12 months, can reduce their risk of getting breast cancer, according to a study published online October 25 {2018} in Breastfeeding Medicine.
https://www.medscape.com/viewarticle/904523?src=mk...
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re: soy and breast cancer
There is at least one study that suggests that breast cancer patients taking Ibrance plus Femara, a common treatment for metastatic breast cancer, should limit their intake of estrogen-like compounds called xenoestrogens, found in soybeans, maize, barley, wheat and other grains, because they reduced the impact of the therapy.
To quote: "Under the influence of either xenoestrogen, the breast cancer cells also resumed proliferating at a rate comparable to that seen in the absence of drug treatment."
"We generally know very little about the interactions of bioactive compounds we are exposed to through our food or the environment with drug treatments. So, in this field there are probably a lot of clinically relevant discoveries yet to be made."
Estrogen-mimicking compounds in foods may reduce effectiveness of breast cancer treatment
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Post-Neoadjuvant Strategies in Breast Cancer
- Achieving pCR after neoadjuvant treatment (NAT) has a strong positive prognostic impact. Adjuvant therapies are not routinely recommended for patients without pCR after NAT.
- The post-neoadjuvant setting is attractive for adjuvant clinical trials. Adjuvant capecitabine was associated with a disease-free and overall survival benefit in patients without pCR after NAT. Tumor-infiltrating lymphocytes, circulating tumor cells, ctDNA, and residual cancer burden may be useful for risk assessment after NAT.
- The present review summarizes the efforts in introducing new therapeutic options for patients with breast cancer and residual disease after neoadjuvant treatment, with a particular focus on the ongoing clinical trials and useful biomarkers for risk stratification.
https://www.cancertreatmentreviews.com/article/S03...(18)30184-1/fulltext0 -
Amica, I think that this is the article:
Metabolomics Reveals that Dietary Xenoestrogens Alter Cellular Metabolism Induced by Palbociclib/Letrozole Combination Cancer Therapy.
More info here: https://www.ncbi.nlm.nih.gov/pubmed/29337187
doi: 10.1016/j.chembiol.2017.12.010.
Additional health press coverage here: https://breastcancer-news.com/2018/01/24/ibrance-f...
I found an interesting rebuttal here: https://www.inspire.com/groups/advanced-breast-can...
(I will let you determine credibility for yourself. Free registration may be required to access site.)
{My impression is that it is hard to know....that (consistent with the quote you posted) we probably don't entirely understand how these substances are metabolized in our bodies. The Fred Hutch article contained some interesting discussion on how "plant-based estrogens are not the same as the hormone estrogen. True estrogens—which attach to certain cells to turn on growth—are only found in animals." It says that soy may actually "decrease overall estrogen." Of course, patients taking Ibrance plus Femara are uniquely situated. For those taking Ibrance plus Femara, it may seem prudent to decease or avoid soy. Otherwise, moderation may be the best course. For those who do consume more soy, it may provide some reassurance that "In human studies, scientists have not found that diets high in soy increase breast cancer risk." This whole discussion has made me worry more about our hormone-and-antibiotic laden U.S. food supply. Ugh.}
https://www.fredhutch.org/en/treatment/survivorshi...
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Breast cancer screening should be offered to women in late 70s, experts say following major study
Henry Bodkin
The TelegraphNovember 20, 2018
https://www.telegraph.co.uk/science/2018/11/20/bre...Edited, wrong link
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